Both, severe hypo- or hyperthyroidism may alter hemodynamic parameters. The aim of our study was to ascertain, whether also distinct changes within normal range of free thyroxine (fT4) would be associated with an impairment of left ventricle function in patients with chronic heart failure. Hundred-forty-eight patients (m121, f27, mean age 63.8±1.14 years) with chronic heart failure, fT4 levels within the normal range (9-22 pmol/l) and without thyrostatics or substitution treatment. Degree of heart failure was quantified by plasma B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP). Patients with fT4 in the range 11.9-14.6 pmol/l [optimal, 2nd-3th quintile] had significantly lower NT-proBNP (718±70.4 pg/ml), than those with fT4<11.8 [low-normal, bottom quintile](1236±223.6 pg/ml; p<0.03) and those with fT4 over 14.6 pmol/l [high-normal, top two quintiles] (1192±114.9 pg/ml; p<0.0002). These differences remain significant, also if adjusted for age, gender and other confounders; adjusted odds ratio was 1.30 (1.05-1.59) for optimal vs. low-normal and 1.27 (1.04-1.55) for optimal vs. high-normal. Similar statistical differences were also found in BNP, but only when optimal and high-normal fT4 ranges were compared. In conclusion, the severity of heart failure seems to be also influenced by only mild deviations of fT4 concentrations from optimal levels., O. Mayer Jr, J. Šimon, J. Čech, H. Rosolová, J. Hrbková, R. Pikner, L. Trefil., and Obsahuje bibliografii a bibliografické údaje
In this study we compared the levels of interleukin (IL)-6, IL-8, IL-10 and tumor necrosis factor-α (TNF-α) in population samples characterized by a high or low level of self-reported depression. We measured serum IL-6, IL-8, IL-10 and TNF-α in two cohorts which differed in scoring on the Zung Self-Rating Depression Scale (ZSDS). The group with a high score in ZSDS (average SDS index = 62.9) was called DEP (n=27), the group with a low score in ZSDS (average SDS index = 29.9) was called NDEP (n=16). The groups did not significantly differ in age, waist circumference and body mass index. For the assessment of serum cytokine levels multiplex immunoanalytic xMAP(LUMINEX) technology was used. We found lower IL-6 in the DEP group (medians; DEP 4.08 pg/ml vs. NDEP 6.11 pg/ml) on the border of statistical significance in multiple regression analysis (p=0.049). Serum levels of all other studied cytokines were not significantly different (medians; IL-8: DEP 2.18 pg/ml vs. NDEP 2.61 pg/ml; IL-10: DEP 2.85 pg/ml vs. NDEP 2.94 pg/ml; TNF-α: DEP 2.32 pg/ml vs. NDEP 2.30 pg/ml). These results are in contradiction to the prevailing opinion that proinflammatory cytokine levels are elevated in people with symptoms of depression. and Obsahuje bibliografii a bibliografické odkazy
Cardiovascular (CV) mortality was reduced more than 50 % in the Czech population at the turn of the century, due to an improvement of major CV risk factors in the general population, interventional procedures implemented into the treatment of acute coronar y events, and new drugs (ACE inhibitors, statins etc.) for CV prevention (Czech MONICA and post-MONICA studies, 1985-2008). An insufficient level of preventive efforts is described in the Czech patients after acute coronary syndrome (Czech part of the EURO ASPIRE studies, 1995-2013). Drug underdosing and wrong patients’ compliance to life style and drug therapy recommendations represent two main reasons of this unsatisfactory situation. The residual vascular risk of patients with stable coronary heart diseas e (CHD) is still high due to a poor control of conventional risk factors on the one hand, and due to increasing weight and glucose metabolism abnormalities on the other hand. Patients with insulin resistance and glucose dis orders have more frequently non-LDL-C dyslipidemia (atherogenic dyslipidemia), hypertriglyceridemic waist and high atherogenic index of plasma (AIP>0.24), i.e. markers of residual CV risk. Among others increased dose of statins and combined lipid modifying therapy should be implemented in patients with CHD, diabetes or metabolic syndrome., H. Rosolová, B. Nussbaumerová, O. Mayer Jr., R. Cífková, J. Bruthans., and Obsahuje bibliografii
Mild hyperhomocysteinemia has been established as a new independent risk factor for atherosclerosis and thrombosis. The metabolic syndrome of insulin resistance is associated with a high risk of coronary heart disease. Our objective was to determine if any relationship exists between the metabolic syndrome of insulin resistance in non-diabetic subjects and total serum homocysteine levels. Sixty-six healthy volunteers (33 males and 33 females) were selected from the population of Pilsen. Insulin resistance was measured by the Insulin Suppression Test using Octreotide. Steady-state plasma glucose concentrations at the end of the test period provided a quantitative measure of insulin resistance. Serum homocysteine level was estimated by high-pressure liquid chromatography. Serum folate and vitamin B12 were estimated using commercial kits on an Abbott IMx analyzer. All other laboratory tests were performed by standard methods in a routine biochemical laboratory. Subjects with the highest tertile of steady-state plasma glucose showed a significantly higher body mass index, blood pressure, fasting plasma triglyceride levels, plasminogen activator inhibitor-1 and lower HDL-cholesterol, i.e. an insulin resistance pattern. These subjects had significantly lower serum homocysteine levels compared with non-insulin resistant subjects. The negative association of insulin resistance and serum homocysteine was unexpected. The contribution of plasma folate levels to serum homocysteine levels and serum creatinine was significantly negative and positive, respectively., H. Rosolová, J. Šimon, O. Mayer Jr., J. Racek, T. Dierzé, D. W. Jacobsen., and Obsahuje bibliografii