Biomedical subjects

H Nĕmcová

Publications and source records attributed to H Nĕmcová.

At least 19 recordsLinked to original sources

PubMed2003

[Ambulatory monitoring of blood pressure in the treatment of hypertension in diabetics].

Hypertension, the most significant cardiovascular risk factor, appears twice more often in persons with diabetes compared to nondiabetic population. A high percentage of complications (40-70%) in diabetic population is caused just by hypertension. That is why timely diagnosis and consistent treatment of hypertension is stressed in patients with diabetes. Blood pressure of young people with type I diabetes is proved to be higher compared to their healthy peers. Both in people with type I and type II diabetes are, compared to other populations, more frequent incidence of a phenomenon called "white coat", increased variability in blood pressure, and higher percentage of non-dippers with high blood pressure. They are on a higher risk for diabetic nephropathy and its quicker progression. Therefore it is desirable to start medication and alter its combination after confirming blood pressure values by ambulatory monitoring so that the blood pressure is well controlled not only by day but also during sleep and early in the morning.

Blood Pressure Monitoring, Ambulatory↗

PubMed2002

[Will ECG combined with echocardiography detect viable myocardium in patients after myocardial infarct?].

The objective of the submitted trial was to use combined examination of ECG at rest and after exercise to detect a viable heart muscle in patients with a postinfarction Q wave and ST elevations. The authors found that according to the character of changes of the ST elevation in ECG after exercise it is not possible to detect patients with a viable myocardium. During the combined procedure using analysis of the kinetic disorder at rest and increase of the ST segment in ECG after exercise it is possible in patients with hypokinesia or akinesia at the site of the Q wave to differentiate successfully 66% patients with a viable heart muscle. This combined procedure can serve as a selective test for implementation of further more accurate diagnostic tests for the detection of a viable heart muscle because in common clinical practice the above data are available in these patients before indication of more complicated examinations.

Coronary Artery Bypass↗

PubMed2001

[Ambulatory blood pressure monitoring in a young population].

Ambulatory twenty four hour blood pressure monitoring (ABPM) is an exact method, enabling by repeated measurements to create blood pressure profile, which shows a close correlation with end organ damage. Normal values were taken from clinical trials, where the mean age of probands was highly above 30 years. The aim of this trial was to determine mean values for ABPM in population aged 18-30 years and to create "normal values" for this population. We have examined 162 probands. The mean office blood pressure was 128.18 +/- 11.2/82.91 +/- 8.29 mm Hg, the mean ABPM (24 hours) was 118.51 +/- 9.11/70.59 +/- 6.30 mm Hg. Systolic, mean and pulse pressure was significantly higher in males. Systolic and pulse blood pressure showed a close correlation with height, weight, waist and waist/hip ratio (r = 0.40-0.47). The upper value of 24 hour BP in young population is between 125/75 mm Hg and 130/80 mm Hg according to our results.

Adolescent↗

PubMed1998

Serologic diagnosis of ovine lentiviruses by whole virus ELISA and AGID test.

Enzyme-linked immunosorbent assay (ELISA) and agar gel immunodiffusion (AGID) are the most widely used serological tests for Maedi-Visna diagnostics. The purpose of the present study was to develop an indirect whole virus ELISA and an immunodiffusion test and compare their sensitivity. A total of 747 ovine serum specimens were analysed for antibodies against this ovine lentivirus. The number of positive results in the ELISA was 430 (57.56%). In the AGID test, a positive result was found in 380 samples (50.87%). In the group of discordant results 78 (10.4%) samples tested positive by the ELISA and negative by the AGID test and 28 sera (3.7%) were found to be positive by the AGID test and negative by the ELISA. The data in this report show the ELISA to be more sensitive than the AGID test, but accurate serological diagnostics should be based on a combination of the two tests.

Animals↗

PubMed1997

Isolation and partial characterization of ovine lentivirus in Czech Republic.

The first isolation and partial characterization of ovine lentivirus in Czech Republic is described. The virus was isolated in a tissue culture system derived from plexus choroideus from sheep. The new isolate was compared with prototypic K1514 Maedi-Visna strain; these two viruses shared antigenic determinants as determined by serological testing. Both viral strains reacted in a PCR reaction with primers situated in the gag and pol gene. Based on similarities of growth characteristics, antigenic determinants and primer binding sites it can be concluded that the isolate OPM is an ovine lentivirus and is at least partly related to the prototypic Maedi-Visna strain K1514.

Animals↗

PubMed1996

[Comparison of dynamic and isometric loading in echocardiographic examinations in patients with ischemic heart disease].

The objective of the work was to compare functional indicators of the left ventricle during isometric (HG) and dynamic (Ergo) echocardiographic load examinations in patients with different grades of ischaemic heart disease. In group A they compared results in 34 patients with affection of three coronary arteries and in group B 15 patients with 1-2 coronary arteries affected. They evaluated the systolic, diastolic blood pressure, heart rate (HR), the index of the diastolic end volume EDV/m2, the index of the systolic end volume ESV/m2, Limacher's index for evaluation of left ventricular motility and the left ventricular ejection fraction (EF) at rest and after both types of loads. The EDV/m2 index increased in group A by 5.2 ml during an isometric load and by 10.4 ml during a dynamic load, in group B it increased by 1.6 and 7.0 ml resp. The values of the ESV/m2 index increased in group A by 8.5 ml during the isometric load and by 14.0 ml during the dynamic load, in group B by 4.1 and 10.8 ml resp. EF values at rest were similar in both groups: group A: 51.4%, B: 51.5%. During the isometric load the EF declined to 45.3% in group A and to 47,1% in group B. During the dynamic load the EF declined to 42% in group A and 42.5 in group B. The dynamic load produces, as compared with the isometric one, a statistically more significant drop of Limacher's index and greater volumetric changes of the left ventricular cavity in the group with 1-2 affected coronary arteries, as compared with the isometric load. In patients with three affected coronary arteries the volumetric changes during an isometric load are comparable with changes after a dynamic load.

Coronary Disease↗

PubMed1996

[Importance of dipyridamole transesophageal echocardiography in the diagnosis of ischemic heart disease].

The importance of dipyridamol echocardiography in the diagnosis of ischaemic heart disease (IHD) was described repeatedly. Nevertheless in roughly 20% patients the transthoracic echocardiographic examination at rest is inaccurate or cannot be carried out because the ultrasonic visibility is poor. In these patients transoesophageal dipyridamol echocardiography (TEE Dip) can provide a suitable alternative. This is why the authors evaluated 36 patients examined on account of IHD before and after administration of 0.80 mg/kg dipyridamol. The left ventricle was visualized in the transgastric short axis and from the apical view. Angiography revealed significant stenosis of the coronary arteries in 23 patients. In 18 patients after administration of dipyridamol new motility disorders developed, in 5 patients with motility of the left ventricular wall, impaired at rest, no new disorder of kinetics developed, i.e. the test was falsely negative. Thirteen patients had no signs of stenosis of the coronary arteries and three developed disorders of the motility of the left ventricular wall. The sensitivity of TEE Dip for the diagnosis of left ventricular ischaemia was 78% and the specificity 79%. Dipyridamol load transoesophageal echocardiography is a method suitable for clinical application with a still satisfactory sensitivity and very good specificity and it can be implemented without involving the risk of serious side-effects.

Adult↗

PubMed1995

[The effect of dipyridamole on pulmonary venous flow in patients with ischemic heart disease].

In 56 patients with ischaemic heart disease the authors evaluated the blood flow in the pulmonary veins, using transoesophageal echocardiography by the pulsed Doppler technique in the left upper pulmonary vein. They assessed the peak systolic velocity (pVS), the systolic integral time-velocity (S-VTI), the peak diastolic velocity (pVD) and the integral time velocity in the diastolic part of the flow (D-VTI). They found a statistically significant correlation between the ratio pVS/pVD and the LVEDP assessed by the invasive method (r = 0.812). In 36 patients the authors evaluated the flow rate and time-velocity integral at rest and after administration of 0.78 mg/kg dipyridamol by the i.v. route. In 17 patients with affections of 2 or 3 coronary arteries (group A) after the administration of dipyridamol an increase of the maximal flow rate occurred in the diastolic portion of the flow (at rest 54.7 +/- 12.5, after dipyridamol 64.9 +/- 14.8 cm/s). The systolic flow velocities did not change in this group of patients (at rest 52.2 +/- 3.0, after dipyridamol 54.3 +/- 14.0 cm/s). In 19 patients with a negative coronarographic finding (group B) or with stenosis of one coronary artery after dipyridamol administration the systolic peak velocity increased (from 58.0 +/- 10 to 70.2 +/- 14.8 cm/s). The pVD values increased slightly after dipyridamol (at rest 42.5 +/- 14.3, after dipyridamol 52.1 +/- 15.6 cm/s).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗

PubMed1993

[Evaluation of physical rehabilitation in myocardial revascularization using echocardiography].

The authors investigated 155 patients, mean age 50.6 years, after revascularization of the myocardium. The group was divided at random into a group with a high intensity of physical rehabilitation (A) and a medium and low rehabilitation group (B). The rehabilitation programme comprised physical exercise at least three times per week for at least 30 mins. with a dynamic load up to 80% of the maximum heart rate in group A and up to 40% in group B. The mean initial haemodynamic indicators in both groups were equal (LVEDP 17.5 mm Hg and 16.5 resp. and EF 52.3% and 50.5% resp. in group A and B). Six months after revascularization the mean values of work tolerance increased in group A more than in group B (58.6 kJ, as compared with 44.2 kJ) and this difference is even greater after three years (70.4 kJ as compared with 51.5 kJ). The mean values of the ejection fraction (EF) at rest do not differ in the two groups after 6 months nor after 3 years (51.3% in group A, as compared with 54.6% in group B after 6 months, and 55.2% vs. 53.7% resp. after three years). The EF after a dynamic load after 6 months and 3 years does not differ in the two groups either (57.2% vs. 56.4% after 6 months and 55.1% vs. 54.5% after three years). Similar results were also obtained on evaluation of the mobility index of the walls at rest and after a dynamic load.(ABSTRACT TRUNCATED AT 250 WORDS)

Echocardiography↗

PubMed1993

[Significance of pulmonary vein flow for the determination of left ventricular filling pressure].

The aim of the submitted study was to evaluate the blood flow in the pulmonary veins by transoesophageal Doppler echocardiography which is the ideal method for recording the blood flow in the pulmonary veins as the ultrasound probe is closely behind the left atrium. In 35 patients with ischaemic heart disease the authors evaluated the blood flow in the pulmonary veins to assess whether the rate of the blood flow in these vessels can serve a non-invasive estimate of the end-diastolic pressure in the left ventricle (LVEDP). It was revealed that venous blood flow has in the majority of cases two anterior peaks during ventricular systole, one anterior peak during diastole and one negative peak during atrial contraction. In patients with normal LVEDP the peak rate and integral time-velocity of the flow curve is greater during systole, while in patients with a higher LVEDP these parameters are higher during diastole. Dopplerian assessment of the flow in the pulmonary veins is safe, relatively non-invasive and simple. This method makes possible rapid visual estimates of the end-diastolic pressure in the left ventricle.

Blood Flow Velocity↗

PubMed1992

[Transesophageal stress echocardiography].

The authors submit their initial experience with the work protocol of transoesophageal loading echocardiography, which they used in 148 patients. The method is meant in the first place for individuals where the records of classical transthoracic echocardiography in 10-25% are difficult to visualize by echocardiography or patients who for any reasons cannot be subjected to common loading examinations. The informative capacity of this method is almost 100%. It makes it possible to evaluate every accurately filling and ejection indicators as well as changes in the motility of cardiac walls.

Contraindications↗

PubMed1992

[Echocardiographic evaluation of the left ventricle in mild hypertension treated with physical exercise].

The authors submit findings of haemodynamic changes during long-term treatment of mild hypertension by physical training. Using this method, blood pressure was normalized in all subjects. The authors conclude that physical activity has a similar impact on the haemodynamics of mild hypertension as drugs which reduce the tension of the sympathetic nerve. A surprising finding was the diminution or complete disappearance of cardiac hypertrophy in this treatment.

Adult↗

PubMed1991

Antihypertensive effect of isradipine on blood pressure at rest and during exercise.

After three months of treatment with isradipine, 20 patients with mild hypertension had reduced their resting blood pressure (BP) from 157/103 to 132/85 mm Hg and their BP during isometric exercise from 192/124 to 166/105 mm Hg. The isradipine dose necessary to normalize BP (both at rest and post-exercise) was 1.25 mg twice daily (2 x 1/2 tablet) in 50% of patients and 2.5 mg twice daily (2 x 1 tablet) in 25%. In the remaining 25% of patients, isradipine was combined with 1 mg/day bopindolol. There were virtually no accompanying side effects; in particular, reflex tachycardia was negligible or absent. It is concluded that isradipine is a reliable antihypertensive treatment in mild-to-moderate hypertension.

Adrenergic beta-Antagonists↗

PubMed1989

[Use of the postural test in stress echocardiography].

The authors introduced and evaluated the clinical importance of the echocardiographic positional test for the detection of left ventricular insufficiency after exercise. They found that in decompensated ischaemic patients, contrary to healthy subjects, left ventricular ejection indicators deteriorate. Latent left ventricular weakness in ischaemic patients without clinical signs of heart failure is revealed by positional reduction of the rate of shortening of the circumferential fibre. The authors conclude that this test does not fully replace the work load examination. The change of position is, however, a simple, preliminary functional test which may be useful in patients with ischaemic heart disease for checking treatment, rehabilitation and the selection of subjects for further aimed examinations.

Coronary Disease↗

PubMed1989

[Diastolic function of the left ventricle in incipient hypertension].

The authors provide evidence that changes of diastolic indicators precede in incipient hypertension the impaired left ventricular function. In marginal hypertonics and in particular in stage 1 hypertonics they found by echocardiography that, as compared with healthy normotonic subjects, sings of impaired relaxation in the early diastole. This is apparent from the significant prolongation of the time constant of relaxation at rest and the maximal speed of relaxation which are due to the early filling of the left ventricle. To increase the sensitivity of the echocardiographic examination of left ventricular functions the isometric loading test proved useful.

Adult↗

PubMed1989

[Echocardiographic orientation evaluation of the function of the left heart ventricle].

The authors discuss the possibility to make use of a simple echocardiographic indicator of left ventricular function--the angle formed by the anterior cusp of the mitral valve and the line of the interventricular septum, assessed from a four-chamber tracing (angle M). Based on echocardiographic examination of 87 subjects they established their own standards. They consider values above 30 degrees as pathological, suggesting impaired left ventricular function. The M angle correlates significantly with invasive (final diastolic pressure in the left ventricle, ejection fraction) and with non-invasive (top speed of shortening of the circumferential fibre) indicators of left ventricular function. The authors assume that this simple, quick screening of left ventricular function will prove helpful, in particular in subjects where visualization by one-dimensional echocardiography from a parasternal approach is difficult. In practice it can be also applied for evaluation of left ventricular function during loads, in particular in dynamic echocardiography.

Cardiomyopathy, Dilated↗

PubMed1989

[Clinical effects of isosorbide dinitrate in the transdermal spray (TD Spray Iso Mack) form].

The authors report on their experience with the transdermal spray, TD spray Iso Mack. Using a graded ergometric test, the authors examined 11 patients with angina on exertion before and 60 minutes after administration of 60 mg of the effective substance by the transdermal route. The average threshold of ischaemia and work tolerance increased significantly and the ECG depression of segment S-T receded. In an open trial six patients were investigated with angina on exertion during three-week treatment with the spray--twice a day 60 mg by the transdermal route--as compared with standard treatment. The number of attacks and consumption of sublingual nitroglycerin decreased significantly. Five patients were subjected to haemodynamic examination before and repeatedly after application of 60 mg of the spray. A significant drop of the filling pressures occurred which persisted for 6 to 8 hours.

Administration, Cutaneous↗

PubMed1989

[Changes in blood pressure in mild forms of hypertension after long-term physical training].

The authors submit the results of a long-term study of the treatment of mild hypertension by physical training. Its advantage, as compared with medicamentous treatment, is the physiological effect on the organism, its financially unpretentious character, and if the population is seriously informed, its wide application. The authors found in general a poor approach to physical activity, in particular among young people due to lack of information on the importance of physical activity. They conclude that physical training is the method of choice in the treatment of mild forms of hypertension. The blood pressure attained normal levels after this treatment in liminal hypertonics as well as hypertonics stage I.

Adult↗