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Myocardial Injury in Stress Echocardiography: Comparison of Dobutamine, Dipyridamole and Dynamic Stress
Mědílek, Karel ; Šťásek, Josef (advisor) ; Paleček, Tomáš (referee) ; Kala, Petr (referee)
Objectives: Stress echocardiography plays important role in investigation of the patients with chest pain. Dipyridamole is reported to be safer than dobutamine stressor, dynamic stress is recommended as the first choice method. We investigated whether commonly used stressors are causing myocardial injury, measured by serum hsTnT. Methods: 135 patients (DSE n=46, ExsE n=46, DIP n=43) with negative SE were studied. Exclusion criteria included known ischaemic heart disease, baseline regional wall motion abnormalities or left ventricle systolic dysfunction (EF≤50%), more than mild left ventricle hypertrophy (septum/posterior wall ≥13 mm), diabetes, pre-diabetes (fasting glycemia >5.6 mmol/L), baseline hsTnT level ≥14 ng/L, baseline blood pressure ≥160/100mmHg, peak pulmonary pressure ≥45mmHg at baseline echocardiography, eGFR <1mL/s/1.73m2 and more than mild to moderate valvular disease. HsTnT was measured before and at 180 minutes after the test was terminated. Results: All patients had low pre-test probability of IHD. HsTnT increased in DSE, less so in ExSE, and was unchanged in DIP group [9.4 (1.5-58.6), 1.1 (-0.9-15.7), -0.1 (-1.4-2.1) ng/L respectively, p<0.001]. In DSE, hsTnT change was associated with peak dobutamine dose (r=0.30, p= 0.045), test length (r=0.43, p=0.003) and atropine use (p<0.001). In...
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Inflammatory Response after the Implantation of Bioresorbable Vascular Scaffolds vs. 2nd Generation Druh-eluting Stents
Novotný, Vojtěch ; Šťásek, Josef (advisor) ; Kala, Petr (referee) ; Kočka, Viktor (referee)
The concept of bioresorbable scaffolds (BVS) originated in the 90s of the 20th century, however, the first commercially available coronary BVS was Absorb BVS in 2011. The dissertation deals with aspects of working with this type of BVS and its use in real practice. We focused on examining the inflammatory response after implantation of Absorb BVS in comparison with the proven 2nd generation metallic drug eluting stent (DES). The introduction systematically discusses the topic of BVS from history, through the composition of BVS and implantation techniques to available literature data. The second topic discussed is the inflammatory response after coronary stent implantation, we provide an overview of available data from studies and the introduction of inflammatory markers, which were analyzed in the main study. The presented work includes three main studies. A Pilot study in which we evaluated the systemic inflammatory response to coronary artery trauma caused by percutaneous coronary intervention previously described in the literature. We verified that the selected laboratory-determined markers of systemic inflammation (hs-CRP, IL-6 and serum amyloid A) increase significantly 24/48 hours after PCI compared to basal. This pilot study was directly followed by the Randomized study, in which we randomly...
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The life quality of patients with the permanent cardiac stimulator
Kučerová, Michaela ; Votroubková, Michaela (advisor) ; Šťásek, Josef (referee) ; Wasyliwová, Vlasta (referee)
Key words: life quality, permanent cardiac stimulator, patient This bachelor thesis is aimed at the problems of the life quality of the patients with the cardiac stimulator. The theoretical part of this work deals with the pieces of knowledge about the people with implanted permanent cardiac stimulator and their life quality. In the first chapter there is the description of anatomy and the physiology of cardiovascular system. The next one deals with the problems of cardiostimulation. The third chapter is focused on nursing care before and after the implantation. Thereinafter the education of the patiences is described. The important chapter in the theoretical part is about the life quality. The last point mentioned is the introduction with the notion home monitoring. The practical research was done to discover if there was a life change after the implantation in the patients'lives. The anonymous nonstandard questionnaire was used for this research. A few questions were used from the questionnaire LHFQ (Living with heart failure questionnaire) . The research was done from December 2007 to March 2008 in the cardiology consulting room and in internal sick-bed ward of the hospital in Havlickuv Brod.
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Echocardiographic Criteria for Aortic Valve-sparing Procedures
Tuna, Martin ; Šťásek, Josef (advisor) ; Lonský, Vladimír (referee) ; Linhartová, Irena (referee)
Risk factors for failure of aortic valve-sparing procedures Introduction: Valve- sparing procedures restore correct function of the aortic valve without the usage of a valve replacement and thus eliminates the risks of its presence. Their disadvantage is the uncertainty of long-term correct function of the valve and the risk of recurrence of the defect. Aim: To evaluate medium to long-term outcomes of aortic valve-sparing procedures with focus on patient survival, reoperation and recurrence of aortic regurgitation. In the analysis of the results of operations identify the risk factors of failure of the aortic valve. To determine the effect of various surgical techniques used in aortic annuloplasty on the risk of aortic annulus re-dilation and the failure of aortic valve-sparing procedure in long-term follow-up. To evaluate the results of valve-sparing procedures in frequency of failure with recurrence of defect and frequency of reoperations between groups of patients with tricuspid and bikuspid aortic valve. Methods: From 11/2007 to 10/2017 was a total of 198 aortic valve sparing operations performed at our department. Patients' mean age was 48.4 ± 13.5 years. Of the total, 74 (37%) patients had tricuspid valve, 121 (61%) had bikuspid valve and 3 (2%) patients had unicuspid aortic valve. Dilatation...
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The life quality of patients with the permanent cardiac stimulator
Kučerová, Michaela ; Votroubková, Michaela (advisor) ; Šťásek, Josef (referee) ; Wasyliwová, Vlasta (referee)
Key words: life quality, permanent cardiac stimulator, patient This bachelor thesis is aimed at the problems of the life quality of the patients with the cardiac stimulator. The theoretical part of this work deals with the pieces of knowledge about the people with implanted permanent cardiac stimulator and their life quality. In the first chapter there is the description of anatomy and the physiology of cardiovascular system. The next one deals with the problems of cardiostimulation. The third chapter is focused on nursing care before and after the implantation. Thereinafter the education of the patiences is described. The important chapter in the theoretical part is about the life quality. The last point mentioned is the introduction with the notion home monitoring. The practical research was done to discover if there was a life change after the implantation in the patients'lives. The anonymous nonstandard questionnaire was used for this research. A few questions were used from the questionnaire LHFQ (Living with heart failure questionnaire) . The research was done from December 2007 to March 2008 in the cardiology consulting room and in internal sick-bed ward of the hospital in Havlickuv Brod.
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