RESUMO
The conjugation of doxorubicin (DOX) with nitric oxide (NO)-releasing groups gave rise to novel anthracyclines, such as nitrooxy-DOX (NitDOX), capable to overcome multidrug resistance. The widely described anthracycline cardiovascular toxicity, however, might limit their clinical use. This study aimed to investigate NitDOX-induced effects, as potential hazard, on vascular smooth muscle A7r5 and endothelial EA.hy926 cell viability, on the mechanical activity of freshly and cultured rat aorta rings, as well as on Cav1.2 channels of A7r5 cells. DOX was used as a reference compound. Although an increase in intracellular radicals and a reduction in mitochondrial potential occurred upon treatment with both drugs, A7r5 and EA.hy926 cells proved to be more sensitive to DOX than to NitDOX. Both compounds promoted comparable effects in A7r5 cells, whereas NitDOX was less active than DOX in inducing DNA damage and in eliciting apoptotic-mediated cell death revealed as an increase in sub-diploid-, DAPI- and annexin V-positive- EA.hy926 cell percentage. Moreover, in EA.hy926 cells, NitDOX doubled basal NO content, while preincubation with the NO-scavenger PTIO increased NitDOX-induced cytotoxicity. DOX exhibited a negligible contracturing effect in endothelium-intact rings, while NitDOX induced a significant ODQ-sensible, vasodilation in endothelium-denuded rings. In arteries cultured with both drugs for 7 days, NitDOX prevented either phenylephrine- or KCl-induced contraction at a concentration 10-fold higher than that of DOX. These results demonstrate that NitDOX displays a more favourable vascular toxicity profile than DOX. Taking into account its greater efficacy against drug-resistant cells, NitDOX is worth of further investigations in preclinical and clinical settings.
Assuntos
Antibióticos Antineoplásicos/administração & dosagem , Doxorrubicina/administração & dosagem , Doadores de Óxido Nítrico/administração & dosagem , Animais , Aorta/efeitos dos fármacos , Aorta/fisiologia , Linhagem Celular , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/fisiologia , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/fisiologia , Humanos , Técnicas In Vitro , Masculino , Músculo Liso Vascular/efeitos dos fármacos , Músculo Liso Vascular/fisiologia , Óxido Nítrico/química , Ratos Wistar , Vasodilatação/efeitos dos fármacosRESUMO
Altered vascular tone responsiveness to pathophysiological stimuli contributes to the development of a wide range of cardiovascular and metabolic diseases. Endothelial dysfunction represents a major culprit for the reduced vasodilatation and enhanced vasoconstriction of arteries. Adipose (fat) tissues surrounding the arteries play important roles in the regulation of endothelium-dependent relaxation and/or contraction of the vascular smooth muscle cells. The cross-talks between the endothelium and perivascular adipose tissues can be assessed ex vivo using mounted blood vessels by a wire myography system. However, optimal settings should be established for arteries derived from animals of different species, ages, genetic backgrounds and/or pathophysiological conditions.
Assuntos
Tecido Adiposo/fisiologia , Endotélio Vascular/fisiologia , Artérias Mesentéricas/fisiologia , Músculo Liso Vascular/fisiologia , Vasoconstrição/fisiologia , Vasodilatação/fisiologia , Tecido Adiposo/citologia , Tecido Adiposo/efeitos dos fármacos , Animais , Cardiotônicos/farmacologia , Endotélio Vascular/citologia , Endotélio Vascular/efeitos dos fármacos , Masculino , Artérias Mesentéricas/citologia , Artérias Mesentéricas/efeitos dos fármacos , Camundongos , Músculo Liso Vascular/citologia , Músculo Liso Vascular/efeitos dos fármacos , Miografia , Fenilefrina/farmacologia , Sirtuína 1/metabolismo , Vasoconstrição/efeitos dos fármacos , Vasodilatação/efeitos dos fármacosRESUMO
Desde diciembre de 2013, la Región de las Américas se enfrenta por primera vez a una epidemia de chikungunya. Los casos iniciales se registraron en el Caribe francés y, debido al comercio y la movilización de personas, esta epidemia no tardó en llegar a la República Dominicana, cuya población es de 10 millones de habitantes y comparte con Haití la isla La Española. En este artículo se difunde información extraída de diversos artículos y documentos oficiales sobre el virus, la infección y la epidemia de chikungunya, que han sido de gran ayuda para orientar la respuesta en la República Dominicana y pueden ser útiles para mejorar tanto el conocimiento como las actuaciones frente a la epidemia de los trabajadores del sector salud de la Región. Se destaca la importancia que revisten las investigaciones realizadas en países y territorios afectados del océano Índico, como la isla de Reunión, durante la epidemia declarada entre 2005 y 2007, cuando se registró una tasa de ataque mayor de 30%, se identificaron los grupos de riesgo, las formas graves y atípicas de la infección, la transmisión vertical del virus, las formas crónicas, que pueden provocar dolores recurrentes durante tres años, y las defunciones directa o indirectamente relacionadas con el virus chikungunya. Por su alta tasa de ataque, el virus chikungunya se convierte en un reto sin precedentes para los ministerios de salud, que exige una adecuada organización de los servicios de salud, la priorización de la atención a los grupos de riesgo y a los pacientes con formas graves de la enfermedad, así como una adecuada comunicación social y respuesta intersectorial.
The Region of the Americas has been affected since December 2013 by a chikungunya epidemic for the first time. Although the first cases were recorded in the French Caribbean, the epidemic quickly spread to the Dominican Republic due to trade and people movements. The Dominican Republic, which shares the island of Hispaniola with Haiti, has a population of 10 million. This article contains information from a range of different publications and official documents about the chikungunya virus infection and epidemic. These papers were extremely helpful for guiding the response to the epidemic in the Dominican Republic and may also be useful for enhancing knowledge of the virus and responses among health workers elsewhere in the region. Particular attention is drawn to the important research undertaken in countries and territories affected by the epidemic in the Indian Ocean area. This is the case, for example, of the island of La Réunion, where the epidemic had an attack rate of more than 30% between 2005 and 2007. Researchers were able to identify risk groups, severe and atypical forms of the infection, cases of vertical transmission, chronic disease causing recurrent pain over three years, and directly- or indirectly-related deaths from the virus. Given its high attack rate, the chikungunya virus has emerged as an exceptional challenge for health ministries and calls for appropriate organized responses from the health services, prioritization of care for risk groups and patients exhibiting severe forms of the disease, and effective social communication and intersectoral actions.
Assuntos
Animais , Ratos , DNA , Angiotensina II/farmacologia , Músculo Liso Vascular/efeitos dos fármacos , Inibidores da Agregação Plaquetária/farmacologia , /análogos & derivados , Vasoconstritores/farmacologia , Anti-Hipertensivos/farmacologia , Benzimidazóis/farmacologia , Compostos de Bifenilo/farmacologia , Divisão Celular/fisiologia , Células Cultivadas , Músculo Liso Vascular/fisiologia , Proteínas Proto-Oncogênicas c-fos/biossíntese , RNA Mensageiro/metabolismo , Ratos Endogâmicos WKY , Tetrazóis/farmacologia , /farmacologiaRESUMO
A mathematical model of renal hemodynamics was used to assess the individual contributions of the tubuloglomerular feedback (TGF) mechanism and the myogenic response to glomerular filtration rate regulation in the rat kidney. The model represents an afferent arteriole segment, glomerular filtration, and a short loop of Henle. The afferent arteriole model exhibits myogenic response, which is activated by hydrostatic pressure variations to induce changes in membrane potential and vascular muscle tone. The tubule model predicts tubular fluid and Cl(-) transport. Macula densa Cl(-) concentration is sensed as the signal for TGF, which acts to constrict or dilate the afferent arteriole. With this configuration, the model afferent arteriole maintains stable glomerular filtration rate within a physiologic range of perfusion pressure (80-180 mmHg). The contribution of TGF to overall autoregulation is significant only within a narrow band of perfusion pressure values (80-110 mmHg). Model simulations of ramp-like perfusion pressure perturbations agree well with findings by Flemming et al. (Flemming B, Arenz N, Seeliger E, Wronski T, Steer K, Persson PB. J Am Soc Nephrol 12: 2253-2262, 2001), which indicate that changes in vascular conductance are markedly sensitive to pressure velocity. That asymmetric response is attributed to the rate-dependent kinetics of the myogenic mechanism. Moreover, simulations of renal autoregulation in diabetes mellitus predict that, due to the impairment of the voltage-gated Ca(2+) channels of the afferent arteriole smooth muscle cells, the perfusion pressure range in which single-nephron glomerular filtration rate remains stable is reduced by ~70% and that TGF gain is reduced by nearly 40%, consistent with experimental findings.
Assuntos
Homeostase/fisiologia , Rim/fisiologia , Modelos Biológicos , Animais , Hemodinâmica/fisiologia , Rim/irrigação sanguínea , Potenciais da Membrana/fisiologia , Músculo Liso Vascular/fisiologiaRESUMO
BACKGROUND: Positron emission tomography (PET) during the cold pressor test (CPT) has been used to assess endothelium-dependent coronary vasoreactivity, a surrogate marker of cardiovascular events. However, its use remains limited by cardiac PET availability. As multidetector computed tomography (MDCT) is more widely available, we aimed to develop a measurement of endothelium-dependent coronary vasoreactivity with MDCT and similar radiation burden as with PET. METHODS AND RESULTS: A study group of 18 participants without known cardiovascular risk factor (9F/9M; age 60±6 years) underwent cardiac PET with (82)Rb and unenhanced ECG-gated MDCT within 4h, each time at rest and during CPT. The relation between absolute myocardial blood flow (MBF) response to CPT by PET (ml·min(-1)·g(1)) and relative changes in MDCT-measured coronary artery surface were assessed using linear regression analysis and Spearman's correlation. MDCT and PET/CT were analyzed in all participants. Hemodynamic conditions during CPT at MDCT and PET were similar (P>0.3). Relative changes in coronary artery surface because of CPT (2.0-21.2%) correlated to changes in MBF (-0.10-0.52ml·min(-1)·g(1)) (ρ=0.68, P=0.02). Effective dose was 1.3±0.2mSv for MDCT and 3.1mSv for PET/CT. CONCLUSIONS: Assessment of endothelium-dependent coronary vasoreactivity using MDCT CPT appears feasible. Because of its wider availability, shorter examination time and similar radiation burden, MDCT could be attractive in clinical research for coronary status assessment.
Assuntos
Vasos Coronários/fisiologia , Tomografia Computadorizada Multidetectores , Tomografia por Emissão de Pósitrons , Radioisótopos de Rubídio , Sistema Vasomotor/fisiologia , Idoso , Vasos Coronários/diagnóstico por imagem , Endotélio Vascular/diagnóstico por imagem , Endotélio Vascular/fisiologia , Estudos de Viabilidade , Feminino , Hemodinâmica/fisiologia , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Músculo Liso Vascular/diagnóstico por imagem , Músculo Liso Vascular/fisiologia , Fluxo Sanguíneo Regional/fisiologia , Ultrassonografia , Sistema Vasomotor/diagnóstico por imagemRESUMO
This paper describes the methodology and application of a wire myograph which has been used for the measurement of vascular reactivity. In an earlier years (pre-1970s) most of the information about the mechanical, morphological and pharmacological properties of vascular smooth muscle was confined only to larger arteries (mainly aorta). Whereas information about smaller arteries was purely inferred from perfusion experiments and histological examination. However, after mid-1970s Prof. Mulvany and Prof. Halpern developed and introduced an astonishing technique, a wire myography, to study the contractile responses of an isolated small resistance arteries (approximately 100-300 microm in internal diameter). This work describes some of the principles used in the investigation of the vessels, based on the use of the small vessel dual wire myograph. A dual myograph allows us simultaneous testing of two vessels. The technique allows segments of small arteries to be mounted as the ring preparations to the myograph chamber, and providing measurements of isometric responses. On the other hand, there are other techniques including an isobaric and isotonic mounting of arteries have been developed to date. The myograph has been used for the investigation of a variety of small and larger arteries and other tubular structures from a wide range of species. In the second part of this report we show an experimental example concerning measurement of endothelial functionality by technique described therein before.
Assuntos
Músculo Liso Vascular/fisiologia , Miografia/instrumentação , Vasoconstrição/fisiologia , Vasodilatação/fisiologia , Animais , HumanosRESUMO
Adequate blood flow provision through alterations in maternal vascular function is essential during pregnancy for optimal fetal development. Abnormal uterine vasculature adaptation, resulting in aberrant blood flow to the placenta, has been implicated as a possible cause of fetal growth restriction (FGR). Our study aimed to develop strategies to evaluate murine vascular function in pregnancy using wire myography. Main uterine artery loop and branch vessels isolated from near-term pregnant mice showed significant contraction to phenylephrine (PE). Endothelial-dependent relaxation was noted with acetylcholine (ACH). U46619 elicited significant contraction of umbilical arteries and veins, but relaxation was only demonstrable with the nitric oxide (NO) donor sodium nitroprusside (SNP). In conclusion, our data suggest that murine uteroplacental and fetoplacental arteries show distinct responses to vasoactive agents. Furthermore, this study indicates that wire myography represents a robust technique for the assessment of murine uteroplacental and fetoplacental vascular function, which will aid evaluation of mouse genetic models of FGR.
Assuntos
Feto/irrigação sanguínea , Músculo Liso Vascular/fisiologia , Placenta/irrigação sanguínea , Útero/irrigação sanguínea , Vasoconstrição , Vasodilatação , Animais , Relação Dose-Resposta a Droga , Feminino , Técnicas In Vitro , Camundongos , Camundongos Endogâmicos C57BL , Músculo Liso Vascular/efeitos dos fármacos , Miografia , Circulação Placentária , Gravidez , Fluxo Sanguíneo Regional , Artérias Umbilicais/fisiologia , Veias Umbilicais/fisiologia , Vasoconstrição/efeitos dos fármacos , Vasoconstritores/farmacologia , Vasodilatação/efeitos dos fármacos , Vasodilatadores/farmacologiaRESUMO
The kidney displays highly efficient autoregulation so that under steady-state conditions renal blood flow (RBF) is independent of blood pressure over a wide range of pressure. Autoregulation occurs in the preglomerular microcirculation and is mediated by two, perhaps three, mechanisms. The faster myogenic mechanism and the slower tubuloglomerular feedback contribute both directly and interactively to autoregulation of RBF and of glomerular capillary pressure. Multiple experiments have been used to study autoregulation and can be considered as variants of two basic designs. The first measures RBF after multiple stepwise changes in renal perfusion pressure to assess how a biological condition or experimental maneuver affects the overall pressure-flow relationship. The second uses time-series analysis to better understand the operation of multiple controllers operating in parallel on the same vascular smooth muscle. There are conceptual and experimental limitations to all current experimental designs so that no one design adequately describes autoregulation. In particular, it is clear that the efficiency of autoregulation varies with time and that most current techniques do not adequately address this issue. Also, the time-varying and nonadditive interaction between the myogenic mechanism and tubuloglomerular feedback underscores the difficulty of dissecting their contributions to autoregulation. We consider the modulation of autoregulation by nitric oxide and use it to illustrate the necessity for multiple experimental designs, often applied iteratively.
Assuntos
Homeostase , Rim/fisiologia , Circulação Renal/fisiologia , Animais , Bloqueadores dos Canais de Cálcio/farmacologia , Retroalimentação , Rim/irrigação sanguínea , Glomérulos Renais/fisiologia , Túbulos Renais/fisiologia , Músculo Liso Vascular/fisiologia , Nifedipino/farmacologia , Óxido Nítrico/fisiologia , Ratos , Circulação Renal/efeitos dos fármacos , Sistema Renina-Angiotensina/fisiologiaAssuntos
Circulação Coronária , Doença das Coronárias/fisiopatologia , Células Endoteliais/fisiologia , Angiografia Coronária , Circulação Coronária/efeitos dos fármacos , Circulação Coronária/fisiologia , Doença das Coronárias/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Humanos , Microcirculação , Músculo Liso Vascular/fisiologia , Fatores de Risco , Tomografia Computadorizada de Emissão , Tomografia Computadorizada de Emissão de Fóton Único , Vasodilatação/efeitos dos fármacosRESUMO
The potent neuropeptide vasodilator, calcitonin gene-related peptide (CGRP), and the vasoactive peptide adrenomedullin (AM) are structurally related. Evidence from our laboratory has demonstrated that these peptides have potent microvascular actions of relevance to cardiovascular and inflammatory effects in health and disease. We wish to further investigate the actions of these peptides through studies in genetically modified mice. We have developed techniques to enable the quantitative analysis of CGRP and AM responses in the mouse microvasculature. A mouse isolated mesentery system was developed that measures changes in perfusion pressure used as an index of microvascular relaxation in the precontracted mesenteric microvascular bed. Bolus injections of CGRP and AM caused dose-dependent decreases in perfusion pressure that were proportional to vascular relaxation. An in vivo mouse skin assay was also used in which agents were injected intradermally into the dorsal skin. The effects of these agents was assessed by the extravascular accumulation of intravenously injected 125I-albumin for their ability to potentiate plasma extravasation induced by a mediator of increased microvascular permeability. CGRP and AM are not directly active in this assay, because it does not directly measure blood flow. However, the vasodilators acted in a potent and dose-dependent manner to significantly potentiate edema formation. The results demonstrate the potent activity of CGRP and the activity (although 100- to 300-fold less potent) of AM. Furthermore, the results demonstrate the increased potency of CGRP in the microvasculature when compared with the structurally distinct peptide VIP and PGE1.
Assuntos
Vasos Sanguíneos/fisiologia , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Microcirculação/metabolismo , Peptídeos/metabolismo , Fluxo Sanguíneo Regional/fisiologia , Vasodilatação/fisiologia , Adrenomedulina , Albuminas/farmacocinética , Alprostadil/metabolismo , Alprostadil/farmacologia , Animais , Vasos Sanguíneos/efeitos dos fármacos , Peptídeo Relacionado com Gene de Calcitonina/farmacologia , Permeabilidade Capilar/efeitos dos fármacos , Permeabilidade Capilar/fisiologia , Relação Dose-Resposta a Droga , Artérias Mesentéricas/efeitos dos fármacos , Artérias Mesentéricas/fisiologia , Camundongos , Microcirculação/efeitos dos fármacos , Músculo Liso Vascular/efeitos dos fármacos , Músculo Liso Vascular/fisiologia , Peptídeos/farmacologia , Ratos , Fluxo Sanguíneo Regional/efeitos dos fármacos , Substância P/farmacologia , Peptídeo Intestinal Vasoativo/metabolismo , Peptídeo Intestinal Vasoativo/farmacologia , Vasodilatação/efeitos dos fármacos , Vasodilatadores/metabolismo , Vasodilatadores/farmacologiaRESUMO
Changes in diastolic indexes during normal aging, including reduced early filling velocity (E), lengthened E deceleration time (DT), augmented late filling (A), and prolonged isovolumic relaxation time (IVRT), have been attributed to slower left ventricular (LV) pressure (LVP) decay. Indeed, this constellation of findings is often referred to as the "abnormal relaxation" pattern. However, LV filling is determined by the atrioventricular pressure gradient, which depends on both LVP decline and left atrial (LA) pressure (LAP). To assess the relative influence of LVP decline and LAP, we studied 122 normal subjects aged 21-92 yr by Doppler echocardiography and MRI. LVP decline was assessed by color M-mode (V(p)) and the LV untwisting rate. Early diastolic LAP was evaluated using pulmonary vein flow systolic fraction, pulmonary vein flow diastolic DT, color M-mode (E/V(p)), and tissue Doppler (E/E(m)). Linear regression showed the expected reduction of E, increase in A, and prolongation of IVRT and DT with advancing age. There was no relation of age to parameters reflecting the rate of LVP decline. However, older age was associated with reduced E/V(p) (P = 0.008) and increased pulmonary vein systolic fraction (P < 0.001), pulmonary vein DT (P = 0.0026), and E/E(m) (P < 0.0001), all suggesting reduced early LAP. Therefore, reduced early filling in older adults may be more closely related to a reduced early diastolic LAP than to slower LVP decline. This effect also explains the prolonged IVRT. We postulate that changes in LA active or passive properties may contribute to development of the abnormal relaxation pattern during the aging process.
Assuntos
Envelhecimento/fisiologia , Diástole/fisiologia , Ecocardiografia , Imageamento por Ressonância Magnética , Função Ventricular Esquerda/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Baltimore , Estudos Transversais , Feminino , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Liso Vascular/crescimento & desenvolvimento , Músculo Liso Vascular/fisiologia , Veias Pulmonares/crescimento & desenvolvimento , Veias Pulmonares/fisiologia , Análise de Regressão , Reprodutibilidade dos Testes , Sístole/fisiologiaRESUMO
Angiotensin II (Ang II) is involved in hypertension-related arterial wall hypertrophy [1]. Regulation of AT II transduction pathway in vascular smooth muscle cells (VSMC) may involve cytoskeleton and extracellular matrix (ECM) [2]. We assessed the role of components of ECM on Cai2+ increase induced by Ang II in Wistar-Kyoto (WKY) and Spontaneously Hypertensive Rats (SHR) aortic VSMC. The effect of Ang II (1 mumol) on Ca2+ mobilization was studied in cultured VSMC isolated from the aorta of 6-wk old WKY (MAP (m +/- SE) = 98 +/- 4 mmHg) and SHR (136 +/- 5 mmHg; p < 0.05), using fluorescent imaging microscopy (Fura-2 AM). Cai2+ release from internal stores and Ca2+ influx were assessed in the absence and upon reintroduction of external Ca2+ respectively. Cells were cultured on uncoated glass coverslips (control) or coated with either collagen I (10 micrograms/mL), collagen IV (7 micrograms/mL), vitronectin (0.1 microgram/mL), fibronectin (3 micrograms/mL) and extracellular matrix extract (matrigel, 1/10) and studied at confluence. Paxillin was located in cells by indirect immunofluorescence micrography. Results are expressed in % of Control. Statistical significance (p < 0.05) was assessed with Student's t-test for unpaired data. The effects on Ang II-induced Ca2+ mobilization of growing cells on ECM are in Table. Paxillin in Control cells appeared as dots at the cell boundaries. Density increased in cells grown on collagen I with a diffuse distribution in the WKY cells. On matrigel, paxillin was located in a belt-like fashion at the periphery of the cell. These effects were not linked to differences in cell cycle (flux cytometry).
Assuntos
Angiotensina II/farmacologia , Aorta/fisiologia , Matriz Extracelular/fisiologia , Músculo Liso Vascular/fisiologia , Animais , Canais de Cálcio , Técnicas de Cultura de Células , Hipertensão/fisiopatologia , Ratos , Ratos Endogâmicos SHR , Ratos Endogâmicos WKY , Transdução de SinaisRESUMO
The passive elastic characteristics of the abdominal aorta were investigated in two experimental animal models, aiming at assessing the stress-strain relation of the aortic wall. Twenty porcine and 15 rabbit healthy abdominal aortas were subjected to uniaxial stress-strain analysis, performed on a tensile-testing device, while immersed in a physiologic saline bath at body temperature. Measured parameters included original length, width and thickness, as well as axial force and extension. Based on these data, Kirchhoff stress and Green-St.Venant strain were computed and one-dimensional constitutive equations were defined, comprising of a power function and two exponential ones, in turn, for the low, physiologic and high-stress regions. The stress-strain curves were plotted as elastic modulus versus stress, displaying nonlinear part I and linear parts II and III. These were regressed, yielding parameters k, q (part I), a, b (part II) and c, d (part III). A detailed comparison of these constitutive parameters was undertaken between the two species, demonstrating variations in d (p<0.05). No statistical differences were found in parameters a, b, c, k and q, implying that the two aortas were equally stiff under low and physiologic stresses, whereas the porcine aorta was stiffer at higher stresses. In conclusion, a bi-exponential in addition to a power law was established, relating stress and strain in the aorta, which is advantageous in comparison with previous constitutive equations. Under passive conditions, the nonlinear nature of this constitutive law may account for the low, part I, physiologic, part II, and high-stress, part III of the stress-strain relationship, supporting the concept of the aortic wall as a biphasic material.
Assuntos
Aorta Abdominal/fisiologia , Simulação por Computador , Endotélio Vascular/fisiologia , Modelos Cardiovasculares , Músculo Liso Vascular/fisiologia , Especificidade da Espécie , Animais , Cadáver , Elasticidade , Feminino , Técnicas In Vitro , Masculino , Dinâmica não Linear , Coelhos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Estresse Mecânico , SuínosRESUMO
CONTEXT: Complications of atherosclerosis cause most morbidity and mortality in patients with diabetes mellitus. Despite the frequency and severity of disease, proven medical therapy remains incompletely understood and underused. OBJECTIVE: To review the epidemiology, pathophysiology, and medical and invasive treatment of atherosclerosis in patients with diabetes mellitus. DATA SOURCES: Using the index terms diabetes mellitus, myocardial infarction, peripheral vascular diseases, cerebrovascular accident, endothelium, vascular smooth muscle, platelets, thrombosis, cholesterol, hypertension, hyperglycemia, insulin, angioplasty, and coronary artery bypass, we searched the MEDLINE and EMBASE databases from 1976 to 2001. Additional data sources included bibliographies of identified articles and preliminary data presented at recent cardiology conferences. STUDY SELECTION: We selected original investigations and reviews of the epidemiology, pathophysiology, and therapy of atherosclerosis in diabetes. We selected randomized, double-blind, controlled studies, when available, to support therapeutic recommendations. Criteria for data inclusion (168 of 396) included publication in a peer-reviewed journal or presentation at a national cardiovascular society-sponsored meeting. DATA EXTRACTION: Data quality was determined by publication in peer-reviewed literature. Data extraction was performed by one of the authors. DATA SYNTHESIS: Diabetes mellitus markedly increases the risk of myocardial infarction, stroke, amputation, and death. The metabolic abnormalities caused by diabetes induce vascular dysfunction that predisposes this patient population to atherosclerosis. Blood pressure control, lipid-lowering therapy, angiotensin-converting enzyme inhibition, and antiplatelet drugs significantly reduce the risk of cardiovascular events. Although diabetic patients undergo revascularization procedures because of acute coronary syndromes or critical limb ischemia, the outcomes are less favorable than in nondiabetic cohorts. CONCLUSIONS: Since most patients with diabetes die from complications of atherosclerosis, they should receive intensive preventive interventions proven to reduce their cardiovascular risk.
Assuntos
Arteriosclerose , Diabetes Mellitus Tipo 2/fisiopatologia , Angiopatias Diabéticas , Arteriosclerose/epidemiologia , Arteriosclerose/fisiopatologia , Arteriosclerose/terapia , Coagulação Sanguínea/fisiologia , Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/etiologia , Transtornos Cerebrovasculares/fisiopatologia , Transtornos Cerebrovasculares/terapia , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/etiologia , Doença da Artéria Coronariana/fisiopatologia , Doença da Artéria Coronariana/terapia , Diabetes Mellitus Tipo 2/complicações , Angiopatias Diabéticas/epidemiologia , Angiopatias Diabéticas/fisiopatologia , Angiopatias Diabéticas/terapia , Endotélio Vascular/fisiologia , Feminino , Humanos , Hiperglicemia/fisiopatologia , Hiperlipidemias/fisiopatologia , Hipertensão/fisiopatologia , Resistência à Insulina/fisiologia , Masculino , Músculo Liso Vascular/fisiologia , Doenças Vasculares Periféricas/epidemiologia , Doenças Vasculares Periféricas/etiologia , Doenças Vasculares Periféricas/fisiopatologia , Doenças Vasculares Periféricas/terapia , Agregação Plaquetária/fisiologiaRESUMO
The dynamic mechanical characteristics of the arterial wall, especially its alinearity and viscoelastic behaviour, are revealed by pressure-distension loops, where the change in diameter (distension) of a lumen is plotted as a function of the change in transmural pressure. For linearity, the pressure-distension loop should be closed and straight, while viscous behavior results in an open loop. For a correct interpretation of the loops, it is essential that both distension and pressure are recorded simultaneously at the same location and processed by circuitries having the same frequency characteristics. The present paper aims at quantifying the effect of misalignment in recording position and of mismatch in frequency characteristics by analyzing the distension and pressure waveforms obtained at known locations in a phantom rig under pulsatile conditions with equipment with a validated frequency response. It is concluded that misalignment of only a few millimeters or mismatch in frequency response, even if the cutoff frequencies are far beyond the signal frequencies of interest, strongly affects the shape of the pressure-distension loop. If the forward and reflected pressure wave partially coincide, position misalignment cannot adequately be corrected for. The frequency mismatch, however, can be corrected for by crosswise preprocessing a waveform by a filter with the frequency response of the registration equipment used for the recording of the other waveform. It is important to consider these artifacts in interpreting pressure-distension loops in the clinical situation.
Assuntos
Artérias/fisiologia , Pressão Sanguínea/fisiologia , Hemorreologia/instrumentação , Modelos Anatômicos , Vasodilatação/fisiologia , Artérias/ultraestrutura , Artefatos , Elasticidade , Desenho de Equipamento , Humanos , Músculo Liso Vascular/fisiologia , Músculo Liso Vascular/ultraestrutura , Pressão , Fluxo Pulsátil , Estresse Mecânico , Ultrassom , ViscosidadeRESUMO
Cold storage is frequently used to store isolated blood vessels for a limited period of time. However preservation of vascular smooth muscle and endothelial functions is time and medium-dependent. The present study was designed to compare the reactivity of rat aorta before and after cold storage for 24 and 48 h in one of four different solutions consisting of Hepes-buffered Krebs solution, Belzer solution, Krebs solution, and Eurocollins solution. Smooth muscle and endothelial functions of the rat aorta were assessed using in vitro isometric tension measurement. The results obtained for vessels preserved for 24 and 48 h were compared with those for vessels studied immediately after harvesting. Sensitivity and maximum contraction to KCl and norepinephrine were not altered in rat aorta preserved up to 48 h in Hepes-Krebs and Belzer solutions. In contrast, the amplitude of contraction elicited by KCl was significantly reduced by 50% and 77% in aorta stored for 24 and 48 h in Krebs solution and by 77% and 96% in those stored in Eurocollins solutions. Similarly, the maximal contraction elicited by norepinephrine was significantly reduced by 60% and 45% in arteries stored for 24 and 48 h in Krebs solution and by 34% and 86% in those stored in Eurocollins solution. In contrast, cold storage in the different media did not alter the relaxations elicited by sodium nitroprusside and forskolin. The endothelium-dependent relaxations in response to acetylcholine were not statistically modified after preservation up to 48 h in Hepes-Krebs solution. In contrast, the maximal relaxations to acetylcholine were significantly decreased after storage for 24 and 48 h in Belzer, Krebs and Eurocollins solutions. These results suggest that among the four media studied, Hepes-Krebs solution is the most suitable medium for the storage of blood vessels under hypothermic conditions.
Assuntos
Aorta Torácica , Criopreservação/métodos , Endotélio Vascular/fisiologia , Músculo Liso Vascular/fisiologia , Soluções para Preservação de Órgãos/química , Preservação de Órgãos/métodos , Animais , Aorta Torácica/fisiologia , Técnicas In Vitro , Contração Isométrica/fisiologia , Masculino , Óxido Nítrico/fisiologia , Ratos , Ratos Sprague-DawleyRESUMO
Knowledge about vascular regulation in bone is central to the understanding of both normal and pathological bone physiology. This article describes a new method for direct assessment of the reactivity of bone blood vessels. Resistance arteries (diameter approximately 250 microns) were isolated from epiphyseal cancellous bone (porcine femoral condyle). Arterial segments (2 mm long) were mounted as ring preparations on a myograph, and isometric force development was measured continuously. Fifty-nine vessels from 31 pigs were investigated. The active force development was maximal at 0.9 x L100 in nine of 12 investigated arteries (L100 corresponds to the circumference the vessel would have if relaxed and exposed to a luminal pressure of 100 mm Hg [13.3 kPa]). In all subsequent experiments, the vessels were stretched to 0.9 x L100. Noradrenaline (2 x 10(-8) to 10(-5) M) induced a concentration-dependent vasoconstriction; mean maximal tension development was 3.69 N/m. This force development would enable the arteries to contract against a pressure of more than 22 kPa (165 mm Hg), indicating preserved function of the media smooth muscle. Response to acetylcholine (10(-7) to 10(-5) M) was observed in only two of 12 arteries. Bradykinin (10(-11) to 10(-6) M) induced a concentration-dependent and reproducible relaxation in all vessels; the relaxation was endothelium-dependent, since no effect of bradykinin was detected after mechanical removal of the endothelium. Sodium nitroprusside (10(-4) M) induced a reproducible and endothelium-independent vasorelaxation. The results demonstrate preserved function of both smooth muscle and endothelium in this preparation. The model allows pharmacological investigations of bone arteries under well defined conditions and enables studies on focal bone lesions and human bone tissue.
Assuntos
Osso e Ossos/irrigação sanguínea , Miografia/métodos , Resistência Vascular , Sistema Vasomotor/fisiologia , Animais , Artérias/fisiologia , Artérias/ultraestrutura , Endotélio Vascular/fisiologia , Endotélio Vascular/ultraestrutura , Feminino , Masculino , Músculo Liso Vascular/fisiologia , Miografia/instrumentação , Suínos , VasoconstriçãoRESUMO
The objective of these experiments was to test the hypothesis that the major alkaloid classes found in endophyte-infected tall fescue could act as growth promoters for vascular smooth muscle. Bovine vascular smooth muscle cells (VSMC) from the dorsal metatarsal artery were grown in vitro and exposed to five concentrations (10(-6), 10(-8), 10(-9), 10(-11) and 0 M) of ergonovine, alpha-ergocryptine, ergovaline, and N-acetyl loline for 48 h. The mitogenic potential of the alkaloids was tested on both actively growing cells (serum fed, 10% fetal bovine serum) and quiescent cells (serum starved, 0.1% serum) to assess the need for serum constituents for alkaloid induced growth or toxicity. Ergonovine stimulated (P < .07) VSMC growth at 10(-6) M concentration in growing and quiescent culturs and at 10(-8) M concentration in quiescent cultures. alpha-Ergocryptine stimulated (P < .01) growth at 10(-6) M concentration in growing cultures and at 10(-8) and 10(-9) M concentrations in quiescent cultures. Ergovaline exhibited a dual activity on the growth of VSMC in culture, stimulating (P = .06) growth of quiescent cells at 10(-9) M concentration but inhibiting (P < .05) growth of growing cultures at concentrations of 10(-6) and 10(-9) M. This duality of activity was also noted for N-acetyl loline: N-acetyl loline stimulated (P < .05) growth of quiescent cultures at concentrations of 10(-8), 10(-9), and 10(-11) M but inhibited (P < .05) growth of growing cultures at concentrations of 10(-8) and 10(-9) M. The growth effects of the alkaloids in vitro on VSMC support in part the hypothesis that the alkaloids may contribute to the vascular complications noted in cattle grazing endophyte-infected tall fescue through hyperplasia of the intima. This would result in a decreased luminal diameter of the blood vessels and a resultant decrease in blood flow to the afflicted tissues. The diminished blood flow to tissues would result in tissue death and reduced ability to dissipate heat.
Assuntos
Acremonium/metabolismo , Alcaloides de Claviceps/farmacologia , Músculo Liso Vascular/citologia , Poaceae , Animais , Bovinos , Doenças dos Bovinos/etiologia , Doenças dos Bovinos/fisiopatologia , Divisão Celular/efeitos dos fármacos , Divisão Celular/fisiologia , Células Cultivadas , Relação Dose-Resposta a Droga , Alcaloides de Claviceps/metabolismo , Ergotismo/etiologia , Ergotismo/fisiopatologia , Ergotismo/veterinária , Técnicas In Vitro , Masculino , Músculo Liso Vascular/efeitos dos fármacos , Músculo Liso Vascular/fisiologia , Vasodilatação/efeitos dos fármacos , Vasodilatação/fisiologiaRESUMO
In anesthetized, mechanically ventilated cats we studied the effects on pulmonary circulation of sustained distension or increased air flow stream in an isolated, innervated upper airway segment constituted by the cervical trachea, the larynx and the pharynx. Direct and averaged pulmonary artery pressures and blood flows were measured. In intact cats, sustained distension as well as increased air flow stream in the upper airway segment induced significant, marked increase in pulmonary artery pressure with concomitant decrease in blood flow. No change in heart rate occurred. Section of the superior laryngeal nerves (SLNs), which denervated the tracheolaryngeal segment but not the epipharynx, markedly reduced and delayed the pulmonary vascular response to mechanical stimulation of the upper airways. The response was not found after cervical bivagotomy. The present observations demonstrate the existence of an airway-to-pulmonary circulation reflex, largely mediated through SLNs afferent pathways, the vagus nerve constituting the efferent arm of the reflex.