Function of the developing heart is dictated by changes in its morphology. For simplicity, we distinguish four stages with different contraction mechanics and conduction parameters. Straight or looped tubular hearts, similar to those of invertebrates such as Drosophila or Ciona, operate as suction pumps and are characterized by a caudally localized pacemaker and slow, peristaltoid conduction and contraction. There is a complete occlusion of the lumen during systole. When the atrial and ventricular chambers appear, the preseptation heart is in many functional aspects similar to the adult heart, but the same function is achieved by different means. There are parallels in design among the hearts of lower vertebrates, such as a spongy ventricle without coronary vasculature and a myocardial atrioventricular canal. Even after septation, considerable maturation of cardiac morphology and function occurs during the foetal and early postnatal period.

• MeSH
• akční potenciály MeSH
• fetální srdce fyziologie   MeSH
• kinetika MeSH
• kontrakce myokardu MeSH
• lidé MeSH
• morfogeneze MeSH
• převodní systém srdeční embryologie   MeSH
• srdce embryologie   MeSH
• srdeční komory embryologie   MeSH
• srdeční síně embryologie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• audiovizuální média MeSH
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

Během vývoje musely živočišné druhy čelit měnícím se životním podmínkám. Na tyto změny bylo nutno se adaptovat. Tak například v době, kdy primitivní obojživelníci opouštěli mateřské prostředí a vydávali se z moře na souš, vznikly v souvislosti se změnou životního prostředí nové regulační systémy, které umožnily přežití na souši – zajistily udržení vnitřního prostředí a krevního tlaku v nových podmínkách...

In the course of evolution, animal species faced changes in the environment and had to adapt to them. For instance, during the period when primitive amphibians were leaving the original marine environment to become terrestrial, new regulatory systems developed in response to this challenge to allow survival in terrestrial conditions by maintaining the internal environment and blood pressure under new conditions. The renin-angiotensin-aldosterone system (RAAS) emerged as well as other mechanisms (e.g., kinine or apelin system) that control action of this system involved in vasoconstriction, sodium retention and inflammation activation. Unfortunately, in a range of pathologies such as hypertension, heart failure or diabetes, the system is unbalanced, i.e., shifted toward vasoconstriction, volume expansion and inflammatory reaction. RAAS in particular is upregulated and its hyperactivity considerably accelerates progression of cardiovascular disease. For this reason, the system needs to be controlled. As the diseases mentioned above affect at least 40 % of the European population, the drugs targeting RAAS, i.e., angiotensin converting enzyme (ACE) inhibitors, sartans, renin inhibitors or mineralocorticoid receptor inhibitors, have come to the forefront of attention. Other candidate therapies targeting RAAS or other associated systems are under clinical evaluation. Angiotensin 1-7 analogues, apelin system activators, Rho-kinase inhibitors and aldosterone synthase inhibitors can be given as examples. At present, after 50 years from the elucidation of the basic mechanisms of action of renin and angiotensin II, a review is presented of new knowledge on how to restore the impaired balance. Last but not least, the article provides information on upcoming activities in development laboratories of pharmaceutical companies.

• MeSH
• antagonisté mineralokortikoidních receptorů farmakokinetika   farmakologie   terapeutické užití   MeSH
• antagonisté receptorů pro angiotenzin MeSH
• kalikrein-kininový systém genetika   účinky záření   MeSH
• kardiovaskulární látky farmakokinetika   klasifikace   terapeutické užití   MeSH
• receptory angiotensinu účinky léků   MeSH
• renin-angiotensin systém fyziologie   účinky léků   MeSH
• renin antagonisté a inhibitory   MeSH
• svaly hladké cévní fyziologie   účinky léků   MeSH

Kouření patří k uznávaným rizikovým faktorům aterosklerózy, jeho aktivní i pasivní formy se podílejí na iniciaci a progresi aterosklerózy i na rozvoji nestabilních forem – akutních koronárních syndromů. Jak vyplývá z českých Doporučení pro léčbu závislosti na tabáku, je kouření v Evropě i v České republice příčinou každého pátého úmrtí, což u nás představuje každý rok přibližně 18 000 úmrtí. Vliv kouření na rozvoj kardiovaskulárních onemocnění je zprostředkován řadou mechanismů. Uplatňují se genetická predispozice, změny vasomotorických funkcí endotelu, strukturální poškození endotelu, změny poddajnosti cévní stěny, změny spektra krevních lipidů, změny funkce krevních destiček a trombofi lie, působení volných kyslíkových radikálů, snížení koncentrací antioxidantů, přítomnost zánětlivých změn a infekce v cévní stěně. V přehledu jsou uvedeny základní poznatky o vlivu kouření na rozvoj aterosklerózy a jejích komplikací, uvedených změn. Zmíněna je také závažnost kouření v populaci dětí s přihlédnutím k tomu, že z patnáctiletých dětí v České republice kouří 25 % dívek a 23 % chlapců (druhé a čtvrté místo na světě, data z roku 2009). Česká kardiologická společnost se proto této problematice v následujících letech bude věnovat systematicky a ve větším rozsahu, než tomu bylo dosud.

Smoking is an established risk factor for the development of atherosclerosis; active as well as passive smoking are involved in the development and progression of atherosclerosis as well as its unstable forms, i.e., acute coronary syndrome. As is evident from the Czech Guidelines for Tobacco Addiction Treatment, smoking is the cause of one of fi ve deaths throughout Europe and in the Czech Republic, resulting in an 18,000 deaths annually in the latter. The eff ect of smoking on the development of cardiovascular disease is mediated by a variety of mechanisms. These include genetic predisposition, altered endothelial vasomotor function, structural endothelial injury, changes in vessel wall compliance, changes in the lipid spectrum, changes in platelet function and thrombophilia, action of free oxygen radicals, decreased antioxidant levels, presence of infl ammation and vessel wall infection. The review presents major concepts regarding the eff ect of smoking on the development of atherosclerosis and its complications as well as the above changes. A major concern is the prevalence of smoking among children, with 25% and 23% 15-year-old Czech girls and boys being smokers, respectively (with the country ranking second and fourth worldwide, respectively; data for 2009). Given the above facts, the Czech Society of Cardiology is determined to pay more systematic and closer attention to this issue than has been the case to date.

• Klíčová slova
• Patofyziologie,
• MeSH
• ateroskleróza epidemiologie   etiologie   prevence a kontrola   MeSH
• cévní endotel patofyziologie   MeSH
• dítě MeSH
• inzulinová rezistence genetika   imunologie   MeSH
• ischemická choroba srdeční epidemiologie   etiologie   prevence a kontrola   MeSH
• kardiovaskulární nemoci epidemiologie   etiologie   prevence a kontrola   MeSH
• kouření epidemiologie   mortalita   škodlivé účinky   MeSH
• lidé MeSH
• odvykání kouření metody   psychologie   MeSH
• reaktivní formy kyslíku metabolismus   škodlivé účinky   MeSH
• rizikové faktory MeSH
• statistika jako téma MeSH
• trombofilie etiologie   metabolismus   MeSH
• zánět krev   metabolismus   patofyziologie   MeSH
• znečištění tabákovým kouřem prevence a kontrola   škodlivé účinky   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• přehledy MeSH
• Geografické názvy
• Česká republika MeSH

OBJECTIVE: Crohn's disease (CD) can be associated with a wide range of extraintestinal manifestations (EIMs), including neurological ones. Published studies differ in their conclusions about the epidemiology and etiopathogenesis of neurological EIMs. The aims of this study were to demonstrate the presence and find risk factors of peripheral (somatic and autonomic) neuropathy patients with severe CD on anti-TNFα biological therapy. MATERIAL AND METHODS: A clinical examination focusing on detection of peripheral sensor-motor nervous dysfunction (including Sudoscan) and examination of autonomic nervous system dysfunction (using Ewing ́s battery tests and spectral analysis) together with laboratory tests and collection of demographic data followed by administration of questionnaires were performed on a total of 30 neurologically asymptomatic outpatients with severe CD on anti-TNFα biological therapy. RESULTS: Peripheral sensor-motor nervous function via clinical neurological examination was pathological in 36.7% and Sudoscan in 33.3% of cases. Statistically significant associations between vibration perception test and age, CD and biological therapy duration, body mass index and Crohn's Disease Activity Index were proved while statistically significant associations between temperature perception test and age and BMI were proved as well. Additionally, a decrease of total protein in a patient ́s serum below the physiological cut-off in the 6 months prior to measurement was associated with a pathological result of a Sudoscan. Cardiovascular autonomic neuropathy based on Ewing ́s battery tests was present in 56.7% of patients, no statistically significant risk factors were found. Our peripheral neuropathy questionnaire correlated with the results of the Sudoscan test and some tests of the clinical examination of peripheral sensor-motor nervous function (discriminatory contact perception test, temperature perception test). CONCLUSIONS: This study demonstrated a relatively high prevalence of peripheral (especially autonomic) neuropathy and verified some risk factors for the development of peripheral somatic neuropathy in asymptomatic patients with severe form of CD on anti-TNFα biological therapy.

• MeSH
• autonomní nervový systém MeSH
• biologická terapie MeSH
• Crohnova nemoc * farmakoterapie   epidemiologie   komplikace   MeSH
• lidé MeSH
• nemoci autonomního nervového systému * MeSH
• nemoci periferního nervového systému * MeSH
• TNF-alfa terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Little is known about the association of kidney dysfunction and outcome in acute severe hypertension. This study aimed to measure the association between baseline chronic kidney disease (estimated glomerular filtration rate), acute kidney injury (AKI, decrease in estimated glomerular filtration rate > or =25% from baseline) and outcome in patients hospitalized with acute severe hypertension. METHODS AND RESULTS: The Studying the Treatment of Acute Hypertension (STAT) registry enrolled patients with acute severe hypertension, defined as > or =1 blood pressure measurement >180 mm Hg systolic and/or >110 mm Hg diastolic and treated with intravenous antihypertensive therapy. Data were compared across groups categorized by admission estimated glomerular filtration rate and AKI during admission. On admission, 79% of the cohort (n=1566) had at least mild chronic kidney disease (estimated glomerular filtration rate <60 mL/min in 46%, <30 mL/min in 22%). Chronic kidney disease patients were more likely to develop heart failure (P<0.0001), non-ST-elevation myocardial infarction (P=0.003), and AKI (P<0.007). AKI patients were at greater risk of heart failure and cardiac arrest (P< or =0.0001 for both). Subjects with AKI experienced higher mortality at 90 days (P=0.003). Any acute loss of estimated glomerular filtration rate during hospitalization was independently associated with an increased risk of death (odds ratio, 1.05; P=0.03 per 10-mL/min decline). Other independent predictors of mortality included increasing age (P<0.0001), male gender (P=0.016), white versus black race (P=0.003), and worse baseline kidney function (P=0.003). CONCLUSIONS: Chronic kidney disease is a common comorbidity among patients admitted with acute severe hypertension, and AKI is a frequent form of acute target organ dysfunction, particularly in those with baseline chronic kidney disease. Any degree of AKI is associated with a greater risk of morbidity and mortality.

• MeSH
• akutní nemoc MeSH
• antihypertenziva terapeutické užití   MeSH
• chronická nemoc MeSH
• dospělí MeSH
• financování organizované MeSH
• hodnocení rizik MeSH
• hodnoty glomerulární filtrace MeSH
• hospitalizace MeSH
• hypertenze epidemiologie   farmakoterapie   patofyziologie   MeSH
• kardiovaskulární systém patofyziologie   MeSH
• kohortové studie MeSH
• komorbidita MeSH
• lidé středního věku MeSH
• lidé MeSH
• morbidita MeSH
• nemoci ledvin epidemiologie   mortalita   terapie   MeSH
• senioři MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• srovnávací studie MeSH

Hypertriglyceridemia and hypertension seem to be very important cardiovascular risk factors. The Prague hereditary hypertriglyceridemic (hHTG) rat was developed as a model of human hypertriglyceridemia. It was demonstrated that these rats are not obese, they are hypertensive and insulin resistant and they have some disturbances in glucose metabolism. Several QTLs were identified for blood pressure, its particular components (dependent on major vasoactive systems) and plasma triglycerides throughout the genome of hHTG rats by using of F(2) hybrids strategy. It is evident that hHTG rats are a suitable model for the study of metabolic disturbances in relation to blood pressure as well as for the search of genetic determinants of these abnormalities. Numerous abnormalities of blood pressure regulation as well as alterations in the structure and function of cardiovascular apparatus (heart, conduit and resistance arteries) were found in hHTG rats. A special attention was paid to possible changes in the efficiency of various vasoactive systems such as nitric oxide, renin-angiotensin-aldosterone system and sympathetic nervous system, which seem to contribute substantially to cardiovascular and/or metabolic abnormalities observed in Prague hereditary hypertriglyceridemic rats.

• MeSH
• hypertenze genetika   metabolismus   patofyziologie   MeSH
• hypertriglyceridemie genetika   metabolismus   patofyziologie   MeSH
• inzulinová rezistence genetika   MeSH
• krysa rodu rattus * MeSH
• lidé MeSH
• metabolický syndrom genetika   metabolismus   MeSH
• modely nemocí na zvířatech * MeSH
• synthasa oxidu dusnatého metabolismus   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus * MeSH
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

Membrane endoglin (Eng, CD105) is a transmembrane glycoprotein essential for the proper function of vascular endothelium. It might be cleaved by matrix metalloproteinases to form soluble endoglin (sEng), which is released into the circulation. Metabolic syndrome comprises conditions/symptoms that usually coincide (endothelial dysfunction, arterial hypertension, hyperglycemia, obesity-related insulin resistance, and hypercholesterolemia), and are considered risk factors for cardiometabolic disorders such as atherosclerosis, type II diabetes mellitus, and liver disorders. The purpose of this review is to highlight current knowledge about the role of Eng and sEng in the disorders mentioned above, in vivo and in vitro extent, where we can find a wide range of contradictory results. We propose that reduced Eng expression is a hallmark of endothelial dysfunction development in chronic pathologies related to metabolic syndrome. Eng expression is also essential for leukocyte transmigration and acute inflammation, suggesting that Eng is crucial for the regulation of endothelial function during the acute phase of vascular defense reaction to harmful conditions. sEng was shown to be a circulating biomarker of preeclampsia, and we propose that it might be a biomarker of metabolic syndrome-related symptoms and pathologies, including hypercholesterolemia, hyperglycemia, arterial hypertension, and diabetes mellitus as well, despite the fact that some contradictory findings have been reported. Besides, sEng can participate in the development of endothelial dysfunction and promote the development of arterial hypertension, suggesting that high levels of sEng promote metabolic syndrome symptoms and complications. Therefore, we suggest that the treatment of metabolic syndrome should take into account the importance of Eng in the endothelial function and levels of sEng as a biomarker and risk factor of related pathologies.

• MeSH
• ateroskleróza metabolismus   patologie   MeSH
• biologické markery metabolismus   MeSH
• buněčná membrána metabolismus   MeSH
• diabetes mellitus 2. typu metabolismus   patologie   MeSH
• endoglin chemie   metabolismus   MeSH
• exprese genu MeSH
• kardiovaskulární nemoci metabolismus   patologie   MeSH
• lidé MeSH
• metabolický syndrom metabolismus   patologie   MeSH
• synthasa oxidu dusnatého, typ III metabolismus   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Cíl: Metabolický syndrom a jeho komponenty se významně podílejí na vzniku nemocí nejen kardiovaskulárních, ale i zažívacího traktu a pankreatobiliárního systému. Cílem naší studie je podat komplexní přehled o chorobách, u nichž je metabolický syndrom indukujícím rizikovým faktorem, respektive u nichž ovlivňuje průběh onemocnění. Výsledky: Metabolický syndrom je významným rizikovým faktorem indukce gastroezofageálního refluxu a jeho komplikace, kterou je Barrettův jícen. Metabolický syndrom byl popsán jako choroba s těsným vztahem k idiopatickým střevním zánětům, onemocnění biliárního stromu a pankreatu. Akutní pankreatitida, jak její vznik u obézních osob, tak tíže jejího průběhu, jsou v těsné korelaci s metabolickým syndromem, podobně průběh chronické, především alkoholické pankreatitidy. Výzvou je studium nealkoholické steatopankreatitidy, především z pohledu funkce pankreatických B-buněk u obézních osob. Nealkoholická steatóza jater a její formy mohou vést až ke vzniku stadia jaterní cirhózy a jsou rizikem jaterního karcinomu. Metabolický syndrom byl popsán i jako rizikový faktor u populační studie karcinomu tlustého střeva. Souhrn: Metabolický syndrom a jeho komponenty jsou významným rizikovým faktorem v indukci řady benigních i maligních chorob gastrointestinálních a pankreatobiliárních. Systémový přístup k ovlivnění metabolického syndromu a jeho komponent je tak jedním z významných přístupů ovlivnění vzniku a průběhu nejen kardiovaskulárních onemocnění.

Goal: Metabolic syndrome and its components play an important part in the development of not only cardiovascular conditions, but also digestive and pancreaticobiliary system diseases. The aim of our study is to present a comprehensive overview of the diseases where metabolic syndrome is an inducing risk factor, or where it affects the course of the disease. Results: Metabolic syndrome is a significant risk factor of induction of gastroesophageal reflux and its complication, which is Barrett‘s esophagus. Metabolic syndrome was described as the disease closely linked to idiopathic intestinal inflammations, diseases of the biliary tree and pancreas. Acute pancreatitis, both its development in obese individuals and the burden of its course, are in close correlation with metabolic syndrome, similarly as the course of chronic, mainly alcoholic pancreatitis. Study of non-alcoholic steatopancreatitis presents a challenge, most importantly with regard to the function of pancreatic B cells in obese individuals. Non-alcoholic hepatic steatosis and its forms may as much as lead to the stage of cirrhosis of the liver and they pose a risk of hepatocellular carcinoma. Metabolic syndrome was also described in a population study as a risk factor for carcinoma of the colon. Summary: Metabolic syndrome and its components present an important risk factor in relation to inducing some benign as well as malignant gastrointestinal and pancreaticobiliary diseases. A systemic approach to influencing the metabolic syndrome and its components is therefore one of the important approaches to influencing the development and course of not only cardiovascular conditions.

• MeSH
• Barrettův syndrom MeSH
• cholelitiáza MeSH
• gastroezofageální reflux etiologie   komplikace   MeSH
• idiopatické střevní záněty MeSH
• lidé MeSH
• metabolický syndrom * komplikace   MeSH
• nádory trávicího systému MeSH
• nealkoholová steatóza jater etiologie   komplikace   MeSH
• obezita komplikace   MeSH
• pankreatitida etiologie   komplikace   MeSH
• ztučnělá játra MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

BACKGROUND: Kidney involvement is common in anti-neutrophil cytoplasm antibody-associated vasculitis (AAV) and the prognosis is determined by the severity of kidney damage. This study focused on long-term kidney outcomes, defining possible risk factors and comparing the performance of three different histological classifications to predict outcomes for patients with AAV. METHODS: The dataset included 848 patients with newly diagnosed AAV who participated in seven randomized controlled trials (RCTs) (1995-2012). Follow-up information was obtained from questionnaires sent to the principal investigators of the original RCTs. RESULTS: The cumulative incidence of end-stage kidney disease (ESKD) at 5 and 10 years was 17% and 22%, respectively. Patients who developed ESKD had reduced patient survival compared with those with preserved kidney function (hazard ratio 2.8, P < .001). Comparing patients with AAV and kidney involvement with a matched general population, patients with AAV had poor survival outcomes, even in early stages of chronic kidney disease. The main cause of death was infection followed by cardiovascular disease in patients developing ESKD and malignancy in those who did not. Some 34% of patients with initial need for dialysis recovered kidney function after treatment. Thirty-five out of 175 in need of kidney replacement therapy (KRT) during follow-up received a kidney transplant with good outcome; there was 86% patient survival at 10 years.In the subcohort of 214 patients with available kidney biopsies, three scoring systems were tested: the Berden classification, the Renal Risk Score and the Mayo Clinic Score. The scores highlighted the importance of normal glomeruli and severe glomerulosclerosis on kidney survival (P < .001 and P = .001, respectively). The Renal Risk Score demonstrated a moderate prediction of kidney survival (area under the curve 0.79; standard error 0.03, 95% confidence interval 0.71-0.83). CONCLUSIONS: Early diagnosis of AAV is extremely important. Even milder forms of kidney involvement have an impact on the prognosis. Patients in need of KRT had the lowest survival rates, but kidney transplantation has shown favorable outcomes for eligible AAV patients. The three histologic scoring systems were all identified as independent prognostic factors for kidney outcome.

• MeSH
• ANCA-asociované vaskulitidy * komplikace   mortalita   terapie   MeSH
• chronické selhání ledvin * mortalita   terapie   etiologie   MeSH
• dospělí MeSH
• hodnoty glomerulární filtrace MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití MeSH
• následné studie MeSH
• prognóza MeSH
• rizikové faktory MeSH
• senioři MeSH
• vyšetření funkce ledvin MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• biologie MeSH

• Konspekt
• Biologické vědy
• NLK Obory
• biologie
• NLK Publikační typ
• učebnice vysokých škol