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
BACKGROUND: Precise determination of the aortic annulus size constitutes an integral part of the preoperative evaluation prior to aortic valve replacement. It enables the estimation of the size of prosthesis to be implanted. Knowledge of the size of the ascending aorta is required in the preoperative analysis and monitoring of its dilation enables the precise timing of the operation. Our goal was to compare the precision of measurement of the aortic annulus and ascending aorta using magnetic resonance (MR), multidetector-row computed tomography (MDCT), transthoracic echocardiography (TTE), and transoesophageal echocardiography (TEE) in patients with degenerative aortic stenosis. METHODS AND RESULTS: A total of 15 patients scheduled to have aortic valve replacement were enrolled into this prospective study. TTE was performed in all patients and was supplemented with TEE, CT and MR in the majority of patients. The values obtained were compared with perioperative measurements. For the measurement of aortic annulus, MR was found to be the most precise technique, followed by MDCT, TTE, and TEE. For the measurement of ascending aorta, MR again was found to be the most precise technique, followed by MDCT, TEE, and TTE. CONCLUSION: In our study, magnetic resonance was found to be the most precise technique for the measurement of aortic annulus and ascending aorta in patients with severe degenerative aortic stenosis.
- MeSH
- aorta ultrasonografie MeSH
- aortální chlopeň patologie radiografie ultrasonografie MeSH
- aortální stenóza radiografie ultrasonografie MeSH
- chirurgická náhrada chlopně MeSH
- echokardiografie MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- prospektivní studie MeSH
- senioři MeSH
- velikost orgánu MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
BACKGROUND: Assessment of fluid responsiveness is an important topic in acute cardiology. Echocardiographic measurement of respiratory variations of aortic blood velocity in ventilated shock patients can accurately predict the effect of volume expansion. On the other hand, it remains unclear whether this respiratory variability is a common physiological reaction to hypovolaemia and whether its measurement is applicable also in spontaneously breathing patients.
- MeSH
- aorta ultrasonografie MeSH
- dechový objem fyziologie MeSH
- dospělí MeSH
- hemodynamika fyziologie MeSH
- krevní tlak fyziologie MeSH
- lidé MeSH
- mechanika dýchání fyziologie MeSH
- referenční hodnoty MeSH
- rychlost toku krve fyziologie MeSH
- tepový objem fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
BACKGROUND/AIMS: Aortic stenosis (AS) and hypertension are associated with cardiac hypertrophy and aortic dilatation. The effect of their coincidence on the ascending aortic dimensions has not yet been evaluated, and therefore was the aim of our study. METHODS: We performed cross-sectional analysis of history, clinical, angiographic and echocardiographic data of consecutive patients evaluated before surgery for non-rheumatic AS. RESULTS: The study sample included 225 patients (age 68+/-9 years, 60% males), with mean transaortic gradient of 55+/-17 mmHg. Hypertension was present in 153 (68%) patients. The hypertensives had more severe dyspnea (NYHA class 2.2+/-0.9 vs 1.9+/-0.9, p = 0.05) and higher prevalence of coronary artery disease (57% vs 33%, p = 0.001), but did not differ from the normotensives in the ascending aortic dimensions, the left ventricular mass, ejection fraction and remodeling patterns. Wider ascending aortic dimensions were independently associated with bicuspid aortic valve (p<0.001), and with maximal gradient in those with tricuspid aortic valve. Vasodilators were used in 84 (54%) hypertensives. CONCLUSION: We found hypertension in 68% of patients with severe AS. Bicuspid aortic valve and stenosis severity were independent predictors of ascending aortic dimensions, but not the history of hypertension and blood pressure.
- MeSH
- antihypertenziva terapeutické užití MeSH
- aorta patologie ultrasonografie MeSH
- aortální stenóza patologie ultrasonografie MeSH
- echokardiografie MeSH
- financování organizované MeSH
- hypertenze farmakoterapie patologie ultrasonografie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mitrální chlopeň ultrasonografie MeSH
- průřezové studie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- MeSH
- aorta ultrasonografie MeSH
- arteria cerebri media ultrasonografie MeSH
- arteriae umbilicales ultrasonografie MeSH
- dospělí MeSH
- lidé MeSH
- placentární oběh MeSH
- rychlost toku krve MeSH
- těhotenství MeSH
- ultrasonografie dopplerovská metody MeSH
- ultrasonografie prenatální metody využití MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
Autoři uvádějí kazuistiku 2denního novorozence s klinickými známkami kritické koarktace aorty, u něhož oyla echokardiograficky prokázána trombóza oblouku a istmu aorty, při operaci nebylo možné organizovaný trombus z aorty odstranit, proto byl úsek aorty s trombem resekován a aorta byla rekonstruována anastomózou konce ke konci, po operaci byla zavedena dlouhodobá antikoagulační léčba Warfarinem. Vyšetření hemokoagulačních faktorů, včetně proteinu C a S a antitrombinu III prokázalo normální nálezy. Test na lupus erythematodes byl rovněž negativní. Anamnestický z průběhu těhotenství matky se rovněž nepodařilo zjistit pri'činu závažné vrozené aortální trombózy. Dítě je po operaci bez obtíží a dobře prospívá.
The authors present the case-history of a two-day-old neonate with clinical signs of critical coarctation of the aorta where echocardiography revealed thrombosis of the aortic arch and isthmus. By surgery it was impossible to remove the organized thrombus from the aorta, therefore the portion of the aorta with the thrombus was resected and the aorta was reconstructed by an end-to-end anastomosis. After surgery long-term anticoagulation treatment with Warfarin was started. Examination of haemocoagulation factors, incl. proteins C and S and antithrombon III revealed normal findings. The test for lupus erythematosus was also negative. From the case-history of the mother's pregnancy the cause of the serious congenital aortic thrombosis could not be traced. The child is all right after surgery and thrives.
- MeSH
- aorta chirurgie patologie ultrasonografie MeSH
- dítě MeSH
- koarktace aorty MeSH
- kojenec MeSH
- lidé MeSH
- novorozenec MeSH
- syndromy aortálního oblouku chirurgie ultrasonografie vrozené MeSH
- trombóza etiologie chirurgie ultrasonografie MeSH
- výkony cévní chirurgie metody MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- aorta patologie ultrasonografie MeSH
- echokardiografie metody MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- MeSH
- aorta patologie ultrasonografie MeSH
- arteria pulmonalis patologie ultrasonografie MeSH
- defekt aortopulmonálního septa MeSH
- dítě MeSH
- dopplerovská echokardiografie MeSH
- kojenec MeSH
- lidé MeSH
- novorozenec MeSH
- truncus arteriosus patologie ultrasonografie MeSH
- ultrazvuk MeSH
- vrozené vady diagnóza MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
