National Repository of Grey Literature 21 records found  1 - 10nextend  jump to record: Search took 0.00 seconds. 
New aproaches to myocardial atrophy attenuation after mechanical unloading - Experimental study of heterotopic heart transplantation in rats
Pokorný, Martin ; Malý, Jiří (advisor) ; Ošťádal, Petr (referee) ; Rohn, Vilém (referee)
Cardiac atrophy, as a result of a long term mechanical unloading observed in patients treated with mechanical circulatory supports, represents a substantial obstacle in cardiac recovery. The first aim of this thesis was to evaluate the course of unloading-induced cardiac atrophy in healthy and failing heart. Mechanical unloading was studied in an experimental model of heterotopic heart transplantation in rats. Heart failure was experimentally induced by chronic volume overload achieved by creation of aorto-caval fistula. The second aim of this thesis was to discover if dietary induced increase in fatty acids concentration in heart tissue, specifically myristic, palmitic and palmitooleic, that are believed to promote physiological heart growth, could attenuate the course of cardiac atrophy. The third aim of this thesis was to examine if increased isovolumic loading obtained by intraventricular implantation of newly designed spring expander would attenuate the development of cardiac atrophy. The level of cardiac atrophy was evaluated as the weight loss of the heterotopically tranplanted heart compared to the control heart on days 7, 14, 21 and 28 after heterotopic transplantation. The cardiomyocyte width and the level of cardiac fibrosis was studied simultaneously. Mechanical unloading following heterotopic...
Cardiac Pacing Hemodynamics
Ulč, Ivan ; Vančura, Vlastimil (advisor) ; Mayer, Otto (referee) ; Ošťádal, Petr (referee)
(EN) Cardiac pacing is the only established treatment method of bradyarrhythmias. Most patients indicated for cardiac pacing need to have one lead implanted in the right ventricle. Activation sequence of the left ventricle during right ventricular pacing resembles the activation sequence in patients with left bundle branch block. When the proportion of paced cycles in the right ventricle reaches significant level, 10-20 % of patients develop pacing induced cardiomyopathy. Direct causal relationship with right ventricular pacing is supported by the improvement of subjective symptoms and objective parameters of the left ventricular function after the upgrade to cardiac resynchronization therapy (CRT). In patients with preexisting heart failure with reduced left ventricular ejection fraction, the best prevention of heart failure worsening is to implant CRT when antibradycardic indication to the right ventricular pacing occurs. In patients with normal or near normal left ventricular function, the situation is more problematic. CRT implantation in all patients with supposed high proportion of right ventricular paced cycles is not only more expensive, but also imposes higher demands on implanting centers and increases the occurrence of immediate as well as long-term complications which do not outweigh...
Possibilities of organ protection after global ischemia during cardiac arrest.
Mudrochová, Hana ; Ošťádal, Petr (advisor) ; Rokyta, Richard (referee) ; Malý, Jiří (referee)
Successful cardiopulmonary resuscitation is the first step to rescue life during cardiac arrest. High mortality even after successful restoration of spontaneous circulation is substantially caused by patophysiological process associated with ischemia-reperfusion injury and it is widely called post-cardiac arrest syndrome (PCAS). There are many patophysiological mechanisms involved in the development and progress of this syndrom; the key role seems to play oxidative stress, triggering the activation cascade of systemic inflammatory reaction. In our study we have tested different possibilities of influencing the post-cardiac arrest syndrom. In the first experimental study we have compared the effect of mild therapeutic hypothermia with controlled normothermia on PCAS in a porcine model of cardiac arrest. In the second study we have compared in the same model the protective effects of mild therapeutic hypothermia, administration of nitric oxide and ischemic postconditioning. Results of the first experiment have revealed that mild therapeutic hypotermia is superior in the resuscitability, maintenance of blood pressure, oxidative stress suppression and organ damage protection than controlled normothermia. In the second experiment we have shown that neither nitric oxide administration, nor ischemic...
Changes of the electric field of the heart in disorders of glucose metabolism and ways of influencing them by correction of impaired autonomic nervous regulation
Fialová, Elena ; Kittnar, Otomar (advisor) ; Danzig, Vilém (referee) ; Ošťádal, Petr (referee)
Diabetes mellitus (DM) is not just a simple metabolic disorder, however, it is considered to be a cardiovascular disease of a metabolic origin. This is apparent especially when speaking about type 2 diabetes (DM II). Patients with DM have a high occurrence of vegetative nervous system (VNS) disorders that manifest themselves as an increased activity of the sympathetic nervous system that correlates with peripheral autonomic neuropathy and is considered to be the major pathophysiological mechanism for the development of DM II. The objective of our study was to determine whether a comprehensive spa treatment (ST) may affect the level of the sympathetic tone of patients suffering from DM II. As an indicator of the sympathetic tone, selected electrocardiographic parameters derived from the HRV, microvolt T-wave alternans, and microvolt R-wave alternans were evaluated. The electrophysiological examination of patients was performed before and after a three-week spa treatment using the KARDiVAR system. The method is used to examine the current state of the autonomic nervous system and carry out an analysis of risk factors and adaptive capabilities of the organism. The results showed favorable changes in DM II patients after the ST, primarily in terms of reduced sympathetic adrenal system activity,...
Effect of pulsatility of blood flow on parametres of vascular damage in patients with mechanical circulatory support
Ivák, Peter ; Netuka, Ivan (advisor) ; Štádler, Petr (referee) ; Ošťádal, Petr (referee)
Ventricular assist devices are an important therapeutic modality in advanced surgical therapy of end-stage heart failure. Devices mainly used until recently generate primarily non- pulsatile blood flow. Despite indisputable clinical success of this therapy, we encounter complications specific to the devices with continuous flow. Complications are mostly attributed to increased shear stress and changes in blood vessels, blood elements and endothelium. The aim of this study was to determine the effect of continuous blood flow on the vasculature and blood elements by longitudinal monitoring of selected biomarkers of vascular health. During the study we monitored circulating microparticles, endothelial progenitor cells and stem cells and examined degradation dynamics of von Willebrand factor and its function. Results obtained in our study confirm the hypothesis of changes in the dynamics of studied markers dependent on the change of characteristics of blood flow. The possible negative effect of continuous flow on monitored parameters was observed in tracked period. In degradation of the high molecular weight von Willebrand factor multimers the probable positive effect of arteficial pulsatility was observed. Further research can provide important data for the development of specific characteristics...
Mild therapeutical hypothermia and oxidative stress after cardiac arrest
Krüger, Andreas ; Ošťádal, Petr (advisor) ; Vízek, Martin (referee) ; Rokyta, Richard (referee)
Successfull cardiopulmonary resuscitation is an essential life-saving tool; nevertheless, general ischemia during cardiac arrest may trigger different pathways that could turn even into a fatal damage; this condition is called post-cardiac arrest syndrome. It has been repeatedly shown that oxidative stress (OS) plays one of the key roles in the development of ischemia-reperfusion injury. However, current evidence on the possible participation of OS in the pathogenesis of post-cardiac arrest syndrome is insufficient. We tested following hypotheses: (i) ischaemia-reperfusion injury after cardiac arrest is accompanied by OS and (ii) mild therapeutical hypothermia decreases OS cardiac arrest. In the experimental part of our work we studied the effects of hypothermia and normothermia on hemodynamic parameters, markers of organ damage and on the OS burden in porcine model of cardiac arrest. Furthermore, we compared the effects of hypothermia with ischaemic postconditioning and nitric oxide administration in the porcine model of extracorporeal cardiopulmonary resuscitation. We found protective effects of hypothermia on all major endpoints including OS in comparison with normothermia; moreover, hypothermia improved also selected variables compared to ischemic postconditioning and nitric oxide. In the...
Vasopresin and its analogues in treatment of cardiac arrest
Truhlář, Anatolij ; Černý, Vladimír (advisor) ; Kasal, Eduard (referee) ; Ošťádal, Petr (referee)
Vasopressin and its analogues in treatment of cardiac arrest Introduction: Recent guidelines for cardiopulmonary resuscitation (CPR) recommend use of drugs as an integral part of treatment. Vasoactive drugs have been used in resuscitation to increase myocardial and cerebral perfusion during chest compressions. Resuscitation research is trying to find alternative vasopressors to adrenaline, for which the long-term survival benefit has not been proven. Successful use of terlipressin in cardiac arrest (CA) was documented in small studies in children and some rare case reports. Terlipressin has never been tested in CA of cardiac aetiology in any clinical or experimental study. Objectives: We aimed to evaluate the role of catecholamines and non-adrenergic vasopressors, vasopressin and terlipressin, during CPR based on review of selected trials. Introduction of a standardized experimental porcine model of ventricular fibrillation (VF) was done for research of therapeutic interventions during CPR. We aimed to evaluate the effects of terlipressin with adrenaline on perfusion of vital organs during prolonged CPR compared to placebo with adrenaline. We tested our hypothesis that terlipressin, if given simultaneously with the first dose of epinephrine during CPR for VF, increases CorPP (coronary perfusion pressure) or...
The importance of genetic testing in prevention of bleeding complications of invasive procedures in cardiology
Sionová, Magdalena ; Moťovská, Zuzana (advisor) ; Ošťádal, Petr (referee) ; Pudil, Radek (referee)
Background: Periprocedural bleeding is the most common complication related to coronary angiography (CAG) and percutaneous coronary intervention (PCI) and it is associated with worse short-term and long-term prognosis. Determining risk factors and genetic variations associated with increased bleeding risk may improve use of avoidance bleeding strategies in prevention of bleeding. Aim: The aim of our study was to a) identify independent risk factors (of the baseline characteristics, clinical, laboratory a procedural data) associated with a higher risk of periprocedural bleeding b) to validate predictive value of CRUSADE and NCDR bleeding risk stratification algorithms c) to analyze the association between the presence of selected single nucleotide polymorphisms of key platelet proteins (GPIa, GPVI, P2Y12, COX-1) and the risk of periprocedural bleeding. Methods: The study included 73 patients with acute or chronic ischemic heart disease who developed bleeding complication within 30 days after invasive procedure (CAG/PCI). The control group consisted of 331 patients without bleeding. Baseline characteristics, clinical state at admission, laboratory data (creatinine, blood count, INR) and procedural data were evaluated. The CRUSADE and NCDR algorithms for bleeding risk were retrospectively applied on both...
Comparison of metabolic parameters, hormonal level changes and cardiovascular risk in patients with gestational diabetes with healthy pregnant controls using ECG mapping method and other noninvasive cardiologic methodics
Žákovičová, Eva ; Charvát, František (advisor) ; Ošťádal, Petr (referee) ; Rušavý, Zdeněk (referee)
History of GDM not only increases the risk of developing type 2 diabetes mellitus, but also the risk of cardiovascular disease that is independent of type 2 DM. Hyperglycemia leads to significant electrophysiological, functional and structural changes in the cardiovascular system and they are interrelated. One of our main goals was to evaluate metabolic and hormonal changes and detect changes in the cardiovascular system and assess their mutual relations in condition of optimal metabolic control using a predetermined treatment algorithm. Echocardiography findings in our group of patients with GDM confirm the presence of incipient structural changes in left ventricular (significantly thicker IVS, PWD and RWT) compared to the control group. The original finding is that, under optimal compensation of diabetes any of monitored parameters of left ventricular diastolic function have not been changed. Furthermore, we found that complex metabolic care with optimal values of blood sugar together with weight gain monitoring in women with GDM leads to improvement of the 24-hour blood pressure profile without increased prevalence of non-dipper women and that nocturnal decline in BP depends on fasting plasma glucose. ECG body surface mapping did not show statistically significant changes in depolarization and...
Platelet reactivity during antiplatelet therapy
Paulů, Petra ; Osmančík, Pavel (advisor) ; Dyr, Jan (referee) ; Ošťádal, Petr (referee)
INTRODUCTION: Dual antiplatelet therapy is the basis of the treatement of patients with coronary artery disease following PCI. It demonstrably reduces the risk of ischemic complications of these patients and thus the morbidity and mortality. Despite all the effort we can see the recurrence of ischemic complications and worsening the prognosis in considerable percentage of patients. Resistance to treatement and resistance to clopidogrel can be marked as reason of therapy failure. AIM: The aim of our study was to a) define the incidence of clopidogrel resistance in real practise b) specify the factors which are associated with clopidogrel resistance c) determine whether the platelet reactivity measured by VerifyNow can be influenced by clopidogrel dose titration d) define the factors which are associated with worse prognosis of patients treated with dual antiplatelet therapy METHODS: We enrolled consecutive patients after PCI who were indicated to dual antiplatelet therapy. The blood samples were drawn within 24 hours after PCI and standart biochemical, hematological and coagulation parametres were determined. Also the serology and genetic analysis and VerifyNow test to determine the platelet reactivity were done. The PRU cut off value 240 was specified as the borderline of ineffective answer to clopidogrel...

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