Pulmonary congestion due to heart failure causes abnormal lung function. Cardiac resynchronization therapy (CRT) is a proven effective treatment for heart failure. The aim of this study was to test the hypothesis that CRT promotes increased lung volumes, bronchial conductance, and gas diffusion. Forty-four consecutive patients with heart failure were prospectively investigated before and after CRT. Spirometry, gas diffusion (diffusing capacity for carbon monoxide), cardiopulmonary exercise testing, New York Heart Association class, brain natriuretic peptide, the left ventricular ejection fraction, left atrial volume, and right ventricular systolic pressure were assessed before and 4 to 6 months after CRT. Pre- and post-CRT measures were compared using either paired Student's t tests or Wilcoxon's matched-pair test; p values <0.05 were considered significant. Improved New York Heart Association class, left ventricular ejection fraction, left atrial volume, right ventricular systolic pressure, and brain natriuretic peptide were observed after CRT (p <0.05 for all). Spirometry after CRT demonstrated increased percentage predicted total lung capacity (90 ± 17% vs 96 ± 15%, p <0.01) and percentage predicted forced vital capacity (80 ± 19% vs 90 ± 19%, p <0.01). Increased percentage predicted total lung capacity was significantly correlated with increased peak exercise end-tidal carbon dioxide (r = 0.43, p = 0.05). Increased percentage predicted forced vital capacity was significantly correlated with decreased right ventricular systolic pressure (r = -0.30, p = 0.05), body mass index (r = -0.35, p = 0.02) and creatinine (r = -0.49, p = 0.02), consistent with an association of improved bronchial conductance and decreased congestion. Diffusing capacity for carbon monoxide did not significantly change. In conclusion, increased lung volumes and bronchial conductance due to decreased pulmonary congestion and increased intrathoracic space contribute to an improved breathing pattern and decreased hyperventilation after CRT. Persistent alveolar-capillary membrane remodeling may account for unchanged diffusing capacity for carbon monoxide.

• MeSH
• fyziologie dýchací soustavy * MeSH
• lidé MeSH
• následné studie MeSH
• plíce patofyziologie   MeSH
• prognóza MeSH
• respirační funkční testy MeSH
• respirační insuficience etiologie   patofyziologie   MeSH
• senioři MeSH
• srdeční resynchronizační terapie metody   MeSH
• srdeční selhání komplikace   patofyziologie   terapie   MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• srovnávací studie MeSH

Activation of sublobule IX-b of the cerebellar vermis evokes hypotension, bradycardia and decrease of the phrenic nerve activity in the anesthetized animal. Cardiac performance during the isovolumic phases of systole and relaxation can be evaluated by dP/dtmax, Vpm, dP/dt/DP40 and tau, respectively. In the present study, we evaluated the changes on cardiac function evoked by the stimulation of sublobule IX-b. New Zealand white rabbits were anesthetized, paralyzed and artificially ventilated. A posterior craniotomy was made to reveal and stimulate the cerebellar uvula (4 s train; 50 Hz; 1 ms; 20 microA). The femoral artery and veins were cannulated and a Swan-Ganz catheter was advanced in the upper abdominal aorta to control afterload when inflating the balloon. The left ventricle was catheterized with a Millar catheter. Blood pressure, heart rate, left ventricular pressure were monitored. Results showed a significant decrease on sublobule IX-b stimulation of all the indices of systolic function and an increase of tau indicating a decrease in the speed of the relaxation. These data provide the first evidence of the influence of sublobule IX-b on cardiac function. They may contribute to the understanding of the origin the cardiovascular changes that were observed in two patients with vermian and paravermian hemorrhage.

• MeSH
• autonomní nervový systém fyziologie   MeSH
• elektrická stimulace MeSH
• funkce levé komory srdeční MeSH
• hemodynamika * MeSH
• komorový tlak (srdce) MeSH
• kontrakce myokardu MeSH
• králíci MeSH
• krevní tlak MeSH
• mozeček fyziologie   MeSH
• srdce inervace   MeSH
• srdeční frekvence MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

AIMS: The cardiac conduction system (CCS) is progressively specified during development by interactions among a discrete number of transcription factors (TFs) that ensure its proper patterning and the emergence of its functional properties. Meis genes encode homeodomain TFs with multiple roles in mammalian development. In humans, Meis genes associate with congenital cardiac malformations and alterations of cardiac electrical activity; however, the basis for these alterations has not been established. Here, we studied the role of Meis TFs in cardiomyocyte development and function during mouse development and adult life. METHODS AND RESULTS: We studied Meis1 and Meis2 conditional deletion mouse models that allowed cardiomyocyte-specific elimination of Meis function during development and inducible elimination of Meis function in cardiomyocytes of the adult CCS. We studied cardiac anatomy, contractility, and conduction. We report that Meis factors are global regulators of cardiac conduction, with a predominant role in the CCS. While constitutive Meis deletion in cardiomyocytes led to congenital malformations of the arterial pole and atria, as well as defects in ventricular conduction, Meis elimination in cardiomyocytes of the adult CCS produced sinus node dysfunction and delayed atrio-ventricular conduction. Molecular analyses unravelled Meis-controlled molecular pathways associated with these defects. Finally, we studied in transgenic mice the activity of a Meis1 human enhancer related to an single-nucleotide polymorphism (SNP) associated by Genome-wide association studies (GWAS) to PR (P and R waves of the electrocardiogram) elongation and found that the transgene drives expression in components of the atrio-ventricular conduction system. CONCLUSION: Our study identifies Meis TFs as essential regulators of the establishment of cardiac conduction function during development and its maintenance during adult life. In addition, we generated animal models and identified molecular alterations that will ease the study of Meis-associated conduction defects and congenital malformations in humans.

• Klíčová slova
• Cardiac development, Mouse targeted mutation, PR elongation, Sinus node dysfunction, Transcription factor,
• MeSH
• akční potenciály MeSH
• fenotyp MeSH
• homeodoménové proteiny * genetika   metabolismus   MeSH
• kardiomyocyty * metabolismus   patologie   MeSH
• kontrakce myokardu MeSH
• myši knockoutované MeSH
• nodus sinuatrialis metabolismus   patofyziologie   MeSH
• převodní systém srdeční * metabolismus   patofyziologie   růst a vývoj   MeSH
• srdeční arytmie patofyziologie   metabolismus   genetika   MeSH
• srdeční frekvence * MeSH
• transkripční faktor Meis1 * genetika   metabolismus   nedostatek   MeSH
• věkové faktory MeSH
• vrozené srdeční vady metabolismus   genetika   patofyziologie   MeSH
• vývojová regulace genové exprese MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• homeodoménové proteiny * MeSH
• Meis1 protein, mouse MeSH Prohlížeč
• transkripční faktor Meis1 * MeSH

OBJECTIVE: This is an experimental work designed to determine, using the isolated perfused rat heart, the effect of the ultra-short acting beta-blocker esmolol on cardiac arrest and cardiac function recovery following esmolol withdrawal. METHODS: Changes in heart rate, coronary flow, diastolic pressure and the rate pressure product were evaluated on the isolated heart (Langendorff model). Esmolol concentrations of 125, 250, and 500 mg/l were tested. In another experiment using esmolol concentration of 250 mg/l, cardiac function recovery was assessed after 20- and 45-min arrest. RESULTS: While concentrations of 250 and 500 mg/l are necessary to produce cardiac arrest, the concentration of 500 mg/l does not result in full cardiac function recovery following esmolol withdrawal. After the highest concentration of esmolol, coronary flow, heart rate and the rate-pressure product recovered to about 80, 70 and 60% of the initial control values, respectively. When comparing 20- and 45-min arrests we found cardiac function normalization occurs later after 45-min arrest. CONCLUSION: The induction of cardiac arrest by esmolol is optimal at a concentration of 250 mg/l. A concentration of 125 mg/l does not result in cardiac arrest and produces bradycardia only, a concentration of 500 mg/l may be dangerous on account of persisting undesirable effects on the rat heart.

• MeSH
• beta blokátory aplikace a dávkování   MeSH
• funkce levé komory srdeční účinky léků   MeSH
• ischemická choroba srdeční chirurgie   MeSH
• koronární cirkulace účinky léků   MeSH
• krysa rodu Rattus MeSH
• perfuze MeSH
• potkani Wistar MeSH
• propanolaminy aplikace a dávkování   MeSH
• srdce účinky léků   patofyziologie   MeSH
• srdeční frekvence účinky léků   MeSH
• techniky in vitro MeSH
• vyvolaná zástava srdce metody   MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Názvy látek
• beta blokátory MeSH
• esmolol MeSH Prohlížeč
• propanolaminy MeSH

Authors conducted a one-year prospective study to determine whether CHOP regimen (cyclophosphamide, doxorubicin, vincristin, and prednisone), used in the treatment of aggressive non-Hodgkin s lymphoma, is associated with the presence of an early impairment of cardiac function. Forty seven patients were prospectively examined (27 male and 20 female) aged 49+/-14 years who were treated with CHOP regimen. Rest echocardiography was performed at baseline and one-year control. Cardiopulmonary exercise test was carried out at one-year control examination. The ejection fraction (EF), parameters of diastolic function, myocardial performance index (MPI), and pVO2 were used as parameters of cardiopulmonary performance. The cumulative dose (CD) of doxorubicin was 277+/-56 (300 mg/m(2)) was given. The baseline EF 64+/-5% (64%) decreased to 58+/-7% (57%) at the one-year control (p<0.0001). 23% of patients exhibited a drop in EF >10% during the follow-up. 43% revealed a pathologically increased value of MPI >0.55, and 47% impaired diastolic function compared to the baseline values, respectively. 21% of patients exhibited a decrease of pVO(2) < 20 ml/kg/min, and 17% pVO(2) < 80% of the reference value, respectively. None of the patients developed signs of heart failure. The Doppler parameters of both diastolic and global LV function were the most affected measures and significantly influenced the cardiopulmonary performance. Multivariate analysis showed that CD > or =300 mg/m(2) (OR=8.08; p<0.05) and the presence of risk factors (OR=9.48; p<0.008) are the best predictors of cardiotoxicity. The results show that subclinical cardiac impairment was frequent in patients receiving the CHOP regimen with safe cumulative doses of doxorubicin. The value of described changes for the development of heart failure has to be assessed during the prospective follow-up.

• MeSH
• cyklofosfamid škodlivé účinky   MeSH
• dospělí MeSH
• doxorubicin škodlivé účinky   MeSH
• echokardiografie MeSH
• funkce levé komory srdeční účinky léků   MeSH
• funkční vyšetření srdce MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• nehodgkinský lymfom farmakoterapie   MeSH
• plíce účinky léků   MeSH
• prednison škodlivé účinky   MeSH
• prospektivní studie MeSH
• protokoly protinádorové kombinované chemoterapie škodlivé účinky   MeSH
• respirační funkční testy MeSH
• senioři MeSH
• sexuální faktory MeSH
• srdce účinky léků   MeSH
• věkové faktory MeSH
• vinkristin škodlivé účinky   MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• zátěžový test účinky léků   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• cyklofosfamid MeSH
• doxorubicin MeSH
• prednison MeSH
• vinkristin MeSH

Sarcoplasmic reticulum (SR) is a specialized tubular network, which not only maintains the intracellular concentration of Ca2+ at a low level but is also known to release and accumulate Ca2+ for the occurrence of cardiac contraction and relaxation, respectively. This subcellular organelle is composed of several phospholipids and different Ca2+-cycling, Ca2+-binding and regulatory proteins, which work in a coordinated manner to determine its function in cardiomyocytes. Some of the major proteins in the cardiac SR membrane include Ca2+-pump ATPase (SERCA2), Ca2+-release protein (ryanodine receptor), calsequestrin (Ca2+-binding protein) and phospholamban (regulatory protein). The phosphorylation of SR Ca2+-cycling proteins by protein kinase A or Ca2+-calmodulin kinase (directly or indirectly) has been demonstrated to augment SR Ca2+-release and Ca2+-uptake activities and promote cardiac contraction and relaxation functions. The activation of phospholipases and proteases as well as changes in different gene expressions under different pathological conditions have been shown to alter the SR composition and produce Ca2+-handling abnormalities in cardiomyocytes for the development of cardiac dysfunction. The post-translational modifications of SR Ca2+ cycling proteins by processes such as oxidation, nitrosylation, glycosylation, lipidation, acetylation, sumoylation, and O GlcNacylation have also been reported to affect the SR Ca2+ release and uptake activities as well as cardiac contractile activity. The SR function in the heart is also influenced in association with changes in cardiac performance by several hormones including thyroid hormones and adiponectin as well as by exercise-training. On the basis of such observations, it is suggested that both Ca2+-cycling and regulatory proteins in the SR membranes are intimately involved in determining the status of cardiac function and are thus excellent targets for drug development for the treatment of heart disease.

• MeSH
• myokard metabolismus   MeSH
• sarkoplazmatické retikulum * metabolismus   MeSH
• srdce fyziologie   MeSH
• vápník * metabolismus   MeSH
• vztahy mezi strukturou a aktivitou MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• vápník * MeSH

Although the heart atria have a lesser functional importance than the ventricles, atria play an important role in the pathophysiology of heart failure and supraventricular arrhythmias, particularly atrial fibrillation. In addition, knowledge of atrial morphology recently became more relevant as cardiac electrophysiology and interventional procedures in the atria gained an increasingly significant role in the clinical management of patients with heart disease. The atrial chambers are thin-walled, and several vessels enter at the level of the atria. The left and right atrium have different structures and shape. In general, both atrial chambers have the venous part, the appendage, and the vestibule; different aspects of each part allow us to distinguish morphologically between the left and right atrium. The human atrial conduction system consists of the sinus node and the atrioventricular node with no histologically specialized conduction pathways in the atrial chamber and an interatrial connection. The data show that the propagation of the impulse depends mainly on the myocardial architecture in the atria and the orientation of the myocytes plays a significant role in conduction. To complete the picture, it is also important to know how the atria develop and what is the embryonic origin of its different structures, as this may play a role in the development of some pathological conditions such as atrial fibrillation or certain types of congenital heart defects. Functional impairment of the atria can in some situations severely compromise heart pumping function, and conversely, can support it if other areas are damaged, balancing the blood flow to the body for some time. Key words Morphology of atrial chambers, Pectinate muscles, Atrial function.

• MeSH
• lidé MeSH
• převodní systém srdeční * fyziologie   MeSH
• srdce - funkce síní * fyziologie   MeSH
• srdeční síně * embryologie   anatomie a histologie   růst a vývoj   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Exercise can improve the cardiovascular health. However, the mechanism contributing to its beneficial effect on elderly patients with myocardial infarction is obscure. 20-month-old male Sprague-Dawley rats were used to establish myocardial infarction (MI) model by permanent ligation of the left anterior descending coronary artery (LAD) of the heart, followed by 4-week interval exercise training on a motor-driven rodent treadmill. The cardiac function, myocardial fibrosis, apoptosis, oxidative stress, and inflammatory responses were determined by using pressure transducer catheter, polygraph physiological data acquisition system, Masson's trichrome staining, and ELISA to evaluate the impact of post-MI exercise training on MI. Western blot were performed to detect the activation of AMPK/SIRT1/PGC-1alpha signaling in the hearts of aged rats. Exercise training significantly improved cardiac function and reduced the cardiac fibrosis. In infarcted heart, the apoptosis, oxidative stress, and inflammation were significantly reduced after 4-week exercise training. Mechanistically, AMPK/SIRT1/PGC-1alpha pathway was activated in the myocardial infarction area after exercise training, which might participate in the protection of cardiac function. Exercise training improves cardiac function in MI rats through reduction of apoptosis, oxidative stress, and inflammation, which may mediate by the activation of AMPK/SIRT1/PGC-1alpha signaling pathway.

• MeSH
• infarkt myokardu * metabolismus   MeSH
• kondiční příprava zvířat * fyziologie   MeSH
• krysa rodu Rattus MeSH
• modely nemocí na zvířatech MeSH
• myokard metabolismus   MeSH
• potkani Sprague-Dawley MeSH
• proteinkinasy aktivované AMP metabolismus   MeSH
• sirtuin 1 metabolismus   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• proteinkinasy aktivované AMP MeSH
• sirtuin 1 MeSH

We performed a randomized controlled trial with the glucagon-like peptide-1 (GLP-1) receptor agonist exenatide as add-on to standard peri-operative insulin therapy in patients undergoing elective cardiac surgery. The aims of the study were to intensify peri-operative glucose control while minimizing the risk of hypoglycaemia and to evaluate the suggested cardioprotective effects of GLP-1-based treatments. A total of 38 patients with decreased left ventricular systolic function (ejection fraction ≤50%) scheduled for elective coronary artery bypass grafting (CABG) were randomized to receive either exenatide or placebo in a continuous 72-hour intravenous (i.v.) infusion on top of standard peri-operative insulin therapy. While no significant difference in postoperative echocardiographic variables was found between the groups, participants receiving exenatide showed improved peri-operative glucose control as compared with the placebo group (average glycaemia 6.4 ± 0.5 vs 7.3 ± 0.8 mmol/L; P < .001; percentage of time in target range of 4.5-6.5 mmol/L 54.8% ± 14.5% vs 38.6% ± 14.4%; P = .001; percentage of time above target range 39.7% ± 13.9% vs 52.8% ± 15.2%; P = .009) without an increased risk of hypoglycaemia (glycaemia <3.3 mmol/L: 0.10 ± 0.32 vs 0.21 ± 0.42 episodes per participant; P = .586). Continuous administration of i.v. exenatide in patients undergoing elective CABG could provide a safe option for intensifying the peri-operative glucose management of such patients.

• Klíčová slova
• cardiac surgery, exenatide, heart function, peri-operative glucose control,
• MeSH
• agonisté receptoru pro glukagonu podobný peptid 1 MeSH
• dysfunkce levé srdeční komory krev   chirurgie   MeSH
• exenatid MeSH
• hyperglykemie krev   epidemiologie   prevence a kontrola   MeSH
• hypoglykemie krev   chemicky indukované   epidemiologie   prevence a kontrola   MeSH
• hypoglykemika aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• incidence MeSH
• inkretiny aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• intravenózní infuze MeSH
• inzulin aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• jednoduchá slepá metoda MeSH
• kardiotonika aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• kombinovaná farmakoterapie škodlivé účinky   MeSH
• koronární bypass škodlivé účinky   MeSH
• lidé MeSH
• nemocnice univerzitní MeSH
• ověření koncepční studie MeSH
• peptidy aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• perioperační péče škodlivé účinky   MeSH
• peroperační komplikace krev   chemicky indukované   epidemiologie   prevence a kontrola   MeSH
• pooperační komplikace krev   chemicky indukované   epidemiologie   prevence a kontrola   MeSH
• receptor pro glukagonu podobný peptid 1 metabolismus   MeSH
• riziko MeSH
• senioři MeSH
• srdce účinky léků   patofyziologie   MeSH
• živočišné jedy aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• agonisté receptoru pro glukagonu podobný peptid 1 MeSH
• exenatid MeSH
• hypoglykemika MeSH
• inkretiny MeSH
• inzulin MeSH
• kardiotonika MeSH
• peptidy MeSH
• receptor pro glukagonu podobný peptid 1 MeSH
• živočišné jedy MeSH

BACKROUND AND AIMS: Early evaluation of cardiac remodeling may be useful in predicting heart failure in patients with arterial hypertension. The identification of biomarkers as useful clinical tools in this regard is ongoing. The aim of this study was to evaluate the association of selected cardiac biomarkers levels with parameters of cardiac structure and function in patients with arterial hypertension. PATIENTS AND METHODS: Included in the study were patients with arterial hypertension with normal left ventricular ejection fraction (LV EF) and absence of signs of heart failure. The levels of selected biomarkers: NT-proBNP, sST2, Galectin-3, GDF-15, Cystatin C, TIMP-1 and ceruloplasmin were measured and assessed together with other biochemical and echocardiographic parameters. RESULTS: A total of 92 patients (61% men) mean age 61.5 years were included. Mean LV EF was 64.7% and mean LV mass index was 91.7 g/m2. NT-proBNP level correlated significantly with the parameters of LV diastolic function: velocity of E wave (r=0.377, P<0.002), and with E/A ratio, (r=0.455, P<0.0001), with E lat (r=-0.354, P=0.006), E/E' ratio, r=0.393, P<0.002, with ePAP (r=0.390, P=0.014), and with age (r=0.384, P<0.0001). Statistically significant correlations for GDF-15 were as follows: with age (r=0.426, P<0.0001) and left atrial diameter (LA) (r=0.401, P<0.0001), for Cystatin C there are statistically significant correlation with age (r=0.288, P=0.006) and LA (r=0.329, P=0.004). Only sST2 level correlated significantly with parameters of cardiac structure: with LV mass (r=0.290, P<0.01) and LV mass index (r=0.307, P=0.012) and with posterior wall thickness PW (r=0.380, P<0.001). No other observed variables including Galectin-3 and TIMP-1, correlated significantly with age or echocardiographic variables. In a comparison of patients with and without left ventricular hypertrophy, statistically significant differences were found only in LA (P<0.0001) and sST2 (P=0.004). In a multivariate logistic regression, sST2 and TIMP were independent predictors of left ventricular hypertrophy. CONCLUSION: NT-proBNP level as a biomarker of cardiac remodeling correlated with parameters of LV diastolic function in patients with arterial hypertension. Soluble ST2 correlated with parameters of cardiac structure. Biomarkers sST2 and TIMP-1 were associated with left ventricular hypertrophy.

• Klíčová slova
• NT-proBNP, TIMP-1, arterial hypertension, biomarkers, cardiac structure, heart function, sST2,
• Publikační typ
• časopisecké články MeSH