Epidemiological studies have demonstrated a relationship between the adverse influence of perinatal development and increased risk of ischemic heart disease in adults. From negative factors to which the fetus is subjected, the most important is hypoxia. The fetus may experience hypoxic stress under different conditions, including pregnancy at high altitude, pregnancy with anemia, placental insufficiency, and heart, lung, and kidney disease. One of the most common insults during the early stages of postnatal development is hypoxemia due to congenital cyanotic heart defects. Experimental studies have demonstrated a link between early hypoxia and increased risk of ischemia/reperfusion injury (I/R) in adults. Furthermore, it has been observed that late myocardial effects of chronic hypoxia, experienced in early life, may be sex-dependent. Unlike in males, perinatal hypoxia significantly increased cardiac tolerance to acute I/R injury in adult females, expressed as decreased infarct size and lower incidence of ischemic arrhythmias. It was suggested that early hypoxia may result in sex-dependent programming of specific genes in the offspring with the consequence of increased cardiac susceptibility to I/R injury in adult males. These results would have important clinical implications, since cardiac sensitivity to oxygen deprivation in adult patients may be significantly influenced by perinatal hypoxia in a sex-dependent manner.
- MeSH
- dospělí MeSH
- hypoxie plodu komplikace patofyziologie MeSH
- ischemická choroba srdeční epidemiologie etiologie patofyziologie MeSH
- kyslík metabolismus MeSH
- lidé MeSH
- reperfuzní poškození myokardu epidemiologie etiologie patofyziologie MeSH
- rizikové faktory MeSH
- sexuální faktory MeSH
- srdce embryologie patofyziologie MeSH
- těhotenství MeSH
- zpožděný efekt prenatální expozice epidemiologie etiologie patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
The heart transplant program at the Institute for Clinical and Experimental Medicine in Prague was established on January 31, 1984. Through November 2012, 881 orthotopic cardiac transplantations have been performed, with an annual rate of about 40 procedures. Current legislation concerning solid organ transplantations in the Czech Republic is described. Like other centers, we have noticed an increasing age of donors, and, reflecting the shortage of grafts, we have expanded our selection criteria for heart transplantation. The advent of a mechanical circulatory support program at our center in April 2003 has given us another valuable tool in the management of chronic heart failure patients. Currently, around half of our patients are transplanted from mechanical support. Nonischemic etiology of heart failure is a leading cause of transplantation at our center, followed by ischemic cardiomyopathy, valvular heart lesions, and adult congenital heart diseases. Our current immunosupression protocol, including induction therapy, is outlined in detail and survival rates, as well as most common complications and our treatment strategies, are also discussed.
- MeSH
- ateroskleróza epidemiologie MeSH
- dítě MeSH
- dospělí MeSH
- homologní transplantace MeSH
- incidence MeSH
- infekce epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nádory epidemiologie MeSH
- podpůrné srdeční systémy statistika a číselné údaje trendy MeSH
- předškolní dítě MeSH
- rejekce štěpu epidemiologie mortalita terapie MeSH
- senioři MeSH
- srdeční selhání epidemiologie mortalita chirurgie MeSH
- transplantace srdce mortalita statistika a číselné údaje trendy MeSH
- výběr pacientů MeSH
- vysokoškolská lékařská centra statistika a číselné údaje MeSH
- získávání tkání a orgánů statistika a číselné údaje trendy MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
