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Contribution of BNP to prognostic stratification of patients with advanced heart failure.
Hegarová, Markéta ; Málek, Ivan (advisor) ; Bedáňová, Helena (referee) ; Pudil, Radek (referee)
Plasma levels of B-type natriuretic peptide (BNP) are a strong and independent predictor of prognosis in patients with advanced heart failure (CHF). However, the importance of this biomarker has been documented only in CHF of common causes such as dilated or ischemic cardiomyopathy. We hypothesized that BNP can serve as a strong predictor of end-stage CHF in group of patients with advanced CHF due to congenital heart disease (CHD) with the right ventricle in systemic position (SRV). The second hypothesis was that BNP monitoring in patients with implanted left ventricular assist device (LVAD) Heart Mate II could detect serious complications which negatively affect prognosis. We performed a retrospective analysis in 28 consecutive patients with severe systolic dysfunction of the SRV (ejection fraction 23 ± 6%) evaluated as heart transplant (HTx) candidates between May 2007 and October 2014. During a median follow-up of 29 months (interquartile range, 9-50), 14 pts reached primary endpoints of the study (death, urgent HTx, and LVAD implantation). We have considered these events equivalent to end-stage CHF. Using ROC analysis, we identified the first measured value of BNP as the strongest predictor of prognosis with the area under the curve (AUC) of 1.00, followed by the New York Heart Association...
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Physical activity in patients after Senning procedure for transposition of the great arteries
Přádová, Kateřina ; Procházka, Michal (advisor) ; Radvanský, Jiří (referee)
Background: The transposition of the great arteries (TGA) is a common congenital heart disease. In the 1980s the Senning procedure was the major approach in correction of TGA in the Czech Republic. Although the most recent operation technique called arterial switch is the method of first choice nowadays, patients after Senning procedure are still visiting the cardiology centre. The aim of this thesis was to evaluate the relationship between the selected parameters from the exercise test and quantified level of physical activity (PA) in these individuals. Methods: 71 patients after the Senning procedure underwent a cardiopulmonary exercise test and they completed an international physical activity questionnaire (IPAQ). Selected data from the questionnaire and the exercise test were evaluated by Pearson correlation coefficient (p < 0,05). Results: 56 patients meet criteria of IPAQ (71 % male, n = 40) and were included in the study. Total PA averaged 6576 ± 5204 MET-minutes/week (median 5271 MET-minutes/week) and 70 % individuals meet criteria for high level of PA according to IPAQ data. Peak VO2 averaged 31,9 ± 6,6 ml/min/kg, maximum heart rate was 177 ± 18,6 beats per minute, the highest work load was 2,7 ± 0,8 W/kg and systolic blood pressure was 185 ± 24,0 mmHg. We found statistically significant...
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