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1.
Braz J Med Biol Res ; 50(1): e5660, 2017 01 09.
Artigo em Inglês | MEDLINE | ID: mdl-28076455

RESUMO

Clopidogrel and aspirin are the most commonly used medications worldwide for dual antiplatelet therapy after percutaneous coronary intervention. However, clopidogrel hyporesponsiveness related to gene polymorphisms is a concern. Populations with higher degrees of genetic admixture may have increased prevalence of clopidogrel hyporesponsiveness. To assess this, we genotyped CYP2C19, ABCB1, and PON1 in 187 patients who underwent percutaneous coronary intervention. Race was self-defined by patients. We also performed light transmission aggregometry with adenosine diphosphate (ADP) and arachidonic acid during dual antiplatelet therapy. We found a significant difference for presence of the CYP2C19*2 polymorphism between white and non-white patients. Although 7% of patients had platelet resistance to clopidogrel, this did not correlate with any of the tested genetic polymorphisms. We did not find platelet resistance to aspirin in this cohort. Multivariate analysis showed that patients with PON1 and CYP2C19 polymorphisms had higher light transmission after ADP aggregometry than patients with native alleles. There was no preponderance of any race in patients with higher light transmission aggregometry. In brief, PON1 and CYP2C19 polymorphisms were associated with lower clopidogrel responsiveness in this sample. Despite differences in CYP2C19 polymorphisms across white and non-white patients, genetic admixture by itself was not able to identify clopidogrel hyporesponsiveness.


Assuntos
Aspirina/farmacologia , Plaquetas/efeitos dos fármacos , Doença da Artéria Coronariana/tratamento farmacológico , Inibidores da Agregação Plaquetária/farmacologia , Ticlopidina/análogos & derivados , Subfamília B de Transportador de Cassetes de Ligação de ATP/genética , Alelos , Arildialquilfosfatase/genética , Clopidogrel , Doença da Artéria Coronariana/genética , Citocromo P-450 CYP2C19/genética , Quimioterapia Combinada , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea , Polimorfismo Genético , Estudos Prospectivos , Ticlopidina/farmacologia
2.
Arq Bras Cardiol ; 102(3 Suppl 1): 1-61, 2014 03.
Artigo em Português | MEDLINE | ID: mdl-24862929
5.
Braz J Med Biol Res ; 43(6): 572-9, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20521015

RESUMO

The objective of this study was to identify intravascular ultrasound (IVUS), angiographic and metabolic parameters related to restenosis in patients with dysglycemia. Seventy consecutive patients (77 lesions) selected according to inclusion and exclusion criteria were evaluated by the oral glucose tolerance test and the determination of insulinemia after a successful percutaneous coronary intervention (PCI) with a bare-metal stent. The degree of insulin resistance was calculated by the homeostasis model assessment of insulin resistance (HOMA-IR). Six-month IVUS and angiogram follow-up were performed. Thirty-nine patients (55.7%) had dysglycemia. The restenosis rate in the dysglycemic group was 37.2 vs 23.5% in the euglycemic group (P = 0.299). The predictors of restenosis using bivariate analysis were reference vessel diameter (RVD): pound2.93 mm (RR = 0.54; 95%CI = 0.05-0.78; P = 0.048), stent area (SA): <8.91 mm(2) (RR = 0.66; 95%CI = 0.24-0.85; P = 0.006), stent volume (SV): <119.75 mm(3) (RR = 0.74; 95%CI = 0.38-0.89; P = 0.0005), HOMA-IR: >2.063 (RR = 0.44; 95%CI = 0.14-0.64; P = 0.027), and fasting plasma glucose (FPG): < or =108.8 mg/dL (RR = 0.53; 95%CI = 0.13-0.75; P = 0.046). SV was an independent predictor of restenosis by multivariable analysis. Dysglycemia is a common clinical condition in patients submitted to PCI. The degree of insulin resistance, FPG, RVD, SA, and SV were correlated with restenosis. SV was inversely correlated with an independent predictor of restenosis in patients treated with a bare-metal stent.


Assuntos
Angioplastia Coronária com Balão , Reestenose Coronária/etiologia , Hiperglicemia/complicações , Stents , Adulto , Idoso , Idoso de 80 Anos ou mais , Angioplastia Coronária com Balão/efeitos adversos , Estudos de Coortes , Reestenose Coronária/diagnóstico por imagem , Reestenose Coronária/metabolismo , Estenose Coronária/diagnóstico por imagem , Estenose Coronária/terapia , Feminino , Homeostase , Humanos , Resistência à Insulina , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Fatores de Risco , Ultrassonografia de Intervenção
6.
Rev. bras. pesqui. méd. biol ; Braz. j. med. biol. res;43(6): 572-579, June 2010. ilus, tab
Artigo em Inglês | LILACS | ID: lil-548266

RESUMO

The objective of this study was to identify intravascular ultrasound (IVUS), angiographic and metabolic parameters related to restenosis in patients with dysglycemia. Seventy consecutive patients (77 lesions) selected according to inclusion and exclusion criteria were evaluated by the oral glucose tolerance test and the determination of insulinemia after a successful percutaneous coronary intervention (PCI) with a bare-metal stent. The degree of insulin resistance was calculated by the homeostasis model assessment of insulin resistance (HOMA-IR). Six-month IVUS and angiogram follow-up were performed. Thirty-nine patients (55.7 percent) had dysglycemia. The restenosis rate in the dysglycemic group was 37.2 vs 23.5 percent in the euglycemic group (P = 0.299). The predictors of restenosis using bivariate analysis were reference vessel diameter (RVD): £2.93 mm (RR = 0.54; 95 percentCI = 0.05-0.78; P = 0.048), stent area (SA): <8.91 mm² (RR = 0.66; 95 percentCI = 0.24-0.85; P = 0.006), stent volume (SV): <119.75 mm³ (RR = 0.74; 95 percentCI = 0.38-0.89; P = 0.0005), HOMA-IR: >2.063 (RR = 0.44; 95 percentCI = 0.14-0.64; P = 0.027), and fasting plasma glucose (FPG): ≤108.8 mg/dL (RR = 0.53; 95 percentCI = 0.13-0.75; P = 0.046). SV was an independent predictor of restenosis by multivariable analysis. Dysglycemia is a common clinical condition in patients submitted to PCI. The degree of insulin resistance, FPG, RVD, SA, and SV were correlated with restenosis. SV was inversely correlated with an independent predictor of restenosis in patients treated with a bare-metal stent.


Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Angioplastia Coronária com Balão , Reestenose Coronária/etiologia , Hiperglicemia/complicações , Stents , Angioplastia Coronária com Balão/efeitos adversos , Estudos de Coortes , Reestenose Coronária/metabolismo , Reestenose Coronária , Estenose Coronária/terapia , Estenose Coronária , Homeostase , Resistência à Insulina , Valor Preditivo dos Testes , Estudos Prospectivos , Fatores de Risco , Ultrassonografia de Intervenção
7.
Heart ; 95(18): 1475-82, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19224906

RESUMO

South America comprises widely different environments consisting of many complex and heterogeneous ethnicities, societies and cultures. During recent decades conspicuous advances in human and societal development have been made. South America now faces three major demographic shifts: population growth; urbanisation (almost 90% of the population live in urban areas) and ageing. Recently, an epidemiological transition has been seen. Urbanisation has brought unfavourable and prominent changes, such as increased smoking rates, stress, lack of physical activity and poor diets (more fat and calories). Consequently, owing to the interaction between environment and genetic susceptibility, the modifications induced by urbanisation have resulted in enhancement of the cardiovascular risk factors and cardiovascular disease (CVD). This situation is responsible for the burden of CVD in South America, requiring effective action towards better detection and control of cardiovascular risk factors aimed at reducing the burden of disease in the region, which tends to be higher and increasingly serious.


Assuntos
Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Pesquisa Biomédica , Métodos Epidemiológicos , Previsões , Promoção da Saúde , Humanos , América do Sul/epidemiologia , Urbanização
8.
Heart ; 95(7): 524-34, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19131444

RESUMO

A century after its discovery, Chagas' disease still represents a major public health challenge in Latin America. Moreover, because of growing population movements, an increasing number of cases of imported Chagas' disease have now been detected in non-endemic areas, such as North America and some European countries. This parasitic zoonosis, caused by Trypanosoma cruzi, is transmitted to humans by infected Triatominae insects, or occasionally by non-vectorial mechanisms, such as blood transfusion, mother to fetus, or oral ingestion of materials contaminated with parasites. Following the acute phase of the infection, untreated individuals enter a chronic phase that is initially asymptomatic or clinically unapparent. Usually, a few decades later, 40-50% of patients develop progressive cardiomyopathy and/or motility disturbances of the oesophagus and colon. In the last decades several interventions targeting primary, secondary and tertiary prevention of Chagas' disease have been attempted. While control of both vectorial and blood transfusion transmission of T cruzi (primary prevention) has been successful in many regions of Latin America, early detection and aetiological treatment of asymptomatic subjects with Chagas' disease (secondary prevention) have been largely underutilised. At the same time, in patients with established chronic disease, several pharmacological and non-pharmacological interventions are currently available and have been increasingly used with the intention of preventing or delaying complications of the disease (tertiary prevention). In this review we discuss in detail each of these issues.


Assuntos
Doença de Chagas/prevenção & controle , Trypanosoma cruzi , Animais , Antiparasitários/uso terapêutico , Bancos de Sangue , Transfusão de Sangue , Doença de Chagas/tratamento farmacológico , Doença de Chagas/transmissão , Doença Crônica , Humanos , Inseticidas , América Latina , Transplante de Órgãos , Medicina Preventiva/métodos
9.
Heart ; 95(17): 1385-92, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19174420

RESUMO

Congenital heart diseases are one of the most common structural defects present at birth, with an approximate incidence of 8 per 1000 live births. As most countries in South America have a high birth rate, they are a significant public health concern. This paper provides a brief overview of the burden of congenital heart disease in South America, focusing on its local prevalence, facilities for treatment and outcomes after medical, surgical or catheter intervention for the most common diseases.


Assuntos
Cardiopatias Congênitas/epidemiologia , Adulto , Criança , Pré-Escolar , Atenção à Saúde/organização & administração , Cardiopatias Congênitas/terapia , Transplante de Coração , Humanos , Incidência , Lactente , Recém-Nascido , Prevalência , América do Sul/epidemiologia , Resultado do Tratamento
12.
Transplant Proc ; 40(3): 875-8, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18455041

RESUMO

Chagas disease (American trypanosomiasis) is caused by the protozoan parasite Trypanosoma cruzi. Chagas disease following solid-organ transplantation has occurred in Latin America. This report presents the occurrence of Chagas disease despite negative serological tests in both the donor and the recipient, as well as the effectiveness of treatment. A 21-year-old woman from the state of Sao Paulo (Brazil) underwent cadaveric donor liver transplantation in November 2005, due to cirrhosis of autoimmune etiology. Ten months after liver transplantation, she developed signs and symptoms of congestive heart failure (New York Heart Association functional class IV). The echocardiogram, which was normal preoperatively, showed dilated cardiac chambers, depressed left ventricular systolic function (ejection fraction = 35%) and moderate pulmonary hypertension. Clinical investigation discarded ischemic heart disease and autoimmune and other causes for heart failure. Immuno fluorescence (immunoglobulin M and immunoglobulin G) and hemagglutination tests for T cruzi were positive, and abundant T cruzi amastigotes were readily identified in myocardial biopsy specimens. Treatment with benznidazole for 2 months yielded an excellent clinical response. At the moment of submission, the patient remains in functional class I. This case highlighted that more appropriate screening for T cruzi infection is mandatory in potential donors and recipients of solid-organ transplants in regions where Chagas disease is prevalent. Moreover, it stressed that this diagnosis should always be considered in recipients who develop cardiac complications, since negative serological tests do not completely discard the possibility of disease transmission and since good results can be achieved with prompt trypanocidal therapy.


Assuntos
Cardiomiopatia Chagásica/diagnóstico , Transplante de Fígado/efeitos adversos , Complicações Pós-Operatórias/parasitologia , Trypanosoma cruzi/isolamento & purificação , Adulto , Animais , Cardiomiopatia Chagásica/tratamento farmacológico , Ecocardiografia , Evolução Fatal , Coração/parasitologia , Humanos , Masculino , Nitroimidazóis/uso terapêutico , Transplante de Pâncreas , Tripanossomicidas/uso terapêutico , Disfunção Ventricular Esquerda
13.
Int J Cardiol ; 116(3): 383-8, 2007 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-17049642

RESUMO

BACKGROUND: A substantial proportion of patients treated with fibrinolytics for acute myocardial infarction (AMI) is subsequently submitted to surgical or percutaneous revascularization procedures during the same hospitalization. However, data comparing these procedures are scarce in the literature. The purpose of this study was to analyze the outcomes of a population with AMI who, during the in-hospital phase, received fibrinolytic therapy followed by coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI). METHODS: The study population included 3532 patients submitted to CABG (N=574) or PCI (N=2958), out of 15,114 patients studied in the InTIME-2 trial. Among patients treated with PCI there were no differences between those who received stents or isolated balloon angioplasty, so that their data were pooled for analysis. RESULTS: CABG and PCI groups were compared regarding all-cause mortality (at 30 days and one year post-AMI) and non-fatal events (reinfarction, need of additional post-discharge revascularization and re-hospitalization for an ischemic event) within 30 days after MI. There was no significant difference in mortality rates between the groups--both unadjusted and adjusted--at 30 days and one year post-MI. The unadjusted 30-day rates of combined fatal and non-fatal events were 10.3% for the CABG group, and 15.3% for the PCI group (odds-ratio 0.64, P=0.0017), but the adjusted odds-ratio for the combined endpoint only achieved borderline significance (P=0.048). CONCLUSION: Mortality rates for CABG and PCI were similar up to one year after AMI, but CABG tends to carry a better event-free survival in the first 30 days.


Assuntos
Angioplastia Coronária com Balão , Ponte de Artéria Coronária , Infarto do Miocárdio/terapia , Terapia Trombolítica , Idoso , Angioplastia Coronária com Balão/mortalidade , Ponte de Artéria Coronária/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/mortalidade , Resultado do Tratamento
14.
Braz J Med Biol Res ; 39(4): 483-7, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16612471

RESUMO

Recent data from our laboratory have shown that patients with the indeterminate form of Chagas' disease can have impairment of left ventricular contractility, as evaluated by the slope of the left ventricle end-systolic pressure-dimension relationship. We also showed that Chagas' disease patients with minimal baseline wall motion abnormalities detected by two-dimensional echocardiography have more intense contractility impairment when compared to patients with the indeterminate form of the disease without this abnormality. The prognostic implications of these findings have not been established. We evaluated 59 patients (37-76 years, mean = 55 years) with different clinical forms of Chagas' disease, who had normal left ventricular global systolic function at baseline (57.6 +/- 6.9%) and who had at least one additional echo during clinical follow-up (0.4-17.6; mean 4.6 years). Group 1 consisted of 14 patients with minor baseline left ventricle wall motion abnormalities and group 2 consisted of 45 patients without these abnormalities. During follow-up, global left ventricle systolic function deterioration was observed in 10 group 1 patients (71.4%) and in only 10 group 2 patients (22.2%; P < 0.005). Age and duration of follow-up were not independent determinants of left ventricular function deterioration in these patients. The present data indicate that mild segmental left ventricular wall motion abnormalities are associated with worsening of systolic function in Chagas' disease patients who have normal baseline global systolic performance.


Assuntos
Doença de Chagas/fisiopatologia , Contração Miocárdica/fisiologia , Disfunção Ventricular Esquerda/fisiopatologia , Adulto , Idoso , Cardiomiopatia Chagásica/diagnóstico por imagem , Cardiomiopatia Chagásica/fisiopatologia , Doença Crônica , Ecocardiografia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Índice de Gravidade de Doença , Disfunção Ventricular Esquerda/diagnóstico por imagem
15.
Rev. bras. pesqui. méd. biol ; Braz. j. med. biol. res;39(4): 483-487, Apr. 2006. tab
Artigo em Inglês | LILACS | ID: lil-425083

RESUMO

Recent data from our laboratory have shown that patients with the indeterminate form of Chagas' disease can have impairment of left ventricular contractility, as evaluated by the slope of the left ventricle end-systolic pressure-dimension relationship. We also showed that Chagas' disease patients with minimal baseline wall motion abnormalities detected by two-dimensional echocardiography have more intense contractility impairment when compared to patients with the indeterminate form of the disease without this abnormality. The prognostic implications of these findings have not been established. We evaluated 59 patients (37-76 years, mean = 55 years) with different clinical forms of Chagas' disease, who had normal left ventricular global systolic function at baseline (57.6 ± 6.9 percent) and who had at least one additional echo during clinical follow-up (0.4-17.6; mean 4.6 years). Group 1 consisted of 14 patients with minor baseline left ventricle wall motion abnormalities and group 2 consisted of 45 patients without these abnormalities. During follow-up, global left ventricle systolic function deterioration was observed in 10 group 1 patients (71.4 percent) and in only 10 group 2 patients (22.2 percent; P < 0.005). Age and duration of follow-up were not independent determinants of left ventricular function deterioration in these patients. The present data indicate that mild segmental left ventricular wall motion abnormalities are associated with worsening of systolic function in Chagas' disease patients who have normal baseline global systolic performance.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Chagas/fisiopatologia , Contração Miocárdica/fisiologia , Disfunção Ventricular Esquerda/fisiopatologia , Doença Crônica , Cardiomiopatia Chagásica/fisiopatologia , Cardiomiopatia Chagásica , Ecocardiografia , Seguimentos , Prognóstico , Índice de Gravidade de Doença , Disfunção Ventricular Esquerda
16.
Braz J Med Biol Res ; 39(1): 1-7, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16400459

RESUMO

The present study describes an auxiliary tool in the diagnosis of left ventricular (LV) segmental wall motion (WM) abnormalities based on color-coded echocardiographic WM images. An artificial neural network (ANN) was developed and validated for grading LV segmental WM using data from color kinesis (CK) images, a technique developed to display the timing and magnitude of global and regional WM in real time. We evaluated 21 normal subjects and 20 patients with LVWM abnormalities revealed by two-dimensional echocardiography. CK images were obtained in two sets of viewing planes. A method was developed to analyze CK images, providing quantitation of fractional area change in each of the 16 LV segments. Two experienced observers analyzed LVWM from two-dimensional images and scored them as: 1) normal, 2) mild hypokinesia, 3) moderate hypokinesia, 4) severe hypokinesia, 5) akinesia, and 6) dyskinesia. Based on expert analysis of 10 normal subjects and 10 patients, we trained a multilayer perceptron ANN using a back-propagation algorithm to provide automated grading of LVWM, and this ANN was then tested in the remaining subjects. Excellent concordance between expert and ANN analysis was shown by ROC curve analysis, with measured area under the curve of 0.975. An excellent correlation was also obtained for global LV segmental WM index by expert and ANN analysis (R2 = 0.99). In conclusion, ANN showed high accuracy for automated semi-quantitative grading of WM based on CK images. This technique can be an important aid, improving diagnostic accuracy and reducing inter-observer variability in scoring segmental LVWM.


Assuntos
Ecocardiografia/métodos , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Redes Neurais de Computação , Disfunção Ventricular Esquerda/diagnóstico por imagem , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Curva ROC , Índice de Gravidade de Doença
17.
Rev. bras. pesqui. méd. biol ; Braz. j. med. biol. res;39(1): 1-7, Jan. 2006. ilus
Artigo em Inglês | LILACS | ID: lil-419153

RESUMO

The present study describes an auxiliary tool in the diagnosis of left ventricular (LV) segmental wall motion (WM) abnormalities based on color-coded echocardiographic WM images. An artificial neural network (ANN) was developed and validated for grading LV segmental WM using data from color kinesis (CK) images, a technique developed to display the timing and magnitude of global and regional WM in real time. We evaluated 21 normal subjects and 20 patients with LVWM abnormalities revealed by two-dimensional echocardiography. CK images were obtained in two sets of viewing planes. A method was developed to analyze CK images, providing quantitation of fractional area change in each of the 16 LV segments. Two experienced observers analyzed LVWM from two-dimensional images and scored them as: 1) normal, 2) mild hypokinesia, 3) moderate hypokinesia, 4) severe hypokinesia, 5) akinesia, and 6) dyskinesia. Based on expert analysis of 10 normal subjects and 10 patients, we trained a multilayer perceptron ANN using a back-propagation algorithm to provide automated grading of LVWM, and this ANN was then tested in the remaining subjects. Excellent concordance between expert and ANN analysis was shown by ROC curve analysis, with measured area under the curve of 0.975. An excellent correlation was also obtained for global LV segmental WM index by expert and ANN analysis (R² = 0.99). In conclusion, ANN showed high accuracy for automated semi-quantitative grading of WM based on CK images. This technique can be an important aid, improving diagnostic accuracy and reducing inter-observer variability in scoring segmental LVWM.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Ecocardiografia/métodos , Hipertrofia Ventricular Esquerda , Interpretação de Imagem Assistida por Computador/métodos , Redes Neurais de Computação , Disfunção Ventricular Esquerda , Estudos de Casos e Controles , Modelos Lineares , Curva ROC , Índice de Gravidade de Doença
18.
Braz J Med Biol Res ; 36(3): 369-75, 2003 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12640502

RESUMO

Studies that consider polymorphisms within the apolipoprotein B (apo B) gene as risk factors for coronary artery disease (CAD) have reported conflicting results. The aim of the present study was to search for associations between two DNA RFLPs (XbaI and EcoRI) of the apo B gene and CAD diagnosed by angiography. In the present study we compared 116 Brazilian patients (92 men) with CAD (CAD+) to 78 control patients (26 men) without ischemia or arterial damage (CAD-). The allele frequencies at the XbaI (X) and EcoRI (E) sites did not differ between groups. The genotype distributions of CAD+ and CAD- patients were different (chi (1) = 6.27, P = 0.012) when assigned to two classes (X-X-/E+E+ and the remaining XbaI/EcoRI genotypes). Multivariate logistic regression analysis showed that individuals with the X-X-/E+E+ genotype presented a 6.1 higher chance of developing CAD than individuals with the other XbaI/EcoRI genotypes, independently of the other risk factors considered (sex, tobacco consumption, total cholesterol, hypertension, and triglycerides). We conclude that the X-X-/E+E genotype may be in linkage disequilibrium with an unknown variation in the apo B gene or with a variation in another gene that affects the risk of CAD.


Assuntos
Apolipoproteínas B/genética , Doença das Coronárias/genética , Desoxirribonuclease EcoRI/genética , Desoxirribonucleases de Sítio Específico do Tipo II/genética , Polimorfismo Genético/genética , Adulto , Alelos , Estudos de Casos e Controles , Estudos Transversais , Feminino , Marcadores Genéticos , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Polimorfismo de Fragmento de Restrição , Estudos Prospectivos , Fatores de Risco
19.
Rev. bras. pesqui. méd. biol ; Braz. j. med. biol. res;36(3): 369-375, Mar. 2003. tab
Artigo em Inglês | LILACS | ID: lil-329463

RESUMO

Studies that consider polymorphisms within the apolipoprotein B (apo B) gene as risk factors for coronary artery disease (CAD) have reported conflicting results. The aim of the present study was to search for associations between two DNA RFLPs (XbaI and EcoRI) of the apo B gene and CAD diagnosed by angiography. In the present study we compared 116 Brazilian patients (92 men) with CAD (CAD+) to 78 control patients (26 men) without ischemia or arterial damage (CAD-). The allele frequencies at the XbaI (X) and EcoRI (E) sites did not differ between groups. The genotype distributions of CAD+ and CAD- patients were different (chi²(1) = 6.27, P = 0.012) when assigned to two classes (X-X-/E+E+ and the remaining XbaI/EcoRI genotypes). Multivariate logistic regression analysis showed that individuals with the X-X-/E+E+ genotype presented a 6.1 higher chance of developing CAD than individuals with the other XbaI/EcoRI genotypes, independently of the other risk factors considered (sex, tobacco consumption, total cholesterol, hypertension, and triglycerides). We conclude that the X-X-/E+E genotype may be in linkage disequilibrium with an unknown variation in the apo B gene or with a variation in another gene that affects the risk of CAD


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Apolipoproteínas B , Doença das Coronárias , Desoxirribonuclease EcoRI , Desoxirribonucleases de Sítio Específico do Tipo II , Polimorfismo Genético , Alelos , Estudos de Casos e Controles , Estudos Transversais , Marcadores Genéticos , Genótipo , Análise Multivariada , Polimorfismo de Fragmento de Restrição , Estudos Prospectivos , Fatores de Risco
20.
Braz J Med Biol Res ; 35(6): 741-52, 2002 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12045841

RESUMO

The purpose of the present study was to evaluate the effects of aerobic physical training (APT) on heart rate variability (HRV) and cardiorespiratory responses at peak condition and ventilatory anaerobic threshold. Ten young (Y: median = 21 years) and seven middle-aged (MA = 53 years) healthy sedentary men were studied. Dynamic exercise tests were performed on a cycloergometer using a continuous ramp protocol (12 to 20 W/min) until exhaustion. A dynamic 24-h electrocardiogram was analyzed by time (TD) (standard deviation of mean R-R intervals) and frequency domain (FD) methods. The power spectral components were expressed as absolute (a) and normalized units (nu) at low (LF) and high (HF) frequencies and as the LF/HF ratio. Control (C) condition: HRV in TD (Y: 108, MA: 96 ms; P<0.05) and FD - LFa, HFa - was significantly higher in young (1030; 2589 ms2/Hz) than in middle-aged men (357; 342 ms2/Hz) only during sleep (P<0.05); post-training effects: resting bradycardia (P<0.05) in the awake condition in both groups; VO2 increased for both groups at anaerobic threshold (P<0.05), and at peak condition only in young men; HRV in TD and FD (a and nu) was not significantly changed by training in either groups. The vagal predominance during sleep is reduced with aging. The resting bradycardia induced by short-term APT in both age groups suggests that this adaptation is much more related to intrinsic alterations in sinus node than in efferent vagal-sympathetic modulation. Furthermore, the greater alterations in VO2 than in HRV may be related to short-term APT.


Assuntos
Exercício Físico/fisiologia , Frequência Cardíaca/fisiologia , Fases do Sono/fisiologia , Vigília/fisiologia , Adulto , Limiar Anaeróbio/fisiologia , Sistema Nervoso Autônomo/fisiologia , Pressão Sanguínea/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio/fisiologia
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