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Risk factors for atherosclerosis and its potential pharmacological effects in patients with coronary artery disease and lower limb
Hromádka, Milan ; Filipovský, Jan (advisor) ; Piťha, Jan (referee) ; Šimon, Jaroslav (referee)
1 Statin therapy in patients with peripheral artery obstructive disease (PAOD) 1.1 Patients with lipid metabolism disorders Simvastatin therapy with the dose titration adjusted to the effect led to the prolongation of claudication interval and to the elevation of ankle-brachial pressure index, which was statistically significant at the interval of 18 months after starting the therapy. At the same time we observed normalization of lipid levels and the lowest levels of oxidative stress markers. Statin use was also associated with lowering homocysteine level. 1.2 Patients without lipid metabolism disorders - the influence on laboratory parameters and functional capacity In patients without lipid metabolism disorder, treated with simvastatin 20 mg daily, we noted an improvement, i.e. prolongation of claudication interval and elevation of ankle-brachial pressure index, while in the control group treated only with a diet we observed further deterioration of capacity. In the control group, the parameters of lipid metabolism were statistically significantly worse after six months and this trend remained even in further control visits with HDL cholesterol slightly lowering. In the simvastatin group, a statistically significant decrease of LDL occurred during several months as well as elevation of HDL...
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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...
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