|
| |
|
| |
|
|
The contribution of myocardial contrast echocardiography in patients with coronary heart disease
Toušek, Petr ; Gregor, Pavel (advisor) ; Chaloupka, Václav (referee) ; Hradec, Jaromír (referee) ; Kittnar, Otomar (referee)
Contrast echocardiography is a new myocardial echocardiographic method that extends the capabilities of conventional echocardiography. In our first two works, we focused on determining the size of infarction in patients after AMI and compared this method with today's most commonly used diagnostic methods. We found good agreement between KEM and SPECT in the evaluation of infarction size and correlation between the extent of oscillations Q on ECG and impaired microvascular perfusion of the myocardium - or the size of infarction. In patients with chronic forms of CHD, we found that the KEM can fairly well predict the kinetics porevaskularizační improvement segments with severely impaired kinetics and in this clinical situation is comparable with Contrast-magnetic resonance imaging. In addition, low variability and low number of investigative areas nehodnotitelných infarction KEM show that it is a simple, easily reproducible and teachable method. Finally, the relatively low cost and wide availability KEM indicate great potential usefulness of this method in clinical practice.
|
|
| |
|
|
The male equivalent of polycystic ovary syndrome
Dušková, Michaela ; Stárka, Luboslav (advisor) ; Haluzík, Martin (referee) ; Kittnar, Otomar (referee)
Polycystic ovary syndrome, the most common endocrinopathy in women (with a prevalence of 5-10 %), is characterized by hormonal and metabolic imbalance. Complexity of symptoms of close relatives of women with PCOS as a mendelian trait raised a hypothesis about the existence of a male equivalent of PCOS. Premature alopecia was suggested as one of the signs of a male phenotype of this syndrome. Androgenetic alopecia is the most common cause of balding in men. AGA is the risk factor of cardiovascular diseases, glucose metabolism disorders and also benign prostate hyperplasia and prostate carcinoma. Polycystic ovary syndrome and metabolic syndrome are the risk factors of obesity and diabetes mellitus. The existence of mendelian form of PCOS initiated a hypothesis about the existence of a male equivalent of PCOS. Premature alopecia was suggested as one of the signs of a male phenotype of this syndrome. However, it can be the sign of metabolic syndrome as well. PCOS is characterized by hyperandrogenaemia while metabolic syndrome is characterized by low androgens.
|
|
|
Detection of Global and Local Ischemic Changes in Electrical Field of the Heart
Šťovíček, Petr ; Kittnar, Otomar (advisor) ; Kneppo, Peter (referee) ; Horký, Karel (referee)
In this thesis, detailed investigation into the electrical field of the heart is presented in patients with various manifestations of myocardial ischemia. Methods of standard scalar electrocardiography and body surface potential mapping were used through statistical and mathematical analysis in order to compare their diagnostic performance. Body surface mapping proved to be more powerful research and diagnostic tool than standard electrocardiography and also constituted a framework for data entering the computer electrical model of the human heart and torso. Global and local ischemic changes were the primary objectives of the individual studies of this thesis. Different patient populations were studied including post myocardial infarction population, patients with variant angina and patients referred for percutaneous coronary angioplasty, and the population of patients suffering from ventricular arrhythmias related mostly to their postinfarction status. Traditional depolarization and repolarization changes were studied together with novel diagnostic parameters such as minimal potential loss within the QRS complex, single-beat cardiac micropotentials and distribution of the QT interval on the human thorax. Critical appraisal and error performance of so called QT interval dispersion was another important...
|
|
|
Ischemia-reperfusion injury in lungs after transplantation and the role of radical oxygen species
Mrázková, Hana ; Lischke, Robert (advisor) ; Třeška, Vladislav (referee) ; Kittnar, Otomar (referee)
Keywords: Lung Tx, EVLP, NHBD, IR injury, ROS, hypercapnia, gender differences This dissertation thesis deals with a very topical issue of the lack of donor organs for lung transplants. As with other organs, the number of patients on waiting lists in terminal stages of their diseases is also constantly rising but there is not an adequate increase in donor organs. We focused our experimental work on the development of research concerning the solution which is most successful in a long-term perspective, i.e. organ transplants from non- heart-beating donors (NHBDs), in an ex vivo lung transplant protocol (EVLP) on an animal model (Wistar rats). This is a method which is clinically established worldwide (in the Czech Republic only experimentally) and is constantly subject to further research. Based on earlier studies, we focused the first experimental part of this work on the potential protective effect of hypercapnic ventilation on ischemia-reperfusion (IR) lung injury in EVLP. The study proved that the hypercapnic ventilation has a protective effect on the generation of reactive oxygen species (ROS) in IR lung injury, but only when used in the period of reperfusion. In the second experimental study, we followed up a very topical issue of the effect of gender on IR lung injury in EVLP in...
|
|
|
Venticular activation patterns in conduction abnormalities and during different pacing modes (aktivační sekvence při poruchách komorového vedení a různých typech komorové stimulace)
Peichl, Petr ; Kautzner, Josef (advisor) ; Lukl, Jan (referee) ; Kittnar, Otomar (referee)
Academic dissertation: Ventricular activation patterns in conduction abnormalities and during different pacing modes Petr Peichl, MD, Department of Cardiology, IKEM, Vídeňská 1958/9, Prague, Czech Republic 5 Congestive heart failure (CHF) is a progressive disease caused by left ventricular dysfunction with high morbidity and mortality rates. Ventricular dysfunction is often linked to ventricular dilatation, which in turn may cause ventricular conduction delays and further worsening of the cardiac function. Recent decade gave rise to cardiac resynchronization therapy (CRT), a therapeutic modality based on premise that preexcitation of late activating10 regions by cardiac pacing may restore the left ventricular synchronous contraction. The goals of the publications included in the dissertation were: (1) to analyze the ventricular activation patterns in patients eligible for CRT with respect to the underlying heart disease and/or QRS morphology on the surface electrocardiogram(ECG), (2) to quantify changes in ventricular activation patterns during different pacing modes and (3) to compare15 the hemodynamic performance of different pacing modes during exercise. 1. Patients with CHF and wide QRS complex represent a broad spectrum of underlying conduction disturbances with variable inter- and intraventricular...
|
|
|
název v anglickém jazyce není uveden
Kasalová, Zdislava ; Škrha, Jan (advisor) ; Piťha, Jan (referee) ; Kittnar, Otomar (referee)
Diabetes mellitus, hypercholesterolaemia and arterial hypertension are the best known risk factors of atherosclerosis- the most common macrovascular disease. The aim of our work was to asses influence of this risk factors on microcirculation. We supposed, that the smallest vessels are the most sensitive to the noxious influence and that microvascular disorder will be early indicator of vascular impairment. Our work has shown, that risk factors influence on microcirculation is completely different, in the contrast with relatively uniform influence on macrovaslular level. Diabetes mellitus presents two completely different entities, from the microvascular point of view. Pathogenesis of microvascular and macrovascular complications in Type 1 and Type 2 diabetes mellitus is the same- it is the long- term hyperglycaemia, but it's influence on microvascular reactivity is completelly different. In Type 1 diabetic patients, microvascular reactivity impairment develops later, and it is in correlation with presence and severity of the most common microvascular complication- peripheral neuropathy. On the contrary, in Type 2 diabetes mellitus microvascular reactivity impairment occures in early stage of this dissease and is not connected with presence and severity of peripheral neuropathy. In patients with...
|
|
| |
guest ::
