RESUMO
OBJECTIVES: Parameters of body surface potential mapping (BSPM) in DM II patients are significantly different comparing with healthy non-diabetic subjects. Hypothesis that these changes are more pronounced in DM II patients with depression was tested in the present study. For this purpose, analysis of the relationship between the Int-QRST (isointegral) maps distribution and the depressive symptoms intensification, as well interrelation between depressive and diabetic symptoms were performed. MATERIAL AND METHODS: BSPM registrations were obtained from the three study groups (aged 37-52 years), namely 40 diabetic patients with clinically documented depression, 30 depressive patient without DM and 90 normal subjects. BSPM recordings were displayed in a form of the Int-QRST maps. Examination with BDI and HbA1c test were also performed in all investigated subjects. RESULTS: Isointegral QRST maps turned out to display abnormal, i.e. non-dipolar distribution. Moreover, extent of Int-QRST maps multipolarity increased in the examined diabetic patients along with DM II duration, BDI scores and HbA1c level. CONCLUSIONS: Non-dipolar distribution of Int-QRST maps, more pronounced in diabetic patients with depression, can be a specific indicator of the increased risk of severe ventricular arrhythmias occurring prior to abnormalities detectable on the standard 12-lead ECG recordings, which is of great importance especially in prevention of life-threatening arrhythmias.
Assuntos
Arritmias Cardíacas/fisiopatologia , Mapeamento Potencial de Superfície Corporal , Depressão/diagnóstico , Diabetes Mellitus/diagnóstico , Adulto , Idoso , Mapeamento Potencial de Superfície Corporal/métodos , Depressão/complicações , Eletrocardiografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos TestesRESUMO
The purpose of the research was to determine the effect of the use of a diet containing 30% triticale grain. In an experiment lasting 28 days, 180 one-day Ross-308 chickens (sex ratio 1:1) with an average initial body weight in treatment of 44.6 g were randomly assigned to 30 metabolic cages/replications, 6 birds in each. To compare the results between treatments, a one-way ANOVA was used with uneven replication numbers. The control group (I) received a standard diet containing maize and soybean meal. In the other treatments, 30% of different cereals were used: II-wheat, III-barley, and IV-triticale. Significant differences in body weight (BW) and feed conversion ratio (FCR) were observed on the 4th day of the life of broiler chickens (p < 0.05). Differences were determined between the control group (90.7 g BW and 1.32 kg of feed/kg BWG in the case of FCR) and birds receiving barley (93.0 g BW and 1.29 kg of feed/kg BWG in the case of FCR), compared to chickens fed diets with a 30% share of wheat grain (86.2 g BW and 1.53 kg feed/kg BWG in the case of FCR) and triticale (86.6 g BW and 1.53 kg feed/kg BWG in the case of FCR). Later, the differences in performance of birds between treatments did not occur (p > 0.05). In the nutrition of broiler chickens, control or 30% of the triticale diet caused a significant reduction (p < 0.01) of the number of Escherichia coli (E. coli) in the crop of broiler chickens (0 log cfu/g), compared to birds obtaining feed with 30% of wheat (1.78 log cfu/g). The diet containing triticale also reduced the number of E. coli (p < 0.05) within the ileum (0.78 log cfu/g) compared to chickens obtaining barley grain in the diet (2.12 log cfu/g). As a result of the use of triticale grain (p < 0.05), the total length of the bird intestines (199.64 cm) was compared to 30% of barley grain (209.76 cm). The increase in the length of the large intestine of broiler chickens in treatments was positively correlated (r = 0.613, p < 0.05) with the number of Lactobacillus sp. in the ileum. Triticale increased the pH in the crop of broilers chickens. The research results indicate that triticale, after longer storage, can be used in amounts of 30% of the diet without significant effect on the performance of broiler chickens, with a reduction in E. coli in crop in comparison with wheat and in ileum with barley.
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Children with chronic kidney disease (CKD) are affected by cardiovascular complications, including disturbances in the intraventricular conduction system. Body surface potential mapping (BSPM) is a non-invasive method of assessing the cardioelectrical field. Our aim was to investigate conduction disturbances in young CKD patients using ventricular activation time (VAT) maps. Our study comprised 22 CKD children (mean age: 13.1 ± 2.5 years) treated conservatively and 29 control patients. For each child 12-lead electrocardiogram (ECG) readings were taken, and blood pressure and serum concentrations of iPTH, Pi, t-Ca, creatinine, Fe(+3), ferritin, and Hb, as well as eGFR were measured. All children underwent registration in the 87-lead BSPM system, and group-mean VAT maps and a difference map, which presents statistically significant differences between the groups, were created. The VAT map distribution in CKD patients revealed abnormalities specific to left anterior fascicle block. The difference map displays the areas of intergroup VAT changes, which are of discriminative value in detecting intraventricular conduction disturbances. Intraventricular conduction impairments in the left bundle branch may occur in children with CKD. BSPM enables conduction disturbances in CKD children to be detected earlier than using 12-lead ECG. The difference map derived from the group-mean isochrone maps precisely localizes the sites of disturbed conduction in the heart intraventricular conduction system.
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Mapeamento Potencial de Superfície Corporal , Nefropatias/fisiopatologia , Adolescente , Criança , Doença Crônica , Eletrocardiografia , Feminino , Ventrículos do Coração/fisiopatologia , Humanos , MasculinoRESUMO
Aim of the study was to assess the effect of KT on heart conduction in HD children. Non-invasive electrocardiographic method of BSPM was used. Isochrone maps, presenting a VAT distribution, were taken from eight HD patients and 26 normal subjects. Patients were divided into two groups: I--three children were HD <12 months prior to KT; II--five children were HD >12 months prior to KT. After KT, the groups were marked as IP and IIP. Serum iPTH and phosphate levels were significantly higher in both HD groups than in controls, with a considerable normalization after transplantation. HD patients demonstrated neither conduction abnormalities on ECG nor left ventricular hypertrophy. Group-mean VAT maps revealed: I and II--similar patterns of complete LBBB; IP--partial normalization to a pattern of anterior fascicle block; IIP--preserved pattern of LBBB. Intraventricular conduction disturbances found in HD children using BSPM were alleviated by KT. Short HD therapy increases a chance of conduction disturbances regression after KT, contrary to the longer HD treatment. BSPM is more sensitive than standard ECG in detecting heart conduction impairments in the HD patients.
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Arritmias Cardíacas/etiologia , Mapeamento Potencial de Superfície Corporal , Falência Renal Crônica/terapia , Transplante de Rim , Diálise Renal/efeitos adversos , Adolescente , Arritmias Cardíacas/diagnóstico , Bloqueio de Ramo/diagnóstico , Bloqueio de Ramo/etiologia , Criança , Eletrocardiografia , Feminino , Humanos , Falência Renal Crônica/cirurgia , MasculinoRESUMO
Body Surface Potential Mapping (BSPM) is a multi-electrode synchronous method for examining electrocardiographic records on the patients' body surface that allows the assessment of changes in the heart conduction system. The aim of the study was to visualize and evaluate changes in the intraventricular system in adolescents with T1D. PATIENTS AND METHODS: Inclusion criteria: age > 12 years, T1D duration >3 years, HbA1c >8%. EXCLUSION CRITERIA: diagnosis of autonomic neuropathy, heart structural defects, heart failure. BSPM data were processed into map plotting to illustrate differences in ventricular activation time (VAT, isochron lines). RESULTS: 33 teenagers (20 boys), mean age 15.0 ± 2.1 years, T1D from 6.8 ± 4.1 years were included. Mean HbA1c was 9.6 ± 2.0%. In the standard ECG recording abnormalities were not present. The distribution of isolines on the group-mean map plotted for T1D patients only initially resembles the course of isolines on the group-map for normal subjects (N = 30), in whom the electrical impulse stimulating the heart ventricles passes through the atrio-ventricular node, then symmetrically excites the branches of His bundle and finally the Purkinje fibers. In T1D patients, after proper onset of intraventricular stimulation, the isolines reflecting the both ventricles reach higher time values, which indicates problems in the propagation of the ventricular depolarization.
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Diabetes Mellitus Tipo 1 , Sistema de Condução Cardíaco/fisiopatologia , Adolescente , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/etiologia , Mapeamento Potencial de Superfície Corporal , Doença do Sistema de Condução Cardíaco , Criança , Diabetes Mellitus Tipo 1/complicações , Eletrocardiografia , Feminino , Hemoglobinas Glicadas , Ventrículos do Coração/diagnóstico por imagem , Humanos , Masculino , Projetos PilotoRESUMO
BACKGROUND: Calcium homeostasis is disturbed in many ways in the course of chronic kidney disease (CKD). The concentration of free cytoplasmic calcium in erythrocytes is increased. Maintenance of a high concentration gradient (between the cystoplasmic and extracellular space) is possible only due to a finely tuned cooperation between many regulating systems in the cytoplasmic membranes and cell organelles. The aim of our study was to evaluate the activity of Ca(2+)-Mg(2+)-dependent ATPase (PMCA), calmodulin and calpain-calpastatin (CANP-CAST) system in erythrocytes of CKD children treated conservatively in the stages II-IV. METHODS: A total of 36 patients with CKD were enrolled in the study. Group A contained patients with CKD stage II; group B with CKD stage III; and group C with CKD stage IV. The control group D consisted of 30 healthy subjects. In the serum, we determined the following: intact parathormon, total calcium, creatinine; in the red blood cells: free cytosolic calcium concentration (Ca(i)(2+)), activity of Ca(2+)-Mg(2+)-transporting ATPase (PMCA), basal PMCA (bPMCA), calmodulin (CALM), CANP, CAST. RESULTS: In all groups, Ca(i)(2+) concentrations were significantly higher, whereas PMCA and bPMCA activity were lower than in the controls. CANP concentrations in group A were elevated compared to the controls, whereas in groups B and C they were significantly lower. In group C, the mean CAST activity reached the highest values. CALM concentrations were decreased versus controls in all groups of patients. CONCLUSIONS: The intracellular Ca(i)(2+) homeostasis is disturbed in children with CKD and aggravates the deterioration of renal function as well. The reasons for the progressing increase of erythrocyte calcium concentration are multifactorial. Undoubtedly, the decreased PMCA activity, the calmodulin deficiency and the dysregulated CANP-CAST system are responsible for that phenomenon. The impact of many other biological modulators, creating a network defending the cell against the calcium accumulation, cannot be excluded.
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ATPase de Ca(2+) e Mg(2+)/metabolismo , Eritrócitos/enzimologia , Nefropatias/sangue , Nefropatias/enzimologia , Adolescente , Proteínas de Ligação ao Cálcio/fisiologia , Calmodulina/fisiologia , Calpaína/fisiologia , Criança , Doença Crônica , HumanosRESUMO
BACKGROUND: Cardiovascular complications are considered a significant problem in patients with chronic kidney disease (CKD). Body surface potential mapping (BSPM) is a noninvasive method that is useful in detecting early changes involving the heart. The aim of the study was to evaluate possible abnormalities within the cardiac intraventricular conduction system in young patients with CKD using the BSPM method. METHODS: Based on the BSPM registrations, the QRS-T isointegral maps were created in 42 young patients with CKD (on hemodialysis, subgroup Ia; on peritoneal dialysis, subgroup Ib; on conservative treatment, group II) and in 26 healthy subjects. Serum levels of electrolytes, urea, and creatinine were also assessed in the entire study population. RESULTS: In the healthy subjects, the maximums of the group mean QRS-T isointegral map were located in the left lower anterior part of the thorax, whereas in the Ia patients, the maximums were focused at the medial sternum line. The QRS-T maps, both for Ib and II groups, showed the positive integrals covering the left part of the anterior thorax. In all the patients with CKD, standard 12-lead electrocardiogram (ECG) and echocardiography findings were within the reference range. CONCLUSIONS: In the hemodialyzed patients with CKD, the group-mean QRS-T isointegral map distribution suggested a significant delay of excitation propagation in the left bundle branch, although no abnormalities were found with standard ECG. In the patients with CKD treated with peritoneal dialysis or conservatively, the group-mean QRS-T isointegral maps were characteristic for the early phase of conduction disturbances within the left bundle branch, which again was not observed on the standard ECG recordings.
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Mapeamento Potencial de Superfície Corporal/métodos , Falência Renal Crônica/complicações , Falência Renal Crônica/diagnóstico , Fibrilação Ventricular/diagnóstico , Fibrilação Ventricular/etiologia , Adolescente , Criança , Feminino , Humanos , Masculino , Prognóstico , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto JovemRESUMO
OBJECTIVES: The present study was undertaken in order to verify the hypothesis stating that patients with depression exhibit some abnormalities concerning a cerebral symmetry. For this purpose, an analysis of the relationship between the VEPs (Visual Evoked Potentials) results and the depressive symptoms intensification, as well interrelation between depressive and diabetic symptoms were performed. MATERIAL AND METHODS: VEPs recordings were obtained from the two study groups (both aged 20-45 years), 20 healthy subjects and 32 diabetic patients with clinically documented depression. The VEPs examination was carried out using a computer system called STELLA (Stimulated Electroencephalogram on Line Analyzer). RESULTS: VEPs examinations revealed a cerebral symmetry in the all control subjects and in 10 out of 32 diabetic patients with depressive disorders. It is noteworthy that 22 of 32 diabetic patients (68.8%) showed a hemispheric asymmetry in the VEPs recordings. Of 12 patients with a moderate depression, 10 showed the left cerebral laterality, and 2--the right laterality. In turn, all 10 patients with major depressive disorder (MDD) demonstrated in the VEPs recordings a significant cerebral laterality with the right hemisphere dominance. CONCLUSIONS: The obtained results suggest that interhemispheric cerebral asymmetry might be considered a specific feature of depression, and, if this is a case, it could justify a conclusion that right hemisphere dominance could be a neurophysiological marker of MDD. It should be emphasized that intensification of the depressive symptoms has an unfavorable influence on course of diabetes mellitus, its self-control and severity of following complications.
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Cérebro/patologia , Depressão/fisiopatologia , Neuropatias Diabéticas/fisiopatologia , Dominância Cerebral/fisiologia , Potenciais Evocados Visuais , Adulto , Mapeamento Encefálico , Estudos de Casos e Controles , Cérebro/fisiopatologia , Depressão/complicações , Diabetes Mellitus/patologia , Diabetes Mellitus/fisiopatologia , Neuropatias Diabéticas/complicações , Neuropatias Diabéticas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Caracteres Sexuais , Adulto JovemRESUMO
UNLABELLED: The highest percent of cardiac muscle damages is written down in children which are exposed to hemodialysis. In this group the heart examinations using body surface heart potential mapping (BSPM) method have been carried out. The aim of the study was to assess the influence of hemodialysis on heart's electrodynamics in children and adolescent during replacement therapy. MATERIAL AND METHODS: Multielectrode recording have been done in every kid before and after hemodialysis. For every record it was created isopotential map. By the comparing our maps with model maps for healthy children it was affirmed that in greater part of studied examples of hemodialysed children there are present early changes indicating conducting disturbances in left bundle of fasciculus atrioventricularis (His) and initial stage of left ventricular hypertrophy (LVH). That changes haven't been confirmed in classic ECG, which suggests that the disturbances in excitation conductance observed on isointegral maps are far beyond the area detected by 12-electrode classic ECG recording. RESULTS: The maps made before dialysis are characterised by large, unsymmetrical isopotential lines changes over the left and right ventricle. After carried out of hemodialysis the image of ECG records was improving. In all of cases the isoline distribution in sternal and anterior lower left part of chest comes back to norm. Changes are visible merely over the left ventricle and in anterior upper right part of chest what is connected with just stabilised conducting disturbances in the left branch of His bundle, left bundle of fasciculus atrioventricularis (His bundle). CONCLUSIONS: 1. In children who are treated by repeated hemodialysis approach to disturbances in the cardiac intraventricular conduction system. 2. Those disturbances are improved by a singular hemodialysis. 3. BSPM method detects earlier changes in the cardiac intraventricular conduction system than the classical ECG.
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Mapeamento Potencial de Superfície Corporal , Sistema de Condução Cardíaco/fisiopatologia , Diálise Renal , Adolescente , Criança , Feminino , Humanos , Hipertrofia Ventricular Esquerda/etiologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Projetos Piloto , Diálise Renal/efeitos adversosRESUMO
BACKGROUND: The progression of chronic kidney disease is accompanied by multi-organ disorders, among which cardiovascular diseases have the status of a serious clinical problem. The body surface potential mapping (BSPM) technique is a non-invasive method which enables the detection of pathological changes in the bioelectrical activity of the heart. OBJECTIVES: The aim of this study was to identify possible disturbances in the intraventricular conduction system in peritoneally dialyzed children. MATERIAL AND METHODS: Cardiac examination consisted of 12-lead electrocardiography, echocardiography and BSPM. The evaluation of disturbances in the cardio-electrical field was performed by comparing the qualitative and quantitative features of the heart potentials on the isopotential map. RESULTS: Data was collected from 10 children treated with automatic peritoneal dialysis (APD) (mean age: 13.6 ±2.3 years) and 26 healthy children. The maps of dialyzed children showed a shift in positive isopotentials toward the left lower part of the thorax, while negative values were observed in its left upper part. A distribution of lines on the isopotential maps revealed disturbances in the stimulation spread within the heart ventricles, especially within the anterior fascicle of the left bundle branch of His. CONCLUSIONS: Intraventricular conduction disturbances were observed in the left bundle branch of His in the peritoneally dialyzed children. The body surface potential mapping was a more sensitive method in identifying the early stage of conduction disturbances within the heart ventricles than 12-lead electrocardiography. Further research involving a larger population of dialyzed children is planned.
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Mapeamento Potencial de Superfície Corporal , Fascículo Atrioventricular , Sistema de Condução Cardíaco/fisiopatologia , Falência Renal Crônica/terapia , Diálise Peritoneal/efeitos adversos , Adolescente , Criança , Ecocardiografia , Eletrocardiografia , Feminino , Ventrículos do Coração/fisiopatologia , Humanos , Falência Renal Crônica/complicações , Masculino , Projetos PilotoRESUMO
BACKGROUND: Decrement of glomerular filtration rate leads to many serious complications that cause both functional and structural impairments of the other organs. Long-term clinical observations of children and teenagers with end-stage renal disease (ESRD) showed that more than one third of those patients manifested various cardio-vascular conditions. The aim of the study was to analyze possible disturbances in the heart ventricular conduction system by using a technique of ventricular activation time (VAT) differences in ESRF children on peritoneal dialysis (PD) with normal electrocardiogram (ECG) examinations. MATERIAL AND METHODS: The study group comprised 10 ESRD children (mean age: 13.6 ± 2.31 years) on peritoneal dialysis - group I. The control group (group II) consisted of 26 age-matched healthy children with no clinical evidence of renal or cardiac disease and with normal 12-lead ECG recordings. Each of the ESRD patients was also subjected to the standard ECG examination. In order to capture possible heart conduction abnormalities, body surface potential mapping (BSPM) recordings were performed in PD patients between the successive dwells ('on empty abdomen') with a HPM-7100 Fukuda Denshi system. Based on the source ECG data, the original technique of a VAT difference map was then applied. RESULTS: Differences between VAT values for the two examined groups of children, controls and ESRD patients on PD, were significantly pronounced in the region of the right upper anterior thorax, the entire left thorax and nearly in the total back. Such a pattern of VAT delays indicates a pathological electric transmission in the intraventricular conduction system of the left anterior fascicle of His bundle. CONCLUSION: 1. VAT maps (isochrone maps) can be useful to detect abnormal spreading and depolarization through the heart ventricles. 2. Map of VAT value differences makes it possible to identify early disturbances in the left His bundle branch in ESRD children treated with peritoneal dialysis regardless of normal 12-lead ECG. 3. Further studies on a larger group of children with ESRD on PD are required to verify the preliminary observations presented herein.
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Sistema de Condução Cardíaco/fisiopatologia , Falência Renal Crônica/fisiopatologia , Falência Renal Crônica/terapia , Diálise Peritoneal , Adolescente , Mapeamento Potencial de Superfície Corporal , Estudos de Casos e Controles , Criança , Eletrocardiografia , Feminino , Humanos , Masculino , Projetos Piloto , Função Ventricular/fisiologiaRESUMO
Patients with end-stage renal disease are affected by cardiovascular complications, including disturbances of the heart intraventricular conduction. Body surface potential mapping is a non-invasive electrocardiographic detection method of initial disturbances in heart activation propagation. A goal of the study was to analyze the effects of single hemodialysis (HD) session on ventricular activation time (VAT) maps obtained from hemodialyzed children. The study group consisted of 13 hemodialyzed children (age: 6-18 years). The control group is composed of 26 healthy subjects. In each HD patient, 12-lead electrocardiogram and echocardiography examinations were performed. Isochrone heart maps, reflecting body surface distribution of VAT isolines, were recorded from an 87-electrode HPM-7100 system for body surface potential mapping, before (group B) and after HD session (group A). The distribution of isochrones and VAT values, as recorded in the HD patients, differed significantly from the reference VATâ map for controls. The highest VAT maximal value was noted in group B (Me: 110 vs. 62 ms in the control group; P < 0.001), becoming significantly lower after HD session (Me: 98 ms for group A vs. 110 ms for group B; P < 0.001). Ventricular activation time maps, recorded before HD session, showed significant VAT delays with isochrone arrangement specific for the left bundle branch block. After HD session, VAT maps presented significant changes, suggesting a normalization process. Ventricular activation time maps in children with end-stage renal disease exhibited disturbances of intraventricular conduction within the left bundle branch block, undetectable on standard electrocardiogram. A single HD session resulted in VAT map improvement related to overall HD treatment duration.
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Diálise Renal/métodos , Insuficiência Renal Crônica/complicações , Adolescente , Criança , Feminino , Ventrículos do Coração/fisiopatologia , Humanos , MasculinoRESUMO
The recent research on ageing processes in mammals throws new light on the biochemistry of circadian clock. The already known regulatory pathways for biological rhythms and metabolism, combined with newly discovered functions of sirtuins, unveil a perspective for new hypotheses, regarding possible links between ageing and circadian rhythms. The NAD World hypothesis - postulated as a systemic regulatory network for the metabolism and ageing, linked with mammalian, NAD+ dependent Sirtuin 1 - conceptually involves two critical elements. One is the systemic, Nampt-controlled NAD+ (nicotinamide phosphoribosyltransferase) biosynthesis, where Nampt (nicotinamide phosphoribosyltransferase) acts as "propulsion" for metabolism and the other is NAD+ dependent deacetylase (SIRT1) - a regulator responsible for various biological effects, depending on its localisation in organism. In this approach, the role of sirtuins, which are evolutionary conservative, NAD+ dependent histone deacetylases, may be very important for the mammalian metabolic clock. This paper is a review of current research on possible links among SIRT1 (Sirtuin 1), metabolism and ageing with particular consideration of the NAD World hypothesis.
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Envelhecimento/fisiologia , Ritmo Circadiano/fisiologia , Redes e Vias Metabólicas/fisiologia , Modelos Biológicos , NAD/biossíntese , Nicotinamida Fosforribosiltransferase/metabolismo , Sirtuína 1/metabolismo , Animais , Histona Desacetilases/metabolismo , Humanos , NAD/metabolismoRESUMO
Osteoporosis has become one of the major public health problems, affecting about two hundred million people worldwide, including one third of all postmenopausal women. The paper presents a review of the current literature concerning the pathophysiology and the most common genetic and environmental determinants that account for the individual predisposition to age-related osteoporosis. Particular emphasis is placed on the specific linkage between the causative factors of osteoporosis and atherosclerotic cardiovascular disease.
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Doenças Cardiovasculares/complicações , Predisposição Genética para Doença , Osteoporose/complicações , Osteoporose/genética , HumanosRESUMO
Sirtuins, silent information regulator 2 (Sir 2) proteins, belong to the family of NAD(+)-dependent enzymes with deacetylase or mono-ADP-ribosyltransferase activity. These enzymes are responsible for processes of DNA repair or recombination, chromosomal stability and gene transcription. In mammals, sirtuins occur in seven varieties, from 1 to 7 (SIRT1-SIRT7), differing among themselves with location. SIRT1, the best known variety, exerts its effects on proteins via NAD(+) coenzymes, being thus associated with cellular energetic metabolism and the 'red-ox' state. Its deficits are, among others, concomitant with stressful situations and associated with pathophysiologies of many medical conditions, including diabetes mellitus, cardiovascular diseases, neurodegenerative syndromes and kidney diseases. In kidney disorders, it promotes (stimulates) the survival of cells in an affected kidney by modulating their responses to various stress stimuli, takes part in arterial blood pressure control, protects against cellular apoptosis in renal tubules by catalase induction and triggers autophagy. More and more available in vitro and in vivo data indicate SIRT1 activity to be oriented, among others, towards nephroprotection. Thus, SIRT1 may become a novel element in the therapy of age-related renal diseases, including diabetic nephropathy.
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Nefropatias Diabéticas/enzimologia , Rim/enzimologia , Substâncias Protetoras/metabolismo , Sirtuína 1/metabolismo , Animais , Apoptose , Autofagia , Pressão Sanguínea , Catalase/genética , Catalase/metabolismo , Nefropatias Diabéticas/genética , Nefropatias Diabéticas/patologia , Metabolismo Energético , Expressão Gênica , Humanos , Isoenzimas/genética , Isoenzimas/metabolismo , Rim/patologia , NAD/metabolismo , Oxirredução , Sirtuína 1/genéticaRESUMO
Recognition of left anterior fascicle block is usually a diagnostic problem. Isochrone maps, displaying results of the body surface potential mapping are helpful in solving this problem. The isochrone maps present changes of heart electric field, especially those concerning a pathway of the depolarization front propagation within the heart conduction system. Body surface potential mapping registrations were performed using a Fukuda Denshi cylindrical system, which enables simultaneous recordings of electrocardiographic signals from the 87 leads. The examined group consisted of 29 patients with left anterior fascicle block (LAFB) and complete right bundle branch block (RBBB) complicated by LAFB. The first group consisted of 7 females and 8 males with the mean age of 62 +/- 11.3 yr., and the second group comprised 8 females and 6 males (the mean age: 64 +/- 5.01 yr.). The control group comprised 30 healthy subjects--the mean age of 50.3 +/- 5.63 yr. In all of examined patients, elementary biochemical tests, echocardiography and X-ray chest examinations were performed. In order to obtain a pattern reflecting a depolarization trajectory in the patients' heart, the ventricular activation time maps (VAT) were constructed, using the own software. This kind of maps is more precise than standard electrocardiograms and makes possible monitoring an activity propagation, as well as its velocity within the heart conduction system. In the patients demonstrating left anterior fascicle block, a subendocardial layer of the bottom left surface of the interventricular septum is the earliest stimulated area of heart (similarly, as in normal subjects). Afterwards, the front of stimulation wave crosses the septum from left to right side. In the next phase, the activation comprises right surface of the septum, as well as subendocardial surfaces of right ventricle free walls, however in the free wall of left ventricle, as a result of left anterior fascicle block, the activation spreads through back part of bundle branch. At this moment, isochrone lines arrange in bottom-right-forward direction. Subsequently, the delayed stimulation wave penetrates the anterior and lateral walls. Isochrones on the right torso are directed rightward and upward. In the final phase, the activation spreads over remaining part of the free wall of left ventricle, moving leftward, upward and backward. On isochrone maps, the final stage of activation propagation is seen on whole upper back part of the torso. In patients demonstrating RBBB with LAFB, the stimulation time is notably delayed. As a result of blocking the right ventricle and left anterior fascicle, the stimulation wave goes to the free wall of left ventricle through the back bundle. Isochrones distribution is similar like in left anterior fascicle block. However, different time of stimulation dispersal in downward direction is observed. Next, the wave propagation moves downward and leftward, coming to the anterior and lateral walls. Later on, a stimulation of the remaining part of the left ventricle free wall is observed, and isochrones wander to the heart bottom. Finally, after about 80 ms from the beginning, a delayed stimulation wave reaches the right ventricle, passing around the blocked area and spreading through terminal fibres within right ventricle. In the both examined groups no significant differences in relation to isochrones distribution were observed, therefore the averaged VAT maps were assumed as a reference pattern for the given groups. A pattern of VAT maps distribution and values of ventricular activation time can be useful in the further investigations concerning an analysis of wave propagation in bundle branch blocks.
Assuntos
Bloqueio de Ramo/diagnóstico , Sistema de Condução Cardíaco/fisiopatologia , Ventrículos do Coração/fisiopatologia , Idoso , Mapeamento Potencial de Superfície Corporal , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The present paper concerns the results of the examinations on Ventricular Activation Time distribution. The registrations were performed using the 30-electrode network connected to from the diamentoid scheme giving the sphere system, in the centre of which the heart is located. The potentials for one ECG cycle were measured at every electrode. The created computer program changed the spheric recordings into the plane development which resulted in the 30 ECG recordings located under the particular electrode. Using these values the activation time was determined for every registration point. On that basis, the isochronic map for the patient is created. The ECG tracings were recorded in 48 healthy subjects, treated as the control group, and in the 96 patients with the previous myocardial infarction varying in location and extension. The obtained maps were compared both within and between the examined groups. For the normal subjects, the isochrone distributions are similar. The lines are arranged according to the physiological activity propagation through the myocardium. The quite different distribution was observed on the isochrone maps obtained from the patients with myocardial infarction, as compared with the maps from the control group. On the basis of the specific isochrone distribution, the exact location and can be identified. The patterns for the given location of the myocardial infarction are significant similarity--the possible differences concern only the foci extensions.