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Seidlerová J, Ceral J, Mateřánková M, König P, Řiháček I, Vysočanová P, Souček M, Filipovský J. Long-term relationship between unattended automated blood pressure and auscultatory BP measurements in hypertensive patients. Blood Press 2018; 28:34-39. [PMID: 30474412 DOI: 10.1080/08037051.2018.1540260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIMS Unattended automated office blood pressure (uAutoOBP) has attracted more attention since SPRINT trial had been published. However, its long-term relationship to attended office blood pressure (AuscOBP) is not known. MATERIAL AND METHODS Stable treated hypertensive subjects were examined in four Czech academic hypertension centers. All subjects attended four clinical visits three months apart. uAutoOBP was measured with the BP Tru device; AuscOBP was measured three times with auscultatory method by the physician. 24-hour ambulatory blood pressure monitoring (ABPM) was performed within one week from the second clinical visit. RESULTS Data on 112 subjects aged 65.6 ± 10.8 years with mean AuscOBP 128.2 ± 12.2/78.5 ± 10.3 mm Hg are reported. Across the four clinical visits, the uAutoOBP was by 10.1/3.7 mm Hg lower than AuscOBP and the mean difference was similar during all four visits (P≥.061). Both uAutoOBP and AuscOBP had similar intra-individual variability during study follow-up as demonstrated by similar intraclass correlation coefficients (ICC, for systolic ICC = 0.50, for diastolic ICC = 0.72). However, the intra-individual variability of the systolic AuscOBP and uAutoOBP difference was high as demonstrated by low ICCs for absolute (ICC = 0.17 [95%CI, 0.09 - 0.25]) and low κ coefficients for categorized differences (κ ≤ 0.16). The main determinant of AuscOBP-uAutoOBP difference was AuscOBP level. The AuscOBP-uAutoOBP difference was poor tool to identify hypertension control categories defined on the basis of AuscOBP and ABPM. CONCLUSIONS Although mean AuscOBP-uAutoOBP differences were relatively similar across the four clinical visits, intra-individual variability of this difference was high. The AuscOBP-uAutoOBP difference was poor tool to identify hypertension control categories defined on the basis of AuscOBP and ABPM. Therefore, uAutoOBP cannot be used as a replacement for ABPM.
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Affiliation(s)
- Jitka Seidlerová
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Prague , Czech Republic.,b Biomedical Centre, Faculty of Medicine in Pilsen , Charles University , Prague , Czech Republic
| | - Jiří Ceral
- c Department of Cardiology , Faculty Hospital Hradec Králové , Hradec Králové , Czech Republic
| | - Markéta Mateřánková
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Prague , Czech Republic
| | - Petr König
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Prague , Czech Republic
| | - Ivan Řiháček
- d Faculty of Medicine, 2nd Department of Internal Medicine , St. Anne's University Hospital Brno, Masaryk University , Brno , Czech Republic
| | - Petra Vysočanová
- e Department of Cardiology , Faculty Hospital Bohunice , Brno , Czech Republic
| | - Miroslav Souček
- d Faculty of Medicine, 2nd Department of Internal Medicine , St. Anne's University Hospital Brno, Masaryk University , Brno , Czech Republic
| | - Jan Filipovský
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Prague , Czech Republic.,b Biomedical Centre, Faculty of Medicine in Pilsen , Charles University , Prague , Czech Republic
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Seidlerová J, Gelžinský J, Mateřánková M, Ceral J, König P, Filipovský J. In the aftermath of SPRINT: further comparison of unattended automated office blood pressure measurement and 24-hour blood pressure monitoring. Blood Press 2018; 27:256-261. [PMID: 29566565 DOI: 10.1080/08037051.2018.1454258] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AIMS Several papers reported that unattended automated office blood pressure (uAutoOBP) is closely related to daytime ambulatory blood pressure monitoring (ABPM). In the present study, we aim to study uAutoOBP and its relation to 24-hour ABPM and ABPM variability. MATERIAL AND METHODS Stable treated hypertensive subjects were examined in two Czech academic hypertension centres. uAutoOBP was measured with the BP Tru device; attended BP three times with auscultatory method (AuscOBP) by the physician. ABPM was performed within one week from the clinical visit. RESULTS Data on 98 subjects aged 67.7 ± 9.3 years with 24-hour ABPM 120.3 ± 10.6/72.7 ± 7.9 mm Hg are reported. uAutoOBP was lower than 24-hour (by -5.2 ± 11.3/-0.5 ± 6.9 mm Hg) and daytime (by -6.7 ± 12.82.4 ± 8.0 mm Hg) ABPM and the individual variability of the difference was very large (up to 30 mm Hg). The correlation coefficients between ABPM and uAutoOBP were similar compared to AuscOBP (p ≥ .17). Variability of uAutoOBP, but not AuscOBP, readings during one clinical visit was related to short-term blood pressure variability of ABPM. The difference between AuscOBP and uAutoOBP was larger in patients with white-coat effect compared to other blood pressure control groups (25.1 ± 7.0 vs. 2.2 ± 10.3 mm Hg; p = .0036). CONCLUSIONS Our study shows that uAutoOBP is not good predictor of ambulatory blood pressure monitoring, not even of the daytime values. It might, however, indicate short-term blood pressure variability and, when compared with AuscOBP, also detect patients with white-coat effect.
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Affiliation(s)
- Jitka Seidlerová
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Hradec Králové , Czech Republic.,b Biomedical Centre, Faculty of Medicine in Pilsen , Charles University , Hradec Králové , Czech Republic
| | - Julius Gelžinský
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Hradec Králové , Czech Republic
| | - Markéta Mateřánková
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Hradec Králové , Czech Republic
| | - Jiří Ceral
- c Department of Cardiology , Faculty hospital Hradec Králové , Hradec Králové , Czech Republic
| | - Petr König
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Hradec Králové , Czech Republic
| | - Jan Filipovský
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Hradec Králové , Czech Republic.,b Biomedical Centre, Faculty of Medicine in Pilsen , Charles University , Hradec Králové , Czech Republic
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Filipovský J, Seidlerová J, Ceral J, Vysočanová P, Špác J, Souček M, Řiháček I, Mateřánková M, König P, Rosolová H. A multicentre study on unattended automated office blood pressure measurement in treated hypertensive patients. Blood Press 2018; 27:188-193. [PMID: 29334262 DOI: 10.1080/08037051.2018.1425606] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS Unattended automated office blood pressure (uAutoOBP) may eliminate white-coat effect. In the present study, we studied its relationships to attended office blood pressure (BP) and ambulatory BP monitoring (ABPM). MATERIAL AND METHODS Stable treated hypertensive subjects were examined in four Czech academic hypertension centres. uAutoOBP was measured with the BP Tru device; attended BP was measured six times: three times with auscultatory method (AuscOBP) by the physician followed optionally by three oscillometric measurements (OscOBP). ABPM was performed within one week from the clinical visit. RESULTS Data on 172 subjects aged 63.7 ± 12.4 years with AuscOBP 127.6 ± 12.1/77.6 ± 10.0 mm Hg are reported. uAutoOBP was by 8.5 ± 9.0/3.0 ± 6.1 mm Hg lower than AuscOBP. The AuscOBP-uAutoOBP difference increased with the AuscOBP level and it did not depend on any other factor. OscOBP differed by 8.6 ± 8.6/1.9 ± 5.7 mm Hg from uAutoOBP. 24-hour mean BP was by 4.2 ± 12.1/3.5 ± 7.8 mm Hg lower than AuscOBP and by 4.3 ± 11.0/0.5 ± 6.9 mm Hg higher than uAutoOBP; the correlation coefficients of 24-hour mean BP with AuscOBP and with uAutoOBP did not differ (p for difference ≥.13). In the lowest BP group (systolic AuscOBP <120 mm Hg or diastolic AuscOBP <70 mm Hg), both AuscOBP and uAutoOBP were lower than 24-hour mean BP, while in the highest BP group (systolic AuscOBP ≥140 mm Hg or diastolic AuscOBP ≥90 mm Hg), they were higher. CONCLUSIONS Compared to uAutoOBP, attended BP measurement gives higher values, both when measured with auscultatory or oscillometric method. Inter-individual variability of AutoOBP - uAuscOBP difference, as well of uAutoOBP - ABPM difference, is large. We did not prove that uAutoOBP would be associated to 24-hour ambulatory BP more closely than attended BP.
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Affiliation(s)
- Jan Filipovský
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Plzen , Czech Republic.,b Biomedical Centre, Faculty of Medicine in Pilsen , Charles University , Plzen , Czech Republic
| | - Jitka Seidlerová
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Plzen , Czech Republic.,b Biomedical Centre, Faculty of Medicine in Pilsen , Charles University , Plzen , Czech Republic
| | - Jiří Ceral
- c Department of Cardiology , Faculty Hospital Hradec Králové , Hradec Králové , Czech Republic
| | - Petra Vysočanová
- d Department of Cardiology , Faculty Hospital Bohunice , Brno , Czech Republic
| | - Jiří Špác
- e 2nd Department of Internal Medicine , Faculty of Medicine, Masaryk University, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Miroslav Souček
- e 2nd Department of Internal Medicine , Faculty of Medicine, Masaryk University, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Ivan Řiháček
- e 2nd Department of Internal Medicine , Faculty of Medicine, Masaryk University, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Markéta Mateřánková
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Plzen , Czech Republic
| | - Petr König
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Plzen , Czech Republic
| | - Hana Rosolová
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Plzen , Czech Republic
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Solar M, Krajina A, Ballon M, Ceral J. [BP.08.04] COSYNTROPIN INFUSION SIGNIFICANTLY INFLUENCES THE RESULTS OF ADRENAL VENOUS SAMPLING IN PATIENTS WITH PRIMARY ALDOSTERONISM. J Hypertens 2017. [DOI: 10.1097/01.hjh.0000523777.55490.c2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Solar M, Krajina A, Ballon M, Raupach J, Brozova M, Ceral J. 4114Adrenal venous sampling in primary aldosteronism: cosyntropin infusion increases the success rate of the procedure but can mask the lateralization of aldosterone secretion. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.4114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Borovec M, Solař M, Ceral J, Michl A. Giant Renal Cyst Mimicking Ascites on Abdominal Ultrasonography. Acta Med (Hradec Kralove, Czech Repub ) 2016; 52:81-2. [DOI: 10.14712/18059694.2016.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
An article describes diagnostic difficulties in patient with giant renal cyst, erroneously diagnosed as ascites on ultrasonographic examination. Patient was initially suspected to have disseminated intraabdominal malignancy. Abdominal paracentesis of supposed ascites was performed. The diagnosis of giant renal cyst was finally made by CT and patient was treated surgically. The limitations of ultrasonographic examination are pointed out are and a brief review of similar cases is given.
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Solař M, Žižka J, Krajina A, Michl A, Raupach J, Klzo L, Ryška P, Ceral J. Comparison of Duplex Ultrasonography and Magnetic Resonance Imaging in the Detection of Significant Renal Artery Stenosis. Acta Med (Hradec Kralove, Czech Repub ) 2016; 54:9-12. [DOI: 10.14712/18059694.2016.10] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: The aim of our study was to evaluate duplex ultrasonography (DUS) and magnetic resonance angiography (MRA) in detection of haemodynamically significant renal artery stenosis (RAS). Methods: The study included patients with high clinical suspicion of renovascular hypertension (RVH). The imaging of renal arteries was performed by DUS, MRA and digital subtraction angiography (DSA). Significant RAS was defined as maximum systolic velocity ≥ 180 cm/sec (DUS) or as 60% reduction of the endoluminal arterial diameter (MRA, DSA). The results of DUS and MRA were assessed in respect to the results of DSA. Results: Arterial supply of 186 kidneys in 94 patients was evaluated. DSA revealed significant RAS in 61 kidneys evaluated. DUS was not able to examine arterial supply in 18 kidneys of 13 patients. In the detection of significant RAS, DUS was characterized by sensitivity and specificity of 85 % and 84 %. MRA achieved satisfactory imaging quality in all but one kidney evaluated. The sensitivity and specificity of MRA in the detection of significant RAS was 93 % and 93 %, respectively. Conclusion: In patients with high clinical probability of RVH, MRA proved to be more reliable and superior in both sensitivity and specificity to DUS in the detection of significant RAS.
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Abstract
When diagnosing primary aldosteronism, the measurement of urinary aldosterone after oral sodium loading is one of the currently recommended confirmatory tests. The aim of the study was to assess the repeatability and interpretation of urinary aldosterone in patients examined for suspected primary aldosteronism. Sixty-four hypertensive patients with suspected primary aldosteronism were prospectively enrolled and examined according to the study protocol. After antihypertensive medications interfering with renin-angiotensin-aldosterone system were withdrawn for at least 2 weeks, the confirmatory testing was performed: oral sodium loading preceded the collection of 24-h urine sample and subsequent saline infusion test. The identical procedures were repeated after 2 weeks. The concordant results of both saline infusion tests served for confirmation/exclusion of primary aldosteronism. Forty-nine patients were included in data analysis. Primary aldosteronism was excluded in 16, and confirmed in 33 individuals. The repeatability of urinary aldosterone was evaluated in 44 patients: the difference of urinary aldosterone levels ranged between 1 and 88% (median 31%). Ninety-three urine samples from 49 patients were used to validate the interpretation of urinary aldosterone in respect to the diagnosis of primary aldosteronism made by saline infusion testing; 96% sensitivity was characterized by urinary aldosterone ≥19 nmol/day, and 96% specificity was associated with urinary aldosterone ≥92 nmol/day. In 22 (45%) patients, urinary aldosterone remained in the "gray" zone between 19 and 92 nmol/day in all provided samples. The estimation of urinary aldosterone excretion after oral sodium loading is associated with marked intraindividual variability, and significant number of inconclusive results.
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Affiliation(s)
- J Ceral
- 1st Department of Internal Medicine - Cardioangiology, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - E Malirova
- Department of Nuclear Medicine, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - M Ballon
- 1st Department of Internal Medicine - Cardioangiology, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - M Solar
- 1st Department of Internal Medicine - Cardioangiology, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
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Filipovský J, Widimský J, Ceral J, Cífková R, Horký K, Linhart A, Monhart V, Rosolová H, Seidlerová J, Souček M, Spinar J, Vítovec J, Widimský J. [Diagnosis and treatment of arterial hypertension. 2012 Guidelines of the Czech Hypertension Society]. Vnitr Lek 2012; 58:785-801. [PMID: 23121067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Koblizek V, Tomsova M, Cermakova E, Papousek P, Pracharova S, Mandalia RAA, Ceral J, Novosad J, Fila L, Sedlak V, Ruta J, Bartos V, Salajka F, Hrnciarik M. Impairment of nasal mucociliary clearance in former smokers with stable chronic obstructive pulmonary disease relates to the presence of a chronic bronchitis phenotype. Rhinology 2012; 49:397-406. [PMID: 21991564 DOI: 10.4193/rhino11.051] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Associations between nasal and bronchial impairment have been repeatedly described in chronic obstructive pulmonary disease (COPD), whereas nasal mucociliary clearance (MCC) in COPD patients is not yet fully understood. We studied nasal MCC parameters in COPD patients and compared them with healthy adults (HA) and with cystic fibrosis (CF) patients with compromised MCC. METHODOLOGY An observational study of 98 COPD ex-smokers and subjects from control groups evaluated for nasal MCC time (NMCCt) and by digital video microscopy of nasal mucosa recording ciliary beat frequency (CBF) and ciliary beat pattern. RESULTS The NMCCt was decreased in HA compared to those with COPD and decreased in those with COPD compared to those with CF. CBF in COPD was lower compared to HA. The index of ciliary dyskinesia in COPD patients differed from HA. We detected higher NMCCt and lower nasal CBF in patients with chronic bronchitis phenotype (CB) compared to non-CB patients. CONCLUSIONS We confirmed the presence of impaired nasal MCC in COPD ex-smokers. These impairments were apparent predominantly in the CB phenotype.
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Affiliation(s)
- V Koblizek
- Pulmonary Department, Charles University in Prague, Czech Republic.
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Ballon M, Ceral J, Solar M, Krajina A, Raupach J, Ungermann L. [Is confirmation of an adrenal adenoma in patients with primary aldosteronism sufficient for indication of adrenalectomy?]. Vnitr Lek 2009; 55:555-559. [PMID: 19662886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Primary aldosteronism is one of the most common forms of secondary arterial hypertension. Adrenalectomy is effective in patients with proven unilateral hypersecretion of aldosterone whereas pharmacotherapy is indicated in bilateral forms of the disease. We can meet the opinion that in patients with confirmed primary aldosteronism and finding ofsuprarenal adenoma > or = 1 cm on computed tomography (CT) scanning, adrenalectomy can be recommended without further investigation. On the other hand we can perform adrenal venous sampling (AVS) to prove unilateral overproduction of aldosterone. OBJECTIVES To evaluate whether AVS is necessary in all patients with unilateral adenoma > or = 1 cm. METHODS We analyzed data from patients with proven primary aldosteronism, CT finding of adenoma > or = 1 cm along with normal morphology of contralateral adrenal gland, and successfully performed AVS. RESULTS Out of 107 patients with proven primary aldosteronism, indicated for AVS, we included 30 patients with CT finding of suprarenal adenoma > or = 1 cm along with normal morphology of contralateral adrenal gland and successful AVS. Unilateral overproduction of aldosterone was found only in 17 cases (56.7%), the results in remaining 13 patients (43.3%) did not confirm activity of adenoma. CONCLUSION Our results support necessity of performing AVS in all patients with primary aldosteronism in whom surgical treatment is considered, CT confirmation ofan adenoma is insufficient in this indication.
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Affiliation(s)
- M Ballon
- I interní klinika Lékarské fakulty UK a FN Hradec Králové.
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Abstract
Compression of the rostral ventrolateral medulla oblongata (RVLM) by an abnormally located artery is regarded as one possible cause of arterial hypertension. There exists a limited set of data suggesting that increased sympathetic activity in patients with RVLM compression may lead to arterial hypertension. Accordingly, we decided to assess the sympathetic activity in patients with severe arterial hypertension and to investigate any correlation with the presence of RVLM compression. Sixty-four patients with severe arterial hypertension were enrolled in our study. Sympathetic activity was evaluated using 24-hour urinary norepinephrine as measured by high-pressure liquid chromatography with electrochemical detection. The presence of RVLM compression was assessed with magnetic resonance imaging. Neurovascular compression of the RVLM was identified in 40 patients, 27 of whom presented left-sided compression. Twenty-four hour urinary norepinephrine averaged 263.6+/-135.9 nmol in patients with neurovascular compression - 255.6+/-137.3 nmol in those with left-sided compression and 251.6+/-138.5 nmol in patients without RVLM compression. We did not identify any increase in urinary norepinephrine in patients with severe arterial hypertension and neurovascular compression of the RVLM. Our results do not support the hypothesis that neurovascular compression of RVLM may exhibit a sympathetically mediated increase in blood pressure.
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Affiliation(s)
- M Solar
- Department of Internal Medicine, University Hospital Hradec Králové, Hradec Králové, Czech Republic
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Solar M, Zizka J, Klzo L, Ceral J. [Current use of magnetic resonance imaging in cardiology]. Vnitr Lek 2008; 54:183-190. [PMID: 23687710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Magnetic resonance imaging is a modern imaging technique that is characterized by high resolution and variable tomographic slices. The development of magnetic resonance technology in last decade led to the expansion of this method in many fields of medicine. In cardiology, the imaging is focused on the heart, aorta, pulmonary, coronary and renal arteries. Dynamic imaging is used for the evaluation of the kinetics and the function of the ventricles. Static imaging serves for the assessment of the myocardial wall in patients with cardiomyopathies and coronary artery disease. The quality of static imaging can improve paramagnetic contrast agent that increasingly accumulates in areas of acute necrosis, fibrosis or infiltration of the myocardium. Magnetic resonance imaging can also diagnose intracardiac tumors and thrombi, valvular heart disease and pericardial disorders. Despite of wide spectrum of diagnostic applications, the clinical use of magnetic resonance imaging is reduced by limited availability and high cost of the examination.
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Affiliation(s)
- M Solar
- I. interní klinika Lékarské fakulty UK a FN Hradec Králové.
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Ceral J, Zizka J, Eliás P, Solar M, Klzo L, Reissigová J. Neurovascular compression in essential hypertension: cause, consequence or unrelated finding? J Hum Hypertens 2006; 21:179-81. [PMID: 17136105 DOI: 10.1038/sj.jhh.1002124] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Odrazka K, Petera J, Zouhar M, Vosmik M, Vaculikova M, Dolezel M, Kohlova T, Filip S, Ceral J, Hobza V, Rehak S, Dolezal J. Clinical results of intensity-modulated radiation therapy (IMRT) for tumors of the head and neck region. Neoplasma 2005; 52:85-94. [PMID: 15800705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Intensity-modulated radiation therapy (IMRT) is an advanced form of the three-dimensional conformal radiation therapy (3D-CRT). Highly conformal dose distribution is the basic feature of IMRT. The head and neck region is suitable for this new technology since the primary tumor is often surrounded by several critical structures. IMRT offers the ability of dose escalation due to steep dose gradient towards healthy tissues. In this review, clinical results of IMRT in several head and neck sites are presented, including intracranial tumors. Parotid-sparing strategies and patterns of local-regional failures are analyzed. The possibilities of irradiation of recurrent malignancies are mentioned. In perspective, the potential of IMRT should be explored in conjunction with altered fractionation regimens, including simultaneous integrated boost (SIB). Particularly, studies with dose escalation are desirable.
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Affiliation(s)
- K Odrazka
- Department of Oncology and Radiotherapy, Charles University Medical School and Teaching Hospital, 50011 Hradec Kralove, Czech Republic.
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Kvasnicka J, Tusl Z, Ceral J, Babu A. [The signal-averaged ECG in long-term monitoring of patients with fulminant myocarditis]. Vnitr Lek 2002; 48 Suppl 1:213-5. [PMID: 12744050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
A case of a 24 year-old patient with fulminant myocarditis is described. The lymphocytic myocarditis was proved by endocardial biopsy. The patient had been followed for 15 months clinically, by transthoracic ultrasound and by the signal averaged ECG. The clinical and ultrasound parameters of the left ventricular systolic dysfunction subsided within 6 months, STT changes on the routine 12-lead ECG within 2 months. On the signal-averaged ECG, changes were observed in both the time and in the frequency domain. When the results of the initial examination (6 weeks after the beginning of the disease) were compared with the examination at the 7th month of the disease there was a prolongation of the QRS duration (from 95 ms to 104 ms), prolongation of the duration of the filtered ECG below 40 microV (from 21.5 to 36.2 microV) and the decrease of the total sum of the potential in the terminal part of the QRS. Most apparent was the decrease in the total sum of the high-frequency components (filter 70-250 Hz) of the QRS (RMSt: from 53.3 microV to 37.9 microV at the same noise level). In contrast to the changes in the time domain parameters there was no tendency in improvement of the RMSt. In patients with myocarditis the signal averaged ECG may prove to be a suitable tool for the long-term follow-up of the subclinical structural abnormalities of the left ventricular wall.
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Affiliation(s)
- J Kvasnicka
- I. interní klinika Lékarské fakulty UK a FN, Hradec Králové
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Kajzr J, Ceral J, Pleskot M, Kvasnicka J, Babu A. [Dysfunction of a valve prosthesis]. Vnitr Lek 2002; 48:53-5. [PMID: 11852589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The authors describe the case of a haemodynamically unstable patient with dysfunction of a valvular prosthesis which was resolved by emergency surgery. In the discussion they deal with two basic causes of these dysfunctions and their possible solutions.
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Affiliation(s)
- J Kajzr
- I. interní klinika FN, Hradec Králové
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Ceral J, Kvasnicka J, Jandík J. [Changes in late potentials in the time period after myocardial infarct]. Acta Medica (Hradec Kralove) Suppl 2001; 42:7-12. [PMID: 11253313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Late potentials are thought to be a non-invasive marker of discrete morphologic and electrophysiologic changes of the ventricular myocardium caused by fibrosis due to myocardial infarction. To find out whether there are significant changes in the signal-averaged ECG (SA ECG) over one year we examined 30 patients following myocardial infarction. When compared to the initial findings, significantly decreased incidence of late potentials was found after one year. Most of the changes in the filtered QRS were located in the terminal portion of the fQRS--in the area of low amplitude signals. Significant differences were noted in the changes found in patients with anterior myocardial infarction (MI) compared with the changes found in patients with posterior MI.
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Affiliation(s)
- J Ceral
- Lékarská fakulta v Hradci Králové, I. katedra interních oborů, Univerzita Karlova v Praze.
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Steiner I, Ceral J, Posltová M, Nozicka Z. [Atheromatous (cholesterol) embolization]. Cesk Patol 2000; 36:128-32. [PMID: 10974750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
A case is presented of an 89-year-old woman who died following an operation for arterial embolism of the lower limb. The autopsy histology showed acute occlusion of a stenosed sclerotic femoral artery by thrombotic and atheromatous emboli. In addition, it showed chronic cholesterol crystal embolism in multiple small arteries of abdominal organs, particularly of the kidneys. Abdominal aorta with severe ulcerated atherosclerosis appeared as the source of embolism.
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Affiliation(s)
- I Steiner
- Fingerlandův ústav patologie Lékarské fakulty UK a Fakultní nemocnice, Hradec Králové
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Ceral J, Kvasnicka J, Jandík J. Changes of signal-averaged ECG in normal subjects after one year. Acta Medica (Hradec Kralove) 1999; 42:15-7. [PMID: 10566175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Repeated signal-averaged electrocardiograms (SA ECG) were recorded twice with a mean interval of 13 months in 11 healthy volunteers in order to acquire basic information on long-term changes of SA ECG. After one year the duration of filtered QRS remains the most stable parameter of SA ECG on the contrary to parameters describing end of fQRS--i.e. both HFLA and RMS. Moreover fQRS seems to have better specificity in comparison to HFLA and RMS. An estimation of significant long-term changes in individual parameters of SA ECG was obtained. According to our results, only changes in QRS +/- 13 ms, fQRS +/- 8 ms, HFLA +/- 22 ms and RMS +/- 17 microV should be considered significant when found in a long-term follow-up of patients with a heart disease.
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Affiliation(s)
- J Ceral
- 1st Department of Internal Medicine, Faculty of Medicine, Charles University, Prague.
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