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The Prevention of the organ damage after out of hospital cardiac arrest
Karásek, Jiří ; Widimský, Petr (advisor) ; Vojáček, Jan (referee) ; Moťovská, Zuzana (referee) ; Bonaventura, Jiří (referee)
The publication summarises in four original papers the authors' results in out-of-hospital cardiac arrest (OHCA). The first paper presents a prospective observational study comparing the effect of mechanical chest compression (LUCAS) and manual chest compression (non-LUCAS) on the 30-day and 180-day survival rate of the patients affected by OHCA. The study included 278 patients (144 underwent mechanical chest compression - LUCAS, and 134 manual chest compression - non-LUCAS). There were no significant differences in restoration of spontaneous circulation (ROSC): (25% in LUCAS vs 30.6% in non-LUCAS, p = 0,35). However, we observed significantly more conversions to shock rhythm in the LUCAS group (20.7% vs 10.10%, p = 0,04). The 30-day survival rate was significantly worse in the LUCAS group (5.07% vs 16.31% in non-LUCAS, p = 0,044). In the case of 180-day survival, no significant differences were detected (9.42% in LUCAS vs 5.45% in non-LUCAS, p = 0,25). The second study examined mechanical chest compression-related injuries as a possible explanation for the mechanical compression failure in survival rates. This retrospective observational study relied on 630 patients who died during CPR that involved mechanical or manual chest compressions. The data were drawn from autopsy reports of all patients....
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Genetic testing in patients with hypertrophic cardiomyopathy
Bonaventura, Jiří ; Veselka, Josef (advisor) ; Pudil, Radek (referee) ; Gregor, Pavel (referee)
Introduction: Hypertrophic cardiomyopathy (HCM) is characterised by marked heterogeneity both in phenotype and genotype. One of the main objectives in medical care is early HCM diagnosis and prevention of cardiovascular events including sudden cardiac death (SCD). In a large number of patients, we do not detect any pathogenic or likely pathogenic (P/LP) variant within molecular genetic analysis. Since the genomic testing is time consuming, expensive and difficult to interpret, the patients should be carefully selected. A proper selection of patients helps to prevent SCD in asymptomatic high-risk patients and reduce the unnecessary preventive steps in low-risk individuals. Hypothesis: There are clinical and morphologic HCM characteristics associated with positive genotype. Objectives: 1) Perform genomic testing in a large cohort of Czech HCM patients 2) Identify clinical and morphologic HCM characteristics associated with positive result of genomic testing (finding P/LP variant) 3) Utilize the clinical and morphologic HCM characteristics to predict the result of genomic testing 4) Facilitate cascade family genetic screening by genotyping HCM probands for early prevention of cardiovascular events before clinically overt HCM 5) Investigate the genotype and outcome of HCM patients treated with ASA...
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