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1.
Food Chem ; 419: 136082, 2023 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-37027971

RESUMEN

Melanoidins present important physiological activities, but their structure is largely unknown. The objective of the present work was to reveal the physicochemical characteristics of biscuit melanoidins(BM) prepared under high temperature(HT) and low temperature(LT) conditions (150 °C/25 min-100 °C/80 min respectively). BM were characterised and analysed by differential scanning calorimetry, X-ray and FT-IR. Moreover, the antioxidant capacity and the zeta potential were determined. The phenolic content of HT-BM was higher than that of LT-BM (19.5 ± 2.6% vs 7.8 ± 0.3% respectively, p ≤ 0.05) and the antioxidant capacity determined by ABTS/DPPH/FRAP (p ≤ 0.05) was greater. Also, HT-BM presented a 30% increase in crystal structure compared to LT-BM according to X-ray analysis. The magnitude of the negative net charge was significantly higher in HT-BM (-36.8 ± 0.6) than in LT-BM (-16.8 ± 0.1)(p ≤ 0.05). FT-IR analysis confirmed the presence of phenolic and intermediate Maillard reaction compounds bound to the HT-BM structure. In conclusion, the different heating treatments applied to biscuits led to differences in the melanoidin structure.


Asunto(s)
Antioxidantes , Alimentos , Antioxidantes/química , Espectroscopía Infrarroja por Transformada de Fourier , Polímeros/química , Reacción de Maillard , Fenoles/análisis
2.
J Funct Biomater ; 14(2)2023 Feb 16.
Artículo en Inglés | MEDLINE | ID: mdl-36826910

RESUMEN

Despite promising clinical results in osteochondral defect repair, a recently developed bi-layered collagen/collagen-magnesium-hydroxyapatite scaffold has demonstrated less optimal subchondral bone repair. This study aimed to improve the bone repair potential of this scaffold by adsorbing bone morphogenetic protein 2 (BMP-2) and/or platelet-derived growth factor-BB (PDGF-BB) onto said scaffold. The in vitro release kinetics of BMP-2/PDGF-BB demonstrated that PDGF-BB was burst released from the collagen-only layer, whereas BMP-2 was largely retained in both layers. Cell ingrowth was enhanced by BMP-2/PDFG-BB in a bovine osteochondral defect ex vivo model. In an in vivo semi-orthotopic athymic mouse model, adding BMP-2 or PDGF-BB increased tissue repair after four weeks. After eight weeks, most defects were filled with bone tissue. To further investigate the promising effect of BMP-2, a caprine bilateral stifle osteochondral defect model was used where defects were created in weight-bearing femoral condyle and non-weight-bearing trochlear groove locations. After six months, the adsorption of BMP-2 resulted in significantly less bone repair compared with scaffold-only in the femoral condyle defects and a trend to more bone repair in the trochlear groove. Overall, the adsorption of BMP-2 onto a Col/Col-Mg-HAp scaffold reduced bone formation in weight-bearing osteochondral defects, but not in non-weight-bearing osteochondral defects.

3.
Molecules ; 26(4)2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33669712

RESUMEN

Hydroxyapatite (HA) is the main inorganic mineral that constitutes bone matrix and represents the most used biomaterial for bone regeneration. Over the years, it has been demonstrated that HA exhibits good biocompatibility, osteoconductivity, and osteoinductivity both in vitro and in vivo, and can be prepared by synthetic and natural sources via easy fabrication strategies. However, its low antibacterial property and its fragile nature restricts its usage for bone graft applications. In this study we functionalized a MgHA scaffold with gold nanorods (AuNRs) and evaluated its antibacterial effect against S. aureus and E. coli in both suspension and adhesion and its cytotoxicity over time (1 to 24 days). Results show that the AuNRs nano-functionalization improves the antibacterial activity with 100% bacterial reduction after 24 h. The toxicity study, however, indicates a 4.38-fold cell number decrease at 24 days. Although further optimization on nano-functionalization process are needed for cytotoxicity, these data indicated that Au-NRs nano-functionalization is a very promising method for improving the antibacterial properties of HA.


Asunto(s)
Antiinfecciosos/farmacología , Durapatita/farmacología , Oro/farmacología , Magnesio/farmacología , Nanotubos/química , Muerte Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Escherichia coli/efectos de los fármacos , Humanos , Pruebas de Sensibilidad Microbiana , Nanotubos/ultraestructura , Espectroscopía de Fotoelectrones , Staphylococcus aureus/efectos de los fármacos , Andamios del Tejido/química
4.
Mater Sci Eng C Mater Biol Appl ; 118: 111394, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33254999

RESUMEN

We report a new chemical method for the functionalization of Mg-hydroxyapatite (Mg-HA) scaffold with Ag nanoparticles (Ag NPs) integrating in one step both the synthesis of the Ag NPs and their nano-structuring into the HA matrix (Ag-Mg-HA scaffold). This method exploits a green photochemical synthesis and allows the direct growth of Ag NPs on the Mg-HA surface. The surface structure of Ag-Mg-HA scaffold, investigated by scanning electron microscopy, shows no significant changes in the morphology upon Ag NPs incorporation. The presence of Ag was confirmed by EDX analysis. TEM and spectroscopic investigations show Ag NPs spherical shaped with a mean diameter of about 20 nm exhibiting the typical plasmon absorption band with maximum at 420 nm. The antibacterial properties of Ag-Mg-HA scaffolds were tested against two bacterial strains, Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). The results show excellent antibacterial properties achieving up to 99% and 100% reduction of colonies for both bacteria cultures after 24 h of incubation and 100% of reduction after 48 h of incubation. The cytotoxicity of Ag-Mg-HA was also in deep investigated assessing both cell proliferation and differentiation using hADSCs (human Adipose Derived Stem Cells) and testing data point at 0, 7, 14 and 24 days. The results show cytotoxic effect with cell proliferation decreasing up to 90% at 24 days and osteogenic differentiation inhibition. The observed cytotoxicity can be probable ascribed to the oxidative stress by ROS. Indeed, considering the effectiveness of the nanofunctionalization method and the excellent antibacterial properties showed by the Ag-Mg-HA scaffold, future works will be devoted to create nanofunctionalized scaffold satisfying both antimicrobial and osteo-regenerative properties.


Asunto(s)
Nanopartículas del Metal , Plata , Antibacterianos/farmacología , Durapatita , Escherichia coli , Humanos , Osteogénesis , Porosidad , Staphylococcus aureus
5.
Heliyon ; 5(6): e01957, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31294109

RESUMEN

The effectiveness of natamycin supported in corn starch-based films to control environmental molds (mainly Penicillium spp) activity that could colonize the surface of semi-hard cheese during ripening, was evaluated. The starch amount was maximized, and this was achieved by adding polyvinyl alcohol (PVA) and also polyurethane (PU) to the formulation. The PU acted as plasticizer and also provided functional groups that interacted with the natamycin and affected its diffusion. When 5 % PU was added, the natamycin migration of the coating doped with 1% natamycin was reduced by half. The natamycin distribution on both sides of the film was also evaluated, concluding that, in line with the reduced migration, when polyurethane is included, the formulation presents high hydrophobicity and natamycin is left with a preferential distribution towards the air face (exterior). For microbiological tests, microorganisms were isolated from cheese factories. Natamycin solutions showed inhibitory effect against environmental molds including Penicillium spp. Accordingly, films loaded with 0.1 % natamycin showed a significant inhibitory effect against Penicillium spp. The polymer combination in this work was optimized to obtain an active coating with good physicochemical properties and enriched with natamycin that has proven to be available for acting against molds and preferentially on the surface exposed to potential mold attack during ripening.

6.
ACS Biomater Sci Eng ; 5(7): 3429-3439, 2019 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-33405727

RESUMEN

Multifunctionalized biomaterials with enhanced bone antiresorptive properties were obtained through adsorption of a bisphosphonate, risedronate, on hydroxyapatite (HA) nanocrystals functionalized with zinc ions and polyethylenimine (PEI). Zn incorporation into the HA structure amounts to about 8 atom %, whereas the PEI content of the bifunctionalized material ZnHAPEIBP is about 5.9 wt %. The mechanism of adsorption and release of the bisphosphonate on ZnHAPEI is compared with that on ZnHA: risedronate adsorption isotherm on ZnHA is a Langmuir type, whereas the isotherm of adsorption on ZnHAPEI is better fitted with a Freundlich model and involved a higher amount of adsorbed risedronate. In vitro cell tests were carried out with a coculture model of osteoblasts and osteoclasts using a model simulating oxidative stress and consequent cellular senescence and osteoporosis by the addition of H2O2. The conditions utilized in the coculture model strongly affect osteoblast behavior. The results show that the composite materials allow an increase in osteoblast viability and recover impairment, revealing a novel characteristic of risedronate that is able to counteract the negative effects of oxidative stress when associated with differently functionalized samples. Both PEI and the bisphosphonate reduce osteoclast viability. Moreover, PEI, and even more risedronate, exerts an inhibitory effect on osteoclast activity.

8.
J Inorg Biochem ; 178: 43-53, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-29049953

RESUMEN

In this work we developed new antibacterial composite materials using polydopamine (PDA) to trigger the deposition of silver nanoparticles (AgNPs) onto calcium phosphates, namely octacalcium phosphate (OCP) and α-tricalcium phosphate (αTCP). Functionalization of OCP and αTCP with a self-polymerized polydopamine layer was obtained by soaking the calcium phosphates in dopamine solution. The PDA surface of functionalized calcium phosphates (OCPd and αTCPd) promoted the deposition of AgNPs by reducing silver ions when soaked in a silver nitrate solution. The amount of deposited AgNPs can be modulated by varying the concentration of silver nitrate solution and the type of substrate. The results of in vitro tests carried out with osteoblast-like MG63 cells indicate that the combination of AgNPs with OCP provides more biocompatible materials than those obtained using αTCP as substrate. In particular, the study of osteoblast activity and differentiation was focused on the samples OCPdAg5 (silver content=8.2wt%) and αTCPdAg5 (silver content=4.7wt%), which did not show any cytotoxicity, and compared with those obtained on pure OCP and αTCP. The results demonstrate that the AgNPs loaded materials support osteoblast viability and differentiation, whereas they significantly inhibit the growth of relevant antibiotic-resistant pathogenic bacteria.


Asunto(s)
Antibacterianos/síntesis química , Biomimética , Fosfatos de Calcio/química , Indoles/química , Polímeros/química , Antibacterianos/química , Línea Celular , Supervivencia Celular , Materiales Biocompatibles Revestidos/química , Humanos , Nanopartículas/química , Osteoblastos/química , Osteoblastos/citología , Osteoblastos/efectos de los fármacos , Reacción en Cadena de la Polimerasa , Plata/química , Propiedades de Superficie
9.
Colloids Surf B Biointerfaces ; 160: 493-499, 2017 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-28992488

RESUMEN

Bisphosphonates are widely employed drugs for the treatment of pathologies characterized by excessive bone resorption, and display a great affinity for apatitic supports. In this work we investigate how hydroxyapatite functionalization can influence the processes of adsorption and release of a bisphosphonate, namely risedronate. To this aim, pure hydroxyapatite (HA), hydroxyapatite with a partial substitution of Zn to Ca (ZnHA) and poly-ethylenimine-functionalized hydroxyapatite (HAPEI) were submitted to interaction with risedronate solution. The results indicate that the mechanisms of adsorption and release are greatly influenced by the type of the apatitic support. All the apatitic supports display Langmuir isotherms for risedronate adsorption. However in the case of HAPEI the plateau is not reached even at high equilibrium concentrations in solution. The data suggest that risedronate adsorption on HAPEI mineral-organic support occurs not only through chemisorption on apatitic phase, as on HA and ZnHA, but also through physisorption involved by PEI coating, which modulates also bisphosphonate release. These properties of tailor-made hydroxyapatite supports could be exploited to develop delivery systems for antiresorptive agents directly on osteoporotic sites.


Asunto(s)
Resorción Ósea/prevención & control , Huesos/efectos de los fármacos , Durapatita/química , Polietileneimina/química , Ácido Risedrónico/farmacología , Adsorción , Animales , Conservadores de la Densidad Ósea/química , Conservadores de la Densidad Ósea/farmacocinética , Conservadores de la Densidad Ósea/farmacología , Preparaciones de Acción Retardada/química , Preparaciones de Acción Retardada/farmacocinética , Preparaciones de Acción Retardada/farmacología , Liberación de Fármacos , Cinética , Microscopía Electrónica de Transmisión , Ácido Risedrónico/química , Ácido Risedrónico/farmacocinética , Termodinámica , Difracción de Rayos X
10.
J Biomed Mater Res A ; 105(12): 3293-3303, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28865182

RESUMEN

In spite of its remarkable anti-oxidant, anti-inflammatory, anti-cancer properties and its possible inhibition activity towards bone resorption, quercetin therapeutic use is limited by its poor bioavailability. Herein we developed a new multifunctionalized system for the local administration of quercetin and alendronate, one of the most potent anti-osteoporotic drugs, with the aim to get a material with enhanced properties. To this purpose we loaded quercetin on hydroxyapatite functionalized with alendronate, as well as on hydroxyapatite. Characterization was performed by means of X-ray diffraction, FT-IR and Raman spectroscopies, thermogravimetric and spectrophotometric analyses. Loading of quercetin from hydro-alcoholic solution increased with time and reached a constant value of about 5 weight% on both substrates, without causing significant structural and morphological modifications. Quercetin functionalized materials exhibit relevant anti-oxidant properties, in agreement with their high radical scavenging activity, and a quercetin sustained release in phosphate buffer. In vitro osteoblast and osteoclast co-culture in a microenvironment altered by oxidative stress shows that both alendronate and quercetin significantly reduce osteoclast viability, whereas they are able to counteract the negative effect of oxidative stress on osteoblast viability and differentiation, suggesting that their relative amount in the functionalized materials can be utilized to tailor bone cells response. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 3293-3303, 2017.


Asunto(s)
Alendronato/farmacología , Antioxidantes/farmacología , Conservadores de la Densidad Ósea/farmacología , Estrés Oxidativo/efectos de los fármacos , Quercetina/farmacología , Alendronato/administración & dosificación , Antioxidantes/administración & dosificación , Materiales Biocompatibles/química , Conservadores de la Densidad Ósea/administración & dosificación , Línea Celular , Técnicas de Cocultivo , Sistemas de Liberación de Medicamentos/métodos , Durapatita/química , Humanos , Osteoblastos/citología , Osteoblastos/efectos de los fármacos , Osteoclastos/citología , Osteoclastos/efectos de los fármacos , Quercetina/administración & dosificación , Difracción de Rayos X
11.
Acta Biomater ; 54: 419-428, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-28238916

RESUMEN

Development of new materials for the local administration of bisphosphonates (BPs) is aimed to avoid the negative side effects of prolonged systemic use of these potent drugs. In this work, we synthesized octacalcium phosphate (OCP) in the presence of two potent BPs and obtained a single crystalline phase up to a zoledronate and alendronate content of 3.5wt% and 5.2wt%, respectively. Both BPs provoke minor structural modifications and a reduction of the crystal dimensions of OCP, which suggests a preferential interaction of the BPs with the structure of the calcium phosphate. Alendronate containing samples display increased values of zeta potential with respect to that of OCP, and an initial burst release of the BP in solution. At variance, the zeta potential of zoledronate functionalized samples decreases on increasing the content of zoledronate, which is not appreciably released in solution. Bone microenvironment response to the composite materials was investigated in vitro using a triculture model. BP functionalized samples downregulate the viability of the cells, sustain osteoblast differentiation and accelerate the production of collagen type I and osteocalcin. At variance, they inhibit monocyte differentiation into osteoclast and provoke a dose dependent reduction of VEGF production, exhibiting antiresorptive and anti-angiogenetic properties that can be usefully exploited for the local treatment of abnormal bone losses. STATEMENT OF SIGNIFICANCE: Bisphosphonates (BPs) are powerful drugs for the treatment of bone diseases. However, BPs systemic administration suffers several undesirable side effects, which stimulate the development of suitable systems for their local administration. In this study we functionalized octacalcium phosphate (OCP) with alendronate and zoledronate in order to get biomaterials able to couple the good biological performance of OCP with the therapeutic properties of the BPs. The results provide novel information on the interaction between these two potent BPs and octacalcium phosphate. Moreover, the triculture in vitro study indicates that the synthesized composite materials stimulate the production of bone extracellular matrix, inhibit monocytes differentiation into osteoclasts and downregulate the release of Vascular Endothelial Growth Factor (VEGF) in a dose dependent way. The data allow to state that the new composite materials can be usefully employed for the local treatment of diseases involving abnormally high bone resorption.


Asunto(s)
Fosfatos de Calcio , Difosfonatos , Imidazoles , Fosfatos de Calcio/química , Fosfatos de Calcio/farmacocinética , Fosfatos de Calcio/farmacología , Línea Celular , Técnicas de Cocultivo , Preparaciones de Acción Retardada/química , Preparaciones de Acción Retardada/farmacocinética , Preparaciones de Acción Retardada/farmacología , Difosfonatos/química , Difosfonatos/farmacocinética , Difosfonatos/farmacología , Evaluación Preclínica de Medicamentos , Células Endoteliales de la Vena Umbilical Humana , Humanos , Imidazoles/química , Imidazoles/farmacocinética , Imidazoles/farmacología , Ácido Zoledrónico
13.
Acta Biomater ; 32: 298-308, 2016 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-26689470

RESUMEN

Quercetin (3,3',4',5,7-pentahydroxy-flavone) is a flavonoid known for its pharmacological activities, which include antioxidant and anti-inflammatory properties, as well as possible beneficial action on diseases involving bone loss. In this work, we explored the possibility to functionalize hydroxyapatite (HA) with quercetin in order to obtain new materials for bone repair through local administration of the flavonoid. HA was synthesized in presence of different concentrations of quercetin according to two different procedures: direct synthesis and phase transition from monetite. Direct synthesis lead to composite nanocrystals containing up to 3.1 wt% quercetin, which provokes a reduction of the crystals mean dimensions and of the length of the coherently scattering domains. Synthesis conditions provoke a partial oxidation of quercetin and, as a consequence, a significant reduction of its radical scavenging activity (RSA). On the other hand, synthesis through phase transition yields samples containing up to 1.3 wt% of quercetin incorporated into hydroxyapatite, with minor structural modifications, which exhibit relevant anti-oxidant activities, as testified by their high RSA levels, (slightly lower than that of pure quercetin). The biological response to these materials was tested using an innovative triculture model involving osteoblast, osteoclast and endothelial cells, in order to mimic bone microenvironment. The results show that the presence of quercetin in the composite materials enhances human osteoblast-like MG63 proliferation and differentiation, whereas it downregulates osteoclastogenesis of osteoclast precursors 2T-110, and supports proliferation and differentiation of human umbilical vein endothelial cells (HUVEC). STATEMENT OF SIGNIFICANCE: The pharmacological activities of the flavonoid quercetin include anti-oxidant and antiinflammatory properties, as well as capability to prevent bone loss. In this paper, we demonstrate that it is possible to synthesize hydroxyapatite functionalized with different amounts of quercetin and obtain new composite materials which display both the good bioactivity of the inorganic phase and the therapeutic properties of the flavonoid. The innovative in vitro model developed in this study, which involves co-culture of osteoblast, osteoclast and endothelial cells, allows to state that the new materials exert a beneficial action onto bone repair microenvironment, stimulating osteoblast proliferation and activity, downregulating osteoclastogenesis, and supporting microangiogenetic processes necessary for new bone formation.


Asunto(s)
Antioxidantes/farmacología , Técnicas de Cocultivo/métodos , Durapatita/farmacología , Células Endoteliales de la Vena Umbilical Humana/citología , Osteoblastos/citología , Osteoclastos/citología , Quercetina/farmacología , Cicatrización de Heridas/efectos de los fármacos , Biomarcadores/metabolismo , Diferenciación Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Cristalización , Durapatita/síntesis química , Durapatita/química , Depuradores de Radicales Libres/química , Células Endoteliales de la Vena Umbilical Humana/efectos de los fármacos , Células Endoteliales de la Vena Umbilical Humana/metabolismo , Humanos , Osteoblastos/efectos de los fármacos , Osteoblastos/metabolismo , Osteoblastos/ultraestructura , Osteoclastos/efectos de los fármacos , Osteoclastos/metabolismo , Transición de Fase/efectos de los fármacos , Quercetina/síntesis química , Quercetina/química , Espectrofotometría Ultravioleta , Difracción de Rayos X
14.
Colloids Surf B Biointerfaces ; 136: 449-56, 2015 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-26445021

RESUMEN

The integration of an implant material with bone tissue depends on the chemistry and physics of the implant surface. In this study we applied matrix assisted pulsed laser evaporation (MAPLE) in order to synthesize calcium alendronate monohydrate (a bisphosphonate obtained by calcium sequestration from octacalcium phosphate by alendronate) and calcium alendronate monohydrate/octacalcium phosphate composite thin films on titanium substrates. Octacalcium phosphate coatings were prepared as reference material. The powders, which were synthesized in aqueous medium, were suspended in deionised water, frozen at liquid nitrogen temperature and used as targets for MAPLE experiments. The transfer was conducted with a KrF* excimer laser source (λ = 248 nm, τFWHM ≤ 25 ns) in mild conditions of temperature and pressure. XRD, FTIR and SEM analyses confirmed that the coatings contain the same crystalline phases as the as-prepared powder samples. Osteoblast derived from stem cells and osteoclast derived from monocytes of osteoporotic subjects were co-cultured on the coatings up to 14 days. Osteoclast displayed significantly reduced proliferation and differentiation in the presence of calcium alendronate monohydrate, pointing to a clear role of the coatings containing this bisphosphonate on inhibiting excessive bone resorption. At variance, osteoblast production of alkaline phosphatase and type I pro-collagen were promoted by the presence of bisphosphonate, which also decreased the production of interleukin 6. The positive influence towards osteoblast differentiation was even more enhanced in the composite coatings, thanks to the presence of octacalcium phosphate.


Asunto(s)
Alendronato/química , Fosfatos de Calcio/química , Materiales Biocompatibles Revestidos , Técnicas de Cocultivo , Humanos , Rayos Láser , Osteoblastos/citología , Osteoclastos/citología , Difracción de Polvo
15.
Eur J Clin Invest ; 45(11): 1153-60, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26365893

RESUMEN

BACKGROUND: Tissue Doppler imaging (TDI) is used to improve risk stratification in patients with chronic heart failure (CHF). So far, few studies have used this method to investigate the characteristics of subjects with CHF and Cheyne-Stokes breathing (CSB). The aim of this study was therefore to evaluate whether TDI assessment may predict the presence of CSB in patients with CHF. MATERIALS AND METHODS: A total of 41 consecutive patients with CHF enrolled in the Daunia Heart Failure Registry underwent echocardiography assessment and nocturnal polygraphy to evaluate the presence of sleep apnea and CSB. Conventional echocardiography and TDI parameters were calculated. We have also quantified by TDI a combined index (EAS index) of diastolic and systolic performance: E'/(A' × S'). RESULTS: Subjects with evidence of CSB (N = 8) were characterized by lower values of A' (5·03 ± 2·64 vs. 7·88 ± 2·64 cm/s, P < 0·01). A' and EAS index values were related to Cheyne-Stokes episode rates (r = -0·49 and 0·52, P < 0·05 and <0·01 respectively), EAS index values also with the number of episodes of central apnea (r = 0·39, P < 0·05). A' values predicted the presence of CSB at poly-somnography examination with an OR 0·62 (95% CI 0·40-0·96, P < 0·05) even after correction for age and gender. CONCLUSIONS: Tissue Doppler imaging values (A') are associated with the presence of sleep apnea at nocturnal polygraphy.


Asunto(s)
Respiración de Cheyne-Stokes/diagnóstico , Ecocardiografía Doppler , Insuficiencia Cardíaca/diagnóstico por imagen , Sistema de Registros , Apnea Central del Sueño/diagnóstico , Anciano , Respiración de Cheyne-Stokes/epidemiología , Enfermedad Crónica , Femenino , Insuficiencia Cardíaca/epidemiología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Polisomnografía , Apnea Central del Sueño/epidemiología , Apnea Obstructiva del Sueño/epidemiología
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