. "218700" . "4"^^ . "N" . "RIV/00023884:_____/11:#0004738!RIV12-MZ0-00023884" . "Critical evaluation of the optimal medical therapy in the cardiac resynchronization therapy candidates - single centre"@en . . "Optim\u00E1ln\u00ED farmakoterapie kandid\u00E1t\u016F srde\u010Dn\u00ED resynchroniza\u010Dn\u00ED l\u00E9\u010Dby - zku\u0161enosti jednoho centra" . "CZ - \u010Cesk\u00E1 republika" . . "chronic heart failure, cardiac resynchronization therapy, optimal medical therap"@en . . . "Optim\u00E1ln\u00ED farmakoterapie kandid\u00E1t\u016F srde\u010Dn\u00ED resynchroniza\u010Dn\u00ED l\u00E9\u010Dby - zku\u0161enosti jednoho centra" . "[6239B3680B68]" . "0042-773X" . . . "6"^^ . . "RIV/00023884:_____/11:#0004738" . . . . "1"^^ . . . . "Optim\u00E1ln\u00ED farmakoterapie kandid\u00E1t\u016F srde\u010Dn\u00ED resynchroniza\u010Dn\u00ED l\u00E9\u010Dby - zku\u0161enosti jednoho centra"@cs . . "Critical evaluation of the optimal medical therapy in the cardiac resynchronization therapy candidates - single centre"@en . "Vnit\u0159n\u00ED l\u00E9ka\u0159stv\u00ED" . "M\u00E1lek, Filip" . "C\u00EDlem studie byl zhodnotit optim\u00E1ln\u00ED farmakoterapii pacient\u016F s chronick\u00FDm srde\u010Dn\u00EDm selh\u00E1n\u00EDm (CHSS), kte\u0159\u00ED byli odesl\u00E1ni referuj\u00EDc\u00EDmi pracovi\u0161ti a ambulantn\u00EDmi kardiology k zaveden\u00ED srde\u010Dn\u00ED resynchroniza\u010Dn\u00ED l\u00E9\u010Dby s defibril\u00E1torem (SRL-D) do Kardiologick\u00E9ho odd\u011Blen\u00ED Nemocnice Na Homolce v obdob\u00ED od 1. ledna 2008 do 30. z\u00E1\u0159\u00ED 2009. Optim\u00E1ln\u00ED farmakoterapie byla analyzov\u00E1na retrospektivn\u011B z dokumentace 179 pacient\u016F s CHSS funk\u010Dn\u00ED t\u0159\u00EDdy NYHA III a IV. Betablok\u00E1tory (BB) u\u017E\u00EDvalo pouze 81% nemocn\u00FDch referovan\u00FDch k SRL-D, inhibitory ACE (ACEi) u\u017E\u00EDvalo pouze 68% pacient\u016F, blok\u00E1tory receptoru angiotenzinu (ARB) u\u017E\u00EDvalo 18% jedinc\u016F a ACEi nebo ARB 81% nemocn\u00FDch, spironolakton 59% nemocn\u00FDch. Doporu\u010Denou denn\u00ED d\u00E1vka BB (carvedilol 25 mg dvakr\u00E1t denn\u011B) u\u017E\u00EDvalo pouze 13% jedinc\u016F, doporu\u010Denou denn\u00ED d\u00E1vku ACEi (enalapril 10 mg dvakr\u00E1t denn\u011B) u\u017E\u00EDvalo pouze 9,4% pacient\u016F. Optim\u00E1ln\u00ED farmakoterapie byla v Kardiologick\u00E9m odd\u011Blen\u00ED po zaveden\u00ED SRL-D zm\u011Bn\u011Bna, BB p\u0159i propu\u0161t\u011Bn\u00ED u\u017E\u00EDvalo 95% nemocn\u00FDch (p < 0,01) a zv\u00FD\u0161il se i po\u010Det pacient\u016F, kte\u0159\u00ED dos\u00E1hli alespo\u0148 50% doporu\u010Den\u00E9 denn\u00ED d\u00E1vky (p < 0,05). L\u00E9\u010Dba ACEi byla po zaveden\u00ED SRL-D doporu\u010Dena u 80% pacient\u016F (p < 0,05), zv\u00FD\u0161il se i po\u010Det nemocn\u00FDch, kte\u0159\u00ED dos\u00E1hli alespo\u0148 50% doporu\u010Den\u00E9 denn\u00ED d\u00E1vky (p < 0,05). Nebyl zji\u0161t\u011Bn v\u00FDznamn\u00FD rozd\u00EDl v u\u017E\u00EDv\u00E1n\u00ED ARB p\u0159ed a po zaveden\u00ED SRL-D. ACEi nebo ARB u\u017E\u00EDvalo po implantaci p\u0159\u00EDstroje 98% jedinc\u016F (p < 0,05) a spironolakton 77% pacient\u016F (p < 0,05). Z\u00E1v\u011Br: Navzdory optim\u00E1ln\u00EDmu slo\u017Een\u00ED farmakologick\u00E9 l\u00E9\u010Dby srde\u010Dn\u00EDho selh\u00E1n\u00ED pouze mal\u00E9 procento kandid\u00E1t\u016F SRL-D dosahuje doporu\u010Den\u00E9 c\u00EDlov\u00E9 denn\u00ED d\u00E1vky l\u00E9k\u016F. Optimalizace farmakoterapie ve specializovan\u00E9m centru vedla k v\u00FDznamn\u011B vy\u0161\u0161\u00EDmu po\u010Dtu nemocn\u00FDch u\u017E\u00EDvaj\u00EDc\u00EDch doporu\u010Denou farmakologickou l\u00E9\u010Dbu se zv\u00FD\u0161en\u00EDm d\u00E1vky BB a ACEi." . "57" . "Optim\u00E1ln\u00ED farmakoterapie kandid\u00E1t\u016F srde\u010Dn\u00ED resynchroniza\u010Dn\u00ED l\u00E9\u010Dby - zku\u0161enosti jednoho centra"@cs . "10" . "C\u00EDlem studie byl zhodnotit optim\u00E1ln\u00ED farmakoterapii pacient\u016F s chronick\u00FDm srde\u010Dn\u00EDm selh\u00E1n\u00EDm (CHSS), kte\u0159\u00ED byli odesl\u00E1ni referuj\u00EDc\u00EDmi pracovi\u0161ti a ambulantn\u00EDmi kardiology k zaveden\u00ED srde\u010Dn\u00ED resynchroniza\u010Dn\u00ED l\u00E9\u010Dby s defibril\u00E1torem (SRL-D) do Kardiologick\u00E9ho odd\u011Blen\u00ED Nemocnice Na Homolce v obdob\u00ED od 1. ledna 2008 do 30. z\u00E1\u0159\u00ED 2009. Optim\u00E1ln\u00ED farmakoterapie byla analyzov\u00E1na retrospektivn\u011B z dokumentace 179 pacient\u016F s CHSS funk\u010Dn\u00ED t\u0159\u00EDdy NYHA III a IV. Betablok\u00E1tory (BB) u\u017E\u00EDvalo pouze 81% nemocn\u00FDch referovan\u00FDch k SRL-D, inhibitory ACE (ACEi) u\u017E\u00EDvalo pouze 68% pacient\u016F, blok\u00E1tory receptoru angiotenzinu (ARB) u\u017E\u00EDvalo 18% jedinc\u016F a ACEi nebo ARB 81% nemocn\u00FDch, spironolakton 59% nemocn\u00FDch. Doporu\u010Denou denn\u00ED d\u00E1vka BB (carvedilol 25 mg dvakr\u00E1t denn\u011B) u\u017E\u00EDvalo pouze 13% jedinc\u016F, doporu\u010Denou denn\u00ED d\u00E1vku ACEi (enalapril 10 mg dvakr\u00E1t denn\u011B) u\u017E\u00EDvalo pouze 9,4% pacient\u016F. Optim\u00E1ln\u00ED farmakoterapie byla v Kardiologick\u00E9m odd\u011Blen\u00ED po zaveden\u00ED SRL-D zm\u011Bn\u011Bna, BB p\u0159i propu\u0161t\u011Bn\u00ED u\u017E\u00EDvalo 95% nemocn\u00FDch (p < 0,01) a zv\u00FD\u0161il se i po\u010Det pacient\u016F, kte\u0159\u00ED dos\u00E1hli alespo\u0148 50% doporu\u010Den\u00E9 denn\u00ED d\u00E1vky (p < 0,05). L\u00E9\u010Dba ACEi byla po zaveden\u00ED SRL-D doporu\u010Dena u 80% pacient\u016F (p < 0,05), zv\u00FD\u0161il se i po\u010Det nemocn\u00FDch, kte\u0159\u00ED dos\u00E1hli alespo\u0148 50% doporu\u010Den\u00E9 denn\u00ED d\u00E1vky (p < 0,05). Nebyl zji\u0161t\u011Bn v\u00FDznamn\u00FD rozd\u00EDl v u\u017E\u00EDv\u00E1n\u00ED ARB p\u0159ed a po zaveden\u00ED SRL-D. ACEi nebo ARB u\u017E\u00EDvalo po implantaci p\u0159\u00EDstroje 98% jedinc\u016F (p < 0,05) a spironolakton 77% pacient\u016F (p < 0,05). Z\u00E1v\u011Br: Navzdory optim\u00E1ln\u00EDmu slo\u017Een\u00ED farmakologick\u00E9 l\u00E9\u010Dby srde\u010Dn\u00EDho selh\u00E1n\u00ED pouze mal\u00E9 procento kandid\u00E1t\u016F SRL-D dosahuje doporu\u010Den\u00E9 c\u00EDlov\u00E9 denn\u00ED d\u00E1vky l\u00E9k\u016F. Optimalizace farmakoterapie ve specializovan\u00E9m centru vedla k v\u00FDznamn\u011B vy\u0161\u0161\u00EDmu po\u010Dtu nemocn\u00FDch u\u017E\u00EDvaj\u00EDc\u00EDch doporu\u010Denou farmakologickou l\u00E9\u010Dbu se zv\u00FD\u0161en\u00EDm d\u00E1vky BB a ACEi."@cs . "The aim of the present study was to evaluate the optimal medical therapy in the chronic heart failure (CHF) patients referred from the comunity centres and the outpatients cardiology clinics for the cardiac resynchronization therapy with defibrilator (CRTD) to the Department of Cardiology, Na Homolce Hospital with the device implantation between 1st January 2008 and 30st September 2009. The optimal medical therapy was analysed retrospectively from the medical records of 179 consecutive CHF patients NYHA class III-IV. Beta-blockers (BB) were used only in 81% subjects referred for CRTD, ACE inhibitors (ACEi) were used only in 68% patients, angiotensin receptor blockers (ARB) were used in 18% subjects. ACEi or ARB were used in 81%, spironolacton was use in 59%. Recommended target DD for BB (carvedilol 25 mg bid) was used only in 13% subjects, recommended target DD for ACEi (enalapril 10 mg bid) was used only in 9,4 % pts. In the Dept. of Cardiology, the optimal medical therapy was changed after CRTD, BB were used in 95% subjects at discharge (p< 0,01) and the number of pts reaching at least of 50% of recommended daily dose (DD) of BB inreased (p < 0,05). ACEi were recommended after CRTD in 80% subjects after implantation (p< 0,05), the number of pts reaching at lest of 50% of recommended DD for ACEIs increased too (p < 0,05). There was no significant difference in ARB use recomended in the hospital (19% after CRTD - NS). ACEi or ARB were used in 98% patients after the device implanted (p<0,05) and spironolacton in 77% after CRTD (p<0,05). Despite optimal composition of the medical heart failure therapy only small number of CRTD candidates are reaching recommended drug dose. The optimization of the pharmacotherapy in the specialized center lead to significantly higher proportion of CHF using recommended medical treatment with the increased dose of BB and ACEI."@en .