Diagnostika příčiny oběhové zástavy u pacientů do 35 let nemusí být snadná. Řada onemocnění vedoucích k oběhové zástavě v nižším věku je hereditárních, s monogenním typem dědičnosti – kardiomyopatie, kanálopatie. Jejich odhalení znesnadňuje i nízká penetrance kauzální genové mutace a rozdílná expresivita. V případě arytmogenní kardiomyopatie je náhlá srdeční smrt či oběhová zástava často první manifestací onemocnění, před rozvinutím výraznějšího strukturálního postižení srdce. Kazuistické sdělení prezentuje případ 27letého sportovce, u kterého došlo k oběhové zástavě s úspěšnou kardiopulmonální resuscitací během soutěžního fotbalového utkání. Přestože na základě provedených zobrazovacích vyšetření nebylo patrné strukturální srdeční onemocnění a nebyla ani naplněna diagnostická kritéria arytmogenní kardiomyopatie, genetické vyšetření formou sekvenování DNA nové generace prokázalo mutaci genu pro desmosomální protein plakophilin 2. Mutační varianty tohoto proteinu patří k nejčastějšímu molekulárnímu podkladu arytmogenní kardiomyopatie. Rozšíření genetického testování v kardiologii může mít výrazný vliv nejen na zpřesnění diagnostiky příčiny oběhové zástavy u přeživších mladých nemocných, ale i na rizikovou stratifikaci blízkých příbuzných probanda.

Diagnosing of the cause of out-of-hospital cardiac arrest in young patients ˂ 35 years old is challenging. Some disorders leading to cardiac arrest have monogenic type of heredity – cardiomyopathies, channelopathies. Diagnostic process may be complicated by low penetrance of causal gene mutation and variable expression. Sudden cardiac death or cardiac arrest often appear as the first clinical manifestation or arrhythmogenic cardiomyopathy before the development of obvious structural heart disease. The case re- port presents 27-year-old male athlete who underwent out-of-hospital cardiac arrest with successful cardiopulmonary resuscitation during soccer match. Despite the fact that there were no signs of structural heart impairment according to cardiac imaging and diagnostic criteria for arrhythmogenic right ventricular cardiomyopathy were not fulfilled, genetic testing using next-generation DnA sequencing revealed gene mutation in desmosome protein plakophilin 2, which represents the most frequent molecular background of arrhythmogenic cardiomyopathy. Extension of molecular testing in cardiology may contribute to more precise detection of the causal disease in young surviving patients who experienced cardiac arrest, as well as better risk stratification of their relatives.

• MeSH
• acidóza diagnóza   MeSH
• anamnéza MeSH
• arytmogenní dysplazie pravé komory diagnóza   etiologie   komplikace   MeSH
• aspirační pneumonie MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• elektrická defibrilace MeSH
• elektrokardiografie MeSH
• fibrilace komor diagnóza   MeSH
• fotbal MeSH
• genetické testování MeSH
• kardiopulmonální resuscitace MeSH
• komorová tachykardie diagnóza   farmakoterapie   komplikace   MeSH
• komorové extrasystoly diagnóza   komplikace   MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• metoprolol aplikace a dávkování   MeSH
• mutace MeSH
• náhlá srdeční smrt * etiologie   prevence a kontrola   MeSH
• neúspěšná terapie MeSH
• plakofiliny genetika   MeSH
• srdce diagnostické zobrazování   MeSH
• terapeutická hypotermie MeSH
• vysoce účinné nukleotidové sekvenování MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH
• práce podpořená grantem MeSH

• MeSH
• magnetická rezonanční tomografie metody   MeSH
• Publikační typ
• monografie MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• radiologie, nukleární medicína a zobrazovací metody

Electroencephalography (EEG) signals recorded during simultaneous functional magnetic resonance imaging (fMRI) are contaminated by strong artifacts. Among these, the ballistocardiographic (BCG) artifact is the most challenging, due to its complex spatio-temporal dynamics associated with ongoing cardiac activity. The presence of BCG residuals in EEG data may hide true, or generate spurious correlations between EEG and fMRI time-courses. Here, we propose an adaptive Optimal Basis Set (aOBS) method for BCG artifact removal. Our method is adaptive, as it can estimate the delay between cardiac activity and BCG occurrence on a beat-to-beat basis. The effective creation of an optimal basis set by principal component analysis (PCA) is therefore ensured by a more accurate alignment of BCG occurrences. Furthermore, aOBS can automatically estimate which components produced by PCA are likely to be BCG artifact-related and therefore need to be removed. The aOBS performance was evaluated on high-density EEG data acquired with simultaneous fMRI in healthy subjects during visual stimulation. As aOBS enables effective reduction of BCG residuals while preserving brain signals, we suggest it may find wide application in simultaneous EEG-fMRI studies.

• MeSH
• artefakty * MeSH
• dospělí MeSH
• elektroencefalografie metody   MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• mladý dospělý MeSH
• multimodální zobrazování metody   MeSH
• počítačové zpracování obrazu metody   MeSH
• zdraví dobrovolníci pro lékařské studie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Konstriktivní perikarditida (KP) je vzácné onemocnění, které se iniciálně často manifestuje nespecifickými příznaky. Klíčovou zobrazovací metodou v diagnostice KP je transthorakální echokardiografie (TTE). Přítomnost fibrilace síní (FS) může komplikovat správnou diagnózu, jelikož některé typické echokardiografické známky KP, jež využívají respirační variabilitu, nemusejí být zjevné, či nejsou rutinně hodnoceny. Kasuistika: U iniciálně asymptomatického 61letého muže s chronickou FS bez známek srdečního selhání byly během posledních tří let opakovaně zjištěny zvýšené hodnoty cholestatických enzymů, jejichž etiologie nebyla zjištěna. Před plánovanou biopsií jater byla provedena detailní TTE, která odhalila některé známky naznačující diagnózu konstriktivní perikarditidy. Ty zahrnovaly "septal bounce", "septal shift", annulus reversus, annulus paradoxus a dilataci dolní duté žíly. Ostatní TTE parametry založené na respirační variabilitě a typicky nacházené u pacientů s KP v sinusovém rytmu nebyly při FS spolehlivě hodnotitelné. Magnetická rezonance a výpočetní tomografie srdce detekovaly zesílení a kalcifikace perikardu, které podporovaly, ale nepotvrzovaly diagnózu konstriktivní perikarditidy. Definitivní diagnóza KP byla stanovena až při pravostranné srdeční katetrizaci s dočasnou komorovou stimulací. Ta ukázala typickou diskordanci vrcholových systolických tlaků v pravé a levé komoře během respirace. Po provedené perikardektomii došlo k poklesu aktivity jaterních enzymů, což podporovalo kauzální roli konstriktivní perikarditidy. Závěr: Konstriktivní perikarditida by měla zvážena jako jedna z možných příčin nejasného zvýšení hodnot cholestatických enzymů. Známky KP při TTE založené na respirační variabilitě nemusejí být u pacientů s FS použitelné. Dočasná komorová stimulace, při které je snížena variabilita délky srdečních cyklů, je schopna demaskovat diskordanci tlaků v komorách a přispět tak diagnóze KP v nejasných případech.

Background: Constrictive pericarditis (CP) is a rare disease frequently with nonspecific initial clinical manifestations. Transthoracic echocardiography (TTE) is a key imaging method for the CP diagnosis. However, concomitant atrial fibrillation (AFib) may complicate the correct diagnosis, since some typical echocardiographic CP markers, especially those based on their respiratory changes may not be obvious or routinely evaluated. Case report: We present a case of initially asymptomatic 61-year-old male with elevated cholestatic enzymes of unclear etiology detected repeatedly over a period of 3 years, with chronic AFib but without signs of heart failure. Prior to planned liver biopsy, a comprehensive TTE was performed showing some signs indicative of CP (including septal bounce and shift, annulus reversus and paradoxus and inferior fixed caval vein dilatation). Other TTE parameters based on respiratory variation, which are typically observed in CP with sinus rhythm, were unreliable in AFib. Cardiac computer tomography and magnetic resonance showed pericardial thickening and calcification supporting but not confirming the CP diagnosis. Only after right ventricular pacing during catheterization, the typical discordance of peak systolic right and left ventricular pressure during respiration confirmed CP diagnosis. After pericardiectomy, cholestatic enzymes decreased supporting the CP causal role. Conclusions: CP should be considered in unexplained increase of cholestatic enzymes. In AFib, the TTE parameters based on respiratory variation may not be useful. However, a combination of the remaining TTE parameters can indicate CP and trigger further investigation. Temporary pacing to avoid beat-to-beat variability in AFib can "unmask" the ventricular pressures discordance, and thus be helpful in unclear CP cases.

• MeSH
• diagnostické zobrazování metody   MeSH
• elektrokardiografie metody   MeSH
• fibrilace síní MeSH
• kardiochirurgické výkony metody   MeSH
• konstriktivní perikarditida * chirurgie   diagnóza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Acquiring pulmonary circulation parameters as a potential marker of cardiopulmonary function is not new. Methods to obtain these parameters have been developed over time, with the latest being first-pass perfusion sequences in cardiovascular magnetic resonance (CMR). Even though more data on these parameters has been recently published, different nomenclature and acquisition methods are used across studies; some works even reported conflicting data. The most commonly used circulation parameters obtained using CMR include pulmonary transit time (PTT) and pulmonary transit beats (PTB). PTT is the time needed for a contrast agent (typically gadolinium-based) to circulate from the right ventricle (RV) to the left ventricle (LV). PTB is the number of cardiac cycles the process takes. Some authors also include corrected heart rate (HR) versions along with standard PTT. Besides other methods, CMR offers an option to assess stress circulation parameters, but data are minimal. This review aims to summarize the up-to-date findings and provide an overview of the latest progress on this promising, dynamically evolving topic.

• MeSH
• kontrastní látky MeSH
• lidé MeSH
• magnetická rezonanční spektroskopie MeSH
• magnetická rezonanční tomografie * metody   MeSH
• plicní oběh fyziologie   MeSH
• prediktivní hodnota testů MeSH
• srdce * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: The known impairments of the cardiovascular system in Parkinson ́s disease (PD) are caused by autonomic dysfunction and manifested mainly in postural hypotension, chronotropic insufficiency, and reduced heart rate variability. Other dysfunctions, mainly stress response, arrhythmia occurrence, and heart morphology changes, are still the subject of research. OBJECTIVES: To assess the heart rate and blood pressure reaction during exercise, advanced measurements of heart volumes and mass using cardiac magnetic resonance (CMR), and occurrence of arrhythmias in PD patients. METHODS: Thirty PD patients (19 men, mean age 57.5 years) without known cardiac comorbidities underwent bicycle ergometry, electrocardiogram Holter monitoring and CMR. Exercise and CMR parameters were compared with controls (24 subjects for ergometry, 20 for CMR). RESULTS: PD patients had lower baseline systolic blood pressure (SBP) (117.8 vs. 128.3 mmHg, p < 0.01), peak SBP (155.8 vs. 170.8 mmHg, p < 0.05), and lower heart rate increase (49.7 vs. 64.3 beats per minute, p < 0.01). PD patients had higher indexed left and right ventricular end-diastolic volumes (68.5 vs. 57.3, p = 0.003 and 73.5 vs. 61.0 mL/m2 , respectively) and also indexed left and right ventricular end-systolic volumes (44.1 vs. 39.0, p = 0.013 and 29.0 vs. 22.0 mL/m2 , p = 0.013, respectively). A high prevalence of atrial fibrillation (8 subjects, 26.7%) was found. CONCLUSIONS: This novel study combining functional and structural approaches showed that PD is linked with weaker blood pressure and heart rate reaction during exercise, increased myocardial mass and heart volumes compared to controls, and a high prevalence of atrial fibrillation.

• MeSH
• elektrokardiografie MeSH
• fibrilace síní * komplikace   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• Parkinsonova nemoc * komplikace   epidemiologie   MeSH
• srdce MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: Cell therapies have emerged as a promising approach in medicine. The basis of each therapy is the injection of 1-100×10(6) cells with regenerative potential into some part of the body. Mesenchymal stromal cells (MSCs) are the most used cell type in the cell therapy nowadays, but no gold standard for the labeling of the MSCs for magnetic resonance imaging (MRI) is available yet. This work evaluates our newly synthesized uncoated superparamagnetic maghemite nanoparticles (surface-active maghemite nanoparticles - SAMNs) as an MRI contrast intracellular probe usable in a clinical 1.5 T MRI system. METHODS: MSCs from rat and human donors were isolated, and then incubated at different concentrations (10-200 μg/mL) of SAMN maghemite nanoparticles for 48 hours. Viability, proliferation, and nanoparticle uptake efficiency were tested (using fluorescence microscopy, xCELLigence analysis, atomic absorption spectroscopy, and advanced microscopy techniques). Migration capacity, cluster of differentiation markers, effect of nanoparticles on long-term viability, contrast properties in MRI, and cocultivation of labeled cells with myocytes were also studied. RESULTS: SAMNs do not affect MSC viability if the concentration does not exceed 100 μg ferumoxide/mL, and this concentration does not alter their cell phenotype and long-term proliferation profile. After 48 hours of incubation, MSCs labeled with SAMNs show more than double the amount of iron per cell compared to Resovist-labeled cells, which correlates well with the better contrast properties of the SAMN cell sample in T2-weighted MRI. SAMN-labeled MSCs display strong adherence and excellent elasticity in a beating myocyte culture for a minimum of 7 days. CONCLUSION: Detailed in vitro tests and phantom tests on ex vivo tissue show that the new SAMNs are efficient MRI contrast agent probes with exclusive intracellular uptake and high biological safety.

• MeSH
• buněčný tracking metody   MeSH
• dextrany chemie   farmakokinetika   toxicita   MeSH
• fyziologie buňky účinky léků   MeSH
• kontrastní látky chemie   farmakokinetika   toxicita   MeSH
• krysa rodu rattus MeSH
• kultivované buňky MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• magnetické nanočástice chemie   toxicita   MeSH
• mezenchymální kmenové buňky chemie   cytologie   účinky léků   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

Rest pulmonary circulation parameters such as pulmonary transit time (PTT), heart rate corrected PTT (PTTc) and pulmonary transit beats (PTB) can be evaluated using several methods, including the first-pass perfusion from cardiovascular magnetic resonance. As previously published, up to 58% of patients after HTx have diastolic dysfunction detectable only in stress conditions. By using adenosine stress perfusion images, stress analogues of the mentioned parameters can be assessed. By dividing stress to rest biomarkers, potential new ratio parameters (PTT ratio and PTTc ratio) can be obtained. The objectives were to (1) provide more evidence about stress pulmonary circulation biomarkers, (2) present stress to rest ratio parameters, and (3) assess these biomarkers in patients with presumed diastolic dysfunction after heart transplant (HTx) and in childhood cancer survivors (CCS) without any signs of diastolic dysfunction. In this retrospective study, 48 patients after HTx, divided into subgroups based on echocardiographic signs of diastolic dysfunction (41 without, 7 with) and 39 CCS were enrolled. PTT was defined as the difference between the onset time of the signal intensity increase in the left and the right ventricle. PTT in rest conditions were without significant differences when comparing the CCS and HTx subgroup without diastolic dysfunction (4.96 ± 0.93 s vs. 5.51 ± 1.14 s, p = 0.063) or with diastolic dysfunction (4.96 ± 0.93 s vs. 6.04 ± 1.13 s, p = 0.13). However, in stress conditions, both PTT and PTTc were significantly lower in the CCS group than in the HTx subgroups, (PTT: 3.76 ± 0.78 s vs. 4.82 ± 1.03 s, p < 0.001; 5.52 ± 1.56 s, p = 0.002). PTT ratio and PTTc ratio were below 1 in all groups. In conclusion, stress pulmonary circulation parameters obtained from CMR showed prolonged PTT and PTTc in HTx groups compared to CCS, which corresponds with the presumption of underlying diastolic dysfunction. The ratio parameters were less than 1.

• MeSH
• lidé MeSH
• magnetická rezonanční spektroskopie MeSH
• magnetická rezonanční tomografie metody   MeSH
• plicní oběh * fyziologie   MeSH
• retrospektivní studie MeSH
• transplantace srdce * škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Three spectral components with periods of about (~) 0.41, ~0.5 and ~1.0 year had been found with serially independent sampling in human circulating melatonin. The time series consisted of around-the-clock samples collected for 24 hours at 4-hour intervals from different patients over several years. Some of these components had been found to be circadian stage-dependent, the daytime measurements following mostly a circannual variation, whereas a half-year characterized the nighttime samples. The latter were incorporated into a circasemiannual map. The relative brevity of the series prevented a check for the coexistence of all three spectral components, even if each component seemed to have a raison d'etre. In time series of transdisciplinary data, a 1.00-year synchronized component is interpreted as representing the seasons. The half-year may qualify the circannual waveform, but it is also a signature of geomagnetics. An ~0.41-year (~5-month) component is the signature of solar flares. It has been called a cis-half-year (cis = on this side of a half-year) and may be detected only intermittently. Charles L. Wolff predicted the existence, among others, of ~0.42- and ~0.56-year components as beat periods of rotations at different solar latitudes.The multiple components characterizing circulating melatonin could also be found in a (to our knowledge unique) data set of a clinically healthy scientist (RBS). Herein, we focus on vascular data self-measured by RBS as he aged from ~20 to ~60 years. A multi-component model consisting of cosine curves with periods of 0.41, 0.50 and 1.00 year was fitted to weekly means of systolic (S) and diastolic (D) blood pressure (BP) and heart rate (HR) collected ~5 times a day over 39 years by RBS. All three components can coexist for a while, although all of them are nonstationary in their characteristics and come and go by the criterion of statistical significance.Intermittently, BP and HR are synchronized selectively with one or the other aspect of RBS' physical environment, namely the seasons (at ~1.0 year), earth magnetism (at ~0.5 year) and/or solar flares (at ~0.42 year). Cosmic-biotic transfer of information, albeit hardly of energy (the biospheric amplitudes are very small) may be mediated in this set of frequency windows. As found earlier, RBS' circulation is also frequency-trapped environmentally in multidecadal windows, HR being locked into the transtridecadal Brückner, or rather Brückner-Egeson-Lockyer, BEL sunspot and terrestrial weather cycle, while his BP follows Hale's didecadal cycle in the changing polarity of sunspots.The ~0.41-year HR cycle may be associated with changes in solar flares, the cis-half-year amplitude of HR showing a cross-correlation coefficient of 0.79 with the total solar flare index (from both solar hemispheres) at a lag of ~3.2 years. The superposed time courses of these two variables indicate the presence of a shared Horrebow-Arago-Schwabe sunspot cycle of ~11 years, the cis-half-year in HR being more prominent after the total solar flare index reaches its ~11-year peak. Differences in the time-varying behavior of BP vs. HR are also described.

• MeSH
• ambulantní monitorování krevního tlaku MeSH
• časové faktory MeSH
• chronobiologické jevy fyziologie   MeSH
• cirkadiánní rytmus fyziologie   MeSH
• financování organizované MeSH
• krevní tlak fyziologie   MeSH
• lidé MeSH
• magnetismus MeSH
• melatonin fyziologie   krev   MeSH
• roční období MeSH
• sluneční aktivita MeSH
• srdeční frekvence fyziologie   MeSH
• Země (planeta) MeSH
• Check Tag
• lidé MeSH

• MeSH
• kardiovaskulární nemoci MeSH

• Konspekt
• Pediatrie
• NLK Obory
• kardiologie
• pediatrie
• NLK Publikační typ
• kolektivní monografie