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Biomedical subjects

J Spácil

Publications and source records attributed to J Spácil.

At least 19 recordsLinked to original sources
PubMed1997

[Favorable effect of treatment with statins on the intima of the common carotid artery in patients with familial hyperlipoproteinemia].

BACKGROUND: In recent years evidence was provided that by measuring the width of the intima of the carotid artery, evaluated by sonography, it is possible to assess the development of arteriosclerosis. The authors used this method to evaluate hypolipidaemic treatment. METHODS AND RESULTS: The authors followed-up by clinical and laboratory methods and treated for a period of 47 months 63 patients with familial hyperlipoproteinaemia. At the beginning and at the end of the follow-up period they made sonographic examinations of the common carotid artery. In 31 patients treated by statins they observed statistically significant changes: cholesterol declined by 23%, LDL cholesterol by 25.3%. The maximal rate in the common carotid artery (ACC) declined from 93 +/- 22 to 73 +/- 13 cm/s. The diameters of the ACC increased from 6.0 +/- 0.8 to 6.5 +/- 0.8 mm. The intima of the ACC diminished from 0.84 +/- 0.26 to 0.75 +/- 0.20 mm. In 22 patients treated with fibrates the anticipated lipid changes occurred. The diameter of ACC did not change, the decline in the width of the intima of the ACC was not statistically significant. In 10 patients who decided that they wanted only dietary treatment the changes in the investigated parameters were small. CONCLUSIONS: In patients with familial hyperlipidaemia who were treated with statins for almost four years the authors observed a diminution of the width of the intima of the common carotid artery which is considered a sign of regressing atherosclerosis.

Anticholesteremic Agents↗
PubMed1997

Decreasing common carotid artery intimal thickness during hypolipidemic therapy.

It has been demonstrated in recent years that ultrasound can be used to measure common carotid artery intimal thickness; an increase in intimal thickness is regarded as an early stage of atherosclerosis. This study was designed to establish whether or not intimal thickness can be modulated by therapy. Twenty-nine patients with familial hyperlipoproteinemias had follow-up ultrasound of the common carotid artery after twenty-nine months of comprehensive therapy. In 21 patients with familial hypercholesterolemia, intimal thickness decreased from 0.83 to 0.68 mm (P < 0.01), in 9 with familial combined hyperlipoproteinemia, the decrease was from 0.77 to 0.74 mm (a decrease was seen in only 50% of patients). With the group taken as a whole, the larger decrease was observed in patients treated with statins while the reduction was less marked in those administered fibrates. The authors found a decrease in common carotid artery intimal thickness following hypolipidemic therapy in patients with hyperlipoproteinemias. Their impression is that this was a manifestation of atherosclerosis regression.

Adult↗
PubMed1996

[Changed views on vasoconstriction of coronary vessels and angina pectoris].

Views on the impact spasms of the coronary arteries (in the work of distinguished internists and cardiologists) changed in recent years. At present it is obvious that even coronaries damaged by atherosclerosis (in particular eccentric stenoses) may react to vasoconstrictor stimuli by a spasm and this promotes various manifestations of ischaemic heart disease. The coronary arteries can respond by vasoconstriction to stimuli to which arteries without atherosclerotic changes react by vasodilatation. Hypolipidaemic treatment reduces not only stenoses of the coronaries but improves also their impaired vasomotorics. A spasm of a "sound" artery remains an exceptional occurrence. This, however, casts no doubts on the importance of the serious character of organic stenoses and the increase of cardiac work which causes ischaemia of the heart muscle.

Angina Pectoris↗
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↗
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

Heart in pituitary diseases.

Of hormones secreted by the pituitary, a direct effect on cardiac metabolism and function is exerted only by growth hormone (GH). Its chronic overproduction in adulthood leads to acromegaly. The main cardiovascular manifestations of acromegaly are hypertension and cardiac hypertrophy. The paper summarizes the results of clinical research into the "acromegalic heart" in an internationally unique group of 78 patients with acromegaly on long-term follow-up. Both clinical findings and experimental data available in the literature indicate that cardiac hypertrophy is due to a direct effect of GH on the myocardium. Hypertension occurs in 50% of patients, has the nature of volume hypertension and exerts only an additive effect on the development of left ventricular hypertrophy. Once GH overproduction has been eliminated, cardiac hypertrophy and hypertension can be reversed to a certain stage, a finding highlighting the necessity of instituting treatment of acromegaly as early and as vigorous as possible.

Acromegaly↗
PubMed1990

[Pregnancy and labor in women with mitral valve prolapse].

In a prospective study the authors investigated 30 pregnant women (mean age 27 +/- 5.5 years) with prolapse of the mitral valve confirmed on echocardiography, without significant mitral regurgitation, in order to assess whether mitral valve prolapse is a risk factor for the development of complications during gestation and childbirth. As control served a group of 30 healthy pregnant women of corresponding age and number of previous pregnancies, incidence of complications during pregnancy, the type of delivery, sex, length, weight and maturity of the neonates. In women with mitral valve prolapse the authors recorded a significantly higher incidence of subjective complaints such as palpitations associated in 7 of 8 cases with sinus tachycardia 110-140/min. at rest and with vasovagal syncopes. The palpitations were always favourably influenced by beta-blocker therapy or by calcium antagonists. Mitral valve prolapse without haemodynamically significant mitral regurgitation during pregnancy is not a significant risk factor for the development of complications.

Adult↗
PubMed1990

[How important is dipyridamole in patients with ischemic heart disease?].

Dipyridamol does not have a proven, clinically significant antithrombotic effect. Treatment is relatively expensive. Dipyridamol can cause ischaemia of the heart muscle in patients with ischaemic heart disease. Dipyridamol administration as part of antithrombotic treatment should therefore be selective. Large does can be used as a supplementary loading test for detection of the ischaemic focus.

Coronary Disease↗
PubMed1990

[Is it possible to treat cardiac hypertrophy?].

Cardiac hypertrophy in heart disease is associated with a deterioration of the patient's prognosis. From experimental work it is known that hypertrophy can recede, sometimes it is, however, associated with an undesirable increase of fibrous tissue in the heart muscle. In clinical practice we can reduce cardiac hypertrophy (assessed mainly by echocardiography), at least in some patients, by reducing or eliminating the evoking cause (e.g. in sportsmen terminate training, in aortic valve disease by replacement of the valve, in hypertonic patients we reduce the pressure by drugs). After regression of hypertrophy later also the amount of fibrous tissue recedes and as a rule the function does not deteriorate. Lately we are trying to influence factors which directly participate in the hypertrophy of the myocytes, in particular in hypertonic subjects by preferential action on the adrenergic system and the renin angiotensin system.

Cardiomegaly↗
PubMed1989

Peripheral circulation in hypertensive and normotensive acromegalics.

Clinical examination and blood pressure measurement over the ankle in 31 patients with acromegaly, showing signs of active disease, did not reveal manifestations of obliterative arterial disease in the lower limbs. Sixteen of the patients had a normal blood pressure; in none of them did the authors find a deviation of blood flow in the foot and in the calf at rest and during reactive hyperaemia following 5-minute ischaemia. Fifteen patients with hypertension were found to have increased resting blood flow in the foot and calf and increased blood flow in the foot during reactive hyperaemia.

Acromegaly↗