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Speckle Tracking Echocardiography
Strecha, Juraj ; Drahanský, Martin (referee) ; Mráček, Štěpán (advisor)
he thesis deals with proposal of an algorithm and implementation of a program that tracks a motion of the heart muscle in the captured ultrasound video of the heart. The point position estimation is calculated by optical flow method. The Active Shape Model method is used to confirm the accuracy of point's position tracking. The user annotates desired structure of the heart arch first and the application displays new points which represent a new deformed heart shape.
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Heart failure with preseved ejection fraction
Charvátová, Běla ; Neckář, Jan (advisor) ; Galatík, František (referee)
Heart failure (HF) has been considered to be one of the biggest challenges in modern medicine. As a leading cause of mortality in industrialised countries, it is vital to understand the disease properly. Heart failure with preserved ejection fraction (HFpEF) represents approximately half of all HF cases. Even though it has been studied a lot recently, little we know about the pathophysiology and the treatment of this complex syndrome. Not only does it affect heart function, but also damage can be caused in other organs such as lungs, kidneys, skeletal muscle etc. It used to be called a diastolic heart failure, because in this syndrome the heart is unable to stretch, relax and fill properly during diastole causing a diastolic dysfunction. In addition, HFpEF is often associated with other diseases that can worsen the patients' outcomes, such as hypertension, diabetes mellitus type 2. obesity, chronic kidney disease, pulmonary hypertension etc. This link to other diseases (comorbidities) can complicate the treatment because of a great heterogeneity between patients with HFpEF. The need for specific treatment pathways for each patient's phenotype is the main drive for searching for adequate suiting animal models in research. In the first half, this work provides a comprehensive overview of HFpEF,...
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Analysis of echocardiographic findings in patients with primary and secondary hypertension using new sophisticated modalities
Kvasnička, Jan ; Holaj, Robert (advisor) ; Wohlfahrt, Peter (referee) ; Danzig, Vilém (referee)
6 Abstract Introduction: Heart damage in essential hypertension (EH) is one of the most serious consequences of high blood pressure. However, in the case of secondary hypertension, multiple pathophysiological effects may apply. For example, pheochromocytomas (PHEOs), which are tumors arising from the chromaffin cells of the adrenal medulla, have the ability to produce, metabolize, and secrete catecholamines. Overproduction of catecholamines leads to cardiac and other impairments by many mechanisms. The aim of our work was to verify this fact and at the same time to investigate whether global longitudinal strain (GLS), measured using speckle tracking echocardiography, can detect this damage earlier and also determine the adjustment of function after adrenalectomy. Methods: We analyzed 17 patients with PHEO and 18 patients with EH with the same hemodynamic parameters. Subsequently, we managed to increase the number of patients with PHEO to 24, and they were also examined 1 year after adrenalectomy. Results: Patients with PFEO did not differ in echocardiographic parameters including left ventricular ejection fraction compared to EH (0.69 ± 0.04 vs. 0.71 ± 0.05; NS), however, they had significantly lower GLS (−14.8 ± 1.5 vs. −17.8 ± 1.7; p < 0.001). One year after adrenalectomy, the GLS parameter improved...
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Role of echocardiography in the evaluation of functional and structural changes of the myocardium
Rob, Daniel ; Linhart, Aleš (advisor) ; Pudil, Radek (referee) ; Málek, Filip (referee)
Echocardiography plays a key role in the evaluation of functional and structural changes of the heart. Fabry disease (FD) is a genetic (X-linked) lysosomal storage disease caused by mutations in the gene for alpha-galactosidase A. Cardiovascular involvement is a major cause of morbidity and mortality in FD. The aim of our work was to refine the diagnosis and risk stratification of Fabry cardiac involvement using echocardiography. In the first part of our retrospective project, we analysed the relationship between the uric acid level, development, and progression of left ventricular (LV) hypertrophy and adverse events. Our results showed a strong relationship between uric acid level and progression of LV hypertrophy, mortality, and cardiovascular events. Uric acid can be used as a marker of cardiovascular risk in FD. In the second part of our retrospective project, we analysed the diagnostic value of tissue doppler imaging (TDI) of mitral annular velocities in Fabry cardiomyopathy. Despite the lower TDI mitral annular velocities in FD, the overlap with the general population is too large to allow reliable diagnosis of FD in routine clinical practice. In the prospective study, we analysed the prevalence, characteristics, prognosis and validity of the current echocardiographic criteria for heart...
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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...
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Novel echocardiographic and magnetic resonance methods in diagnostics of cardiac amyloidosis.
Fikrle, Michal ; Paleček, Tomáš (advisor) ; Hutyra, Martin (referee) ; Krejčí, Jan (referee)
Amyloidosis is a term used for a whole group of diseases caused by deposition of a substance called amyloid into different tissues. Amyloid may be produced by a range of pathologic processes. Heart affliction is typical for only several types of amyloidoses. Heart involvement is then the patient`s prognosis major limiting factor. Diagnosis of heart amyloidosis is difficult especially for nonspecific symptoms and nonspecific findings obtained during common diagnostic procedures. The aim of this thesis was to evaluate usefulness of novel diagnostic methods, namely cardiac magnetic resonance with gadolinium enhancement and a simplified echocardiographic evaluation of left ventricular longitudinal strain, in diagnosing amyloid cardiomyopathy. In our first study we examined 22 patients with light chain amyloidosis by echocardiography and also with cardiac magnetic resonance with late gadolinium enhancement. We compared morphologic and functional parameters acquired by magnetic resonance examination, which is considered a gold standard for morphologic and functional measurements, with values obtained by echocardiographic measurement. Afterwards we evaluated the presence and eventually pattern of late gadolinium enhancement during cardiac magnetic resonance exam. From acquired data we conclude that the...
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Oxidative and carbonyl stress,microinflammation and cardiovascular risk in patiens with chronic kidney disease
Peiskerová, Martina ; Kalousová, Marta (advisor) ; Teplan, Vladimír (referee) ; Racek, Jaroslav (referee)
Short summary: Background: High cardiovascular risk in patients with chronic kidney disease is partly due to mineral dysbalance, microinflammation and oxidative stress. CKD patients accumulate traditional and non-traditional CV risk factors. FGF23, MMPs and PlGF belong among these non-traditional biomarkers of CV risk. FGF23 is a phosphaturic hormone and inhibitor of calcitriol synthesis. It is associated with vascular calcifications. Matrix-metalloproteinases (e.g. MMP-2, MMP-9) are proteolytic, proinflammatory enzymes, contributing to myocardial remodelation. Placental growth factor (PlGF) is a proangiogenic cytokine that is associated with LV hypertrophy in animal model. Plasmatic FGF23, MMPs and PlGF are elevated in CKD. Aim: We aimed to describe dynamic changes between several novel biomarkers of CV risk (FGF23, MMP-2, MMP-9 and PlGF) in CKD stages 1-5, to describe their mutual correlations and possible association with traditional CV risk markers. We studied possible association of laboratory and echocardiographic parameters in patients with CKD stages 2-4. Methods: In a cross-sectional study we evaluated 80 patiens with CKD 1-5 and 44 healthy controls. In a prospective study we evaluated echocardiographic and laboratory parameters in 62 patients with CKD 2-4 for an average study period of 36±10...
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Studium of the clinical impact of different forms of cardiac resynchronisation therapy by patients with chronic heart failure
Burianová, Lucie ; Kautzner, Josef (advisor) ; Janoušek, Jan (referee) ; Táborský, Miloš (referee)
Studium of the clinical impact of different forms of cardiac resynchronization therapy by patients with chronic heart failure MUDr. Lucie Burianová ABSTRACT: Introduction: Biventricular (BiV) pacing decreases mortality and improves quality of life of patients with severe heart failure. Haemodynamic and short time clinical studies suggest that isolated leftventricular pacing could have the same effect. Aims: Compare the effect of BiV and leftventricular pacing by subjects with dilated cardiomyopathy and severe heart failure with the attention to signs of dyssynchrony and remodelation of the left chamber. In methodical substudy compare the results of left chamber volumes and ejection fraction (EF LK) measured by CT angiography and 2-dimensional echocardiography with use of contrast agent (K-ECHO). Methods: Patients indicated for cardiac resynchronization therapy were randomized for either BiV or leftventricular pacing. After implantation of the device they were examinated clinically and by echocardiography every 3 months in the period of one year. Four years from the onset of the study the major adverse events in both groups were evaluated. The results of left chamber volumes and EF LK measured by K-ECHO and CT angiography were compared. Results: We enrolled 33 patients. We found clinical improvement in both...
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