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Novel echocardiographic and magnetic resonance methods in diagnostics of cardiac amyloidosis.
Fikrle, Michal ; Paleček, Tomáš (advisor) ; Hutyra, Martin (referee) ; Krejčí, Jan (referee)
Amyloidosis is a term used for a whole group of diseases caused by deposition of a substance called amyloid into different tissues. Amyloid may be produced by a range of pathologic processes. Heart affliction is typical for only several types of amyloidoses. Heart involvement is then the patient`s prognosis major limiting factor. Diagnosis of heart amyloidosis is difficult especially for nonspecific symptoms and nonspecific findings obtained during common diagnostic procedures. The aim of this thesis was to evaluate usefulness of novel diagnostic methods, namely cardiac magnetic resonance with gadolinium enhancement and a simplified echocardiographic evaluation of left ventricular longitudinal strain, in diagnosing amyloid cardiomyopathy. In our first study we examined 22 patients with light chain amyloidosis by echocardiography and also with cardiac magnetic resonance with late gadolinium enhancement. We compared morphologic and functional parameters acquired by magnetic resonance examination, which is considered a gold standard for morphologic and functional measurements, with values obtained by echocardiographic measurement. Afterwards we evaluated the presence and eventually pattern of late gadolinium enhancement during cardiac magnetic resonance exam. From acquired data we conclude that the...
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Using of non-invasive cardiac imaging for precise evaluation of atrium size and prediction of atrial wall fibrosis in patients with atrial fibrillation
Fingrová, Zdeňka ; Havránek, Štěpán (advisor) ; Kittnar, Otomar (referee) ; Skála, Tomáš (referee)
Atrial fibrillation is the most prevalent arrhythmia worldwide and remains one of the major causes of morbidity and mortality. Atrial fibrillation is an arrhythmia that has a various etiology and takes number of clinical forms. Due to the heterogenity of atrial fibrillation, it is necessary to individualize the optimal treatment strategy, ie conservative pharmacological therapy or interventional therapy as catheter ablation. Inncorrect indication of catheter ablation of atrial fibrillation leads to low success rate of the procedure and increases the risk of the procedure. The success rate of catheter ablation of atrial fibrillation depends on many clinical parameters, including the size and volume of the left atrium and the presence of pathological tissue in the atrial myocardium. In everyday practice, echocardiography (2D-echocardiography) is the most dominant method in estimation of the left atrial parameters, for it's simplicity, non- invasiveness, financial costs and the absence of ionizing radiation. Different methods for assesment of left atrial parameters are cardiac CT, cardiac magnetic resonance imaging and methods of 3-D echocardiography or 3-D angiography. The results of the present studies show that in patients with non-valvular atrial fibrillation who are indicated for catheter...
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Modern Markers of Organ Damage in Clinical Practice
Brož, Pavel ; Rajdl, Daniel (advisor) ; Topolčan, Ondřej (referee) ; Jabor, Antonín (referee)
Physical activity is a useful tool in the prevention of many diseases. Hospitalization after strenuous exercise from cardiac or noncardiac causes, even in young athletes without previous symptoms, can occur. These situations are not uncommon and e.g. after completing a half- marathon clinical symptoms suspicious from cardiac etiology can be present. Limitations of biomarkers used in daily clinical practice can lead to misinterpretation with additional consequences to the patient's outcome. Our goal was to describe changes of markers used in daily clinical practice after extreme physical activity and after exercise under laboratory conditions. We performed two studies in cooperation with Department of cardiology and Department of sports medicine. The goal of our first study was to examine high sensitivity troponin I (hsTnI), galectin-3, cystatin C, NGAL and ultrasensitive CRP (uCRP) after extremely long run during the competition in long distance running. The goal of our second study was to examine high- sensitivity troponin T (hsTnT) and hsTnI, creatinine and cystatin C, and urine albumin and NGAL after a standardized two-hour treadmill run under laboratory conditions and to find possible connection with echocardiographic, laboratory and other assessed parameters. The second goal of study under laboratory...
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Oxidative and carbonyl stress,microinflammation and cardiovascular risk in patiens with chronic kidney disease
Peiskerová, Martina ; Kalousová, Marta (advisor) ; Teplan, Vladimír (referee) ; Racek, Jaroslav (referee)
Short summary: Background: High cardiovascular risk in patients with chronic kidney disease is partly due to mineral dysbalance, microinflammation and oxidative stress. CKD patients accumulate traditional and non-traditional CV risk factors. FGF23, MMPs and PlGF belong among these non-traditional biomarkers of CV risk. FGF23 is a phosphaturic hormone and inhibitor of calcitriol synthesis. It is associated with vascular calcifications. Matrix-metalloproteinases (e.g. MMP-2, MMP-9) are proteolytic, proinflammatory enzymes, contributing to myocardial remodelation. Placental growth factor (PlGF) is a proangiogenic cytokine that is associated with LV hypertrophy in animal model. Plasmatic FGF23, MMPs and PlGF are elevated in CKD. Aim: We aimed to describe dynamic changes between several novel biomarkers of CV risk (FGF23, MMP-2, MMP-9 and PlGF) in CKD stages 1-5, to describe their mutual correlations and possible association with traditional CV risk markers. We studied possible association of laboratory and echocardiographic parameters in patients with CKD stages 2-4. Methods: In a cross-sectional study we evaluated 80 patiens with CKD 1-5 and 44 healthy controls. In a prospective study we evaluated echocardiographic and laboratory parameters in 62 patients with CKD 2-4 for an average study period of 36±10...
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Echocardiographic assessment of left ventricular systolic function in rats adapted to hypoxia and exercise training
Hrdlička, Jaroslav ; Papoušek, František (advisor) ; Vybíral, Stanislav (referee)
- 4 - Abstract Adaptation to hypoxia or exercise training has cardioprotective effects against acute ischemic injury, but can potentially negatively influence heart function. Possible negative changes depend on the degree of hypoxia and exercise training intensity. It is therefore necessary to evaluate the effects of the specific adaptation protocols used. The ideal technique is echocardiography, which enables non-invasive, repeated and long-term measurements of the same individual allowing to study the development of changes in the course of adaptation. The aim of this study was to determine the effects of selected protocols of adaptation to intermittent hypobaric hypoxia (corresponding to the altitude of 4,000 to 8,000 meters above sea level, for 15 weeks in total) and exercise training (running speed 30 m.min-1 for 60 min a day, 4 weeks in total) on the left ventricle geometry and systolic function in rats. We assessed basic echocardiographic parameters of the ventricle geometry and function such as fractional shortening, ejection fraction, stroke volume, cardiac output etc. The adaptation of rats to intermittent hypobaric hypoxia lead neither to the impairment of systolic function nor to the development of left ventricle hypertrophy compared to controls; signs of moderate hypertrophy were observed only...
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