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Remodeling of the intima-media complex of the common carotid artery and left ventricle myocardium in patients with primary and secondary hypertension
Majtan, Bohumil ; Holaj, Robert (advisor) ; Piťha, Jan (referee) ; Danzig, Vilém (referee)
Arterial hypertension ranks among the most prevalent cardiovascular disorders and represents one of the most significant risk factors for cardiovascular morbidity and mortality. Beyond hypertension itself, additional hemodynamic and neuroendocrine influences contribute to the pathological mechanisms that induce structural alterations in the cardiovascular system. Of notable importance in this process is the excessive production of aldosterone and catecholamines. The objective of the research has been to study the impact of aldosterone and catechola- mine excess on intima-media complex remodeling in the common carotid artery and left ventricular wall in primary aldosteronism (PA) and pheochromocytoma (PHEO) patients. Texture analysis of the intima-media complex of the common carotid artery was conducted in 33 PA patients, 52 EH patients, and 33 normotensive individuals. 140 Haralick features and 10 wavelets were analyzed and utilized to train an XGBoost classifier. Additionally, the intima-media thickness (IMT) of the common carotid artery and left ventricular mass index (LVMi) were examined in 50 PHEO patients before and 5 years post- adrenalectomy and compared to 50 EH patients. In differentiating between PA and EH, we achieved a classification accuracy of 73 %, compared to the clinical gold...
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Major dietary mistakes in patients with primary aldosteronism and essential hypertension
Hampl, Petr ; Petrák, Ondřej (advisor) ; Krátká, Zuzana (referee)
Abstact Arterial hypertension is one of the most serious risk factors for cardiovascular complications in the form of stroke, heart failure, ischemic heart disease, and other manifestations of atherosclerosis. Damage caused by the disease increases over time due to asymptomatic course and interaction with other risk factors, especially dyslipidemia, insulin resistance, smoking habits, or obesity. These combinations of risk factors, together with hypertension, further multiply the overall cardiovascular risk of sufferers. Although arterial hypertension is influenced by pharmacological treatment and lifestyle modification, its high prevalence represents a serious health problem in both the Czech Republic and in other developed countries. This bachelor thesis aims to evaluate the eating habits of patients with essential hypertension, a multifactorial form of the disease without a specific causing cause, and of hypertonics with primary aldosteronism, which arises on the basis of autonomous overproduction of aldosterone. Although this form of disease has a specifically treatable cause, its course and organ complications are often more serious than those of essential hypertension. Dietary habits, together with adherence to other nonpharmacological measures, can largely moderate the manifestations of the disease...
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Salt intake by patients with primary hyperaldosteronism
Sahatciu, Mrika ; Petrák, Ondřej (advisor) ; Krátká, Zuzana (referee)
1 Abstract My bachelor's thesis focuses on the intake of table salt and other dietary approaches and habits in patients with primary aldosteronism, an extreme form of salt-sensitive hypertension. The theoretical part deals with the definition of the term and risk factors associated with primary aldosteronism, summarizes the diagnosis and treatment procedures especially dietary measures which are very important in the treatment. The practical part was based and developed using an anonymous questionnaire form. The questionnaire consisted of 66 questions ranging from sociodemographic to awareness, education, dietary habits and dietary preferences in relation to salt intake. The purpose of this study was thereby to determine the dietary habits and sodium chloride intake of patients with primary aldosteronism. The total number of patients who were approached was 15, mostly males which were 11 and females were 4. The diet was fairly regular, but with more than half prioritizing lunch and dinner rather than breakfast. When they had a higher intake of cold cuts, salty bars, chips compared to fruit and vegetables. Most of the patients were educated about salt restriction diet and diet in hypertension due to the characteristics of the cohort, but few of them actually follow it. And there were no efforts to limit salt...
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Large artery properties in primary and secondary - endocrine hypertension
Rosa, Ján ; Widimský, Jiří (advisor) ; Mlíková Seidlerová, Jitka (referee) ; Špinar, Jindřich (referee)
Arterial stiffness represented by carotid-femoral pulse wave velocity (PWV) is considered to be an independent cardiovascular risk factor. This study was focused on large artery properties investigation in specific forms of hypertension using applanation tonometer Sphygmocor (Atcor Medical). PWV was significantly higher in resistant hypertension patients when compared to moderate essential hypertension (EH) patients. This difference appears to be independent of clinical blood pressure (BP). Night-time BP appears to be a more accurate predictor of PWV in EH. In another study we demonstrated that primary hyperparathyroidism (PH) (both hypertensive or non-hypertensive forms) might be associated with higher PWV when compared to EH patients or to normotensive controls and that this difference is independent of age and clinical BP. Neither calcium serum level, nor parathyroid hormone has been associated with PWV. Specific treatment by parathyroidectomy (PTX) seems to be beneficial for PWV decrease, which might be mainly determined by improved BP control after surgery. Since PTX indications for asymptomatic forms of PH have been discussed, our data suggest the potential benefit to the extent of subclinical organ damage after surgical treatment in these patients. Similarly, we prooved higher PWV in...
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Left ventricle remodeling in patients with primary aldosteronism and essential hypertension
Indra, Tomáš ; Holaj, Robert (advisor) ; Ošťádal, Petr (referee) ; Paleček, Tomáš (referee)
Myocardial damage is one of the most serious consequences of arterial hypertension. Changes in the heart structure and function develop not only due to pressure overload itself, but many other hemodynamic and neurohumoral factors contribute to their formation. Our work has compared echocardiohraphic strucutural anf functional changes of the left ventricle, caused by essential hypertension and hypertension associated with primary aldosteronism (PA) as the most common reason for secondary hypertension. The first part of our work focused on the differences in left ventricle geometry in men with PA and essential hypertension after separating it's low-renin form (where, similarly to PA, the plasma volume expansion was considered to have the dominant effect on left ventricle remodelation). In men with low-renin forms of hypertension including PA, we observed greater both endsystolic and enddiastolic diameter of the left ventricle, lower relative wall thickness and more frequent eccentric type of hypertrophy when compared to essential hypertensives with normal renin levels. Whereas left ventricle cavity diameters were positively correlated to aldosterone levels, wall thicknesses were associated mainly with hypertension severity expressed as an average 24hour blood pressure and number of antihypertensives....
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Metabolic and structural differences in primary aldosteronism and essential hypertension
Šomlóová, Zuzana ; Widimský, Jiří (advisor) ; Mlíková Seidlerová, Jitka (referee) ; Červenka, Luděk (referee)
Hypertension is a major risk factor for cardiovascular (CV) disease, and patients with primary aldosteronism (PA) - the most common endocrine cause of hypertension - have a higher incidence of CV complications. The aim of this study was to evaluate the incidence of metabolic differences and organ complications - kidney, heart and blood vessels damage in patients with essential hypertension (EH), PA and its most common forms - idiopathic hyperaldosteronism (IHA) and aldosterone-producing adenoma (APA). We found a higher incidence of metabolic syndrome and a higher incidence of metabolic abnormalities in IHA compared to APA - higher prevalence of metabolic syndrome, higher levels of triglycerides and lower levels of HDL cholesterol and thereby a higher cardiometabolic risk. Metabolic profile of patients with IHA is similar to EH in contrast to APA. Arterial stiffness was expressed as pulse wave velocity (PWV), in central arteries as carotid-femoral PWV and at peripheral level as femoral-ankle PWV. Patients with PA with comparable levels of blood pressure (BP) have higher stiffness of central elastic and peripheral muscular arteries than patients with EH. The main predictor of impaired peripheral arterial stiffness is the plasma aldosterone level. Patients with IHA have higher central arterial...
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Laboratory Diagnosis of Primary Aldosteronism
Hulová, Dagmar ; Martínková, Markéta (advisor) ; Bárta, František (referee)
Primary aldosteronism is a common form of endocrine hypertension, characterized by inappropriate production of aldosterone by the adrenal cortex, usually because of the unilateral adenoma (APA) or bilateral hyperplasia (IHA). The aim of this study was answer the question, if it is possible to distinguish APA from IHA with the use of the postural or the confirmatory test. From the laboratory results of the postural test, it was found that for the differentiation between the two most common forms of primary hyperaldosteronism APA and IHA is the postural test unusable in most cases. By the confirmation test was confirmed that there is not suppression of aldosterone after the administration of the saline solution to patients with primary aldosteronism below 100 ng∙l-1 in most cases (for APA in 85 %, for IHA in 65 %), in the remaining cases the value of the aldosterone do not decrease below 50 ng∙l-1 A higher value of the aldosterone in APA after the administration of the saline solution in the confirmation test could be considered a laboratory indicator of overproduction in APA.
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Large artery properties in primary and secondary - endocrine hypertension
Rosa, Ján ; Widimský, Jiří (advisor) ; Mlíková Seidlerová, Jitka (referee) ; Špinar, Jindřich (referee)
Arterial stiffness represented by carotid-femoral pulse wave velocity (PWV) is considered to be an independent cardiovascular risk factor. This study was focused on large artery properties investigation in specific forms of hypertension using applanation tonometer Sphygmocor (Atcor Medical). PWV was significantly higher in resistant hypertension patients when compared to moderate essential hypertension (EH) patients. This difference appears to be independent of clinical blood pressure (BP). Night-time BP appears to be a more accurate predictor of PWV in EH. In another study we demonstrated that primary hyperparathyroidism (PH) (both hypertensive or non-hypertensive forms) might be associated with higher PWV when compared to EH patients or to normotensive controls and that this difference is independent of age and clinical BP. Neither calcium serum level, nor parathyroid hormone has been associated with PWV. Specific treatment by parathyroidectomy (PTX) seems to be beneficial for PWV decrease, which might be mainly determined by improved BP control after surgery. Since PTX indications for asymptomatic forms of PH have been discussed, our data suggest the potential benefit to the extent of subclinical organ damage after surgical treatment in these patients. Similarly, we prooved higher PWV in...
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Left ventricle remodeling in patients with primary aldosteronism and essential hypertension
Indra, Tomáš ; Holaj, Robert (advisor) ; Ošťádal, Petr (referee) ; Paleček, Tomáš (referee)
Myocardial damage is one of the most serious consequences of arterial hypertension. Changes in the heart structure and function develop not only due to pressure overload itself, but many other hemodynamic and neurohumoral factors contribute to their formation. Our work has compared echocardiohraphic strucutural anf functional changes of the left ventricle, caused by essential hypertension and hypertension associated with primary aldosteronism (PA) as the most common reason for secondary hypertension. The first part of our work focused on the differences in left ventricle geometry in men with PA and essential hypertension after separating it's low-renin form (where, similarly to PA, the plasma volume expansion was considered to have the dominant effect on left ventricle remodelation). In men with low-renin forms of hypertension including PA, we observed greater both endsystolic and enddiastolic diameter of the left ventricle, lower relative wall thickness and more frequent eccentric type of hypertrophy when compared to essential hypertensives with normal renin levels. Whereas left ventricle cavity diameters were positively correlated to aldosterone levels, wall thicknesses were associated mainly with hypertension severity expressed as an average 24hour blood pressure and number of antihypertensives....
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