XXXII. KONGRES ČESKÉ INTERNISTICKÉ SPOLEČNOSTI ČLS J. E. PURKYNĚ: 19.–21. 11. 2025, BrnoAbstracts

Redakce

Vnitr Lek 2026, 72(Suppl.A)  

Valve-in-valve transcatheter implantation of a valve replacement in the mitral position using the LAMPOON techniqueCase reporty#E-publication

Beáta Šoltésová, Zuzana Hlubocká, Tomáš Bouček, Tomáš Kovárník, David Zemánek

Vnitr Lek 2026, 72(2):E7-E11 | DOI: 10.36290/vnl.2026.028  

Over the last ten years, there has been a significant progression in the possibilities of trascatheter intervention on the mitral valve, both on the native valve and on bioprostheses. Although surgical treatment of mitral defects currently prevails, transcatheter mitral valve replacement is mainly used in patients with a high surgical risk or in patients with valve replacement with a bioprosthesis in whom reoperation is no longer possible. Transcatheter implantation of a bioprosthesis into the mitral position has its specifics and complications. One of the possible complications is the formation of a significant obstruction in the outflow tract of...

Reassessing the SIBO-Hypertension Link in Symptomatic PatientsOriginal articles#E-publication

Pavol Fülöp, Lívia Szczygieľová, Štefan Tóth, Tibor Porubän, Mariana Dvorožňáková, Natália Vaňová

Vnitr Lek 2026, 72(2):E1-E6 | DOI: 10.36290/vnl.2026.027  

Background: Recent evidence suggests small intestinal bacterial overgrowth (SIBO) may serve as a diagnostic marker for hypertension through gut-cardiovascular axis mechanisms. However, this relationship has not been evaluated in symptomatic gastrointestinal patients. We aimed to assess the association between SIBO and arterial hypertension in patients undergoing clinical evaluation for gastrointestinal symptoms. Methods: Retrospective cross-sectional analysis of 331 consecutive symptomatic patients (263 controls, 68 with hypertension) who underwent hydrogen breath testing. SIBO was diagnosed using North American Consensus criteria (H₂ rise ≥20...

Hlavní téma – novinky v kardiologiiEditorial

MUDr. Michael Jenšovský

Vnitr Lek 2026, 72(2):71  

RECENZE KNIHY Etika a komunikace v medicíněReview

Prof. MUDr. Jan Škrha, DrSc.

Vnitr Lek 2026, 72(2):133  

Zmírnění příznaků i projevů chronického žilního onemocnění všech stadií při užívání mikronizované purifikované flavonoidní frakce - metaanalýza 56 studiíCommentaries

MUDr. Zuzana Zafarová

Vnitr Lek 2026, 72(2):127-132  

AI audio processing transforms healthcareAI in medicine and health care

Jan Rychtar

Vnitr Lek 2026, 72(2):123-126 | DOI: 10.36290/vnl.2026.026  

Artificial intelligence is revolutionizing audio processing in healthcare. The article presents key applications: ambient AI scribe systems automatically generate medical documentation from doctor-patient conversations, saving hours of work and reducing burnout. Intelligent voicebots streamline phone communication in clinics. In diagnostics, AI analyzes cough sounds to detect respiratory diseases, while digital stethoscopes recognize heart murmurs with accuracy exceeding that of typical physicians. Voice analysis reveals signs of Parkinson's disease, Alzheimer's dementia, and depression. Smartphone applications enable sleep apnea screening from nighttime...

Fixed combination of rosuvastatin and perindopril - the next step in cardiovascular disease preventionPharmacological profile

Jiří Vítovec

Vnitr Lek 2026, 72(2):120-122 | DOI: 10.36290/vnl.2026.025  

The combination of a statin and an ACE inhibitor represents a modern therapeutic approach to the simultaneous management of hypercholesterolemia and arterial hypertension - the two main risk factors for cardiovascular disease (CVD). The fixed-dose combination of rosuvastatin and perindopril provides comprehensive prevention of CVD in patients at high or very high risk. This combination offers synergistic effects on blood pressure and lipid levels, and its simplified regimen improves patient adherence. This article summarizes the pharmacological properties of both agents, the rationale and benefits of their fixed combination, clinical indications, and...

Hyperuricemia: Indications for treatment vs. non-treatment according to current guidelinesGood advice

Zdeněk Monhart

Vnitr Lek 2026, 72(2):118-119 | DOI: 10.36290/vnl.2026.024  

Pharmacological treatment of hyperuricemia is indicated in patients with clear clinical manifestations such as gout or nephrolithiasis. Current guidelines do not support pharmacotherapy for asymptomatic hyperuricemia, even in the presence of chronic kidney disease (CKD) or cardiovascular disease.

Spironolactone in the treatment of heart failure and resitant arterial hypertensionReview articles

Filip Málek

Vnitr Lek 2026, 72(2):113-116 | DOI: 10.36290/vnl.2026.023  

Chronic heart failure is clinical syndrome charatcterised by increasing prevalence and unfavorable prognosis. Resistent arterial hypertension increases the risk of cardiovascular events and the risk of death from cardiovascular causes. Both heart failure and resistant arterial hypertension are associated with secondary hyperaldosternism. Spironolactone blocks the adverse effects of aldosterone on the level of its receptors Its efficacy in the indications of heart failure and resistant arterial hypertension is supported by scientific findings, it is also supported by the guidelines from professional societies.Spironolactone reduces mortality and morbidity...

New generation anti-obesity drugs and bone health in postmenopausal womenReview articles

Jana Tomasová Studýnková

Vnitr Lek 2026, 72(2):104-112 | DOI: 10.36290/vnl.2026.022  

Obesity represents a major global medical and socioeconomic challenge. The prevalence of overweight and obesity has increased markedly over the past three decades and currently affects nearly one third of the world's population. Up to 70 % of women experience weight gain during the menopausal transition. Glucagon-like peptide-1 receptor agonists (GLP-1RA) represent an effective pharmacological treatment for overweight and obesity and have become an important therapeutic option across various populations, including peri- and postmenopausal women. Available data suggest that some of these agents may have a beneficial effect on bone mineral density and...

Hypertension in women and menReview articles

Barbora Nussbaumerová

Vnitr Lek 2026, 72(2):99-103 | DOI: 10.36290/vnl.2026.021  

This paper summarizes current knowledge on the epidemiology, diagnosis, treatment, and the potential development of target organ damage in hypertension in women and men, with an emphasis on sex-related differences, based on current clinical guidelines. Women have a lower prevalence of hypertension at a younger age; however, after menopause, prevalence may equal or even exceed that in men. Women with high-normal blood pressure may be more likely to develop hypertension than men. Compared with men, women may be more susceptible to hypertension-related target organ damage, and hypertension in women may be associated with a higher risk of ischemic heart...

What's new in the ESC guidelines for management of valvular heart disease?Main topic

Hana Línková

Vnitr Lek 2026, 72(2):92-96 | DOI: 10.36290/vnl.2026.020  

Valvular heart disease is a major cause of morbidity and mortality, especially in the elderly population. In 2025, updated recommendations from the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) were published, reflecting the rapid development of transcatheter treatment methods, advances in imaging techniques, and new results from clinical studies. Compared to the recommendations issued in 2021, they mark a further step forward and change clinical practice. This mainly involves shifting interventions to earlier stages of disease development and expanding the role of transcatheter treatment of valve...

Recent advances in the pharmacotherapy of pulmonary arterial hypertensionMain topic

Lucie Miksová, Pavel Jansa

Vnitr Lek 2026, 72(2):86-91 | DOI: 10.36290/vnl.2026.019  

Pulmonary arterial hypertension (PAH) is a rare, progressive, and life-threatening disease characterized by pathological remodeling of the pulmonary vasculature, ultimately leading to right ventricular failure. Despite substantial advances in diagnostic strategies and therapeutic options over recent decades, the prognosis of patients with PAH remains unfavorable, and a sustained low-risk profile cannot be achieved in a considerable proportion of patients even when treated according to current guideline recommendations. Current PAH-specific pharmacotherapy primarily targets the endothelin, prostacyclin, and nitric oxide-cGMP signaling pathways, with...

Advances in the treatment of acute coronary syndromes - from standardized algorithms to individualized therapyMain topic

Karolína Bartošková, Zuzana Moťovská

Vnitr Lek 2026, 72(2):81-84 | DOI: 10.36290/vnl.2026.018  

Recent years have brought a shift in the management of acute coronary syndromes (ACS) from uniform treatment algorithms towards an individualized, risk-based approach. This strategy integrates ischaemic and bleeding risk assessment, clinical course and patient comorbidities. The most relevant changes concern antithrombotic therapy, including duration and composition of dual antiplatelet therapy, early P2Y12 inhibitor monotherapy and de-escalation strategies. Further developments involve the selective use of mechanical circulatory support in cardiogenic shock and an expanding role of adjunctive pharmacotherapy after myocardial infarction. This review...

Novel therapies for hypertrophic cardiomyopathyMain topic

Michael Jenšovský, Veronika Puchnerová, Jiří Bonaventura, Petr Ošťádal

Vnitr Lek 2026, 72(2):76-80 | DOI: 10.36290/vnl.2026.017  

Hypertrophic cardiomyopathy (HCM) is a genetic disease that requires complex diagnostics and evolving therapeutic options. We present advances in pharmacotherapy of HCM in the year 2025. We focus on the results of trials involving myosin inhibitors and the implications of these studies on daily practice. Additionally, we explore experimental therapies with novel mechanisms of action in different stages of development. Lastly, we describe the current structure of expert centers that care for HCM patients in the Czech Republic.

Zaznělo na XXXII. kongresu České internistické společnosti ČLS JEP, 19.–22. 11. 2025, Brno: 
Autonomní nervový systém a kardiovaskulární léčba: zaměřeno na β-blokátoryInsert

MUDr. Zuzana Zafarová

Vnitr Lek 2026, 72(1)  

Internista a kardiolog profesor Richard Češka se stal šéfem světové interní medicínyLatest from the society#E-publication

prof. MUDr. Michael Aschermann, DrSc.

Vnitr Lek 2026, 72(1):e22-e23  

Neutrophil-lymphocyte ratio as a marker of increased cardiovascular risk in patients with moderate to severe hidradenitis suppurativa: prospective observational studyOriginal articles#E-publication

Tereza Neplechová, Zlatica Žingorová, Tomáš Bolek, Matej Samoš, Martin Jozef Péč, Denis Hrivnák, Karolína Vorčáková

Vnitr Lek 2026, 72(1):E15-E21 | DOI: 10.36290/vnl.2026.012  

Aim: Hidradenitis suppurativa (HS) is a pro-inflammatory condition associated with other comorbidities, such as obesity and an increased risk of cardiovascular (CV) disease. One of the prognostic markers of CV risk is the neutrophil-to-lymphocyte ratio (NLR), which is an inflammatory marker and a strong prognostic indicator for patients suffering from various diseases. The aim of this study was to confirm the increased cardiovascular risk in patients with moderate to severe HS based on an elevated NLR compared to a control group of healthy individuals. Materials and methods: In this study, we prospectively monitored laboratory parameters in 51 patients...

Serotonin as a biomarker in inflammatory bowel diseasesOriginal articles#E-publication

Zuzana Cingelová, Stanislava Blažíčková

Vnitr Lek 2026, 72(1):E6-E14 | DOI: 10.36290/vnl.2026.011  

Background: Non-specific inflammatory bowel disease (IBD) - Crohn's disease and ulcerative colitis are chronic diseases of the gastrointestinal tract. Diagnosis requires endoscopic examination with histology sampling. In addition to calprotectin, serotonin is also being discussed in professional circles as a suitable non-invasive biomarker for the diagnosis of IBD. Objective: The aim was to assess the possibility of using serotonin as a biomarker in the diagnosis of inflammatory bowel disease (IBD). Patients and methods: Serum and stool samples were collected from a Slovak cohort of 60 patients with active and remitting MC and UC. Serum serotonin and...

Naltrexone and its potential use in the treatment of autoimmune diseasesReview articles#E-publication

Karolína Absolonová, Ivan Šterzl

Vnitr Lek 2026, 72(1):E1-E5 | DOI: 10.36290/vnl.2026.010  

In this article, we present a selection of findings from the literature regarding the potential use of low-dose naltrexone, so-called LDN in the treatment of chronic autoimmune diseases, its immunomodulatory and anti-inflammatory effects. Naltrexone is an opioid receptor antagonist, currently used in the treatment of addiction. Its low doses (usually 4.5 mg per day) are experimentally used to treat pain and inflammation in some chronic and autoimmune diseases (e.g. fibromyalgia, multiple sclerosis, Crohn's disease). Its immunomodulatory effect in these diseases is realized mainly through opioid receptors and the innate immunity receptor TLR4 and leads...

AI v medicíně a zdravotnictví – nová rubrika časopisu Vnitřní lékařstvíEditorial

doc. MUDr. Ondřej Volný, Ph.D.

Vnitr Lek 2026, 72(1):3  

Artificial intelligence in cardiology: Current clinical applications and regulatory framework in the EUAI in medicine and health care

Lukáš Evin

Vnitr Lek 2026, 72(1):60-66 | DOI: 10.36290/vnl.2026.009  

In recent years, artificial intelligence (AI) has become a standard part of modern cardiology, influencing diagnostics, interventional treatment, and patient follow-up. It is gaining ground most rapidly in areas with large volumes of structured signals or imaging data, particularly in ECG analysis, long-term ambulatory rhythm monitoring, support systems for electrophysiological procedures, and cardiovascular applications of computed tomography. At the same time, systems are being developed for the urgent triage of critical findings on CT/CTA (Computed Tomography Angiography) scans and tools that support standardized echocardiographic examinations even...

Interdisciplinary recommendations for thrombophilia testingIn brief

Eva Drbohlavová, Jaromír Gumulec, Alena Buliková, Petr Dulíček, Jana Hirmerová, Radovan Malý, Ester Zápotocká, Jan Blatný, Jan Václavík, Petr Kessler

Vnitr Lek 2026, 72(1):56-59  

In this interdisciplinary consensus of four medical societies dealing with thrombophilic disorders, we summarize the rules of diagnosis and care of patients with congenital or acquired thrombophilias, i.e. factors increasing the risk of venous thromboembolic disease. The primary goal is to standardize the care of these patients with respect to the rules of evidence-based medicine. The recommendations imply under which circumstances, in which clinical situations, for which patients and which tests it is useful to investigate which thrombophilias and when not. Despite the long history and very good availability of diagnostic tests for individual thrombophilias,...

Blood pressure and energy drinksGood advice

Markéta Sovová, Eliška Sovová

Vnitr Lek 2026, 72(1):52-55 | DOI: 10.36290/vnl.2026.008  

Energy drinks (ED) contain a combination of stimulants, mainly caffeine and taurine, which affect the central nervous and cardiovascular systems. Their consumption is growing among the population, especially among young people, which increases interest in their possible health effects. Caffeine increases sympathetic activity, peripheral vascular resistance, and blood pressure, while taurine may have partially protective effects. Other ingredients in energy drinks, such as carbohydrates and plant extracts, may contribute to metabolic and autonomic changes. Short-term use of energy drinks leads to an increase in systolic and diastolic blood pressure,...

Acute kidney injury induced by synthetic cannabinoidsCase reports

Eva Zvárová, Jan Václavík

Vnitr Lek 2026, 72(1):47-50 | DOI: 10.36290/vnl.2026.007  

Acute kidney injury (AKI) is a potentially life-threatening condition with a range of possible causes that can be didactically classified as prerenal, renal, and postrenal. Differential diagnosis of the etiologically heterogeneous renal subgroup of AKI requires a comprehensive approach and includes, among others, vasculitides, systemic connective tissue diseases, infectious disorders and intoxication with medications or drugs. This case report describes a 21-year-old patient admitted to the internal medicine department with non-oliguric stage III AKI of unclear etiology, clinically dominated by dyspeptic symptoms. Imaging and laboratory tests, including...

Surprising finding of a large intracardial mass in the right atrium during catheter ablation of atrial fibrillationCase reports

Katarína Doležalová, Filip Souček, Vojtěch Šebetovský, Zdeněk Stárek

Vnitr Lek 2026, 72(1):43-46 | DOI: 10.36290/vnl.2026.006  

Myxomas are the most common primary cardiac tumors, most often located in the left atrium. Right atrial myxomas are rare and often remain asymptomatic for a long time, which complicates early diagnosis.  Our case report describes a 53year-old male endurance athlete diagnosed with paroxyzmal atrial fibrillation, who was referred for catheter ablation – specifically, pulmonary vein isolation. During the planned procedure, intracardiac ultrasound revealed a large, mobile mass in the right atrium, attached by a stalk to the interatrial septum. The procedure was immediately aborted. Subsequent transesophageal echocardiography and cardiac magnetic...

Arterial hypertension is an important topic even in patients admitted to hospitals for other reasonsCase reports

Pavel Rutar

Vnitr Lek 2026, 72(1):38-42 | DOI: 10.36290/vnl.2026.005  

Arterial hypertension affects nearly 20% of Czech population. Due to this high prevalence, arterial hypertension has become a diagnosis seen on daily basis by general practitioners in primary care as well by specialists in hospitals. Despite the amount of energy and time which doctors give into the treatment of hypertension, we can still find patients who are not treated in the best way. And because we can still find some space for improvement, we should take care about the treatment of hypertension even at patients who came to the hospital for other reasons. Hospitalisation on its own brings very good conditions for frequent blood pressure controls...

Clinic and treatment of aortic diseases - ESC guidelinesReview articles

Veronika Jankovičová

Vnitr Lek 2026, 72(1):29-35 | DOI: 10.36290/vnl.2026.004  

Aortic diseases represent a growing clinical problem with increasing prevalence, especially in older age groups. The availability of imaging methods, especially echocardiography, CT with ECG gating and MRI, plays a crucial role in diagnosis. Management of aortic aneurysms and acute aortic syndromes (AAS) is based on an accurate assessment of morphology, risk factors and growth dynamics. Prevention includes screening of selected populations and control of risk factors, especially arterial hypertension. Thoracic and abdominal aortic aneurysms have different etiopathogenesis, risk of complications and indication criteria for surgical or endovascular treatment....

Gut microbiome in internal medicineReview articles

Zdeněk Lys, Lukáš Štos, David Galis, Veronika Janošcová, Jan Václavík

Vnitr Lek 2026, 72(1):22-28 | DOI: 10.36290/vnl.2026.003  

The gut microbiome is a dynamic ecosystem with many physiological tasks not only in the gut itself, but also in interaction with the immune, endocrine, and nervous systems, as well as in the complex functioning of the organism. Knowledge of the role of the microbiome in the pathophysiology of diseases is growing across the entire spectrum of internal medicine. Knowledge of the role of the microbiome and its metabolites in the context of genetic and epigenetic factors may play a significant role in the diagnosis and treatment of several diseases. Despite many obstacles to clarifying the role of the microbiome, such as high inter- and intra-individual...