BACKGROUND: Plasma N-terminal fragment of pro brain natriuretic peptide (NT-proBNP) concentration is elevated in cardiovascular diseases such as congestive heart failure, where increased levels of NT-proBNP indicate cardiac dysfunction, hypervolemia, and higher risk of hospitalization and death. These associations apply also to patients with severe impairment of kidney function. Little is known about diferences in plasma level of NT-proBNP in patients receiving hemodialysis (HD) versus those receiving continuous ambulatory peritoneal dialysis (CAPD). AIM: To evaluate differences in plasma NT-proBNP concentration between HD and CAPD patients. METHODS: Plasma NT-proBNP concentration was prospectively measured in consecutive patients receiving either HD or CAPD at our hospital center. All other standard clinical parameters were recorded. The correlation between plasma NT-proBNP concentration and the type of dialysis was then examined. RESULTS: We studied 99 consecutive patients on HD (age 62 ± 15 years, 66% male) and 18 consecutive patients on CAPD (age 56 ± 18 years, 67% male). Both groups had similar baseline characteristics including duration of dialysis, left ventricular function and mass, and cardiothoracic ratio. Significantly more patients on HD had abnormal NT-proBNP levels compared to patients on CAPD (97% vs 44%; P<0.0001), and this difference remained highly significant when using various NT-proBNP cut off values. A subgroup analysis revealed that the lower NT-proBNP levels of CAPD patients are most pronounced in patients with preserved left ventricular ejection function. As expected, NT-proBNP levels correlated negatively with left ventricular function and positively with cardiothoracic ratio, and this applied to both HD and CAPD groups. CONCLUSION: The lower concentration of NT-proBNP in patients on CAPD compared to those on HD suggests that CAPD produces lesser hemodynamic stress, especially in patients with preserved left ventricular systolic function. Even though increased NT-proBNP levels have been shown to predict increased morbidity and mortality, further studies are necessary to assess the long term benefit of CAPD compared to HD.

• MeSH
• chronické selhání ledvin krev   terapie   MeSH
• dialýza ledvin * MeSH
• kontinuální ambulantní peritoneální dialýza * MeSH
• lidé středního věku MeSH
• lidé MeSH
• natriuretický peptid typu B krev   MeSH
• peptidové fragmenty krev   MeSH
• prospektivní studie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

AIM: The aim of this study was to compare the quality of life after transcatheter aortic valve implantation (TAVI) and surgical replacement (SAVR) at one year. METHODS: The study included 45 consecutive high-risk patients (average age 82.0 years; logistic Euroscore 22.3%) with symptomatic severe aortic stenosis allocated to TAVI transfemoral, TAVI transapical using the Edwards-Sapien valve or SAVR with the Edwards Perimount bioprosthesis (n=15 in each). The pre-operative characteristics were similar except for more myocardial infarctions in TAVI. The quality of life was assessed using the standardized EQ-5D questionnaire at baseline and on days 30, 90 and 360. The protocol was approved by the local ethics committee and an informed consent was signed. A total of 7 patients (15.5%) died during follow-up. RESULTS: At baseline no significant differences in any of the quality-of-life parameters were found except for usual activities described as "best" (46.7% in SAVR vs. 10.0% in TAVI; P=0.002). At 30 and 90 days surviving patients were similar and at 360 days only the anxiety/depression score was "best" in 83.3% SAVR vs. 59.1% (P=0.046). Functional status improved in all patients (NYHA class I-II in 13.3% at baseline vs. 78.9% at 360-days) and the general health median significantly improved in TAVI patients (from 50 to 67; P=0.001) with a positive trend in SAVR patients (P=0.060). CONCLUSIONS: At one year, the general quality of life of high-risk patients had significantly improved after transcatheter aortic valve implantation with a positive trend in surgically treated patients.

• MeSH
• aortální stenóza psychologie   chirurgie   MeSH
• chirurgická náhrada chlopně * metody   mortalita   psychologie   MeSH
• hodnocení rizik MeSH
• kvalita života * MeSH
• lidé MeSH
• prognóza MeSH
• průzkumy a dotazníky MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• srdeční chlopně umělé MeSH
• srdeční katetrizace * přístrojové vybavení   metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

AIMS: To determine the effect of pre-existing pulmonary hypertension (PHT) on early hemodynamics, morbidity and mortality after heart transplantation (HTx). METHODS: Data were prospectively collected from 149 patients, who underwent HTx between January 2000 and December 2007. The subjects were divided into 3 groups: Group A (n=84) without PTH, group B (n=50) with mild to moderate PTH and group C (n=15) with severe PTH. We studied hemodynamic profile, tricuspid valve regurgitation (TR), incidence of acute cellular rejections (AR), infections, duration of hospitalization, 30-day mortality and a long-term survival. RESULTS: Baseline characteristics were similar in all groups. Using vasodilator treatment PVR was successfully brought down to normal range 2.5 ± 0.6 Wood' units (WU) on the day 1 following the surgery in all groups. Over 80% of patients were treated in Group C, 32% in Group A and 46% in Group B. There was no significant difference in the severity of TR among the 3 groups early after HTx (severe TR was observed in 46%, 54%, 33%, respectively). There was no significant difference in incidence of AR (G ≥ 2 Banff classification) (23%, 23%, 33%, respectively), infections (28%, 32%, 33%, respectively) or duration of hospitalization (30, 30, 28 days, respectively). There was no correlation between pre-transplant PHT and 30-day mortality or a long-term survival. CONCLUSIONS: In our cohort, PHT dropped very quickly after HTx, and was not associated with acute right heart failure following the surgery. Reversible PTH does not have a negative impact on short- or long-term survival after HTx.

• MeSH
• časové faktory MeSH
• délka pobytu statistika a číselné údaje   MeSH
• hemodynamika účinky léků   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití MeSH
• následné studie MeSH
• plicní hypertenze farmakoterapie   etiologie   mortalita   patofyziologie   MeSH
• prospektivní studie MeSH
• retrospektivní studie MeSH
• transplantace srdce škodlivé účinky   mortalita   MeSH
• vazodilatancia terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH