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Patogenesis of aortic stenosis. Posibillity of medical treatment
Štěrbáková, Gabriela ; Linhartová, Kateřina (advisor) ; Rosolová, Hana (referee) ; Staněk, Vladimír (referee) ; Hricák, Vasiľ (referee)
Background: Calcific aortic stenosis is the most frequent and most frequently operated valvular diasease. Currently, there is no known medical treatment to slow the progression of the disease. The aim of our study was first, to assess predictors of the progression of the aortic valve calcification, and second, to assess the association of the progression of aortic stenosis with the bisphosphonate treatment. Methods: Part I - prospective follow-up of consecutive patients with coronary artery disease associated with aortic stenosis (mean transvalvular aortic gradient of 30 mmHg or greater), aortic sclerosis or normal aortic valve were prospectively identified. Clinical, laboratory, echocardographic, angiographic and calcium score evaluation using multidetector computer tomography at baseline, and at the end ofthe study. Predictor of calcification were sought using multivariate regression. Part II - pilot retrospective study of patients with aortic stenosis and two echocardiographies >8 months apart. The patients were divided into those treated with bisphosphonates for osteoporosis and those not treated. We compared the annualized gradient change between the groups and identified predictors of AS progression. Results: Part I 294 patients were prospectively enrolled, with mean follow-up 30±11 months....
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Patogenesis of aortic stenosis. Posibillity of medical treatment
Štěrbáková, Gabriela ; Linhartová, Kateřina (advisor) ; Rosolová, Hana (referee) ; Staněk, Vladimír (referee) ; Hricák, Vasiľ (referee)
Background: Calcific aortic stenosis is the most frequent and most frequently operated valvular diasease. Currently, there is no known medical treatment to slow the progression of the disease. The aim of our study was first, to assess predictors of the progression of the aortic valve calcification, and second, to assess the association of the progression of aortic stenosis with the bisphosphonate treatment. Methods: Part I - prospective follow-up of consecutive patients with coronary artery disease associated with aortic stenosis (mean transvalvular aortic gradient of 30 mmHg or greater), aortic sclerosis or normal aortic valve were prospectively identified. Clinical, laboratory, echocardographic, angiographic and calcium score evaluation using multidetector computer tomography at baseline, and at the end ofthe study. Predictor of calcification were sought using multivariate regression. Part II - pilot retrospective study of patients with aortic stenosis and two echocardiographies >8 months apart. The patients were divided into those treated with bisphosphonates for osteoporosis and those not treated. We compared the annualized gradient change between the groups and identified predictors of AS progression. Results: Part I 294 patients were prospectively enrolled, with mean follow-up 30±11 months....
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Quality of life of patients with stenosis of aortic valve
ŠVECOVÁ, Valentyna
This bachelor thesis is focused on the quality of life of patients operated for aortic valve stenosis. The aim of the thesis was to describe and compare the quality of the patients´ lives before the replacement of the native aortic valve with a mechanical or a biological valve to the state three months after the surgery. The research was done in the Cardio-Centre of the Hospital České Budějovice, a. s. The patients of the Cardio-Centre represented the studied group and were selected using the simple deliberate selection method. The research itself was done using the ?postal survey? method, i.e. without the assistance of the professional staff. Two hypotheses were established: Hypothesis 1 (H1): The quality of life of the patients suffering from aortic valve stenosis is negatively affected in the evaluated domains of HRQoL; Hypothesis 2 (H2): The quality of life of the patients with aortic valve stenosis is better three months after the surgery than before the surgery. Health related quality of life was studied using the quantitative research method based on the Short-Form SF-36 questionnaire, Generic type, in the HRQoL methodology in eight domains: physical functions, physical limitations in role activities, emotional limitations in role activities, physical and emotional limitations in social activities, pain, mental health, vitality, general perception of health status. The received data were converted into the electronic form using the related software that assessed the average score of the quality of life correlative of the state of health. The results before and after the replacement of the aortic valve were compared mutually and also to the international standard of HRQoL. The results have helped to prove that surgical replacement of the native aortic valve results in an improvement of the quality of the patients lives. It has been proved through the research that the quality of life had been improved in all domains, what confirmed the H2 hypothesis ? i.e. the quality of life of the patients with aortic valve stenosis is better three months after the surgery than before the surgery. It has been also discovered that the quality of life of the patients with aortal valve stenosis is significantly lower than the quality of life in health population represented by the results of the Oxford research. This confirmed the H1 hypothesis ? i.e. the quality of life of the patients suffering from aortic valve stenosis is negatively affected in the evaluated domains of HRQoL. The bachelor thesis may be of benefit to the cardio-centres and the cardiology departments. The results of the research may contribute to better understanding of the patients by the staff, to improve the hospital care and to widen the patients´ knowledge of this fact. A colloquium for the nursing staff aimed at the quality of life of patients suffering from a cardiovascular disease could be organized. The thesis may also be used to stimulate further research in comparing the quality of life dependent on different types of replacements or on the age of the patients.
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