Cor triatriatum sinister (CTS) patrí k zriedkavým vrodeným srdcovým anomáliám. Zvyčajne je ľavá predsieň rozdelená membránou, ktorá bráni prítoku krvi cez pľúcne žily k mitrálnej chlopni a spôsobuje klinické príznaky ako u mitrálnej stenózy s pľúcnou kongesciou a pľúcnou hypertenziou. Najlepším spôsobom liečby je chirurgické odstránenie membrány, ale je možná aj katetrizačná intervencia. V našom príspevku uvádzame prípad pacienta s vrodenou anomáliou CTS, u ktorého sme úspešne, katetrizačne balónom dilatovali stenotický otvor v membráne s priaznivým hemodynamickým a klinickým výsledkom.
Cor triatriatum sinister (CTS) is a rare cardiac congenital anomaly. Left atrium is separated by the membrane which is the cause of obstruction in blood flow from pulmonic veins to mitral valve, and mimicks the clinic manifestation of mitral stenosis with pulmonic congestion and pulmonary hypertension. Surgical resection of the membrane is the best option, but there is also possibility of transcatheter intervention. We here present the patient with the anomaly of CTS, who underwent cardiac catheterization and successful balloon dilatation of the orifice in the membrane with positive haemodynamic and clinical result.
- MeSH
- balónková angioplastika metody MeSH
- cor triatriatum * chirurgie diagnostické zobrazování patologie MeSH
- dilatace MeSH
- kardiochirurgické výkony metody MeSH
- lidé MeSH
- senioři MeSH
- srdeční katetrizace metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- kazuistiky MeSH
The main goal of our prospective randomized study was comparing compare the effectiveness of ventilation control method "Automatic proportional minute ventilation (APMV) "versus manually set pressure control ventilation modes in relationship to lung mechanics and gas exchange. 80 patients undergoing coronary artery bypass grafting (CABG) were randomized into 2 groups. 40 patients in the first group No.1 (APMV group) were ventilated with pressure control (PCV) or pressure support ventilation (PSV) mode with APMV control. The other 40 patients (control group No.2) were ventilated with synchronized intermittent mandatory ventilation (SIMV-p) or pressure control modes (PCV) without APMV. Ventilation control with APMV was able to maintain minute ventilation more precisely in comparison with manual control (p<0.01), similarly deviations of ETCO(2) were significantly lower (p<0.01). The number of manual corrections of ventilation settings was significantly lower when APMV was used (p<0.01). The differences in lung mechanics and hemodynamics were not statistically significant. Ventilation using APMV is more precise in maintaining minute ventilation and gas exchange compared with manual settings. It required less staff intervention, while respiratory system mechanics and hemodynamics are comparable. APMV showed as effective and safe method applicable on top of all pressure control ventilation modes.
- MeSH
- hemodynamika fyziologie MeSH
- koronární bypass metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- mechanika dýchání fyziologie MeSH
- prospektivní studie MeSH
- senioři MeSH
- umělé dýchání metody MeSH
- ventilace umělá s výdechovým přetlakem metody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
BACKGROUND: The metabolic syndrome (MS) is a clustering of cardiovascular risk. The high prevalence of metabolic syndrome among populations of lower socioeconomic status is a cause of concern and calls for an effective public health response. OBJECTIVES: The aim of this study was to determine the prevalence of metabolic syndrome in the Roma population compared with the non-Roma population in the eastern part of Slovakia and to determine the parameter which has the strongest association with metabolic syndrome. RESULTS: 123 Roma and 79 non-Roma patients with metabolic syndrome were evaluated. In the subgroup of Roma men, we found that waist circumference conferred the highest chance of MS (more than 12-times), followed by triglycerides (TG) (3.670-times). In the subgroup of non-Roma men, we found that waist circumference conferred the highest chance of MS (more than 16-times), followed by high-density lipoprotein (HDL) (4.348-times increased risk per one unit decrease in HDL). In the subgroup of Roma women as well as non-Roma women, we found that serum TG conferred the highest chance of MS, followed by waist circumference for Roma women. Comparing non-classical risk factors for MS we found that only age (with OR 1.977) and high-sensitivity C-reactive protein (hsCRP) (OR 1.887) were significant and independent predictors of MS in Roma men. Among Roma women apolipoprotein B100 was also found to be an independent predictor of MS, besides age and hsCRP. CONCLUSION: Our study confirmed that the prevalence of metabolic syndrome is strongly associated with hypertriglyceridemic waist, besides other risk factors, a marker of the atherogenic metabolic triad among younger Roma population, which may be the reason for the increased cardiovascular (CV) morbidity and mortality in elderly Roma compared with non-Roma. In light of these results, better prevention of CV events for Roma minority settlements in Slovakia should be provided.
- MeSH
- apolipoprotein B-100 krev MeSH
- biologické markery krev MeSH
- C-reaktivní protein MeSH
- charakteristiky bydlení statistika a číselné údaje MeSH
- dospělí MeSH
- index tělesné hmotnosti MeSH
- lidé středního věku MeSH
- lidé MeSH
- lipidy krev MeSH
- lipoproteiny HDL krev MeSH
- metabolický syndrom krev etnologie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- obezita krev etnologie MeSH
- obvod pasu etnologie fyziologie MeSH
- odds ratio MeSH
- prevalence MeSH
- rizikové faktory MeSH
- Romové etnologie statistika a číselné údaje MeSH
- rozložení podle pohlaví MeSH
- triglyceridy krev MeSH
- věkové rozložení MeSH
- venkovské obyvatelstvo statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Slovenská republika MeSH
BACKGROUND: Obesity-induced metabolic syndrome is a multiple risk factor for cardiovascular (CV) risk factors and type 2 diabetes, and ethnic minorities seem to have unfavourable medical risk factors in general more frequently than majority populations. OBJECTIVE: The aim of this study was to evaluate the prevalence of cardiovascular risk factors in relation to metabolic syndrome in the Roma population compared with the non-Roma population residing in the eastern part of Slovakia. RESULTS: 123 Roma and 79 non-Roma patients with metabolic syndrome were evaluated. Men between 40-55 years of age had 4.76-times higher odds and women 5.26-times higher odds for metabolic sydrome compared with the younger population. We found statistically significant higher waist circumference in the Roma subpopulation and higher body mass index as well, although in selected population with metabolic syndrome. HDL cholesterol was significantly lower in both Roma men and women, and LDL cholesterol was not significant in men and women with metabolic syndrome. Triglycerides levels were significantly higher in non-Roma women only. High-sensitivity C-reactive protein (hsCRP) values were not in correlation with age but were associated with the increasing number of fulfilled criteria for metabolic syndrome in both subgroups (Roma, non-Roma), independently of gender. CONCLUSION: Our study confirmed higher prevalence of obesity, metabolic syndrome and other CV risk factors associated with metabolic syndrome among younger Roma population, which may be associated with increased cardiovascular disease (CVD) morbidity and mortality among elderly Roma compared with non-Roma.
- MeSH
- charakteristiky bydlení statistika a číselné údaje MeSH
- dospělí MeSH
- dyslipidemie etnologie MeSH
- index tělesné hmotnosti MeSH
- kardiovaskulární nemoci etnologie MeSH
- komorbidita MeSH
- lidé středního věku MeSH
- lidé MeSH
- metabolický syndrom etnologie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- prevalence MeSH
- rizikové faktory MeSH
- Romové etnologie statistika a číselné údaje MeSH
- rozložení podle pohlaví MeSH
- věkové rozložení MeSH
- venkovské obyvatelstvo statistika a číselné údaje MeSH
- zánět etnologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Slovenská republika MeSH
Mechanické podpory srdca sú v súčasnej dobe jednou z najdynamickejšie sa rozvíjajúcich oblastí modernej kardiológie a kardiochirurgie v terapii akútneho i chronického srdcového zlyhania. Hlavným cieľom je zlepšenie alebo úplné opätovné nastolenie odpovedajúcich hemodynamických parametrov a dostatočnej orgánovej perfúzie. V tomto prípade prezentujeme tragický prípad pacientky, u ktorej sa na základe koronarografi e a IVUS kvantifi kácie dvoch stenóz nepodarilo odhadnúť nepriaznivý klinický trend, po troch mesiacoch došlo k vzniku akútneho infarktu myokardu v dôsledku kritickej stenózy na kmeni ACS, a to v mieste, ktoré bolo pôvodne popisované ako „zdravé“. Záchrana pacientky bola komplikovaná jej negatívnym postojom a emergentná kardiochirurgická revaskularizácia bola začatá s dvojhodinovým oneskorením, už v rozvíjajúcom sa kardiogénnom šoku. Napriek komplexným opatreniam, vrátane úspešnej revaskularizácie, zavedenej balónkovej kontrapulzácii a implantácii obojkomorovej mechanickej podpory obehu (Levitronix) sa nepodarilo zabrániť rozvoju multiorgánového zlyhania, ARDS a neskôr exitu pacientky. K intervenčnej či chirurgickej revaskularizácii myokardu sa pristupuje pri prítomnosti stenóz nad 50–60 % diametra. Veríme, že v budúcnosti dokážeme takýmto prípadom predchádzať.
Mechanical cardiac support is currently one of the most dynamic areas of modern cardiology and cardiac surgery in the treatment of acute and chronic heart failure. The main objective is to improve or completely restore the corresponding hemodynamic parameters and adequate organ perfusion. In this paper, we present the tragic case of a female patient, in whom coronary angiography and quantifi cation of two stenoses by intravascular ultrasound failed to predict an unfavourable clinical trend; three months later, the patient suff ered an acute myocardial infarction due to critical stenosis of the left main coronary artery at a site originally described as “intact”. Patient salvage was complicated by her unwillingness and emergency cardiac surgery revascularization was started with a two-hour delay, already in the presence of evolving cardiogenic shock. Comprehensive measures including successful revascularization, intra-aortic balloon contrapulsation and implantation of a biventricular assist device (Levitronix) failed to prevent the development of multiorgan failure, acute respiratory distress syndrome, and subsequent death of the patient. The interventional or surgical myocardial revascularizations are used in the presence of stenoses exceeding 50–60% of diameter. We believe, we will anticipate such cases from happening.
- MeSH
- dospělí MeSH
- dyslipidemie komplikace MeSH
- echokardiografie metody využití MeSH
- fatální výsledek MeSH
- Hodgkinova nemoc farmakoterapie komplikace radioterapie MeSH
- hypertenze komplikace MeSH
- infarkt myokardu diagnóza komplikace terapie MeSH
- kardiogenní šok komplikace terapie MeSH
- kontrapulzace metody využití MeSH
- koronární angiografie metody využití MeSH
- koronární stenóza diagnóza komplikace terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- multiorgánové selhání komplikace MeSH
- podpůrné srdeční systémy trendy využití MeSH
- revaskularizace myokardu metody využití MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
Úvod: Základom liečby u pacientov s infarktom myokardu s eleváciou segmentov ST (STEMI) je včasná reperfúzia. Čím skôr sa od začiatku príznakov podarí obnoviť prietok uzatvorenou cievou, tým menší je rozsah infarktu myokardu, tým lepšia je výsledná funkcia ĽK (1). Cieľ: Analyzovali sme ejekčnú frakciu ĽK u pacientov so STEMI po primárnej koronárnej intervencii (PCI) v závislosti od dĺžky celkového ischemického času (interval „príznak-balón“). Metodika: Retrospektívnou analýzou sme analyzovali 147 konsekutívnych pacientov so STEMI po primárnej PCI. Zaradení boli iba pacienti bez anamnézy prekonaného infarktu myokardu. V 62 prípadoch bola primárnou PCI vykonaná nekompletná revaskularizácia, v 85 prípadoch kompletná revaskularizácia. Pri štatistickom spracovaní sme použili Pearsonovú korelačnú analýzu, T-test a lineárnu regresnú analýzu. Výsledky: Medián intervalu „príznak-balón“ bol 4 h a 53 min. Horšia EF ĽK po výkone je asociovaná s dlhším intervalom „príznak-balón“ (β = -0,321, p < 0,001), nekompletnou revaskularizáciou (β = 0,194, p = 0,005) a potrebou zákroku na RIA (β = -0,480, p < 0,001). Pacienti s kompletnou revaskularizáciou mali významne lepšiu EF ĽK ako pacienti s nekompletnou revaskularizáciou (p = 0,045). Naše analýzy potvrdzujú dôležitosť minimalizácie časových strát predhospitalizačnej i hospitalizačnej fázy STEMI. Dlhšie časové intervaly majú významne negatívny dopad na funkciu ľavej komory (ĽK) u pacientov po primárnej PCI.
Introduction: Basic treatment in patients with ST segment elevation myocardial infarction (STEMI) is early reperfusion. The sooner the flow of closed artery is restored the lesser is the rate of heart attack, the better is the final function of the left ventricle LV (1). Aim: Ejection fraction of LV in patients with STEMI after primary coronary intervention (PCI) was analyzed depending on whole ischemic time (interval „symptom-balloon“). Methods: Retrospective analysis was used to analyze 147 consecutive patients with STEMI after primary PCI. Only patients without history of overcome heart attack were included. In 62 cases incomplete revascularization was performed by primary PCI, in 85 cases complete revascularization. Pearson´s correlation analysis, T-test and linear recessive analysis were used for statistical processing. Results: Mean time of interval „symptom-balloon“ was four hrs and fifty three min. Worse LVEF after procedure is associated with longer interval „symptom-balloon“ (β = -0.321, p < 0.001), incomplete revascularization (β = 0.194, p = 0.005) and need of intervention on RIA (β = -0.480, p < 0.001). Patients with complete revascularization had significantly better LVEF than those with incomplete revascularization (p = 0.045). Our analyses confirm the need of time loss minimizing of pre-hospitalization as well as hospitalization phase STEMI. Longer time intervals have significantly negative impact on left ventricle function in patients after primary PCL.
- MeSH
- dospělí MeSH
- echokardiografie transezofageální metody MeSH
- kardiochirurgické výkony metody MeSH
- lidé MeSH
- perikardiální efuze diagnóza etiologie patologie MeSH
- poranění srdce diagnóza patologie terapie MeSH
- Valsalvův sinus MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH