• MeSH
• ateroskleróza etiologie   imunologie   mikrobiologie   patologie   MeSH
• bakteriální infekce komplikace   imunologie   MeSH
• imunita MeSH
• lidé MeSH
• virové nemoci komplikace   imunologie   MeSH
• zánět MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• komentáře MeSH
• úvodníky MeSH

Atherosclerosis is a chronic inflammation and the cause of most cardiovascular diseases. It is the main cause of death in the Western world today, even though growing incidence of atherosclerosis-related diseases has been recently observed in developing countries, too. In many patients with atherosclerosis, however, traditional risk factors for atherosclerosis are not identifiable. This has renewed the interest, in recent years, in the links between atherosclerosis and environmental exposures, including infectious agents. Infection was identified as as risk factor for atherosclerosis in the first half of the 20th century. Experimental and clinical studies have shown that infection can stimulate atherogenic processes and that there are significant interactions between infection and traditional risk factors. Yet there are questions concerning etiology, pathogenesis and appropriate interventions which remain unanswered. The following article provides an overview of the role of the infectious agents in atherosclerosis and discusses possible intervention strategies.

• MeSH
• ateroskleróza mikrobiologie   MeSH
• bakteriální infekce komplikace   MeSH
• lidé MeSH
• virové nemoci komplikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

Atherosclerosis is guided by chronicle inflammation process. In the last decades of the 20th century, studies considering infection another possible risk factor of atherosclerosis development were written. Helicobacter pylori, Porphyromas gingivalis, some viruses but most frequently Chlamydia pneumonie are infection agens mentioned in these studies. Some of them emphasize also combined infections caused by more pathogenic factors having influence on vascular inflammation. Serological, epidemiological, histological and imunological studies show the pathogenic influence of acute or chronic infections. Many studies selected makrolid antibiotics as treatment in patients with ischaemic heart disease. However, existing experience with antibiotics did not bring clear results. These studies have mentioned the fact antibiotics have not been indicated as treatment in patients with acute or chronic vascular system infliction by atherosclerosis. Since the experimental and clinical research of influence of inflammations on the development of atherosclerosis moved forward a lot, no exact evidence of this complicated pathogenic mechanism was given. It will obviously take some time to confirm whether the relation between infections and artherosclerosis is causal, i.e. initiating the pathogenic process, accelerating it or keeping it alive.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• ateroskleróza farmakoterapie   imunologie   mikrobiologie   patologie   MeSH
• bakteriální infekce komplikace   imunologie   MeSH
• Chlamydophila pneumoniae MeSH
• imunita MeSH
• infekce bakteriemi rodu Chlamydophila komplikace   MeSH
• lidé MeSH
• rizikové faktory MeSH
• virové nemoci komplikace   imunologie   MeSH
• zánět MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antibakteriální látky MeSH

BACKGROUND: Cytomegalovirus (CMV) and Chlamydia pneumoniae (C. pneumoniae) antigens and DNA sequences have been demonstrated in atherosclerotic plaques by several investigators. Most significantly, CMV DNA was found both in atherosclerotic lesions as well as in uninvolved areas of aortas and carotid artery, whereas C. pneumoniae was mostly detected in advanced carotid atherosclerotic lesions. METHODS AND RESULTS: Atherosclerotic plaques removed from seventeen patients during carotid endarterectomy were analysed for the simultaneous presence of CMV and C. pneumoniae DNA sequences using polymerase chain reaction (PCR). Of the seventeen samples, nine (53%) were positive for CMV DNA sequences and seven (41%) contained C. pneumoniae DNA sequences. Four samples (24%) were positive for both CMV and C. pneumoniae DNA. CMV DNA or C. pneumoniae DNA was detected in 12 (71%) of 17 carotid plaques and 2 additional patients had high titers of antibodies to CMV. CMV DNA and C. pneumoniae DNA were found in the same tissue specimens in 4 (24%) patients. CONCLUSIONS: These results present evidence that CMV DNA and/or C. pneumoniae DNA can be detected in 71% of carotid atherosclerotic plaques and in some instances DNA of both agents in the same tissue. The possible pathogenetic role of these agents in the initiation or promotion of the development of atherosclerotic plaques deserves increased attention.

• MeSH
• arterioskleróza krev   mikrobiologie   patologie   chirurgie   MeSH
• chlamydiové infekce komplikace   MeSH
• Chlamydophila pneumoniae genetika   imunologie   MeSH
• cytomegalovirové infekce komplikace   MeSH
• Cytomegalovirus genetika   imunologie   MeSH
• DNA bakterií genetika   MeSH
• DNA virů analýza   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci arterie carotis krev   mikrobiologie   patologie   chirurgie   MeSH
• polymerázová řetězová reakce MeSH
• protilátky virové krev   MeSH
• sekvence nukleotidů MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• studie případů a kontrol 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
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• DNA bakterií MeSH
• DNA virů MeSH
• protilátky virové MeSH

Cardiovascular diseases (not including COVID-19 infection) are still one of the most common causes of mortality and morbidity in our country and in developed countries. Today no one questions the intervention of all risk factors for atherosclerosis after a cardiovascular event, although unfortunately even in this case the recommended target values are often not achieved. However, the intervention of risk factors in primary prevention is often neglected. Atherosclerosis is a long-term process, developing since the childhood. It is a continuous process and the event itself is only the culmination of this process. Therefore, it is necessary to intervene in key risk factors early in life, and we have ample evidence that even early pharmacological intervention has a clear effect on slowing or stopping the process of atherosclerosis.

• Klíčová slova
• arterial hypertension, combination therapy, dyslipidemia, early intervention, risk factors of atherosclerosis,
• MeSH
• ateroskleróza * komplikace   MeSH
• COVID-19 * MeSH
• dítě MeSH
• dyslipidemie * komplikace   farmakoterapie   MeSH
• hypertenze * komplikace   farmakoterapie   MeSH
• kardiovaskulární nemoci * etiologie   prevence a kontrola   MeSH
• lidé MeSH
• rizikové faktory MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Our aim was to detect markers of Chlamydia pneumoniae (CPN) and human cytomegalovirus (HCMV) infection in patients with peripheral vascular occlusive disease and to follow markers of inflammation, endothelial dysfunction and lipid metabolism alteration in patients with active infection. CPN genome was detected in 9 (47.4 %) patients by at least one PCR method. Serological markers of acute CPN infection were found in 5 (26.3 %) subjects; each of them showed also positivity in at least one of the PCR methods. HCMV DNA were detected in 2 (10.5 %) patients; HCMV-specific antibodies were detected in 14 (73.7 %) subjects, however only in IgG subclass. Subjects with HCMV PCR positivity thus showed no serological markers of active HCMV infection. Laboratory findings of acute CPN infection were associated with increased plasma levels of Lp(a), triacylglycerols, atherogenic index of plasma and E-selectin (p < 0.05). No significant differences were found in the other markers, including plasma levels of total cholesterol, ferritin, homocysteine, oxidized LDL, IL-6, IL-8, IL-18, TNF-alpha, soluble forms of VCAM-1 and ICAM-1, von Willebrand factor, C-reactive protein, and plasma nitrites & nitrates. Frequent presence of chlamydial DNA in atheromatous plaques from patients with peripheral vascular disease was confirmed. HCMV DNA was detected only sporadically and with positivity in anamnestic anti-HCMV antibodies (IgG) only, indicating a rare presence of latent virus rather than active replication. Patients with laboratory markers of acute CPN infection exhibited more pronounced alterations in lipid metabolism and endothelial dysfunction.

• MeSH
• arteria femoralis diagnostické zobrazování   metabolismus   mikrobiologie   patologie   virologie   MeSH
• arteria poplitea diagnostické zobrazování   metabolismus   mikrobiologie   patologie   virologie   MeSH
• ateroskleróza diagnostické zobrazování   etiologie   metabolismus   mikrobiologie   patofyziologie   virologie   MeSH
• bérec krevní zásobení   MeSH
• biologické markery MeSH
• cévní endotel patofyziologie   MeSH
• Chlamydophila pneumoniae izolace a purifikace   MeSH
• cytokiny krev   MeSH
• cytomegalovirové infekce komplikace   metabolismus   patofyziologie   virologie   MeSH
• DNA bakterií analýza   krev   MeSH
• DNA virů analýza   krev   MeSH
• dospělí MeSH
• dyslipidemie etiologie   MeSH
• infekce bakteriemi rodu Chlamydophila komplikace   metabolismus   mikrobiologie   patofyziologie   MeSH
• ischemie etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lipoprotein (a) krev   MeSH
• mladý dospělý MeSH
• onemocnění periferních cév diagnostické zobrazování   etiologie   metabolismus   mikrobiologie   patofyziologie   virologie   MeSH
• radiografie MeSH
• senioři MeSH
• stenóza MeSH
• vaskulitida etiologie   metabolismus   mikrobiologie   patofyziologie   virologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• biologické markery MeSH
• cytokiny MeSH
• DNA bakterií MeSH
• DNA virů MeSH
• lipoprotein (a) MeSH

BACKGROUND: The biological properties of some herpesviruses such as the ability of latent persistency in the host cells and the presence of viral DNA in atherosclerotic lesions, suggest the possible role of herpesviruses in the development of atherosclerosis. Although many authors proved the presence of viral DNA in arterial wall tissue, the role of herpesviruses in the origin and progress of atherogenesis still remains unclear. OBJECTIVES: The aim of this study was to confirm the presence of viral DNA in arterial wall and to associate the presence of these viruses with the development of atherosclerosis in patients with ischemic heart disease (IHD). STUDY DESIGN: A possible role of HCMV, EBV and HHV6 in the development of atherosclerosis was tested in 244 IHD patients and 87 coronarographically negative controls. The presence of viral DNA in aortic and venous walls, as well as in a peripheral blood samples was tested by the use of polymerase chain reaction (PCR) accompanied by, immunological tests for anti-virus antibodies IgM and IgG types for all experimental groups. RESULTS: The genomic DNA of HCMV was found in 76 and 59%, DNA of EBV in 59 and 50%, and DNA of HHV6 in 0.08 and 0.0%, of arterial walls of IHD patients and non-ischemic control group, respectively. No viral DNA was found in venous samples. Significant association (P < 0.01) has been proved between CMV infection and IHD. CONCLUSIONS: Our results suggest that HCMV and EBV can be found in the arterial wall, so that the arterial wall could be a potential site of persistency of those viruses. We also proved a significant association between the presence of HCMV DNA in aortic walls and atherosclerosis. Despite of the high genetic and biological similarity between CMV and HHV6 no substantial role of HHV6 in atherosclerosis has been proved.

• MeSH
• aorta virologie   MeSH
• buněčné linie MeSH
• cytomegalovirové infekce komplikace   virologie   MeSH
• Cytomegalovirus izolace a purifikace   MeSH
• DNA virů analýza   izolace a purifikace   MeSH
• herpetické infekce virologie   MeSH
• infekce virem Epsteina-Barrové virologie   MeSH
• ischemická choroba srdeční virologie   MeSH
• koronární cévy virologie   MeSH
• leukocyty mononukleární virologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lidský herpesvirus 6 izolace a purifikace   MeSH
• nemoci koronárních tepen virologie   MeSH
• polymerázová řetězová reakce MeSH
• vény virologie   MeSH
• virus Epsteinův-Barrové izolace a purifikace   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• DNA virů MeSH

Polymorphonuclear leukocytes or neutrophils are the main executors of cellular death, both in septic inflammation during bacterial infection and in sterile inflammation during trauma or surgery. Whereas in septic inflammation neutrophils perform a useful function to fortify the host's defense against infection, in sterile inflammation, by contrast, they contribute to unwelcome tissue damage. Regardless of the situation, activated neutrophils exhibit a prolonged lifespan and delayed apoptotic death which, under normal conditions, is a prerequisite for their natural renewal. Traditionally, delayed neutrophil apoptosis was considered to promote trauma or surgical injury. According to the results of recent studies, however surprising they may appear, the reverse might be in keeping with what happens IN VIVO. Apoptotic signaling in neutrophils could, by contrast, contribute to intrinsic protection of the host's tissues. This review article, aimed preferentially but not exclusively at the cardiac surgeon, presents some new information in support of this viewpoint, which fits in with our own observations.

• MeSH
• antigeny CD95 metabolismus   MeSH
• apoptóza * MeSH
• ateroskleróza imunologie   patologie   MeSH
• bakteriální infekce imunologie   patologie   MeSH
• kardiochirurgické výkony škodlivé účinky   MeSH
• lidé MeSH
• ligand Fas metabolismus   MeSH
• neutrofily imunologie   patologie   MeSH
• přirozená imunita MeSH
• protoonkogenní proteiny c-bcl-2 metabolismus   MeSH
• signální transdukce MeSH
• zánět imunologie   patologie   prevence a kontrola   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• antigeny CD95 MeSH
• ligand Fas MeSH
• protoonkogenní proteiny c-bcl-2 MeSH

BACKGROUND: Home-based cardiac telerehabilitation (HBCT) is a feasible and effective alternative to traditional center-based cardiac rehabilitation (CBCR). Currently, there are only limited studies focusing on a long-term effect of HBCT, which means it is essential to do more research in this study field. AIM: This study aimed at investigating a 1-year effect of a randomized controlled study using Cardiac Rehabilitation through the Global Position System (CR-GPS) compared to outpatient cardiac rehabilitation. Study focused on cardiorespiratory fitness (CRF) and health-related quality of life (HRQL) in patients with coronary heart disease (CAD). DESIGN: A long-term follow-up of a randomized study. SETTING: Patients were enrolled, and the intervention was performed in an outpatient or home-based model. The results were obtained and evaluated in a hospital. POPULATION: Patients who participated in the CR-GPS study were diagnosed with CAD with low to moderate cardiovascular risk. METHODS: Patients enrolled in the study were eligible participants who had previously completed a 12-week HBCT program using a wrist heart rate (HR) monitor or attended a traditional CBCR. Primary outcome was the change in CRF expressed in peak oxygen uptake (pVO2), and the secondary outcomes were self-reported HRQL, objectively measured anthropometric characteristics, and mortality and hospitalization rates. RESULTS: Forty-four patients (76%) completed the long-term follow-up. The average peak of pVO2 was higher after 1-year follow-up in the telerehabilitation group (HBCT 25.5 mL/kg/min compared to the active control group CBCR 23.6 mL/kg/min P=0.047). No statistically significant difference between the two groups was found after long-term follow-up for the parameter HRQL. For both groups, there was a significant improvement in the range of perceptions of general health. There was no death case and no difference in hospitalization rate between the groups. CONCLUSIONS: This study supports the HBCT model. It has been demonstrated that it induces satisfactory long-term effects in pVO2, exercise performance, and perceived general health in CAD patients with low to moderate cardiovascular risk. CLINICAL REHABILITATION IMPACT: Cardiovascular telerehabilitation using wrist HR monitors is a feasible and effective rehabilitation method that can help patients eliminate barriers that prevent them from using CBCR programs. Especially in the current global situation with the COVID-19 pandemic, this topic is becoming increasingly important.

• MeSH
• COVID-19 * MeSH
• kardiovaskulární rehabilitace * MeSH
• kvalita života MeSH
• lidé MeSH
• následné studie MeSH
• nemoci koronárních tepen * MeSH
• pandemie MeSH
• SARS-CoV-2 MeSH
• telerehabilitace * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

BACKGROUND: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. METHODS: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P=0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P=0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P=0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P=0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P=0.31). CONCLUSIONS: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846 .).

• MeSH
• antiflogistika aplikace a dávkování   škodlivé účinky   MeSH
• ateroskleróza krev   farmakoterapie   MeSH
• C-reaktivní protein metabolismus   MeSH
• cévní mozková příhoda prevence a kontrola   MeSH
• dvojitá slepá metoda MeSH
• humanizované monoklonální protilátky MeSH
• incidence MeSH
• infarkt myokardu farmakoterapie   prevence a kontrola   MeSH
• infekce etiologie   MeSH
• interleukin-1beta antagonisté a inhibitory   imunologie   MeSH
• kardiovaskulární nemoci epidemiologie   mortalita   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lipidy krev   MeSH
• monoklonální protilátky aplikace a dávkování   škodlivé účinky   MeSH
• neutropenie chemicky indukované   MeSH
• sekundární prevence MeSH
• senioři MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• antiflogistika MeSH
• C-reaktivní protein MeSH
• canakinumab MeSH Prohlížeč
• humanizované monoklonální protilátky MeSH
• interleukin-1beta MeSH
• lipidy MeSH
• monoklonální protilátky MeSH