Ateroskleróza aneb Výběr z "interního kmene"

Richard Češka

Vnitr Lek 2018, 64(1):6-7  

Stanovisko výboru České společnosti pro aterosklerózu k doporučením ESC/EAS pro diagnostiku a léčbu dyslipidemií z roku 2016

Michal Vrablík, Jan Piťha, Vladimír Bláha, Renata Cífková, Tomáš Freiberger, Pavel Kraml, Hana Rosolová, Vladimír Soška, Tomáš Štulc, Zuzana Urbanová, Helena Vaverková

Vnitr Lek 2018, 64(1):9-16 | DOI: 10.36290/vnl.2018.002  

Diabetic dyslipidemia and microvascular complications of diabetes

David Karásek, Helena Vaverková

Vnitr Lek 2018, 64(1):17-24 | DOI: 10.36290/vnl.2018.003  

Diabetic dyslipidemia is one of the main risk factors for atherosclerosis. Although its participation in diabetic microvascular complications is not that dominant, dyslipidemia may play an important role in formation and progression of these complications. Pathophysiological mechanisms by which diabetic dyslipidemia affects the etiopathogenesis of diabetic nephropathy, retinopathy, neuropathy and diabetic foot are presented. The data from clinical studies and treatment possibilities for particular microvascular complications using lipid-lowering therapy are discussed.

Familial combined hyperlipidemia - the most common genetic dyslipidemia in population and in patients with premature atherothrombotic cardiovascular disease

Helena Vaverková, David Karásek

Vnitr Lek 2018, 64(1):25-29 | DOI: 10.36290/vnl.2018.004  

Familial combined hyperlipidemia (FCH) is the most frequent genetic dyslipidemia (DLP) with high risk of early atherosclerosis manifestation. It is characterized by elevated both triglycerides ≥ 1.5 mmol/l and apolipoprotein B ≥ 1.2 g/l (hyper-TG/hyper-ApoB fenotype), with at least two affected family members. Despite the fact that plasmatic levels of total cholesterol and LDL-C are usually lower than in familial hypercholesterolemia and full expression of DLP in FCH occurs in adulthood, risk of premature manifestation of atherosclerosis is similar in both these familial DLP. It is probably due to the presence of other atherogenic lipid and non-lipid...

Epidemiology of hypercholesterolemia

Barbora Nussbaumerová, Hana Rosolová

Vnitr Lek 2018, 64(1):30-37 | DOI: 10.36290/vnl.2018.005  

Hypercholesterolemia is one of the most important risk factors of cardiovascular (CV) disease. Epidemiology follows the prevalence, the incidence and the possibilities of risk factors or diseases intervention. A review of observation epidemiologic studies, pharmacotherapy and treatment perspectives is presented. The first epidemiologic studies, e.g. the Framingham Heart Study or MRFIT showed hyperlipidemia is associated with the incidence of CV disease. The North Karelia Project showed the intervention of CV risk factors is useful on population-based principles. Interventional studies with statins showed the usefulness of LDL cholesterol lowering to...

MedPed - the reality of familial hypercholesterolemia care at the biggest center

Martina Vaclová, Tomáš Freiberger, Lucie Schwarzová, Lukáš Tichý, Michal Vrablík, Richard Češka

Vnitr Lek 2018, 64(1):38-42 | DOI: 10.36290/vnl.2018.006  

The MedPed project (Make Early Diagnosis to Prevent Early Deaths) aiming at screening, diagnosis and treatment of patients with familial hypercholesterolemia (FH) was initiated more than 19 years ago. More than 60 cooperating centers and a large number of health care professionals have been involved. Till November 15, 2017 the nationwide database has comprised 7 567 entries of individual FH patients, 439 of these being children up to 19 years of age. Given the recently corrected estimated population frequency of FH of 1 to 250 this number represents 18.9 % of the predicted number of 40 000 FH individuals in the Czech Republic. Although the number of...

The role of PCSK9-inhibitors and of lipoprotein apheresis in the treatment of homozygous and severe heterozygous familial hypercholesterolemia: A rivalry, or are things quite different?

Vladimír Bláha, Milan Bláha, Miriam Lánská, Eduard Havel, Pavel Vyroubal, Zdeněk Zadák, Pavel Žák

Vnitr Lek 2018, 64(1):43-50 | DOI: 10.36290/vnl.2018.007  

PCSK9-inhibitors belong to the new class of hypolipidemic agents. They enhance catabolism of low density lipoprotein cholesterol (LDL-C) through inhibiting activity of proprotein convertase subtilisin/kexin type 9 (PCSK9). They are monoclonal antibodies (alirocumab, evolocumab etc). Under clinical development are also other types of PCSK9-inhibitors which act at a subcellular level. The treatment with PCSK9-inhibitors can be beneficially combined with lipoprotein apheresis (LA). If such treatment using PCSK9-inhibitors is possible with regard to an individual patient's genotype, the combination of LA and PCSK9-inhibitors leads to slowing the space...

Cardiovascular risk in patients with rheumatic disease and its management

Jiří Laštůvka, Sabína Oreská, Michal Tomčík, Michal Vrablík

Vnitr Lek 2018, 64(1):51-59 | DOI: 10.36290/vnl.2018.008  

Cardiovascular disease (CVD) risk in patients with rheumatic diseases is increased by 50 % compared to the general population. This is a result of the increased inflammatory activity as well as modification of traditional CVD risk factors by the primary disease. So called lipid paradox, paradoxical decrease of concentrations of atherogenic plasma lipids due to increased inflammatory activity and their rise with successful anti-inflammatory treatment, is of particular importance. CVD risk in rheumatic diseases is further modified by drugs used for their treatment: while some treatment modalities increase the risk (e.g. glucocorticoids), others may act...

Examination methods for coronary atherosclerosis regression with special focus on GLAGOV trial

Tomáš Kovárník, Karel Kopřiva, Jan Pudil

Vnitr Lek 2018, 64(1):61-64 | DOI: 10.36290/vnl.2018.009  

Authors summarize trials assessing regression of coronary atherosclerosis. Special interest is devoted to imagine techniques. Authors describe in a detail methodology and results of GLAGOV trial.

Effect of pulsatility on markers of vascular damage in patients with implanted continuous flow mechanical circulatory support

Peter Ivák, Jan Piťha, Ivana Králová Lesná, Ivan Netuka

Vnitr Lek 2018, 64(1):66-71 | DOI: 10.36290/vnl.2018.010  

Ventricular assist devices are an important therapeutic modality in advanced surgical therapy of end-stage heart failure. Previously most frequently used devices generated mainly non-pulsatile blood flow. Despite indisputable clinical success of this therapy, we encounter complications specific to the devices generating continuous flow. Complications are mainly attributed to changes in shear stress and subsequent changes of the blood vessel characteristics, mainly of endothelium. Effect of continuous flow on the vasculature and blood elements, therefore, became a subject of intense recent research. Effect of continuous flow on the vascular bed is subject...

Remarks on biomarkers of cardiovascular risk

Janka Franeková, Antonín Jabor

Vnitr Lek 2018, 64(1):72-76 | DOI: 10.36290/vnl.2018.011  

Authors describe state-of-the-art in the routine laboratory diagnostics of cardiovascular risk with special emphasis on metrology, traceability, external quality assessment, biological variation, and reference change value. While analytical quality of total cholesterol, triglycerides, glucose, and HbA_1c is satisfactory, improvements are needed for HDL-cholesterol, LDL-cholesterol, apolipoprotein A1, apolipoprotein B, Lp(a), and LpPLA2 measurements. Biological variation is a strong player in the lipid diagnostics, because reference change value is above 20 % for majority of biomarkers. Current methodology for the measurement of remnant cholesterol...

Long non-coding RNAs in the pathophysiology of atherosclerosis

Jan Novák, Julie Bienertová Vašků, Miroslav Souček

Vnitr Lek 2018, 64(1):77-82 | DOI: 10.36290/vnl.2018.012  

The human genome contains about 22 000 protein-coding genes that are transcribed to an even larger amount of messenger RNAs (mRNA). Interestingly, the results of the project ENCODE from 2012 show, that despite up to 90 % of our genome being actively transcribed, protein-coding mRNAs make up only 2-3 % of the total amount of the transcribed RNA. The rest of RNA transcripts is not translated to proteins and that is why they are referred to as "non-coding RNAs". Earlier the non-coding RNA was considered "the dark matter of genome", or "the junk", whose genes has accumulated in our DNA during the course of evolution. Today we already know that non-coding...

The current position of hydrochlorothiazide among thiazide and thiazide-like diuretics

Jiří Slíva

Vnitr Lek 2018, 64(1):83-85 | DOI: 10.36290/vnl.2018.013  

Thiazide and thiazide-like diuretics are an important group of drugs used in the treatment of essential arterial hyper-tension. While their beneficial therapeutic effect in monotherapy is evident, they are increasingly used in fixed combinations, particularly with ACE inhibitors or sartans. The aim of this article was to summarize the current status of hydrochlorothiazide and compare its effects with other substances in this subgroup of diuretics.

Josef Marek, Václav Hána a kolektiv. Endokrinologie

Richard Češka

Vnitr Lek 2018, 64(1):89  

Česko-slovenská lipidová akademie

Martin Šatný

Vnitr Lek 2018, 64(1):86-88