The inconsistency of data regarding intrauterine programming of cardiovascular risk factors may be largely caused by genetic predisposition and later lifestyle. We analyzed whether low birth weight and apolipoprotein E (Apo E) polymorphism participate in the onset of hypercholesterolemia in children. Our approach was based on hypothesis that genetically enhanced susceptibility of different individuals might influence the effects of intrauterine programming. Two groups were selected from 2000 children at the beginning of an ongoing study: high-cholesterol group (HCG, n=67) and low-cholesterol group as a control (LCG, n=72). Both groups were divided into tertilles according to birth weight and we compared birth weight and apo E gene polymorphism between and within groups. The birth weight in HCG was 0.3 kg lower than the controls (p<0. 001). The frequency of apoE4 was 31 % in HCG and only 10 % in LCG. The frequency of apoE4+ genotypes was not significantly different between tertilles based on birth weight in HCG. We suppose that intrauterine undernutrition, demonstrated by a lower birth weight, participates in the development of hypercholesterolemia already in childhood. The effects of low birth weight and the candidate gene - apoE, are synergic., P. Szitányi, H. Pistulková, J. A. Hubáček, H. Stuchlíková, R. Poledne., and Obsahuje bibliografii a bibliografické odkazy
Non-surgical management of aortic valve disease has been given considerable attention. Several recent publications have already reported its use in clinical practice. The main issue is to get an understanding of the pathophysiological processes and, most importantly, extensive experimental activity. In addition to testing various animal models, technical and material aspects are also being intensively investigated. It is not clear yet whether the durability and applicability of this promising development will be comparable with the standard of current cardiac surgery. Nonetheless, even the use of some models as a temporary approach helping to improve the circulatory status, not allowing safe surgery, is certainly justified. At any rate, a new stage of research and clinical application has been set off. However, experimental background continues to be simply indispensable. The paper is a short review of the issue., J. Šochman, J. H. Peregrin., and Obsahuje bibliografii a bibliografické odkazy
According to table of mortality of people in Czech Republic, more than 50 % of all deaths pertain to the heart disease and vascular disease and 50 % of these patients present the ischemic heart disease. Therefore build research center is needed that would be deal with these problems. and Bohuslav Ošťádal.
The present study proposed procedure for predicting an optimal left and right ventricular pacing interval delay (V-V interval). In 16 patients (heart failure, left bundle branch block, biventricular pacing) two methods (A and B) identifying optimal V-V interval were tested. Method A: predicted optimal V-V interval A (POVV-A) = electromechanical delay of the segment paced by left ventricle lead minus electromechanical delay of the segment paced by right ventricle lead. Method B: predicted optimal V-V interval B (POVV-B) = difference in the onset of aortic and pulmonary flows. Both methods were validated using echocardiography and right-sided heart catheterization. Cardiac output during POVV-A (4.6 l.min-1 ) was significantly better than that during POVV-A minus 20 ms (4.3 l.min-1, p<0.01) and POVV-A plus 20 ms (4.3 l.min-1 , p<0.01), and than that during POVV-B (4.4 l.min-1, p<0.05). LV dP/dt during POVV-A (818 mm Hg.s-1 ) exceeded that during POVV-A plus 20 ms (717 mm Hg.s-1 , p<0.05) and POVV-A minus 20 ms (681 mm Hg.s-1, p<0.05), and that during POVV-B (727 mm Hg.s-1 , p<0.01). The time difference in onsets of myocardial deformation of left ventricle segment paced by the left ventricle and right ventricle lead allows identifying the optimal V-V interval and improves left ventricle performance., M. Novák, J. Lipoldová, J. Meluzín, J. Krejčí, P. Hude, V. Feitová, L. Dušek, P. Kamarýt, J. Vítovec., and Obsahuje bibliografii a bibliografické odkazy
The effect of increased coronary flow on transmural ventricular repolarization was investigated in six pentobabital-anesthetized sheep. Fresh blood at 10 ml/min was injected into the left circumflex coronary artery (LCX) in addition to the normal coronary flow. Unipolar electrocardiograms were simultaneously registered from epicardium, mid-myocardium and endocardium with fine plunge needles. Activation-recovery interval (ARI) was measured from the unipolar electrocardiograms and was used for estimating the ventricular repolarization duration. It was found that intracoronary blood injection (n=3) prolonged ARI in the epicardium, mid-myocardium and endocardium by an average of 34 ± 16, 28 ± 18 and 25 ± 13 ms, respectively (p<0.01). Pretreatment with nitro-L-arginine (n=3), a nitric synthase inhibitor, diminished the flow-induced ARI prolongation across the ventricular wall. In conclusion, an increase in coronary flow lengthens the duration of transmural ventricular repolarization. These effects appear to be mediated by nitric oxide from the coronary endothelium., Y.-Z. Zhang, B. He, L.-X. Wang., and Obsahuje bibliografii a bibliografické odkazy
Both, severe hypo- or hyperthyroidism may alter hemodynamic parameters. The aim of our study was to ascertain, whether also distinct changes within normal range of free thyroxine (fT4) would be associated with an impairment of left ventricle function in patients with chronic heart failure. Hundred-forty-eight patients (m121, f27, mean age 63.8±1.14 years) with chronic heart failure, fT4 levels within the normal range (9-22 pmol/l) and without thyrostatics or substitution treatment. Degree of heart failure was quantified by plasma B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP). Patients with fT4 in the range 11.9-14.6 pmol/l [optimal, 2nd-3th quintile] had significantly lower NT-proBNP (718±70.4 pg/ml), than those with fT4<11.8 [low-normal, bottom quintile](1236±223.6 pg/ml; p<0.03) and those with fT4 over 14.6 pmol/l [high-normal, top two quintiles] (1192±114.9 pg/ml; p<0.0002). These differences remain significant, also if adjusted for age, gender and other confounders; adjusted odds ratio was 1.30 (1.05-1.59) for optimal vs. low-normal and 1.27 (1.04-1.55) for optimal vs. high-normal. Similar statistical differences were also found in BNP, but only when optimal and high-normal fT4 ranges were compared. In conclusion, the severity of heart failure seems to be also influenced by only mild deviations of fT4 concentrations from optimal levels., O. Mayer Jr, J. Šimon, J. Čech, H. Rosolová, J. Hrbková, R. Pikner, L. Trefil., and Obsahuje bibliografii a bibliografické údaje
Reliable diagnosis of congenital heart defects and arrhythmias in utero has been possible since the introduction of fetal echocardiography. The nation-wide prenatal ultrasound screening program in the Czech Republic enabled detection of cardiac abnormities in 1/3 of patients born with any congenital heart disease and up to 83 % of those with critical forms. Prenatal frequency of individual heart anomalies significantly differed from the postnatal frequency. Fetal isolated complete atrioventricular block and supraventricular tachycardia may lead to heart failure and are important causes of fetal mortality. The regression of heart failure was achieved by a conversion to the sinus rhythm in the supraventricular tachycardia and by increase of ventricular rate in the complete atrioventricular block., V. Tomek ... [et al.]., and Obsahuje seznam literatury
Our present focus on the hypoxic immature heart is driven by clinical urgency: cyanotic congenital cardiac malformations remain the single largest cause of mortality from congenital defects and ischemic heart disease is no more the disease of the fifth and older decades but its origin as well as risk factors are present already during early ontogeny. Moreover, the number of adult patients operated for cyanotic congenital heart disease during infancy steadily increases. This group approaches the age of the rising risk of serious cardiovascular diseases, particularly ischemic heart disease. Experimental results have clearly shown that the immature heart is significantly more tolerant to oxygen deficiency than the adult myocardium. However, the mechanisms of this difference have not yet been satisfactorily clarified; they are likely the result of developmental changes in cardiac energy metabolism, including mitochondrial function. The high resistance of the newborn heart cannot be further increased by ischemic preconditioning or adaptation to chronic hypoxia; these protective mechanisms appear only with decreasing tolerance during development. Resistance of the adult myocardium to acute oxygen deprivation may be significantly influenced by perinatal hypoxia. These results suggest that the developmental approach offers new possibilities in the studies of pathogenesis, prevention and therapy of critical cardiovascular diseases., B. Ošťádal ... [et al.]., and Obsahuje seznam literatury
Kryptor system was proven to be a rapid, standard method for pregnancy-associated plasma protein A and proform eosinophilic major basic protein (PAPP-A/proMBP) complex detection in coronary artery disease (CAD). No age and/or gender differences in 51 controls and 110 stable coronary artery disease (SCAD) patients were found. SCAD patients did not differ from controls and no difference in PAPP-A/proMBP levels with regards to the number of affected vessels was found. In 21 unstable angina pectoris (UAP), in 35 without and 66 with ST elevation acute myocardial infarctions (NSTEMI, STEMI respectively) patients PAPP-A/proMBP levels were increased (P=0.004 and P<0.0005, respectively). PAPP-A/proMBP levels did not correlate with cardiac troponin I (cTnI) in STEMI and NSTEMI patients. PAPP-A/ proMBP increase was more frequent than cTnI (P=0.036) within the early phase of STEMI. In NSTEMI patients PAPP-A/proMBP positivity was present in 50 % of cTnI negative cases. Receiver operating characteristic (ROC) analysis revealed the highest diagnostic accuracy of PAPP-A/proMBP (0.919) in STEMI cTnI positive cases. The highest specificity/sensitivity PAPP-A/proMBP levels for particular acute coronary syndrome (ACS) types were 10.65-14.75 mIU/l. Combination of PAPP-A/proMBP with cTnI increases their diagnostic efficacy within the early phase of ACS. Our results suggest that PAPP-A/proMBP complex is involved in processes preceding vulnerable plaque development in ACS., P. Hájek, M. Macek, M. Hladíková, B. Houbová, D. Alan, V. Durdil, J. Fiedler, M. Malý, P. Ošťádal, J. Veselka,A. Krebsová., and Obsahuje bibliografii a bibliografické odkazy
The present study investigated cardiac function in hearts of mice with total deficiency of the β1-, β2- and β3-adrenoceptors (TKO) in comparison to wildtype mice (WT). We investigated cardiac morphology and echocardiographic function, measured protein expression of Ca2+-regulatory proteins, SERCA 2a activity, myofibrillar function, and performed running wheel tests. Heart weight and heart-to-body weight ratio were significantly smaller in TKO as compared to WT. This was accompanied by a decrease in the size of the cardiomyocytes in TKO. Heart rate and ejection fraction were significantly diminished in TKO as compared to WT. Protein expressions of SERCA 2a, ryanodine receptor and Na+/Ca2+-exchanger were similar in TKO and WT mice, but phospholamban protein expression was increased. PKAdependent phosphorylation of phospholamban at serine 16 was absent and CaMKII-dependent phosphorylation at threonine 17 was decreased in TKO. All alterations were paralleled by a decrease in SERCA 2a-activity. A similar maximal calciumdependent tension but an increased myofibrillar calciumsensitivity was measured in TKO as compared to WT. We did not observe relevant functional impairments of TKO in running wheel tests. In the absence of β-agonistic stimulation, SERCA 2a activity is mainly regulated by alterations of phospholamban expression and phosphorylation. The decreased SERCA 2a activity following β-adrenoceptor deficiency may be partly compensated by an increased myofibrillar calcium-sensitivity., S. Lee ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy