A vascularis intervenciókat követő restenosis vizsgálata klinikai és kísérletes tanulmányokban

Restenosis following endovascular interventions is the main limitation of their long-term success. The incidence of restenosis varies according to the method (stenting, endarterectomy) and the treated vascular region, but the pathomechanism and risk factors are similar. The current article reviews of the author's previous studies in this field. In clinical studies, we compared the restenosis rate after carotid artery stenting and carotid endarterectomy. We also analyzed the complement activation profile after these interventions. In another study, we investigated the role of two polymorphisms of the estrogen receptor alpha in the occurrence of carotid restenosis after either carotid artery stenting or carotid endarterectomy. In an animal model of carotid endarterectomy, we studied the role of the nitrite-oxide-cyclic guanosine monophosphate signaling and the effect of the phosphodiesterase-5 inhibitor therapy in neointimal hyperplasia. Our results suggest that higher incidence of restenosis following carotid endarterectomy can be correlated with the more highly expressed complement activation after this type of carotid intervention. Polymorphisms in the estrogen receptor alpha gene could contribute to the restenosis formation, especially in women. Neointimal hyperplasia can be attenuated by increased cyclic guanosine monophosphate signaling

Prevalence of physiological and pathological electrocardiographic fndings in Hungarian athletes

In Hungary, ECG is a keystone of routine athletic screening. Its signifcance is based on simplicity, quickness and high informative value as well as the fact that appearance of pathological ECG signs can precede the formation of structural heart diseases. During screening of healthy athletes, we studied the incidence of athletic ECG changes and pathological ECG abnormalities. METHODS: We performed detailed analysis of 12-lead ECG recordings of asymptomatic elite, non-elite and master athletes and controls. RESULTS: 227 athletes (male: 180, age: 27.2+/-8.7 years) and 89 controls (male: 57, age: 28.1+/-6.8 years) were examined. Benign ECG signs: sinus bradycardia, early repolarization and isolated Voltage criteria of left ventricular hypertrophy were common and more often in athletes compared to controls. Potentially pathological ECG signs: ST- (6.6% vs. 1.1%, p < 0.05) and T-wave (15.0% vs. 5.6%, p < 0.05) changes and signs of pathological left ventricular hypertrophy (5.3% vs. 0%, p < 0.05) occurred more frequently in athletes compared to controls. CONCLUSIONS: Signs of pathological left ventricular hypertrophy and repolarization abnormalities are more often in athletes. No structural heart disease could be verifed in the background of the disorders. However, athletes having pathological ECG should be kept under tight cardiology control. Exact defnition and widespread knowledge of pathological ECG changes is essential in early recognition of high risk athletes

A D-vitamin szerepe a krónikus szívelégtelenség kialakulásában [The role of vitamin D in the development of cardiac failure]

Congestive heart failure is a chronic disease, whose incidence is especially growing in the subpopulation of elderly people. The majority of these patients have vitamin D levels in the insufficient range. Skin synthesis is the most important vitamin D source for humans. Congestive heart failure patients have relatively low outdoor activities. Consequently, a disease-related sedentary lifestyle is an important cause for the insufficient vitamin D status in patients. However, there is an accumulating body of evidence that vitamin D insufficiency plays a role in the etiology and pathogenesis of congestive heart failure. Vitamin D has direct effect on heart cells and indirect effect on the risk factors of the disease. Four major potential mechanisms may be important to explain the direct effects of vitamin D against congestive heart failure: the effect on myocardial contractile function, the regulation of natriuretic hormone secretion, the effect on extracellular matrix remodelling and the regulation of inflammation cytokines. It has been demonstrated that vitamin D has a high impact on congestive heart failure main risk factors as hypertension, renin-angiotensin system malfunction and atherosclerosis. In spite of the robust preclinical data only few clinical observations prove the positive effect of vitamin D on congestive heart failure

A coronariarendszer komputertomográfiás vizsgálata - Országos Plakk Regiszter és Adatbázis (OPeRA)

INTRODUCTION AND AIM: Coronary computer tomography angiography is a unique non-invasive imaging technique with the capability to provide information regarding plaque quantity, burden and structure. A reliable registry is required to use the data of these examinations in research projects. The difficulty is that registries need double data entry simultaneously to the hospital information system. METHOD: Our registry solves this problem through a structured reporting tool, which generates clinical report and stores all data simultaneously. The automatically generated report is based on international guidelines. RESULTS: Between August 1. 2014 and September 1. 2015 we registered the data of 2866 patients. Coronary plaque was observed in 77.03% of the patients, 33.18% of the plaques were calcified. Severe stenosis was present in 13.71% of the patients. CONCLUSIONS: The structured reporting decreases reporting time, eliminates double data entry related errors. Our goal is to initiate a nationwide, unified registry, the National Plaque Registry and Database. Orv. Hetil., 2017, 158(3), 106-110

Cardiac Computed Tomography Radiomics: A Comprehensive Review on Radiomic Techniques

Radiologic images are vast three-dimensional data sets in which each voxel of the underlying volume represents distinct physical measurements of a tissue-dependent characteristic. Advances in technology allow radiologists to image pathologies with unforeseen detail, thereby further increasing the amount of information to be processed. Even though the imaging modalities have advanced greatly, our interpretation of the images has remained essentially unchanged for decades. We have arrived in the era of precision medicine where even slight differences in disease manifestation are seen as potential target points for new intervention strategies. There is a pressing need to improve and expand the interpretation of radiologic images if we wish to keep up with the progress in other diagnostic areas. Radiomics is the process of extracting numerous quantitative features from a given region of interest to create large data sets in which each abnormality is described by hundreds of parameters. From these parameters datamining is used to explore and establish new, meaningful correlations between the variables and the clinical data. Predictive models can be built on the basis of the results, which may broaden our knowledge of diseases and assist clinical decision making. Radiomics is a complex subject that involves the interaction of different disciplines; our objective is to explain commonly used radiomic techniques and review current applications in cardiac computed tomography imaging.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/