Poruchy autonomní funkce srdce asociované s komorovými extrasystolami (KES) jsou často spojeny se snížením ejekční frakce a se zvýšenou kardiovaskulární morbiditou a mortalitou. Standardní zobrazovací techniky jako magnetická rezonance srdce (CMR) a koronární angiografie zajišťují vyloučení jiných příčin komorových extrasystol jako ischemie a neischemické fibrózy myokardu, ale nejsou schopny zobrazit narušení autonomního nervového systému srdce. Toto lze studovat pomocí scintigrafie myokardu (SPECT) s použitím 123 I-metajodbenzylguanidinu (MIBG). Vyšetřili jsme pilotní soubor šesti pacientů, z nichž u tří pacientů byla zjištěna porucha v adrenergní inervaci myokardu levé komory, a ty prezentujeme jako kazuistiky.
Disturbances of autonomic function in the heart associated with premature ventricular complexes (PVC) are associated with a decrease in ejection fraction as well as increased cardiac morbidity and mortality. Standard imaging techniques such as cMRI and coronary angiography secure the exclusion of other causes of PVC as ischemia and progressive fibrosis. These methods are not suitable for cardiac autonomic nervous system imaging and can't describe the cause of related PVCs. This may be described by 123I-metaiodobenzylguanidine (MIBG) scintigraphy. We examined a pilot group of 6 patients, in which 3 individuals presented a disorder in the adrenergic innervation of the left ventricular myocardium and we present these as case reports.
- MeSH
- 3-jodobenzylguanidin farmakologie terapeutické užití MeSH
- autonomní nervový systém diagnostické zobrazování MeSH
- diagnostické zobrazování metody MeSH
- kazuistiky jako téma MeSH
- komorové extrasystoly * diagnostické zobrazování diagnóza etiologie MeSH
- lidé MeSH
- multimodální zobrazování * klasifikace metody MeSH
- myokard patologie MeSH
- pilotní projekty MeSH
- senioři MeSH
- zobrazování myokardiální perfuze metody MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
In this prospective study involving 37 Duchenne muscular dystrophy (DMD) patients aged 8-18 years and older, we examined the impact of neurological and cardiac factors on quality of life (QoL). Our findings revealed a negative correlation between upper limb movement and overall mobility, self-service, and usual activities. Ambulatory and non-ambulatory DMD patients showed significant differences in mobility-related parameters. Cardiac evaluations demonstrated associations between mitral annular plane systolic excursion (MAPSE) and mobility-related aspects. The PEDSQL 3.0 neuromuscular model questionnaire further highlighted age-related and movement-related correlations with QoL. The loss of ambulatory status and reduced upper limb movement were negatively associated with QoL, while upper limb movement positively correlated with septal MAPSE. However, no significant associations were found between MAPSE and anxiety/depression. These findings underscore the multifaceted impact of DMD on QoL and emphasize the importance of considering both neurological and cardiac factors in comprehensive patient care.
- Publikační typ
- časopisecké články MeSH
PURPOSE: Despite the best efforts of neurologists, the results of pharmacotherapy in the late stages of Parkinson's disease are often disappointing and accompanied by debilitating side effects. Under these circumstances, deep brain stimulation is a viable treatment option. The aim of the meticulous pre-surgical planning is not only precise electrode implantation, but also the avoidance of intraoperative vascular conflicts potentially causing intracerebral bleeding. MATERIAL AND METHODS: In this report, we present a patient with early-onset Parkinson's disease whose cerebral vascular anatomy precluded standard bilateral subthalamic nucleus electrode implantation. Initially, right subthalamic stimulation alone provided a very mild clinical benefit that was not reflected in the patient's quality of life. In this patient, an unusual configuration of intracerebral electrodes with right subthalamic and left pallidal stimulation electrodes was applied 15 months after the initial subthalamic electrode implantation. RESULTS: The procedure has had a highly beneficial long-term effect without any significant complications. The greatest improvement was noted using the setting 1.8 V, 130 Hz, 90 μs at the right side (STN) and 3.7 V, 130 Hz, 120 μs at the left side (GPi). This allowed the patient to return to his daily life activities. CONCLUSIONS: The reported case provides a new perspective of treatment possibilities in complex functional neurosurgical cases requiring exceptional individualisation of the treatment approach.
- MeSH
- elektrody MeSH
- hluboká mozková stimulace * metody MeSH
- kvalita života MeSH
- lidé MeSH
- Parkinsonova nemoc * terapie komplikace MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
INTRODUCTION: One of the most common complications of coronavirus disease 2019 (COVID-19) is myocardial injury, and although its cause is unclear, it can alter the heart's contractility. This study aimed to characterize the ventricular and atrial strain in patients who recovered from COVID-19 using cardiovascular magnetic resonance feature-tracking (CMR-FT). METHODS: In this single-center study, we assessed left ventricle (LV) and right ventricular (RV) global circumferential strain (GCS), global longitudinal strain (GLS), global radial strain (GRS), left atrial (LA) and right atrial (RA) longitudinal strain (LS) parameters by CMR-FT. The student's t-test and Wilcoxon rank-sum test were used to compare the variables. RESULTS: We compared seventy-two patients who recovered from COVID-19 (49 ± 16 years) to fifty-four controls (49 ± 12 years, p = 0.752). The patients received a CMR examination 48 (34 to 165) days after the COVID-19 diagnosis. 28% had LGE. Both groups had normal LV systolic function. Strain parameters were significantly lower in the COVID-19 survivors than in controls. DISCUSSION: Patients who recovered from COVID-19 exhibited significantly lower strain in the left ventricle (through LVGCS, LVGLS, LVGRS), right ventricle (through RVGLS and RVGRS), left atrium (through LALS), and right atrium (through RALS) than controls.
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- tisková chyba MeSH
Komunikace mezi koronárními tepnami a velkými tepnami či srdečními dutinami v podobě píštěle je spíše raritní anomálií vyskytující se asi v 0,1-1,0 % koronarografovaných pacientů.1 Naše kazuistika popisuje 65letou pacientku, jež byla přijata na naše pracoviště k došetření echokardiograficky suspektního levopravého zkratu. Bylo provedeno transezofageální echokardiografické vyšetření s nálezem komunikace mezi kmenem levé věnčité tepny (ACS) a koronárním sinem. Koronarografické vyšetření a následně provedená CT koronarografie potvrdila nález gigantické fistuly mezi kmenem ACS a koronárním sinem. Vzhledem k rozsahu zkratu bylo indikováno kardiochirurgické řešení s ligaturou píštěle, bez nutnosti revaskularizace. V dalším průběhu došlo ke zlepšení subjektivního stavu pacientky, redukci dušnosti a i poklesu plicní hypertenze.
Communication between coronary arteries and large arteries or heart cavities in the form of fistula is a rare anomaly occurring in about 0.1-1.0% of coronarographed patients. Our case report describes a 65-year-old patient admitted to our department for suspicious left-right short circuit. Transesophageal echocardiography was performed and revealed communication between the left coronary artery trunk and the coronary sinus. Coronary angiography and subsequent CT coronarography confirmed the finding of a gigantic fistula between the ACS strain and the coronary sinus. Due to the extent of the short circuit, cardiac surgery was indicated - fistula ligation was performed, without subsequent revascularization. In the following course, the patient's subjective condition improved whereas dyspnea and pulmonary hypertension decreased.
- Klíčová slova
- levopravý zkrat,
- MeSH
- anomálie koronárních cév * chirurgie diagnostické zobrazování patologie MeSH
- CT angiografie MeSH
- echokardiografie MeSH
- kardiochirurgické výkony metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- ligace metody MeSH
- píštěle * chirurgie diagnostické zobrazování komplikace patologie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- práce podpořená grantem MeSH
- Publikační typ
- abstrakt z konference MeSH
Infiltrace srdce při generalizaci lymfomu může vést k poškození jeho funkce, což se může manifestovat srdečním selháním, arytmiemi nebo systémovými embolizacemi. Kazuistika popisuje případ 64leté ženy se záchytem non-hodgkinského difuzního B-buněčného lymfomu v srdci prezentujícího se srdečním selháním. Pacientka za hospitalizace podstoupila řadu zobrazovacích metod k určení diagnózy (echokardiografie, magnetická rezonance srdce, CT hrudníku a břicha). Útvar měl rozměry 90 × 80-90 × 90 mm, byl rozšířen predominantně v pravostranných srdečních oddílech, postiženo bylo rovněž i mezisíňové septum, ústí horní duté žíly a výtokové trakty obou komor. K přesnému zhodnocení nálezu byla doplněna magnetická rezonance srdce a endomyokardiální biopsie, v rámci pátrání po možném origu i CT hrudníku a břicha s nálezem diseminované lymfadenopatie. Histologická verifikace byla vzhledem k rychlému fatálnímu průběhu stanovena až post mortem.
Infiltration of the heart in generalized lymphoma can lead to impaired cardiac function. Usually this manifests as heart failure, arrhythmias or systemic embolism. The case report describes a 64-year-old woman who presented with progressive shortness of breath and lower extremities edema. Extensive diagnostic workup including cardiac magnetic resonance imaging and CT scan revealed a well-defined, right-sided cardiac mass and generalized lymphadenopathy. The dimensions of the lesion were 90 × 80-90 × 90 mm and the tumor expanded predominantly into the right atrial septum and the mouth of the upper vena cava. In addition, the outflow tracts of both chambers were also affected. Despite prompt and rigorous treatment, the patient died four days following admission due to sudden cardiac arrest. Post-mortem histological assessment verified a non-Hodgkin's diffuse B-cell lymphoma.
- MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfom diagnóza MeSH
- nádory srdce * diagnóza MeSH
- pitva MeSH
- smrt MeSH
- srdeční selhání * etiologie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
BACKGROUND: Cadmium-Zinc-Telluride (CZT) technology allows use of low activities of radiopharmaceuticals. The aim was to verify the values of left ventricular volume parameters, obtained via ultra-low-dose thallium Single Photon Emission Computed Tomography (SPECT) using a CZT camera. METHODS AND RESULTS: Forty-five patients referred for an assessment of myocardial perfusion or viability imaging were examined using CZT-SPECT and 1.5 T magnetic resonance (MRI) scanner. The ultra-low-dose protocol with 0.5 Mbq 201-Tl per kg of body weight was used. The values of end-systolic (ESV) and end-diastolic volumes (EDV), left ventricular ejection fraction (EF) and myocardial mass (MM) were assessed using both techniques. A very good correlation was found between the EF, ESV, and EDV values assessed with CZT-SPECT and cardiac magnetic resonance MRI; the Pearson coefficients were 0.86, 0.95, and 0.91, respectively. A moderate correlation was found for myocardial mass, r = 0.57. Compared to MRI, SPECT systematically overestimated ESV and MM, while it underestimates the EF, with P ≤ .001 in all cases. There was no difference in EDV estimation. CONCLUSIONS: Left ventricular volumes and ejection fraction assessed via ultra-low-dose CZT-SPECT showed very good correlation with the values obtained by MRI. A moderate correlation was found for myocardial mass.
- MeSH
- funkce levé komory srdeční * MeSH
- jednofotonová emisní výpočetní tomografie * metody MeSH
- kadmium MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- radioizotopy thallia MeSH
- telur MeSH
- tepový objem MeSH
- zinek MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Atrial fibrillation (AF) is an abnormal and irregular heartbeat caused by uncoordinated electrical impulses in the left atrium (LA), which could induce lasting changes in the heart tissue or could be a consequence of underlying cardiac disease. This study aimed to assess the left atrial phasic function and deformation in paroxysmal AF (PAF) patients-who had not received radiofrequency ablation and had no signs of permanent AF-using the cardiovascular magnetic resonance (CMR) feature-tracking (FT) technique. Fifty subjects (27 PAF patients and 23 controls) were included and examined with CMR. Their LA volume, LA function, LA longitudinal strain (LS) and LA strain rate were assessed in the LA reservoir, conduit, and contractile phases. PAF patients exhibited higher LA volumes than controls, while their LA emptying fraction and LA LS was significantly lower in all three phases. In contrast, the corresponding emptying volumes (total, passive and active) were similar in both groups. The LA volumetric rates from CMR-derived volume curves differed significantly in PAF patients vs controls in the reservoir and contractile phases. In contrast, the equivalent LV volumetric rates were similar. This study suggests that assessing the LA phasic function could offer insight into early LA impairments for PAF patients.
