Heart Failure Division

Doc.MUDr. Vojtěch Melenovský, CSc.

Deputy director of the Research Department, senior consultant of the Heart Failure Division

Phone: 23 605 5190, 23 605 5100
E-mail: vojtech.melenovsky@ikem.cz srdecni.selhani@ikem.cz

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Received medical training and graduated with summa cum laude at 1st Faculty of Medicine, Charles University, Prague in 1994.
After graduation he worked as junior physician at 3rd Internal Department of General University Hospital of 1st Faculty of Medicine in Prague, initially in the field of metabolism, but later he converted to cardiology. In 2001 he received board certification in cardiology and PhD degree equivalent, with thesis about endothelial dysfunction and risk factors and atherosclerosis. Later became involved in clinical research (with Dr. D. Wichterle) in pathophysiology of cardiovascular regulations in hypertension and heart failure.

In 2002-2005 he spent 3 years as post-doc fellow in the labs of David Kass, Johns Hopkins Hospital and of Edward D. Lakatta, NIA-NIH in Baltimore, MD, USA.

Since 2005 he works in the Institute of Clinical end Experimental Medicine- IKEM as Research deputy director of Cardiology department.

In 2012-2013 he was Fulbright visiting professor at Mayo Clinic working with Dr. Barry A. Borlaug.

In 2013 he was appointed as Associated professor at 1st Faculty of Medicine, Charles University in Prague.

In 2022 was appointed as full professor of internal medicine at 1st Faculty of Medicine, Charles University in Prague.

Since 2013 he is medical director of heart failure service at IKEM.

Besides his clinical duties, he leads interdisciplinary research program focused on hemodynamic and metabolic aspects of heart failure pathophysiology, collaborating with Czech Academy of Sciences, Charles University, BIOCEV, Harvard University and Mayo Clinic. This research is funded by Czech Science foundation (GACR) and Agency for Health research (AZV). He is active member of Heart Failure Association of ESC, Czech Cardiology society, American heart Association and ISHLT.

Dr. Melenovsky published 166 peer-reviewed research papers that were cited >20 000x, h-index: 48 (WOS).
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Currently, the IKEM Cardiology Centre utilises almost all therapeutic approaches available in the world in the treatment of chronic heart failure, including the heart transplantation programme. This programme is developed on a level comparable with leading transplantation centres in the world. Patients with chronic heart failure are examined in the outpatient setting and further steps are determined upon evaluation of their condition. Some patients benefit from implantation of a special cardiostimulation system able to stimulate both ventricles and synchronise their function (biventricular stimulator); other patients need to be protected against life-threatening arrhythmias by implantation of a device that can recognise any serious rhythm disorder and cancel it by a discharge (automatic implantable defibrillator). These devices are implanted in patients during hospitalisation. Detailed assessments needed to decide on surgical therapy are another reason for hospitalisation. In some cases, we consider surgical reconstruction of coronary arteries (aortocoronary bypass), replacement of impaired cardiac valves or surgical treatment of the left ventricle. However, most patients are treated using medications and are monitored in the outpatient setting.

Since 1984, the IKEM Cardiology Centre has performed more than 1,000 heart transplantations in patients with highly advanced heart failure.

The care of these patients has its specific features. The donated heart induces an immune response in the recipient organism, causing rejection of the transplanted organ. Therefore after the transplantation, every patient must use a combination of drugs for the rest of their life to prevent rejection of the transplanted organ – immunosuppressants. This immunosuppressive therapy must be managed by doctors – specialists with rich clinical experience. Rejection episodes of the transplanted heart – acute rejections – sometimes also occur with immunosuppressive therapy, especially early after the transplantation. In order to detect these conditions as soon as possible before they are manifested by a cardiac function disorder and in order to provide timely treatment, endomyocardial biopsy is done in patients after heart transplantation in regular intervals. This procedure is done at the catheterisation theatre and consists in the collection of very small samples of the heart muscle using a small pincer – the bioptome. The samples of the heart are examined on the same day and further therapy is adjusted according to the result.

In the first year from heart transplantation, most follow-up visits associated with endomyocardial biopsy are done during hospitalisation. Between control hospitalisations, patients undergo outpatient cardiology assessments. After the first year from transplantation the patients are monitored in the outpatient setting.

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