RESUMEN
Idiopathic pulmonary arterial hypertension (IPAH) initial evaluation and follow-up, a rare and incurable disease if left untreated, is based on a multiparametric approach (functional status of the patient, biomarkers, hemodynamic parameters and imaging evaluation of right heart impairment). Arterial stiffness (AS) and endothelial glycocalyx are indices of systemic circulation. We present the 3-years follow-up of a female IPAH patient. We propose aortic stiffness and endothelial glycocalyx indices as non-invasive markers of either improvement or deterioration of IPAH disease.
Asunto(s)
Hipertensión , Rigidez Vascular , Biomarcadores , Hipertensión Pulmonar Primaria Familiar , Femenino , Estudios de Seguimiento , Glicocálix , Humanos , Arteria PulmonarRESUMEN
An association between androgenic alopecia (AGA), coronary artery disease, and hypertension has been reported in previous epidemiological studies. The authors evaluated the relationship of target organ damage caused by hypertension with AGA in 101 newly diagnosed and untreated hypertension men with mild to moderate AGA (AGAm ), severe AGA (AGAs ), and non-AGA. Pulse wave velocity (PWV), office and 24-hour pulse pressure (PP), carotid intima-media thickness (IMT), left ventricular hypertrophy (LVH), coronary flow reserve (CFRd), and AGA severity by Hamilton-Norwood scale were estimated. CFRd was significantly impaired in AGAs patients compared with AGAm (P=.007) and non-AGA patients (P=.02). No differences were found within groups regarding PWV, PP, IMT, and LVH. AGA severity was related to CFRd (independently) and PP while AGA duration and age of onset were related to CFRd and PP, respectively. The authors conclude that impaired coronary microcirculation and aortic stiffness might precede the appearance of significant stenotic coronary lesions in hypertensive patients with severe AGA. In addition, hypertensive patients with severe and early AGA onset seem to be exposed to an augmented cardiovascular risk.
