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Allograft coronary artery disease
Kocík, Miroslav ; Málek, Ivan (advisor) ; Horký, Karel (referee) ; Hejnal, Jaroslav (referee)
We have proved high incidence of early detected TxCAD in OHTx recipients' population. Neither any of immunologic nor nonimmunologic factors tested in our study was found to represent a risk factor for early detected TxCAD development except of donor age and recipient's BMI. Despite proving survival to be worse in recipients suffering from early detected TxCAD in compare to the rest of OHTx recipients, we have failed to demonstrate, that early detected TxCAD is an independent risk factor for OHTx recipients negative clinical outcome. Similarly despite demonstration, that serious cardiac events are more frequent in subgroup of patients with early detected TxCAD, we have failed to prove early detected TxCAD to represent an independent risk factor for its occurrence.
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Treatment of heart failure guided by B-type natriuretic peptide plasma levels
Krupička, Jan ; Hradec, Jaromír (advisor) ; Málek, Ivan (referee) ; Ošťádal, Bohuslav (referee)
Incidence of heart failure is steadily increasing over the past several decades, partly due to the population aging and improved methods in the treatment of patients with acute coronary syndromes. With regard to the evidence that natriuretic peptides are independent prognostic markers of cardiovascular diseases and reflect actual hemodynamic and clinícal status of the patients with heart failure, an idea has emerged to use natriuretic peptide monitoring in guidance of heart failure therapy. This means to treat heart failure with the goal of decreasing BNP and NT-proBNP plasma levels as low as possible. (...) ln conclusion, in our first study we found out that the treatment strategy of heart failure guided by plasma SNP did not lead to significant reduction of cardiovascular events in comparison with the standard treatment strategy. Nevertheless, we observed trend in favor of the strategy based on SNP. In our second study we described fast and transient rise of plasma SNP concentrations immediately after short-term maximal physical exercise in healthy individuals. However, this rise did not reach pathological values typical for heart failure. We assume that it was probably caused by SNP release from cardiomyocytes storage granules rather than synthesis de novo.
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Contribution of New Immunosuppressants after Heart Transplantation
Skalická, Blanka ; Málek, Ivan (advisor) ; Horký, Karel (referee) ; Lischke, Robert (referee)
Background: Acute cellular rejection and graft vascular disease are major factors limiting the survival after orthotopic heart transplantation (OHTx). Tacrolimus could be more potent than cyclosporin A in therapy of recurrent acute rejection episodes in OHTx patients. Dyslipidemia is one of the risk factors involved in the development of graft vascular disease. Statins are common part of standard drug regimen after OHTx. On the other hand, they are potentially dangerous as they could interact with cyclosporin A. Study in healthy volunteers showed that tacrolimus should have no interactions with statins. Aim: In the first study we retrospectively assessed the effect of switching patients after OHTx with recurrent cellular rejection episodes from cyclosporin A to tacrolimus. In the second (prospective) study we evaluated the efficacy and safety of combined therapy with tacrolimus and atorvastatin in patients after OHTx with dyslipidemia. (...) Conclusions: Tacrolimus has a beneficial effect not only on recurrent acute rejection episodes in heart transplant recipients but it also decreases the incidence of future rejection episodes. In patients after OHTx with dyslipidemia switching to tacrolimus and atorvastatin could be a suitable therapeutic option, because this combination is safe and effective in...
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Revitalization of a Historical Monument, Trenčín
Málek, Ivan ; Bindr, Tomáš (referee) ; Marek, Jiří (advisor)
The aim of the proposed changes are aimed at creating a vertical division of functionality. The basement will be used for public purposes, the 1st floor will keep it's use as commercial spaces for rent, with less exposed parts of the disposition being converted into administrative spaces. The 2nd floor will be converted into flats of different sizes to accommodate a broad range of social classes, which should help bring life back to the city center. Much consideration is given to budgetary concerns, since the private owners have limited resources, while the changes should affect the daily routines of the tenants as little as possible. Another goal is to remove some of the insensitive building interventions made during the communist era, to restore the historical values of the entire building.
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