Cíl: Cílem práce bylo ověřit senzitivitu a specificitu gated SPECT-zobrazení myokardu a posoudit přínos metodou zjištěných kvantitativních parametrů perfuze a funkce levé komory pro detekci rizikových pacientů s nemocí více koronárních tepen. Metodika: Byl analyzován soubor 582 pacientů (412 mužů, průměrný věk 62 ± 10 let, 164 pacientů po předchozím infarktu myokardu a 125 po revaskularizaci) vyšetřených pomocí zátěžového gated SPECT myokardu, jejichž nález byl následně ověřen koronarograficky. Pro kvantifikaci sumačního zátěžového skóre (SSS), ejekční frakce (EF) a poměru tranzientní ischemické dilatace (TID) levé komory byl použit software 4D-MSPECT. Výsledky: Na základě vizuálního hodnocení obrazů perfuze byla senzitivita a specificita SPECT 93% (389/417) a 79% (130/165). Kvantitativní analýza perfuze ukázala nárůst SSS podle počtu postižených povodí: SSS 9, 13 a 16 při postižení jednoho, dvou, resp. tří povodí. Známky poischemického omráčení levé komory (pozátěžové zhoršení EF > 5 % a/nebo zvýšený poměr TID > 1,17) mělo 46 %, 52 % a 66 % pacientů s nemocí jedné, dvou, resp. tří tepen. Závěr: Kvantitativní parametry perfuze a funkce (vysoké SSS nebo známky poischemického omráčení) umožňují identifikaci rizikových pacientů, u nichž lze předpokládat nemoc více tepen.

Aim: The aim of this study was to analyze the sensitivity and specificity of cardiac gated SPECT imaging and to assess the diagnostic potential of quantitative perfusion and the left ventricular function parameters to identify high-risk patients with multivessel coronary artery disease (CAD). Methods: 582 patients (412 men, mean age 62 ± 10 years, 164 after previous myocardial infarction, 125 after revascularization) underwent a stress gated SPECT study followed by coronary angiography. A summed stress score (SSS), poststress and rest left ventricular ejection fraction (LVEF) and transient ischemic dilatation ratio (TID) were obtained through the use of 4D-MSPECT software. Results: In visual assessment, the sensitivity and specificity of SPECT were 93% (389/417), and 79% (130/165), respectively. In quantitative perfusion analysis, SSS rose with the number of diseased vessels: SSS were 9, 13 and 16 in patients with 1-, 2- and 3-vessel disease, respectively. We observed signs of postischemic left ventricular stunning (worsening of LVEF by exercise > 5% and/or TID ratio > 1.17) in 46%, 52%, and 66% of patients with 1-, 2-, and 3-vessel disease, respectively. Conclusion: Quantitative perfusion and function parameters (high SSS or signs of postischemic stunning) enable the identification of high-risk patients with multivessel CAD.

• MeSH
• Myocardial Ischemia radiography   MeSH
• Tomography, Emission-Computed, Single-Photon methods   MeSH
• Coronary Angiography methods   MeSH
• Sensitivity and Specificity MeSH
• Exercise Test MeSH

Observational studies suggest that conventional right ventricular apical pacing may have a deleterious effect on left ventricular function. In this study, we examined whether biventricular pacing is superior to right ventricular apical pacing in preventing deterioration of left ventricular systolic function and cardiac remodeling in patients with bradycardia and a normal ejection fraction. METHODS: In this prospective, double-blind, multicenter study, we randomly assigned 177 patients in whom a biventricular pacemaker had been successfully implanted to receive biventricular pacing (89 patients) or right ventricular apical pacing (88 patients). The primary end points were the left ventricular ejection fraction and left ventricular end-systolic volume at 12 months. RESULTS: At 12 months, the mean left ventricular ejection fraction was significantly lower in the right-ventricular-pacing group than in the biventricular-pacing group (54.8+/-9.1% vs. 62.2+/-7.0%, P<0.001), with an absolute difference of 7.4 percentage points, whereas the left ventricular end-systolic volume was significantly higher in the right-ventricular-pacing group than in the biventricular-pacing group (35.7+/-16.3 ml vs. 27.6+/-10.4 ml, P<0.001), with a relative difference between the groups in the change from baseline of 25% (P<0.001). The deleterious effect of right ventricular apical pacing occurred in prespecified subgroups, including patients with and patients without preexisting left ventricular diastolic dysfunction. Eight patients in the right-ventricular-pacing group (9%) and one in the biventricular-pacing group (1%) had ejection fractions of less than 45% (P=0.02). There was one death in the right-ventricular-pacing group, and six patients in the right-ventricular-pacing group and five in the biventricular-pacing group were hospitalized for heart failure (P=0.74). CONCLUSIONS: In patients with normal systolic function, conventional right ventricular apical pacing resulted in adverse left ventricular remodeling and in a reduction in the left ventricular ejection fraction; these effects were prevented by biventricular pacing. (Centre for Clinical Trials number, CUHK_CCT00037.) 2009 Massachusetts Medical Society

• MeSH
• Atrioventricular Block complications   MeSH
• Bradycardia etiology   physiopathology   therapy   MeSH
• Double-Blind Method MeSH
• Ventricular Dysfunction, Left etiology   prevention & control   therapy   MeSH
• Echocardiography, Three-Dimensional MeSH
• Financing, Organized MeSH
• Ventricular Function, Left MeSH
• Pacemaker, Artificial MeSH
• Quality of Life MeSH
• Humans MeSH
• Cardiac Volume MeSH
• Prospective Studies MeSH
• Randomized Controlled Trials as Topic MeSH
• Ventricular Remodeling MeSH
• Aged MeSH
• Sick Sinus Syndrome complications   MeSH
• Stroke Volume MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Multicenter Study MeSH
• Comparative Study MeSH

OBJECTIVES: This article discusses methods of examining subjective social status (SSS), which is based on the concept of social determinants of health described by Wilkinson and Marmot in 1998. METHODS: SSS research was conducted with Cooperation from the Scientific and Technical Research (COST) program, with financial support from the Czech Ministry of Education, Youth and Sports. This study is part of a project entitled the "Health and Social Status of Immigrants and Asylum Seekers in the Czech Republic" (registration number OC 10031), which was started in 2010 and concluded in May 2011. The study included 246 respondents of which: 69 (28.1%) had emigrated from Vietnam; 93 (37.8%) from the Ukraine; and 84 (34.1%) from Mongolia. In terms of qualitative strategies, 13 individual immigrants and asylum seekers were personally interviewed. This research was thus conceived as being both quantitative-qualitative, which included the use of the appropriate technical tools (i.e., questionnaires and interviews with select immigrants and asylum seekers). SSS was determined using the Pearson's chi-square test, as well as through correspondence and cluster analyzes. Sign schemes were used to detect select significant relationships in contingency tables. The minimum significance level chosen was α ≤ 0.05. RESULTS: When examining the SSS of select nationalities, differences were observed in the perception of subjective social status. The correspondence analysis results clearly show that Ukrainians best perceived their social status (within the selected parameters). One measure of subjectively perceived social status related to Czech language proficiency (i.e., one criterion was the comprehension of spoken Czech; e.g., whether the respondent could read or speak Czech, or how they assessed their own Czech proficiency). CONCLUSION: The SSS study clearly revealed typical links among select nationalities living in the Czech Republic, and highlighted risks related to the degree of integration (and its relationship to social exclusion). This study served as a pilot project for follow-up research conducted by the second COST project entitled: "Social Determinants of Health and their Impact on the Health of Immigrants Living in the Czech Republic" (registration number LD 13044 COST). The follow-up study included 1 000 respondents of Slovak, Vietnamese, Ukrainian, Russian and Polish nationality and is currently underway at the Faculty of Health and Social Studies at the University of South Bohemia in the Czech Republic. The methodological tools used were taken from the COST pilot project (which is the topic of this article) and were adjusted as needed (i.e., both objective and subjective criteria were used for examining social status).

• MeSH
• Emigrants and Immigrants psychology   statistics & numerical data   MeSH
• Risk Assessment MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Surveys and Questionnaires MeSH
• Social Class * MeSH
• Social Stigma * MeSH
• Health Status * MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH
• Mongolia MeSH
• Ukraine MeSH
• Vietnam MeSH

Conventional dual-chamber pacing maintains atrioventricular synchrony but results in high percentages of ventricular pacing, which causes ventricular desynchronization and has been linked to an increased risk of atrial fibrillation in patients with sinus-node disease. METHODS: We randomly assigned 1065 patients with sinus-node disease, intact atrioventricular conduction, and a normal QRS interval to receive conventional dual-chamber pacing (535 patients) or dual-chamber minimal ventricular pacing with the use of new pacemaker features designed to promote atrioventricular conduction, preserve ventricular conduction, and prevent ventricular desynchronization (530 patients). The primary end point was time to persistent atrial fibrillation. RESULTS: The mean (+/-SD) follow-up period was 1.7+/-1.0 years when the trial was stopped because it had met the primary end point. The median percentage of ventricular beats that were paced was lower in dual-chamber minimal ventricular pacing than in conventional dual-chamber pacing (9.1% vs. 99.0%, P<0.001), whereas the percentage of atrial beats that were paced was similar in the two groups (71.4% vs. 70.4%, P=0.96). Persistent atrial fibrillation developed in 110 patients, 68 (12.7%) in the group assigned to conventional dual-chamber pacing and 42 (7.9%) in the group assigned to dual-chamber minimal ventricular pacing. The hazard ratio for development of persistent atrial fibrillation in patients with dual-chamber minimal ventricular pacing as compared with those with conventional dual-chamber pacing was 0.60 (95% confidence interval, 0.41 to 0.88; P=0.009), indicating a 40% reduction in relative risk. The absolute reduction in risk was 4.8%. The mortality rate was similar in the two groups (4.9% in the group receiving dual-chamber minimal ventricular pacing vs. 5.4% in the group receiving conventional dual-chamber pacing, P=0.54). CONCLUSIONS: Dual-chamber minimal ventricular pacing, as compared with conventional dual-chamber pacing, prevents ventricular desynchronization and moderately reduces the risk of persistent atrial fibrillation in patients with sinus-node disease. (ClinicalTrials.gov number, NCT00284830 [ClinicalTrials.gov].). Copyright 2007 Massachusetts Medical Society.

• MeSH
• Atrial Fibrillation prevention & control   MeSH
• Kaplan-Meier Estimate MeSH
• Cardiac Pacing, Artificial methods   MeSH
• Pacemaker, Artificial adverse effects   MeSH
• Humans MeSH
• Sinoatrial Node MeSH
• Aged MeSH
• Heart Rate MeSH
• Heart Ventricles MeSH
• Sick Sinus Syndrome therapy   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH

BACKGROUND: Anderson-Fabry disease (AFD) is an X-linked inherited lysosomal disease caused by a defect in the gene encoding lysosomal enzyme α-galactosidase A (GLA). Atrio-ventricular (AV) nodal conduction defects and sinus node dysfunction are common complications of the disease. It is not fully elucidated how frequently AFD is responsible for acquired AV block or sinus node dysfunction and if some AFD patients could manifest primarily with spontaneous bradycardia in general population. The purpose of study was to evaluate the prevalence of AFD in male patients with implanted permanent pacemaker (PM). METHODS: The prospective multicentric screening in consecutive male patients between 35 and 65 years with implanted PM for acquired third- or second- degree type 2 AV block or symptomatic second- degree type 1 AV block or sinus node dysfunction was performed. RESULTS: A total of 484 patients (mean age 54 ± 12 years at time of PM implantation) were enrolled to the screening in 12 local sites in Czech Republic. Out of all patients, negative result was found in 481 (99%) subjects. In 3 cases, a GLA variant was found, classified as benign: p.Asp313Tyr, p.D313Y). Pathogenic GLA variants (classical or non-classical form) or variants of unclear significance were not detected. CONCLUSION: The prevalence of pathogenic variants causing AFD in a general population sample with implanted permanent PM for AV conduction defects or sinus node dysfunction seems to be low. Our findings do not advocate a routine screening for AFD in all adult males with clinically significant bradycardia.

• MeSH
• Atrioventricular Block * diagnosis   epidemiology   therapy   MeSH
• Bradycardia complications   therapy   MeSH
• Adult MeSH
• Fabry Disease * diagnosis   epidemiology   genetics   MeSH
• Pacemaker, Artificial * adverse effects   MeSH
• Middle Aged MeSH
• Humans MeSH
• Prospective Studies MeSH
• Aged MeSH
• Sick Sinus Syndrome diagnosis   epidemiology   therapy   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Publication type
• Journal Article MeSH

Cieľ: Zistiť, nakoľko je určenie Wenckebachovho bodu (WB) spoľahlivá metodika pre indikáciu AAI/R stimulácie. Zistiť výskyt vzniku poruchy AV vedenia, zmeny prevodovej kapacity AV uzla (WB) po implantácii kardiostimulátora v režime AAI/R. Zistiť výskyt fi brilácie predsiení, fl utteru predsiení a iných predsieňových arytmií v sledovanom súbore pacientov. Zistiť nutnosť nasledujúcich hospitalizácií z kardiologických príčin a výskyt komplikácií. Metodika: V rokoch 1996–2006 sme 104 pacientom indikovaným na implantáciu trvalého kardiostimulátora pre SSS implantovali stimulačný systém v režime AAI/R. V dlhodobom sledovaní zostalo 97 pacientov (62,8 % žien) s priemerným vekom 72,6 roka. Dĺžka sledovania bola 52,9 ± 26,3 mesiaca. Výsledky: V súbore pacientov sme zaznamenali minimum prípadov vzniku AV prevodovej poruchy. Jeden pacient bol po 19 mesiacoch reimplantovaný pre paroxyzmálnu AF na stimulačný režim VVIR mimo naše pracovisko. Neskôr sme u tohto pacienta opäť pozorovali sínusový rytmus. Úprava stimulačného režimu na DDD po 30 mesiacoch pre paroxyzmálnu AV blokádu III. stupňa bola indikovaná u jedného pacienta. V sledovanom období sme v skupine pacientov nezaznamenali ani jeden prípad vzniku chronickej fi brilácie pred siení. Výskyt paroxyzmálnej fi brilácie predsiení vyžadujúcej elektrickú kardioverziu sme zaznamenali u jedného pacienta, ktorému sme vykonali dvakrát elektrickú kardioverziu v krátkom časovom intervale. Ostatných päť prípadov paroxyzmálnej fi brilácie predsiení sme riešili medikamentózne. Vo všetkých prípadoch indikovaná liečba bola účinná v prevencii recidív paroxyzmálnej fi brilácie predsiení. V jednom prípade sme zaznamenali dve krátke epizódy fl utteru predsiení v trvaní troch až štyroch sekúnd. V tomto prípade sme medikamentózne neintervenovali. Záver: Zistili sme veľmi nízky výskyt vzniku AV prevodovej poruchy (jeden pacient). Hodnota WB sa v dlhodobom sledovaní podstatne nemenila. Pacienti s implantovaným AAI/R kardiostimulátorom mali v našom súbore nízky výskyt chronickej (jeden pacient) a paroxyzmálnej (šesť pacientov) fi brilácie predsiení. Výskyt komplikácií bol nízky. Periimplantačné meranie Wenckebachovho bodu sa javí ako vhodná metodika pre indikáciu trvalej AAI/R stimulácie. Predsieňová stimulácia u pacientov so sick sinus syndrómom (SSS) by mala byť viac využívaná ako doteraz.

Aim: To find out how much determination of the Wenckebach point (WB) is a reliable method for indicating long-term treatment of patients with sick sinus syndrome (SSS) and AAI/R cardiac pacing. To detect changes in the conduction capacity of the AV node (WB) after pacemaker (PM) implantation. To determine the prevalence of atrial fi brillation, fl utter, and other atrial arrhythmias. To identify the need for hospitalization of cardiac patients and the incidence of complications. Methods: A total of 104 consecutive patients who underwent AAI/R mode PM implantation for symptomatic SSS from March 1996 to December 2006 were studied. The mean age of the remaining 97 patients (62.8% women) was 72.6 years. The length of follow-up was 52.9 ± 26.3 months. Results: A minimum of AV conduction disturbances occurred in our cohort. The WB in long-term monitoring was substantially unchanged. After 19 months of paroxysmal atrial fi brillation (AF), one patient had re-implantation to VVIR mode outside our department. Later on, we again observed sinus rhythm in this patient. Due to the paroxysmal complete AV block, upgrade to DDD mode was indicated in one case 30 months after PM implant. During the follow-up period, we did not observe any cases of chronic AF. In one case, we observed recurrent paroxysmal AF, successfully managed, dealt with two DC cardioversions within a short time interval. The remaining fi ve cases of paroxysmal AF’s were successfully treated with drugs. In all cases, the indicated treatment was eff ective in preventing relapses into paroxysmal AF. In one case, a short period of atrial fl utter for a duration of up to four seconds was detected. Conclusions: Periprocedural measurement of the WB appears to be an appropriate and suffi cient method to indicate permanent AAI/R pacing. Atrial pacing should be used more frequently in sinus node disease.

• MeSH
• Stroke diagnosis   complications   MeSH
• Atrial Fibrillation diagnosis   etiology   therapy   MeSH
• Hemodynamics physiology   MeSH
• Cardiac Pacing, Artificial methods   adverse effects   utilization   MeSH
• Pacemaker, Artificial classification   utilization   MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Evidence-Based Medicine statistics & numerical data   trends   MeSH
• Sinoatrial Node physiopathology   MeSH
• Statistics as Topic MeSH
• Thromboembolism diagnosis   complications   MeSH
• Outcome and Process Assessment, Health Care MeSH
• Check Tag
• Humans MeSH

Cíl: Cílem práce bylo posoudit prognostický význam koronárního kalciového skóre v kombinaci se zátěžovým zobrazením myokardu pomocí jednofotonové emisní tomografi e (SPECT) u asymptomatických rizikových pacientů. Metodika: Byl analyzován soubor 128 pacientů (79 mužů a 49 žen, průměrný věk 54 ± 10 let, 25 s diabetem), kteří prodělali zátěžové gated SPECT vyšetření a současně kvantifi kaci kalciového skóre. Sumační perfuzní zátěžové a rozdílové skóre (SSS, resp. SDS), ejekční frakce (EF) a end-diastolické, resp. end-systolické objemy levé komory (EDV/ESV) byly automaticky stanoveny programem 4D-MSPECT. Závažná kardiální příhoda byla defi nována jako náhlá srdeční smrt nebo nefatální infarkt myokardu (IM), a dále byly evidovány obtíže vyžadující revaskularizaci. Výsledky: Během průměrného sledovacího období 17 ± 9 měsíců jsme evidovali dva nefatální IM a osm revaskularizací. V podskupině 10 pacientů s kardiální příhodou byla v porovnání s pacienty bez příhody horší perfuze (SSS 10 ± 12 vs. 1 ± 0 a SDS 6 ± 9 vs. 0 ± 1; p < 0,05), funkce levé komory (pozátěžová EF 56 ± 12 % vs. 68 ± 9 %, klidová EF 56 ± 7 % vs. 66 ± 9 %, pozátěžové EDV/ESV 129 ml/59 ml vs. 98 ml/34 ml; p < 0,05) a vyšší kalciové skóre (588 ± 1475 vs. 78 ± 136; p < 0,05). Roční incidence kardiálních příhod narůstala s hodnotou kalciového skóre (2,5 %, 6,1 %, 11,1 % a 14,8 % pro kalciové skóre 0–10, 11–100, 101–400 a > 400). Žádná kardiální příhoda nebyla zaznamenána u 20 z 27 asymptomatických pacientů, kteří měli kalciové skóre ≥ 101 a současně normální SPECT. Závěr: Stanovení kalciového skóre v kombinaci se zátěžovým SPECT zobrazením myokardu umožňuje posoudit prognózu asymptomatických rizikových pacientů.

Aim: The aim of this study was to investigate the prognostic value of coronary artery calcium (CAC) score in combination with cardiac stress sigle-photon emission tomography (SPECT) imaging in an asymptomatic population. Methods: One hundred twenty-eight consecutive asymptomatic patients (79 men, mean age 54±10 years, 25 with diabetes) underwent stress cardiac gated SPECT imaging and CT assessment of CAC score. Perfusion summed stress and diff erence score (SSS and SDS, resp.), the left ventricular ejection fraction (LVEF) and end-diastolic/end-systolic volumes (EDV/ESV) were automatically calculated using 4D-MSPECT. Cardiac event was defi ned as either cardiac death, nonfatal myocardial infarction (MI), or conditions requiring coronary revascularization. Results: During an average follow-up of 17±9 months, two patients had nonfatal MI, and revascularization was required in 8 patients. In the subgroup of 10 patients with cardiac events, the observed parameters was signifi cantly worse than in patients without cardiac event concerning perfusion (SSS 10±12 vs. 1±0 and SDS 6±9 vs. 0±1, P<0.05), the left ventricular function (stress LVEF 56±12% vs. 68±9%, rest LVEF 56±7% vs. 66%±9, stress EDV/ESV 129 ml/59 ml vs. 98 ml/34 ml, P<0.05), and CAC score (588±1475 vs. 78±136, P<0.05). An annual cardiac event rate depended on the amount of CAC (2.5%, 6.1%, 11.1%, and 14.8% for CAC score 0–10, 11–100, 101–400, and >400, resp.). Moderate and high risk CAC score (101–400 and >400, resp.) was detected in 27 patients; however, no cardiac event was observed in 20 of them who had CAC ≥101 and simultaneously normal stress gated SPECT. Conclusion: CAC scoring combined with cardiac gated SPECT enables evaluation of prognosis in asymptomatic risk individuals.

• Keywords
• gated SPECT myokardu, koronární kalciové skóre, stratifikace rizika,
• MeSH
• Financing, Organized MeSH
• Risk Assessment MeSH
• Myocardial Infarction epidemiology   MeSH
• Myocardial Ischemia epidemiology   pathology   MeSH
• Tomography, Emission-Computed, Single-Photon methods   MeSH
• Calcinosis classification   MeSH
• Ventricular Dysfunction MeSH
• Humans MeSH
• Death, Sudden, Cardiac epidemiology   MeSH
• Coronary Artery Disease epidemiology   etiology   MeSH
• Predictive Value of Tests MeSH
• Prognosis MeSH
• Risk Factors MeSH
• Technetium Tc 99m Sestamibi diagnostic use   MeSH
• Exercise Test methods   utilization   MeSH
• Check Tag
• Humans MeSH

BACKGROUND: The first dual-chamber leadless pacemaker (DC-LP) system consists of 2 separate atrial and ventricular devices that communicate to maintain synchronous atrioventricular pacing and sensing. The initial safety and efficacy were previously reported. OBJECTIVE: The purpose of this study was to evaluate the chronic electrical performance of the DC-LP system. METHODS: Patients meeting standard dual-chamber pacing indications were enrolled and implanted with the DC-LP system (Aveir DR, Abbott), including right atrial and ventricular helix-fixation LPs (atrial leadless pacemaker [ALP], ventricular leadless pacemaker [VLP]). Pacing capture threshold, sensed amplitude, and pacing impedance were collected using the device programmer at prespecified timepoints from 0-6 months postimplant. RESULTS: De novo devices were successfully implanted in 381 patients with complete 6-month data (62% male; age 69 ± 14 years; weight 82 ± 20 kg; 65% sinus nodal dysfunction, 30% atrioventricular block). ALPs were implanted predominantly in the right atrial appendage anterior base and VLPs primarily at the mid-to-apical right ventricular septum. From implant to 1 month, pacing capture thresholds (0.4-ms pulse width) improved in both ALPs (2.4 ± 1.5 V to 0.8 ± 0.8 V; P <.001) and VLPs (0.8 ± 0.6 V to 0.6 ± 0.4 V; P <.001). Sensed amplitudes improved in both ALPs (1.8 ± 1.3 mV to 3.4 ± 1.9 mV; P <.001) and VLPs (8.8 ± 4.0 mV to 11.7 ± 4.2 mV; P <.001). Impedances were stable in ALPs (334 ± 68 Ω to 329 ± 52 Ω; P = .17) and reduced in VLPs (789 ± 351 Ω to 646 ± 190 Ω; P <.001). Electrical measurements remained relatively stable from 1-6 months postimplant. No differences in electrical metrics were observed among ALP or VLP implant locations. CONCLUSION: This first in-human evaluation of the new dual-chamber leadless pacemaker system demonstrated reliable electrical performance throughout the initial 6-month evaluation period.

• MeSH
• Atrioventricular Block therapy   physiopathology   MeSH
• Time Factors MeSH
• Equipment Design * MeSH
• Cardiac Pacing, Artificial * methods   MeSH
• Pacemaker, Artificial * MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Aged MeSH
• Heart Ventricles physiopathology   MeSH
• Sick Sinus Syndrome therapy   physiopathology   MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

The desorption isotherms of two durable meat products (sample 1 - durable fermented meat product and sample 2 - unheated durable meat product) by Dynamic Dewpoint Isotherm (DDI) at 20, 25, and 30 °C and Saturated Salt Slurry (SSS) method at 20 °C has been studied. The data acquired from these measurements for 7 models (GAB, DLP, Henderson, Chin, Smith, Oswin, Halsey) were used and statistically evaluated. Based on our collected data, the most suitable model for these types of durable meat products is the DLP model. For the DDI method, DLP model (20-30 °C) reached the R2 = 0.999, P value 3.48-4.22 of sample 1 and R2 = 0.999, P value 1.51-3.24 of sample 2. For SSS method DLP model (20 °C) reached R2 = 0.999, P value 4.23 of sample 1 and R2 = 0.998, P value 3.68 of sample 2. The most commonly used GAB model according to statistical treatment was very accurate only for the DDI method, GAB model (20-30 °C) reached R2 ≥ 0.994, P value 1.93-7.12 of sample 1 and R2 = 0.999, P value 1.76-5.54 of sample 2. In general, for DDI method for both samples have models (DLP, GAB, Halsey, Henderson, and Oswin) a P value of less than 10% for all three measured temperatures. For the SSS method, only the DLP and Henderson models are below 10% for both samples. It has been verified that the DDI method is a suitable and accurate method for measuring desorption isotherms for durable meat products.

• Publication type
• Journal Article MeSH

Cíl: Posoudit přínos měření kalciového skóre při stratifikaci rizika pomocí zátěžového perfuzního gated SPECT vyšetření u pacientů s diabetem (DM), resp. s ledvinným selháním v dialyzačním programu (CHSL- HD). Metodika: Retrospektivní analýza souboru 67 pacientů (40 mužů, průměrný věk 59 +/-12 let, 28 s DM, 22 s CHSL- HD, 17 současně DM a CHSL- HD), kteří měli zátěžové gated SPECT vyšetření a kvantifikaci kalciového skóre. Sumační perfuzní zátěžové a rozdílové skóre (SSS, resp. SDS), ejekční frakce (EF) a enddiastolické, resp. endsystolické objemy levé komory (EDV/ ESV) byly automaticky stanoveny programem 4D- MSPECT. Závažná kardiální příhoda byla definována jako náhlá srdeční smrt nebo nefatální infarkt myokardu (IM) a dále byly evidovány obtíže vyžadující revaskularizaci. Výsledky: Během průměrného sledovacího období 18 +/- 10 měsíců jsme evidovali 8 úmrtí, 4 nefatální IM a 7 revaskularizací. V podskupině 19 pacientů s kardiální příhodou byla v porovnání se 48 pacienty bez příhody signifikantně horší perfuze (SSS 9 +/- 11 vs 2 +/- 3 a SDS 6 +/- 9 vs 1 +/- 2, P < 0,05), funkce levé komory (pozátěžová EF 53 % +/- 13 % vs 59 % +/- 13 %, klidová EF 55 % +/- 14 % vs 59 % +/- 12 %, pozátěžové EDV/ ESV 144 ml/ 71 ml vs 128 ml/ 59 ml, P < 0,05) a vyšší kalciové skóre (1 965 +/- 1 772 vs 387 +/- 740, P < 0,05). U pacientů bez reverzibilní poruchy perfuze (SDS < 2) byla v porovnání s pacienty s SDS >/= 2 nižší roční incidence závažných příhod (8 % vs 19,6 %, P < 0,05) a revaskularizací (4 % vs 19,6 %, P < 0,05). Vyšší incidence závažných příhod byla u pacientů s pozátěžovým poklesem EF > 5 % a/ nebo s extenzivními kalcifikacemi s kalciovým skóre > 709 (23,8 % vs 1,9 % u pacientů s SDS < 2 a 26,7 % vs 9,5 % u pacientů s SDS >/= 2, P < 0,05). Závěr: Nález výrazně zvýšeného kalciového skóre obdobně jako průkaz poischemického omráčení levé komory umožňuje další stratifikaci rizika u pacientů s reverzibilní poruchou perfuze i bez perfuzní abnormality.

Aim: The aim of this study was to evaluate added value of coronary artery calcium score (CAC) measurement as an adjunct to cardiac gated SPECT for risk stratification in population of patients with diabetes mellitus (DM) and/ or chronic renal failure on hemodialysis (CHRF‑ HD). Methods: Retrospective analysis of 67 patients, who were referred for stress gated myocardial perfusion SPECT and CAC. Characteristics of study population: 40 men, mean age 59 ± 12 years, DM (n = 28), CHRF‑ HD (n = 22), DM and CHRF‑ HD simultaneously (n = 17). Perfusion summed stress and different scores (SSS, SDS), the left ventricle ejection fraction (LVEF) and enddiastolic/ endsystolic volumes (EDV/ ESV) were automatically calculated using 4D‑ MSPECT software. The hard cardiac event was defined as sudden cardiac death or myocardial infarction (MI); angina or other symptoms requiring coronary revascularization were also calculated. Results: During the average period of 18 ± 10 months, we registered 8 cardiac deaths, 4 nonfatal MI and 7 patients underwent revascularization. In the subgroup of 19 patients with cardiac events, the observed parameters were significantly worse concerning perfusion (SSS 9 ± 11 vs 2 ± 3 and SDS 6 ± 9 vs 1 ± 2, P < 0.05), the left ventricle function (stress LVEF 53% ± 13% vs 59% ± 13 %, rest LVEF 55% ± 14% vs 59% ± 12%, stress EDV/ ESV 144 ml/ 71 ml vs 128 ml/ 59 ml, P < 0.05), and CAC score (1 965 ± 1 772 vs 387 ± 740, P < 0.05) in comparison with patients without cardiac event. In patients without a reversible perfusion abnormality (SDS < 2), we observed lower annual hard event rate (8% vs 19.6%, P < 0.05) and revascularization procedures (4% vs 19.6%, P < 0.05) in comparison with patients with SDS ≥ 2. In patients with or without reversible defects, we registered significantly higher annual hard event rate in the setting of post‑stress worsening of the LVEF > 5% and/ or severe CAC score ≥ 709 (23.8% vs 1.9% in patients with SDS < 2, and 26.7% vs 9.5% in patients with SDS ≥ 2, P < 0.05). Conclusion: The findings of highly elevated CAC score as well as the post‑stress left ventricle stunning enable further risk stratification in patients with or without reversible perfusion abnormalities.

• MeSH
• Ventricular Function, Left MeSH
• Risk Assessment MeSH
• Myocardial Ischemia MeSH
• Calcinosis MeSH
• Diabetes Complications MeSH
• Coronary Vessels MeSH
• Middle Aged MeSH
• Humans MeSH
• Death, Sudden, Cardiac MeSH
• Coronary Artery Disease complications   MeSH
• Renal Insufficiency complications   MeSH
• Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography MeSH
• Exercise Test MeSH
• Myocardial Perfusion Imaging MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH