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Biomedical subjects

V Vísek

Publications and source records attributed to V Vísek.

At least 37 records · Page 2Linked to original sources

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↗

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↗

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↗

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↗

The possibility of non-invasive identification of occluded coronary artery in acute myocardial infarction. A comparison of ECG and echocardiography with coronary arteriography or autopsy.

In 73 patients with acute occlusion of single coronary artery, the authors assessed the possibilities of ECG and echocardiography in determining non-invasively which of the 3 main arteries had been occluded. The sensitivity of ECG for the individual arteries and particular ECG signs ranged between 30-98%, the specificity was between 86-100%. While it was always possible to determine occlusion of the left anterior descending coronary artery (LAD), in several cases it was difficult to distinguish between occlusion of the left circumflex (LCX) and the right coronary artery (RCA). The LCX occlusion is a frequent source of error in interpreting electrocardiograms of patients with fresh myocardial infarction. The sensitivity of echocardiography in identifying the occluded coronary artery ranged between 77-100%, specificity 97-100%. The following ECG and echocardiographic signs of coronary occlusion were determined. The LAD occlusion is indicated by ECG changes in V1-4, and anteroseptal and apica asynergy on echocardiography. LCX occlusion: increased R wave amplitude in V1, and lateral and posterior wall asynergy. The RCA occlusion: ECG changes in II, III, aVF, asynergy of the posterior wall and part of the septum and right ventricle. These combined signs make possible the identification the occluded coronary artery in 95% of patients with myocardial infarction.

Adult↗