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Biomedical subjects

J Petrásek

Publications and source records attributed to J Petrásek.

At least 19 recordsLinked to original sources
PubMed1995

[Decrease in common carotid artery intimal thickness after hypolipemic therapy].

BACKGROUND: In recent years evidence was provided that it is possible to assess sonographically the thickness of the intima of the common carotid artery, whereby an increase of the thickness of the intima is considered an early stage of atherosclerosis. In the submitted work the authors tried to assess whether it is possible to influence the thickness of the intima by therapy. METHOD AND RESULTS: In 32 patients with familial hyperlipoproteinaemia sonographic control examinations of the common carotid artery were performed after 27 months of comprehensive treatment. In 21 subjects with familial hypercholesterolaemia the thickness of the intima decreased from 0.83 mm to 0.68 mm (p < 0.01), in 8 subjects with familial combined hyperlipoproteinaemia from 0.77 mm to 0.74 mm (a decline was recorded in half the subjects). In the whole group the greatest decrease was recorded in subjects treated with statins and a smaller decrease in those treated with fibrates. CONCLUSIONS: The authors assume that the decrease of the thickness of the intima of the common carotid artery recorded in hyperlipoproteinaemic patients after hypolipidaemic treatment is a manifestation of regression of atherosclerosis.

Adult↗
PubMed1995

[Apoptosis--programmed cell death].

The authors summarize findings on apoptosis-programmed cellular death, incl. basic data on expression of genes promoting (p53, c-myc, MTS 1 and fas) or inhibiting (bcl-2, bcr-abl) this process. The authors discuss clinical possibilities of controlling apoptosis, in particular in oncology and in autoimmune disease, AIDS, metabolic disorders etc.

Apoptosis↗
PubMed1994

[Old age from the viewpoint of the cardiologist].

The general cardiovascular performance of old people is determined by: a) inherent changes of the cardiovascular system which develop with age; b) delay of degenerative changes in some subjects caused by genetic factors, optimal physical activity and a proper diet; c) acquired diseases, in particular arteriosclerosis and hypertension. As a result of degenerative changes of the vascular wall the systolic pressure rises advancing age, some of the old people develop isolated systolic hypertension. Mild hypertrophy of the left ventricle develops also. The contracting ability of the heart muscle is preserved, the ejection fraction at rest and the cardiac output do not change. However, the diastolic function changes significantly-the elasticity of the left ventricle declines and its filling depends more on the atrial systole. A frequent cause of heart failure in old people is diastolic dysfunction. Pharmacotherapy of old people has some specific features which are discussed in more detail. A recent multicentre clinical investigation SHEP proved unequivocally, that effective treatment of systolic hypertension reduced in old people the risk of cerebrovascular attacks by 33%, of acute myocardial infarction by 27% and of cardiac failure by more than 50%! Based on these results it is clear that systolic hypertension must be treated equally systematically as diastolic hypertension. The approach to old people with cardiovascular disease must be strictly individual. Age alone must not be the reason for refusing access to the complete spectrum of modern diagnostic and therapeutic possibilities.

Aged↗
PubMed1993

[Carotid artery and femoral artery disease in asymptomatic patients with various types of hyperlipoproteinemias and in healthy persons].

The authors examined by means of the sonograph Siemens Quantum 2000 the carotid and femoral arteries of 21 controls and 91 asymptomatic subjects with different types of hyperlipoproteinaemia (HLP). 46 patients suffered from familial hypercholesterolaemia, another 19 patients with hypercholesterolaemia suffered from ischaemic heart disease, 21 patients had familial combined hyperlipoproteinaemia and 5 patients had familial dysbetalipoproteinaemia. In the controls no plaques or stenoses were detected. In the different groups with HLP plaques and stenoses on the carotid artery were found in 15-36%, on the femoral artery in 24-63%. In patients with HLP on the common carotid artery in different groups a detectable intima was found more frequently, a statistically highly significantly wider intima (0.73 +/- 0.17 mm to 0.84 +/- 0.31 mm) and a lower maximum rate (79 +/- 18 cm/s to 98 +/- 24 cm/s) than in controls (0.41 +/- 0.14 mm and 121 +/- 30 cm/s resp.). On the common carotid the authors found a significant direct correlation between age and the cholesterol level and between age and the width of the intima and an indirect correlation between age and the maximal rate. The differences in the width of the intima and maximum rate were preserved even when the groups were adjusted for age. Changes of the femoral artery were less marked.

Adult↗
PubMed1993

[The intima of the common carotid artery in patients with hyperlipoproteinemia].

Using sonography, the common carotid artery was examined in patients with hyperlipoproteinaemia and in controls. In 21 controls, the intima was present in 62%, intimal thickness was 0.41 +/- 0.14 mm. In patients with familial hypercholesterolaemia free of ischaemic heart disease (46 patients), the intima was demonstrable in 89%, intimal thickness was 0.74 +/- 0.21 mm. In patients with ischaemic heart disease (19 patients), the intima could be demonstrated in 100%, its thickness was 0.84 +/- 0.31 mm. In 21 patients with familial combined hyperlipoproteinaemia, the intima was present in 90%, intimal thickness was 0.73 +/- 0.17 mm. Intimal thickness was significantly greater (p < 0.001) in all groups of patients with hyperlipoproteinaemia than in the control group. A significant correlation between cholesterol levels and intimal thickness (p < 0.01) was demonstrated.

Adult↗
PubMed1992

[Incidence and changes in mitral regurgitation in balloon valvotomy of the mitral valve. A color Doppler study].

The objective of the work was a detailed examination of the incidence and changes of mitral regurgitation (MR) in conjunction with percutaneous transluminal valvotomy of the mitral valve (VMCH). Using coloured Doppler mapping, the authors examined a total of 40 patients before and in the course of one week after VMCH. They assessed the number of regurgitation jets the site of their development, the timing and haemodynamic impact of MR. Knowing the site of development of MR, the authors were able to assess whether the regurgitation after VMCH persisted, developed de novo or disappeared. The total number of mitral regurgitation increased after VMCH from 38 to 51 (increase by 34%, p < 0.05) with a significant rise of the number of double regurgitation jets (4 before as compared with 12 after VMCH, p < 0.05). Before VMCH the authors recorded a holocystic MR in 53%, after VMCH in 86% of the patients (p < 0.01). While before VMCH almost half the regurgitation jets originated in the central portion of the valve, after VMCH MR originated mainly from the area of commissures (48% regurgitation jets before, 79% after VMCH, p < 0.01). Only in 33% of MR after VMCH persisting regurgitation was involved, almost half (47%) of 38 regurgitation jets present before VMCH, disappeared after valvulotomy. MR displays a considerable variability. This may be one of the reasons why prediction of the development and severity of MR after PTMV is difficult.

Catheterization↗
PubMed1991

The effect of metoprolol on left ventricular systolic and diastolic function in essential hypertension.

Using ultrasound techniques, parameters of left ventricular systolic and diastolic function were assessed in 23 patients with degree I-II essential hypertension treated with metoprolol. Metoprolol administration was followed by increases in ejection fraction (p less than 0.01) and stroke volume (p less than 0.05), a decrease in heart rate (p less than 0.01) while cardiac output remained unchanged. Left ventricular filling was abnormal in 12 patients (52.2%). After metoprolol, the ratio of early diastolic to late diastolic transmitral velocity (E/A) rose; the increase indirectly correlated both with the baseline value of E/A (r = -0.59, p less than 0.01), and the change in heart rate (t = -0.65, p less than 0.01). Improved left ventricular diastolic filling was significant only in patients showing abnormal baseline diastolic function, and may be due to the decrease in heart rate rather than a direct effect exerted by metoprolol on the myocardium.

Adult↗
PubMed1990

[Disorders of the cardiovascular system in Turner's syndrome].

A group of 22 adults with Turner's syndrome, mean age 29.6 years, was subjected to a careful examination by one-dimensional, two-dimensional, pulsed and coloured Doppler echocardiography. The purpose was to assess the incidence and character of congenital and acquired abnormalities of the cardiovascular system which occur within the framework of this defined genetic syndrome. A quite normal echocardiographic finding was recorded in 13 patients, i. e. in 59.1%. In the remainder a wide spectrum of abnormalities was found such as prolapse of the mitral valve (in 13.6%), bicuspid aortal valve with a medium regurgitation (4.5%), hypoplasia of the coronary cusp of the aortal valve (4.5%), dilatation of the ascending aorta with a residual significant stenosis at the site after operation of coarctation of the thoracic aorta (4.5%), subaortal defect of the interventricular septum (4.5%) and slight left ventricular hypertrophy in patients with arterial hypertension (9.1%). Echocardiographic examination in Turner's syndrome makes early diagnosis of abnormalities of the cardiovascular system possible, incl. quantification of the haemodynamic impact. Some of these pathological changes (bicuspid aortal valve, dilatation of the root of the aorta) are for a long time clinically silent but may be nevertheless associated with serious complications. An echographic diagnosis made in time may be of decisive importance for the prevention of complications.

Adolescent↗
PubMed1990

[The effect of OROS metoprolol in mild and moderately severe essential hypertension].

The authors tested in an open, uncontrolled trial in a group of 23 patients with essential hypertension grade I-II (WHO classification) the effect of Metoprolol OROS. The OROS system is a new form of Metoprolol administration which makes it possible to maintain by a single dose per day a steady plasma concentration, while preserving the cardioselectivity and total 24-hour effectiveness during treatment of hypertension and angina pectoris. After eight weeks of Metoprolol OROS administration, in doses gradually adjusted to the therapeutic action, gradually a significant decrease of the heart rate (HR) occurred, of the systolic blood pressure (BPs) and diastolic blood pressure (BPd) (p less than 0.01 for all values) in a recumbent as well as upright position. A reduction of the BPd in an upright position by greater than or equal to 10 mm Hg was achieved in 85% of the patients, in 73.9% of the patients the BPd in an upright position dropped below 95 mm Hg. Four patients developed side-effects which were mild to medium severe (vertigo, palpitations, fatigue, sensation of tremor, tension in the lower extremities). Two patients discontinued treatment early, the main reason in both being palpitations which were under better conversely, in two patients palpitations which were not adequately controlled by previous metoprolol treatment, disappeared completely during Metoprolol OROS treatment. During the trial no significant changes in the investigated laboratory values incl. total cholesterol were recorded, Metoprolol OROS administered once per day is an effective, safe and well tolerated preparation in treatment of mild to medium severe essential hypertension.

Adult↗
PubMed1989

[New aspects and possibilities in the diagnosis of pheochromocytoma].

Pheochromocytoma is still a dangerous disease which is often difficult to diagnose. Evidence of the wide spectrum of its clinical picture was found in a group of 13 patients who were examined in the last 5 years. Drawing on their experience, the authors evolved a scheme of diagnostic examination. The primary biochemical examination involves the determination of urinary excretion of free catecholamines adrenaline, noradrenaline and dopamine simultaneously with their methylated metabolites metanephrine and normetanephrine, which help to make a more exact diagnosis in cases where the results of free catecholamines are not clear. Patients with pheochromocytoma lack diurnal rhythm of catecholamine excretion and thus the collection is made twice - by day and night. The determination of plasma catecholamines provides additional information. Only half the patients were found to have the level of vanillylmandelic acid increased. A significantly increased dopamine excretion points to the malignant form of the disease. The localization is established with the aid of computed tomography and, if needed, also by the determination of plasma catecholamines through selective cavae sampling. The final step serving to verify the diagnosis involves analysis of catecholamines in tumour tissue.

Adrenal Gland Neoplasms↗
PubMed1989

Valvular regurgitations in healthy young people.

Using colour Doppler flow imaging technique (CDFI) 153 young healthy volunteers (80 M, 73 W) aged 23.9 +/- 1.4 years were studied for the prevalence and characteristics of regurgitations in morphologically normal valves. Regurgitation in normal pulmonary valve was found in 67.4%. Mid- to end-diastolic pulmonary regurgitation prevailed with the jet of predominantly central type, with the mean maximal jet length (DJmax) = 1.1 cm and the mean proximal jet width = 0.3 cm. "Physiological" mitral regurgitation was registered in 39.3%, with DJmax = 1.3 cm, mean maximal left atrial systolic dimension at the moment of maximal regurgitation (DLAmax) = 4.2 cm and with LJmax/DLAmax ratio of 0.3. Tricuspid regurgitation was present in 54%, with DJmax = 2.1 cm. Aortic regurgitation was found in 1.3% only. Authors propose diagnostic criteria to differentiate regurgitations in normal valves ("physiological" regurgitations) from pathological ones.

Adult↗
PubMed1988

The nature of cardiac hypertrophy in acromegaly: an echocardiographic study.

M-mode echocardiography was used to study cardiac involvement in 78 patients with acromegaly. Proportionate concentric or eccentric left ventricular hypertrophy (LVH) was a common finding. Calculated left ventricular mass (LVM) was increased significantly in a hormonally active disease group compared to an inactive disease group or a control group (153 +/- 7 vs. 96 +/- 8 and 89 +/- 3 g/m2 resp.; p less than 0.001 for both). The increase of LVM in hormonally active disease is due to predominantly LV dilatation, whereas associated hypertension, if present, aggravates the LVH exclusively due to thickening of the LV wall. Hypocorticalism, if present, does not influence the degree of LVH. Asymmetric septal hypertrophy was not found to be specific for acromegaly and was seen in only 7.7% of patients. There was no correlation between LVM and both the plasma levels of growth hormone and duration of disease. On the basis of a retrospective analysis of LVM in successfully treated patients the authors conclude that specific heart muscle disease in acromegaly, manifesting itself as LVH, is slowly reversible after cessation of the growth hormone hyperproduction.

Acromegaly↗