BACKGROUND: Ankle brachial index (ABI) has been increasingly used in general practice to identify individuals with low ABI at high cardiovascular risk. However, there has been no consensus on the clinical significance of high ABI. The aim of our study was to compare aortic stiffness as a marker of cardiovascular risk in individuals with low (<1.0), normal (1.0-1.4), and high ABI (>1.4). METHODS: A total of 911 individuals from the Czech post-MONICA study (a randomly selected 1% representative population sample, aged 54 ± 13.5 years, 47% of men) were examined. ABI was measured using a handheld Doppler and aortic pulse wave velocity (aPWV) using the Sphygmocor device. RESULTS: Of the 911 individuals, 28 (3.1%) had low ABI and 23 (2.5%) high ABI. There was a U-shaped association between aPWV and ABI. aPWV was significantly higher in individuals with low and high ABI compared with the normal ABI group (11.1 ± 2.8, 8.3 ± 2.3, p < 0.001; 10.8 ± 2.5, 8.3 ± 2.3 m/s, p < 0.001, respectively). In a model adjusted for age, sex, systolic, diastolic, mean blood pressure and examiner, aPWV remained increased in both extreme ABI groups compared with the normal ABI group. In logistic regression analysis, aPWV together with glucose level, male sex, and a history of deep venous thrombosis were independent predictors of high ABI, while cholesterol was not. CONCLUSION: This is the first study showing increased aortic stiffness in individuals with high ABI, presumably responsible for increased left ventricular mass described previously in this group. These findings suggest increased cardiovascular risk of high ABI individuals.
- MeSH
- analýza rozptylu MeSH
- aorta patofyziologie ultrasonografie MeSH
- dospělí MeSH
- hodnocení rizik MeSH
- kardiovaskulární nemoci diagnóza etiologie patofyziologie ultrasonografie MeSH
- lidé středního věku MeSH
- lidé MeSH
- logistické modely MeSH
- poddajnost MeSH
- prediktivní hodnota testů MeSH
- pulzatilní průtok MeSH
- rizikové faktory MeSH
- senioři MeSH
- tlakový index kotník-paže MeSH
- ultrasonografie dopplerovská MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
viii, 303 s. : il. (převážně barev.) ; 26 cm + 1 DVD-ROM
"Now there is a source of recent information on the basic and clinical usefulness of real-time 3D echocardiography for echocardiographers, cardiologists, cardiac sonographers, and internists. This excellent reference helps clinicians improve pre- and post-surgical planning, attain better measurement of heart function, decrease exam times, and enhance patient communication. An accompanying DVD shows procedures in real time"--Provided by publisher.
- MeSH
- echokardiografie trojrozměrná * metody MeSH
- kardiologie MeSH
- kardiovaskulární nemoci ultrasonografie MeSH
- Publikační typ
- monografie MeSH
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- kardiologie
Serum concentrations of matrix metalloproteinase (MMP) 3 and MMP9 were evaluated in 82 asymptomatic type 2 diabetes mellitus patients without cardiovascular complications and in 41 non-diabetic control subjects. In the asymptomatic diabetic patients, the correlations of these concentrations with diabetes duration, selected biochemical parameters such as glycated haemoglobin (HbA(1c)), and echocardiographic parameters of diastolic function were also assessed. Pulsed and tissue Doppler echocardiography was performed in the two groups. Mean ± SD age was 61 ± 6 years for the asymptomatic diabetic patients and 61 ± 5 years for controls. Mean ± SD concentrations of MMP3 and MMP9 were significantly higher in the asymptomatic diabetic patients (67.5 ± 10.4 and 77.8 ± 28.8 μg/l, respectively) than in controls (47.2 ± 6.1 and 51.1 ± 13.7 μg/l, respectively). In the asymptomatic diabetic patients, MMP3 correlated only with albuminuria (r = 0.341) and MMP9 only with HbA(1c) (r = 0.262); neither MMP was correlated with echocardiographic parameters of diastolic function. Thus, in asymptomatic type 2 diabetic patients without cardiovascular complications, serum MMP3 and MMP9 were elevated, MMP9 was associated with HbA(1c) and MMP3 was associated with albuminuria, however, MMP3 and MMP9 were not associated with echocardiographic parameters of diastolic function.
- MeSH
- antihypertenziva terapeutické užití MeSH
- diabetes mellitus 2. typu krev enzymologie patofyziologie ultrasonografie MeSH
- diastola MeSH
- echokardiografie MeSH
- hypolipidemika terapeutické užití MeSH
- kardiovaskulární nemoci komplikace farmakoterapie patofyziologie ultrasonografie MeSH
- lidé středního věku MeSH
- lidé MeSH
- matrixová metaloproteinasa 3 krev MeSH
- matrixová metaloproteinasa 9 krev MeSH
- studie případů a kontrol MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Vascular accesses (especially polytetrafluoroethylene grafts) with a permanently low flow (Qa <600 ml/min) are prone to thrombosis and thus have short patency. The reason for a permanently low flow is usually medial calcinosis of the inflow artery in diabetics. We retrospectively studied the long-term patency of low-flow grafts with careful ultrasound surveillance and preemptive interventions. METHODS: Twenty subjects with Qa permanently <600 ml/min were included. Ultrasound surveillance was performed every 3 months in addition to classical monitoring techniques. Significant stenosis was strictly defined as the combination of B-mode narrowing >50% + >2-fold peak systolic velocity increase + 1 additional criterion (residual diameter <2.0 mm or flow volume decrease by >20%). Such stenoses were treated by preemptive percutaneous intervention. Primary and secondary patencies were calculated. RESULTS: The primary patency was 357 ± 316 days and the secondary (cumulative) patency was 996 ± 702 days. The number of interventions was 2.09/patient year, but >10 in 6 (33%) subjects. 93 and 80% of grafts were patent 1 and 2 years after access creation, respectively. CONCLUSION: Low-flow accesses undergoing ultrasound surveillance with strict diagnostic criteria and preemptive interventions had patencies similar to accesses with normal Qa in our study. This was enabled by a relatively high rate of interventions.
- MeSH
- cévní protézy normy trendy MeSH
- dospělí MeSH
- kardiovaskulární nemoci chirurgie ultrasonografie MeSH
- lidé středního věku MeSH
- lidé MeSH
- polytetrafluoroethylen normy MeSH
- retrospektivní studie MeSH
- rychlost toku krve * fyziologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
The aim of this retrospective study was to assess if negative treadmill echocardiographic (NTME) results retained their favorable prognosis over a long period of follow-up (median, 95 months) in the setting of ischemic stress electrocardiographic (ISECG) results. METHODS: Consecutive patients with NTME results were analyzed as 2 groups (those with ISECG results and those with normal stress electrocardiographic results). Patients were followed up for a median duration of 95 months to identify major adverse cardiac events (MACEs), including all-cause death, myocardial infarction, and coronary revascularization. RESULTS: Six hundred seventy-seven patients fulfilled the inclusion criteria. Fifty-eight patients had MACEs (8.6%). The annual event rate was 1%. There was an increased unadjusted rate of MACEs among patients with ISECG results (15% vs 8%; P = .025). After adjusting for clinical and stress variables, ISECG results were not independently predictive of MACEs (P = .2). Female gender, prior coronary artery disease, metabolic equivalents achieved, and chest pain at stress were the independent predictors of MACEs. CONCLUSIONS: Patients with NTME results had excellent long-term outcomes, regardless of ISECG results, over a median 95-month follow-up period. The findings of this study reaffirm the importance of benign long-term outcomes in the setting of good exercise capacity.
- MeSH
- analýza přežití MeSH
- echokardiografie statistika a číselné údaje MeSH
- hodnocení rizik metody MeSH
- incidence MeSH
- kardiovaskulární nemoci mortalita ultrasonografie MeSH
- lidé MeSH
- míra přežití MeSH
- následné studie MeSH
- prognóza MeSH
- reprodukovatelnost výsledků MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- zátěžový test statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Michigan MeSH
Hlavním účelem tohoto sdělení je přitáhnout pozornost čtenářů k prostému snímku hrudníku a možnostem získat z něj maximum diagnostických informací, v případě potřeby i s určitou pomocí skiaskopického vyšetření. Morfologické nálezy jsou doplněny hemodynamickými úvahami. Úzká spolupráce s kardiologem umožňuje radiologovi účinně se účastnit diagnostického a terapeutického rozhodování.
A brief outline of an overview lecture read on the XXXV. Czech Congress of Radiology 2006 in Český Krumlov. The main purpose of this communication is to evoke the interest to gain maximum information from plain chest X-rays with some support of fluoroscopy, when needed. Anatomic observations are combined with haemodynamic considerations. A close cooperation with the cardiologist enables radiologists to participate effectively in diagnostic and therapeutic decisions.
Ischemická choroba srdeční je stále metlou evropských zemí včetně České republiky. Na počátku ischemické choroby srdeční stojí v naprosté většině případů aterosklerotické postižení tepenného systému, včetně důležitých tepen zásobujících srdeční sval.
- MeSH
- arteria brachialis patologie ultrasonografie MeSH
- cévní endotel patofyziologie ultrasonografie MeSH
- diabetes mellitus 2. typu MeSH
- dilatace patologická etiologie ultrasonografie MeSH
- finanční podpora výzkumu jako téma MeSH
- hyperemie etiologie ultrasonografie MeSH
- kardiovaskulární nemoci diagnóza etiologie ultrasonografie MeSH
- lidé MeSH
- ultrasonografie metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- srovnávací studie MeSH
elektronický časopis
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- kardiologie
- radiologie, nukleární medicína a zobrazovací metody
- NLK Publikační typ
- elektronické časopisy
