Josef Veselka

• Professor
• Chemnitz University of Technology

Aims: The first cases of alcohol septal ablation (ASA) for obstructive hypertrophic cardiomyopathy (HCM) were published two decades ago. Although the outcomes of single-centre and national ASA registries have been published, the long-term survival and clinical outcome of the procedure are still debated. Methods and results: We report long-term o...

Hypertrophic obstructive cardiomyopathy is an inherited myocardial disease defined by cardiac hypertrophy (wall thickness ≥15 mm) that is not explained by abnormal loading conditions, and left ventricular obstruction greater than or equal to 30 mm Hg. Typical symptoms include dyspnoea, chest pain, palpitations, and syncope. The diagnosis is usually...

Background: One of the major determinants of exercise intolerance and limiting symptoms among patients with obstructive hypertrophic cardiomyopathy (HCM) is an elevated intracardiac pressure resulting from left ventricular outflow tract obstruction. Aficamten is an oral selective cardiac myosin inhibitor that reduces left ventricular outflow tract...

Introduction: In patients with obstructive hypertrophic cardiomyopathy (oHCM), the SEQUOIA-HCM trial demonstrated that aficamten, a next-in-class cardiac myosin inhibitor, improved exercise capacity, heart failure symptoms and hemodynamics compared with placebo. Aficamten’s impact on overall quality-of-life (QoL) in oHCM has not been reported. Hypo...

Importance Impaired exercise capacity is a cardinal manifestation of obstructive hypertrophic cardiomyopathy (HCM). The Phase 3 Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Placebo in Adults With Symptomatic Obstructive HCM (SEQUOIA-HCM) is a pivotal study characterizing the treatment effect of aficamten, a next-in-class cardi...

BACKGROUND A primary goal in treating obstructive hypertrophic cardiomyopathy (oHCM) is to improve patients’ health status: their symptoms, function, and quality of life. The health status benefits of aficamten, a novel cardiac myosin inhibitor, have not been comprehensively described. OBJECTIVES This study sought to determine the effect of aficam...

Background Aficamten, a novel cardiac myosin inhibitor, reversibly reduces cardiac hypercontractility in obstructive hypertrophic cardiomyopathy. We present a prespecified analysis of the pharmacokinetics, pharmacodynamics, and safety of aficamten in SEQUOIA‐HCM (Safety, Efficacy, and Quantitative Understanding of Obstruction Impact of Aficamten in...

Hypertrophic cardiomyopathy is the most common genetic cardiac disease with vast genetic heterogeneity. First-degree relatives of patients with HCM are at 50% risk of inheriting the disease-causing mutation. Genetic testing is helpful in identifying the relatives harbouring the mutations. When genetic testing is not available, relatives need to be...

Background The genetic basis of hypertrophic cardiomyopathy (HCM) is complex, and the relationship between genotype status and clinical outcome is incompletely resolved. Methods and Results We assessed a large international HCM cohort to define in contemporary terms natural history and clinical consequences of genotype. Consecutive patients (n=146...

In the abstract of the article cited above, the clinical trial number for DISCHARGE (NCT02400229) was inadvertently omitted. The abstract has been revised to include the ClinicalTrials.gov identification. The editors apologize for the error. The online version of the article (https://doi.org/10.2337/dc23-0710) has been updated to correct the error.

Abstract When patients suspected of having coronary artery disease were stratified by body mass index category, no difference in clinical outcomes was observed between those who underwent initial management with CT and those who underwent invasive coronary angiography. Background Recent trials support the role of cardiac CT in the evaluation of...

Background The use of beta-blockers in hypertrophic obstructive cardiomyopathy (HOCM) patients after alcohol septal ablation (ASA) lacks data support. We aimed to evaluate the effect of metoprolol on exercise capacity, hemodynamic and laboratory parameters, and quality of life in HOCM patients after ASA. Methods This was a prospective randomized s...

Background Hypertrophic cardiomyopathy (HCM) patients with a pathogenic variant are presumed to have worse prognosis than patients without a pathogenic mutation. However, the genetic basis of hypertrophic cardiomyopathy (HCM) is complex, and relationship between genotype status and outcomes have not been completely resolved. Objective We assessed...

OBJECTIVE To compare cardiac computed tomography (CT) with invasive coronary angiography (ICA) as the initial strategy in patients with diabetes and stable chest pain. RESEARCH DESIGN AND METHODS This prespecified analysis of the multicenter DISCHARGE trial in 16 European countries was performed in patients with stable chest pain and intermediate...

Background We present an uncommon case of a patient with hypertrophic obstructive cardiomyopathy and idiopathic pulmonary fibrosis. The case demonstrates the importance of pre-transplant cardiology workup and the need of interdisciplinary approach in diagnosing the cause of dyspnoea. Case summary The 52-year-old male patient was diagnosed with idi...

Hypertrophic cardiomyopathy (HCM) is a genetic condition with multiple different genetic and clinical phenotypes. As awareness for HCM increases, it is important to also be familiar with potential treatment options for the disease. Treatment of HCM can be divided into two different categories, medical and interventional. Typically for obstructive f...

Introduction. Use of the mechanically expandable transcatheter aortic valve (MEV) has been recently linked to increased risks of valve dysfunction and cardiovascular mortality. The risk of developing conduction disturbance with the MEV valve is well-known, and the negative prognostic impact of permanent pacemaker implantation (PPI) after transcathe...

Background: The current ACC/AHA guidelines on hypertrophic cardiomyopathy (HCM) caution that alcohol septal ablation (ASA) might be less effective in patients with left ventricular outflow tract obstruction (LVOTO) ≥100 mmHg. Methods: We used a multinational registry to evaluate the outcome of ASA patients according to baseline LVOTO. Results:...

Introduction The role of eicosanoids, metabolites of arachidonic acid with cardio-renal activity, remains unclear in human heart failure (HF). Methods We enrolled 50 patients with HF to measure plasma 14,15-EET and 14,15-DHET levels using commercial ELISA kits and compared them with 25 age- and sex-matched controls. Results Both of the measured e...

Background Association of congestive heart failure (CHF) and chronic kidney disease (CKD) worsens the patient’s prognosis and results in poor survival rate. The aim of this study was to examine if addition of endothelin type A (ETA) receptor antagonist to the angiotensin-converting enzyme inhibitor (ACEi) will bring additional beneficial effects in...

Evaluation of the effects of endothelin type A (ETA) receptor blockade on the echocardiography, hemodynamic cardiac and renal parameters, and the course of high-output heart failure (HF) in rats with angiotensin II-dependent hypertension. Eight-week-old male Ren-2 transgenic rats (TGR) were used as a model of angiotensin II-dependent hypertension....

Objective: Evaluation of the effect of endothelin type A (ETA) receptor blockade on the course of volume-overload heart failure in rats with angiotensin II-dependent hypertension. Methods: Ren-2 renin transgenic rats (TGR) were used as a model of hypertension. Heart failure was induced by creating an aorto-caval fistula (ACF). Selective ETA rece...

Aim Sex affects the prognosis of many cardiovascular diseases. This study aimed to assess the predicted sudden cardiac death (SCD) risk and evaluate the actual survival between male and female patients with hypertrophic cardiomyopathy (HCM). Methods We included 573 HCM patients diagnosed between 1998 and 2021 in a tertiary cardiovascular centre. W...

This study aimed to derive a new score, the Alcohol Septal Ablation-Sudden Cardiac ARREst (ASA-SCARRE) risk score, that can be easily used to evaluate the risk of sudden cardiac arrest events (sudden cardiac death, resuscitation, or appropriate implantable cardioverter-defibrillator discharge) after alcohol septal ablation (ASA) in patients with hy...

Pulmonary embolism is a potentially lethal manifestation of venous thromboembolic disease. It is one of the three main causes of cardiovascular morbidity and mortality in developed countries. Over the years, better diagnostic and risk stratification measures were implemented. A generous range of new treatment options is becoming available, particul...

Background Atrioventricular block is a frequent major complication after alcohol septal ablation (ASA). Objectives The aim of this study was to evaluate the outcomes of patients with implanted permanent pacemaker (PPM) related to a high-grade atrioventricular block after ASA for hypertrophic obstructive cardiomyopathy. Methods We used a multinati...

Background and purpose: Carotid artery near-occlusion is a type of severe stenosis with complete or partial distal luminal collapse and intracranial collaterals. This study aimed to compare 30-day outcomes and 10-year survival in patients undergoing carotid artery stenting for near-occlusion with a control group of patients with severe stenosis....

Introduction: Long-term data on the Lotus® (Boston Scientific, USA) valve are lacking. Aim: To evaluate mid-term outcomes of aortic stenosis patients treated with either Lotus or Evolut R® valves (Medtronic, USA). Material and methods: Our study sample comprised 190 patients (71 Lotus and 119 Evolut valves). The mean clinical follow-up was 2.0...

Adverse remodelling following an initial insult is the hallmark of heart failure (HF) development and progression. It is manifested as changes in size, shape, and function of the myocardium. While cardiac remodelling may be compensatory in the short term, further neurohumoral activation and haemodynamic overload drive this deleterious process that...

Introduction: An association exists between low socio-economic status (SES) and increased cardiovascular and all-cause mortality worldwide. Aim: To evaluate the impact of educational level as a marker of socio-economic status (SES) on the clinical condition of patients before transcatheter aortic valve implantation (TAVI) and survival after TAVI...

Background: Long-term effect of carotid stenting (CAS) on the stabilization of the plaque is almost unrecognized. Vascular healing and remodeling might seal the atherosclerotic plaque with neointimal hyperplasia decreasing the vulnerability. We aimed to assess long-term change in the lipid signal, stent and luminal dimensions and restenosis after...

Cardiovascular medicine at its beginning was dominated by surgical treatment options. The trend of the last decades is heading towards catheterization procedures. Alcohol septal ablation (ASA) was published by Sigwart in 1995 [1] whereas transcatheter aortic valve implantation (TAVI) was performed in 2002 for the first time [2]. Both methods have b...

Introduction: New therapeutic strategies for congestive heart failure (CHF) are needed, and the current knowledge, including our previous studies, suggests that targeting the endothelin (ET) system could be a promising approach. Hypothesis: Chronic selective blockade of ET type A (ETA) receptors combined with angiotensin-converting enzyme inhibitor...

Hypertrophic cardiomyopathy (HCM) is a common inherited heart disease with an estimated prevalence of up to 1 in 200 individuals. In the majority of cases, HCM is considered a Mendelian disease, with mainly autosomal dominant inheritance. Most pathogenic variants are usually detected in genes for sarcomeric proteins. Nowadays, the genetic basis of...

This study evaluates the effects of chronic treatment with EET-A, an orally active epoxyeicosatrienoic acid (EETs) analog, on the course of aorto-caval fistula (ACF)-induced heart failure (HF) in Ren-2 transgenic rats (TGR), a model characterized by hypertension and augmented activity of the renin-angiotensin system (RAS). The results were compared...

The aim of the present study was to perform kidney messenger ribonucleic acid (mRNA) analysis in normotensive, Hannover Sprague–Dawley (HanSD) rats and hypertensive, Ren-2 renin transgenic rats (TGR) after doxorubicin-induced heart failure (HF) with specific focus on genes that are implicated in the pathophysiology of HF-associated cardiorenal synd...

Objectives This paper sought to evaluate the occurrence of decompression sickness (DCS) after the application of a patent foramen ovale (PFO) screening and risk stratification strategy. Background PFO is associated with an increased risk of DCS. Recently, transcatheter closure was reported to reduce DCS occurrence in divers with a high-grade shunt...

Aim: The authors analysed numbers of endovascular neurointerventional procedures in Czech Republic comprehensive neurovascular centres in the years from 2013 to 2020. Methods: The questionnaire was sent to all tertiary and two secondary neurovascular centres in Czech Republic. Numbers of each specified procedure were required. On basis of the 3 mos...

The COVID-19 pandemic has affected the whole world. It applies to all age and social groups. It is no different with athletes. So far, we cannot say for sure what the long-term consequences of SARS-CoV-2 infection are. Recent evidence, however, suggests that we should be very careful when returning to sports. After self-isolation, the athlete shoul...

We describe a case of an 80-year-old male patient with symptomatic severe aortic stenosis treated with transcatheter valve implantation (TAVI). The most common and preferred type of transcatheter valve delivery is through the femoral artery. However, if transfemoral access is not possible, an alternate route may be chosen. Such routes include, but...

Intravascular imaging, particularly optical coherence tomography, has brought significant improvement in diagnostic and therapeutical approaches to coronary artery disease and has offered superior high-resolution visualization of coronary arteries. The ability to obtain images of intramural and transmural coronary structures allows the study of the...

Background The aim of this study was to evaluate short- and long-term outcomes related to dose of alcohol administered during alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy (HOCM). Current guidelines recommend using 1–3 mL of alcohol administered in the target septal perforator artery, but this recommendation...

Doxorubicin’s (DOX) cardiotoxicity contributes to the development of chemotherapy-induced heart failure (HF) and new treatment strategies are in high demand. The aim of the present study was to characterize a DOX-induced model of HF in Ren-2 transgenic rats (TGR), those characterized by hypertension and hyperactivity of the renin-angiotensin-aldost...

Introduction: There is a need to implement a preclinical model in addition to the well established ischemic or volume-overload models that would mimic the clinical course of patients with chemotherapy-induced heart failure. Doxorubicin is an anthracycline chemotherapeutic that is widely used in oncology, although its cardiotoxicity. Hypothesis: Dox...

Background/Introduction Intravascular imaging is commonly used in coronary interventions and improves outcomes. On the contrary, it is almost unrecognized for the guidance of carotid stenting (CAS). Purpose The aim of this study was to compare quantitative angiography (QA) and intravascular ultrasound (IVUS) in the assessment of the severity of ca...

Background/Introduction Patent foramen ovale (PFO) is associated with increased risk of decompression sickness (DCS) due to paradoxical embolization of nitrogen bubbles that form during and after ascent. Screening for PFO using transcranial Doppler ultrasonography (TCD) is currently not recommended for all divers. If a diver is diagnosed with a hig...

Objectives: To test the accuracy of clinical pre-test probability (PTP) for prediction of obstructive coronary artery disease (CAD) in a pan-European setting. Methods: Patients with suspected CAD and stable chest pain who were clinically referred for invasive coronary angiography (ICA) or computed tomography (CT) were included by clinical sites...

Introduction There is lack of long-term data outside of controlled clinical trials in carotid artery stenting (CAS). In this study, we compared the short-term outcome, long-term survival, and rate of re-interventions for restenosis in patients after CAS, related to the extent of carotid atherosclerosis classified as single-vessel (unilateral) or do...

Hypertrofická kardiomyopatie (HKMP) je s předpokládanou prevalencí 1/500 až 1/200 obyvatel jedním z nejčastějších geneticky podmíněných srdečních onemocnění. Pro HKMP je charakteristická výrazná fenotypová i genotypová heterogenita. Pacienti s HKMP by měli být komplexně a mutidisciplinárně vyšetřeni, aby nebyly přehlédnuty některé syndromické formy...

Most atherosclerotic plaques (APs) form in typical predilection areas of low endothelial shear stress (ESS). On the contrary, previous data hinted that plaques rupture in their proximal parts where accelerated blood flow causes high ESS. It was postulated that high ESS plays an important role in the latter stages of AP formation and in its destabil...

Background According to European guidelines, alcohol septal ablation (ASA) for hypertrophic obstructive cardiomyopathy (HOCM) may be less effective in patients with extensive septal scarring on cardiac magnetic resonance (CMR). This study aimed to analyze the impact of late gadolinium enhancement (LGE) on CMR on the effectiveness of ASA. Method We...

An amendment to this paper has been published and can be accessed via the original article.

Background: Health-related quality of life (HRQoL) is impaired in patients with stable angina but patients often present with other forms of chest pain. The aim of this study was to compare the pre-diagnostic HRQoL in patients with suspected coronary artery disease (CAD) according to angina type, gender, and presence of obstructive CAD. Methods:...

Atrial fibrillation is the most common arrhythmia in the adult population, and its incidence and prevalence are still rising. Cardiac devices are widely used in clinical practice in the management of various rhythm disturbances and heart failure treatment. Many patients who receive a pacemaker, implantable cardioverter-defibrillator, or cardiac res...

Alcohol septal ablation (ASA) is an effective interventional therapeutic strategy to reduce or eliminate left ventricular outflow tract obstruction in patients with hypertrophic obstructive cardiomyopathy (HOCM). Although ASA was introduced 25 years ago, there are still no available guidelines to follow. Therefore, most interventional cardiologists...

We sought to analyse plasma levels of peripheral blood microRNAs (miRs) as biomarkers of ST-segment-elevation myocardial infarction (STEMI) due to type-1 myocardial infarction as a model situation of vulnerable plaque (VP) rupture. Samples of 20 patients with STEMI were compared both with a group of patients without angina pectoris in whom coronary...

Background The presence and extent of ventricular dyssynchrony are currently assessed from the QRS complex morphology and width. However, similar ECG pattern may be caused by variable ventricular activation sequence. This may then contribute to inter‐individually different response to cardiac resynchronization therapy (CRT). Methods Electroanatomi...

Background: The genetic background of patients with hypertrophic cardiomyopathy (HCM) treated with alcohol septal ablation (ASA) and its relationship to the outcomes are not known. We aimed to investigate whether the outcome of genotype positive (G+) patients differs from genotype negative (G−) patients treated with ASA. Methods: We included 129...

Transcatheter aortic valve implantation (TAVI) is a well-established management option for symptomatic patients with severe aortic stenosis. The minimally invasive transfemoral approach is considered to be superior to non-transfemoral accesses; however, its use is often limited by concomitant peripheral artery disease (PAD). Percutaneous translumin...

Background Dyssynchronous activation of the heart is a prerequisite for cardiac resynchronization (CRT) efficacy. Although the main goal of CRT is to resynchronize ventricular contraction, our abilities to quantify mechanical dyssynchrony are still limited. However, so called “internal stretch fraction” (ISF) might serve as a marker of global disco...

Background/Introduction Long-term effect of carotid stenting (CAS) on the stabilization of the plaque is not well described. The interaction among the late stent expansion, neointimal hyperplasia, and lipid core might explain stabilization of the plaque and low long-term incidence of stroke after CAS. Purpose To assess long-term change in the lipi...

Hypertrophic cardiomyopathy (HCM) is a frequent inherited heart disease with an estimated prevalence of up to 1 in 200 individuals. In the majority of cases, HCM is inherited as an autosomal dominant genetic trait with pathogenic variants detected in sarcomeric proteins. Nevertheless, the genetic basis of HCM is more complex. More than 2 000 mutati...

Hypertrophic cardiomyopathy (HCM) is a frequent inherited heart disease with an estimated prevalence of up to 1 in 200 individuals. In the majority of cases, HCM is inherited as an autosomal dominant genetic trait with pathogenic variants detected in sarcomeric proteins. Nevertheless, the genetic basis of HCM is more complex. More than 2 000 mutati...

The aim of this paper is to present application of BIM models for the complex quality assessment and environmental analysis based on LCA. An experimental two storey building of TiCo Project representing a full scale part of a real multi-storey residential building has been used for this case study. The presented BIM model contains all relevant envi...

Objective The current guidelines suggest alcohol septal ablation (ASA) is less effective in hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular hypertrophy, despite acknowledging that systematic data are lacking. Therefore, we analysed patients in the Euro-ASA registry to test this statement. Methods We compared th...

Conflicting results have been published considering the role of head-up tilt test (HUTT) positivity as a prognostic factor in patients with hypertrophic cardiomyopathy (HCM). The relationship between HCM patients' genotype and their HUTT results has not been previously reported. The aim of this study was to evaluate patients with HCM and their HUTT...

Aims: Based on European guidelines, alcohol septal ablation (ASA) for hypertrophic obstructive cardiomyopathy (HOCM) is indicated only in patients with interventricular septum (IVS) thickness >16 mm. The aim of this study was to evaluate the short- and long-term outcomes in ASA patients with mild hypertrophy (IVS ≤ 16 mm). Methods and results: W...

Background: Patent foramen ovale (PFO), male sex, age, and body mass index (BMI) were all identified as potential risk factors of decompression sickness (DCS). It has been debated whether PFO might cause unprovoked DCS (i.e. without violation of decompression procedure) due to paradoxical embolization of venous gas emboli. To date, there are no da...

Introduction: The outcome of patients ≥ 60 years of age after alcohol septal ablation (ASA) for obstructive hypertrophic cardiomyopathy (HCM) remains unresolved. We sought to determine the long-term survival and the causes of death in this population. Material and methods: We enrolled 156 consecutive patients (69 ±6 years, 69% women, follow-up:...

Sudden cardiac arrest (CA) is a common cause of death in industrialized countries. The incidence of out-of-hospital cardiac arrest (OHCA) is estimated at 350,000 to 700,000 patients in Europe every year. The survival rate of OHCA used to be very poor, but advances in cardiopulmonary resuscitation and post-cardiac arrest care including targeted temp...

Cardiac resynchronization therapy (CRT) has proven efficacious in the treatment of patients with heart failure and dyssynchronous activation. Currently, we select suitable CRT candidates based on the QRS complex duration (QRSd) and morphology with left bundle branch block being the optimal substrate for resynchronization. To improve CRT response ra...

In anticoagulated patients with mechanical valve prostheses, heparin is still the only possible alternative to warfarin that we choose in some specific situations. One such situation is pregnancy due to the known teratogenic effect of warfarin in a dose-dependent manner. During outpatient treatment with low molecular weight heparin, its efficacy sh...