Biomedical subjects

J Fabián

Publications and source records attributed to J Fabián.

At least 19 recordsLinked to original sources

PubMed2002

[Electrocardiography after heart transplantation].

In the submitted review the authors describe the position and importance of electrocardiographic examination after transplantation of the heart (HTx). They describe findings recorded in animal experiments, typical ECG characteristics after HTx and their importance as well as the clinical application of this method for diagnosis of electrophysiological abnormalities specially in relation to rejection and reinnervation of the graft. The authors' conclusions are based on a critical analysis of relevant data in the literature as well as their own experimental and clinical experience.

Animals↗

PubMed2001

[An unusually long survival after surgery in post-infarct rupture of the interventricular septum and resection of a left ventricular aneurysm].

In the submitted case-history the author describes a patient who 15 years previously underwent after an extensive myocardial infarction with rupture of the interventricular septum and a left ventricular aneurysm a plastic operation of the interventricular rupture and aneurysmectomy. This man, at present 70 years old, lives without any significant restrictions. The author advocates an active, intensive and aggressive diagnostic and therapeutic approach in all thus vitally threatened patients for whom this arsenal offers a much greater hope for extension and improvement of life than the classical conservative therapy.

Aged↗

PubMed2000

["Non-cardiac" surgery in patients after heart transplantation].

UNLABELLED: Aim of the study are description and analysis of the frequency, spectrum and results of "non cardiac" surgery after heart transplantation (HTx). PATIENTS: Up to December 1999, 74 patients (9 females) of age 18-65 years (median 49) were followed-up from 1 to 144 months (median 35) after heart transplantation (HTx). RESULTS: In 10 patients 12 symptomatic non cardiac diseases require surgical procedures. Four had cholecystolithiasis, one patient cholecystolithiasis with choledocholithiasis. The rest of them suffered from renal artery occlusion, carcinoma of the cervix uteri, umbilical hernia, ileus, sigmoidal carcinoma and two from benign prostatic hyperplasia. In all patients with cholecystolithiasis laparoscopic cholecystectomy was performed. In the case of concomitant choledocholithiasis endoscopic extraction of stones was carried out. In the other patients nephrectomy, cervix uteri conisation, hernioplasty, adhesiolysis, resection of sigma and transuretral resection of prostatae were carried out. All procedures were performed by standard methods and no major complications were noted. CONCLUSION: Non cardiac diseases requiring surgical management after HTx are common. By steady improvement of survival after HTx increasing incidence of these conditions has to be expected. The management of them is similar of those in "non transplant" patients. However the care should be paid to immunosuppressive state and therapy.

Adolescent↗

PubMed1999

Coenzyme Q10 depletion and mitochondrial energy disturbances in rejection development in patients after heart transplantation.

UNLABELLED: Sixty endomyocardial biopsies (EMB) and whole blood or plasma samples from 34 patients after heart transplantation (HTx-pts) were studied. Acute rejection of the transplanted heart was histologically graded as: 0 (without), 0-1 (incipient), 1 (mild), 2 (moderate). The level of coenzyme Q10 (CoQ10) in 28 EMB was estimated by HPLC. Mitochondrial respiratory chain function and energy production were measured in 60 EMB. This study is the first report showing a correlation between: (a) histological signs of rejection in the human transplanted heart and (b) CoQ10 level of EMB, CoQ10 blood level, and mitochondrial bioenergetic processes: inhibition in FAD-part, but not in NAD-part of respiratory chain. In all patients after heart transplantation (HTx-pts) the dynamic balance between total antioxidant status and degree of oxidative stress was disturbed. CONCLUSIONS: CoQ10 level and mitochondrial bioenergetic functions of EMB contribute to the explanation of pathobiochemical mechanisms of origin and development rejection of human transplanted heart. We suppose that estimation of EMB CoQ10 level could be used as a bioenergetic marker of rejection development in human transplanted heart. CoQ10 therapy could contribute to the prevention of rejection of the transplanted heart.

Antioxidants↗

PubMed1998

Participation of coenzyme Q10 in the rejection development of the transplanted heart: a clinical study.

Coenzyme Q10 and alpha-tocopherol concentrations were assessed in 28 endomyocardial biopsies from 22 patients and in 61 blood samples from 31 patients after heart transplantation with histologically confirmed signs of rejection. The values were compared to the group of 14 patients with cardiomyopathies of unclear etiology as candidates for heart transplantation. Blood analyses were also compared with 50 healthy persons. Myocardial and blood coenzyme Q10 concentrations were already significantly decreased in the incipient phase of rejection (degree 0-1) and also in rejection phase 1 and 2. In patients without rejection signs myocardial and blood coenzyme Q10 values were similar to those of cardiomyopathic patients. No significant differences were found in alpha-tocopherol concentrations in relation to signs of rejection. Increased plasma lipid peroxidation quantified as malondialdehyde production was detected in all groups of transplanted patients. The results contribute to the explanation of some pathobiochemical mechanisms participating in the rejection development of the transplanted heart.

Adult↗

PubMed1998

[Preparation for heart transplantation in Slovakia 1994-1997].

The authors present the process of introduction heart transplant programme in the years 1994-1997 in Slovakia. A short historical review about heart transplantation is given in the article. Fundamental requirements for heart transplantation realization, activities of Working group "Heart transplantation", methods of follow-up of patients after heart transplantation and selection of candidates for transplantation, are discussed. The authors also deal with surgical and anaesthesiological prerequisites for this programme realization. In conclusion they claim that the requirements for regular programme of heart transplantation are accomplished. (Tab. 2, Fig. 3, Ref. 21.)

Heart Transplantation↗

PubMed1998

[Hyperlipoproteinemia in patients after heart transplantation].

Hyperlipidaemia is one of the most frequent metabolic disorders after heart transplantation (HTx). The significance of hyperlipidaemia is stressed mainly in relation to graft vascular disease (GVD) which is the leading cause of death more than one year after transplantation. Recently the evidence on the role of hyperlipidaemia (HLP) in the pathogenesis of GVD is growing. Total cholesterol (TC), triglycerides (TAG) HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C) were analysed cross-sectionally in 35 patients (30 males), aged 20-64 (median 40) years, more than one year after HTx. In 25 patients HTx was performed because of dilated cardiomyopathy (D-KMP), in 10 because of coronary artery disease (CAD). TC more than 5.6 mmol/l was detected in 29 (83%), TAG > 2.3 mmol/l in 15 (43%), LDL-C >3.6 mmol/l in 28 (80%) and HDL-C < 1.4 mmol/l in 25 (75%) of patients. There were no statistically significant differences in evaluated parameters found between the groups of patients operated on because of CAD and D-CMP, with and without glucose tolerance disorder and groups treated with higher (> 5 mg/D) and lower (.5 mg/D) dose of prednisone. Significant linear correlation of body mass index (BMI) and TAG or BMI and HDL/C resp. was confirmed. Pathogenesis of HLP after HTx is complex. Except of obesity, no unambiguous evidence of the role of glucose tolerance disorder or prednisone dose in immunosuppressive treatment were found. (Tab. 2, Fig. 3, Ref. 21.)

Adult↗

PubMed1998

[Diagnosis and therapy of acute rejection in patients after orthotopic heart transplantation].

OBJECTIVE: In organ allotransplantation represents a serious problem acute rejection, which is the reaction of recipient organism aimed to reject the transplanted organ. AIM: To obtain experience in the field of routine long term are of patients after heart transplantation living in Slovakia. METHOD: 33 patients after orthotopic heart transplantation (HTx) were included in our long term care by the 1. June 1996. According to the accepted protocol we make the whole set of examinations is performed. This includes endomyocardial biopsy which is the only reliable method for the detection of rejection and also the criterion of sufficiency of immunosuppressive therapy. RESULTS: Acute rejection was revealed in 14 (43%) patients. CONCLUSIONS: Tactics of therapy and the length of the interval to subsequent biopsy were determined according to the histological findings of preceding biopsy, the clinical status and the combination of immunosuppression therapy. (Tab. 2, Ref. 13.)

Acute Disease↗

PubMed1997

[Dilated cardiomyopathy and heart transplantation].

Authors compare selected demographic, clinical, methodological and laboratory parameters in 20 patients who underwent heart transplantation (HTx) because of dilated cardiomyopathy (DKMP) with those, who have had HTx because of progressive and otherwise unresolved coronary artery disease (KCH). Patients operated because of DKMP were younger than those who underwent HTx for KCH. Women were only in the group of DKMP. Otherwise there were no differences between these two groups. The global analysis showed, that the majority of patients after HTx were asymptomatic. However, high incidence of obesity, hyperlipoproteinemia, cytopoenia, renal and hepatal dysfunction were found. Finally the authors presented an overview of standard chronic therapy after HTx and proposed some approaches to undesirable habits and disorders which aggravated the prognosis of the patients after HTx.

Adult↗

PubMed1997

[Electrophysiologic and electrocardiographic aspects of the transplanted heart].

Specific electrophysiological properties of transplanted heart are caused mainly by complex surgery, suppression of autonomic innervation, and allograft rejection. Interpretation of ECG may be difficult because of two P waves. The other most prevalent ECG abnormalities are: incomplete or complete right bundle branch block, shift of QRS axis to the left, shorter QT interval, decreased precordial voltage. The influence of denervation is apparent in: higher basic heart rate, chronotropic dysfunction, different responsiveness to various cardiac drugs, susceptibility to fatal ventricular arrhythmias. The prevalence of bradyarrhythmias and tachyarrhythmias is higher than in other population. Many of them correlate with acute or chronic cardiac rejection. It is desirable to utilize specific electrophysiological properties for noninvasive detection of allograft rejection.

Arrhythmias, Cardiac↗

PubMed1997

[Hematologic aspects of heart transplantation].

Heart transplantation is an accepted therapeutic method for end-stage heart failure. The aim of the presented paper is to provide a short review of haematologic problems of heart transplantation. Haemostatic disorders, cytopenias and lymphoproliferative diseases are the most frequent haematologic complications of this highly sophisticated procedure. Perioperative bleeding tendency is due to cardiopulmonary bypass, both qualitative and quantitative platelet disorders and hyperfibrinolysis are the main causes. Incidence of cytopenias (mono- and/or bi- and/or tricytopenia) reaches up to 70%. They are multifactorial as to etiology and coincidence with viral infection, antimicrobial and immunosuppressive therapy. Lymphoproliferative disease affects about 1.2% of patients during the first year after transplantation. Posttransplant lymphoproliferative diseases are highly variable as to manifestation and prognosis-ranging from indolent course to rapid, aggressive growth. Routine cytostatic therapy is generally ineffective. Crucial therapeutic measure is to turn off immunosuppressive therapy. (Tab. 3, Fig. 2, Ref. 41).

Blood Coagulation Disorders↗

PubMed1997

[Quality of life after heart transplantation--psychosocial aspects].

The aim of this study was to evaluate psychosocial quality of life after heart transplantation. We examined 29 patients (25 M and 4 F), average age was 43.5 y (18-62 y). The age at time of heart transplantation was 43 years (17-55 y). The time after heart transplantation was 3.3 year (0.3-9 y). Spielberger's Questionnaire of Anxiety, Knobloch's inventory of neuroticism, Freiburg's Personality Inventory and Quality of Life Inventory were used, 33% of patients demonstrated increasing frequency and 29% of patients increasing intensity of neurotic symptoms. 23% of patients presented increasing levels of anxiety (as a state). The personality dimensions (depression, excitability and low emotional stability) displayed high frequency. The results showed that patients were more satisfied with family support, with sexual activities, and less satisfied with financial situation, social activities, social isolations, sleep, memory, excitability, fatigue. 41.5% of patients returned back to work. The results indicate that these psychosocial factors play an important role in quality of life after heart transplantation. That is why if is necessary to dedicate an increasing attention to them. (Tab. 1, Fig. 6, Ref. 14.)

Adolescent↗

PubMed1996

[Heart transplantation--one possibility in the treatment of advanced congestive heart failure].

The authors present epidemiological data about congestive heart failure, its most common etiology and prognosis. They justify the performance of heart transplantation (HTx) in the treatment of congestive heart failure. They analyze the present state of HTx in the world and describe also the history of HTx in Slovakia. They present the review of contraindications and indications for the inclusion of recipients into the HTx programme and describe the further fates of these patients. They regard the HTx as an integral component of the therapeutical approach to the precisely defined group of patients with otherwise refractory congestive heart failure. (Tab. 4, Fig. 6, Ref. 38.)

Animals↗

PubMed1996

[Cardiopathies of unknown origin--a cooperative interdisciplinary study].

The authors described aim. objectives, design and criteria of the study which is oriented to the clinical and research problems of heart diseases of uncertain origin. The paper presents the preliminary experience with invasive cardiological techniques in this field. At the same time the authors discuss the potential impact of the basic research on the prevention and effective treatment of cardiopathy which is until now of unknown origin.

Adolescent↗

PubMed1996

[Clinical aspects of cardiopathy of unknown origin].

Frequently even physical and noninvasive examinations with laboratory analysis do not determine the final aetiology of cardiac symptoms, and it is necessary to complete them with an invasive examination with the aim of ascertaining the primary cause. Our article gives information about the results of clinical, laboratory and noninvasive examinations in the group of patients suspected of cardiopathy of unknown origin.

Adult↗

PubMed1996

[Angiocardiography of cardiopathy of unknown origin].

Authors described their experiences with angiocardiography, (selective coronarography and left ventriculography), in 41 patients aged from 32 to 59 years with the preliminary diagnosis of cardiopathy of unknown origin. The patients with diagnosis of cardiopathy of unknown origin were those, who cannot be assigned to any of the known and acknowledge diagnostic categories, not even by using complex clinical, laboratory and noninvasive cardiological diagnostic procedures. Angiocardiography enabled to produce new and unexpected data of diagnostic value three patients with heart disease (all of the three mentioned patients had significant changes of the coronary supply, i.e. the reduction in lumen diameter of the coronary vessel being of more than 50% with local or total wall motion abnormalities). The other thirty-eight patients had normal findings of the coronary supply. One patient had a normal coronarographic findings, normal left ventricular wall motion and also the subsequent histological examination from the endomyocardial bioptic sample of the heart tissue, did not confirm pathological abnormalities. Selective coronarography and left ventriculography is a useful and safe clinical diagnostic procedure in exactly defined groups of patients.

Adult↗

PubMed1996

[Echocardiography of cardiopathies].

The authors deal with the relation of echocardiography and diseases of the cardiac muscle, draftly classified as cardiopathies. The author's starting point is issued from the presumption that heart diseases which lack the characteristic diagnostic signs in echocardiographic picture affect the heart's systolic and diastolic functions. Echocardiography enables to quantify the extent of affliction of both functions. On the basis of analysis of a set of 22 prospectively examined patients the authors judge as to wether the results of individual volume measurements by means of echocardiographic imaging (one dimensional, two dimensional, Doppler) are correct. In the frame of systolic and diastolic functions examination they highlight the Doppler evaluation due to its technical simplicity and good correlations with literal documents dealing with invasive examinations.

Adult↗

PubMed1996

[Parameters of oxidative stress in patients with cardiopathies].

BACKGROUND: Routine biochemical parameters in the blood of patients with chronic cardiopathies are nonspecific and of no reliable diagnostic value. OBJECTIVES: Since marked changes of some biochemical blood parameters concerning the oxidative metabolism of the organism were observed in patients with acute myocardial diseases, the aim of this study was to estimate some antioxidant enzyme activities and metabolites in the blood of patients with cardiopathies-diseases with chronic heart failure of unknown origin. METHODS: In 21 hospitalized patients with cardiopathy the venous blood samples were analyzed for plasma levels of thiobarbituric acid reactive substances (TBARS) as representatives of lipid peroxidation, levels of selenium and zinc as well as the activities of superoxide dismutase (SOD) and glutathione peroxidase (GPX) and reduced glutathione (GSH) level in erythrocytes. RESULTS: Comparing the group of 25 clinically healthy individuals some marked changes in enzyme activities and metabolite levels were found in patients with cardiopathy: a significant increase of plasma TBARS and-on the other hand-markedly decreased activities of SOD and GPX and of GSH level in erythrocytes. Also a decreased plasma selenium level was observed in patients. CONCLUSIONS: A marked decrease of antioxidant enzyme activities and GSH levels suggest a possible drop in total antioxidant status of patients with cardiopathy. Raised TBARS plasma levels might be regarded as a decreased ability of organism to abolish the produced free reactive oxygen forms leading thus to rise in lipoprotein rare.

Adult↗