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Endurance training-induced changes in left ventricular diastolic function and right ventricular parameters have been investigated extensively in adolescent athletes. Our aim was to examine the parameters for adolescent athletes (n=121, 15.1±1.6 years) compared to adult athletes and age-matched non-athletes. We explored the effects of influencing factors on the echocardiographic parameters. Significantly higher E/A (p<0.05) and e' values (p<0.001) were detected in adolescent athletes compared to age-matched non-athletes' and also adult athletes' parameters. Significantly lower structural and functional right ventricular parameters (p<0.05) were detected in adult athletes. In adolescent athletes significantly higher right ventricular diameters, tricuspid S wave, right ventricular end-diastolic and end-systolic area values (p<0.05) were found compared to the matching parameters of non-athletes. We found significantly higher corrected tricuspid annular plane systolic excursion values (p<0.001) in athletes compared to the non-athletes. Based on multivariate analysis lean body mass, body surface area, age and cumulative training time were proved as strong predictive factors of both left ventricular diastolic and right ventricular parameters. Supernormal left ventricular diastolic function and significantly higher right ventricular parameters are indicative of cardiac adaptation. Well-defined cut-off values should be applied to discriminate pathological conditions in the relation of the influencing factors.
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Atletas , Entrenamiento Aeróbico , Función Ventricular Izquierda , Función Ventricular Derecha , Adaptación Fisiológica , Adolescente , Adulto , Ecocardiografía , HumanosRESUMEN
Acute myocardial infarction (MI) is one of the most common causes of death worldwide. Pituitary adenylate cyclase activating polypeptide (PACAP) is a cardioprotective neuropeptide expressing its receptors in the cardiovascular system. The aim of our study was to examine tissue PACAP-38 in a translational porcine MI model and plasma PACAP-38 levels in patients with ST-segment elevation myocardial infarction (STEMI). Significantly lower PACAP-38 levels were detected in the non-ischemic region of the left ventricle (LV) in MI heart compared to the ischemic region of MI-LV and also to the Sham-operated LV in porcine MI model. In STEMI patients, plasma PACAP-38 level was significantly higher before percutaneous coronary intervention (PCI) compared to controls, and decreased after PCI. Significant negative correlation was found between plasma PACAP-38 and troponin levels. Furthermore, a significant effect was revealed between plasma PACAP-38, hypertension and HbA1c levels. This was the first study showing significant changes in cardiac tissue PACAP levels in a porcine MI model and plasma PACAP levels in STEMI patients. These results suggest that PACAP, due to its cardioprotective effects, may play a regulatory role in MI and could be a potential biomarker or drug target in MI.
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Arritmias Cardíacas/sangre , Infarto del Miocardio/sangre , Polipéptido Hipofisario Activador de la Adenilato-Ciclasa/sangre , Infarto del Miocardio con Elevación del ST/genética , Anciano , Animales , Arritmias Cardíacas/fisiopatología , Arritmias Cardíacas/cirugía , Femenino , Hemoglobina Glucada/genética , Ventrículos Cardíacos/metabolismo , Ventrículos Cardíacos/patología , Ventrículos Cardíacos/cirugía , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/genética , Infarto del Miocardio/patología , Infarto del Miocardio/cirugía , Infarto del Miocardio sin Elevación del ST/sangre , Infarto del Miocardio sin Elevación del ST/genética , Infarto del Miocardio sin Elevación del ST/fisiopatología , Infarto del Miocardio sin Elevación del ST/cirugía , Intervención Coronaria Percutánea/efectos adversos , Polipéptido Hipofisario Activador de la Adenilato-Ciclasa/genética , Factores de Riesgo , Infarto del Miocardio con Elevación del ST/sangre , Infarto del Miocardio con Elevación del ST/patología , Infarto del Miocardio con Elevación del ST/cirugía , Porcinos , Resultado del Tratamiento , Troponina/sangreRESUMEN
INTRODUCTION: Soluble urokinase-type plasminogen activator receptor (suPAR) is upregulated by inflammation and plays a role in the pathogenesis of atherosclerosis. Chronic obstructive pulmonary disease (COPD) is associated with enhanced systemic inflammation and increased risk for atherosclerosis, however, studies analysing the circulating suPAR levels in COPD are contradictory. The aim of the study was to investigate plasma suPAR concentrations together with markers of arterial stiffness in COPD. MATERIALS AND METHODS: Twenty-four patients with COPD and 18 non-COPD, control subjects participated in the study. Plasma suPAR was measured, together with lung volumes, symptom burden, exacerbation history, markers of arterial stiffness and soluble inflammatory biomarkers, such as endothelin-1, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6). RESULTS: Plasma suPAR levels were higher in COPD (2.84 ± 0.67 ng/ml vs. 2.41 ± 0.57 ng/ml, p = 0.03) and were related to lung function measured with FEV1 (r = - 0.65, p < 0.01) and symptom burden determined with the modified Medical Research Council questionnaire (r = 0.55, p < 0.05). Plasma suPAR concentrations correlated with various measures of arterial stiffness in all subjects, but only with ejection duration in COPD (r = - 0.44, p = 0.03). CONCLUSIONS: Plasma suPAR levels are elevated in COPD and relate to arterial stiffness. Our results suggest that suPAR may be a potential link between COPD and atherosclerosis.
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Enfermedades Cardiovasculares/sangre , Enfermedad Pulmonar Obstructiva Crónica/sangre , Receptores del Activador de Plasminógeno Tipo Uroquinasa/sangre , Rigidez Vascular , Anciano , Biomarcadores/sangre , Proteína C-Reactiva/análisis , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/fisiopatología , Estudios de Casos y Controles , Estudios Transversales , Endotelina-1/sangre , Femenino , Volumen Espiratorio Forzado , Humanos , Interleucina-6/sangre , Pulmón/fisiopatología , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Índice de Severidad de la Enfermedad , Regulación hacia Arriba , Capacidad VitalRESUMEN
BACKGROUND/AIMS: The prevalence of overweight and obesity in children and adolescents is increasing worldwide, and this condition is a risk factor for cardiovascular mortality. The aim of this study was to assess the prevalence of overweight and obesity among the 3-18-year-old population in Szolnok City and the surrounding areas. METHODS: Anthropometric data from healthy, white individuals recruited from nursery, elementary, and secondary schools were used to assess the prevalence of obesity and overweight in Szolnok City and the surrounding area, Jász-Nagykun-Szolnok county, Hungary. Healthy subjects numbering 6,824 (54% boys) were included; overweight and obesity were defined according to the relevant guidelines. RESULTS: Overweight individuals constituted 13.4% of the population and 6.6% were obese. The total prevalence was higher in boys (21.6%) than in girls (18.1%). The peak of the prevalence was observed at age 10 in both sexes (boys 33%, girls 27%) followed by a gradual decrease, which was more significant in the case of girls. CONCLUSIONS: On the basis of the recent Hungarian data, we have not detected any changes in overweight and obesity in the age group 3-9 years and we have found a significant decrease in the age group 7-14 years. Prevention of overweight and obesity in early childhood is essential.
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Sobrepeso/epidemiología , Obesidad Infantil/epidemiología , Adolescente , Índice de Masa Corporal , Niño , Preescolar , Femenino , Humanos , Hungría/epidemiología , Masculino , PrevalenciaRESUMEN
Cardiovascular diseases are the most common diseases worldwide. They are responsible for one third of global deaths and they are the leading cause of disability, too. The usage of different levels of prevention in combination with effective risk assessment improved these statistical data. Risk assessment based on classic risk factors has recently been supported with several new markers, such as asymmetric dimethylarginine, which is an endogenous competitive inhibitor of nitric oxide synthase. Elevated levels of asymmetric dimethylarginine have been reported in obese, smoker, hypercholesterolemic, hypertensive and diabetic patients. According to previous studies, asymmetric dimethylarginine is a suitable indicator of endothelial dysfunction, which is held to be the preceding condition before atherosclerosis. Several researches found positive correlation between higher levels of asymmetric dimethylarginine and coronary artery disease onset, or progression of existing coronary disease. According to a study involving 3000 patients, asymmetric dimethylarginine is an independent risk factor of cardiovascular mortality in patients with coronary artery disease. This article summarizes the role of asymmetric dimethylarginine in prediction of cardiovascular diseases, and underlines its importance in cardiovascular prevention.
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Arginina/análogos & derivados , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/diagnóstico , Endotelio Vascular/fisiopatología , Óxido Nítrico Sintasa/antagonistas & inhibidores , Arginina/sangre , Arginina/metabolismo , Aterosclerosis/sangre , Aterosclerosis/diagnóstico , Aterosclerosis/fisiopatología , Biomarcadores/sangre , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Cardiovasculares/prevención & control , Humanos , Valor Predictivo de las Pruebas , Medición de Riesgo , Factores de RiesgoRESUMEN
Recently, several vasoactive molecules have been found in pericardial fluid (PF). Thus, we hypothesized that in coronary artery disease due to ischemia or ischemia-reperfusion, the level of vasoconstrictors, mainly endothelin-1 (ET-1), increases in PF, which can increase the vasomotor tone of arteries. Experiments were performed using an isometric myograph. Vasomotor effects of PF from patients undergoing coronary artery bypass graft (PFCABG, n = 14) or valve replacement (PFVR, n = 7) surgery were examined in isolated rat carotid arteries (N = 14; n = 26). Vasomotor responses to KCl (40 or 60 mmol/L) were also tested. The selective endothelin A receptor antagonist BQ123 (10(-6) mol/L) was used to elucidate the role of ET-1. Both the first and the second additions of KCl elicited increases in the isometric force of the isolated arteries (KCl1, 6.1 ± 0.2 mN; KCl2, 6.5 ± 0.9 mN). PFCABG and PFVR elicited substantial increases in the isometric force of arteries (PFCABG, 3.1 ± 0.7 mN; PFVR, 3.0 ± 0.9 mN; p > 0.05). The presence of the selective endothelin A receptor blocker significantly reduced arterial contractions to PFCABG (before BQ123, 2.6 ± 0.5 mN vs. after BQ123, 0.8 ± 0.1 mN; p < 0.05). This study is the first to demonstrate that PFs of patients elicit substantial arterial constrictions, which is mediated primarily by ET-1. Interfering with the vasoconstrictor action of PF could be a potential therapeutic target to improve coronary blood flow in cardiac patients.
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Arterias Carótidas/fisiología , Enfermedad de la Arteria Coronaria , Endotelina-1/fisiología , Líquido Pericárdico/química , Líquido Pericárdico/fisiología , Vasoconstricción/fisiología , Animales , Enfermedad de la Arteria Coronaria/cirugía , Antagonistas de los Receptores de Endotelina/farmacología , Endotelina-1/análisis , Humanos , Técnicas In Vitro , Masculino , Péptidos Cíclicos/farmacología , Cloruro de Potasio/farmacología , Ratas , Vasoconstricción/efectos de los fármacosRESUMEN
OBJECTIVE: This study aimed to determine the effect of single-bout exercise on aortic stiffness parameters in young basketball players. METHOD AND RESULTS: A total of 108 young male subjects (mean age 14.2 ± 3.4 years) were enrolled into the study. Simultaneous measure- ment of aortic pulse wave velocity (PWVao) and augmentation index (Alxao) were performed with the oscillometric, occlusive device. Echocardiographic parameters of left ventricular systolic and diastolic function at rest were also measured in sportsmen. We did not find significant differences of resting PWVao in comparison with young sportsmen (S) and age-matched healthy volunteers (V): 5.82 ± 0.14 m/s vs 5.83 ± 0.12 m/s for S and V groups, respectively. The values of PWVao measured after dynamic exercise, isometric exercise, and rest were 8.0 ± 0.5 m/s, 5.86 ± 0.1 m/s and 5.82 ± 0.1 m/s, respectively. We confirmed that values after dynamic exercise are significantly different from those after isometric exercise (P < 0.01) and those after rest (P < 0.01). The Alxao values exhibited a considerable, but statistically non-significant, decrease during dynamic exercise in the three groups (11.7 ± 7% vs 3.8 ± 3% vs- 0.9 ± 0.9% for groups 1, 2, and 3, respectively). CONCLUSION: We applied a feasible, clinically useful method which allowed us to measure changes in aortic PWV and Alx during acute, single-bout exercise on the basketball court in young sportsmen.
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Atletas , Ejercicio Físico/fisiología , Ventrículos Cardíacos/diagnóstico por imagen , Deportes/fisiología , Rigidez Vascular/fisiología , Función Ventricular Izquierda/fisiología , Adolescente , Velocidad del Flujo Sanguíneo , Presión Sanguínea , Niño , Ecocardiografía , Humanos , Masculino , Análisis de la Onda del PulsoRESUMEN
BACKGROUND: Homocysteine (Hcy) is involved in various methylation processes, and its plasma level is increased in cardiac ischemia. Thus, we hypothesized that levels of homocysteine correlate with the morphological and functional remodeling of ischemic hearts. Thus, we aimed to measure the Hcy levels in the plasma and pericardial fluid (PF) and correlate them with morphological and functional changes in the ischemic hearts of humans. METHODS: Concentration of total homocysteine (tHcy) and cardiac troponin-I (cTn-I) of plasma and PF were measured in patients undergoing coronary artery bypass graft (CABG) surgery (n = 14). Left-ventricular (LV) end-diastolic diameter (LVED), LV end-systolic diameter (LVES), right atrial, left atrial (LA) area, thickness of interventricular septum (IVS) and posterior wall, LV ejection fraction (LVEF), and right ventricular outflow tract end-diastolic area (RVOT EDA) of CABG and non-cardiac patients (NCP; n = 10) were determined by echocardiography, and LV mass was calculated (cLVM). RESULTS: Positive correlations were found between Hcy levels of plasma and PF, tHcy levels and LVED, LVES and LA, and an inverse correlation was found between tHcy levels and LVEF. cLVM, IVS, and RVOT EDA were higher in CABG with elevated tHcy (>12 µM/L) compared to NCP. In addition, we found a higher cTn-I level in the PF compared to the plasma of CABG patients (0.08 ± 0.02 vs. 0.01 ± 0.003 ng/mL, p < 0.001), which was ~10 fold higher than the normal level. CONCLUSIONS: We propose that homocysteine is an important cardiac biomarker and may have an important role in the development of cardiac remodeling and dysfunction in chronic myocardial ischemia in humans.
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Measurement of aortic pulse wave velocity (PWVao) is recommended for stratifying individual cardiovascular (CV) risk in adults. Diseases in children and adolescents might influence aortic stiffness. It is necessary to exclude overweight (OW), obese (O) subjects, and individuals with increased systolic (SBP) and/or diastolic blood pressure (DBP) from the population, when creating normal values of PWVao in children and adolescents. Body mass index (BMI), SBP/DBP cut-off values have remarkably changed in this population during the last decade. Aims of our study were to expand our previously published PWVao database and to revise it by using the recently determined normal values. PWVao was measured by an occlusive-oscillometric device (Arteriograph, TensioMed Ltd, Budapest, Hungary) in a healthy population aged 3-18 years. 7940 (4374 boys) participants were recruited, 1912 OW/O subjects and 1368 individuals with high SBP/DBP were excluded. Finally, n = 4690 (2599 boys) participants were enrolled. Mean PWVao values increased from 5.4 ± 0.6 to 6.4 ± 0.5 m/s (p < 0.05) in boys and from 5.5 ± 0.6 to 6.4 ± 0.5 m/s (p < 0.05) in girls. Mean PWVao values were significantly lower in our new study, in boys in age groups of 9-16, in girls in age groups of 11-17. This is the largest and widest age-ranged database of PWVao published to date. Due to the change of BMI and SBP/DBP reference values during the last decade, the "old" database of PWVao needed to be revised. As a result of this, normal values of PWVao decreased significantly in both sexes.
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Análisis de la Onda del Pulso , Rigidez Vascular , Adolescente , Índice de Masa Corporal , Niño , Humanos , Masculino , Oscilometría , Valores de ReferenciaRESUMEN
Összefoglaló. Bevezetés: A szív- és érrendszeri betegségek a vezeto halálokok között szerepelnek világszerte, az összes halálozás egyharmadáért, míg az európai halálozások közel feléért felelosek. Célkituzés: Vizsgálatunk célja volt a heveny szívinfarktus okozta epidemiológiai és egészségbiztosítási betegségteher elemzése. Adatok és módszerek: Adataink a Nemzeti Egészségbiztosítási Alapkezelo (NEAK) finanszírozási adatbázisából származnak a 2018-as évre vonatkozóan. Meghatároztuk az éves betegszámokat és a legnagyobb kiadással rendelkezo ellátási forma, az aktívfekvobeteg-szakellátás tekintetében a 100 000 fore jutó prevalenciát, valamint az éves egészségbiztosítási kiadásokat korcsoportos és nemenkénti bontásban az egyes ellátási típusokra vonatkozóan. A heveny szívinfarktust a Betegségek Nemzetközi Osztályozásának 10. revíziója alapján az I21-es kódcsoporttal azonosítottuk. Eredmények: A NEAK heveny szívinfarktusra fordított kiadása összesen 16,728 milliárd Ft (61,902 millió USD; 52,463 millió EUR) volt 2018-ban. A teljes kiadás 95,8%-át az aktívfekvobeteg-szakellátás költségei (16,032 milliárd Ft; 59,321 millió USD; 50,276 millió EUR) képezték; ezen ellátási forma keretén belül összesen 16 361 fo (9742 férfi és 6619 no) került kórházi felvételre. A valamennyi életkorra számított, 100 000 lakosra vetített prevalencia 208,54 beteg volt a férfiak és 129,61 beteg a nok esetében az aktívfekvobeteg-szakellátásban. A nemenkénti eloszlást tekintve az aktívfekvobeteg-szakellátásban a férfiak abszolút száma - a 75 év felettiek kivételével - valamennyi vizsgált korcsoportban meghaladta a nokét. Következtetés: Az aktívfekvobeteg-szakellátás igénybevétele bizonyult a legfobb költségtényezonek. Orv Hetil. 2021; 162(Suppl 1): 6-13. INTRODUCTION: Cardiovascular diseases have been the leading causes of death worldwide accounting for one third of all-cause mortality, and nearly half of mortality in Europe. OBJECTIVE: The aim of our study was to determine the epidemiological disease burden of acute myocardial infarction. DATA AND METHODS: Data were derived from the financial database of the National Health Insurance Fund Administration (NHIFA) of Hungary for 2018. Data analysed included annual patient numbers, prevalence per 100 000 population in acute inpatient care, health insurance costs calculated for age groups and sex for all types of care. Patients with acute myocardial infarction were identified with the code: I21 of the International Classification of Diseases, 10th revision. RESULTS: In 2018, NHIFA spent 16.728 billion HUF on the treatment of acute myocardial infarction, 61.902 million USD, 52.463 million EUR. Acute inpatient care accounted for 95.8% of costs (16.032 billion HUF; 59.321 million USD; 50.276 million EUR) with 16 361 persons (9742 male; 6619 females) hospitalised. Based on patient numbers in acute in-patient care, prevalence per 100 000 among men was 208.54, among women 129.61 patients. In all age groups, except for patients aged >75 years, the number of males was higher than that of females. CONCLUSION: Acute inpatient care was the major cost driver in the treatment of acute myocardial infarction. Orv Hetil. 2021; 162(Suppl 1): 6-13.
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Costo de Enfermedad , Infarto del Miocardio , Anciano , Femenino , Costos de la Atención en Salud/estadística & datos numéricos , Humanos , Hungría/epidemiología , Seguro de Salud/economía , Masculino , Infarto del Miocardio/economía , Infarto del Miocardio/epidemiología , Infarto del Miocardio/terapiaRESUMEN
By 1980, it was thought that we already knew most of the major mechanisms regulating vascular tone. However, after the somewhat serendipity discovery that endothelium is involved in mediation of relaxation to acetylcholine, a whole new world opened up and we had to rewrite our concept regarding vascular function and its regulation (not to mention many other fields). The new player was an endothelium derived relaxing factor, which molecular constitution has been identified to be nitric oxide (NO). This review summarizes the major molecular steps concerning how NO is synthetized from L-arginine. Also, the fate of L-arginine is described via the arginase and methylation pathways; both of them are affecting substantially the level and efficacy of NO. In vitro and in vivo effects of L-arginine are summarized and controversial clinical findings are discussed. On the basis of the use of methylated L-arginines, the vasomotor effects of endothelial NO released to agonists and increases in flow/wall shear stress (a major biological stimulus) is summarized. In this review the role of NO in the regulation of coronary vascular resistance, hence blood flow, is delineated and the somewhat questionable clinical use of NO donors is discussed. We made an attempt to summarize the biosynthesis, role, and molecular mechanisms of endogenously produced methylated L-arginine, asymmetric dimethylarginine (ADMA) in modulating vascular resistance, affecting the function of the heart. Additionally, the relationship between ADMA level and various cardiovascular diseases is described, such as atherosclerosis, coronary artery disease (CAD), ischemia/reperfusion injuries, and different types of coronary revascularization. A novel aspect of coronary vasomotor regulation is identified in which the pericardial fluid ADMA and endothelin play putative roles. Finally, some of the open possibilities for future research on L-arginine-NO-ADMA signaling are highlighted.
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Prevalence of overweight (OW) and obesity (O) in children and adolescents has been increased in the past three decades. Increased arterial stiffness measuring by aortic pulse wave velocity (PWVao) might be detected in OW/O children and adolescents. The aim of our study was to compare the arterial function parameters (AFPs), such as PWVao; aortic augmentation index (Aixao); aortic systolic blood pressure (SBPao) and brachial systolic blood pressure (SBPbrach) measured simultaneously in O/OW patients and healthy subjects. In our study 6,816 subjects (3,668 boys) aged 3-18 years were recruited and categorized by their body mass index (BMI) into normal weight (N), OW and O groups regarding their age and sex. AFPs were measured by a non-invasive, occlusive-oscillometric device. 19.9% (n = 1,356) of the population were OW/O, 911 (516 boys) were OW and 445 (272 boys) were O. After accounting for the effect of covariates, PWVao did not differ significantly between N (5.9 ± 0.8 m/s) and OW patients (5.9 ± 0.8 m/s); and N (6.0 ± 0.7 m/s) and O patients (6.0 ± 0.8 m/s). Aixao was significantly lower in OW (9.3 ± 7.4% vs. 7.6 ± 7.0%, p < 0.00001) and in O patients (9.7 ± 8.1% vs. 6.6 ± 7.2%, p < 0.00001) compared to controls. No significant difference was found regarding SBPao values between controls and OW and O groups (N = 110.7 ± 12.4 mmHg vs. OW = 110.3 ± 11.9 mmHg; N = 115.6 ± 14.0 mmHg vs. O = 114.3 ± 12.8 mmHg). According to our results we may conclude that the unchanged PWVao in O/OW subjects might be due to the compensatory decrease in Aixao, referring to enhanced vasodilatory status in the studied population.
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BACKGROUND: Asymptomatic atherosclerosis is a common entity even at young age. Studies have suggested a strong relationship between increased arterial stiffness and asymptomatic carotid atherosclerosis (ACA) in general population, particularly in those with high cardiovascular risk, but no data exist from a younger population free from recognized cardiovascular disease. Hypothesis. We hypothesized there is an association between ACA and aortic pulse wave velocity (PWVao) in middle-aged, apparently healthy, normotensive population to reveal increased cardiovascular risk. METHODS: We examined the relationship between ACA and PWVao in 236 apparently healthy, asymptomatic, normotensive, middle-aged subjects (age 47 ± 8 years; 52% women). PWVao was measured with the oscillometric method (Arteriograph). ACA was assessed by carotid artery ultrasonography. RESULTS: ACA was present in 51 subjects. Subjects with ACA were older (p < 0.009), more likely to be smokers (p < 0.009), more likely to be smokers (p < 0.009), more likely to be smokers (p < 0.009), more likely to be smokers (p < 0.009), more likely to be smokers (p < 0.009), more likely to be smokers (p < 0.009), more likely to be smokers (p < 0.009), more likely to be smokers (. CONCLUSIONS: PWVao measured by the Arteriograph proved to be an independent marker of ACA. Our study may reveal high CV risk, detected as increased PWVao, which according to our study is related in a very high probability to asymptomatic carotid atherosclerosis in apparently healthy, young, and middle-aged subjects.
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Angiografía/métodos , Aorta , Enfermedades de las Arterias Carótidas/diagnóstico , Oscilometría/métodos , Análisis de la Onda del Pulso/métodos , Adulto , Anciano , Aterosclerosis/diagnóstico , Arterias Carótidas , Estudios Transversales , Femenino , Humanos , Hungría , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Ultrasonografía/métodos , Rigidez VascularRESUMEN
Introduction: The prevalence of overweight and obesity is increasing worldwide, which affects not only adults, but children and adolescents as well. Moreover, this condition may lead to several comorbidities, such as elevated or even high blood pressure. Aim: Aim of this study was to assess the prevalence of overweight- and obesity-related elevated and high blood pressure in a population aged 3-18 years in Hungary. Method: Between 2005 and 2018, altogether 8624 (boys = 4719) individuals were enrolled to this study. Normal weight, overweight and obese groups were created on the basis of body mass index. The diagnosis of elevated (systolic and/or diastolic blood pressure is between 90th and 95th percentile) and high blood pressure (systolic and/or diastolic blood pressure is over 95th percentile) was based on detailed examination (laboratory tests, abdominal ultrasonography, paediatric cardiology and 24-hours ambulatory blood pressure monitoring). Results: In this study, the prevalence of overweight and obesity was 23.5% overall, 26.4% in boys and 20% in girls. The prevalence of elevated blood pressure was 9.8% in overweight patients, while it was 4.6% in the obese group. The prevalence of high blood pressure was 8.3% (odds ratio: 1.1%, 95% CI) among overweight subjects, while it was 26.7% (odds ratio: 3.6, 95% CI) in the obese group. Conclusion: To the best of our knowledge, this is the first Hungarian population-based study on the prevalence of overweight- and obesity-related elevated and high blood pressure assessed in a large contemporary cohort of children and adolescents. The cardiovascular risk is increased in this patient group. Hence, it is essential to set up a proper primary prevention strategy. Orv Hetil. 2020; 161(4): 151-160.
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Hipertensión/epidemiología , Obesidad Infantil/epidemiología , Adolescente , Niño , Preescolar , Femenino , Humanos , Hungría/epidemiología , Masculino , PrevalenciaRESUMEN
The concentration of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, is increased in patients with coronary heart disease (CHD). The potential effect of percutaneous coronary intervention (PCI) with stent placement on ADMA plasma level in CHD patients has not yet been investigated. Concentrations of ADMA, L-arginine, symmetric dimethylarginine (SDMA), and L-ornithine were measured in the plasma of 30 CHD patients 24 h before, and 1 h, 5 days, and 30 days following PCI with bare-metal stent or drug-eluting stent placement (stent group) and in the plasma of 20 patients without CHD who underwent angiography alone (control group). A repeated measures ANOVA revealed the significant time by group interaction for ADMA (F=12.8, p<0.0001), SDMA (F=5.5, p=0.013), L-ornithine (F=12.5, p<0.0001), L-aginine (F=4.7, p=0.013) and L-arginine/ADMA ratio (F=7.1, p<0.001). Post-hoc ANOVAs showed that this interaction was due to the fact that control patients without stent placement responded to the coronary angiography with a significant increase in ADMA (F=4.4, p=0.009), SDMA (F=4.7, p=0.007) and L-ornithine (F=28.3, p<0.0001) levels, whereas the stent implantation independent of the stent type used significantly reduced the cardiovascular risk factor ADMA (F=10.8, p<0.0001). Thus, the current study demonstrates that in patients with CHD, PCI stent placement markedly decreases the plasma level of cardiovascular risk factor ADMA. Coronary angiography alone results in an increase of ADMA. We conclude that the stent effect on ADMA level cannot be explained by unspecific effects of the coronary angiography and is independent of the stent type used.
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Arginina/análogos & derivados , Enfermedad Coronaria/sangre , Enfermedad Coronaria/cirugía , Óxido Nítrico Sintasa/antagonistas & inhibidores , Stents , Anciano , Arginina/sangre , Procedimientos Quirúrgicos Cardiovasculares/rehabilitación , Estudios de Casos y Controles , Regulación hacia Abajo , Inhibidores Enzimáticos/sangre , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Factores de TiempoRESUMEN
BACKGROUND: Cognitive deficit related to open heart surgery came into the focus of interest according to professional and social expectations. The negative effects on quality of life and the large number of involved patients emphasize the need its investigation. MATERIAL/METHODS: The bedside measurement of simple and choice reaction times (sRT and cRT) has the objectivity of cortical evoked potential analysis without the need for EEG instrumentation and laboratory. This is a functional assessment similar to neuropsychological tests, but requires a significantly shorter time and is less demanding for the patient. RESULTS: Fifty patients who had undergone open heart surgery were investigated. Statistically significant positive correlation of sRT and cRT prolongation and perfusion time was found. At the same time there were no statistically significant changes in mean sRT and cRT values before (sRT: 208+/-54 s, cRT: 369+/-59 s) and after (sRT: 229+/-67 s, cRT: 392+/-105 s) the surgery, probably due to the inhomogeneous patient population. The weak correlation (coefficients: 0.1418-0.8484) for sRT and cRT changes as a function of perfusion time confirms the presence of other factors of postoperative brain damage. CONCLUSIONS: The investigated bedside test is clinically feasible, simple, and can be completed within 30 minutes. Further studies are encouraged to compare this method with other tests in a larger, stratified cardiac surgery population.
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Trastornos del Conocimiento , Circulación Extracorporea/efectos adversos , Sistemas de Atención de Punto , Desempeño Psicomotor/fisiología , Tiempo de Reacción/fisiología , Adulto , Anciano , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Análisis de Regresión , Cirugía Torácica/métodosAsunto(s)
Presión Sanguínea , Índice de Masa Corporal , Humanos , Niño , Masculino , Adolescente , Femenino , Hungría , Presión Sanguínea/fisiología , Valores de Referencia , Estudios Transversales , Sobrepeso/fisiopatología , Determinación de la Presión Sanguínea/métodos , Preescolar , Adulto Joven , Arteria Braquial/fisiopatología , Obesidad/fisiopatología , Obesidad Infantil/fisiopatologíaRESUMEN
INTRODUCTION: Pulse wave velocity (PWV) and augmentation index (AIx) are parameters of arterial stiffness and wave reflection. PWV and AIx are strong indicators for cardiovascular risk and are used increasingly in clinical practice. Previous systems for assessment of PWV and AIx are investigator dependent and time consuming. The aim of this study was to validate the new oscillometric method (Arteriograph) for determining PWV and AIx by comparing it to two clinically validated, broadly accepted tonometric and piezo-electronic systems (SphygmoCor and Complior). DESIGN AND METHOD: PWV and AIx were measured up to five times in 51 patients with the SphygmoCor, Complior and Arteriograph. In 35 patients, the measurements were repeated after 1 week in a second session using the same protocol. RESULTS: The correlations of the PWV as assessed with the Arteriograph with the values obtained using the SphygmoCor (r = 0.67, P < 0.001) and the Complior (r = 0.69, P < 0.001) were highly significant. Variability and reproducibility for PWV were best for the Arteriograph, followed by Complior and SphygmoCor. AIx (SphygmoCor versus Arteriograph) were very closely correlated (r = 0.92, P < 0.001). PERSPECTIVES: The Arteriograph is a new, easy-to-use and time-effective method for assessing arterial stiffness and wave reflection.
Asunto(s)
Arterias/fisiopatología , Manometría , Oscilometría/métodos , Adulto , Anciano , Velocidad del Flujo Sanguíneo , Presión Sanguínea , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los ResultadosRESUMEN
AIM: We aimed to investigate the effects of a single carbon dioxide (CO2) treatment on arterial stiffness by monitoring the changes of aortic pulse-wave velocity (PWV) and aortic augmentation index (AIXao), which are indicators of arterial stiffness. PATIENTS AND METHODS: PWV and AIXao were measured by an invasively validated oscillometric device. The measurements of stiffness parameters were performed before the CO2 treatment, and at 1, 4 and 8 h after the first treatment. RESULTS: Thirty-one patients were included. No significant changes were found in PWV. AIXao decreased significantly 1 h and 4 h after CO2 treatment compared to baseline values (p=0.034 and p<0.001). AIXao increased 8 h after the CO2 treatment, but remained significantly lower than baseline AIXao values (p=0.016). CONCLUSION: CO2 treatment is capable of reducing peripheral vascular resistance. We hypothesize that CO2 is not only a temporal vasodilator but is also capable of activating vasodilation pathways.