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Role of echocardiography in the evaluation of functional and structural changes of the myocardium
Rob, Daniel ; Linhart, Aleš (advisor) ; Pudil, Radek (referee) ; Málek, Filip (referee)
Echocardiography plays a key role in the evaluation of functional and structural changes of the heart. Fabry disease (FD) is a genetic (X-linked) lysosomal storage disease caused by mutations in the gene for alpha-galactosidase A. Cardiovascular involvement is a major cause of morbidity and mortality in FD. The aim of our work was to refine the diagnosis and risk stratification of Fabry cardiac involvement using echocardiography. In the first part of our retrospective project, we analysed the relationship between the uric acid level, development, and progression of left ventricular (LV) hypertrophy and adverse events. Our results showed a strong relationship between uric acid level and progression of LV hypertrophy, mortality, and cardiovascular events. Uric acid can be used as a marker of cardiovascular risk in FD. In the second part of our retrospective project, we analysed the diagnostic value of tissue doppler imaging (TDI) of mitral annular velocities in Fabry cardiomyopathy. Despite the lower TDI mitral annular velocities in FD, the overlap with the general population is too large to allow reliable diagnosis of FD in routine clinical practice. In the prospective study, we analysed the prevalence, characteristics, prognosis and validity of the current echocardiographic criteria for heart...
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The role of apoptosis in patients with coronary artery disease
Teringová, Elena ; Toušek, Petr (advisor) ; Málek, Filip (referee) ; Pařenica, Jiří (referee)
in English language Background: Apoptosis plays an important role in the myocardial injury after acute myocardial infarction and in the subsequent development of heart failure. Aim: To clarify serum kinetics of apoptotic markers TRAIL and sFas and their relation to left ventricular ejection fraction (LVEF) in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods: In 101 patients with STEMI treated with pPCI, levels of TRAIL and sFas were measured in series of serum samples obtained during hospitalization and one month after STEMI. LVEF was assessed at admission and at one-month. Major adverse cardiovascular events (MACE - i.e. death, re-MI, hospitalisation for heart failure and stroke) were analysed during a two-year follow-up. Results: Serum level of TRAIL significantly decreased one day after pPCI (50.5pg/mL) compared to admission (56.7pg/mL), subsequently increased on day 2 after pPCI (58.8pg/mL) and reached its highest level at one month (70.3pg/mL). TRAIL levels on day 1 and 2 showed a significant inverse correlation with troponin and a significant positive correlation with LVEF at baseline. Moreover, TRAIL correlated significantly with LVEF one month after STEMI (day 1: r=0.402, p<0.001, day 2: r=0.542, p<0.001). On...
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New biomarkers for prognostication after cardiac arrest
Vondráková, Dagmar ; Málek, Filip (advisor) ; Vízek, Martin (referee) ; Rokyta, Richard (referee)
Cardiac arrest is an extremely serious condition characterized by global ischemia followed by reperfusion after successful resuscitation and restoration of spontaneous circulation. Despite all advances in current medicine, the prognosis of cardiac arrest survivors remains very poor. One of the major problems in these patients is, therefore, the early and reliable determination of the prognosis that is necessary for choosing the most appropriate diagnostic and therapeutic approach. However, the current possibilities for early prognostication in cardiac arrest survivors remain very limited. The aims of our work were: (i) to study the possibilities of influencing oxidative stress as one of the key pathogenic factors involved in the development of so-called post-cardiac arrest syndrome; and (ii) to determine the prognostic value of copeptin, neuron-specific enolase (NSE) and markers of oxidative stress in cardiac arrest survivors. In the experimental part of the work we used porcine model of cardiac arrest for the comparison of the effects of hypothermia, ischemic postconditioning (IPC) and administration of nitric oxide (NO) on oxidative stress burden and organ damage; we found that neither NO nor IPC did have a superior protective effect over hypothermia. In the clinical part we have in several...
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The role of apoptosis in patients with coronary artery disease
Teringová, Elena ; Toušek, Petr (advisor) ; Málek, Filip (referee) ; Pařenica, Jiří (referee)
in English language Background: Apoptosis plays an important role in the myocardial injury after acute myocardial infarction and in the subsequent development of heart failure. Aim: To clarify serum kinetics of apoptotic markers TRAIL and sFas and their relation to left ventricular ejection fraction (LVEF) in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods: In 101 patients with STEMI treated with pPCI, levels of TRAIL and sFas were measured in series of serum samples obtained during hospitalization and one month after STEMI. LVEF was assessed at admission and at one-month. Major adverse cardiovascular events (MACE - i.e. death, re-MI, hospitalisation for heart failure and stroke) were analysed during a two-year follow-up. Results: Serum level of TRAIL significantly decreased one day after pPCI (50.5pg/mL) compared to admission (56.7pg/mL), subsequently increased on day 2 after pPCI (58.8pg/mL) and reached its highest level at one month (70.3pg/mL). TRAIL levels on day 1 and 2 showed a significant inverse correlation with troponin and a significant positive correlation with LVEF at baseline. Moreover, TRAIL correlated significantly with LVEF one month after STEMI (day 1: r=0.402, p<0.001, day 2: r=0.542, p<0.001). On...
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New biomarkers for prognostication after cardiac arrest
Vondráková, Dagmar ; Málek, Filip (advisor) ; Vízek, Martin (referee) ; Rokyta, Richard (referee)
Cardiac arrest is an extremely serious condition characterized by global ischemia followed by reperfusion after successful resuscitation and restoration of spontaneous circulation. Despite all advances in current medicine, the prognosis of cardiac arrest survivors remains very poor. One of the major problems in these patients is, therefore, the early and reliable determination of the prognosis that is necessary for choosing the most appropriate diagnostic and therapeutic approach. However, the current possibilities for early prognostication in cardiac arrest survivors remain very limited. The aims of our work were: (i) to study the possibilities of influencing oxidative stress as one of the key pathogenic factors involved in the development of so-called post-cardiac arrest syndrome; and (ii) to determine the prognostic value of copeptin, neuron-specific enolase (NSE) and markers of oxidative stress in cardiac arrest survivors. In the experimental part of the work we used porcine model of cardiac arrest for the comparison of the effects of hypothermia, ischemic postconditioning (IPC) and administration of nitric oxide (NO) on oxidative stress burden and organ damage; we found that neither NO nor IPC did have a superior protective effect over hypothermia. In the clinical part we have in several...
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