OBJECTIVE: Despite availability of an array of antihypertensive drugs, malignant hypertension remains a life-threatening condition, and new therapeutic strategies for the treatment of malignant hypertension and malignant hypertension-associated organ damage are needed. The aim of the present study was to assess the effects of nitric oxide (NO)-independent soluble guanylyl cyclase (sGC) stimulator on the course of malignant hypertension. The second aim was to investigate if the treatment with sodium-glucose cotransporter type 2 (SGLT2) inhibitor would augment the expected beneficial actions of the sGC stimulation on the course of malignant hypertension. METHODS: As a model of malignant hypertension, Ren-2 transgenic rats (TGR) treated with nonspecific NO synthase inhibitor (Nω-nitro- l -arginine methyl ester, l -NAME) was used. Blood pressure (BP) was monitored by radiotelemetry, and the treatment was started 3 days before administration of l -NAME. RESULTS: The treatment with sGC stimulator BAY 41-8543, alone or combined with SGLT2 inhibitor empagliflozin, abolished malignant hypertension-related mortality in TGR receiving l -NAME. These two treatment regimens also prevented BP increases after l -NAME administration in TGR, and even decreased BP below values observed in control TGR, and prevented cardiac dysfunction and malignant hypertension-related morbidity. The treatment with the SGLT2 inhibitor empagliflozin did not further augment the beneficial actions of sGC stimulator on the course of malignant hypertension-related mortality. CONCLUSION: The treatment with NO-independent sGC stimulator displayed marked protective actions on the course of malignant hypertension-related mortality and malignant hypertension-related cardiac damage. This suggests that application of sGC stimulator could be a promising therapeutic means for the treatment of malignant hypertension.
- Klíčová slova
- malignant hypertension, renin–angiotensin system, sodium-glucose cotransporter type 2 inhibitor, soluble guanylyl cyclase stimulator,
- MeSH
- benzhydrylové sloučeniny farmakologie MeSH
- glifloziny MeSH
- glukosidy farmakologie terapeutické užití MeSH
- hypertenze maligní * prevence a kontrola farmakoterapie MeSH
- krevní tlak účinky léků MeSH
- krysa rodu Rattus MeSH
- morfoliny MeSH
- NG-nitroargininmethylester farmakologie MeSH
- potkani transgenní MeSH
- pyrazoly * farmakologie terapeutické užití MeSH
- pyrimidiny * terapeutické užití farmakologie MeSH
- rozpustná guanylátcyklasa * metabolismus MeSH
- zvířata MeSH
- Check Tag
- krysa rodu Rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- BAY 41-8543 MeSH Prohlížeč
- benzhydrylové sloučeniny MeSH
- empagliflozin MeSH Prohlížeč
- glifloziny MeSH
- glukosidy MeSH
- morfoliny MeSH
- NG-nitroargininmethylester MeSH
- pyrazoly * MeSH
- pyrimidiny * MeSH
- rozpustná guanylátcyklasa * MeSH
Implanted cardiac pacemaker (PM) or implantable cardioverter defibrillator (ICD) has been so far considered a contra-indication to magnetic resonance imaging (MRI). In the last few years MRI conditional cardiac implantable electronic devices have been marketed enabling patients undergo MRI under specific conditions. We present current state of the art and provide overview of available MRI conditional devices. Magnetic resonance imaging in these patients should be performed only in cases where the requested information can not be obtained using alternative imaging technique.
- MeSH
- defibrilátory implantabilní * MeSH
- design vybavení MeSH
- kardiostimulátor * MeSH
- lidé MeSH
- magnetická rezonanční tomografie * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: Catheter ablation for paroxysmal atrial fibrillation is widely used for patients with drug-refractory paroxysms of arrhythmia. Recently, novel technologies have been introduced to the market that aim to simplify and shorten the procedure. AIM: To compare the clinical outcome of pulmonary vein (PV) isolation using a multipolar circular ablation catheter (PVAC group), with point-by-point PV isolation using an irrigated-tip ablation catheter and the CARTO mapping system (CARTO group; CARTO, Biosense Webster, Diamond Bar, CA, USA). METHODS: Patients with documented PAF were randomized to undergo PV isolation using PVAC or CARTO. Atrial fibrillation (AF) recurrences were documented by serial 7-day Holter monitoring. RESULTS: One hundred and two patients (mean age 58 ± 11 years, 68 men) were included in the study. The patients had comparable baseline clinical characteristics, including left atrial dimensions and left ventricular ejection fraction, in both study arms (PVAC: n = 51 and CARTO: n = 51). Total procedural and fluoroscopic times were significantly shorter in the PVAC group (107 ± 31 minutes vs 208 ± 46 minutes, P < 0.0001 and 16 ± 5 minutes vs 28 ± 8 minutes, P < 0.0001, respectively). The AF recurrence was documented in 23% and 29% of patients in the PVAC and CARTO groups, respectively (P = 0.8), during the mean follow-up of 200 ± 13 days. No serious complications were noted in both study groups. CONCLUSIONS: Clinical success rates of PV isolation are similar when using multipolar circular PV ablation catheter and point-by-point ablation with a three-dimensional (3D) navigation system in patients with PAF, and results in shorter procedural and fluoroscopic times with a comparable safety profile.
- MeSH
- elektrody MeSH
- fibrilace síní diagnostické zobrazování chirurgie MeSH
- fluoroskopie MeSH
- katetrizační ablace přístrojové vybavení metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- recidiva MeSH
- senioři MeSH
- tepový objem fyziologie MeSH
- venae pulmonales diagnostické zobrazování chirurgie 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
- randomizované kontrolované studie MeSH
- Geografické názvy
- Česká republika MeSH
Hypoxic pulmonary vasoconstriction (HPV), an important physiological mechanism, is regulated by changes in the production of and interactions among reactive oxygen species (ROS). There is controversy, however, over whether HPV is mediated by an increase or a decrease in ROS production. Also, the role of NO in HPV remains unclear. The aim of this study was to investigate whether the inhibition of HPV by the antioxidant tempol was dependent on the concentration of NO, and how its effect was influenced by increased basal pulmonary vascular tone. In isolated rat lungs, we measured vasoconstrictor responses to acute ventilatory hypoxia before and after administration of tempol during perfusion with or without L-NAME. We found that tempol abolished HPV independently of NO production. When we increased basal vascular tone by K(+)-induced depolarization, we also found that tempol completely inhibited HPV. Our results indicate that inhibition of HPV by the superoxide dismutase mimetic tempol does not depend on either NO production or a decrease in basal vascular tone.
- MeSH
- antioxidancia farmakologie MeSH
- cyklické N-oxidy farmakologie MeSH
- hypoxie farmakoterapie metabolismus MeSH
- inhibitory enzymů farmakologie MeSH
- krysa rodu Rattus MeSH
- NG-nitroargininmethylester farmakologie MeSH
- oxid dusnatý metabolismus MeSH
- plicní oběh účinky léků fyziologie MeSH
- reaktivní formy kyslíku metabolismus MeSH
- spinové značení MeSH
- superoxiddismutasa metabolismus MeSH
- vazokonstrikce účinky léků fyziologie MeSH
- zvířata MeSH
- Check Tag
- krysa rodu Rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- antioxidancia MeSH
- cyklické N-oxidy MeSH
- inhibitory enzymů MeSH
- NG-nitroargininmethylester MeSH
- oxid dusnatý MeSH
- reaktivní formy kyslíku MeSH
- spinové značení MeSH
- superoxiddismutasa MeSH
- tempol MeSH Prohlížeč