a1_Diabetes mellitus is a risk factor of cardiovascular diseases. ECG of patients with diabetes mellitus type 1 (DM 1) shows tachycardia (block of parasympathetic innervation) and abnormal repolarization (increased QT interval and QT dispersion (QTd)) indicating a risk of ventricular tachycardia and sudden death in young people with DM 1. The aim of the present report was to measure 145 parameters of the heart electric field in 22 patients (14 men, 8 women) with DM 1 without complications (mean age 32.8±11.4 years) and in 22 controls (11 men, 11 women, mean age 30.1±3.4 years). The duration of diabetes was 13.9 ±7.8 years. The parameters were regist ered by the diagnostic system Cardiag 112.2 and statistically evaluated by the Student and Mann-Whitney test. Tachycardia (86.3±2.7 beats.min-1), shortening of both QRS (79.9±1.6 ms) and QT (349.0±5.9 ms) and increased QT dispersion (115±36 ms) were observed in DM 1 when compared with the controls (75.0±2.1 beats. min -1, QRS 89.9±2.7 ms, QT 374.0±4.4 ms, QTd 34.0±12.0 ms, p<0.01). The QTc was 415.2±4.1 ms in DM 1 and 401.4±6.6 ms in controls (NS)., a2_Other significant findings in DM 1 were: higher maximum of depolarization isopotential maps (DIPMmax) in the initial phase of QRS and less positive in the terminal phase, more negative minimum (DIPMmin) during QRS similarly as the minimum in depolarization isointegral maps (DIIMmin) and the minimum in isointegral map of the Q wave (Q-IIMmin), lower maximum in repolarization isopotential maps (RIPMmax) and less negative minimum (RIPMmin), more negative amplitude of Q wave (Q-IPMAM) and more pronounced spread of depolarization (activation time). Our results confirmed a decreased parasympathetic to sympathetic tone ratio (tachycardia, shortening of the activation time) and revealed different depolarization and repolarization patterns in DM 1. The differences in heart electric field parameters measured by the BSPM method in DM 1 and in the controls indicate the importance of ECG examination of diabetic patients type 1 in the prevention of cardiovascular diseases., D. Žďárská, P. Pelíšková, J. Charvát, J. Slavíček, M. Mlček, E. Medová, O. Kittnar., and Obsahuje bibiografii a bibliografické odkazy
An increased risk of myocardial ischemic changes was demonstrated in patients suffering from panic disorder (PD). Using classical ECG methods, this risk cannot be evaluated in most patients. We measured the vectocardiogram (VCG) using Frank orthogonal leads and body surface maps (BSM) including 12-lead ECG. In our study of 11 PD patients (2 men, 9 women), without any seizures and pharmacological treatment and without cardiovascular symptoms, we found marked sinus tachycardia (heart rate 90.1±12.2 min-1) and a shorter R-R interval (678±93.6 ms) than in 27 controls (heart rate 73.6±7.7min-1, R-R 822.7±86.4 ms) (5 men, 22 women) (p<0.001). The VCG measured spatial QRS-STT angle was more opened (70.3±24.5°) than in the control group (49.5±19.5°) (p<0.05). The maximum (extremum) in depolarization (DIAM max 30, 40) and repolarization (RIAM max 35) of body surface isoarea and isointegral (RIIM max) maps was less positive (p<0.001) and the minimum (DIAM min 40) was less negative than in the controls (p<0.05) even in the period free of a panic attack. Our results showed the changes in the heart electric field parameters occurred in PD patients when compared to the control group., K. Pišvejcová, I. Paclt, J. Slavíček, O. Kittnar, A. Dohnalová, E. Kitzlerová., and Obsahuje bibliografii
Extracorporeal membranous oxygenation (ECMO) is increasingly used in the management of refractory cardiac arrest. Our aim was to investigate early effects of ECMO after prolonged cardiac arrest. In fully anesthetized swine (48 kg, N=18) ventricular fibrillation (VF) was induced and untreated period (20 min) of cardiac arrest commenced, followed by 60 min extracorporeal reperfusion (ECMO flow 100 ml/kg.min). Hemodynamics, arterial blood gasses, plasma potassium, tissue oximetry (StO2) and cardiac (EGM) and cerebral (BIS) electrophysiological parameters were continuously recorded and analyzed. Within 3 minutes of VF hemodynamic and oximetry parameters fall abruptly while metabolic parameters destabilize gradually over 20 minutes peaking at pH 7.04±0.05, pCO2 89±14 mmHg, K+ 8.5±1.6 mmol/l. During reperfusion most parameters restore rapidly: within 3-5 minutes mean arterial pressure reaches >40 mmHg, StO2 >50 %, paO2 >100 mmHg, pCO2 <50 mmHg, K+ <5 mmol/l. EGMs mean amplitude peaks at 4.5±2.4 min. Cerebral activity (BIS>60) reappeared in 5 animals after 87±21 min. In 12/18 animals return of spontaneous circulation was achieved. In conclusions, ECMO provides rapid restitution of internal milieu even after prolonged arrest. However, despite normalization of global parameters full recovery was not guaranteed since cardiac and cerebral electrical activities were sufficiently restored only in some animals. More sensitive and organ specific indicators need to be identified in order to estimate adequacy of cardiac support devices., M. Mlček, ... [et al.]., and Obsahuje seznam literatury
Glucocorticoids (GCs) are steroid hormones produced by the adrenal cortex in reaction to stress stimuli. GCs production is not stable over a 24-hour period; the plasma concentration peaks in the morning (approximately upon awakening) and then the plasma levels decrease, reaching the nadir in the evening. In our experiments, the levels of cortisol, cortisone, DHEA and DHEAS were tested in young female pigs (n=23) during heart catheterization at two different day times (in the morning and in the afternoon). The non-parametric Mann-Whitney test for statistical analysis was used. We found only minimal statistical differences in studied markers between the morning and afternoon group (p>0.05). The absence of circadian variation in GCs levels could originate either at an early age of our experimental pigs, or in stressful conditions on the experiment day, or most likely the day before (e.g. social isolation, fasting, transport, and catheterization), respectively. We can conclude there is no difference in the stress load between morning and afternoon experiments, and therefore we can assume the stress load is not a limiting factor for the timing when catheterization should be preferably performed., H. Skarlandtová ... [et al.]., and Obsahuje seznam literatury
Negative expiratory pressure (NEP) applied at the mouth during tidal expiration provides a non-invasive method for detecting expiratory flow limitation. Forty-two children were studied, i.e. 25 children with different respiratory symptoms (R) and 17 without any respiratory symptoms (NR). Children were examined without any sedation. A preset NEP of -5 cm H 2 O was applied; its duration did not exceed duration of tidal expiration. A significance of FL was judged by determining of a flow-limited range (in % of tidal volume). FL was found in 48 % children of R group. No patient of the NR group elicited FL (P<0.001 R vs. NR). The frequency of upper airway collapses was higher in R group (12 children) than in NR gr oup (5 children). In conclusion, a high frequency of tidal FL in the R group was found, while it was not present in NR group. A relatively high frequency of expiratory upper airway collapses was found in both groups, but it did not differ significantly. NEP method represents a reasonable approach for tidal flow limitation testing in non-sedated preschool children., A. Jiřičková, J. Šulc, P. Pohunek, O. Kittnar, A. Dohnalová, J Kofránek., and Obsahuje bibliografii
Gestational diabetes mellitus (GDM) represents additional risks to both mother and infant. Moreover it increases a woman's risk of cardiovascular disease in the postpartum. The aim of our study was therefore to detect changes of both the QT dispersion and the electrical heart field that could be typical for GDM. Body surface potential maps were obtained using the Cardiac 112.2 device from 26 young women with GDM and 54 young healthy pregnant women in the 36th week of pregnancy. The same recordings were obtained from 18 healthy women in the same age (19-36 years). The average QT dispersion (±SD) in women suffering from GDM was significantly higher (107±25 ms) both than in those with physiological pregnancy (73±18 ms) and than in the normal subjects (34±12 ms) (P<0.001). Moreover we have found in GDM patients shorter QRS complex 82.0±6.8 ms vs. 89.5±8.2 ms in healthy pregnant women and 90.8±7.9 ms in the control group (p=0.011), more horizontal electrical heart axis [16.4±20.1° vs. 42.4±28.7° and 74.6±39.2° respectively (P<0.05)] and lower some depolarization and repolarization amplitudes on isopotential and isointegral maps. According to these results we suppose that described electrocardiographic changes reflect a deterioration of the complete process of ventricular depolarization and repolarization in GDM., E. Medová, ... [et al.]., and Obsahuje seznam literatury