RESUMO
A female full-term neonate, accompanied by her parents, was referred to the paediatric surgery department on the day of after birth. She presented with a 9 cm length pathological umbilical cord, of which the first 7 cm was red and wet, with ulceration, necrosis and healing areas. The patient never had a fever. Abdominal palpation showed no umbilical hernia and abdominal Doppler ultrasound was normal. After several days of disinfection, by biseptine antiseptic solution, and a monthly follow-up, most of the umbilical cord fell out. It only remained a 4 cm length navel consisting of 2 cm of excessive skin and 2 cm of mucous tissue. The lesion was surgically excised at 6 months old. The patient was discharged on postoperative day 1. The results of the histology confirmed the diagnosis of an epithelialised umbilical cord. The 1-month follow-up was uneventful.
Assuntos
Cordão Umbilical , Umbigo , Feminino , Recém-Nascido , Criança , Humanos , Lactente , Angiografia , Febre , Testes de Função CardíacaRESUMO
Pulse-wave velocity (PWV) can be used to quantify arterial stiffness, allowing for a diagnosis of this condition. Multi-beam laser-doppler vibrometry offers a cheap, non-invasive and user-friendly alternative to measuring PWV, and its feasibility has been previously demonstrated in the H2020 project CARDIS. The two handpieces of the prototype CARDIS device measure skin displacement above main arteries at two different sites, yielding an estimate of the pulse-transit time (PTT) and, consequently, PWV. The presence of multiple beams (channels) on each handpiece can be used to enhance the underlying signal, improving the quality of the signal for PTT estimation and further analysis. We propose two methods for multi-channel LDV data processing: beamforming and beamforming-driven ICA. Beamforming is done by an SNR-weighted linear combination of the time-aligned channels, where the SNR is blindly estimated from the signal statistics. ICA uses the beamformer to resolve its inherent permutation and scale ambiguities. Both methods yield a single enhanced signal at each handpiece, where spurious peaks in the individual channels as well as stochastic noise are well suppressed in the output. Using the enhanced signals yields individual PTT estimates with a low spread compared to the baseline approach. While the enhancement is introduced in the context of PTT estimation, the approaches can be used to enhance signals in other biomedical applications of multi-channel LDV as well.
Assuntos
Artérias Carótidas , Análise de Onda de Pulso , Artérias Carótidas/diagnóstico por imagem , Ultrassonografia Doppler , Testes de Função Cardíaca , LasersRESUMO
Aim: This study aimed to investigate the preliminary clinical outcomes of microwave ablation (MWA)-assisted surgical treatment for large glioma. Materials and Methods: In total, six cases of large glioma (diameter >4 cm) were described. All cases were treated with MWA-assisted surgical resection, which was performed using ultrasound to guide the accurate placement of the antenna in the central region of the tumor. The MWA power was 40-45 W, and 6 min was applied. Changes in the ablation area were observed using intraoperative Doppler ultrasound and contrast-enhanced ultrasound (CEUS). Ten patients treated with surgical resection alone were included in the control group. Data on surgical times (i.e., the time from the incision of the dura to the removal of the tumor), intraoperative blood loss, and complications were recorded. Results: The median patient age was 45 years (range: 36.5-60.3 years). The median lesion diameter was 4.9 cm (range: 4.3-5.8). The microwave power was 40-45 W, and the median ablation time was 240 s (range: 208-297 s). The intra-tumoral vascular flow was significantly reduced after MWA. The median surgical time was shorter (38.5 min [range: 34.3-42.8 min]) and the median intraoperative blood loss was less (400 mL, [range: 400-450 mL]) in the combination treatment group than in the surgery-alone group. During the ablation process, no obvious additional neurological deficits were detected; however, a tube-shaped carbonide was found after the operation. Conclusion: MWA may be a useful complement to conventional techniques for the surgical resection of large glioma.
Assuntos
Perda Sanguínea Cirúrgica , Glioma , Humanos , Adulto , Pessoa de Meia-Idade , Micro-Ondas/uso terapêutico , Glioma/diagnóstico por imagem , Glioma/cirurgia , Angiografia , Testes de Função CardíacaRESUMO
AIMS: Cardiac reserve is a sensitive tool for early detection of cardiac dysfunction. However, cardiac reserve assessment by catecholamine stress echocardiography in mice varied in the doses of ß-adrenergic agonists and the time point for measurements, which may lead to inaccurate readouts. This study aims to establish a standardized protocol for assessing cardiac reserve in mice. MAIN METHODS: C57BL/6J mice under isoflurane anesthesia were intraperitoneally injected with varying doses of isoproterenol (Iso), and subjected to echocardiographic measurements. KEY FINDINGS: Heart rate (HR), ejection fraction (EF), fractional shortening (FS), global longitudinal strain (GLS) and strain rate all reached peak values within 1-3 min after Iso injection at doses higher than 0.2 mg/kg. Compared with 0.1 mg/kg Iso, 0.2 mg/kg Iso resulted in higher HR, EF, FS and GLS, whereas doses higher than 0.2 mg/kg did not yield further increase. Cardiac response of female mice recapitulated main characteristics of those of male mice except that female mice displayed higher maximum HR and were more sensitive to higher doses of Iso. Furthermore, the advantages of present stress protocol over conventional baseline echocardiographic measurements were verified in comparisons of exercised vs. sedentary and aged vs. young mice for cardiac function evaluation. SIGNIFICANCE: We developed a reproducible and sensitive approach to evaluate cardiac reserve by continuously monitoring cardiac function every minute for 3 min after 0.2 mg/kg Iso injection. This approach will enable detection of subtle cardiac dysfunction and accelerate innovative research in cardiac pathophysiology.
Assuntos
Cardiopatias , Coração , Feminino , Masculino , Animais , Camundongos , Camundongos Endogâmicos C57BL , Coração/diagnóstico por imagem , Ecocardiografia , Testes de Função Cardíaca , Isoproterenol/farmacologiaRESUMO
This study aimed to evaluate the performance of traditional-deep learning combination model based on Doppler ultrasound for diagnosing malignant complex cystic and solid breast nodules. A conventional statistical prediction model based on the ultrasound features and basic clinical information was established. A deep learning prediction model was used to train the training group images and derive the deep learning prediction model. The two models were validated, and their accuracy rates were compared using the data and images of the test group, respectively. A logistic regression method was used to combine the two models to derive a combination diagnostic model and validate it in the test group. The diagnostic performance of each model was represented by the receiver operating characteristic curve and the area under the curve. In the test cohort, the diagnostic efficacy of the deep learning model was better than traditional statistical model, and the combined diagnostic model was better and outperformed the other two models (combination model vs traditional statistical model: AUC: 0.95 > 0.70, P = 0.001; combination model vs deep learning model: AUC: 0.95 > 0.87, P = 0.04). A combination model based on deep learning and ultrasound features has good diagnostic value.
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Aprendizado Profundo , Neoplasias , Humanos , Ultrassonografia , Angiografia , Testes de Função CardíacaRESUMO
Artificial intelligence (AI) has been developed for echocardiography1-3, although it has not yet been tested with blinding and randomization. Here we designed a blinded, randomized non-inferiority clinical trial (ClinicalTrials.gov ID: NCT05140642; no outside funding) of AI versus sonographer initial assessment of left ventricular ejection fraction (LVEF) to evaluate the impact of AI in the interpretation workflow. The primary end point was the change in the LVEF between initial AI or sonographer assessment and final cardiologist assessment, evaluated by the proportion of studies with substantial change (more than 5% change). From 3,769 echocardiographic studies screened, 274 studies were excluded owing to poor image quality. The proportion of studies substantially changed was 16.8% in the AI group and 27.2% in the sonographer group (difference of -10.4%, 95% confidence interval: -13.2% to -7.7%, P < 0.001 for non-inferiority, P < 0.001 for superiority). The mean absolute difference between final cardiologist assessment and independent previous cardiologist assessment was 6.29% in the AI group and 7.23% in the sonographer group (difference of -0.96%, 95% confidence interval: -1.34% to -0.54%, P < 0.001 for superiority). The AI-guided workflow saved time for both sonographers and cardiologists, and cardiologists were not able to distinguish between the initial assessments by AI versus the sonographer (blinding index of 0.088). For patients undergoing echocardiographic quantification of cardiac function, initial assessment of LVEF by AI was non-inferior to assessment by sonographers.
Assuntos
Inteligência Artificial , Cardiologistas , Ecocardiografia , Testes de Função Cardíaca , Humanos , Inteligência Artificial/normas , Ecocardiografia/métodos , Ecocardiografia/normas , Volume Sistólico , Função Ventricular Esquerda , Método Simples-Cego , Fluxo de Trabalho , Reprodutibilidade dos Testes , Testes de Função Cardíaca/métodos , Testes de Função Cardíaca/normasRESUMO
PURPOSE: Cranial autonomic symptoms are typically associated with the trigeminal autonomic cephalalgias and also present in substantial cases of migraine. Autonomic nervous system dysfunctions are also been reported in headache disorders and postulated to promote headache attacks. This study was aimed to evaluate the parasympathetic and sympathetic autonomic functions tests in patients with a episodic primary headache and to investigate, if any, electrophysiological abnormalities in the blink reflex test and sympathetic skin response test in these patients. METHODS: In this cross-sectional study, a total of 100 patients, 50 patients each of migraine and tension-type headache attending the neurology OPD and fulfilling the diagnostic criteria of headache disorders were enrolled. Autonomic functions tests were performed in the Department of Physiology, whereas electrophysiological tests were powered by the Editorial Manager and ProduXion Manager from Aries Systems Corporation performed in the Department of Neurology. RESULTS: Significant association ( P < 0.05) was observed in "blood pressure response to sustained handgrip" (sympathetic activity) and "heart rate response to Valsalva maneuver" (parasympathetic activity) among patients with migraine. Although the mean sympathetic skin response latency of patients with migraine was within the normal range, it was significantly prolonged in comparison with the control group. "Blood pressure response to sustained handgrip" and "heart rate variability" were found to be significantly ( P < 0.05) different in patients with a tension-type headache. The blink reflex test was observed to be normal in all patients with a headache. Patients with migraine showed a significant dysautonomia in category three of the Ewing battery for autonomic functional disability. CONCLUSIONS: Autonomic functional abnormality, both sympathetic and parasympathetic, does exist in patients with a primary episodic headache.
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Transtornos da Cefaleia , Transtornos de Enxaqueca , Cefaleia do Tipo Tensional , Humanos , Cefaleia do Tipo Tensional/complicações , Frequência Cardíaca/fisiologia , Força da Mão , Estudos Transversais , Cefaleia , Transtornos da Cefaleia/complicações , Testes de Função CardíacaRESUMO
Cardiorespiratory fitness measured as ËVO2max is considered an important variable in the risk prediction of cardiovascular disease and all-cause mortality. Non-exercise ËVO2max prediction models are applicable, but lack accuracy. Here a model for the prediction of ËVO2max using seismocardiography (SCG) was investigated. 97 healthy participants (18-65 yrs., 51 females) underwent measurement of SCG at rest in the supine position combined with demographic data to predict ËVO2max before performing a graded exercise test (GET) on a cycle ergometer for determination of ËVO2max using pulmonary gas exchange measurements for comparison. Accuracy assessment revealed no significant difference between SCG and GET ËVO2max (mean±95% CI; 38.3±1.6 and 39.3±1.6 ml·min-1·kg-1, respectively. P=0.075). Further, a Pearson correlation of r=0.73, a standard error of estimate (SEE) of 5.9 ml·min-1·kg-1, and a coefficient of variation (CV) of 8±1% were found. The SCG ËVO2max showed higher accuracy, than the non-exercise model based on the FRIENDS study, when this was applied to the present population (bias=-3.7±1.3 ml·min-1·kg-1, p<0.0001. r=0.70. SEE=7.4 ml·min-1·kg-1, and CV=12±2%). The SCG ËVO2max prediction model is an accurate method for the determination of ËVO2max in a healthy adult population. However, further investigation on the validity and reliability of the SCG ËVO2max prediction model in different populations is needed for consideration of clinical applicability.
Assuntos
Consumo de Oxigênio , Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Testes de Função Cardíaca , Teste de EsforçoRESUMO
OBJECTIVE: Patients with COPD are prone to cardiac remodeling; however, little is known about cardiac function in patients recovering from an acute exacerbation of COPD (AECOPD) and its association with exercise capacity. The aim of this study was to evaluate the cardiac function and structure and to compare their relationship with exercise capacity in patients with a recent AECOPD and patients with clinically stable COPD. METHODS: This was a cross-sectional study including 40 COPD patients equally divided into two groups: recent AECOPD group (AEG) and clinically stable COPD group (STG). Echocardiography was performed to assess cardiac function and chamber structure. The six-minute walk distance (6MWD) and the Duke Activity Status Index (estimated Vo2) were used in order to assess exercise capacity. RESULTS: No significant differences in cardiac function and structure were found between the groups. The 6MWD was associated with early/late diastolic mitral filling velocity ratio (r = 0.50; p < 0.01), left ventricular posterior wall thickness (r = -0.33; p = 0.03), and right atrium volume index (r = -0.34; p = 0.04), whereas Vo2 was associated with right atrium volume index (r = -0.40; p = 0.02). CONCLUSIONS: Regardless of the clinical condition (recent AECOPD vs. stable COPD), the cardiac function and structure were similar between the groups, and exercise capacity (determined by the 6MWD and Vo2) was associated with cardiac features.
Assuntos
Tolerância ao Exercício , Coração , Doença Pulmonar Obstrutiva Crônica , Humanos , Estudos Transversais , Ecocardiografia , Teste de Esforço , Tolerância ao Exercício/fisiologia , Ventrículos do Coração/diagnóstico por imagem , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Testes de Função Cardíaca , Coração/diagnóstico por imagem , Coração/fisiologiaAssuntos
COVID-19 , Coração , Criança , Humanos , Coração/fisiologia , Coração/virologia , Testes de Função CardíacaRESUMO
The complexity of the depressive symptoms observed in humans makes modeling depressive behavior in rodents challenging. Here, we present a highly reproducible protocol to generate mouse models that mimic several aspects of depression, namely anhedonia and loss of motivation. We describe acclimatization of animals and baseline determination, followed by the chronic unpredictable stress (CUS) protocol to induce anhedonic and resilient behaviors. The protocol can generate anhedonic and resilient mice at roughly equal frequencies, providing a reliable model for translational research. For complete details on the use and execution of this protocol, please refer to Baczynska et al. (2022), Bijata et al. (2022), and Krzystyniak et al. (2019).
Assuntos
Anedonia , Estresse Psicológico , Animais , Modelos Animais de Doenças , Testes de Função Cardíaca , Humanos , Camundongos , Camundongos Endogâmicos C57BLRESUMO
Reversible protein phosphorylation is a posttranslational modification of regulatory proteins involved in cardiac signaling pathways. Here, we focus on the role of protein phosphatase 2A (PP2A) for cardiac gene expression and stress response using a transgenic mouse model with cardiac myocyte-specific overexpression of the catalytic subunit of PP2A (PP2A-TG). Gene and protein expression were assessed under basal conditions by gene chip analysis and Western blotting. Some cardiac genes related to the cell metabolism and to protein phosphorylation such as kinases and phosphatases were altered in PP2A-TG compared to wild type mice (WT). As cardiac stressors, a lipopolysaccharide (LPS)-induced sepsis in vivo and a global cardiac ischemia in vitro (stop-flow isolated perfused heart model) were examined. Whereas the basal cardiac function was reduced in PP2A-TG as studied by echocardiography or as studied in the isolated work-performing heart, the acute LPS- or ischemia-induced cardiac dysfunction deteriorated less in PP2A-TG compared to WT. From the data, we conclude that increased PP2A activity may influence the acute stress tolerance of cardiac myocytes.
Assuntos
Isquemia , Miócitos Cardíacos , Proteína Fosfatase 2 , Sepse , Animais , Testes de Função Cardíaca , Isquemia/metabolismo , Lipopolissacarídeos/metabolismo , Camundongos , Miócitos Cardíacos/metabolismo , Fosforilação , Proteína Fosfatase 2/genética , Proteína Fosfatase 2/metabolismo , Processamento de Proteína Pós-Traducional , Sepse/metabolismoRESUMO
Inherited cardiomyopathy caused by the p.(Arg14del) pathogenic variant of the phospholamban (PLN) gene is characterized by intracardiomyocyte PLN aggregation and can lead to severe dilated cardiomyopathy. We recently reported that pre-emptive depletion of PLN attenuated heart failure (HF) in several cardiomyopathy models. Here, we investigated if administration of a Pln-targeting antisense oligonucleotide (ASO) could halt or reverse disease progression in mice with advanced PLN-R14del cardiomyopathy. To this aim, homozygous PLN-R14del (PLN-R14 Δ/Δ) mice received PLN-ASO injections starting at 5 or 6 weeks of age, in the presence of moderate or severe HF, respectively. Mice were monitored for another 4 months with echocardiographic analyses at several timepoints, after which cardiac tissues were examined for pathological remodeling. We found that vehicle-treated PLN-R14 Δ/Δ mice continued to develop severe HF, and reached a humane endpoint at 8.1 ± 0.5 weeks of age. Both early and late PLN-ASO administration halted further cardiac remodeling and dysfunction shortly after treatment start, resulting in a life span extension to at least 22 weeks of age. Earlier treatment initiation halted disease development sooner, resulting in better heart function and less remodeling at the study endpoint. PLN-ASO treatment almost completely eliminated PLN aggregates, and normalized levels of autophagic proteins. In conclusion, these findings indicate that PLN-ASO therapy may have beneficial outcomes in PLN-R14del cardiomyopathy when administered after disease onset. Although existing tissue damage was not reversed, further cardiomyopathy progression was stopped, and PLN aggregates were resolved.
Assuntos
Proteínas de Ligação ao Cálcio/genética , Cardiomiopatias/tratamento farmacológico , Oligonucleotídeos Antissenso/administração & dosagem , Substituição de Aminoácidos , Animais , Proteínas de Ligação ao Cálcio/antagonistas & inibidores , Proteínas de Ligação ao Cálcio/química , Cardiomiopatias/genética , Cardiomiopatias/fisiopatologia , Modelos Animais de Doenças , Feminino , Testes de Função Cardíaca/efeitos dos fármacos , Humanos , Masculino , Camundongos , Oligonucleotídeos Antissenso/farmacologia , Agregados Proteicos/efeitos dos fármacos , Resultado do TratamentoRESUMO
Chagas disease (CD), caused by Trypanosoma cruzi, affects approximately 6 to 7 million people in Latin America, with cardiomyopathy being the clinical manifestation most commonly associated with patient death during the acute phase. The etiological treatment of CD is restricted to benznidazole (Bz) and nifurtimox (Nif), which involve long periods of administration, frequent side effects, and low efficacy in the chronic phase. Thus, combined therapies emerge as an important tool in the treatment of CD, allowing the reduction of Bz dose and treatment duration. In this sense, amiodarone (AMD), the most efficient antiarrhythmic drug currently available and prescribed to CD patients, is a potential candidate for combined treatment due to its known trypanocidal activity. However, the efficacy of AMD during the acute phase of CD and its interaction with Bz or Nif are still unknown. In the present study, using a well-established murine model of the acute phase of CD, we observed that the Bz/AMD combination was more effective in reducing the peak parasitemia than both monotherapy treatments. Additionally, the Bz/AMD combination reduced (i) interleukin-6 (IL-6) levels in cardiac tissue, (ii) P-wave duration, and (iii) frequency of arrhythmia in infected animals and (iv) restored gap junction integrity in cardiac tissue. Therefore, our study validates AMD as a promising candidate for combined therapy with Bz, reinforcing the strategy of combined therapy for CD. IMPORTANCE Chagas disease affects approximately 6 to 7 million people worldwide, with cardiomyopathy being the clinical manifestation that most commonly leads to patient death. The etiological treatment of Chagas disease is limited to drugs (benznidazole and nifurtimox) with relatively high toxicity and therapeutic failures. In this sense, amiodarone, the most effective currently available antiarrhythmic drug prescribed to patients with Chagas disease, is a potential candidate for combined treatment due to its known trypanocidal effect. In the present study, we show that combined treatment with benznidazole and amiodarone improves the trypanocidal effect and reduces cardiac damage in acutely T. cruzi-infected mice.
Assuntos
Amiodarona/uso terapêutico , Doença de Chagas/tratamento farmacológico , Nitroimidazóis/uso terapêutico , Trypanosoma cruzi/efeitos dos fármacos , Amiodarona/efeitos adversos , Amiodarona/farmacologia , Animais , Modelos Animais de Doenças , Quimioterapia Combinada/métodos , Coração/efeitos dos fármacos , Cardiopatias/induzido quimicamente , Cardiopatias/patologia , Testes de Função Cardíaca , Humanos , Masculino , Camundongos , Nitroimidazóis/efeitos adversos , Nitroimidazóis/farmacologia , Parasitemia/tratamento farmacológicoRESUMO
This study was to investigate the value of echocardiographic data in assessing changes in cardiac function before and after transcatheter closure in children and adult patients with patent ductus arteriosus (PDA). In this study, 150 patients with isolated PDA treated by cardiac catheterization and transcatheter closure were selected as the study sample. Real-time color Doppler echocardiography was used both after and after operation. The results showed that the left ventricle returned to normal in 75 patients one day after operation, with an average age of 10.95 ± 3.27 years; the left ventricle did not return to normal in 10 patients 360 days after operation, with an average age of 64.31 ± 7.05 years. Left ventricular end diastolic volume index (LVEDVI) and left ventricular end systolic volume index (LVESVI) of patients decreased significantly one day after operation and remained at 51.95 ± 9.55 mL/m2 and 20.36 ± 8.11 mL/m-2, respectively. In summary, echocardiographic data have a high reference value in assessing cardiac function characteristics in children and adult patients with PDA and are worthy of further promotion.
Assuntos
Permeabilidade do Canal Arterial/diagnóstico por imagem , Permeabilidade do Canal Arterial/cirurgia , Ecocardiografia/métodos , Adolescente , Adulto , Idoso , Fenômenos Fisiológicos Cardiovasculares , Criança , Biologia Computacional , Permeabilidade do Canal Arterial/fisiopatologia , Ecocardiografia/estatística & dados numéricos , Ecocardiografia Doppler em Cores/métodos , Ecocardiografia Doppler em Cores/estatística & dados numéricos , Feminino , Testes de Função Cardíaca , Sopros Cardíacos/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Dispositivos de Oclusão Vascular , Função Ventricular Esquerda , Adulto JovemRESUMO
Cachexia is associated with poor prognosis in chronic heart failure patients, but the underlying mechanisms of cachexia triggered disease progression remain poorly understood. Here, we investigate whether the dysregulation of myokine expression from wasting skeletal muscle exaggerates heart failure. RNA sequencing from wasting skeletal muscles of mice with heart failure reveals a reduced expression of Ostn, which encodes the secreted myokine Musclin, previously implicated in the enhancement of natriuretic peptide signaling. By generating skeletal muscle specific Ostn knock-out and overexpressing mice, we demonstrate that reduced skeletal muscle Musclin levels exaggerate, while its overexpression in muscle attenuates cardiac dysfunction and myocardial fibrosis during pressure overload. Mechanistically, Musclin enhances the abundance of C-type natriuretic peptide (CNP), thereby promoting cardiomyocyte contractility through protein kinase A and inhibiting fibroblast activation through protein kinase G signaling. Because we also find reduced OSTN expression in skeletal muscle of heart failure patients, augmentation of Musclin might serve as therapeutic strategy.
Assuntos
Caquexia/genética , Fibrose Endomiocárdica/genética , Insuficiência Cardíaca/genética , Proteínas Musculares/genética , Músculo Esquelético/metabolismo , Atrofia Muscular/genética , Fatores de Transcrição/genética , 2',3'-Nucleotídeo Cíclico 3'-Fosfodiesterase/genética , 2',3'-Nucleotídeo Cíclico 3'-Fosfodiesterase/metabolismo , Idoso , Idoso de 80 Anos ou mais , Animais , Caquexia/metabolismo , Caquexia/fisiopatologia , Caquexia/prevenção & controle , Estudos de Casos e Controles , Proteínas Quinases Dependentes de AMP Cíclico/genética , Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , Proteínas Quinases Dependentes de GMP Cíclico/genética , Proteínas Quinases Dependentes de GMP Cíclico/metabolismo , Modelos Animais de Doenças , Fibrose Endomiocárdica/metabolismo , Fibrose Endomiocárdica/fisiopatologia , Fibrose Endomiocárdica/prevenção & controle , Feminino , Regulação da Expressão Gênica , Insuficiência Cardíaca/metabolismo , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/prevenção & controle , Testes de Função Cardíaca , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Proteínas Musculares/agonistas , Proteínas Musculares/antagonistas & inibidores , Proteínas Musculares/deficiência , Atrofia Muscular/metabolismo , Atrofia Muscular/fisiopatologia , Atrofia Muscular/prevenção & controle , Miocárdio/metabolismo , Miocárdio/patologia , Miócitos Cardíacos/metabolismo , Miócitos Cardíacos/patologia , RNA Interferente Pequeno/genética , RNA Interferente Pequeno/metabolismo , Transdução de Sinais , Fatores de Transcrição/agonistas , Fatores de Transcrição/antagonistas & inibidores , Fatores de Transcrição/deficiênciaRESUMO
Cardiovascular diseases (CVDs) are now the leading cause of mortality and morbidity worldwideï¼resulting in a large global economic burden. Recently, complementary and alternative medicine, such as traditional Chinese medicine (TCM) have received great attention. Puerarin (Pue) is an isoflavone isolated from the roots of Pueraria lobata (Willd.) Ohwi (also named "Ge gen" in China), and is a versatile TCM herb used for the treatment of fever, diarrhea, diabetes mellitus CVDs and cerebrovascular diseases. Numerous lines ofin vitro studies, as well as in vivo animal experiments have established that Pue offers beneficial roles against the progression of atherosclerosis, ischemic heart diseases, heart failure hypertension and arrhythmia by inhibiting pathological processes, such as the mitigation of endothelium injury, protection against inflammation, the disturbance of lipid metabolism, protection against ischemic reperfusion injury, anti-myocardial remodeling and other effects. Here, we provide a systematic overview of the pharmacological actions and molecular targets of Pue in cardiovascular disease prevention and treatment, to provide insights into the therapeutic potential of Pue in treating cardiovascular diseases.
Assuntos
Doenças Cardiovasculares/patologia , Isoflavonas/farmacologia , Sistemas de Liberação de Medicamentos , Endotélio Vascular/efeitos dos fármacos , Células Espumosas/efeitos dos fármacos , Testes de Função Cardíaca , Hipolipemiantes/farmacologia , Inflamação/patologia , Mediadores da Inflamação/metabolismo , Isoflavonas/farmacocinética , Músculo Liso Vascular/efeitos dos fármacos , Isquemia Miocárdica/patologia , Inibidores da Agregação Plaquetária/farmacologia , PuerariaAssuntos
Mergulho , Testes de Função Cardíaca , Humanos , Ultrassonografia , Ultrassonografia DopplerRESUMO
INTRODUCTION: Takotsubo syndrome (TTS) is clinically indistinguishable from an acute coronary syndrome (ACS). In the absence of valid markers for differential diagnosis, coronary angiography has been indispensable. METHODS: In our study, we evaluated the serum levels of sST-2, GDF-15, suPAR and H-FABP in 92 patients with the suspicion of TTS (51 TTS and 41 ACS patients) and 40 gender matched controls (no coronary artery disease or signs of heart failure) at baseline. RESULTS: H-FABP was significantly higher in ACS patients compared to TTS patients. Even in in propensity score matching for left ventricular ejection fraction, sex and cardiovascular risk factors, differences in the plasma levels of H-FABP in the matched cohort of TTS vs ACS remained statistically significant. Whereas, sST-2 was significantly elevated in TTS patients. H-FABP was superior for prediction of an ACS with even higher accuracy than hs troponin in differential diagnosis (AUC 0.797, p ≤ 0.0001); the optimal cut off for discrimination towards a TTS was calculated as 2.93 ng/ml (sensitivity 70.0%, specificity 82.4%, PPV 75.7%, NPV 77.4%). sST-2 seemed most appropriate for identification of a TTS (AUC 0.653, p = 0.012). The optimal cut off for differential diagnosis was 11018.06 pg/ml (sensitivity 82.0%, specificity 51.2%, PPV 69.4%, NPV 71.9 %). CONCLUSION: H-FABP and sST-2 are the most promising markers with better accuracy than preexisting biomarkers in differential diagnosis in our study and therefore, could be crucial for the guidance of treatment in patients with high bleeding risk, advanced renal failure or multimorbidity.