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Neuromodulation in heart failure
Naar, Jan ; Ošťádal, Petr (advisor) ; Rokyta, Richard (referee) ; Vízek, Martin (referee)
The prognosis of heart failure with reduced ejection fraction remains poor. Neurohumoral activation, including increased cardiac sympathetic nerve activity, plays an important role in the pathogenesis as well as disease progression. Recently, several neuromodulation strategies have been proposed that aim to directly affect the residual autonomic imbalance. Spinal cord stimulation is one of the proposed methods. In the clinical part of this project, we assessed the mid-term effect of spinal cord stimulation on cardiac sympathetic nerve activity and the acute effect on autonomic balance. In the total study population, we did not detect any changes in cardiac sympathetic nerve activity or heart rate variability. However, we observed that the patients with high baseline sympathetic nerve activity or low heart rate variability responded favourably to therapy, reflected in reduced cardiac sympathetic nerve activity and increased heart rate variability. Considering these results, we conducted an experimental study focused on the effect of acute severe heart failure on heart rate variability. In a porcine model of hypoxic myocardial dysfunction, we observed a significant reduction in heart rate variability in all parameters recorded. Our results indicate that spinal cord stimulation may improve autonomic...
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The use of virtual reality in combination with electrostimulation of spinal cord and its influence on individual with incomplete spinal cord injury
Svobodová, Anna ; Vařeková, Jitka (advisor) ; Šifta, Petr (referee)
Title: The use of virtual reality in combination with electrostimulation of spinal cord and its influence on individual with incomplete spinal cord injury. Objectives: The main aim of this work is to find out if virtual reality in form of terapheutic videos filmed in the first person perspective and in combination with electrostimulation of spinal-cord has influence on neurological state and subjective perception of young man with spinal-cord injury. Methods: A 25-year-old proband, with incomplete spinal cord lesion syndrome for 10 years, underwent this qualitative research (case study). Proband had been watching ten-minute-long therapeutic videos through VR headset in combination with electrostimulation on average 2-3 times per week over a period of 5 months. In order to record proband's neurological state ASIA Impairment Scale test was used. This test was carried out before, during and after the research. Proband's subjective feelings and pain were evaluated on a point scale: 0-10 and recorded in proband's diary. Results: Proband's sensitivity showed minor improvement. Input score of sensory subscores light touch on ASIA Impairment Scale test were 84 points and output score increased to 86 points. Input score of sensory subscores pin prick were 75 and output score increased to 78 points (of total...
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The use of virtual reality in combination with electrostimulation of spinal cord and its influence on individual with incomplete spinal cord injury
Svobodová, Anna ; Vařeková, Jitka (advisor) ; Šifta, Petr (referee)
Title: The use of virtual reality in combination with electrostimulation of spinal cord and its influence on individual with incomplete spinal cord injury. Objectives: The main aim of this work is to find out if virtual reality in form of terapheutic videos filmed in the first person perspective and in combination with electrostimulation of spinal-cord has influence on neurological state and subjective perception of young man with spinal-cord injury. Methods: A 25-year-old proband, with incomplete spinal cord lesion syndrome for 10 years, underwent this qualitative research (case study). Proband had been watching ten-minute-long therapeutic videos through VR headset in combination with electrostimulation on average 2-3 times per week over a period of 5 months. In order to record proband's neurological state ASIA Impairment Scale test was used. This test was carried out before, during and after the research. Proband's subjective feelings and pain were evaluated on a point scale: 0-10 and recorded in proband's diary. Results: Proband's sensitivity showed minor improvement. Input score of sensory subscores light touch on ASIA Impairment Scale test were 84 points and output score increased to 86 points. Input score of sensory subscores pin prick were 75 and output score increased to 78 points (of total...
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