- MeSH
- elektrokardiografie dějiny MeSH
- komunikace dějiny MeSH
- rozhlas dějiny MeSH
- telekomunikace dějiny MeSH
- telemedicína * dějiny MeSH
- Publikační typ
- historické články MeSH
- MeSH
- dějiny 20. století MeSH
- dějiny 21. století MeSH
- dějiny lékařství MeSH
- kardiologie * dějiny MeSH
- významné osobnosti MeSH
- Check Tag
- dějiny 20. století MeSH
- dějiny 21. století MeSH
- Publikační typ
- biografie MeSH
- historické články MeSH
- přehledy MeSH
- Geografické názvy
- Česká republika MeSH
- Československo MeSH
- O autorovi
- Libenský, Václav, 1877-1938 Autorita
- Brumlík, Josef, 1897-1979 Autorita
- Mentl, Stanislav, 1894-1981 Autorita
- Prusík, Bohumil, 1886-1964 Autorita
- Herles, František, 1900-1991 Autorita
- Winternitz, Max, 1900-1952 Autorita
- Sova, Josef, 1914-1988 Autorita
- Černohorský, Jindřich, 1916-1989 Autorita
- Laufberger, Vilém, 1890-1986 Autorita
- Weber, Klement, 1890-1971 Autorita
- Vančura, Antonín, 1899-1956 Autorita
- Endrys, Jiří, 1925- Autorita
- Ganz, Vilém, 1919-2009 Autorita
- Froněk, Arnošt, 1923-2020 Autorita
- Aschermann, Michael, 1944- Autorita
- Klein, Otto, 1891-1962 Autorita
- Bravený, Pavel, 1931-2018 Autorita
- Kvasnička, Jiří, 1934- Autorita
- Berkowitz, Vojtěch Baruch, 1926-2012 Autorita
- Peleška, Bohumil, 1921-1986 Autorita
- Belán, Alfred, 1925-2011 Autorita
- Vítek, Bohumil, 1926-1993 Autorita
- Hůla, Josef, 1923-1999 Autorita
- Brod, Jan, 1912-1985 Autorita
- Fejfar, Zdeněk, 1916-2003 Autorita
- Jerie, Pavel, 1927-2018 Autorita
- Kölbel, František, 1933-2016 Autorita
BACKGROUND: Hyperuricemia is associated with a poorer prognosis in heart failure (HF) patients. Benefits of hyperuricemia treatment with allopurinol have not yet been confirmed in clinical practice. The aim of our work was to assess the benefit of allopurinol treatment in a large cohort of HF patients. METHODS: The prospective acute heart failure registry (AHEAD) was used to select 3160 hospitalized patients with a known level of uric acid (UA) who were discharged in a stable condition. Hyperuricemia was defined as UA ≥500 μmoL/L and/or allopurinol treatment at admission. The patients were classified into three groups: without hyperuricemia, with treated hyperuricemia, and with untreated hyperuricemia at discharge. Two- and five-year all-cause mortality were defined as endpoints. Patients without hyperuricemia, unlike those with hyperuricemia, had a higher left ventricular ejection fraction, a better renal function, and higher hemoglobin levels, had less frequently diabetes mellitus and atrial fibrillation, and showed better tolerance to treatment with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and/or beta-blockers. RESULTS: In a primary analysis, the patients without hyperuricemia had the highest survival rate. After using the propensity score to set up comparable groups, the patients without hyperuricemia had a similar 5-year survival rate as those with untreated hyperuricemia (42.0% vs 39.7%, P = 0.362) whereas those with treated hyperuricemia had a poorer prognosis (32.4% survival rate, P = 0.006 vs non-hyperuricemia group and P = 0.073 vs untreated group). CONCLUSION: Hyperuricemia was associated with an unfavorable cardiovascular risk profile in HF patients. Treatment with low doses of allopurinol did not improve the prognosis of HF patients.
- MeSH
- akutní nemoc MeSH
- alopurinol aplikace a dávkování MeSH
- antiuratika aplikace a dávkování MeSH
- biologické markery krev MeSH
- časové faktory MeSH
- hyperurikemie krev komplikace farmakoterapie MeSH
- kyselina močová krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití trendy MeSH
- následné studie MeSH
- příčina smrti MeSH
- prognóza MeSH
- prospektivní studie MeSH
- registrace * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- srdeční selhání komplikace mortalita MeSH
- tendenční skóre * MeSH
- výsledek terapie MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: The role of co-morbidities in the prognosis of patients hospitalized for AHF was examined using the AHEAD (A--atrial fibrillation, H--haemoglobin<130 g/l for men and 120 g/l for women (anaemia), E--elderly (age>70years), A--abnormal renal parameters (creatinine>130 μmol/l), D--diabetes mellitus) scoring system. METHODS: AHEAD--multicentre prospective Czech registry of AHF patients; GREAT registry--international cohort of AHF patients. Data from 5846 consecutive patients hospitalized for AHF (AHEAD registry; derivation cohort) were analysed to build the AHEAD score. Each risk factor of the AHEAD score was counted as 1 point. The model was validated externally using an international cohort of similar patients in the GREAT registry (6315). RESULTS: Main outcome was one year all-cause mortality. The mean age of patients was 72±12 years, with 61.6% of patients aged >70 years; 43.4% were women. Atrial fibrillation was present in 30.7%, anaemia in 38.2%, creatinine>130 mmol/l (abnormal renal parameters) in 30.1%, and diabetes mellitus in 44.0%. The mean AHEAD score was 2.1. In patients with AHEAD scores of 0-5, the one-year mortality rates were 13.6%, 23.4%, 32.0%, 41.1%, 47.7%, and 58.2%, respectively (p<0.001), and the 90 month mortality rates were 35.1%, 57.3%, 73.5%, 84.8%, 88.0%, and 91.7%, respectively (p<0.001). CONCLUSION: The AHEAD is a simple scoring system based on the analysis of co-morbidities for the estimation of the short and long term prognosis of patients hospitalized for AHF.
- MeSH
- akutní nemoc MeSH
- časové faktory MeSH
- hodnocení rizik metody MeSH
- incidence MeSH
- lidé MeSH
- míra přežití trendy MeSH
- mortalita v nemocnicích trendy MeSH
- následné studie MeSH
- prediktivní hodnota testů MeSH
- příčina smrti trendy MeSH
- prognóza MeSH
- prospektivní studie MeSH
- registrace * MeSH
- reprodukovatelnost výsledků MeSH
- rizikové faktory MeSH
- senioři MeSH
- srdeční katetrizace MeSH
- srdeční selhání klasifikace diagnóza epidemiologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
x
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- MeSH
- aortální stenóza diagnóza MeSH
- atrioventrikulární nodální reentry tachykardie diagnóza MeSH
- Brugadův syndrom diagnóza MeSH
- elektrokardiografie * dějiny trendy MeSH
- hypertrofická kardiomyopatie diagnóza MeSH
- infarkt myokardu diagnóza MeSH
- ischemická choroba srdeční diagnóza MeSH
- koronární stenóza diagnóza MeSH
- lidé MeSH
- nemoci srdce diagnóza MeSH
- pankreatitida diagnóza MeSH
- perikarditida diagnóza MeSH
- plicní embolie diagnóza MeSH
- syndrom dlouhého QT diagnóza MeSH
- synkopa diagnóza MeSH
- Wolffův-Parkinsonův-Whiteův syndrom diagnóza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- abstrakt z konference MeSH
AIMS: Liver pathology caused by cardiac dysfunction is relatively well recognized, however, its clinical importance has not been fully evaluated. TheAIM of this study was to assess the prevalence of liver function tests (LFTs) abnormalities and to identify associated factors mediating hepatic impairment in patients with acute heart failure (AHF). METHODS: The AHEAD (Acute Heart Failure Database) registry is a database conducted in 9 university hospitals and 5 regional health care facilities in the Czech Republic. From December 2004 to October 2012, the data of 8818 patients were included. The inclusion criteria for the database followed the European guidelines for AHF. Serum activities of all LFTs and total bilirubin were available in 1473 patients at the baseline. RESULTS: In patients with AHF, abnormal LFTs were seen in 76% patients (total bilirubin in 34%, γ-glutamyltransferase in 44%, alkaline phosphatase in 20%, aspartate aminotransferase in 42%, alanine aminotransferase in 35%). Patients with cardiogenic shock were more likely to have LFTs abnormalities compared to mild AHF and pulmonary oedema. LFTs abnormalities were strongly associated with AHF severity (left ventricular ejection fraction and NYHA functional class) and clinical manifestation. While hepatocellular LFTs pattern predominated in left sided forward AHF, cholestatic profile occurred mainly in bilateral and right sided AHF. Additionally, patients with moderate to severe tricuspid regurgitation had significantly higher prevalence of abnormalities in cholestatic LFTs. CONCLUSIONS: Defining the LFTs profile typical for AHF plays an important role in management of AHF patients, since it may avoid redundant hepatic investigations and diagnostic misinterpretations.
- MeSH
- akutní nemoc MeSH
- alkalická fosfatasa krev MeSH
- aspartátaminotransferasy krev MeSH
- gama-glutamyltransferasa krev MeSH
- jaterní testy MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci jater epidemiologie etiologie metabolismus MeSH
- prevalence MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- srdeční selhání komplikace MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
BACKGROUND: Obesity is clearly associated with increased morbidity and mortality rates. However, in patients with acute heart failure (AHF), an increased BMI could represent a protective marker. Studies evaluating the "obesity paradox" on a large cohort with long-term follow-up are lacking. METHODS: Using the AHEAD database (a Czech multi-centre database of patients hospitalised due to AHF), 5057 patients were evaluated; patients with a BMI <18.5 kg/m2 were excluded. All-cause mortality was compared between groups with a BMI of 18.5-25 kg/m2 and with BMI >25 kg/m2. Data were adjusted by a propensity score for 11 parameters. RESULTS: In the balanced groups, the difference in 30-day mortality was not significant. The long-term mortality of patients with normal weight was higher than for those who were overweight/obese (HR, 1.36; 95% CI, 1.26-1.48; p<0.001)). In the balanced dataset, the pattern was similar (1.22; 1.09-1.39; p<0.001). A similar result was found in the balanced dataset of a subgroup of patients with de novo AHF (1.30; 1.11-1.52; p = 0.001), but only a trend in a balanced dataset of patients with acute decompensated heart failure. CONCLUSION: These data suggest significantly lower long-term mortality in overweight/obese patients with AHF. The results suggest that at present there is no evidence for weight reduction in overweight/obese patients with heart failure, and emphasize the importance of prevention of cardiac cachexia.
- MeSH
- akutní nemoc MeSH
- analýza přežití MeSH
- databáze faktografické MeSH
- hospitalizace MeSH
- index tělesné hmotnosti MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nadváha MeSH
- následné studie MeSH
- obezita komplikace MeSH
- proporcionální rizikové modely MeSH
- senioři MeSH
- srdeční selhání komplikace mortalita patologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Initial risk stratification in patients with acute heart failure (AHF) is poorly validated. Previous studies tended to evaluate the prognostic significance of only one or two selected ECG parameters. The aim of this study was to evaluate the impact of multiple ECG parameters on mortality in AHF. The Acute Heart Failure Database (AHEAD) registry collected data from 4,153 patients admitted for AHF to seven hospitals with Catheter Laboratory facilities. Clinical variables, heart rate, duration of QRS, QT and QTC intervals, type of rhythm and ST-T segment changes on admission were collected in a web-based database. 12.7 % patients died during hospitalisation, the remainder were discharged and followed for a median of 16.2 months. The most important parameters were a prolonged QRS and a junctional rhythm, which independently predict both in-hospital mortality [QRS > 100 ms, odds ratio (OR) 1.329, 95 % CI 1.052-1.680; junctional rhythm, OR 3.715, 95 % CI 1.748-7.896] and long-term mortality (QRS > 120 ms, OR 1.428, 95 % CI 1.160-1.757; junctional rhythm, OR 2.629, 95 % CI 1.538-4.496). Increased hospitalisation mortality is predicted by ST segment elevation (OR 1.771, 95 % CI 1.383-2.269) and prolonged QTC interval >475 ms (OR 1.483, 95 % CI 1.016-2.164). Presence of atrial fibrillation and bundle branch block is associated with increased unadjusted long-term mortality, but mostly reflects more advanced heart disease, and their predictive significance is attenuated in the multivariate analysis. ECG in patients admitted for acute heart failure carries significant short- and long-term prognostic information, and should be carefully evaluated.
- MeSH
- akutní nemoc MeSH
- časové faktory MeSH
- elektrokardiografie * MeSH
- lidé středního věku MeSH
- lidé MeSH
- mortalita v nemocnicích * MeSH
- prediktivní hodnota testů MeSH
- prognóza MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- srdeční selhání diagnóza mortalita MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- práce podpořená grantem MeSH