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Pre-hospital phase of acute myocardial infarction from the patient's perspective
Pokorná, Petra ; Hocková, Jana (advisor) ; Jankovcová, Kateřina (referee)
Acute myocardial infarction (AMI) represents severe complication of atherosclerotic vascular disease. Despite therapeutic advances and better risk factor control, acute myocardial infarction remains the leading cause of death worldwide. Goal of this thesis was to interview a group of patients hospitalized for acute myocardial infarction and evaluate their knowledge of disease course, perception of disease representing a sudden change of health status, awareness of disease symptoms and motivation for future lifestyle changes. Quantitative research with inductive approach was chosen for our research. Data was collected using individualized non-standardized semi-structured interview. Seven selected patients hospitalized for acute myocardial infarction with ST elevation were entered into our analysis. All the patients were informed in advance about our research methods and ethical aspects. All the participants had insufficient awareness of AMI symptoms. However, intensity of disease symptoms was severe, so they contacted health system early. Majority of them called emergency service. Level of education had significant impact on patient behavior. Patients with university degree had the best awareness of disease symptoms and shortest times from symptom onset to medical system contact. They were...
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Genetic and Proteomic Screening in Patients with Cardiovascular Disease.
Boháčová, Jana
The aim of this study is to analyse a genetic and proteomic aspects that could play an important role in development of chosen cardiovascular disease. Matrix metalloproteinases are enzymes that contribute strongly to the degradation of extracellular matrix components. In this study the serological levels of MMP-2 and MMP-9 were investigated using immunological testing in patients with aortic valve disease and in patients with myocardial infarction. Significantly higher levels of MMP-2 and MMP-9 were determined in both above mentioned groups of patients. Association of serum levels of MMP-2 and MMP-9 and development of concomitant aortic dilatation was not confirmed in patients with aortic valve disease. Changes in serum levels within 24 hours and after 6 months post myocardial infarction were characterized. About 10 % of patients operated for aortic valve disease suffer simultaneously from ascending aortic dilatation. The current study did not reveal any significant genetic variation in TGFBR2 gene and in chosen exons of FBN1 gene in these patients. Further genetic research is needed to identify the cause of the pathology in aortic wall. Gene expression of selected genes was measured by microarray screening in patients with myocardial infarction. These genes were related to MMPs and did not show...
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Development of Material Based on Hyaluronic Acid s Hydrogels for Myocardial Regeneration
Kovářová, Lenka ; Kubala,, Lukáš (referee) ; Prokš,, Vladimír (referee) ; Pekař, Miloslav (advisor)
The thesis is focused on material development based on hyaluronic acid usable in regenerative medicine, especially for heart tissue regeneration after myocardial infarction. The object of the study is the oxidized form of hyaluronic acid (HA-Ox) and hydroxyphenyl derivative of HA (HA-TA). HA-Ox can be crosslinked with a bifunctional alkoxyamine POA and HA-TA undergoes an enzymatic reaction in the presence of hydrogen peroxide catalysed by horseradish peroxidase leading to gel formation. To describe the materials, chemical and physical properties, gelation kinetics and conditions of crosslinking reactions were studied. Hydrogels were characterized by mechanical and viscoelastic properties, degradability or stability in simulated body fluids. These hydrogels serve as scaffolds for the selected cell type. To promote cell adhesion and viability, an RGD sequence has been bonded to the structure of HA-TA. This resulting material is also compatible with selected applicators. Its viscosity and extrusion force are low enough to allow application with a catheter with a very small internal diameter. The applicability of the material through the supply tube to the hydrogel reservoir of the second SPREADS device showed good homogeneity, cell distribution and viability. Finally, the material was applied in vivo using these devices during a preclinical study.
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Body Surface Potential Mapping In Animal Experiments - Pilot Study
Novotna, Petra
The aim of this article is to present a pilot case study in the area of body surface potential mapping. This technology was used to record data from animal experiments with the goal to find out, what information could be derived from recorded ECGs in the protocol including induced myocardial ischemia. Data recorded before and after the ischemia were compared. Differences in ECG beat morphology were observed, also local changes in analysed intervals (QT, ST, QS, PT) were visible. It was hypothesiced that QT interval will be prolonged after myocardial ischemia. Nevertheless, according to out pilot study this hypothesis was declined.
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The role of C-reactive protein in cardiac ischemic tolerance
Perglerová, Aneta ; Neckář, Jan (advisor) ; Vebr, Pavel (referee)
Ischemic heart disease (CHD) is a set of pathophysiological states, disorders of blood flow and oxygen supply of the myocardium due to vascular constriction or thrombus blockage. Inflammation plays an important role in CHD. The inflammatory response is associated with the synthesis of acute phase proteins in the liver such as C-reactive protein (CRP). CRP plays an important role in acute forms of CHD such as myocardial infarction (MI). The development of CHD may be supported by the occurrence of some of the risk factors (eg. atherosclerosis, hypertension, plasma CRP). Increased CRP levels may support the initiation of atherosclerotic plaque formation as well as in the case of hypertension the presence of CRP increases the risk of developing CHD. The healing proces after acute MI is accompanied by an inflammatory phase where CRP occurs naturally and CRP is important to accelerate inflammation. There may be a situation which inflammation goes into a chronic phase because it is not terminated in time, with constant CRP synthesis. High levels of CRP may decrease the prognosis after MI. The elevated plasma CRP has a negative effect on the expansion of MI and the associated ventricular dilatation, which may result in a rupture of the cardiac wall. Hypertrophy is the compensatory mechanism of the...
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The needs of the ICU patient after myocardial infarction requiring V-A ECMO support
Procházková, Tereza ; Konopásková, Marie (advisor) ; Pražáková, Zuzana (referee)
Introduction: The coronary heart disease is still an actual topic. The mortality has been in recent years declining, but prevalence in the population stagnates, so involve a large group of patients. The incidence of acute myocardial infarction is still high. One of the methods of reperfusion therapy is the cardiac surgery by coronary artery bypass graft, which may be postoperatively complicated by the development of low cardiac output syndrome with the need of the extracorporeal membrane oxygenation. These patients require very specialized not only during the critical phase, but also during the long-term convalescence including rehabilitation, weaning from the artificial lung ventilation, self-sufficiency training and help with return to normal life. Literature search: The theoretical part is based on the research of National Medical Library (NLK) and Study and Scientific Library of the Pilsen Region (SVKPL). The PubMed, Scopus, Web of science and Science direct databases were used to search articles in professional publications, including the latest cohort studies. The periodicals Cor et Vasa, the European Heart Journal, Critical Care and the European Journal of Cardiovascular Nursing were used. An important source of information is the guidelines of the Czech Society of Cardiology (ČKS), European...
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The role of a diet in the prevention and treatment of cardiovascular diseases and evaluation of eating habits of patients with heart attack
Jakešová, Andrea ; Tůmová, Eva (advisor) ; Šišková, Ivana (referee)
This diploma thesis deals with the role of nutrition in the prevention and treatment of cardiovascular diseases. The theoretical part describes basic knowledge about cardiovascular diseases, prevalence, risk factors and the importance of nutrition in their prevention and treatment. The theoretical part describes in detail the effect of intake of carbohydrates, fiber, describes the role of glycemic index of foods, fat intake and their chemical composition, minerals, alcohol and coffee. One part of the theoretical part also describes the role of nutrition in the treatment. The research part is devoted to the dietary habits of patients who have already had an acute myocardial infarction. The aim of the research is to find out whether patients follow current recommendations for the prevention and treatment of CVD, or how the actual diets of these patients differ from recommendations. The data were collected using a questionnaire filled in during interviews with selected patients. It was found out that patients hospitalized for acute myocardial infarction have insufficient knowledge to build a balanced diet, or that nutritional recommendations are consciously violated. Problematic is especially the choice of fats, the unbalanced composition of the diet, the frequent consumption of too fat and sweet...
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Automatic detection of myocardial infarction in ECG
Nejedlý, Lukáš ; Kozumplík, Jiří (referee) ; Smíšek, Radovan (advisor)
This master’s thesis deals with the automatic detection of myocardial infarction in ECG. Semester work consists of two parts. The theoretical part provides a description of the electrical conduction system of the heart, spreading of electrical activity through the heart muscle, the methods of ECG scanning and the ECG curve. There are also mentioned the causes of myocardial ischemia and various methods of its detection. Another part is devoted to high-frequency ECG, analysis of HFQRS and clinical studies which describe the use of high-frequency ECG in diagnosis of myocardial infarction. In the practical part is proposed an algorithm using low-frequency components ECG and an algorithm using high-frequency components ECG for automatic detection of myocardial infarction. The proposed algorithms are implemented in programming environment MATLAB and tested on signals from the PTB database. The final part of the master‘s thesis is devoted to the comparison of the success of myocardial infarction by means of low frequency and high frequency components of ECG and comparison of achieved results with results from clinical studies.
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Genetic and Proteomic Screening in Patients with Cardiovascular Disease.
Boháčová, Jana
The aim of this study is to analyse a genetic and proteomic aspects that could play an important role in development of chosen cardiovascular disease. Matrix metalloproteinases are enzymes that contribute strongly to the degradation of extracellular matrix components. In this study the serological levels of MMP-2 and MMP-9 were investigated using immunological testing in patients with aortic valve disease and in patients with myocardial infarction. Significantly higher levels of MMP-2 and MMP-9 were determined in both above mentioned groups of patients. Association of serum levels of MMP-2 and MMP-9 and development of concomitant aortic dilatation was not confirmed in patients with aortic valve disease. Changes in serum levels within 24 hours and after 6 months post myocardial infarction were characterized. About 10 % of patients operated for aortic valve disease suffer simultaneously from ascending aortic dilatation. The current study did not reveal any significant genetic variation in TGFBR2 gene and in chosen exons of FBN1 gene in these patients. Further genetic research is needed to identify the cause of the pathology in aortic wall. Gene expression of selected genes was measured by microarray screening in patients with myocardial infarction. These genes were related to MMPs and did not show...
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Genetic and Proteomic Screening in Patients with Cardiovascular Disease.
Šímová, Jana ; Škvor, Jiří (advisor) ; Gregor, Pavel (referee) ; Čurila, Karol (referee)
The aim of this study is to analyse a genetic and proteomic aspects that could play an important role in development of chosen cardiovascular disease. Matrix metalloproteinases are enzymes that contribute strongly to the degradation of extracellular matrix components. In this study the serological levels of MMP-2 and MMP-9 were investigated using immunological testing in patients with aortic valve disease and in patients with myocardial infarction. Significantly higher levels of MMP-2 and MMP-9 were determined in both above mentioned groups of patients. Association of serum levels of MMP-2 and MMP-9 and development of concomitant aortic dilatation was not confirmed in patients with aortic valve disease. Changes in serum levels within 24 hours and after 6 months post myocardial infarction were characterized. About 10 % of patients operated for aortic valve disease suffer simultaneously from ascending aortic dilatation. The current study did not reveal any significant genetic variation in TGFBR2 gene and in chosen exons of FBN1 gene in these patients. Further genetic research is needed to identify the cause of the pathology in aortic wall. Gene expression of selected genes was measured by microarray screening in patients with myocardial infarction. These genes were related to MMPs and did not show...
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