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Effect of continuous blood flow on cerebrovascular perfusion and hemocoagulation in patients with implantable left ventricular assist device
Koňařík, Miroslav
;
Szárszoi, Ondrej
(advisor) ;
Ošťádal, Petr
(referee) ;
Brát, Radim
(referee)
Implantation of left ventricular assist devices (LVADs) is an integral treatment modality in patients with heart failure. In most cases, it refers to a machine which generates continuous blood flow with reduced pulse pressures. The effect of reduced pulsatility on organ function, such as homeostatic regulatory mechanisms is still unknown. The goal of our study was to understand whether continuous blood flow generated by mechanical support devices affects cerebrovascular regulatory mechanisms (study A), and whether or not hemocoagulation is affected in regard to complications relating to hemocompatibility (study B). Study A utilized finger plethysmography and TCD ultrasonography to detect possible changes in static cerebral auto-regulation when compared to a range of rotations per minute (rpm) of the LVAD, which served as a model for either accentuation or reduction in residual arterial pulsatility. Study B divided patients with implanted LVADs based on the incidence of selected thrombophilic mutations. Both groups of patients were placed on individualized anticoagulation protocols. The results were focused on the incidence of thromboembolic and hemorrhagic complications, and eventual morbidity/mortality of the patient. Our findings did not confirm disruption to static cerebral auto-regulation,...
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The influence of the enzyme methylentetrahydrofolate reductase polymorphisms and the thrombophilic mutations on the course of pregnancy
STRÁSKÁ, Markéta
The aim of this work was to give a summary of the enzyme methylentetrahydrofolate reductase (MTHFR) polymorphisms and particular thrombophilias in the lead with the mutations in the coagulation factors V (Leiden) and II (prothrombin G20210A) and their possible connection with some of the most frequent pregnancy complications. The practical part was designed as an optimization of the multiplex RFLPPCR for detection of MTHFR C677T polymorphism, prothrombin G20210A and factor V Leiden mutations.
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