{"id":43689,"date":"2023-11-15T06:42:32","date_gmt":"2023-11-15T05:42:32","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=43689"},"modified":"2023-11-15T06:42:33","modified_gmt":"2023-11-15T05:42:33","slug":"na-selhani-srdce-upozorni-rychly-test-z-krve","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=43689","title":{"rendered":"Na selh\u00e1n\u00ed srdce upozorn\u00ed rychl\u00fd test z\u00a0krve"},"content":{"rendered":"\n

U\u017e z\u00a0mal\u00e9ho vzorku krve mohou l\u00e9ka\u0159i zjistit, jestli za zdravotn\u00edmi pot\u00ed\u017eemi jejich pacient\u016f ne\u010d\u00edh\u00e1 srde\u010dn\u00ed selh\u00e1n\u00ed. Pokud toti\u017e tento \u017eivotn\u011b d\u016fle\u017eit\u00fd org\u00e1n nen\u00ed v\u00a0po\u0159\u00e1dku, za\u010dne produkovat specifick\u00fd hormon. Zv\u00fd\u0161en\u00e1 p\u0159\u00edtomnost tohoto hormonu v\u00a0krvi znamen\u00e1, \u017ee \u010dlov\u011bk s\u00a0velkou pravd\u011bpodobnost\u00ed trp\u00ed srde\u010dn\u00edm selh\u00e1n\u00edm. Test m\u016f\u017ee nyn\u00ed prov\u00e9st praktick\u00fd l\u00e9ka\u0159, internista a kardiolog, a to rovnou u sebe v\u00a0ordinaci nebo s\u00a0pomoc\u00ed extern\u00ed laborato\u0159e. V\u00a0\u010cesku trp\u00ed selh\u00e1n\u00edm srdce statis\u00edce lid\u00ed, des\u00edtky procent o tom nev\u00ed.<\/strong><\/p>\n\n\n\n

\u201eTestov\u00e1n\u00ed markeru je jednoduch\u00e9 a praktick\u00e9 ve chv\u00edli, kdy je t\u0159eba rychle potvrdit, nebo vylou\u010dit, jestli za pot\u00ed\u017ee pacienta nem\u016f\u017ee pr\u00e1v\u011b srde\u010dn\u00ed selh\u00e1n\u00ed. Pokud je hodnota ozna\u010duj\u00edc\u00ed p\u0159\u00edtomnost hormonu zvan\u00e9ho mozkov\u00fd natriuretick\u00fd peptid (BNP) <\/em>v krevn\u00ed plazm\u011b vysok\u00e1, pak je t\u0159eba poslat pacienta k n\u00e1m-specialist\u016fm pro dal\u0161\u00ed vy\u0161et\u0159en\u00ed a p\u0159\u00edpadn\u00e9 nasazen\u00ed l\u00e9\u010dby,\u201c <\/em>vysv\u011btluje prof. MUDr. Ale\u0161 Linhart, DrSc., FESC, p\u0159ednosta II. intern\u00ed kliniky kardiologie a angiologie VFN v Praze.<\/p>\n\n\n\n

K\u00a0testov\u00e1n\u00ed hormonu (peptidu NT-proBNP)p\u0159istupuj\u00ed prakti\u010dt\u00ed l\u00e9ka\u0159i ve chv\u00edli, kdy si pacient st\u011b\u017euje na \u0161patn\u00e9 d\u00fdch\u00e1n\u00ed, otoky nohou a je unaven\u00fd. \u201eNa srde\u010dn\u00ed selh\u00e1n\u00ed mus\u00edme myslet nap\u0159\u00edklad u pacient\u016f s\u00a0cukrovkou, vysok\u00fdm krevn\u00edm tlakem nebo s\u00a0chronick\u00fdm onemocn\u011bn\u00edm ledvin a tak\u00e9 u ob\u00e9zn\u00edch. Stanoven\u00ed hladiny peptidu v\u00a0krvi n\u00e1m pom\u00e1h\u00e1 p\u0159i diferenci\u00e1ln\u00ed diagnostice, kdy pot\u0159ebujeme rychle ur\u010dit, co na\u0161eho pacienta tr\u00e1p\u00ed. \u0158ada praktick\u00fdch l\u00e9ka\u0159\u016f u\u017e m\u00e1 v\u00a0ordinaci p\u0159\u00edstroj, s\u00a0jeho\u017e pomoc\u00ed lze <\/em>NT-proBNP zm\u011b\u0159it hned na m\u00edst\u011b, u p\u0159\u00edstroje je ale nutn\u00e9 prov\u00e1d\u011bt pravideln\u011b kontrolu kvality testov\u00e1n\u00ed,\u201c<\/em> upozor\u0148uje praktick\u00e1 l\u00e9ka\u0159ka a \u010dlenka v\u00fdboru Spole\u010dnosti v\u0161eobecn\u00e9ho l\u00e9ka\u0159stv\u00ed MUDr. Ludmila Bezd\u00ed\u010dkov\u00e1. P\u0159ipom\u00edn\u00e1, \u017ee pokud praktik pos\u00edl\u00e1 pacienta kv\u016fli\u00a0podez\u0159en\u00ed na srde\u010dn\u00ed selh\u00e1n\u00ed ke kardiologovi, m\u011bl by do zpr\u00e1vy nam\u011b\u0159en\u00e9 hodnoty NT-proBNP zaznamenat, aby z t\u011bchto v\u00fdsledk\u016f mohl vych\u00e1zet. <\/p>\n\n\n\n

Hodnotu hormonu v\u00a0krvi m\u016f\u017ee podle prof. Linharta zkreslit i obezita. \u201eRozhodn\u011b v\u0161ak plat\u00ed, \u017ee vysok\u00e9 hodnoty peptidu zna\u010d\u00ed vysok\u00e9 riziko srde\u010dn\u00edho selh\u00e1n\u00ed. Pacient by m\u011bl podstoupit dal\u0161\u00ed vy\u0161et\u0159en\u00ed srdce, nap\u0159\u00edklad ultrazvuk, abychom p\u0159i\u0161li na p\u0159esnou p\u0159\u00ed\u010dinu jeho obt\u00ed\u017e\u00ed a podle toho mu nasadili spr\u00e1vn\u00e9 l\u00e9ky. Jsme pro, aby se m\u011b\u0159en\u00ed prov\u00e1d\u011blo \u010dast\u011bji ne\u017e doposud, proto\u017ee m\u016f\u017ee p\u0159isp\u011bt k\u00a0odhalen\u00ed srde\u010dn\u00edho selh\u00e1n\u00ed tam, kde se skr\u00fdv\u00e1 za jin\u00e9 nemoci typu \u00fanavov\u00fd syndrom nebo diabetes. Krom\u011b n\u00e1s \u2013 praktik\u016f a internist\u016f \u2013 bychom uv\u00edtali, aby jej mohli prov\u00e1d\u011bt i diabetologov\u00e9 pr\u00e1v\u011b kv\u016fli tomu, \u017ee srde\u010dn\u00ed selh\u00e1n\u00ed cukrovku 2. typu \u010dasto prov\u00e1z\u00ed,\u201c<\/em> dopl\u0148uje prof. Linhart.<\/p>\n\n\n\n

Test z krve m\u016f\u017ee l\u00e9ka\u0159\u016fm nazna\u010dit, zda je \u010dlov\u011bk, kter\u00fd u\u017e se se srde\u010dn\u00edm selh\u00e1n\u00edm l\u00e9\u010d\u00ed, kompenzovan\u00fd, tedy jestli l\u00e9\u010dba zab\u00edr\u00e1, jak m\u00e1. Pokud by to tak nebylo, hodnoty peptidu \u201esko\u010d\u00ed\u201c nahoru. \u201eTakov\u00e9 pacienty um\u00edme sledovat, a uvolnit tak specialist\u016fm ruce pro \u0159e\u0161en\u00ed komplikovan\u00fdch p\u0159\u00edpad\u016f. A tak\u00e9 samotn\u00fdm pacient\u016fm usnadnit p\u0159\u00edstup ke zdravotn\u00ed p\u00e9\u010di,\u201c<\/em> dod\u00e1v\u00e1 MUDr. Bezd\u00ed\u010dkov\u00e1.<\/p>\n\n\n\n

<\/a> M\u011b\u0159en\u00ed peptidu z krve by se m\u011blo dostat i do pr\u00e1v\u011b tvo\u0159en\u00e9ho N\u00e1rodn\u00edho kardiovaskul\u00e1rn\u00edho pl\u00e1nu. \u201ePracujeme na tom, aby se test NT-pro BNP stal standardn\u00ed sou\u010d\u00e1st\u00ed laboratorn\u00edch odb\u011br\u016f prov\u00e1d\u011bn\u00fdch p\u0159i preventivn\u00ed prohl\u00eddce v\u0161em pacient\u016fm od 55 let a rizikov\u00fdm jedinc\u016fm, zejm\u00e9na ku\u0159\u00e1k\u016fm s d\u00fdchac\u00edmi probl\u00e9my a ob\u00e9zn\u00edm, u\u017e ve v\u011bku mlad\u0161\u00edm,\u201c<\/em> \u0159\u00edk\u00e1 p\u0159edseda Sdru\u017een\u00ed praktick\u00fdch l\u00e9ka\u0159\u016f MUDr. Petr \u0160onka.<\/p>\n\n\n\n

Vysok\u00e1 hodnota natriuretick\u00e9ho peptidu z\u00e1rove\u0148 m\u016f\u017ee poukazovat na plicn\u00ed hypertenzi, chronickou bronchitidu, astma nebo na nemocn\u00e9 ledviny \u2013 proto je t\u0159eba p\u0159\u00ed\u010dinu \u0159\u00e1dn\u011b vy\u0161et\u0159it odborn\u00edkem.<\/p>\n\n\n\n

Choroby srdce jsou nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou \u00famrt\u00ed v \u010cesku, v p\u0159\u00edpad\u011b srde\u010dn\u00edho selh\u00e1n\u00ed experti p\u0159esn\u00fd po\u010det pacient\u016f neznaj\u00ed, nicm\u00e9n\u011b v\u00fdskyt odhaduj\u00ed na 3 % populace. Ka\u017edoro\u010dn\u011b dal\u0161\u00edch asi 40 000 nemocn\u00fdch p\u0159ibude. P\u0159ibli\u017en\u011b 50 % pacient\u016f se srde\u010dn\u00edm selh\u00e1n\u00edm do 5 let po diagn\u00f3ze zem\u0159e. Selh\u00e1n\u00ed srdce je \u010dasto spojeno i s jin\u00fdmi chorobami, jako jsou diabetes 2. typu a onemocn\u011bn\u00ed ledvin. Kardiologov\u00e9 maj\u00ed k dispozici \u0159adu modern\u00edch l\u00e9\u010debn\u00fdch postup\u016f a l\u00e9k\u016f, nap\u0159\u00edklad tzv. glifloziny, kter\u00e9 postup nemoci zpomaluj\u00ed a sni\u017euj\u00ed riziko toho, \u017ee pacient bude muset pro zhor\u0161en\u00ed srde\u010dn\u00ed \u010dinnosti do nemocnice.<\/p>\n\n\n\n

O srde\u010dn\u00edm selh\u00e1n\u00ed:<\/strong><\/p>\n\n\n\n

Srde\u010dn\u00ed selh\u00e1n\u00ed postihuje v\u00edce ne\u017e 60 milion\u016f lid\u00ed na cel\u00e9m sv\u011bt\u011b, v \u010cR je nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou hospitalizace. V p\u0159\u00ed\u0161t\u00edch 25 letech lze dle odborn\u00edk\u016f o\u010dek\u00e1vat 50% n\u00e1r\u016fst hospitalizac\u00ed pro srde\u010dn\u00ed selh\u00e1n\u00ed. Obecn\u011b kardiologov\u00e9 odhaduj\u00ed, \u017ee do roku 2030 se bude v \u010cesku l\u00e9\u010dit asi 450 000 nemocn\u00fdch s touto diagn\u00f3zou. Mezi nej\u010dast\u011bj\u0161\u00ed p\u0159\u00edznaky srde\u010dn\u00edho selh\u00e1n\u00ed pat\u0159\u00ed du\u0161nost, otoky nohou a \u00fanava. V\u00edce informac\u00ed najdete na www.srdcedycha.cz<\/em><\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

U\u017e z\u00a0mal\u00e9ho vzorku krve mohou l\u00e9ka\u0159i zjistit, jestli za zdravotn\u00edmi pot\u00ed\u017eemi jejich pacient\u016f ne\u010d\u00edh\u00e1 srde\u010dn\u00ed selh\u00e1n\u00ed. Pokud toti\u017e tento \u017eivotn\u011b d\u016fle\u017eit\u00fd org\u00e1n nen\u00ed v\u00a0po\u0159\u00e1dku, za\u010dne […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":29445,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-43689","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/43689","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=43689"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/43689\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/29445"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=43689"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=43689"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=43689"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}