This article presents an overview of existing approaches to perform vectorcardiographic (VCG) diagnostics of ischemic heart disease (IHD). Individual methodologies are divided into categories to create a comprehensive and clear overview of electrical cardiac activity measurement, signal pre-processing, features extraction and classification procedures. An emphasis is placed on methods describing the electrical heart space (EHS) by several features extraction techniques based on spatiotemporal characteristics or signal modelling and signal transformations. Performance of individual methodologies are compared depending on classification of extent of ischemia, acute forms - myocardial infarction (MI) and myocardial scars localization. Based on a comparison of imaging methods, the advantages of VCG over the standard 12-leads ECG such as providing a 3D orthogonal leads imaging, better performance, and appropriate computer processing are highlighted. The issues of electrical cardiac activity measurements on body surface, the lack of VKG databases supported by a more accurate imaging method, possibility of comparison with the physiology of individual cases are outlined as potential reserves for future research.
- Klíčová slova
- Automatization, Classification, ECG, Electrical heart space, Ischemic heart disease, VCG,
- MeSH
- elektrokardiografie metody MeSH
- infarkt myokardu * MeSH
- lidé MeSH
- myokard MeSH
- počítačové zpracování signálu MeSH
- srdce fyziologie MeSH
- vektorkardiografie * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
BACKGROUND: Solitary fibrous tumour of the liver is a rare mesenchymal tumour, occurring usually in women and with various symptomatology. The symptoms mostly result from pressure of the tumour mass on surrounding organs. Due to unknown biological behaviour and gradual increase of tumour volume, surgical resection is mostly the preferred treatment option. CASE: A 75-year-old woman with a history of endometrial cancer, presenting with an incidental finding of a liver mass, initially considered of infectious origin (either echinococcosis or cysticercosis). Further diagnostics did not clarify the aetiology, a surgical revision was rejected at the time. The subsequent follow-up was interrupted by the development of symptoms of gastrointestinal and renal obstruction, which led to a complete surgical removal of the tumour, sized 30 × 25 × 20 cm. A histopathological examination showed a CD34 and STAT6 positivity, leading to a diagnosis of a giant solitary fibrous tumour of the liver. The patient recovered well, without any signs of recurrence. CONCLUSION: The solitary fibrous tumour of the liver is a rare, often incidental finding. It is considered benign, but malignant growth was also reported. A gradual growth mostly results in pressure on other organs. A surgical resection is the treatment of choice. Transarterial embolization is another treatment possibility. Due to indeterminate malignant potential a regular follow-up is necessary, including tumour markers and imaging methods.
- Klíčová slova
- Liver neoplasms, biopsy, case reports, general surgery, surgical oncology,
- MeSH
- játra patologie MeSH
- lidé MeSH
- nádorové biomarkery MeSH
- senioři MeSH
- solitární fibrózní tumory * diagnóza chirurgie patologie MeSH
- transkripční faktor STAT6 MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- nádorové biomarkery MeSH
- transkripční faktor STAT6 MeSH
Introduction: This study proposes an algorithm for preprocessing VCG records to obtain a representative QRS loop. Methods: The proposed algorithm uses the following methods: Digital filtering to remove noise from the signal, wavelet-based detection of ECG fiducial points and isoelectric PQ intervals, spatial alignment of QRS loops, QRS time synchronization using root mean square error minimization and ectopic QRS elimination. The representative QRS loop is calculated as the average of all QRS loops in the VCG record. The algorithm is evaluated on 161 VCG records from a database of 58 healthy control subjects, 69 patients with myocardial infarction, and 34 patients with bundle branch block. The morphologic intra-individual beat-to-beat variability rate is calculated for each VCG record. Results and Discussion: The maximum relative deviation is 12.2% for healthy control subjects, 19.3% for patients with myocardial infarction, and 17.2% for patients with bundle branch block. The performance of the algorithm is assessed by measuring the morphologic variability before and after QRS time synchronization and ectopic QRS elimination. The variability is reduced by a factor of 0.36 for healthy control subjects, 0.38 for patients with myocardial infarction, and 0.41 for patients with bundle branch block. The proposed algorithm can be used to generate a representative QRS loop for each VCG record. This representative QRS loop can be used to visualize, compare, and further process VCG records for automatic VCG record classification.
- Klíčová slova
- ECG, QRS detection, QRS loop alignment, VCG, digital filtering, intra-individuality, isoelectric line detection, representative QRS loop,
- Publikační typ
- časopisecké články MeSH
Endofibrosis is a rare disease that predominantly affects athletes and is caused by a gradual occlusion of the (usually iliac) artery due to a thickening of the intima. From our experience, we report in this article two cases with the entity of endofibrosis in females around 30 years old. The first case presented with acute limb ischemia, and the second one was with pain in the leg during exercise. In addition, both cases are professional cyclists. They were eventually diagnosed with endofibrosis and underwent surgical procedures. They are now pursuing their professional career successfully. Last but not least, endofibrosis might be classified as an occupational disease, particularly, in the case of professional athletes or cyclists.
- Klíčová slova
- athletes, compression syndrome, cyclists, endofibrosis, histopathology, iliac artery, iliac artery stenosis, peripheral artery, professional, vascular pathology,
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
This paper deals with a wavelet-based algorithm for automatic detection of isoelectric coordinates of individual QRS loops of VCG record. Fiducial time instants of QRS peak, QRS onset, QRS end, and isoelectric PQ interval are evaluated on three VCG leads ( X , Y , Z ) together with global QRS boundaries of a record to spatiotemporal QRS loops alignment. The algorithm was developed and optimized on 161 VCG records of PTB diagnostic database of healthy control subjects (HC), patients with myocardial infarction (MI) and patients with bundle branch block (BBB) and validated on CSE multilead measurement database of 124 records of the same diagnostic groups. The QRS peak was evaluated correctly for all of 1,467 beats. QRS onset, QRS end were detected with standard deviation of 5,5 ms and 7,8 ms respectively from the referee annotation. The isoelectric 20 ms length PQ interval window was detected correctly between the P end and QRS onset for all the cases. The proposed algorithm complies the ( 2 σ C S E ) limits for the QRS onset and QRS end detection and provides comparable or better results to other well-known algorithms. The algorithm evaluates well a wide QRS based on automated wavelet scale switching. The designed multi-lead approach QRS loop detector accomplishes diagnostic VCG processing, aligned QRS loops imaging and it is suitable for beat-to-beat variability assessment and further automatic VCG classification.
- Klíčová slova
- QRS detection, isoelectric line detection, segmentation, vectorcardiography, wavelet transform,
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD), often associated with obesity and metabolic syndrome, manifests itself as steatosis, hepatic fibrosis, cirrhosis, or even end-stage liver disease. NAFLD causes inflammation, insulin resistance and cardiovascular complications. The current study aimed to evaluate the beneficial effects of bariatric surgery on biochemical parameters of hepatic functions in obese patients by comparing them before and one-year after the surgery. METHODS: A total of 72 morbidly obese patients underwent bariatric surgery between 2016 and 2018. The incidence of diabetes mellitus in this group was 29%, median body weight was 124.5 kg (109.0-140.0) and mean body mass index (BMI) was 44.38 ± 6.770 kg/m2. The used surgical procedures included gastric bypass, sleeve gastrectomy, laparoscopic gastric plication, and single anastomosis duodeno-ileal bypass-sleeve gastrectomy. Biochemical parameters including ALT/AST ratio (AAR), NAFLD fibrosis score (NFS), hepatic fibrosis index (FIB-4) and Fatty Liver Index (FLI) were evaluated in all patients at the time of surgery and one year after the intervention. RESULTS: Significant improvement after the intervention was observed in 64 patients. A significant reduction in body weight (P<0.0001), waist circumference (P<0.0001), and body mass index (P<0.0001) were observed. NAFLD liver fibrosis index changed significantly (P<0.0001), suggesting a trend of improvement from advanced fibrosis towards stages 0-2. The FIB-4 fibrosis index indicated significant improvement (P=0.0136). Besides, a significant decline in hepatic steatosis (P<0.0001) was observed after bariatric surgery as compared to the pre-surgery fatty liver conditions. CONCLUSION: Among the strategies to overcome NAFLD-associated impediments, bariatric surgery can be considered effective in reducing obesity and metabolic co-morbidities. TRIAL REGISTRATION: ClinicalTrials.gov (NCT04569396).
- Klíčová slova
- NAFLD, bariatric surgery, liver fibrosis, obesity,
- MeSH
- bariatrická chirurgie * škodlivé účinky MeSH
- fibróza MeSH
- jaterní cirhóza komplikace MeSH
- játra MeSH
- lidé MeSH
- morbidní obezita * komplikace patologie chirurgie MeSH
- následné studie MeSH
- nealkoholová steatóza jater * etiologie chirurgie MeSH
- prospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: Bariatric surgery has a significant impact on dietary intake, weight loss, patient's metabolism and also on defaecation stereotypes. AIM: To investigate changes in bowel habits of morbidly obese patients after laparoscopic sleeve gastrectomy (LSG). MATERIAL AND METHODS: This was a prospective clinical cohort study conducted to assess changes in bowel habits after LSG in a single institution. RESULTS: In total, 124 patients were enrolled in the study (age 47.1 ±11.2 years, body mass index (BMI) 44.3 ±6.8 kg/m2). The mean weight loss 6 months after LSG was 29.1 ±11.1 kg; percentage excess weight loss was 56.2 ±20.4%. Before surgery, 35.5% of patients had constipation and 6.5% of patients had faecal incontinence (FI). No correlation was found between rising level of BMI and constipation or incontinence prevalence/severity. Data analysis has not confirmed increased prevalence/severity of postoperative constipation or incontinence 6 months after LSG. Out of the group of patients with preoperative constipation, clinically relevant improvement was noted in 45.5% of patients after the surgery. Among patients without constipation before surgery, impairment was noted in 21.2% of patients. Out of the group of patients with preoperative incontinence, improvement was found in 37.5% of patients; none of these patients reported clinically relevant impairment of incontinence symptoms. CONCLUSIONS: The present study has not revealed increased prevalence/severity of postoperative constipation or anal incontinence 6 months after LSG. Our findings suggest that weight loss in patients after LSG might be associated with an improvement of constipation symptoms of individual patients.
- Klíčová slova
- constipation, defaecatory disorders, faecal incontinence, obesity, sleeve gastrectomy,
- Publikační typ
- časopisecké články MeSH
