Introduction: The six-minute walk test (6MWT) is a well-established tool for assessing submaximal functional capacity for cardiac patients, but space limitations challenge its implementation. Treadmill-based (TR) 6MWT is a promising alternative, but it requires patients to complete a familiarization test to adapt treadmill speed regulation. With the advancement of sensors, it is possible to automatically control speed for individual patients and thus overcome the space limitation or the speed control difficulty on the treadmill for each patient.Methods: This study investigated the validity and interchangeability of automated speed TR6MWT and standard hallway (HL) 6MWT. Eighteen patients were assessed at baseline of the 12-week cardiac rehabilitation program. Fourteen of them were assessed after rehabilitation. All patients performed three TR6MWTs and three HL6MWTs at baseline and one of each test after the program.Results: Patients well tolerated the TR6MWT. There was a strong correlation between both test methods (r = 0.79). However, patients performed significantly better in HL6MWT (514.8m ± 59.7m) than in TR6MWT (447.2 ± 79.1m) with 95% CI, 40.4-94.6m, p < 0.05. Both tests showed high test-retest reliability (intraclass correlation coefficient of 0.86). The TR6MWT showed a valuable comparison of the effect of the cardiac rehabilitation program (20% increase, effect size 1.1) even though it is not interchangeable with the HL6MWT.Conclusion: The automated speed TR6MWT appears to be an acceptable tool with adequate validity, reliability, and responsiveness for assessing functional capacity in patients utilizing cardiac rehabilitation programs.

• Klíčová slova
• Six minute walk test, automatized treadmill, cardiac rehabilitation, functional capacity, technology-assisted assessment,
• MeSH
• chůze fyziologie   MeSH
• kardiovaskulární rehabilitace * MeSH
• lidé MeSH
• reprodukovatelnost výsledků MeSH
• test chůzí MeSH
• zátěžový test metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The automatic implantable cardioverter-defibrillator constitutes a new therapeutic alternative in malignant ventricular tachyarrhythmias unresponsive to drug therapy. In Czechoslovakia, the device was first implanted to a 29-year-old patient on 31 October, 1984. The article, apart from presenting his case report and a description of the therapeutic procedure, includes the electrocardiograms attesting to the device's effective performance as registered by continuous Holter monitoring.

• MeSH
• dospělí MeSH
• elektrická defibrilace přístrojové vybavení   MeSH
• elektrokardiografie MeSH
• lidé MeSH
• následné studie MeSH
• srdeční frekvence MeSH
• srdeční komory MeSH
• tachykardie terapie   MeSH
• zátěžový test MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

DDDR cardiac pacemakers meet the demand of the two main goals of modern cardiac pacing enauring both the synchronization of atriums and ventricles and the frequency response to physical exercise. In this way they simulate the normal heart rhythm behaviour best of all pacemakers in use. Since 1992 through 1995 the DDDR pacemakers were implanted in 27 patients aged 20-79 (mean 59.9) years in our pacemaker centre. The follow-up period has amounted to 46 months. 26 patients suffered from advanced sinus syndrome with the chronotropic incompetence and with the atrioventricular block, the remaining young man was given the pacemaker because of congenital atrioventricular block. In one patient epicardial leads implanted by thoracotomy have been used. After the wound had healed and the pulse energy had been reduced, the pacemaker bearers underwent the stepwise symptoms limited bicycle or treadmill stress test. During the follow-up the incidence of particular complications was assessed. In comparison with the DDD mode without the sensor, the DDDR pacemakers exhibiting the rate adaptation did improve the working capacity in particular patients in the stress test. (Tab. 1, Fig. 5, Ref. 16).

• MeSH
• dospělí MeSH
• kardiostimulace umělá metody   MeSH
• kardiostimulátor * MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• srdeční arytmie terapie   MeSH
• syndrom chorého sinu terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

Technological advancement in hardware and software development in myocardial perfusion imaging (MPI) leads to the shortening of acquisition time and reduction of the radiation burden to patients. We compared semiquantitative perfusion results and functional parameters of the left ventricle between new dedicated cardiac system with astigmatic collimators called IQ-SPECT (Siemens Medical Solutions, USA) and conventional single photon emission tomography (SPET) system equipped with standard low energy high resolution collimators. A group of randomly selected 81 patients underwent consecutively the MPI procedure on IQ-SPECT and on conventional SPET systen, both without attenuation correction. The summed scores and the values of the functional parameters of the left ventricle: ejection fraction (EF), end-systolic and end-diastolic volumes (ESV, EDV) received from the automatic analysis software were compared and statistically analyzed. Our results showed that summed scores values were significantly higher for the IQ-SPECT system in comparison to the conventional one. Calculated EF were significantly lower for IQ-SPECT, whereas evaluated left ventricular volumes (LVV) were significantly higher for this system. In conclusion, we recorded significant differences in automatically calculated semiquantitative perfusion and functional parameters when compared uncorrected studies obtained by the IQ-SPECT with the conventional SPET system.

• MeSH
• dysfunkce levé srdeční komory diagnostické zobrazování   etiologie   MeSH
• jednofotonová emisní výpočetní tomografie metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci koronárních tepen komplikace   diagnostické zobrazování   MeSH
• reprodukovatelnost výsledků MeSH
• senzitivita a specificita MeSH
• srdeční akcí synchronizované zobrazovací metody metody   MeSH
• tepový objem * MeSH
• vylepšení obrazu metody   MeSH
• zátěžový test MeSH
• zobrazování myokardiální perfuze metody   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• srovnávací studie MeSH

AIM: The aim of this study was to evaluate added value of coronary artery calcium score (CAC) measurement as an adjunct to cardiac gated SPECT for risk stratification in population of patients with diabetes mellitus (DM) and/or chronic renal failure on hemodialysis (CHRF-HD). METHODS: Retrospective analysis of 67 patients, who were referred for stress gated myocardial perfusion SPECT and CAC. Characteristics of study population: 40 men, mean age 59 +/- 12 years, DM (n = 28), CHRF-HD (n = 22), DM and CHRF-HD simultaneously (n = 17). Perfusion summed stress and different scores (SSS, SDS), the left ventricle ejection fraction (LVEF) and enddiastolic/endsystolic volumes (EDV/ESV) were automatically calculated using 4D-MSPECT software. The hard cardiac event was defined as sudden cardiac death or myocardial infarction (MI); angina or other symptoms requiring coronary revascularization were also calculated. RESULTS: During the average period of 18 +/- 10 months, we registered 8 cardiac deaths, 4 nonfatal MI and 7 patients underwent revascularization. In the subgroup of 19 patients with cardiac events, the observed parameters were significantly worse concerning perfusion (SSS 9 +/- 11 vs 2 +/- 3 and SDS 6 +/- 9 vs 1 +/- 2, P < 0.05), the left ventricle function (stress LVEF 53% +/- 13% vs 59% +/- 13%, rest LVEF 55% +/- 14% vs 59% +/- 12%, stress EDV/ESV 144 ml/71 ml vs 128 ml/59 ml, P < 0.05), and CAC score (1 965 +/- 1 772 vs 387 +/- 740, P < 0.05) in comparison with patients without cardiac event. In patients without a reversible perfusion abnormality (SDS < 2), we observed lower annual hard event rate (8% vs 19.6%, P < 0.05) and revascularization procedures (4% vs 19.6%, P < 0.05) in comparison with patients with SDS > or = 2. In patients with or without reversible defects, we registered significantly higher annual hard event rate in the setting of post-stress worsening of the LVEF > 5% and/or severe CAC score > or = 709 (23.8% vs 1.9% in patients with SDS < 2, and 26.7% vs 9.5% in patients with SDS > or = 2, P < 0.05). CONCLUSION: The findings of highly elevated CAC score as well as the post-stress left ventricle stunning enable further risk stratification in patients with or without reversible perfusion abnormalities.

• MeSH
• funkce levé komory srdeční MeSH
• hodnocení rizik MeSH
• kalcinóza diagnostické zobrazování   MeSH
• komplikace diabetu * MeSH
• koronární cévy diagnostické zobrazování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhlá srdeční smrt MeSH
• nemoci koronárních tepen komplikace   diagnostické zobrazování   MeSH
• renální insuficience komplikace   MeSH
• srdeční akcí synchronizovaná jednofotonová emisní počítačová tomografie * MeSH
• zátěžový test MeSH
• zobrazování myokardiální perfuze * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH