RESUMEN
BACKGROUND: Aortic pulse wave velocity (PWV) was linked to LV-geometry and -function in patients with kidney disease and non-ischemic cardiomyopathy. The role of aortic compliance after acute STEMI is so far unknown. In the present study, we prospectively investigated the relationship of increased aortic stiffness with biomarkers of myocardial wall stress 4 months after STEMI. METHODS: 48 STEMI patients who were reperfused by primary coronary angioplasty underwent cardiovascular magnetic resonance (CMR) at baseline and at 4-month follow-up. The CMR protocol comprised cine-CMR as well as gadolinium contrast-enhanced CMR. Aortic PWV was determined by velocity-encoded, phase-contrast CMR. Blood samples were routinely drawn at baseline and follow-up to determine N-terminal pro-B-type natriuretic peptide (NT-proBNP). In a subgroup of patients, mid-regional pro-adrenomedullin (MR-proADM) and mid-regional pro-A-type natriuretic peptide (MR-proANP) levels were determined. RESULTS: Patients with a PWV above median (>7.0m/s) had significantly higher NT-proBNP, MR-proADM and MR-proANP concentrations at 4-month follow-up than patients with a PWV below median (all p<0.02). PWV showed moderate to good correlation with NT-proBNP, MR-proAMD and MR-proANP levels 4 months after STEMI (all p<0.05). Multivariate analysis revealed PWV, beside myocardial infarct size, as an independent predictor of 4-month NT-proBNP levels after correction for age, creatinine and LV ejection fraction (model r: 0.781, p<0.001). CONCLUSION: Aortic stiffness is directly associated with biomarkers of myocardial wall stress 4 months after reperfused STEMI, suggesting a role for aortic stiffness in chronic LV-remodelling.
Asunto(s)
Angioplastia Coronaria con Balón , Enfermedades de la Aorta/epidemiología , Enfermedades de la Aorta/metabolismo , Infarto del Miocardio , Miocardio/metabolismo , Rigidez Vascular , Adulto , Anciano , Factor Natriurético Atrial/metabolismo , Biomarcadores/metabolismo , Creatinina/metabolismo , Femenino , Estudios de Seguimiento , Humanos , Imagen por Resonancia Cinemagnética , Masculino , Persona de Mediana Edad , Análisis Multivariante , Infarto del Miocardio/epidemiología , Infarto del Miocardio/metabolismo , Infarto del Miocardio/terapia , Péptido Natriurético Encefálico/metabolismo , Fragmentos de Péptidos/metabolismo , Flujo Pulsátil , Factores de Riesgo , Estrés Mecánico , Volumen SistólicoRESUMEN
Using currently available ultrasound equipment, 38 BPK and CPK mice were evaluated at 7 days of age for the presence of autosomal recessive polycystic kidney disease (ARPKD). The kidneys were less echogenic than adjacent soft tissues and measured between 5.1 and 6.3 mm from pole to pole in 32 unaffected mice and 1 with ARPKD. In 5 mice with ARPKD, the kidneys were similar in echogenicity to adjacent soft tissues and measured between 6.9 and 8.4 mm from pole to pole. Renal sonography is able to identify most mice with polycystic kidney disease prior to the development of abdominal enlargement and laboratory abnormalities, and shows promise for future applications in animal research.
