heart
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- MeSH
- angiografie přístrojové vybavení metody MeSH
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- vrozené srdeční vady diagnostické zobrazování MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- Publikační typ
- časopisecké články MeSH
The aim of this experimental study was to evaluate a newly designed cone-shaped aortic valve prosthesis (CAVP) for one-step transcatheter placement in an orthotopic position. The study was conducted in 15 swine using either the transcarotid (11 animals) or the transfemoral (4 animals) artery approach. A 12- or 13-Fr sheath was inserted via arterial cutdown. The CAVP was deployed under fluoroscopic control and its struts, by design, induced significant native valve insufficiency. CAVP function was evaluated by aortography and aortic pressure curve tracing. In 11 of 15 swine the CAVP was properly deployed and functioned well throughout the scheduled period of 2-3 h. In three swine the CAVPs were placed lower than intended, however, they were functional even in the left ventricular outflow tract position. One swine expired due to inadvertent low CAVP placement that caused both aortic regurgitation and immobilization of the anterior mitral valve leaflet by the valve struts. We conclude that this design of CAVP is relatively easy to deploy, works well throughout a short time period (2-3 h), and, moreover, seems to be reliable even in a lower-than-orthotopic position (e.g., infra-annulary space). Longer-term studies are needed for its further evaluation.
- MeSH
- angiografie metody MeSH
- aortální insuficience diagnostické zobrazování chirurgie MeSH
- arteria femoralis MeSH
- arteriae carotides MeSH
- bioprotézy * MeSH
- chirurgická náhrada chlopně metody MeSH
- hodnocení rizik MeSH
- modely nemocí na zvířatech MeSH
- náhodné rozdělení MeSH
- prasata MeSH
- protézy - design MeSH
- senzitivita a specificita MeSH
- srdeční chlopně umělé * MeSH
- srdeční katetrizace metody MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
Recently an expert consensus document advised to standardize user procedures and a new cut-off value for carotid-femoral pulse wave velocity in daily practice. Our aim was to observe aortic pulse wave velocity (PWVao) and augmentation index (AIXao) in two high cardiovascular risk groups: patients with verified coronary artery disease (CAD) or with type 2 diabetes mellitus (T2DM). We also aimed to determine the cut-off values for PWVao, AIXao in CAD and T2DM patients using oscillometric device (Arteriograph). We investigated 186 CAD and 152 T2DM patients. PWVao and AIXao increased significantly in the CAD group compared to the age-, gender-, blood pressure-, and heart rate-matched control group (10.2+/-2.3 vs. 9.3+/-1.5 m/s; p<0.001 and 34.9+/-14.6 vs. 31.9+/-12.8 %; p<0.05, respectively). When compared to the apparently healthy control subjects, T2DM patients had significantly elevated PWVao (9.7+/-1.7 vs. 9.3+/-1.5 m/s; p<0.05, respectively), however the AIXao did not differ significantly. The ROC-curves of CAD and healthy control subjects explored cut-off values of 10.2 m/s for PWVao and 33.23 % for AIXao. Our data provide supporting evidence about impaired arterial stiffness parameters in CAD and T2DM. Our findings encourage the implementation of arterial stiffness measurements by oscillometric method in daily clinical routine.
- MeSH
- analýza pulzové vlny MeSH
- angiografie metody MeSH
- diabetes mellitus 2. typu farmakoterapie patofyziologie MeSH
- dospělí MeSH
- krevní tlak fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci koronárních tepen farmakoterapie patofyziologie MeSH
- pohlavní dimorfismus MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- srdeční frekvence fyziologie MeSH
- stárnutí fyziologie MeSH
- tuhost cévní stěny * 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
- srovnávací studie MeSH
- MeSH
- angiografie škodlivé účinky metody MeSH
- koronární angiografie * MeSH
- lidé MeSH
- srdeční katetrizace škodlivé účinky metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- MeSH
- angiografie * přístrojové vybavení metody MeSH
- balónková angioplastika * přístrojové vybavení metody MeSH
- katetrizace přístrojové vybavení metody MeSH
- lidé MeSH
- neuroradiografie metody MeSH
- srdeční katetrizace metody MeSH
- terapeutická embolizace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- angiografie škodlivé účinky metody MeSH
- dospělí MeSH
- koronární angiografie * MeSH
- koronární nemoc diagnostické zobrazování mortalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- senioři 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
- Geografické názvy
- Československo MeSH
BACKGROUND: Catheter ablation in the left atrium has become a common therapeutic strategy in the management of atrial fibrillation (AF). The high degree of success and safety profile of this procedure is dependent on precise knowledge of the true anatomy in the chamber. This information is imported mostly from cardiac computed tomography. A novel method for imaging the left atrial anatomy is three-dimensional rotational angiography (3DRA). METHODS: The aim of our study was to the compare clinical outcome and safety of catheter ablation for atrial fibrillation guided by 3DRA vs. conventional CT scan. One hundred and twenty-five patients referred for AF catheter ablation at St. Anne's University Hospital Brno were included in the retrospective analysis of clinical outcome within the first year after the procedure. RESULTS: There was a close correlation in overall procedural parameters between the groups. The frequency of recurrent episodes of AF (24% in CT-guided group vs. 27% in 3DRA-guided group, P=0.721) as well as the onset of atypical atrial flutter after the procedure (10% vs. 8%, respectively, P=0.731) were similar in both groups. No difference in the number of patients necessitating repeat ablation (5% vs. 5%, P=0.984) was found. Procedural complications of ablations guided by 3DRA were comparable with those guided by CT (2% vs. 3%, respectively, P=0.568). CONCLUSION: 3DRA has proven to be a safe and simple method for imaging the left atrium and guiding catheter ablation for AF. This approach is anticipated to become a new standard in 3D reconstruction of the left atrium.
- Klíčová slova
- atrial fibrillation, catheter ablation, computed tomography, electrophysiology, imaging, left atrium, three dimensional rotational atriography,
- MeSH
- angiografie metody MeSH
- délka operace MeSH
- fibrilace síní diagnostické zobrazování chirurgie MeSH
- intervenční radiografie metody MeSH
- katetrizační ablace škodlivé účinky metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- počítačová rentgenová tomografie metody MeSH
- recidiva MeSH
- srdeční síně diagnostické zobrazování MeSH
- venae pulmonales diagnostické zobrazování MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
A new method in creating 3D models of the left atrium (LA) and esophagus before catheter ablation of atrial arrhythmias is 3D rotational angiography (3DRA) of the LA. The purpose of this retrospective study was to test various acquisition protocols of the 3DRA and attempt to define the parameters influencing the success of the protocols. From August 2010 to November 2014, 3DRA of the LA using the Philips Allura FD 10 X-ray system was performed in 547 consecutive patients using right atrial and left atrial protocols. Visualization of the esophagus was performed after oral administration of a contrast agent. Patients were monitored for success (creation of a useful 3D models) and evaluated for a number of parameters affecting the success of 3DRA. The success of the RA protocol was 88.89 % with and 91.91 % without esophagus imaging. The success of the LA protocol was 97.42 % with and 94.54 % without esophagus imaging. The only factor reducing the success of the RA protocol was BMI; the LA protocol was not influenced by any factor. Ventricular fibrillation induced in two patients was successfully treated with defibrillation. 3DRA of the LA is a reliable method that supports catheter ablation of complex atrial arrhythmias. The LA protocol with esophagus imaging was significantly more reliable than the RA protocol; the other protocols were comparable. The RA protocol may be negatively affected by high BMI. Simultaneous imaging of the esophagus is safe and feasible, and the LA protocol can be recommended.
- Klíčová slova
- 3D rotational angiography of the left atrium, Acquisition protocols, Catheter ablation of arrhythmias, Complex atrial arrhythmias, Image integration,
- MeSH
- angiografie metody MeSH
- ezofágus diagnostické zobrazování MeSH
- fibrilace síní diagnostické zobrazování patofyziologie chirurgie MeSH
- index tělesné hmotnosti MeSH
- johexol aplikace a dávkování analogy a deriváty MeSH
- katetrizační ablace * MeSH
- kontrastní látky aplikace a dávkování MeSH
- lidé středního věku MeSH
- lidé MeSH
- modely kardiovaskulární MeSH
- počítačová simulace MeSH
- prediktivní hodnota testů MeSH
- rentgenový obraz - interpretace počítačová * MeSH
- reprodukovatelnost výsledků MeSH
- retrospektivní studie MeSH
- senioři MeSH
- srdeční síně diagnostické zobrazování patofyziologie chirurgie MeSH
- zobrazování trojrozměrné * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Názvy látek
- iopromide MeSH Prohlížeč
- johexol MeSH
- kontrastní látky MeSH
AIMS: The objective of this study was to evaluate the mobility of the oesophagus and the stability of the three-dimensional (3D) model of the oesophagus using 3D rotational angiography (3DRA) of the left atrium (LA) and the oesophagus, fused with live fluoroscopy during catheter ablation for atrial fibrillation. METHODS AND RESULTS: From March 2015 to September 2015, 3DRA of the LA and the oesophagus was performed in 33 patients before catheter ablation for atrial fibrillation. Control contrast oesophagography was performed every 30 min. The positions of the oesophagograms and the 3D model of the LA and the oesophagus were repeatedly measured and compared with the spine. The average shift of the oesophagus ranged from 2.7 ± 2.2 to 5.0 ± 3.5 mm. The average real-time oesophageal shift ranged from 2.7 ± 2.2 to 3.8 ± 3.4 mm. No significant shift was detected until the 90th minute of the procedure. The average shift of the 3D model of the LA and the oesophagus ranged from 1.4 ± 1.8 to 3.3 ± 3.0 mm (right-left direction) and from 0.9 ± 1.2 to 2.2 ± 1.3 mm (craniocaudal direction). During the 2 h procedure, there were no significant shifts of the model. CONCLUSION: During catheter ablation for atrial fibrillation, there is no significant change in the position of the oesophagus until the 90th minute of the procedure and no significant shift in the 3D model of the LA and the oesophagus. The 3D model of the oesophagus reliably depicts the position of the oesophagus during the entire procedure.
- Klíčová slova
- 3D Rotational angiography of the left atrium and oesophagus, Atrioesophageal fistula, Catheter ablation of atrial fibrillation, Image integration, Mobility of the oesophagus,
- MeSH
- anatomická značka MeSH
- angiografie metody MeSH
- časové faktory MeSH
- chirurgie s pomocí počítače škodlivé účinky metody MeSH
- délka operace MeSH
- ezofágus diagnostické zobrazování MeSH
- fibrilace síní diagnostické zobrazování patofyziologie chirurgie MeSH
- fluoroskopie MeSH
- intervenční radiografie metody MeSH
- katetrizační ablace škodlivé účinky metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- pohyb těles MeSH
- prediktivní hodnota testů MeSH
- prospektivní studie MeSH
- rentgenový obraz - interpretace počítačová * MeSH
- reprodukovatelnost výsledků MeSH
- senioři MeSH
- srdeční síně diagnostické zobrazování patofyziologie chirurgie MeSH
- výsledek terapie MeSH
- zobrazování trojrozměrné * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The hypertrophy of vascular smooth muscle cells as well as neointimal proliferation is critical in vascular remodeling, whereas leptin has proved to play an important role recently. The aim of the study was to investigate possible associations of two common leptin gene polymorphisms with restenosis after percutaneous coronary intervention (PCI). To study the association of two promoter polymorphisms, LEP -2548 G/A and LEP -188 C/A (dbSNP ID rs7799039 and rs791620) with neointimal proliferation in humans, 98 consecutive patients undergoing stenting into small coronary arteries (<3 mm) were genotyped. After a 6-month follow-up, the restenosis rate was estimated. Restenosis >50% occurred in 33.3% of patients carrying both A alleles, 33.3% of carriers of A and C alleles, and 31.4% of carriers of two CC alleles of LEP -188 C/A polymorphism; and in 25.0% of patients with AA, 32.7% with AG, and 30.4% with GG genotype of LEP -2548 G/A polymorphism. Interestingly, the heterozygote AG genotype of LEP -2548 polymorphism represented a highly significant risk for multiple-vessel disease when compared to both homozygote genotypes AA/GG (odds ratio = 4.038, 95% confidence interval: 1.732-9.465, P(corr) = 0.001). Based on our findings, the AG genotype of LEP -2548 G/A polymorphism might be considered a genetic marker for multiple-vessel disease but not for restenosis after PCI. The role of the leptin gene polymorphisms as genetic markers of restenosis will require further investigation to elucidate the underlying pathophysiological consequences.
- MeSH
- alely MeSH
- angiografie metody MeSH
- dospělí MeSH
- genotyp * MeSH
- heterozygot MeSH
- jednonukleotidový polymorfismus MeSH
- koronární restenóza * MeSH
- leptin krev genetika MeSH
- lidé středního věku MeSH
- lidé MeSH
- polymorfismus genetický * MeSH
- proliferace buněk MeSH
- promotorové oblasti (genetika) * MeSH
- riziko MeSH
- senioři MeSH
- stenty MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- leptin MeSH