Jure Dolenc

Pulmonary hypertension in patients with advanced heart failure is associated with increased levels of interleukin-6.

Abstract Context: Inflammatory, endothelial and neurohormonal biomarkers are involved in heart failure (HF) and pulmonary hypertension (PH) pathogenesis. Objective: To study these biomarkers in PH due to advanced HF. Materials and methods: Thirty adults with HF were included. Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hsCRP), endothelin-1 and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) were measured in peripheral vein and pulmonary artery during right heart catheterisation. Results: IL-6, TNF-α, hsCRP and NT-proBNP correlated with pulmonary pressures independent of ventricular function, HF etiology and vascular bed. IL-6 was independent predictor of systolic pulmonary artery pressure (sPAP). Discussion and conclusion: Inflammatory biomarkers correlate to PH severity. IL-6 predicts sPAP in advanced HF.

Sixteen Years of Systematic Management of Adult Congenital Heart Disease – The experience of the University Medical Centre Ljubljana, Slovenia

Prirođena srčana bolest (PSB) najčešća je prirođena anomalija i pojavljuje se u oko 0,8 % novorođenčadi. Veliki napredak u pedijatrijskoj kardijalnoj kirurgiji i intervencijskoj kardiologiji, postignut u nekoliko posljednjih desetljeća rezultirao je povećanjem broja bolesnika s PSB-om koji prežive do odrasle dobi. Zbog toga smo suočeni s novom populacijom odraslih koji žive s PSB-om. Unatoč tomu, dosta je vremena i napora utrošeno dok prirođena srčana bolest odraslih (PSBO) nije prepoznata kao novo područje kardiologije.

The commonest mistakes in the treatment of adult patients with congenital heart disease

Background: General practitioners and medical specialists are seeing adults with congenital heart disease in their everyday practice more frequently than ever. The lack of experience and knowledge in this field of cardiology often leads to mistakes in the treatment of these patients. The purpose of this article is to point out the commonest problems and mistakes in dealing with this group of patients. Conclusions: In the following article we pointed out the commonest problems and mistakes in dealing with adults with congenital heart disease, such as differing various types of atrial septal defects and differing atrial septal defect from patent foramen ovale. We also pointed out the commonest mistakes in dealing with patients with cyanotic heart disease, especially those with Eisenmenger syndrome.

Non-compaction cardiomyopathy - an unusual cause of heart failure.

Introduction: Non-compaction cardiomyopathy is a rare inborn anomaly caused by disorder of endomyocardial morphogenesis. The diagnosis is based on echocardiographic criteria. The prevalence in the adult population is not known. The symptoms are atypical. Three main groups of clinical signs exist: heart failure, thromobembolic events and arrhythmias. In the group of patients with reduced left ventricular function the prognosis is poor and the treatment options are limited. Patients and methods: In the recent 10 years, 7 patients with non-compaction cardiomyopathy were diagnosed at the Department of Cardiology of the University Medical Centre Ljubljana. Results: All seven patients were males, their mean age at the last follow-up being 39 ± 20.3 years (range 20 to 70 years). Five patients were diagnosed in adulthood. All of them fulfilled the echocardiographic diagnostic criteria of noncompaction cardiomyopathy. Five patients had depressed function of both ventricles, two patients had isolated left ventricular dysfunction. Three patients had decreased left ventricular ejection fraction, six patients showed left ventricular diastolic dysfunction. Only three patients had normal physical capacity. Two patients presented with clinical signs of overt heart failure. During follow-up, one patient died from heart failure. We observed thromboembolic events in one patient. Three patients suffered from nonsustained ventricular tachycardias and two patients had rhythm conduction abnormalities. Conclusions: Non-compaction cardiomyopathy is a rare disorder. We observed all common complications in our group of patients. The majority of patients displayed dysfunction of the affected ventricle and the dysfunction was more pronounced in older patients. Treatment of complications is an important factor in long-term survival of these patients.

Ebstein's anomaly and a rare coagulation disorder - case report and review of literature.

Backgrounds: Ebstein’s anomaly of tricuspid valve is a rare congenital heart anomaly. Surgical implantation of artefi cial tricuspid valve is a standard treatment modality. Common late complication of such surgical procedure is artefi cial valve thrombosis. Th is is a life threatening condition, which demands surgical intervention promptly. Conclusions: In following article, we describe a case of a patient with Ebstein’s anomaly and late artefi cial tricuspid valve thrombosis. Th e case was complicated with a mild form of haemophilia C, a rare coagulation disorder. Genetic analysis was also performed.