Quantitative ballistocardiography (Q-BCG) for measurement of cardiovascular dynamics.

In the seventies of the past century ballistocardiography had been thought to be obsolete in cardiology for impossibility of objective calibration. In the present work the quantitative ballistocardiography (Q-BCG) for measurement of systolic force (F) and minute cardiac force (MF) in sitting subject was described. The new principle of piezoelectric transducer enabled to register the force caused by the heart and blood movement, which was not measured before. The calibration proved that the action of the force on the transducer was expressed quantitatively without the amplitude-, time-, and phase deformation. The close relationship of skeletal muscle force and F was proved. The F and MF changed under different physiological conditions (age, partial pressure of oxygen, body weight, skeletal muscle force). It was shown that the systolic force (F) and minute cardiac force (MF) are the physiological parameters neurohumorally regulated similarly as the heart rate or systolic volume.

New clearance evaluation method for hepatological diagnostics.

Pulse dye densitometry (PDD) enables the evaluation of hemodynamic state as well as liver function. A repeated examination, even after a short pause (or under stress condition), enables to follow safely the dynamics of liver pathology. From presented parameters we have evaluated as reliable the C5-clearance, an expression of equilibrium state in the two compartment liver system. Furthermore, T-index expresses ratio of C5 value to cardiac output, it is a sensitive indicator of the blood pole, i.e. sinusoidal uptake, which is in very good correlation with staging of hepatopathies. The isolated h constant in correlation to T-index is valuable For functional grading. The Japanese automatic analyzer of indocyanine green (ICG) dilution and elimination curves, after incorporation of a two compartment mathematical model, becomes more useful for complex hepatological diagnostics. Non-invasive PDD is becoming of uppermost importance to clinical interest, yielding comparable results as other complicated and invasive examinations and may be, therefore, repeated in short time intervals for different indications with minimal stress of examined patient.

[The role and importance of ambulatory monitoring of blood pressure in the diagnosis, control and therapy of hypertension]. / Místo a význam ambulantního monitorování krevního tlaku v diagnostice, kontrole a terapii hypertenze.

For the diagnosis, control and treatment of hypertension for non-invasive assessment of the blood pressure at present a combination of three methods is used. Clinical assessment (by a physician in the surgery or in bed in bedridden patients) is the basic approach, if necessary supplemented by assessment at home and/or ambulatory monitoring of the blood pressure. Twenty-four-hour ambulatory monitoring can provide representative blood pressure readings. It furnishes information which cannot be obtained in another way; if correctly indicated and the results are used in practice, it is effective and economical. It permits evaluation of the blood pressure response to physical and emotional activity in the course of the day, to assess changes of blood pressure during sleep and to define the prognosis of the disease more accurately. It makes it possible to establish a correct indication of medicamentous therapy, selection of effective drugs and correct timing of the doses. In the submitted paper the authors describe also the limitations of the method as well as possible complications during implementation. Long-term monitoring of the blood pressure should resolve special problems in selected groups of patients. In indicated cases it should be available also in this country and introduced to an appropriate extent also in selected departments concerned with hypertensiology.

[The importance of 201Tl scintigraphy in stress tests for the diagnosis of silent myocardial ischemia]. / Význam 201Tl scintigrafie pri zátezi pro diagnózu nemé ischémie myokardu.

Using thallium scintigraphy after a load (LTS), the authors tested suspected silent myocardial ischaemia (SIM) in subjects without angina pectoris. They examined 21 active pilots suspected of SIM after a previous ECG loading test (LET) and 33 patients with diabetes type I and II. In six pilots (28.6%) they found on LTS accumulation defects suggesting ischaemic disorders of the large coronary arteries. All except one had during submaximal load during LTS obvious depression of the ST segment on the ECG. Except one, in another five pilots small depressions of the ST segment were associated with normal LTS. Twelve diabetic patients (36.4%) had obvious minor accumulation defects on LTS. Only two had on the ECG a ST depression under 2 mm during LTS. Based on data in the literature suggesting a higher sensitivity and specificity of LTS, as compared with LET and the possibility of a false positive diagnosis of SIM from LET alone, the authors recommend when SIM is suspected to use also LTS. A more detailed diagnosis of SIM is essential not only with regard to the assessment of work capacity but also for the long-term follow-up of patients with SIM for assessment of its incidence, impact and prognosis in our population.