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Some aspects of pathophysiology of pulmonary arterial hypertension and its epidemiology in the Czech Republic
Jansa, Pavel ; Aschermann, Michael (advisor) ; Widimský, Jiří (referee) ; Čerbák, Roman (referee)
1 Univerzita Karlova v Praze 1. lékařská fakulta Některé aspekty patofyziologie plicní arteriální hypertenze a její výskyt v České republice Some aspects of pathophysiology of pulmonary arterial hypertension and its epidemiology in the Czech Republic MUDr. Pavel Jansa Praha 2011 2 Abstract Pulmonary arterial hypertension (PAH) is a group of diseases characterized by a progressive increase of resistance and pressure in pulmonary vascular bed. In all types of PAH the same four pathological processes are reported: vasoconstriction, inflammation, thrombosis and remodelling. The genetic background is essential for the development of PAH. We aimed to investigate the role of polymorphisms of endothelial nitric oxide synthase (eNOS) genes in PAH. We studied 142 PAH patients and 189 healthy subjects. We examined 3 polymorphisms of the eNOS gene, including the Glu298Asp polymorphism, 27-base pair (bp) variable numbers of tandem repeats (VNTR) and -786 T/C promoter gene polymorphism. Prevalence of 27-bp VNTR allele A was higher in patients with PAH compared with healthy controls. Patients with PAH associated with connective tissue diseases had higher prevalence of AA genotype compared with other PAH subgroups. The Glu298Asp polymorphism and -786 T/C polymorphism are not associated with PAH. Thrombotic arteriopathy is...
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Relation between the reperfusion of pulmonary arteries after an acute pulmonary embolism to the development of chronic thromboembolic pulmonary hypertension.
Mrózek, Jan ; Jansa, Pavel (advisor) ; Maxová, Hana (referee) ; Hutyra, Martin (referee)
Relation between the reperfusion of pulmonary arteries after acute pulmonary embolism to the development of chronic thromboembolic pulmonary hypertension Incomplete resolution of thromboemboli following acute pulmonary embolism (PE) is a key factor in development of chronic thromboembolic pulmonary hypertension (CTEPH). In our study, we evaluated the incidence, risk factors and clinical impact of incomplete reperfusion after acute PE. Study population and methods: 85 patients after the first acute PE were assessed clinically and by pulmonary scintigraphy and echocardiography at month 6, 12 and 24 after an acute PE. Results: Incomplete reperfusion was detected in 23.5 % of patients after 6 months, in 24.9 % of patients after 12 months and in 18.6 % of patients after 24 months. At month 6, patients with incomplete reperfusion were more obese when compared with patients with normal reperfusion BMI 30.8 vs 28.3 kg/m2 ; p=0.012) and their initial hemoglobin levels were higher (143.0 vs 136.0 g/l; p=0.012). Similar results were observed at month 12 - patients with residual perfusion defects were more obese (BMI 31.1 vs 28.5; p=0.016) with higher initial hemoglobin levels (144.0 vs 136.0; p=0.007). Patients with incomplete reperfusion at month 24 were significantly older (67.7 vs 55.0 years; p=0.02), their...
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The relation between the measurement of dilation of the pulmonary trunk and the measurment of peripheral pulmonary-vascular reshaping for patiens with CTEPH.
Paynová, Karolina ; Jansa, Pavel (advisor) ; Herget, Jan (referee)
Chronic tromboembolic pulmonary hypertension (CTEPH) is believed to result from acute pulmonary embolism. It manifests itself in the growth of blood pressure in pulmonary circulation. This condition, if not treated, can lead to the failure of right heart. The treatment of CTEPH is the surgical pulmonary endarterectomy, which consists in enucleation of organized fibrotic thrombus with the part of the vascular arterial wall. The prerequisite for the successful surgery is the selection of suitable candidates, mostly the patients with the central location of disability and the absence of the peripheral vascular remodelation. The peripheral vascular remodelationis difficult to recognize by contemporary diagnostic methods. A recent study has shown that patients with hypertensive aneurysm of the pulmonary artery have the good life prognosis and the dilation of the pulmonary artery is the manifestation of the long lasting disease. Peripheral vascular remodelationof CTEPH is also typical for the long lasting disease. Therefore, the measurement of dilatation of the pulmonary artery in patients with CTEPH could correlate with the peripheral remodelation. In this thesis we have confirmed that patients with CTEPH with more severe dilation of pulmonary artery have longer anamnesis of problems, more severe...
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The relation between the measurement of dilation of the pulmonary trunk and the measurment of peripheral pulmonary-vascular reshaping for patiens with CTEPH.
Paynová, Karolina ; Jansa, Pavel (advisor) ; Lindner, Jaroslav (referee)
Přírodovědecká fakulta Univerzity Karlovy Katedra antropologie a genetiky člověka Bc. Karolina Paynová Vztah míry dilatace plicnice k míře periferní plicní cévní remodelace u pacientů s chronickou tromboembolickou plicní hypertenzí. The relation between the measurement of pulmonary artery dilation and the measurement of peripheral pulmonary vascular remodeling for patients with CTEPH. Abstrakt anglicky Abstract in english Abstract Chronic tromboembolic pulmonary hypertension (CTEPH) is believed to result from acute pulmonary embole. It manifests itself in the growth of blood pressure in pulmonary circulation. This condition, if not treated, can lead to the failure of right heart. The treatment of CTEPH is the surgical pulmonary endarterectomy, which consists in enucleation of organized fibrotic thrombus with the part of the vascular arterial wall. The prerequisite for the successful surgery is the selection of suitable candidates, mostly the patients with the central location of disability and the absence of the peripheral vascular remodelation. The peripheral vascular remodelation is difficult to recognize by contemporary diagnostic methods. A recent study has shown that patients with hypertensive aneurysm of the pulmonary artery have the good life prognosis and the dilation of the pulmonary artery is the...
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Some aspects of pathophysiology of pulmonary arterial hypertension and its epidemiology in the Czech Republic
Jansa, Pavel ; Aschermann, Michael (advisor) ; Widimský, Jiří (referee) ; Čerbák, Roman (referee)
1 Univerzita Karlova v Praze 1. lékařská fakulta Některé aspekty patofyziologie plicní arteriální hypertenze a její výskyt v České republice Some aspects of pathophysiology of pulmonary arterial hypertension and its epidemiology in the Czech Republic MUDr. Pavel Jansa Praha 2011 2 Abstract Pulmonary arterial hypertension (PAH) is a group of diseases characterized by a progressive increase of resistance and pressure in pulmonary vascular bed. In all types of PAH the same four pathological processes are reported: vasoconstriction, inflammation, thrombosis and remodelling. The genetic background is essential for the development of PAH. We aimed to investigate the role of polymorphisms of endothelial nitric oxide synthase (eNOS) genes in PAH. We studied 142 PAH patients and 189 healthy subjects. We examined 3 polymorphisms of the eNOS gene, including the Glu298Asp polymorphism, 27-base pair (bp) variable numbers of tandem repeats (VNTR) and -786 T/C promoter gene polymorphism. Prevalence of 27-bp VNTR allele A was higher in patients with PAH compared with healthy controls. Patients with PAH associated with connective tissue diseases had higher prevalence of AA genotype compared with other PAH subgroups. The Glu298Asp polymorphism and -786 T/C polymorphism are not associated with PAH. Thrombotic arteriopathy is...
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