Impact of imidapril on cardiac mitochondrial function in an ex-vivo animal model of global myocardial ischemia.

Imidapril is an angiotensin I converting enzyme inhibitor, a class of drugs with known cardioprotective activity. It is now known that this is due not only to their antihypertensive activity, but also to the fact that they decrease cellular and tissue levels of angiotensin II, a potent vasoconstrictor and inducer of myocardial fibrosis. These mechanisms may explain the good clinical results of this class of drugs in the treatment of coronary artery disease and heart failure, two diseases whose etiopathogenesis is closely related to the activation of the renin-angiotensin-aldosterone system. However, the impact of this class of drugs on cardiac mitochondrial function during acute myocardial ischemia is still largely unknown. With the aim of studying the effect of imidapril on cardiac mitochondrial function during acute ischemia, we used an ex-vivo animal model, perfused in a Langerdorff system and then subjected to ischemia in the presence or absence of imidapril. We evaluated mitochondrial membrane electrical potential, respiratory chain O2 consumption, and rate and amplitude of mitochondrial swelling. We conclude that imidapril did not significantly change oxygen consumption by cardiac mitochondria, as assessed by the rate of respiratory state 3 (the state that corresponds to the active phosphorylation phase). However, imidapril significantly increased transmembrane electrical potential and, in ischemic cardiac mitochondria, was able to prevent the calcium-induced increase in the rate and amplitude of mitochondrial swelling, thus enabling better preservation of mitochondrial membrane structure, with consequent improvement of electrical potential after the phosphorylation cycle. These findings enabled a better understanding of the mechanisms behind the cytoprotection provided by imidapril during ischemic cardiomyopathy, clearly highlighting, at a cellular biology level, the importance of pharmacological modulation of cardiac mitochondrial function during acute ischemia.

[Dysmenorrhea in adolescents and young adults: prevalence, related factors and limitations in daily living]. / Dismenorreia em adolescentes e jovens adultas: prevalência, factores associados e limitações na vida diária.

OBJECTIVE: To determine the prevalence of dysmenorrhea, limitations in daily living and health care use due to menstrual pain. MATERIAL AND METHODS: Observational transversal study of 274 adolescents and young adults (age ≤ 26) who had menstruated in the six months prior to the study, assisted at a Primary Health Care Center. Data were obtained by a 24-item anonymous questionnaire, which included questions about socio-demographic variables, menstrual cycle, presence, duration, severity, treatment and limitations of dysmenorrhea. RESULTS: One hundred and seventy-two (62.8%) subjects experienced menstrual pain. Of these, 65.7% reported having limitations in their daily activities due to dysmenorrhea. The prevalence of limitations in daily living was influenced by the presence of additional symptoms (r=0.331; p <0.001), pain intensity (r=0.281; p <0.001) and pain duration (r=0.172; p=0.027). The most commonly mentioned limitation was anxiety/depression (42.5%). Fourteen of the subjects reported missing school or work due to dysmenorrhea. A total of 48 respondents sought medical help and 135 reported using therapeutic measures to ease their pain. The most common treatments reported for pain treatment included NSAID's (38.5%) and oral pills (37.0%). The existence of additional symptoms (r=0.247; p=0.001) and the intensity of pain (r=0.160; p=0.039) led to the search for health care. CONCLUSIONS: Dysmenorrhea is highly prevalent among this sample of adolescents and young adults and is related to absenteeism. Thus, health care providers should regularly screen for dysmenorrhea and offer appropriate treatment.