Search PubMed⌕ Search

Biomedical subjects

V Cervenka

Publications and source records attributed to V Cervenka.

At least 37 records · Page 2Linked to original sources
PubMed1988

Myocardial contrast echocardiography: a new method for the evaluation of regional myocardial blood flow.

Myocardial contrast echocardiography is a new method enabling detailed evaluation of blood flow distribution within the myocardium. It is performed by means of intracoronary injection of small volumes of carrier solutions containing small microbubbles of a size similar to that of red blood cells. The perfused myocardium opacifies densely, while the ultrasonic backscatter of nonperfused areas does not change. This method enables evaluation of the physiologic impact of coronary stenosis, diagnosis of "small vessel disease", collateral blood flow assessment, infarct size measurement and, with the help of videomemory and a computer, also regional myocardial blood quantification. This paper reviews all hitherto published studies with myocardial contrast echocardiography in humans including some studies only recently submitted for publication. These studies examined a total of 169 patients. No complications of intracoronary injection of microbubbles were described. Transient ECG and haemodynamic changes of less than 30 seconds' duration are less pronounced than during routine coronary arteriography. This paper describes the methodology, safety, physiology and potential clinical usefulness of myocardial contrast echocardiography.

Contrast Media↗
PubMed1988

Clinical findings in hypertrophic cardiomyopathy and their relationship to the disease severity.

The clinical and electrocardiographic findings of 82 patients presenting with hypertrophic cardiomyopathy were compared with the distribution and extent of myocardial hypertrophy. The clinical and ECG signs did not depend on either the presence or the degree of the obstruction. Subjective complaints (with the exception of dypnoea) were not related to the value of myocardial thickness but they correlated with the square extent of the area affected by hypertrophy of the myocardium. It was distinct in the case of dyspnoea and especially syncope the occurrence of which was significantly higher in patients with a higher extent of hypertrophy. This extent of hypertrophy was reflected in our previously published classification of hypertrophic cardiomyopathies which is based on echocardiographic analyses of the individual parts of myocardial thickness.

Adolescent↗
PubMed1988

The picture of hypertrophic cardiomyopathy in the elderly.

The aim of the study was to analyse the findings obtained in 27 patients with hypertrophic cardiomyopathy who lived to be 60 and more. Elderly patients are, more frequently than younger ones, women, mostly with a negative family history (81% vs. 30% in younger patients), with a lower incidence of syncope (11% vs. 25%), smaller myocardial wall thickness and lesser extent of hypertrophy. Elderly patients displayed mitral ring calcification more often (18%) than younger subjects (6%) or those of the same age but free of hypertrophic cardiomyopathy (3%). Pathological Q waves on the ECG recording were likewise less frequent (7.6% vs. 20.4%). While elderly patients exhibited manifest proneness to elevated values of left ventricular end-diastolic pressure, there were no marked differences in obstruction.

Aged↗
PubMed1988

Myocardial contrast echocardiography. A review of clinical studies.

A review is presented of to date published studies devoted to contrast echocardiography of the myocardium and covering a total of 169 patients. No complications occurred during investigations; slight transient ECG and haemodynamic changes of less than 30 s duration were not as pronounced as during coronary arteriography. Intracoronary administration of a 3-4 ml solution containing microbubles close to erythrocyte size leads to opacification of the perfused part of the myocardium in echocardiographic image, whereas the echogenity of nonperfused parts remains unchanged. With the use of this method it might be possible to evaluate the significance of coronary stenosis, to diagnose the "disease of small arteries", to assess the collateral circulation, myocardial infarction size, and to quantify the blood flow in various parts of the myocardium in real time. The method is promising for the assessment of myocardial microcirculation as a complement of coronary arteriography.

Contrast Media↗
PubMed1988

Severe diffuse hypokinesis of the remote myocardium--the main cause of cardiogenic shock? An echocardiographic study of 75 patients with extremely large myocardial infarctions.

Two-dimensional echocardiography was performed in 75 patients with extensive myocardial infarctions to prove why cardiogenic shock develops only in a minority of such patients. 23 patients with clinical signs of shock formed group A, and 52 patients without signs of shock group B. The extent of akinesis and/or dyskinesis was the same in both groups. The "Asynergy Index"--involving also hypokinesis--was more favourable in group B (126 +/- 28, compared with 158 +/- 23 in group A, p less than 0.05). The ejection fraction was significantly higher in group B (33 +/- 12%, compared with 17 +/- 6% in group A, p less than 0.01). The cause of these differences was severe diffuse hypokinesis of the remote myocardium, which was present in all 23 patients with cardiogenic shock and only in 2 patients without shock (p less than 0.001). All 23 patients with shock had multi-vessel disease, which was present only in 19% of patients without shock (p less than 0.01). The study shows that in addition to two known conditions necessary for the development of cardiogenic shock (multi-vessel disease and infarct size at least 40% of the left ventricle), there exists a third condition of equal importance: severe diffuse hypokinesis of the remote myocardium.

Adult↗
PubMed1987

Autoantibodies in hypertrophic cardiomyopathy and their clinical significance.

Data concerning autoantibodies in hypertrophic cardiomyopathy are rare and controversial and only the results of indirect immunofluorescence methods are available in the literature. The aim of this study was to determine the frequency and clinical significance of autoantibodies in hypertrophic cardiomyopathy by means of the Western blot which is a highly sensitive immunological technique. Sera from twelve (48.0%) of the whole group of 25 patients with hypertrophic cardiomyopathy reacted with actin from the HeLa extract. The incidence of anti-actin antibodies in sera from 23 ischaemic heart disease patients was 13.0% (P less than 0.025) and in 37 apparently healthy subjects was 8.1% (P less than 0.001). When samples were assayed on the actomyosin prepared from Xenopus laevis muscle, sera of 14 (56.0%) of the patients exhibited actin positivity while the positivity in ischaemic heart disease and in healthy subjects was found to be 13.0 and 13.5%, respectively (P less than 0.001). Presence of anti-actin antibodies was related to the functional and clinical status and the progression of the disease. Anti-actin antibodies were found more frequently in medically treated patients. These data suggest that anti-actin antibodies are probably not directly involved in the pathogenesis of hypertrophic cardiomyopathy, but their detection might be useful as an additional marker of disease severity.

Actins↗
PubMed1986

Use of verapamil in the treatment of hypertrophic cardiomyopathy.

Thirty-seven patients with hypertrophic cardiomyopathy were treated with verapamil in a dose of 240-360 mg/day and followed for 40 months. Marked symptomatic improvement (by at least one class according to the NYHA classification) occurred in 21 (57%) of the patients improved. An increase of left ventricular end-diastolic dimension and volume was recorded. A significant reduction of isovolumic relaxation period (peak velocity of filling and peak velocity of circumferential fibre changes in diastole) occurred. These favourable effects were, however, no longer unequivocal from the fourth month of treatment onwards. Verapamil treatment in hypertrophic cardiomyopathy is a valuable approach by which symptomatic improvement and a favourable effect on some left ventricular functions can be achieved. Its value is, however, to some degree reduced by the lack of long-term effect.

Adolescent↗