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New diagnostic and therapeutic aspects of inflammatiory cardiomyopathy
Kuchynka, Petr ; Šimek, Stanislav (advisor) ; Krejčí, Jan (referee) ; Gregor, Pavel (referee)
Introduction: Inflammatory cardiomyopathy (DCMi) represents a non-familial form of dilated cardiomyopathy (DCM) and endomyocardial biopsy (EMB) is crucial for its diagnosis. Aims: To assess the prevalence of DCMi in patients with DCM of unclear origin, to evaluate the significance of serological tests for antibodies against infectious cardiotrophic agents and to analyze the effect of specific therapy guided by EMB results. Methods: EMB was performed in 56 subjects (mean age 52 ± 10 years) with DCM of unclear etiology and left ventricular (LV) ejection fraction (EF) < 40% with a history of heart failure less than 1 year. EMB samples were analyzed by immunohistochemistry, polymerase chain reaction (PCR) and electron microscopy. Results: Immunohistochemical examination revealed myocardial inflammation in 26 patients (46%), the PCR method detected genome of microbial agents in 32 patients (57%). Electron microscopy showed the presence of particles of microbial agents in 41 patients (73%). Serological blood tests found no IgM antibody positivity against any of the investigated microbial agents. Targeted antibiotic therapy in patients with evidence of Borrelia burgdorferi (Bb) genome in the EMB led to a reduction in LV size, improvement of LV EF and alleviate symptoms of heart failure. Conclusion: DCMi...
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Analysis of selected genetic markers in patients after heart transplant
Petříková, Nikola ; Hubáček, Jaroslav (advisor) ; Vrablík, Michal (referee)
Heart transplantation is performed in patients with end-stage heart failure, in whom all other methods of treatment failed. The most common causes of end-stage heart failure are dilated cardiomyopathy and coronary artery disease. The destiny of these patients is highly variable. Prediction of long term survival in patients after heart transplantation is not satisfactory and up to now has not been found reliable marker. Most of the patients die after heart transplantation due to cardiovascular disease. This thesis is focused on molecular genetics and statistical analysis of four single nucleotide polymorphisms, namely rs17817449 (16q12.2, FTO gene), rs2943634 (2q36.3; intergenic region), rs6922269 (6q25.1; MTHFD1L gene), and rs10757274 (9p21.3; intergenic region). According to genome wide association studies are these SNPs assosiated with cardiovascular diseases. We genotyped DNA samples of 364 heart donors and 364 heart recipients. The results were statistically compared (using OR and Pearson's χ2 test) with the control group, which consisted of samples of individuals from the general population MONICA study. We examined the genotype in patients whose hearts failed due to dilated cardiomyopathy or coronary artery disease and then in patients with cardiac allograft vasculopathy. Furthermore, we focused on...
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New diagnostic and therapeutic aspects of inflammatiory cardiomyopathy
Kuchynka, Petr ; Šimek, Stanislav (advisor) ; Krejčí, Jan (referee) ; Gregor, Pavel (referee)
Introduction: Inflammatory cardiomyopathy (DCMi) represents a non-familial form of dilated cardiomyopathy (DCM) and endomyocardial biopsy (EMB) is crucial for its diagnosis. Aims: To assess the prevalence of DCMi in patients with DCM of unclear origin, to evaluate the significance of serological tests for antibodies against infectious cardiotrophic agents and to analyze the effect of specific therapy guided by EMB results. Methods: EMB was performed in 56 subjects (mean age 52 ± 10 years) with DCM of unclear etiology and left ventricular (LV) ejection fraction (EF) < 40% with a history of heart failure less than 1 year. EMB samples were analyzed by immunohistochemistry, polymerase chain reaction (PCR) and electron microscopy. Results: Immunohistochemical examination revealed myocardial inflammation in 26 patients (46%), the PCR method detected genome of microbial agents in 32 patients (57%). Electron microscopy showed the presence of particles of microbial agents in 41 patients (73%). Serological blood tests found no IgM antibody positivity against any of the investigated microbial agents. Targeted antibiotic therapy in patients with evidence of Borrelia burgdorferi (Bb) genome in the EMB led to a reduction in LV size, improvement of LV EF and alleviate symptoms of heart failure. Conclusion: DCMi...
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