In this study, we investigated the mechanism underlying electrocardiogram (ECG) alterations in a rabbit model of acute pulmonary thromboembolism (PTE). Twelve healthy adult New Zealand white rabbits were used, with eight in the experimental group (PTE group) and four in the control group. After developing the rabbit model of acute PTE, ECG and coronary angiography were performed. HE staining was conducted on the right and left ventricular tissues, and polymerase chain reaction (PCR) was used to determine brain natriuretic peptide (BNP), tumor necrosis factor-alpha (TNF-?), and Troponin I (TNI) mRNA expression in the myocardium. There were considerable changes in the ST segment of the ECG in the PTE group. Coronary angiography revealed the absence of spasm, stenosis, and occlusion. In the plasma of the PTE group, the levels of D-dimer, BNP, TNF-?, and TNI were significantly elevated, and these changes were statistically significant (P<0.05). PCR analysis of ventricular myocardial tissue indicated significantly higher levels of BNP, TNF-?, and TNI mRNA in the PTE group than in the control group. These differences were statistically significant (P<0.05). The ST-T variations on the ECG of rabbits with acute PTE correlate strongly with the temporary changes in right heart volume caused by acute PTE. Keywords: Animal model of pulmonary embolism, B-type natriuretic peptide, Electrocardiogram, Pulmonary thromboembolism, Troponin I, Tumor necrosis factor-alpha.

• MeSH
• akutní nemoc MeSH
• elektrokardiografie * MeSH
• králíci MeSH
• modely nemocí na zvířatech * MeSH
• natriuretický peptid typu B krev   MeSH
• plicní embolie * patofyziologie   krev   MeSH
• TNF-alfa krev   metabolismus   genetika   MeSH
• troponin I krev   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• natriuretický peptid typu B MeSH
• TNF-alfa MeSH
• troponin I MeSH

BACKGROUND AND AIM: Assessment of appropriateness of CT pulmonary angiograms (CTPA) in patients with suspected pulmonary embolism (PE) is based on risk stratification algorithms such as simplified the Geneva Score (sGS) in combination with D-dimer blood tests. The aim of this study was to validate the diagnostic yield and appropriateness of CTPA examinations in accordance with 2014 European Society of Cardiology (ESC) guidelines. MATERIALS AND METHODS: Data from 155 outpatients who underwent CTPA for clinical suspicion of PE were gathered from the radiology information system (RIS) and the clinical information system (CIS). We assessed the presence of sGS items and D-dimer blood test results in RIS from CTPA request forms and from clinical documentation in CIS. RESULTS: Based on the RIS, there were 2.6% patients with high (sGS≥3) and 97.4% patients with low pre-test PE probability (sGS<3), and CTPA indication was formally comprehendible in 75.5% using sGS and D-dimer blood tests. Based on RIS and CIS data in combination, there were 41.3% patients with high and 58.7% patients with low pre-test PE probability, and CTPA indication was formally comprehendible in 88.4%. Using RIS and CIS in combination, PE probability was upgraded from low to high probability in 39.7% compared with RIS alone. In 12.9%, there was a lack of data in RIS for CTPA justification. CONCLUSION: There is a high diagnostic yield when applying current diagnostic guidelines to our data. There was however a notable discrepancy between the data transferred to the CTPA request forms from the full clinical documentation, therefore not readily available for clinical decision making.

• Klíčová slova
• CT examination justification, CT pulmonary angiography, D-Dimers, acute pulmonary embolism, clinical decision making, diagnostic guidelines,
• MeSH
• CT angiografie * MeSH
• fibrin-fibrinogen - produkty degradace analýza   MeSH
• hodnocení rizik MeSH
• lidé středního věku MeSH
• lidé MeSH
• plicní embolie krev   diagnostické zobrazování   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• validační studie MeSH
• Názvy látek
• fibrin fragment D MeSH Prohlížeč
• fibrin-fibrinogen - produkty degradace MeSH

Patients with pulmonary embolism (PE) may have symptomatic or asymptomatic concomitant deep vein thrombosis (DVT). The reported prevalence of PE-associated DVT is variable, and thus, the utility of routine testing is controversial. The aim of our study was to analyze the prevalence of DVT and the factors associated with proximal DVT/whole-leg DVT in patients with symptomatic PE. In 428 consecutive patients (mean age: 59 ± 16.4 years; 52.3% men), we performed clinical examination and complete bilateral compression ultrasound and ascertained medical history and risk factors for DVT/PE. χ2 and t tests were used. Deep vein thrombosis was found in 70.6%; proximal DVT in 49.5%. Sensitivity/specificity of DVT symptoms was 42.7%/93.7% for whole-leg DVT and 47.6%/83.3% for proximal DVT. Male gender significantly prevailed among those with whole-leg DVT and with proximal DVT (58.9% and 61.8%). Active malignancy was significantly more frequent in the patients with proximal DVT than without proximal DVT (10.4% vs 3.7%). In conclusion, the prevalence of PE-associated DVT is quite high but clinical diagnosis is unreliable. In our group, male gender and active malignancy were significantly associated with the presence of concomitant proximal DVT.

• Klíčová slova
• compression ultrasound, deep venous thrombosis, prevalence, pulmonary embolism,
• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• plicní embolie * krev   epidemiologie   etiologie   MeSH
• prevalence MeSH
• rizikové faktory MeSH
• senioři MeSH
• sexuální faktory MeSH
• žilní trombóza * krev   komplikace   epidemiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Natriuretic peptides (NP) have been intensively studied and also used in clinical practice. Their use is important for diagnosis and risk stratification of heart failure, pulmonary embolism and acute coronary syndrome. For the correct interpretation of the results is necessary to know factors, which induce elevation of natriuretic peptides. The article shows an overview of the physiology of the NP, the factors that influence the levels of NP, like heart failure, acute coronary syndrome and pulmonary embolism etc. There is also mentioned possibility of using synthetic derivates of natriuretic peptides in therapy of heart failure.

• MeSH
• akutní koronární syndrom krev   diagnóza   MeSH
• lidé MeSH
• natriuretické peptidy krev   MeSH
• plicní embolie krev   diagnóza   MeSH
• prediktivní hodnota testů MeSH
• srdeční selhání krev   diagnóza   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• natriuretické peptidy MeSH

BACKGROUND: The prognostic value of D-dimer testing in patients with acute pulmonary embolism (PE) has not been thoroughly studied. METHODS: We used the RIETE Registry data to assess the 90-day prognostic value of increased IL Test D-dimer levels at baseline in patients with PE, according to the presence or absence of cancer. RESULTS: As of May 2013, 3,283 patients with acute PE underwent D-dimer testing using IL Test D-dimer. Among 2,588 patients without cancer, those with D-dimer levels in the highest quartile had a higher rate of fatal PE (2.6% vs. 0.9%; p=0.002), fatal bleeding (1.1% vs. 0.3%; p=0.017) and all-cause death (9.1% vs. 4.4%; p<0.001) at 90 days compared with those with levels in the lowest quartiles. Among 695 patients with cancer, those with levels in the highest quartile had a similar rate of fatal PE or fatal bleeding but higher mortality (35% vs. 24%; p<0.01). On multivariate analysis, non-cancer patients with D-dimer levels in the highest quartile had an increased risk for fatal PE (odds ratio [OR]: 3.3; 95% CI: 1.6-6.6), fatal bleeding (OR: 4.3; 95% CI: 1.4-13.7) and all-cause death (OR: 2.1; 95% CI: 1.4-3.1) compared with patients with levels in the lowest quartiles. CONCLUSIONS: Non-cancer patients with acute PE and IL Test D-dimer levels in the highest quartile had an independently higher risk for fatal PE, fatal bleeding and all-cause death at 90 days than those with levels in the lowest quartiles. In patients with cancer, D-dimer levels failed to predict fatal PE or fatal bleeding.

• MeSH
• antikoagulancia terapeutické užití   MeSH
• fibrin-fibrinogen - produkty degradace analýza   metabolismus   MeSH
• lidé MeSH
• nádory krev   MeSH
• plicní embolie krev   MeSH
• prognóza MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antikoagulancia MeSH
• fibrin fragment D MeSH Prohlížeč
• fibrin-fibrinogen - produkty degradace MeSH

Aprotinin, a nonspecific serine protease inhibitor, has been primarily used as a haemostatic drug in cardiac surgery with cardio-pulmonary bypass (CPB). This study investigated the effect of aprotinin on the post-operative levels of procalcitonin (PCT) and a set of cytokines in patients undergoing pulmonary artery endarterectomy (PEA). We analyzed 60 patients with chronic thromboembolic pulmonary hypertension undergoing PEA. 30 patients (Group A) were treated with aprotinin (2,00,00 IU prior anesthesia, then 2,00,00 IU in CPB prime and 50,00 IU per hour continuously); a further 30 patients (Group B) received tranexamic Acid (1 g before anesthesia, 1 g after full heparin dose and 2 g in CPB prime). PCT, TNFalpha, IL-1beta, IL-6, and IL-8 arterial concentrations were measured from before until 72 hours after surgery. Aprotinin significantly affected early post-PEA plasma PCT. Patients treated with aprotinin (Group A) had lower peak PCT levels compared to patients in Group B (1.52 ng/ml versus 2.18, p=0.024). Postoperative peak values of PCT and IL-6 correlated closely in both groups (r=0.78, r=0.83 respectively). Aprotinin attenuates the post-PEA increase of PCT in the same manner as other pro-inflammatory cytokines. Significant correlation between PCT and IL-6 post-surgery may be indicative of an indirect IL-6-mediated pathway of PCT alteration.

• MeSH
• aprotinin terapeutické užití   MeSH
• biologické markery krev   MeSH
• časové faktory MeSH
• endarterektomie * MeSH
• hemostatika terapeutické užití   MeSH
• interleukin-1beta krev   MeSH
• interleukin-6 krev   MeSH
• interleukin-8 krev   MeSH
• kalcitonin krev   MeSH
• kardiochirurgické výkony * MeSH
• kardiopulmonální bypass * MeSH
• kyselina tranexamová terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mediátory zánětu krev   MeSH
• peptid spojený s genem pro kalcitonin MeSH
• plicní embolie krev   komplikace   chirurgie   MeSH
• plicní hypertenze krev   etiologie   chirurgie   MeSH
• proteinové prekurzory krev   MeSH
• senioři MeSH
• TNF-alfa krev   MeSH
• upregulace MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• aprotinin MeSH
• biologické markery MeSH
• CALCA protein, human MeSH Prohlížeč
• CXCL8 protein, human MeSH Prohlížeč
• hemostatika MeSH
• IL6 protein, human MeSH Prohlížeč
• interleukin-1beta MeSH
• interleukin-6 MeSH
• interleukin-8 MeSH
• kalcitonin MeSH
• kyselina tranexamová MeSH
• mediátory zánětu MeSH
• peptid spojený s genem pro kalcitonin MeSH
• proteinové prekurzory MeSH
• TNF-alfa MeSH

In a group of 993 patients with serious medical diseases an important deficiency of antithrombin III was found in patients with hepatic insufficiency, pulmonary embolism and with disseminated intravascular coagulation. Acquired antithrombin III deficiency in these conditions develops when the antithrombin production in the liver is low and also in patients with shock syndrome and disseminated intravascular coagulation. Assessment of antithrombin III is of diagnostic and prognostic value in thrombotic and prethrombotic conditions and its results is decisive for adequate substitution. Adequate AT III substitution without concurrent heparin administration in patients with septicaemia and manifestations of DIC improves the prognosis of patients with an increased endothelial resistance.

• MeSH
• diseminovaná intravaskulární koagulace krev   MeSH
• kardiovaskulární nemoci krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nedostatek antitrombinu III * MeSH
• nemoci jater krev   MeSH
• plicní embolie krev   MeSH
• prognóza MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

The authors examined in 60 patients with acute pulmonary embolism values of blood gases and acid-base equilibrium, incl. 30 from arterialized capillary blood, in another 30 subjects from arterial blood. On analysis of capillary blood hypoxaemia was present in all subjects, on analysis of arterial blood only in 63%. Respiratory alkalosis was found on capillary examination in 37%, on arterial examination in 23% of the patients. Hypoxaemia and hypocapnia thus are not specific phenomena in acute pulmonary embolism, in particular when accurate blood collection for analysis is respected, and normal values of paO2 and paCO2 do not rule out the presence of pulmonary embolism. In the development of hypoxaemia in patients with pulmonary embolism participates above all an incomplete right-to-left pulmonary shunt, as revealed during calculation of the magnitude of the shunt by means of the so-called oxygen method in 30 patients with embolism, as compared with a group of 10 healthy subjects.

• MeSH
• acidobazická rovnováha * MeSH
• akutní nemoc MeSH
• dospělí MeSH
• koncentrace vodíkových iontů MeSH
• kyslík krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• oxid uhličitý krev   MeSH
• plicní embolie krev   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• kyslík MeSH
• oxid uhličitý MeSH

• MeSH
• agregace trombocytů MeSH
• endotel patofyziologie   MeSH
• kapilární permeabilita MeSH
• lidé MeSH
• plicní embolie krev   MeSH
• plicní hypertenze krev   MeSH
• plicní oběh * MeSH
• počet trombocytů MeSH
• syndrom dechové tísně krev   MeSH
• trombocyty fyziologie   MeSH
• vazodilatace MeSH
• vazokonstrikce MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• alfa-1-antitrypsin analýza   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• plicní embolie krev   MeSH
• senioři MeSH
• tromboflebitida krev   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• alfa-1-antitrypsin MeSH