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Biomedical subjects

M Kozáková

Publications and source records attributed to M Kozáková.

At least 19 recordsLinked to original sources
PubMed1991

[A mobile thrombus simulating a myxoma of the right atrium].

Two-dimensional echocardiography is due to the detailed visualization of the right atrium and adjacent structures an indispensible non-invasive method for the detection pathological masses. In the differential diagnosis of these masses most frequently a mobile thrombus and myxoma are involved. The authors are presenting the case-history of a 71-year-old female patient where during hospitalization on account of a suspect non-Q-wave myocardial infarction in an anteroseptal position echocardiography revealed a pathological mass in the right atrium. From the case-history and results of examinations it was not possible to evaluate unequivocally the nature of the revealed mass. In view of the considerable risk of embolization into the pulmonary artery and coinciding ischaemic heart disease the patient was indicated for surgery and a mobile thrombus was removed. The described case draws attention to the differential diagnosis of right atrial masses and the optimal therapeutic approach.

Aged↗
PubMed1990

Randomized double-blind comparison of isosorbide dinitrate and nifedipine in variant angina pectoris.

The antianginal and anti-ischemic effect of isosorbide dinitrate (ISDN), 120 mg once daily, and nifedipine, 20 mg twice daily, both in slow-release formulations, were compared in 17 patients with variant angina pectoris in a randomized, double-blind trial. The design included a placebo run-in period and two 6-week crossover periods of active treatment. Mean frequency of angina decreased significantly from 43 attacks per week during the placebo period to 4 per week with ISDN and 8 with nifedipine (p less than 0.001). Sublingual nitroglycerin consumption decreased significantly from 37 tablets per week with placebo to 3 tablets per week with ISDN and 7 with nifedipine (p less than 0.001). Both drugs reduced the silent and symptomatic ST-segment deviations on ambulatory electrocardiographic recording and increased maximal exercise tolerance. Episodes of coronary spasm could be provoked, by hyperventilation, in all patients during the placebo phase but in no patient during therapy with either active drug. Thus, both ISDN and nifedipine, in their slow-release formulations, are effective in the treatment of variant angina pectoris.

Adult↗
PubMed1990

[Pharmacokinetics and pharmacodynamics of furosemide in liver cirrhosis].

12 patients with cirrhosis of the liver (6 with ascites) and 6 control persons were given 80 mg furosemide intravenously and were followed up for pharmacokinetic, renal and haemodynamic effects. The patients with ascitic cirrhosis (AC) and the control persons were found to have the same plasma furosemide concentrations; however, the AC patients excreted significantly less furosemide into the urine in an 8-hour period than the control persons, which was due especially to lower urine furosemide excretion during the first hour after application in comparison with the control group (75 +/- 6.8 vs. 100.8 +/- 8.8 mumol/h, p less than 0.05). During the first post-furosemide hour, the AC patients had a significantly lower diuresis (13.3 +/- 2.4 vs. 23.9 +/- 1.1 ml/min, p less than 0.01) as well as natriuresis (1367.4 +/- 771.4 vs. 3242 +/- 137.5 mumol/min, p less than 0.01) than the control group and a significantly lower excretion fraction of sodium than the patients with live cirrhosis without ascites (6.5 +/- 0.8 vs. 10.7 +/- 1.5%, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Furosemide↗
PubMed1990

[Color-coded doppler echocardiography in atrial septal defects].

The magnitude of a left-to-right shunt in atrial septal defects was evaluated independently in catheterizations of the heart according to saturations and characteristics of the shunt stream in colour-flow Doppler echocardiography. The ratio of the pulmonary and systemic flow (Qp/Qs) assessed in 14 patients with atrial septal defects during catheterization correlated significantly with the maximal breadth (r = 0.8; p less than 0.001) and maximum area (r = 0.78; p less than 0.01) of the visualized shunted stream in transthoracic colour-flow Doppler echocardiography. Examination by means of transoesophageal colour-flow Doppler echocardiography in 8 patients revealed a correlation only with the maximal breadth of the shunted stream (r = 0.95; p less than 0.001). The magnitude of the maximum area of the shunted stream in transthoracic colour-flow Doppler echocardiography made it only possible to differentiate patients with a significant and not significant left-to-right shunt, i.e. Qp/Qs greater or smaller than 1.5:1. All patients with a shunt greater than 1.5:1 had a maximal area of the shunted stream greater than 10 sq.cm or 6 sq.cm/sq.m resp. Colour-flow Doppler echocardiography is a suitable method for the semiquantitative evaluation of the haemodynamic significance of atrial septal defects in adult patients.

Adolescent↗
PubMed1990

[Peroperative detection of embolizing material in the heart. The importance of peroperative transesophageal echocardiography].

During operation, 102 patients were continually monitored for heart function using transoesophageal echocardiography. Echo-contrast particles (mostly of mi-minute echo-contrast particles were also monitored through the right and left hearts. The most frequent and significant evidence was found in the right heart in the left ventricle. The authors discuss the etiolo-less frequent and less significant in abdominal operations (57%). In 27% patients undergoing chest surgery, minute echo-contrast particles were also monitored in the left ventricle. The authors discuss the etiology (fat droplets, marrow particles, thrombotic material, air) as well as the clinical significance of the monitored findings. With the exception of orthopedic patients, where even large particles were sporadically observed to pass through, these findings are of no clinical significance.

Echocardiography↗
PubMed1990

[Cardiovascular manifestations of systemic lupus erythematosus].

The authors assessed the damage of the cardiovascular apparatus in a group of 57 patients with systemic lupus erythematosus. Arterial hypertension was recorded in 19 patients (33%). The other most frequent defects were damage of the pericardium in 12 patients (21%) incl. 8 (14%) who had a pericardial exudate. Ischaemic heart disease was recorded in six patients. Serious forms of vasculitis were recorded in three patients and haemodynamically significant aortal insufficiency in two patients. Other forms of cardiovascular damage were rare.

Adolescent↗
PubMed1990

[Transesophageal echocardiography--new possibilities of peroperative monitoring of cardiac hemodynamics].

The authors describe a new method of monitoring of the heart during operation--Intraoperative transoesophageal echocardiography (TEE). They discuss the influence exerted on the cardiovascular system by anaesthesia and surgery and the possibility of echocardiography to record their consequences. The authors describe briefly the technique of this monitoring, possibilities how to evaluate the global and regional function of the left ventricle, the cardiac output, preload. They compare intraoperative transoesophageal echocardiography with invasive methods used for monitoring of cardiac function during operation.

Echocardiography↗
PubMed1989

[Comparison of isosorbide dinitrate and nifedipine in the treatment of variant angina pectoris. Randomized study].

The effects of isosorbide dinitrate single dose 120 mg daily and nifedipine 20 mg twice daily were studied in 17 patients with variant angina pectoris due to coronary artery spasm. After a placebo phase the patients were randomized to treatment with either isosorbide dinitrate or nifedipine. After six weeks the patients were crossovered for another six weeks period of treatment. There was significant decrease of number of angina attacks during both treatment regimens. Using 24 hours Holter monitoring we also proved significant decrease of number of ST segment elevation or depression, either symptomatic or asymptomatic. There was increase of performed work during exercise tests after both treatment periods. The efficacy of Isoket 120 mg and Adalat Retard 2 x 20 mg daily in the treatment of patients with active variant angina pectoris was comparable in our study. 3 patients suffered untolerable headache during isosorbide dinitrate phase and had to terminate treatment after first day only.

Adult↗
PubMed1989

[Reaction of the cardiovascular and humoral system to acute hypervolemia in patients with liver cirrhosis].

The results of the study showed that the cardiovascular system of patients with hepatic cirrhosis and ascites tolerate acute hypervolemia better than patients with hepatic cirrhosis without ascites. It can be explained by a rapid transfer of surplus liquid into the abdominal cavity. Further, it was found that the low cardiac output at rest in patients with hepatic cirrhosis evidently indicated a latent cardiac insufficiency becoming manifest only after the volume exertion. In our control group, jaundice produced bradycardia and hypotension without cardiodepressive effects. Patients with cirrhosis and with or without ascites responded to furosemide probably associated with the elution of vasoconstrictive substances in the same way as the control group. Following acute volume expansion, no differences were found between the compensated and decompensated cirrhotic patients and the healthy control group, not even in the natriuretic hormone of the secretion. However, the relevant organs of each control group had a varied response to the elevated plasma level of natriuretic factor.

Adult↗
PubMed1989

[Holter monitoring of patients treated with cytostatic agents].

After cytostatic treatment severe arrhythmias, the development of angina pectoris and even the development of acute myocardial infarction and sudden death were observed. Therefore we made in 42 patients with malignant haematological disease treated with cytostatics 96 Holter monitorings of the electrocardiographic signal. The monitoring was made during the administration of cytostatics as well as during the time interval between the administration of combinations of cytostatics. In both instances (during the administration and during the interval between administration) we recorded a surprisingly high, mean all-day as well as maximal, heart rate. In the group monitored during administration of chemotherapeutic drugs we observed 5-8 hours after administration of cytostatics serious ventricular arrhythmias [incl. ventricular tachycardia], denivelization of the ST segment, paroxysms of supraventricular tachycardia. In the group monitored during the interval between administration of cytostatics the sick-sinus syndrome was recorded, as well as a passive nodal rhythm, disorders of the intraventricular conduction. The described changes are explained by the release of vasoactive substances after administration of cytostatics, by a change of the transmembrane calcium transport leading to an increased excitability of the heart muscle and possibly to coronary spasms and direct irreversible damage of the conduction system.

Adult↗
PubMed1989

Atrial natriuretic factor in liver cirrhosis--the influence of volume expansion.

Plasma levels of atrial natriuretic factor (ANP) were examined in 12 patients with liver cirrhosis (6 with ascites) and 6 controls before and after the administration of the infusion of 2000 ml of saline solution per 70 kg of body weight during 2 hours. Basal concentration of ANF tended to be slightly, but nonsignificantly higher in patients with ascitic liver cirrhosis (5.5 +/- 1.3 fmol/ml) than in controls (3.0 +/- 1.0 fmol/ml) and in patients with non-ascitic liver cirrhosis (4.6 +/- 1.3 fmol/ml). Saline administration led to the comparable increase of plasma ANF in ascitic (14.2 +/- 4.0 fmol/ml) and non-ascitic cirrhotics (15.7 +/- 3.7 fmol/ml) and in controls (12.4 +/- 4.3 fmol/ml). The increase of plasma ANF was accompanied by the suppression of plasma renin activity (PRA) and plasma aldosterone (PA) in all groups; in ascitic patients, however, PRA and PA remained above the normal range. While in controls and non-ascitic cirrhotics saline administration led to the increase of urine flow rate /from 0.74 +/- 0.13 to 2.04 +/- 0.44 ml/min, P less than 0.01, in controls; from 0.83 +/- 0.05 to 1.28 +/- 0.07 ml/min, P less than 0.01, in non-ascitic cirrhotics) and urinary sodium excretion (from 110.7 +/- 21.3 to 364.8 +/- 74.4 umol/min, P less than 0.01, in controls; from 125.0 +/- 16.7 to 218.7 +/- 24.3 umol/min, P less than 0.01 in non-ascitic cirrhotics), in patients with ascitic liver cirrhosis neither urine flow rate (from 0.66 +/- 0.1 to 0.72 +/- 0.15 ml/min, n.s.), nor urinary sodium excretion (from 16.7 +/- 9.9 to 54.2 +/- 40.3 umol/min, n.s.) changed significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

Aldosterone↗
PubMed1989

Changes of myocardial functions in acute hepatic porphyrias. Role of heme arginate administration.

In three patients with attacks of acute intermittent porphyria we found markedly impaired functions of the left ventricle accompanied by ECG changes that returned to normal after administration of heme arginate or cytochrome C administration. In nine patients with other types of porphyria, and in one patient with acute intermittent porphyria not suffering an attack, no significant changes of left ventricle function were observed. The changes seen in patients with an acute attack may be ascribed to acute myocardial hypoxia resulting from defective biosynthesis of heme. We assume that the exogenous supply of heme may improve cellular hypoxia.

Acute Disease↗
PubMed1989

[Repeated ergometric loading].

The action of cardioactive substances is tested by repeated ergometric loads. The aim of the present work was to assess whether after previous loads in the organism certain adaptational changes persist, cardiovascular, respiratory or metabolic, which might influence the course of a subsequent load. The authors exposed therefore two groups of patients to identical loads after 2- or 24-hour intervals and investigated the behaviour of some spiroergometric indicators. From the results ensued that a load repeated after 2-hour intervals takes place under different conditions. In this participates probably the increase of the a-v difference for oxygen and to a smaller extent also adaptation of the respiratory system. Loads repeated after 24-hour intervals were comparable.

Adaptation, Physiological↗