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1.
Cardiol Rev ; 29(1): 39-42, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33136582

RESUMEN

Patients older than 65 years hospitalized with COVID-19 have higher rates of intensive care unit admission and death when compared with younger patients. Cardiovascular conditions associated with COVID-19 include myocardial injury, acute myocarditis, cardiac arrhythmias, cardiomyopathies, cardiogenic shock, thromboembolic disease, and cardiac arrest. Few studies have described the clinical course of those at the upper extreme of age. We characterize the clinical course and outcomes of 73 patients with 80 years of age or older hospitalized at an academic center between March 15 and May 13, 2020. These patients had multiple comorbidities and often presented with atypical clinical findings such as altered sensorium, generalized weakness and falls. Cardiovascular manifestations observed at the time of presentation included new arrhythmia in 7/73 (10%), stroke/intracranial hemorrhage in 5/73 (7%), and elevated troponin in 27/58 (47%). During hospitalization, 38% of all patients required intensive care, 13% developed a need for renal replacement therapy, and 32% required vasopressor support. All-cause mortality was 47% and was highest in patients who were ever in intensive care (71%), required mechanical ventilation (83%), or vasopressors (91%), or developed a need for renal replacement therapy (100%). Patients older than 80 years old with COVID-19 have multiple unique risk factors which can be associated with increased cardiovascular involvement and death.


Asunto(s)
Lesión Renal Aguda/terapia , Mortalidad Hospitalaria , Terapia de Reemplazo Renal/estadística & datos numéricos , Respiración Artificial/estadística & datos numéricos , Vasoconstrictores/uso terapéutico , Centros Médicos Académicos , Accidentes por Caídas , Lesión Renal Aguda/etiología , Anciano de 80 o más Años , Arritmias Cardíacas/etiología , Arritmias Cardíacas/fisiopatología , Aspartato Aminotransferasas/metabolismo , Proteína C-Reactiva/metabolismo , /metabolismo , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/metabolismo , Enfermedades Cardiovasculares/fisiopatología , Causas de Muerte , Trastornos de la Conciencia/fisiopatología , Disnea/fisiopatología , Femenino , Ferritinas/metabolismo , Fiebre/fisiopatología , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Hospitalización , Humanos , Hipoxia/fisiopatología , Hipoxia/terapia , Vida Independiente , Unidades de Cuidados Intensivos/estadística & datos numéricos , Hemorragias Intracraneales/etiología , Hemorragias Intracraneales/fisiopatología , Recuento de Leucocitos , Hepatopatías/etiología , Hepatopatías/metabolismo , Recuento de Linfocitos , Masculino , Debilidad Muscular/fisiopatología , Péptido Natriurético Encefálico/metabolismo , Casas de Salud , Terapia por Inhalación de Oxígeno , Polipéptido alfa Relacionado con Calcitonina/metabolismo , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/fisiopatología , Troponina I/metabolismo
2.
Cardiovasc Pathol ; 50: 107296, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33022373

RESUMEN

Cardiovascular diseases (CVDs) comprise a group of disorders ranging from peripheral artery, coronary artery, cardiac valve, cardiac muscle, and congenital heart diseases to arrhythmias and ultimately, heart failure. For all the advances in therapeutics, CVDs are still the leading cause of mortality the world over, hence the significance of a thorough understanding of CVDs at the molecular level. Disparities in the expressions of genes and microRNAs (miRNAs) play a crucial role in the determination of the fate of cellular pathways, which ultimately affect an organism's physiology. Indeed, miRNAs serve as the regulators of gene expressions in that they perform key functions both in several important cellular pathways and in the regulation of the onset of various diseases such as CVDs. Many miRNAs are expressed in embryonic, postnatal, and adult hearts; their aberrant expression or genetic deletion is associated with abnormal cardiac cell differentiation, disruption in heart development, and cardiac dysfunction. A substantial body of evidence implicates miRNAs in CVD development and suggests them as diagnostic biomarkers and intriguing therapeutic tools. The present review provides an overview of the history, biogenesis, and processing of miRNAs, as well as their function in the development, remodeling, and diseases of the heart.


Asunto(s)
Enfermedades Cardiovasculares/genética , Sistema Cardiovascular/crecimiento & desarrollo , MicroARNs/genética , Animales , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Cardiovasculares/terapia , Regulación del Desarrollo de la Expresión Génica , Marcadores Genéticos , Terapia Genética , Humanos , MicroARNs/uso terapéutico , Morfogénesis
3.
Arterioscler Thromb Vasc Biol ; 41(1): 179-185, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33086867

RESUMEN

Traditionally, much research effort has been invested into focusing on disease, understanding pathogenic mechanisms, identifying risk factors, and developing effective treatments. A few recent studies unraveling the basis for absence of disease, including cardiovascular disease, despite existing risk factors, a phenomenon commonly known as resilience, are adding new knowledge and suggesting novel therapeutic approaches. Given the central role of endothelial function in cardiovascular health, we herein provide a number of considerations that warrant future research and considering a paradigm shift toward identifying the molecular underpinnings of endothelial resilience.


Asunto(s)
Enfermedades Cardiovasculares/fisiopatología , Endotelio Vascular/fisiopatología , Vasodilatación/fisiología , Animales , Humanos , Factores de Riesgo
4.
Physiol Rep ; 8(24): e14644, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33340273

RESUMEN

This review examines the stress hormone cortisol which plays an important role in regulating and supporting different bodily functions. Disruption in cortisol production has an impact on health and this review looks at a wide range of papers where cortisol has been indicated as a factor in numerous chronic conditions-especially those which are classed as "noncommunicable diseases" (NCDs). Timely detection, screening, and treatment for NCDs are vital to address the growing problem of NCDs worldwide-this would have health and socioeconomic benefits. Interestingly, many of the papers highlight the pro-inflammatory consequences of cortisol dysregulation and its deleterious effects on the body. This is particularly relevant given the recent findings concerning COVID-19 where pro-inflammatory cytokines have been implicated in severe inflammation.


Asunto(s)
/sangre , Enfermedades Cardiovasculares/sangre , Ritmo Circadiano , Diabetes Mellitus Tipo 2/sangre , Hidrocortisona/sangre , Sistema Hipotálamo-Hipofisario/metabolismo , Inflamación/sangre , Estrés Fisiológico , Animales , Biomarcadores/sangre , /fisiopatología , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/fisiopatología , Citocinas/sangre , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/fisiopatología , Humanos , Sistema Hipotálamo-Hipofisario/fisiopatología , Inflamación/epidemiología , Inflamación/fisiopatología , Mediadores de Inflamación/sangre
5.
Vasc Health Risk Manag ; 16: 535-543, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33324067

RESUMEN

Introduction: The aim of this study was to evaluate the relationship between adipokines and arterial stiffness in a group of 85 elderly subjects and the role of leptin and adiponectin on subclinical vascular damage, defined by a PWV>10 m/s. Methods: In each subject, we evaluated anthropometry, body composition by DXA (fat mass, fat mass%, lean mass), metabolic variables, leptin, adiponectin, systolic, diastolic, mean arterial pressure and pulse pressure (SBP, DBP, MAP, PP), carotid-femoral pulse wave velocity (cfPWV) and carotid-radial pulse wave velocity (crPWV). Results: In the study population, significant associations were observed between cfPWV and crPWV, age, SBP, MAP, waist circumference, fat body mass and leptin. The study population was subdivided in 2 subgroups according to adipokine patterns: group 1 included patients with high adiponectin and low leptin, and group 2 patients had high leptin and low adiponectin. SBP, PP, cfPWV were significantly higher in subjects with high leptin and low adiponectin (group 2). Even after adjustment for gender, fat mass%, MAP, HDL cholesterol and triglycerides, cfPWV was higher in group 2 than group 1. In a logistic binary regression on the entire population, considering subclinical vascular damage as a dependent variable and age, gender, MAP, fat mass%, triglycerides, HDL cholesterol and category of subjects with high leptin and low adiponectin as independent variables, MAP and category of subjects with high leptin and low adiponectin were significant predictors (OR, respectively, 1.09 and 3.61). Conclusion: In conclusion, in the elderly, the presence at the same time of high leptin levels and low adiponectin levels seems to have synergic effects on arterial stiffness.


Asunto(s)
Adiponectina/sangre , Envejecimiento/sangre , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/fisiopatología , Leptina/sangre , Rigidez Vascular , Factores de Edad , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Composición Corporal , Enfermedades Cardiovasculares/diagnóstico , Femenino , Humanos , Masculino , Factores de Riesgo
6.
Rev. esp. cardiol. Supl. (Ed. impresa) ; 20(supl.E): 27-32, dic. 2020. ilus, tab
Artículo en Español | IBECS | ID: ibc-195344

RESUMEN

La pandemia ocasionada por la rápida expansión del SARS-CoV-2 ha producido la mayor crisis sanitaria de la época moderna. La estrecha relación del virus con la enzima de conversión de la angiotensina ha suscitado un torrente de especulaciones por el posible papel del sistema renina-angiotensina-aldosterona (SRAA) en la regulation de la infection. La alerta generada ha cuestionado el empleo de fármacos inhibidores del SRAA, tanto los inhibidores de la enzima de conversión de la angiotensina como los antagonistas del receptor de la angiotensina II. está situación ha motivado la publication de varios estudios que no han encontrado asociación entre el uso de inhibidores del SRAA y una mayor susceptibilidad a la infección o a una peor evolution clínica. En está revisión se abordan los aspectos más relevantes de la interacción del SARS-CoV-2 con el SRAA y las implicaciones clínicas en torno al uso de inhibidores del SRAA durante la pandemia


The pandemic caused by the rapid spread of the SARS-CoV-2 virus has produced the greatest health crisis of modern times. The close relationship between the virus and angiotensin-II converting enzyme has provoked a torrent of speculation about the possible role of the renin-angiotensin-aldosterone system (RAAS) in mediating infection. The subsequent alarm has raised questions about the use of RAAS inhibitors, such as angiotensin-converting enzyme inhibitors and angiotensin-II receptor blockers. The result has been the publication of several studies that have failed to find an association between the use of RAAS inhibitors and greater susceptibility to infección or a worse clínical outlook. This review considers the most significant aspects of the interaction between SARS-CoV-2 and the RAAS and the clínical implications of using RAAS inhibitors during the pandemic


Asunto(s)
Humanos , Infecciones por Coronavirus/fisiopatología , Neumonía Viral/fisiopatología , Pandemias , Sistema Renina-Angiotensina/fisiología , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Cardiovasculares/virología , Infecciones por Coronavirus/tratamiento farmacológico , Neumonía Viral/tratamiento farmacológico
7.
Rev. esp. cardiol. Supl. (Ed. impresa) ; 20(supl.E): 40-42, dic. 2020.
Artículo en Español | IBECS | ID: ibc-195346

RESUMEN

En diciembre de 2019, se detectaron en China los primeros casos de una neumonía cuyo agente causante se identificó como un nuevo coronavirus, el SARS-CoV-2. Dicho virus causa la enfermedad COVID-19, cuyas virulencia y capacidad de transmision, junto con la ausencia de vacuna o de un tratamiento especifico, han condicionado un impacto sin precedentes en los sistemas sanitarios. La COVID-19 puede producir una afección grave en el sistema cardiovascular. Los pacientes con factores de riesgo cardiovascular o con una enfermedad cardiovascular subyacente son poblaciones particularmente vulnerables, con un riesgo muy elevado de sufrir complicaciones y muerte. Sin embargo, se ha tenido que asistir a dichos pacientes con una evidencia científica inexistente o muy escasa. En este suplemento se analizan la Fisiopatología de la COVID-19, los mecanismos directos e indirectos de la afección cardiovascular y los diversos tipos de complicaciones cardiovasculares. Asimismo se resumen los documentos que la SEC elaboro para dar una respuesta practica a la compleja situación asistencial generada. También se describen las futuras formas de la reorganizacion ambulatoria, principalmente mediante telemedicina, para dar continuidad asistencial. Para terminar, se analizan los diferentes tipos de tratamientos farmacológicos utilizados y sus posibles interacciones. El presente suplemento, con una serie de artículos elaborados por autores de prestigio, resume el conocimiento actual sobre dicha enfermedad y aporta datos e Información de gran valor práctico


In December 2019, clinicians in China first observed cases of pneumonia whose cause was identified as a new coronavirus, SARS-CoV-2. This virus causes COVID-19 disease, which has a virulence and transmission rate that, coupled with the absence of a vaccine or specific treatment, has had an unprecedented impact on health systems. COVID-19 can cause serious cardiovascular disease. Patients with cardiovascular risk factors or with an underlying cardiovascular condition form a particularly vulnerable population with a very high risk of complications and death. However, these patients had to be treated on the basis of very limited or nonexistent scientific evidence. This supplement discusses the pathophysiology of COVID-19, the direct and indirect mechanisms of associated cardiovascular disease, and the different types of cardiovascular complications that can occur. It also summarizes Spanish Society of Cardiology publications that have been produced to provide a practical response to the resulting complex health-care situation. In addition, the supplement describes how outpatient care can be reorganized in the future to ensure continuity of care, principally through telemedicine. Finally, the different types of pharmacological treatment available are discussed, along with their potential interactions. This supplement, which contains a series of articles prepared by influential authors, summarizes current knowledge about this disease and provides data and Información of great practical value


Asunto(s)
Humanos , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Cardiovasculares/virología , Infecciones por Coronavirus/complicaciones , Neumonía Viral/complicaciones , Pandemias , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Atención Ambulatoria/normas , Sociedades Médicas
8.
PLoS One ; 15(12): e0241368, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33259484

RESUMEN

OBJECTIVES: Little is known about the physical activity of patients after cardiac surgery. This study was designed to assess this activity using a connected bracelet. METHODS: In this prospective, monocentric study, patients scheduled for cardiac surgery were offered to wear an electronic bracelet. The main objective was to measure the physical activity recovery. Secondary objectives were the predictors of the correct use of the monitoring system, of the physical recovery and, if any, the relationship between physical activity and out-of-hospital morbidity. RESULTS: One hundred patients were included. Most patients (86%) were interested in participating in the study. The compliance to the device and to the study protocol was good (94%). At discharge, the mean number of daily steps was 1454 ± 145 steps, increasing quite homogeneously, reaching 5801±1151 steps at Day 60. The best fit regression curve gave a maximum number of steps at 5897±119 (r2 = 0.97). The 85% level of activity was achieved at Day 30±3. No predictor of noncompliance was found. At discharge, age was independently associated with a lower number of daily steps (p <0.001). At Day 60, age, peripheral arterial disease and cardio-pulmonary bypass duration were independently associated with a lower number of daily steps (p = 0.039, p = 0.041 and p = 0.033, respectively). CONCLUSIONS: After cardiac surgery, wearing a smart bracelet recording daily steps is simple, well tolerated and suitable for measuring physical activity. Standard patients achieved around 6000 daily steps 2 months after discharge. 85% of this activity is reached in the first month. CLINICAL TRIAL REGISTRY NUMBER: NCT03113565.


Asunto(s)
Rehabilitación Cardiaca , Enfermedades Cardiovasculares/terapia , Monitoreo Fisiológico , Dispositivos Electrónicos Vestibles , Adolescente , Adulto , Anciano , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Cardiovasculares/cirugía , Ejercicio Físico/fisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Cirugía Torácica , Adulto Joven
9.
J Immunol Res ; 2020: 8632048, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33299899

RESUMEN

Novel coronavirus disease 2019 (COVID-19) causes pulmonary and cardiovascular disorders and has become a worldwide emergency. Myocardial injury can be caused by direct or indirect damage, particularly mediated by a cytokine storm, a disordered immune response that can cause myocarditis, abnormal coagulation, arrhythmia, acute coronary syndrome, and myocardial infarction. The present review focuses on the mechanisms of this viral infection, cardiac biomarkers, consequences, and the possible therapeutic role of purinergic and adenosinergic signalling systems. In particular, we focus on the interaction of the extracellular nucleotide adenosine triphosphate (ATP) with its receptors P2X1, P2X4, P2X7, P2Y1, and P2Y2 and of adenosine (Ado) with A2A and A3 receptors, as well as their roles in host immune responses. We suggest that receptors of purinergic signalling could be ideal candidates for pharmacological targeting to protect against myocardial injury caused by a cytokine storm in COVID-19, in order to reduce systemic inflammatory damage to cells and tissues, preventing the progression of the disease by modulating the immune response and improving patient quality of life.


Asunto(s)
Adenosina Trifosfato/metabolismo , Enfermedades Cardiovasculares/virología , Receptores Purinérgicos/metabolismo , Agonistas del Receptor de Adenosina A2/farmacología , /metabolismo , Enfermedades Cardiovasculares/inmunología , Enfermedades Cardiovasculares/fisiopatología , Citocinas/metabolismo , Humanos , Isquemia Miocárdica/inmunología , Isquemia Miocárdica/fisiopatología , Isquemia Miocárdica/virología , Pandemias , Antagonistas Purinérgicos/farmacología , Receptor de Adenosina A2A/metabolismo , Receptor de Adenosina A3/metabolismo , Transducción de Señal/efectos de los fármacos , Transducción de Señal/inmunología
10.
Am J Cardiol ; 133: 162-165, 2020 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-33172590

RESUMEN

Adolf Fick was a German physiologist, born in Kassel in 1829, who studied medicine at the University of Marburg and graduated in 1851. He worked first in Zurich and then in Wurzburg. Most of his studies were based on physics and mathematics, and deep analysis, and only later were proven by experiments. Fick's name in physics is associated to the laws of diffusion of solutions, and in medicine to the principle of cardiac output calculation. In 1855, he proposed Fick's laws on gas diffusion. In 1870, he devised Fick's principle, which allows the measurement of cardiac output and calculations of intracardiac shunts from the arteriovenous oxygen difference. The method was later generalized to the Fick principle, according to which the flow of an indicator taken up or released by an organ corresponds to the difference between the indicator flows in the inflow and outflow tracts. Fick invented several devices most of them aimed to improve precision in his physiologic experiments. In 1868, he invented the plethysmograph, for recording the speed of blood in the human artery. In 1888, the tonometer for measuring from outside the hydrostatic pressure inside the eyeball. After 3 decades as Professor in Wurzburg, he retired. Fick died at Blankenberge, Belgium in 1901 age 71 years old.


Asunto(s)
Gasto Cardíaco , Cardiología/historia , Enfermedades Cardiovasculares/historia , Fisiología/historia , Enfermedades Cardiovasculares/fisiopatología , Alemania , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Matemática/historia
13.
PLoS One ; 15(11): e0241193, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33175849

RESUMEN

BACKGROUND: Programmes using motivational interviewing show potential in facilitating lifestyle change, however this has not been well established and explored in individuals at risk of, yet without symptomatic pre-existent cardiovascular disease. The objective of this systematic review and meta-analysis was to determine the effectiveness of motivational interviewing in supporting modifiable risk factor change in individuals at an increased risk of cardiovascular disease. METHODS: Systematic review and meta-analysis with results were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Health-related databases were searched for randomised controlled trials from 1980 to March 2020. Criteria for inclusion included; preventive programmes, motivational interviewing principles, modification of cardiovascular risk factors in adults of both genders, different ethnicities and employment status, and having at least 1 or more modifiable cardiovascular risk factor/s. Two reviewers independently extracted data and conducted a quality appraisal of eligible studies using an adapted Cochrane framework. The Cochrane framework supports to systematically identify, appraise and synthesize all the empirical evidence that meets the pre-specified eligibility criteria to answer a specific question. FINDINGS: A total of 12 studies met the inclusion criteria. While completeness of intervention reporting was found to be adequate, the application of motivational interviewing was found to be insufficiently reported across all studies (mean overall reporting rate; 68%, 26% respectively). No statistical difference between groups in smoking status and physical activity was reported. A random effects analysis from 4 studies was conducted, this determined a synthesized estimate for standardised mean difference in weight of -2.00kg (95% CI -3.31 to -0.69 kg; p = 0.003), with high statistical heterogeneity. Pooled results from 4 studies determined a mean difference in LDL-c of -0.14mmol/l (5.414mg/dl), which was non-significant. The characteristics of interventions more likely to be effective were identified as: use of a blended approach delivered by a nurse expert in motivational interviewing from an outpatient-clinic. The application of affirmation, compassion and evocation, use of open questions, summarising, listening, supporting and raising ambivalence, combining education and barrier change identification with goal setting are also important intervention characteristics. CONCLUSIONS: While motivational interviewing may support individuals to modify their cardiovascular risk through lifestyle change, the effectiveness of this approach remains uncertain. The strengths and limitations of motivational interviewing need to be further explored through robust studies.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Ejercicio Físico/psicología , Estilo de Vida Saludable/fisiología , Entrevista Motivacional , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/fisiopatología , Colesterol/sangre , Ejercicio Físico/fisiología , Humanos , Lipoproteínas LDL/sangre , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo , Resultado del Tratamiento , Triglicéridos/sangre
14.
Arch Biochem Biophys ; 696: 108662, 2020 12 15.
Artículo en Inglés | MEDLINE | ID: mdl-33159890

RESUMEN

Environmental pollution is a major cause of global mortality and burden of disease. All chemical pollution forms together may be responsible for up to 12 million annual excess deaths as estimated by the Lancet Commission on pollution and health as well as the World Health Organization. Ambient air pollution by particulate matter (PM) and ozone was found to be associated with an all-cause mortality rate of up to 9 million in the year 2015, with the majority being of cerebro- and cardiovascular nature (e.g. stroke and ischemic heart disease). Recent evidence suggests that exposure to airborne particles and gases contributes to and accelerates neurodegenerative diseases. Especially, airborne toxic particles contribute to these adverse health effects. Whereas it is well established that air pollution in the form of PM may lead to dysregulation of neurohormonal stress pathways and may trigger inflammation as well as oxidative stress, leading to secondary damage of cardiovascular structures, the mechanistic impact of PM-induced mitochondrial damage and dysfunction is not well established. With the present review we will discuss similarities between mitochondrial damage and dysfunction observed in the development and progression of cardiovascular disease and neurodegeneration as well as those adverse mitochondrial pathomechanisms induced by airborne PM.


Asunto(s)
Contaminantes Atmosféricos/toxicidad , Enfermedades Cardiovasculares/fisiopatología , Mitocondrias/efectos de los fármacos , Enfermedades Neurodegenerativas/fisiopatología , Estrés Oxidativo/efectos de los fármacos , Material Particulado/toxicidad , Animales , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Humanos , Enfermedades Neurodegenerativas/epidemiología , Enfermedades Neurodegenerativas/etiología
15.
Med Sci (Paris) ; 36(11): 1004-1011, 2020 Nov.
Artículo en Francés | MEDLINE | ID: mdl-33151864

RESUMEN

In the first part of this review [22], "How and why circulatory phylogenesis fits into the evolution of species", we explained that the acquisition of a high-pressure arterial sector, as originally described by William Harvey in 1619, was the consequence, during evolution, of the appearance of vasomotor tone, inducing systemic friction forces (peripheral resistances), which, regulated locally (by vasodilatation), allows to adapt metabolic needs to the demand of functionally active territories. In this second part, we will try to understand how this phylogenesis directly influences the physiology, then the pathologies of the circulatory system in humans which are largely predominant, but not exclusively.


Asunto(s)
Evolución Biológica , Circulación Sanguínea/fisiología , Enfermedades Cardiovasculares/etiología , Animales , Enfermedades Cardiovasculares/patología , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Hematológicas/etiología , Enfermedades Hematológicas/patología , Enfermedades Hematológicas/fisiopatología , Historia del Siglo XV , Historia del Siglo XVI , Historia del Siglo XVII , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Hipertensión/etiología , Hipertensión/fisiopatología , Modelos Biológicos , Filogenia
16.
PLoS One ; 15(11): e0242147, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33166366

RESUMEN

The aim of time-varying heart rate variability spectral analysis is to detect and quantify changes in the heart rate variability spectrum components during nonstationary events. Of the methods available, the nonparametric short-time Fourier Transform and parametric time-varying autoregressive modeling are the most commonly employed. The current study (1) compares short-time Fourier Transform and autoregressive modeling methods influence on heart rate variability spectral characteristics over time and during an experimental ozone exposure in mature adult spontaneously hypertensive rats, (2) evaluates the agreement between short-time Fourier Transform and autoregressive modeling method results, and (3) describes the advantages and disadvantages of each method. Although similar trends were detected during ozone exposure, statistical comparisons identified significant differences between short-time Fourier Transform and autoregressive modeling analysis results. Significant differences were observed between methods for LF power (p ≤ 0.014); HF power (p ≤ 0.011); total power (p ≤ 0.027); and normalized HF power (p = 0.05). Furthermore, inconsistencies between exposure-related observations accentuated the lack of agreement between short-time Fourier Transform and autoregressive modeling overall. Thus, the short-time Fourier Transform and autoregressive modeling methods for time-varying heart rate variability analysis could not be considered interchangeable for evaluations with or without interventions that are known to affect cardio-autonomic activity.


Asunto(s)
Enfermedades Cardiovasculares/fisiopatología , Frecuencia Cardíaca , Algoritmos , Análisis de Varianza , Animales , Sistema Nervioso Autónomo/fisiología , Modelos Animales de Enfermedad , Electrocardiografía , Análisis de Fourier , Masculino , Ozono , Ratas , Ratas Endogámicas SHR , Análisis de Regresión , Estadísticas no Paramétricas , Telemetría
17.
Atherosclerosis ; 314: 58-62, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33161318

RESUMEN

Coronavirus disease 2019 (COVID-19) increases the risk of several non-pulmonary complications such as acute myocardial injury, renal failure or thromboembolic events. A possible unifying explanation for these phenomena may be the presence of profound endothelial dysfunction and injury. This review provides an overview on the association of endothelial dysfunction with COVID-19 and its therapeutic implications. Endothelial dysfunction is a common feature of the key comorbidities that increase risk for severe COVID-19 such as hypertension, obesity, diabetes mellitus, coronary artery disease or heart failure. Preliminary studies indicate that vascular endothelial cells can be infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and evidence of widespread endothelial injury and inflammation is found in advanced cases of COVID-19. Prior evidence has established the crucial role of endothelial cells in maintaining and regulating vascular homeostasis and blood coagulation. Aggravation of endothelial dysfunction in COVID-19 may therefore impair organ perfusion and cause a procoagulatory state resulting in both macro- and microvascular thrombotic events. Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) and statins are known to improve endothelial dysfunction. Data from smaller observational studies and other viral infections suggests a possible beneficial effect in COVID-19. Other treatments that are currently under investigation for COVID-19 may also act by improving endothelial dysfunction in patients. Focusing therapies on preventing and improving endothelial dysfunction could improve outcomes in COVID-19. Several clinical trials are currently underway to explore this concept.


Asunto(s)
/virología , Enfermedades Cardiovasculares/virología , Endotelio Vascular/virología , /patogenicidad , Antagonistas de Receptores de Angiotensina/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Animales , Coagulación Sanguínea , /epidemiología , Enfermedades Cardiovasculares/tratamiento farmacológico , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/fisiopatología , Endotelio Vascular/efectos de los fármacos , Endotelio Vascular/fisiopatología , Interacciones Huésped-Patógeno , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Pronóstico , Sistema Renina-Angiotensina , Factores de Riesgo
18.
Trends Endocrinol Metab ; 31(12): 893-904, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33172748

RESUMEN

Coronavirus disease 2019 (COVID-19) patients with pre-existing cardiovascular disease (CVD) or with cardiovascular complications have a higher risk of mortality. The main cardiovascular complications of COVID-19 include acute cardiac injury, acute myocardial infarction (AMI), myocarditis, arrhythmia, heart failure, shock, and venous thromboembolism (VTE)/pulmonary embolism (PE). COVID-19 can cause cardiovascular complications or deterioration of coexisting CVD through direct or indirect mechanisms, including viral toxicity, dysregulation of the renin-angiotensin-aldosterone system (RAAS), endothelial cell damage and thromboinflammation, cytokine storm, and oxygen supply-demand mismatch. We systematically review cardiovascular manifestations, histopathology, and mechanisms of COVID-19, to help to formulate future research goals and facilitate the development of therapeutic management strategies.


Asunto(s)
/fisiopatología , Enfermedades Cardiovasculares/fisiopatología , /metabolismo , Arritmias Cardíacas/inmunología , Arritmias Cardíacas/metabolismo , Arritmias Cardíacas/fisiopatología , /metabolismo , Enfermedades Cardiovasculares/inmunología , Enfermedades Cardiovasculares/metabolismo , Síndrome de Liberación de Citoquinas/inmunología , Síndrome de Liberación de Citoquinas/fisiopatología , Cardiopatías/inmunología , Cardiopatías/metabolismo , Cardiopatías/fisiopatología , Insuficiencia Cardíaca/inmunología , Insuficiencia Cardíaca/metabolismo , Insuficiencia Cardíaca/fisiopatología , Humanos , Hipoxia/inmunología , Hipoxia/metabolismo , Hipoxia/fisiopatología , Infarto del Miocardio/inmunología , Infarto del Miocardio/metabolismo , Infarto del Miocardio/fisiopatología , Miocarditis/inmunología , Miocarditis/metabolismo , Miocarditis/fisiopatología , Embolia Pulmonar/inmunología , Embolia Pulmonar/metabolismo , Embolia Pulmonar/fisiopatología , Sistema Renina-Angiotensina/fisiología , /metabolismo , Choque/inmunología , Choque/metabolismo , Choque/fisiopatología , Troponina/metabolismo , Tromboembolia Venosa/inmunología , Tromboembolia Venosa/metabolismo , Tromboembolia Venosa/fisiopatología
19.
Colomb Med (Cali) ; 51(2): e4320, 2020 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-33012891

RESUMEN

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which causes coronavirus disease 2019 (COVID-19) has resulted in a global health crisis. Prior to the arrival of this viral pandemic, the world was already plagued with a significant burden of cardiovascular disease. With the introduction of the novel virus, the world now faces a double jeapordy. Early reports have suggested an increased risk of death in individuals with underlying cardio-metabolic disorders. The exact effects of COVID-19 on the cardiovascular system are not well determined, however lessons from prior viral epidemics suggest that such infections can trigger acute coronary syndromes, arrhythmias and heart failure via direct and indirect mechanisms. In this article, we aimed to discuss the effects and potential underlying mechanisms of COVID -19 as well as potential implications of treatments targeted against this virus on the cardiovascular system.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Betacoronavirus/aislamiento & purificación , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Cardiovasculares/virología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/terapia , Humanos , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/terapia , Factores de Riesgo
20.
Ann Card Anaesth ; 23(4): 401-408, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33109794

RESUMEN

COVID-19 pandemic is mainly related with the pulmonary problems initially but now as the pandemic is growing it is observed that almost all organ systems of the body are affected. Up to 20-30% patients who are admitted in Covid hospitals are showing cardiovascular involvement. Severity of cardiovascular disease in a COVID-19 patient depends whether a patient is having pre-existing cardiac disease or not. Patients with pre-existing cardiac disease have more severe infection and associated mortality. Severe COVID-19 infection shows close association with myocardial damage and various arrythmias. The cardiovascular involvement occurs by either engagement directly with the angiotensin converting enzyme 2 or indirectly by the effect of inflammatory mediators which are generated as a result of viral-host response to infection. The COVID-19 disease is said to produce a wide spectrum of affliction ranging between even asymptomatic patient to Cardiovascular syndrome. Even after recovering from COVID-19 patients can reappear in the hospital with cardiomyopathies and arrythmias.


Asunto(s)
Betacoronavirus , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/fisiopatología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/fisiopatología , Neumonía Viral/complicaciones , Neumonía Viral/fisiopatología , Humanos , Pandemias
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