|
|
Role of echocardiography in cardiac resynchronization therapy
Marek, Josef ; Linhart, Aleš (advisor) ; Mandysová, Eva (referee) ; Ozábalová, Eva (referee)
Cardiac resynchronization therapy (CRT) is an established treatment of patients with heart failure with reduced ejection fraction associated with QRS complex prolongation. However, about 30% of patients do not respond to CRT favorably, more so patients with shorter QRS duration and QRS morphology other than typical left bundle branch block. Echocardiography plays a crucial role in management of all those patients. Echocardiographic assessment of myocardial mechanics can quantitate myocardial deformation and find myocardial segments that are latest mechanically activated in a dyssynchronously contracting left ventricle. Left ventricular (LV) lead placement in this area is associated with clinical response to CRT. On the other hand, lead placement within a scar has been associated with bad prognosis. The aim of this work was to investigate whether left ventricular lead placed close to the site of latest mechanical activation is beneficial especially in patients with shorter QRS durations or atypical QRS morphology. This has been done by analyzing data of the randomized trial STARTER, which compared echo-guided LV lead navigation to routine empirical lead placement. The STARTER trial proved clinical benefit of echo-guided LV lead placement towards the site of latest mechanical activation. In our...
|
|
|
Valvular heart diseases: some of the less frequent aspects of the problem-the task of noninvazive methods
Línková, Hana ; Gregor, Pavel (advisor) ; Mandysová, Eva (referee) ; Linhartová, Kateřina (referee)
Unusual aspects of valvular heart disease - the role of noninvasive imaging methods MUDr. Hana Línková Abstract More than 100 million people around the word suffer from valvular heart diseases (VHD). We observe changes in the etiological spectrum in well developed countries. The number of postrheumatic diseases diminishes, while there is an increased number of patients diagnosed with degenerative VHD, in particular with aortic stenosis (AS). The observed increase of VHD, in particular secundary etiology of VHD, is also connected with an improved treatment of heart failure. Less frequently, the VHD can result from unusual mechanisms, in particular regurgitation VHD developed on both native and artificial valves. This work concentrates on the VHD which developed more or less due to iatrogenic mechanism. A special attention is payed to noninvasive imaging methods used for VHD diagnoses, their prediction and prevention. These diseases developed as a result of drugs therapy which can induce valvulopathy or they can appear as a complication of transcathether aortic valve replacement (TAVI) with patients with AS. In the first part of this work, possible effects of Pergolide is described. Pergolide - an agonist of dopamine receptors- used in the treatment of Parkinson disease (PD) can contribute to the development...
|
|
|
The Role of Patent Foramen Ovale in the Pathophysiology of Decompression Sickness.
Honěk, Jakub ; Šefc, Luděk (advisor) ; Linhartová, Kateřina (referee) ; Mandysová, Eva (referee)
Patent foramen ovale (PFO) has been associated with an increased risk of decompression sickness (DCS) in divers. Pathophysiologicaly this has been ascribed to paradoxical embolization of nitrogen bubbles from venous blood to systemic circulation, resulting in obstruction of peripheral capillaries and ischemic injury. However, the role of PFO has been largely debated and experimental and prospective clinical data has been missing. It is of note, that this hypothesis is not only of theoretical importance. The proof of PFO as a causative factor of DCS and, importantly, of unpredictable events (unprovoked DCS) could affect millions of divers worldwide through improved therapy and prevention. In our research we aimed to describe the pathophysiological role of PFO in decompression sickness and to determine whether the prevention of arterialization of post-dive venous gas emboli (VGE) would decrease the incidence of unprovoked DCS in divers. We have screened 489 scuba divers for the presence of PFO by means of transcranial color-coded Doppler ultrasonography. In a retrospective analysis we found that the incidence of unprovoked decompression sickness was 7% among these divers and that PFO was the only risk factor. Subsequently, we have studied the occurrence of VGE and arterial gas emboli (AGE) in divers with...
|
|
|
Valvular heart diseases: some of the less frequent aspects of the problem-the task of noninvazive methods
Línková, Hana ; Gregor, Pavel (advisor) ; Mandysová, Eva (referee) ; Linhartová, Kateřina (referee)
Unusual aspects of valvular heart disease - the role of noninvasive imaging methods MUDr. Hana Línková Abstract More than 100 million people around the word suffer from valvular heart diseases (VHD). We observe changes in the etiological spectrum in well developed countries. The number of postrheumatic diseases diminishes, while there is an increased number of patients diagnosed with degenerative VHD, in particular with aortic stenosis (AS). The observed increase of VHD, in particular secundary etiology of VHD, is also connected with an improved treatment of heart failure. Less frequently, the VHD can result from unusual mechanisms, in particular regurgitation VHD developed on both native and artificial valves. This work concentrates on the VHD which developed more or less due to iatrogenic mechanism. A special attention is payed to noninvasive imaging methods used for VHD diagnoses, their prediction and prevention. These diseases developed as a result of drugs therapy which can induce valvulopathy or they can appear as a complication of transcathether aortic valve replacement (TAVI) with patients with AS. In the first part of this work, possible effects of Pergolide is described. Pergolide - an agonist of dopamine receptors- used in the treatment of Parkinson disease (PD) can contribute to the development...
|
guest ::
