Acute effects of swimming aerobic exercise on contractility and intracellular calcium handling in isolated right ventricular cardiomyocytes / Efectos agudos del ejercicio de natación aeróbica sobre la contractilidad y el manejo del calcio intracelular en cardiomiocitos aislados del ventrículo derecho / Efeitos agudos do exercício aeróbio de natação na contratilidade e no transiente de cálcio intracelular em cardiomiócitos isolados do ventrículo direito

Objectives: The acute adjustments on the contractile function and the intracellular calcium (Ca2+) handling in the cardiomyocytes of the right ventricle (RV) after an acute aerobic exercise session are not known. Our aim was to investigate the acute responses of the contractile function and the intracellular Ca2+ handling in isolated RV cardiomyocytes after a swimming exercise session.Methods: Ten-week-old female Wistar rats were randomly allocated into two groups: control (C; n = 5) and exercise (Ex; n = 7). It was performed a swimming exercise session for 30 minutes. with an overload of 4% relative to the body weight attached to the tail. The rats were sacrificed after the exercise session for the analysis of the RV contractile function parameters and the intracellular Ca2+ handling by the isolated cardiomyocyte technique.Results: Body and heart weights, as well as sarcomere length were similar between the groups. Also, it was not observed differences between the groups for RV cardiomyocyte contractile parameters. However, the systolic and diastolic intracellular Ca2+ concentration was significantly lower in the Ex group compared to C with maintenance of Ca2+ amplitude.Conclusion: An acute swimming aerobic exercise session promotes cardiomyocyte contractility maintenance even with systolic and diastolic intracellular Ca2+ concentration reduced in the RV cardiomyocytes, reflecting an improvement in the intracellular Ca2+ handling.(AU)

Objetivos: se desconocen los ajustes agudos de la función contráctil y el manejo del calcio (Ca2+) intracelular en los cardiomiocitos del ventrículo derecho (VD) tras una sesión de ejercicio aeróbico agudo. Nuestro objetivo fue investigar las respuestas agudas de la función contráctil y el manejo del Ca2+ intracelular en cardiomiocitos aislados del VD después de una sesión de ejercicio de natación.Métodos: se asignaron al azar ratas Wistar hembra de diez semanas de edad en dos grupos: control (C; n = 5) y ejercicio (Ex; n = 7). Se realizó una sesión de ejercicios de natación durante 30 minutos con una sobrecarga del 4% con respecto al peso corporal adherido a la cola. Las ratas fueron sacrificadas después de la sesión de ejercicio para el análisis de los parámetros de la función contráctil del VD y el manejo del Ca2+ intracelular mediante la técnica de cardiomiocitos aislados.Resultados: los pesos corporales y cardíacos, así como la longitud del sarcómero, fueron similares entre los grupos. Además, no se observaron diferencias entre los grupos para los parámetros contráctiles de los cardiomiocitos del VD. Sin embargo, la concentración de Ca2+ intracelular sistólica y diastólica fue significativamente menor en el grupo Ex en comparación con C con el mantenimiento de la amplitud de Ca2+.Conclusión: Una sesión de ejercicio aeróbico de natación aguda promueve el mantenimiento de la contractilidad de los cardiomiocitos incluso con una concentración de Ca2+ intracelular sistólica y diastólica reducida en los cardiomiocitos del VD, lo que refleja una mejora en el manejo del Ca2+ intracelular.(AU)

Objetivo: os ajustes agudos na função contrátil e no transiente do cálcio (Ca2+) intracelular nos cardiomiócitos do ventrículo direito (VD) após uma sessão aguda de exercício aeróbio não são conhecidos. Desta forma objetivo foi investigar as respostas agudas da função contrátil e do no transiente Ca2+ intracelular em cardiomiócitos do VD isolados após uma sessão de exercício de natação.Métodos: Ratas Wistar com dez semanas de idade foram alocadas aleatoriamente em dois grupos: controle (C; n = 5) e exercício (Ex; n = 7). Foi realizada uma sessão de exercícios de natação por 30 minutos com uma sobrecarga de 4% em relação ao peso corporal preso à cauda. Os ratos foram sacrificados após a sessão de exercícios para análise dos parâmetros da função contrátil do VD e do transiente Ca2+ intracelular pela técnica de cardiomiócitos isolados.Resultados: Os pesos corporais e cardíacos, bem como o comprimento do sarcômero foram semelhantes entre os grupos. Além disso, não foram observadas diferenças entre os grupos para os parâmetros contráteis dos cardiomiócitos do VD. No entanto, a concentração de Ca2+ intracelular sistólica e diastólica foi significativamente menor no grupo Ex em comparação com C com manutenção da amplitude de Ca2+. Conclusão: Uma sessão aguda de exercício aeróbio de natação promove a manutenção da contratilidade dos cardiomiócitos mesmo com a concentração intracelular de Ca2+ sistólica e diastólica reduzida nos cardiomiócitos do VD, refletindo uma melhora no manuseio do Ca2+ intracelular.(AU)

Primera experiencia en España de la modulación de la contractilidad cardiaca. Una nueva alternativa para los pacientes con insuficiencia cardiaca / First experience in Spain of cardiac contractility modulation. A new alternative for patients with heart failure

No disponible

Residual effects of mental fatigue on subjective fatigue, reaction time and cardiac responses / Efectos residuales de la fatiga mental en la fatiga subjetiva, tiempo de reacción y respuestas cardíacas / Efeitos residuais da fadiga mental na fadiga subjetiva, tempo de reação e respostas cardíacas

This study investigated the residual effects of mental fatigue induced by the 30-minute incongruent Stroop Color Word task on subjectively perceived fatigue, reaction time, and heart rate variability (HRV) in 20 adult volunteers (10 men; 10 women). Dependent variables were assessed before, immediately after, and at 15, 30, 45, and 60 minutes after two conditions: (a) a 30-minute incongruent Stroop Color Word task (mental fatigue condition); or (b) a 30-minute control condition. At pre-testing, there were no significant differences between experimental conditions for any variable. However, there was a residual effect of mental fatigue on psychological responses for up to ~15 minutes after the experimental manipulation (p < 0.01). For the reaction time task, significant differences were observed only immediately after the mental fatigue, compared to the control condition (p < 0.0001). There were no significant differences between experimental conditions for any parameters of HRV at any testing period. In addition, there were no significant gender related differences at any period or in either condition for any variable. The data suggest that mental fatigue can alter psychological responses for up to ~15 min after its induction, and mental fatigue may impair cognitive reaction time performance without changing autonomic cardiac responses

Este estudio investigó los efectos residuales de la fatiga mental inducidos por 30 minutos Test de Stroop con palabra con color incongruente sobre la fatiga percibida subjetivamente, el tiempo de reacción y la variabilidad de la frecuencia cardíaca (HRV) en 20 voluntarios adultos (10 hombres, 10 mujeres). Las variables dependientes se evaluaron antes, inmediatamente después y a los 15, 30, 45 y 60 minutos después de dos condiciones: (a) Test de Stroop con palabra con color incongruente de 30 minutos (condición de fatiga mental); o (b) condición de control de 30 minutos. En la pre condiciones, no hubo diferencias significativas entre las condiciones experimentales para ninguna variable. Sin embargo, hubo un efecto residual de la fatiga mental en las respuestas psicológicas durante hasta ~ 15 minutos después de la manipulación experimental (p < 0,01). Para la tarea de tiempo de reacción, se observaron diferencias significativas solo inmediatamente después de la fatiga mental, en comparación con la condición de control (p < 0,0001). No hubo diferencias significativas entre las condiciones experimentales para ningún parámetro de HRV en ningún período. Además, no hubo diferencias significativas relacionadas con el género en ningún período ni en ninguna de las condiciones para ninguna variable. Los datos sugieren que la fatiga mental puede alterar las respuestas psicológicas hasta ~ 15 min después de su inducción, y la fatiga mental puede afectar el rendimiento del tiempo de reacción cognitiva sin cambiar las respuestas cardíacas autónomas

Este estudo investigou os efeitos residuais da fadiga mental induzida por 30 minutos do teste de Stroop com a palavra de cor incongruente na fadiga percebida de maneira subjetiva, tempo de reação e variabilidade da frequência cardíaca (VFC) em 20 voluntários adultos (10 homens; 10 mulheres). As variáveis dependentes foram avaliadas antes, imediatamente após e aos 15, 30, 45 e 60 minutos após duas condições: (a) teste de Stroop com a palavra de cor incongruente de 30 minutos (condição fadiga mental); ou (b) uma condição controle de 30 minutos. No pré-teste, não houve diferenças significativas entre as condições experimentais para qualquer variável. No entanto, houve um efeito residual da fadiga mental nas respostas psicológicas por até ~ 15 minutos após a manipulação experimental (p <0,01). Para o teste de tempo de reação, foram observadas diferenças significativas apenas imediatamente após a fadiga mental, em comparação com a condição controle (p <0,0001). Não houve diferenças significativas entre as condições experimentais para quaisquer parâmetros da VFC em qualquer período. Além disso, não houve diferenças significativas relacionadas ao gênero em qualquer período ou em qualquer condição para qualquer variável. Os dados sugerem que a fadiga mental pode alterar as respostas psicológicas por até 15 minutos após sua indução, e a fadiga mental pode prejudicar o desempenho cognitivo pela piora tempo de reação sem alterar as respostas autonômicas cardíacas

Recomendaciones de fluidoterapia perioperatoria para la cirugía abdominal mayor. Revisión de las recomendaciones de la Vía RICA. Parte III: terapia hemodinámica guiada por objetivos. Fundamento para el mantenimiento del tono vascular y la contractilidad / Fluid therapy recommendations for major abdominal surgery. Via RICA recommendations revisited. Part III: goal directed hemodynamic therapy. Rationale for maintaining vascular tone and contractility

No disponible

The effects of verapamil and its combinations with glutamate and glycine on cardiodynamics, coronary flow and oxidative stress in isolated rat heart

The role of N-methyl-D-aspartate receptor (NMDA-R) in heart is still unclear. For these ionotropic glutamate receptors is characteristic the necessity of both co-agonists, glutamate and glycine, for their activation, which primarily allows influx of calcium. The aim of the present study was to examine the effects of verapamil, as a calcium channel blocker, alone and its combination with glycine and/or glutamate on cardiac function, coronary flow, and oxidative stress in isolated rat heart or to examine the effects of potential activation of NMDA-R in isolated rat heart. The hearts of male Wistar albino rats were excised and perfused according to Langendorff technique, and cardiodynamic parameters and coronary flow were determined during the administration of verapamil and its combinations with glutamate and/or glycine. The oxidative stress biomarkers, including thiobarbituric acid-reactive substances, nitrites, superoxide anion radical, and hydrogen peroxide, were each determined spectrophotometrically from coronary venous effluent. The greatest decline in parameters of cardiac contractility and systolic pressure was in the group that was treated with verapamil only, while minimal changes were observed in group treated with all three tested substances. Also, the largest changes in coronary flow were in the group treated only with verapamil, and at least in the group that received all three tested substances, as well as the largest increase in oxidative stress parameters. Based on the obtained results, it can be concluded that NMDA-R activation allows sufficient influx of calcium to increase myocardial contractility and systolic pressure, as well as short-term increase of oxidative stress (AU)

No disponible

Relación presión/volumen en el laboratorio de ecocardiografía de estrés. ¿Cómo influye el tamaño del ventrículo izquierdo (dimensión diastólica del ventrículo izquierdo)? / Pressure-volume relationship in the stress-echocardiography laboratory: Does (left ventricular end-diastolic) size matter?

Introducción y objetivos: La variación en la relación presión/volumen telesistólica entre el reposo y el estrés máximo es un índice de contractilidad del ventrículo izquierdo independiente de la poscarga. Aún no está claro si depende del volumen telediastólico y hasta qué punto. El objetivo de este estudio es evaluar la dependencia de la variación de la relación presión/volumen telesistólica entre el reposo y estrés (Δ) y el volumen telediastólico en pacientes con ecocardiografía de estrés negativa y con todos los intervalos de función ventricular izquierda en reposo. Métodos: Analizamos los datos interpretables obtenidos de 891 pacientes (593 varones; 63 ± 12 años) con fracción de eyección del 47 ± 12%: 338 pacientes estaban sanos, prácticamente sanos o hipertensos; 229 tenían arteriopatía coronaria y 324, miocardiopatía dilatada isquémica o no isquémica. Se los estudió con ecocardiografía de estrés en ejercicio (n =172), dipiridamol (n = 482) o dobutamina (n = 237). La relación presión/volumen telesistólica se evaluó en reposo y en estrés máximo a partir de una medición bruta de la presión arterial sistólica mediante esfigmógrafo con manguito y el volumen telesistólico, por ecocardiografía bidimensional mediante el método de Simpson biplanar. Resultados: Los valores absolutos de la variación reposo-estrés en la relación presión/volumen telesistólica fueron más altos con ejercicio y dobutamina que con dipiridamol. En la población general, se observó relación inversa entre la relación presión/volumen telesistólica y el volumen telediastólico en reposo (r2 = 0,69; p < 0,001) y en estrés máximo (r2 = 0,56; p < 0,001), pero no se observó esta relación al considerar la variación reposo-estrés de la relación presión/volumen telesistólica (r2 = 0,13). Conclusiones: El volumen telediastólico ventricular izquierdo no afecta a la variación reposo-estrés de la relación presión/volumen telesistólica en ventrículos izquierdos normales o anómalos durante el estrés físico o farmacológico (AU)

Introduction and objectives: The variation between rest and peak stress end-systolic pressure-volume relation is an afterload-independent index of left ventricular contractility. Whether and to what extent it depends on end-diastolic volume remains unclear. The aim of this study was to assess the dependence of the delta rest-stress end-systolic pressure-volume relation on end-diastolic volume in patients with negative stress echo and all ranges of resting left ventricular function. Methods: We analyzed interpretable data obtained in 891 patients (593 men, age 63 ± 12 years) with ejection fraction 47% ± 12%: 338 were normal or near-normal or hypertensive; 229 patients had coronary artery disease; and 324 patients had ischemic or nonischemic dilated cardiomyopathy. They were studied with exercise (n = 172), dipyridamole (n = 482) or dobutamine (n = 237) stress echocardiography. The end-systolic pressure-volume relation was evaluated at rest and peak stress from raw measurement of systolic arterial pressure by cuff sphygmomanometer and end-systolic volume by biplane Simpson rule dimensional echocardiography. Results: Absolute values of delta rest-stress end-systolic pressure-volume relation were higher for exercise and dobutamine than for dipyridamole. In the overall population, an inverse relationship between end-systolic pressure-volume relation and end-diastolic volume was present at rest (r2 = 0.69, P < .001) and peak stress (r2 = 0.56, P < .001), but was absent if the delta rest-stress end-systolic pressure-volume relation was considered (r2 = 0.13). Conclusions: Left ventricular end-diastolic volume does not affect the rest-stress changes in end-systolic pressure-volume relation in either normal or abnormal left ventricles during physical or pharmacological stress (AU)

ECG de noviembre de 2015 / ECG, November 2015

No disponible

Nueva causa de arrastre presistólico: extrasistolia-PR largo / New cause of presystolic drag: long PR extrasystoles

No disponible

Rotura de aneurisma iliaco durante el preacondicionamiento con levosimendán previo a cirugía de revascularización coronaria, ¿fue levosimendán el factor más influyente? / Iliac aneurysm rupture during preconditioning with levosimendan for coronary artery graft, it was levosimendan the most influencing factor?

No disponible

Actualización en el manejo de fármacos vasoactivos en insuficiencia cardiaca aguda y shock cardiogénico y mixto / Update on the use of vasoactive drugs for acute heart failure and cardiogenic and undifferentiated shock

Los fármacos vasoactivos poseen propiedades inotrópicas y vasomotoras. La variabilidad de su respuesta se explica por múltiples factores relacionados con la dosis empleada, la densidad, la afinidad y la selectividad de sus receptores, así como por las complejas vías de señalización. Su indicación no solo debería recaer en un umbral de presión arterial recomendado, sino también en parámetros objetivos de microcirculación. Hasta el momento no se ha demostrado que ningún fármaco vasoactivo aumente la supervivencia, y la crítica más importante es por los graves efectos adversos. Las líneas de investigación se han centrado en la búsqueda de fármacos más selectivos intentando evitar estos efectos adversos y no solo buscando la mejoría sintomática y hemodinámica a corto plazo (AU)

Vasoactive drugs can have inotropic or vasomotor properties or both. Variability in responses to these drugs can be explained by factors related to the dose used, the drugs’ affinity for specific receptors, the density and selectivity of these receptors, and the operation of complex signaling pathways. Indications for their use should not be based solely on recommended blood pressure thresholds but should also take into account objective microcirculatory parameters. To date, no vasoactive drug has been shown to increase survival, and the main criticism of their use is that they produce serious adverse effects. Research has focused on finding more selective compounds that will avoid these adverse effects and has not only sought to achieve short-term improvements in symptoms and hemodynamics (AU)

Mejoría hemodinámica y de la contractilidad con la estimulación multipunto del ventrículo izquierdo en la terapia de resincronización cardiaca / Improvement in Hemodynamics and Contractility With Multipoint Left Ventricular Pacing in Cardiac Resynchronization Therapy

No disponible

Relación entre el estado de gravedad previo y el pronóstico de la parada cardiaca intrahospitalaria / Relationship between previous severity of illness and outcome of in-hospital cardiac arrest

OBJETIVOS: Analizar si el estado de gravedad previo, el láctico, la creatinina y el índice inotrópico se relacionan con la mortalidad de la parada cardiaca (PC) intrahospitalaria en niños y si un índice de predicción pronóstica diseñado para adultos tiene utilidad en pediatría. MÉTODOS: Se estudió a 44 niños de edades entre un mes y 18 años de edad que presentaron una PC en el hospital durante un período de 2 años. Se analizaron la relación entre las puntuaciones de gravedad PRIMS y PELOD, el láctico, la creatinina, el tratamiento previo con fármacos vasoactivos, el índice inotrópico con la recuperación de la circulación espontánea (RCE) y la supervivencia. RESULTADOS: Un 90,3% de los pacientes recuperaron la circulación espontánea y un 59% sobrevivió al alta del hospital. Un 68,2% de los pacientes recibían inotrópicos previos a la PCR. Los pacientes fallecidos presentaban valores de lactato previos a la parada más elevados (3,4 mmol/L) que los supervivientes (1,4 mmol/L), p = 0,04. No existieron diferencias en las puntuaciones de PRISM, PELOD, los valores de creatinina, el tratamiento con inotrópicos, con adrenalina, el número de inotrópicos, o el índice inotrópico antes de la PCR entre fallecidos y supervivientes. CONCLUSIÓN: La elevación de ácido láctico previa a la parada cardiaca puede ser un indicador de mal pronóstico en la PC en los niños

OBJECTIVES: To analyze the relationship between previous severity of illness, lactic acid, creatinine and inotropic index with mortality of in-hospital cardiac arrest (CA) in children, and the value of a prognostic index designed for adults. METHODS: The study included total of 44 children aged from 1 month to 18 years old who suffered a cardiac arrest while in hospital. The relationship between previous severity of illness scores (PRIMS and PELOD), lactic acid, creatinine, treatment with vasoactive drugs, inotropic index with return of spontaneous circulation and survival at hospital discharge was analyzed. RESULTS: The large majority (90.3%) of patients had a return of spontaneous circulation, and 59% survived at hospital discharge. More than two-thirds (68.2%) were treated with inotropic drugs at the time of the CA. The patients who died had a higher lactic acid before the CA (3.4 mmol/L) than survivors (1.4 mmol/L), P=.04. There were no significant differences in PRIMS, PELOD, creatinine, inotropic drugs, and inotropic index before CA between patients who died and survivors. CONCLUSION: A high lactic acid previous to cardiac arrest could be a prognostic factor of in-hospital cardiac arrest in children

Contractile responses to rat urotensin II in resting and depolarized basilar arteries

The effects of human urotensin II (hUII) on the vascular tone of different animal species has been studied extensively. However, little has been reported on the vasoactive effects of rat urotensin (rUII) in murine models. The aim of the present study was to investigate the effects of rUII on vasoreactivity in rat basilar arteries. Basilar arteries from adult male Wistar rats (300-350 g) were isolated, cut in rings, and mounted on a small vessel myograph to measure isometric tension. rUII concentrations were studied in both resting and depolarized state. To remove endothelial nitric oxide effects from the rUII response, we treated selected arterial rings with Nω-nitro-L-arginine methyl ester (L-NAME). 10 μM rUII produced a potent vasoconstrictor response in rat basilar arteries with intact endothelium, while isometric forces remained unaffected in arterial rings treated with lower rUII concentrations. Although L-NAME did not have a significant effect on 10 μM rUII-evoked contraction, it slightly increased arterial ring contraction elicited by 1 μM rUII. In depolarized arteries, dose-dependent rUII increased depolarization-induced contractions. This effect was suppressed by L-NAME. Our results show that the rat basilar artery has a vasoconstrictor response to rUII. The most potent vasoconstrictor effect was produced by lower doses of rUII (0.1 and 1 μM) in depolarized arteries with intact endothelium. This effect could facilitate arterial vasospasm in vascular pathophysiological processes such as subarachnoid hemorrhage and hypertension, when sustained depolarization and L-type Ca2+ channel activation are present

Evaluación de la contractilidad y la poscarga en la unidad de cuidados intensivos / Evaluation of contractility and postloading in the intensive care unit

La inestabilidad hemodinámica y la insuficiencia cardíaca son causas frecuentes de ingreso en la unidad de cuidados intensivos. El estudio de los determinantes de la función cardiovascular, fundamentalmente precarga, poscarga y contractilidad adquieren una importancia crucial en estas situaciones. En este capítulo, se revisarán los conceptos de contractilidad y poscarga, así como sus métodos de evaluación. La tecnología disponible nos permite la combinación de varias técnicas diferentes de monitorización hemodinámica que aportan una información o un enfoque distinto sobre el mismo problema y nos ayudan a evaluar de una manera más precisa las alteraciones de la contractilidad y la poscarga. Esta información es útil para tomar decisiones diagnósticas y terapéuticas que ayuden a mejorar el pronóstico de los pacientes críticos (AU)

Cardiovascular failure is a common disorder in critical care medicine. When admitted to the ICU, patients with hemodynamic deterioration should be examined rapidly to correctly assess the main determinants of cardiovascular function (preload, afterload and contractility). This review examines the assessment of contractility and afterload involving the combined use of several hemodynamic monitors, which allows different approaches to the same problem, with a view to improving the efficiency of management and treatment in critically ill patients (AU)

Prevención del ictus en la fibrilación auricular / Prevention of stroke in atrial fibrillation

No disponible

Insuficiencia cardiaca en un paciente con Wolff-Parkinson-White / Heart failure in a patient with Wolff-Parkinson-White syndrome

No disponible

Age-related regulation of excitation–contraction coupling in rat heart

No disponible

Hearts from subjects with different ages have different Ca2+ signaling. Release of Ca2+ from intracellular stores in response to an action potential initiates cardiac contraction. Both depolarization-stimulated and spontaneous Ca2+ releases, Ca2+ transients and Ca2+ sparks, demonstrate the main events of excitation–contraction coupling (ECC). Global increase in free Ca2+concentration ([Ca2+] i ) consists of summation of Ca2+ release events in cardiomyocytes. Since the Ca2+ flux induced by Ca2+ sparks reports a summation of ryanodine-sensitive Ca2+ release channels (RyR2s)’s behavior in a spark cluster, evaluation of the properties of Ca2+ sparks and Ca2+ transients may provide insight into the role of RyR2s on altered heart function between 3-month-old (young adult) and 6-month-old (mature adult) rats. Basal [Ca2+] i and Ca2+ sparks frequency were significantly higher in mature adult rats compared to those of young adults. Moreover, amplitudes of Ca2+ sparks and Ca2+ transients were significantly smaller in mature adults than those of young adults with longer time courses. A smaller L-type Ca2+ current density and decreased SR Ca2+ load was observed in mature adult rats. In addition, RyR2s were markedly hyperphosphorylated, and phosphorylation levels of PKA and CaMKII were higher in heart from mature adults compared to those of young adults, whereas their SERCA protein levels were similar. Our data demonstrate that hearts from rats with different ages have different Ca2+ signaling including hyperphosphorylation of RyR2s and higher basal [Ca2+] i together with increased oxidized protein-thiols in mature adult rats compared to those of young adults, which play important roles in ECC. Finally, we report that ECC efficiency changes with age during maturation, partially related with an increased cellular oxidation level leading to reduced free protein-thiols in cardiomyocytes (AU)

Conceptos básicos en la terapéutica hemodinámica / Basic concepts of hemodynamic therapeutics

No disponible