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Prevalence of Atrial Fibrillation as a Risk Factor in Patients after Circulatory Arrest for Ventricular Fibrillation
Šmíd, Jiří ; Vančura, Vlastimil (advisor) ; Mayer, Otto (referee) ; Skalická, Hana (referee)
Atrial fibrillation is the most common arrhythmia occurring in the adult population. Sudden cardiac death is one of the most common causes of cardiovascular death, accounting for up to 50% of all cardiovascular deaths. A number of trials have investigated the association between atrial fibrillation and other heart diseases, including sudden cardiac death. Atrial fibrillation is increasing in prevalence and incidence in the population and is associated with higher morbidity and mortality in patients. The pathophysiological mechanisms in atrial fibrillation are very complex and are linked to a number of other diseases. With these diseases they may share a common background and may interact together. A higher incidence of atrial fibrillation is described especially in patients with coronary artery disease, heart failure, and arterial hypertension. Increased mortality or higher incidence of ventricular arrhythmias, including ventricular fibrillation, has been described in studies in ICD carriers, but also in the general population, where atrial fibrillation has been shown to be an independent risk factor associated with up to a 3-fold increased risk of AF. This paper want to provide a comprehensive picture of the relationship between atrial fibrillation and sudden cardiac death. It provides information...
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Metabolic and Genetic Factors of Vascular Ageing
Gelžinský, Július ; Mayer, Otto (advisor) ; Petrák, Ondřej (referee) ; Wohlfahrt, Peter (referee)
Arterial system is a system of vessels distributing blood. Ageing of arterial system leads to two distinct pathologies: atherosclerosis and arteriosclerosis - stiffening of arterial wall. These pathologies can coexist and interfere; however, they differ in their pathogenesis, location, scope and consequences. Progressive loss of elastic properties of large arteries is natural part of vascular ageing. It is directly responsible for several age dependent consequences, such as increase of central systolic pressure or prevalence of isolated systolic hypertension in the elderly. Clinically, central arteries stiffness manifests as aortic pulse wave velocity, which can be quantified, among other methods, using applanation tonometry. There is abundant evidence that aortic pulse wave velocity represents an independent predictor of cardiovascular mortality and morbidity. The most important mechanism in arterial stiffening is repeated mechanical damage which leads to fractures, fragmentation and thinning of elastin. Stiffening of large arteries can be accelerated by several other mechanisms, e.g. deposition of several substances (calcium, advanced glycation end-products, etc.), metabolic turnover of key elements of vascular extracellular matrix (collagen and elastin) or individual genetic susceptibility. In...
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Secondary prevention practice and prognosis of patients after ischemic stroke
Vaněk, Jiří ; Mayer, Otto (advisor) ; Rokyta, Richard (referee) ; Vítovec, Jiří (referee)
SECONDARY PREVENTION PRACTICE AND PROGNOSIS OF PATIENTS AFTER ISCHEMIC STROKE JIŘÍ VANĚK, M.D. 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic ABSTRACT It is evident that cerebrovascular disease including ischemic stroke belongs to the most common cause of disability or death in the world population. Secondary prevention in poststroke patiens can lead to reduce risk of recurrence or extend lifetime like in coronary heart disease (CHD). The principles of secondary prevention are well implemented in population with CHD, but the situation in poststroke patients is quite different. The assesment of secondary prevention in poststroke patiens and a comparison with patient with CHD was selected for a goal of this study. The study population consisted of Czech patients examined in the framework of well-defined surveys in patients after their first ischemic stroke. Patients represented pooled Czech samples of the project EUROASPIRE Stroke Modul or Stroke Survey in 2007 and in 2013. Better results in acute care were detected. Admissions in stroke unit in 2013 were realized more often than 2007 and fibrinolisis was aplicated more frequently too. On the contrary, arterial hypertension wasn't controlled better than the general population of...
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The effect of silymarin, naringin and resveratrol on the liver damage induced by some xenobiotics
Kovaříková, Pavla ; Eybl, Vladislav (advisor) ; Anzenbacherová, Eva (referee) ; Mayer, Otto (referee)
The vast majority of exogenous substances is metabolized in the liver. In the course of the biotransformation, partly biologically non-active products, partly reactive species leading to cell structure injury and even to the liver failure are produced. Oxidative stress plays a significant role in the toxic- and drug-induced liver damage. Endogenous and exogenous antioxidants contribute to equilibrium between the production and the elimination of reactive oxygen species and thus prevent the oxidative stress. In acute experiments in rats we examined the ability of natural antioxidants silymarin, naringin and resveratrol and of synthetic chelator deferipron to protect against liver damage induced by paracetamol, thioacetamide and tamoxifen. The following parameters of oxidative stress were measured in the liver homogenates: level of lipid peroxidation (LP), concentration of reduced glutathione (GSH), activities of glutathione peroxidase (GPx) and of catalase (CAT); in some cases the iron liver content. The following markers of liver damage were measured in serum: alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamate dehydrogenase (GLDH). Concernig markers of oxidative status, silymarin exerted the most efficient antioxidant properties amelioratig the TAA- and TAM-induced lipid...
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Effects of selected natural substances on the antioxidant system of an organism
Hodková, Anna ; Eybl, Vladislav (advisor) ; Mayer, Otto (referee) ; Anzenbacherová, Eva (referee)
of study named: Effects of selected natural substances on the antioxidant system of an organism Developed: Mgr. Anna Hodková Department of Pharmacology and Toxikology, Faculty of Medicine in Pilsen, Charles University in Prague Pilsen 2016 The aim of this study was to compare the effects of selected natural substances on the antioxidant defense system under comparable conditions, focusing on influencing the activity of selenoenzymes thioredoxin reductase (TrxR-1) and glutathione peroxidase (GPx-1). Experiments were performed in rats (Wistar, male). Livers, and in some cases kidneys were collected in all experiments. Homogenates were created from the collected organs and subsequently the activity of TrxR-1 and GPx-1, glutathione reductase (GR), catalase (CAT) and superoxide dismutase (SOD), and reduced glutathione (GSH) and lipid peroxidation (LP) levels were determined. We demonstrated significant effects of selected natural substances on the redox system, including influences of selenoenzymes thioredoxin reductase and glutathione peroxidase. The biggest influence on the activity of selenoenzymes thioredoxin reductase and glutathione peroxidase had hydroxytyrosol (HT) and oleuropein (OLEU). In rat liver tissue there was a significant decrease of the activity of both above mentioned enzymes after...
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Inflammatory and Fibrotic Myocardial Involvement
Šedivý, Jakub ; Hromádka, Milan (advisor) ; Mayer, Otto (referee) ; Pařenica, Jiří (referee)
1 Inflammatory and fibrotic myocardial involvement MUDr. Jakub Šedivý, Kardiologické oddělení FN Plzeň Introduction: The aim of my work was to evaluate the comprehensive approach to diagnosis and eventually monitoring the trend in two cardiac diseases of non-ischemic etiology. The first part is focused on evaluation of the inflammatory changes in patients with "infarct-like" myocarditis based on magnetic resonance (MRI) and laboratory tests. We also considered the possibility of restricting the length of physical activity restriction by bicycle ergometry. The second topic was the comprehensive assessment of cardiac risk in patients with systemic sclerosis, including the assessment of possible MR and new laboratory markers of myocardial fibrosis. Materials and methods: In the first part, we included prospectively 30 patients with "infarct- like" myocarditis and with a positive finding of late gadolinium enhancement (LGE) on MRI. Follow up MRI, echocardiography and stress ECG were performed at 1 and 6 month intervals. In the study focused on systemic sclerosis, a total of 33 long-term patients were prospectively enrolled. The study included a comparison of a group of 20 healthy volunteers. Results: In 47% of patients with infarct-like myocarditis, we found a left ventricular dyskinesia, but only 17% of...
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Therapeutic drug monitoring in clinical practice and research
Ďuricová, Jana ; Grundmann, Milan (advisor) ; Mayer, Otto (referee) ; Vítovec, Jiří (referee)
Introduction: The human cytochrome P450 2D6 (CYP2D6) is involved in the oxidative metabolism of about 25 % of all commonly prescribed drugs. It is characterized by high range of interindividual variability due to both environmental and genetic factors. The ability to measure the activity of CYP2D6 enzyme is of high significance. Genotyping alone is not sufficient to accurately predict an individual's actual CYP2D6 activity, phenotyping on the other hand can determine the exact enzymatic activity as it also reflects non-genetic factors. Beta-blocker agent metoprolol undergoes extensive pre-systemic elimination, with enzyme CYP2D6 accounting for about 70 to 80 % of its metabolism. Metoprolol also serves as one of the probe drugs of CYP2D6. The metabolic ratio of metoprolol over its metabolite -hydroxymetoprolol in plasma 3 hours after metoprolol administration is used for the measurement of CYP2D6 enzyme activity. Aims: To compare CYP2D6 metabolic activity after first metoprolol dose and in steady state. Further to investigate the influence of CYP2D6 activity on metoprolol pharmacokinetics and pharmacodynamics in patients on metoprolol therapy. Methods: Thirteen adult hypertensive patients in whom an introduction of beta-blocker metoprolol was indicated were included for comparison of CYP2D6...
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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...
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Inflammatory and Fibrotic Myocardial Involvement
Šedivý, Jakub ; Hromádka, Milan (advisor) ; Mayer, Otto (referee) ; Pařenica, Jiří (referee)
1 Inflammatory and fibrotic myocardial involvement MUDr. Jakub Šedivý, Kardiologické oddělení FN Plzeň Introduction: The aim of my work was to evaluate the comprehensive approach to diagnosis and eventually monitoring the trend in two cardiac diseases of non-ischemic etiology. The first part is focused on evaluation of the inflammatory changes in patients with "infarct-like" myocarditis based on magnetic resonance (MRI) and laboratory tests. We also considered the possibility of restricting the length of physical activity restriction by bicycle ergometry. The second topic was the comprehensive assessment of cardiac risk in patients with systemic sclerosis, including the assessment of possible MR and new laboratory markers of myocardial fibrosis. Materials and methods: In the first part, we included prospectively 30 patients with "infarct- like" myocarditis and with a positive finding of late gadolinium enhancement (LGE) on MRI. Follow up MRI, echocardiography and stress ECG were performed at 1 and 6 month intervals. In the study focused on systemic sclerosis, a total of 33 long-term patients were prospectively enrolled. The study included a comparison of a group of 20 healthy volunteers. Results: In 47% of patients with infarct-like myocarditis, we found a left ventricular dyskinesia, but only 17% of...
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Secondary prevention practice and prognosis of patients after ischemic stroke
Vaněk, Jiří ; Mayer, Otto (advisor) ; Rokyta, Richard (referee) ; Vítovec, Jiří (referee)
SECONDARY PREVENTION PRACTICE AND PROGNOSIS OF PATIENTS AFTER ISCHEMIC STROKE JIŘÍ VANĚK, M.D. 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic ABSTRACT It is evident that cerebrovascular disease including ischemic stroke belongs to the most common cause of disability or death in the world population. Secondary prevention in poststroke patiens can lead to reduce risk of recurrence or extend lifetime like in coronary heart disease (CHD). The principles of secondary prevention are well implemented in population with CHD, but the situation in poststroke patients is quite different. The assesment of secondary prevention in poststroke patiens and a comparison with patient with CHD was selected for a goal of this study. The study population consisted of Czech patients examined in the framework of well-defined surveys in patients after their first ischemic stroke. Patients represented pooled Czech samples of the project EUROASPIRE Stroke Modul or Stroke Survey in 2007 and in 2013. Better results in acute care were detected. Admissions in stroke unit in 2013 were realized more often than 2007 and fibrinolisis was aplicated more frequently too. On the contrary, arterial hypertension wasn't controlled better than the general population of...
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