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Cardiorenal syndrome and detection of early changes in kidney and myocardial function including determination of risk factors in asymptomatic patients with arterial hypertension
Svěcený, Jakub ; Charvát, Jiří (advisor) ; Teplan, Vladimír (referee) ; Jakabčin, Jozef (referee)
Cardiorenal syndrome and detection of early changes in kidney and myocardial function including determination of risk factors in asymptomatic patients with arterial hypertension The presented thesis aimed at determining the possibility to identify changes related to cardiorenal syndrome development in patients with satisfactorily compensated arterial hypertension. In the group of 96 patients within the period of 2 years we repeatedly examined 24-hour blood pressure monitoring, ultrasound imaging (echocardiography, renal resistive index), a set of laboratory analyses of cardiac and renal functions, and analyzed the relations between the blood pressure values and the monitored cardiac and renal parameters. In the preliminary examination we discovered an association between the 24-hour diastolic pressure and glomerular filtration. The main finding based on the follow-up monitoring was the rise of the renal resistive index and its significant correlation with the ratio of diastolic to systolic pressures without any relation to changes in anti-hypertension medication. By contrast, we did not identify any significant changes when evaluating the cardiac parameters. The results of the research emphasize the importance of monitoring not just systolic, but also diastolic blood pressure, to recognize a...
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Pathophysiology and clinical implications of late coronary thrombosis after implantation of drug eluting stents in patients with manifest atherosclerosis
Jakabčin, Jozef ; Červinka, Pavel (advisor) ; Poledne, Rudolf (referee) ; Mates, Martin (referee)
Pathophysiology and clinical implications of late coronary thrombosis after implantation of drug eluting stents in patients with manifest atherosclerosis Abstract Drug-eluting stents (DES) have markedly reduced restenosis rates compared with bare metal stents (BMS) in controlled randomized trials. Concerns have been raised about a possibly increased incidence of stent thrombosis (ST) after discontinuation of dual antiplatelet treatment compared with BMS. While a restenosis is relatively benign process, this serious complication is an issue because mortality of such event is reaching almost 50%. Among well recognized predictors of late stent thrombosis (delayed endothelisation, renal failure, bifurcation lesions, diabetes, premature antiplatelet therapy discontinuation, slow thrombus disappearance), the stent under expansion and stent deployment technique are also considered to be a contributor for development of late stent thrombosis. There was a paucity of data regarding the IVUS guidance during DES implantation. The aim of this study was to assess the role of IVUS guidance during implantation of DES on longterm outcome in patients with high clinical and angiographic risk profile. Methods: Between January 2004 and December 2005, 2110 patients underwent percutaneous coronary intervention, including 276...
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Pathophysiology and clinical implications of late coronary thrombosis after implantation of drug eluting stents in patients with manifest atherosclerosis
Jakabčin, Jozef ; Červinka, Pavel (advisor) ; Poledne, Rudolf (referee) ; Mates, Martin (referee)
Pathophysiology and clinical implications of late coronary thrombosis after implantation of drug eluting stents in patients with manifest atherosclerosis Abstract Drug-eluting stents (DES) have markedly reduced restenosis rates compared with bare metal stents (BMS) in controlled randomized trials. Concerns have been raised about a possibly increased incidence of stent thrombosis (ST) after discontinuation of dual antiplatelet treatment compared with BMS. While a restenosis is relatively benign process, this serious complication is an issue because mortality of such event is reaching almost 50%. Among well recognized predictors of late stent thrombosis (delayed endothelisation, renal failure, bifurcation lesions, diabetes, premature antiplatelet therapy discontinuation, slow thrombus disappearance), the stent under expansion and stent deployment technique are also considered to be a contributor for development of late stent thrombosis. There was a paucity of data regarding the IVUS guidance during DES implantation. The aim of this study was to assess the role of IVUS guidance during implantation of DES on longterm outcome in patients with high clinical and angiographic risk profile. Methods: Between January 2004 and December 2005, 2110 patients underwent percutaneous coronary intervention, including 276...
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