Status of nutrition and cardiovascular system in children from the south Moravian region of the Czech Republic: a pilot study.

Nutritional status, its assessment and its influence on numerous diseases is currently still being discussed. The aim of this study was to determine the current state of nutrition by various research methods in school children. Also, to verify the accuracy of body mass index (BMI) determination in school environment and to compare the nutritional status in two different types of school. We used a quantitative questionnaire method in 64 children from schools in the South Moravian Region. We have verified the weight and height measurement in the same group by sophisticated instruments. We have determined the basic parameters of the cardiovascular system (non-invasive continuously blood pressure recording; mutual spectral analysis for estimation of baroreflex sensitivity; applanation tonometry and cardiac polygraphy for arterial stiffness evaluation). The indicative questionnaire method encountered a problem with the weight of almost 40 % of the population approached - both obesity (14.3 %) and malnutrition (25.2 %). Cardiovascular parameters were in physiological range for the given age categories. We found increased values in BMI, % of body fat and heart rate in children from countryside type of school, respectively. We concluded that obesity/malnutrition are both common phenomena in the children population in the Czech Republic.

Evaluation of the right ventricular function in hypertrophic obstructive cardiomyopathy: a strain and tissue Doppler study.

We investigated the utility of strain, strain rate, and tissue Doppler imaging (TDI) for the evaluation of the right ventricle (RV) impairment in patients with a hypertrophic obstructive cardiomyopathy (HOCM) who underwent a successful alcohol septal ablation (ASA) and were without RV hypertrophy. A group of 19 patients suffering from HOCM with 22 controls was compared. The parameters of TDI were evaluated in mitral and tricuspid annulus. Strain and strain rate derived from TDI were assessed in an apical free wall of RV, as well as in basal segments of the left ventricle. Between both groups, there were significant differences only in isovolumic pre-ejection time (79.2+/-17.3 ms vs. 58.5+/-8.1 ms, p<0.01), isovolumic relaxation time (104.7+/-26.2 ms vs. 77.3+/-24.5 ms, p<0.01), myocardial performance (Tei) index measured from TDI (0.61+/-0.14 vs. 0.49+/-0.09, p<0.01), and early peak diastolic velocity of TDI (10.6+/-1.67 cm/s vs. 12.6+/-2.21 cm/s; p<0.05). Our results suggest the impairment of both systolic and diastolic RV function in patients suffering from HOCM. TDI-related parameters appear to be more sensitive than strain and strain rate for evaluation.

[Blunt injury of heart and thoracic aorta]. / Tupá poranení srdce a hrudní aorty.

With growing number and seriousness of traffic accidents and with improving quality of the rescue system, an increasing number of patients with blunt chest injury and injury of intracardiac organs arrive at the hospital facilities. Heart and thoracic aorta can be wounded simultaneously and by similar mechanisms. Myocardial contusion means autoptic or intraoperative finding of necrotic myocardium as a consequence of trauma. The term blunt cardiac injury with description of the anatomic, functional or electrocardiographic abnormality is recommended for the clinical use. Blunt injury may affect any part of the heart and thoracic aorta, most frequently the right ventricle and aortic isthmus. While diagnosis and treatment of serious injury of the heart seems unequivocal, there is no agreement about the appropriate duration and intensity of monitoring, the use of echocardiography and about the assessment of myocardial markers in stable patients with blunt chest injury.

Submaximal exercise in healthy volunteers: the relationship between gastric mucosal and systemic energy status.

The effect of exercise on gastric mucosal energy status has not been fully elucidated. The aim of this study was to evaluate the impact of submaximal cycling on gastric mucosal energy balance and its relationship to changes in systemic energy status. Ten healthy volunteers (age 20-40 years) were investigated at rest (BL), during 30 min of submaximal exercise (E) on bicycle ergometry and during the 30 min after the completion of cycling. Gastric mucosal PCO(2) ( P(gm)CO(2)) was measured by air tonometry at 10-min intervals and the gastric mucosal-arterial PCO(2) difference ( PCO(2)gap) was calculated. Hemodynamics, arterial blood gases, lactate and pyruvate were also measured. PCO(2)gap significantly increased throughout exercise [BL: 0.2 kPa (median), -0.1-0.6 kPa (25th-75th percentiles); E(10 min): 1.0 kPa, 0.8-1.7 kPa; E(20 min): 1.35 kPa, 0.8-1.8 kPa; E(30 min): 1.5 kPa, 0.9-2.0 kPa]. The early changes in PCO(2)gap ( PCO(2)gap at E(10 min) minus PCO(2)gap at BL) correlated significantly and positively with corresponding changes in arterial lactate ( r(2)=0.58, P<0.05) and lactate-to-pyruvate ratio ( r(2)=0.72, P<0.05). On recovery, all metabolic parameters normalized within 30 min. We conclude that submaximal cycling in volunteers leads to the early derangement of gastric mucosal energy balance. The time course of PCO(2)gap parallels changes in systemic energy status.

Effects of the T-type calcium channel blockade with oral mibefradil on the electrophysiologic properties of the human heart.

BACKGROUND: As the calcium T-channel blockade is a new pharmacological category with presumably unique electrophysiological effects, the influence of its only representative yet mibefradil was tested after the single oral dose. MATERIAL AND METHODS: 10 patients underwent the electrophysiologic examination. Normal baseline values in sinus node cycle length (SNCL), sinus node recovery time (SNRT), corrected sinus node recovery time (CSNRT), PA interval, atrial effective refractory period, AH interval, Wenckebach point (WP), atrioventricular nodal refractory period, and HV interval were measured using standard techniques. After that a single dose of 100 mg mibefradil was given and the testing repeated in 90 minutes. RESULTS: Though non-significantly in a study-group limited in size due to global withdrawal of mibefradil, sinus node automaticity was suppressed (prolongation of SNRT by 5.1% and CSNRT by 11.5%) and heart rate lowered (SNCL prolonged by 2.8%) comparatively more than was the negative dromotropic effect on the atrioventricular node (negligible prolongation of AH interval by 1.1% and WP cycle by 0.4%). CONCLUSIONS: Demonstrated electrophysiological effects of oral mibefradil with more pronounced influence on the automaticity of the sinus node seem to be in agreement with the preclinical data on the predominant role of T-channels in the pacemaker activity of the sinus node. According to the Framingham data on the risk of heart rate for the cardiovascular as well as all-cause mortality, calcium T-channel blockade offers a desirable profile for antihypertensive treatment. From this point of view development of new representatives of calcium T-channel blockers could be a useful contribution to clinical practice.

[Antiphospholipid syndrome and vascular disease]. / Antifosfolipidový syndrom a vaskulární nemoc.

The antiphospholipid syndrome is a rare disease causing recurring arterial and/or venous thromboses at various sites with the first manifestations at a young age. A case report of a 46-year old man with the first venous system manifestations at the age of 19 before description of the syndrome in literature, is presented. The diagnosis was made when he was 44 years old. Bilateral stenoses in the carotid region and a rare manifestation of renal arteries involvement with renovascular hypertension developed. Critical stenosis of the left renal artery resulted in an afunctional left kidney, significant stenosis of the right renal artery was treated by angioplasty and stent implantation. The patient status stabilized only after intensive anticoagulant treatment with warfarin.

[Echocardiographic findings in cerebrovascular accidents]. / Echokardiografické nálezy u cévních mozkových príhod.

The authors present a review on the frequency and causes of cardiogenic systemic embolism and on the influence of damage of the central nervous system on the heart muscle. 10-20% of ischaemic cerebrovascular attacks are of cardioembolic origin. In patients with chronic atrial fibrillation the risk of a cerebrovascular attack is six times higher than in the corresponding population with a sinus rhythm. Views on the preventive administration of anticoagulants differ so far. In extensive myocardial infarctions of the anterior wall thrombi in the left ventricle are present in 30-40%. Thrombolytic treatment affects their formation; so far it is not clear whether it reduces the risk of embolization. With technical advances in echocardiography, and in particular transoesophageal echocardiography, attention is focused on abnormal findings in patients with cerebrovascular attacks without manifest heart disease. Most frequently in these patients a prolapse of the mitral valve is found, a foramen ovale patents, an aneurysm of the atrial septum, sometimes thrombi in the left auricula atrialis of an otherwise quite normal heart. A rare finding are cardiac tumours, systemic embolism being frequently their first clinical manifestation. An indicator of high risk of thromboembolism is probably a spontaneous echo contrast in the left atrium, detected reliably only from an oesophageal approach. In the second part the authors summarize contemporary knowledge on the effect of damage of the central nervous system on cardiac action. Cerebral injury or haemorrhage accompany kinetic disorders of the left ventricle of varying impact. Myocardial damage is caused by a high catecholamine level and can be prevented by administration of beta blockers.(ABSTRACT TRUNCATED AT 250 WORDS)