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1.
Opt Express ; 26(21): 28140-28149, 2018 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-30469869

RESUMO

A key requirement in the field of ultrafast vibrational spectroscopy is to efficiently generate intense tunable narrowband picosecond laser pulses synchronized to a broadband femtosecond laser source. Current nonlinear methods for picosecond pulse generation suffer from complexities in both experimental implementation and pulse frequency tunability. We present here a straightforward method for spectral bandwidth compression that produces frequency tunable picosecond pulses with efficient power conversion. Broadband femtosecond laser pulses are compressed to narrowband picosecond pulses using frequency domain sum-frequency generation of spatially chirped pulses, achieving spectral bandwidths of <20 cm-1 and power conversion efficiency of ∼18%. The experimental design of the bandwidth compressor is presented and its application to stimulated Raman spectroscopy is demonstrated.

2.
J Cardiovasc Magn Reson ; 18(1): 86, 2016 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-27846914

RESUMO

There were 116 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2015, which is a 14 % increase on the 102 articles published in 2014. The quality of the submissions continues to increase. The 2015 JCMR Impact Factor (which is published in June 2016) rose to 5.75 from 4.72 for 2014 (as published in June 2015), which is the highest impact factor ever recorded for JCMR. The 2015 impact factor means that the JCMR papers that were published in 2013 and 2014 were cited on average 5.75 times in 2015. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by highly cited papers such as official reports. However, the progress of the journal's impact over the last 5 years has been impressive. Our acceptance rate is <25 % and has been falling because the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors have felt that it is useful once per calendar year to summarize the papers for the readership into broad areas of interest or theme, so that areas of interest can be reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality papers to JCMR for publication.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Imageamento por Ressonância Magnética , Publicações Periódicas como Assunto , Animais , Bibliometria , Doenças Cardiovasculares/patologia , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/terapia , Políticas Editoriais , Humanos , Fator de Impacto de Revistas , Valor Preditivo dos Testes , Prognóstico
3.
J Cardiovasc Magn Reson ; 17: 99, 2015 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-26589839

RESUMO

There were 102 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2014, which is a 6% decrease on the 109 articles published in 2013. The quality of the submissions continues to increase. The 2013 JCMR Impact Factor (which is published in June 2014) fell to 4.72 from 5.11 for 2012 (as published in June 2013). The 2013 impact factor means that the JCMR papers that were published in 2011 and 2012 were cited on average 4.72 times in 2013. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following publication, and is significantly influenced by highly cited papers such as official reports. However, the progress of the journal's impact over the last 5 years has been impressive. Our acceptance rate is <25% and has been falling because the number of articles being submitted has been increasing. In accordance with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors have felt that it is useful once per calendar year to summarize the papers for the readership into broad areas of interest or theme, so that areas of interest can be reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality papers to JCMR for publication.


Assuntos
Pesquisa Biomédica , Cardiologia , Doenças Cardiovasculares/diagnóstico , Imageamento por Ressonância Magnética , Publicações Periódicas como Assunto , Animais , Bibliometria , Pesquisa Biomédica/estatística & dados numéricos , Cardiologia/estatística & dados numéricos , Doenças Cardiovasculares/patologia , Doenças Cardiovasculares/fisiopatologia , Políticas Editoriais , Humanos , Fator de Impacto de Revistas , Imageamento por Ressonância Magnética/estatística & dados numéricos , Publicações Periódicas como Assunto/estatística & dados numéricos , Valor Preditivo dos Testes , Prognóstico , Índice de Gravidade de Doença , Fatores de Tempo
4.
BJR Case Rep ; 1(2): 20150182, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-30363137

RESUMO

A middle-aged female patient presented with increasing dyspnoea following delivery of her second child. Echocardiography showed left ventricular (LV) dilatation and severe global impairment of systolic function (ejection fraction < 10%) but normal right ventricular (RV) dimensions. Plasma B-type natriuretic peptide level was elevated. Post-partum cardiomyopathy (PPCM) was considered and after initiating appropriate heart failure pharmacotherapy, her symptoms improved significantly. Cardiovascular MR showed RV free wall dyskinesia and aneurysms at the LV apex, RV free wall and RV outflow tract. Genetic analysis showed a C11842T substitution in the titin gene (TTN). This is the first case to propose an overlap syndrome of PPCM and arrhythmogenic RV cardiomyopathy.

6.
Br J Sports Med ; 46 Suppl 1: i51-8, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23097480

RESUMO

Preparticipation screening programmes for underlying cardiac pathologies are now commonplace for many international sporting organisations. However, providing medical clearance for an asymptomatic athlete without a family history of sudden cardiac death (SCD) is especially challenging when the athlete demonstrates particularly abnormal repolarisation patterns, highly suggestive of an inherited cardiomyopathy or channelopathy. Deep T-wave inversions of ≥ 2 contiguous anterior or lateral leads (but not aVR, and III) are of major concern for sports cardiologists who advise referring team physicians, as these ECG alterations are a recognised manifestation of hypertrophic cardiomyopathy (HCM) and arrhythmogenic right ventricular cardiomyopathy (ARVC). Subsequently, inverted T-waves may represent the first and only sign of an inherited heart muscle disease, in the absence of any other features and before structural changes in the heart can be detected. However, to date, there remains little evidence that deep T-wave inversions are always pathognomonic of either a cardiomyopathy or an ion channel disorder in an asymptomatic athlete following long-term follow-up. This paper aims to provide a systematic review of the prevalence of T-wave inversion in athletes and examine T-wave inversion and its relationship to structural heart disease, notably HCM and ARVC with a view to identify young athletes at risk of SCD during sport. Finally, the review proposes clinical management pathways (including genetic testing) for asymptomatic athletes demonstrating significant T-wave inversion with structurally normal hearts.


Assuntos
Displasia Arritmogênica Ventricular Direita/diagnóstico , Atletas , Cardiomiopatia Hipertrófica/diagnóstico , Eletrocardiografia , Esportes/fisiologia , Displasia Arritmogênica Ventricular Direita/terapia , Cardiomiopatia Hipertrófica/terapia , Procedimentos Clínicos , Morte Súbita Cardíaca/prevenção & controle , Diagnóstico Precoce , Testes Genéticos/métodos , Humanos , Exame Físico/métodos , Prognóstico , Medição de Risco/métodos
7.
Asian Pac J Trop Biomed ; 2(4): 320-30, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23569923

RESUMO

Diabetes mellitus is one of the common metabolic disorders acquiring around 2.8% of the world's population and is anticipated to cross 5.4% by the year 2025. Since long back herbal medicines have been the highly esteemed source of medicine therefore, they have become a growing part of modern, high-tech medicine. In view of the above aspects the present review provides profiles of plants (65 species) with hypoglycaemic properties, available through literature source from various database with proper categorization according to the parts used, mode of reduction in blood glucose (insulinomimetic or insulin secretagogues activity) and active phytoconstituents having insulin mimetics activity. From the review it was suggested that, plant showing hypoglycemic potential mainly belongs to the family Leguminoseae, Lamiaceae, Liliaceae, Cucurbitaceae, Asteraceae, Moraceae, Rosaceae and Araliaceae. The most active plants are Allium sativum, Gymnema sylvestre, Citrullus colocynthis, Trigonella foenum greacum, Momordica charantia and Ficus bengalensis. The review describes some new bioactive drugs and isolated compounds from plants such as roseoside, epigallocatechin gallate, beta-pyrazol-1-ylalanine, cinchonain Ib, leucocyandin 3-O-beta-d-galactosyl cellobioside, leucopelargonidin-3- O-alpha-L rhamnoside, glycyrrhetinic acid, dehydrotrametenolic acid, strictinin, isostrictinin, pedunculagin, epicatechin and christinin-A showing significant insulinomimetic and antidiabetic activity with more efficacy than conventional hypoglycaemic agents. Thus, from the review majorly, the antidiabetic activity of medicinal plants is attributed to the presence of polyphenols, flavonoids, terpenoids, coumarins and other constituents which show reduction in blood glucose levels. The review also discusses the management aspect of diabetes mellitus using these plants and their active principles.


Assuntos
Hipoglicemiantes , Fitoterapia , Extratos Vegetais , Plantas Medicinais , Animais , Células Cultivadas , Flavonoides , Humanos , Insulina , Ilhotas Pancreáticas , Camundongos , Polifenóis , Ratos
8.
Asian Pac J Trop Biomed ; 2(8): 660-4, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23569990

RESUMO

Harmine, a beta-carboline alkaloid, is widely distributed in the plants, marine creatures, insects, mammalians as well as in human tissues and body fluids. Harmine was originally isolated from seeds of Peganum harmal in 1847 having a core indole structure and a pyridine ring. Harmine has various types of pharmacological activities such as antimicrobial, antifungal, antitumor, cytotoxic, antiplasmodial, antioxidaant, antimutagenic, antigenotoxic and hallucinogenic properties. It acts on gamma-aminobutyric acid type A and monoamine oxidase A or B receptor, enhances insulin sensitivity and also produces vasorelaxant effect. Harmine prevents bone loss by suppressing osteoclastogenesis. The current review gives an overview on pharmacological activity and analytical techniques of harmine, which may be useful for researcheres to explore the hidden potential of harmine and and will also help in developing new drugs for the treatment of various diseases.


Assuntos
Carbolinas/análise , Carbolinas/farmacologia , Harmina/análise , Harmina/farmacologia , Animais , Humanos , Insetos , Plantas
9.
Asian Pac J Trop Med ; 4(11): 866-9, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22078948

RESUMO

OBJECTIVE: To screen different analogues of mangiferin pharmacologically for antipyretic activity. METHODS: The naturally occurring xanthone glycoside mangiferin was isolated by column chromatography from the ethanolic extract of stem bark of Mangifera indica. Mangiferin was further converted to 5-(N-phenylamino methyleno) mangiferin, 5-(N-p-chlorophenylamino methyleno) mangiferin, 5-(N-2-methyl phenylamino methyleno) mangiferin, 5-(N-p-methoxy phenylamino methyleno) mangiferin, 5-(N, N-diphenylamino methyleno) mangiferin, 5-(N-α-napthylamino methyleno) mangiferin and 5-(N-4-methyl phenylamino methyleno) mangiferin analogues. The synthesized compounds were further screened for antipyretic activity along with mangiferin at a dose level of 100 and 200 mg/kg. Mangiferin and its analogues were characterized by melting point andR(f)value determination and through spectral technique like UV, IR, and NMR spectral analysis. RESULTS: The antipyretic activity of mangiferin as well as all analogues was found to be more significant in at higher dose ie. 200 mg/kg which was depicted through a decrease in rectal temperature up to 3 h. CONCLUSIONS: The antipyretic activity of mangiferin and its analogues may be attributed to inhibition in synthesis of TNF-α and anti-oxidant activity associated with amelioration of inflammatory actions of cytokines.


Assuntos
Febre/tratamento farmacológico , Mangifera/química , Fitoterapia , Casca de Planta/química , Extratos Vegetais/uso terapêutico , Xantonas/uso terapêutico , Animais , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Febre/induzido quimicamente , Glicosídeos/farmacologia , Glicosídeos/uso terapêutico , Camundongos , Extratos Vegetais/farmacologia , Saccharomyces cerevisiae , Resultado do Tratamento , Xantonas/administração & dosagem , Xantonas/síntese química , Xantonas/farmacologia
10.
Asian Pac J Trop Biomed ; 1(4): 316-22, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23569783

RESUMO

OBJECTIVE: To evaluate antidiabetic and antioxidant potential of Hybanthus enneaspermus in different models. METHODS: The oral glucose tolerance test (OGTT) and normoglycemic effect of alcoholic extract of Hybanthus enneaspermus (AHE) were evaluated at a dose of 125, 250 and 500 mg/kg p.o. while hypoglycemic activity and effect on body weight were tested at 250 and 500 mg/kg p.o. per day for 21 days in Streptozotocin (STZ) induced diabetic rats. Further, glucose uptake by hemidiaphram was also evaluated. The total polyphenolic and flavonoid were determined and their correlation with various antioxidant assays was also determined. RESULTS: The results showed high level of phenolic content in AHE. AHE also exhibited higher total antioxidant capacity, good reducing power and a significant scavenger of reactive oxygen species like DPPH radical, nitric oxide, hydrogen peroxide and deoxyribose. Furthermore there was a significant increase in the body weight and decrease in the blood glucose level on treatment with the AHE. AHE increased glucose uptake on isolated rat hemi-diaphragm compared to control group. CONCLUSIONS: AHE reduce blood glucose level in STZ-induced diabetic model. It does not show significant effect in normoglycemic study but showes significant effect in OGT. AHE has significant antioxidant activity, which may be attributed to high phenolic content.


Assuntos
Antioxidantes/uso terapêutico , Diabetes Mellitus Experimental/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Extratos Vegetais/uso terapêutico , Violaceae/química , Animais , Antioxidantes/isolamento & purificação , Peso Corporal , Teste de Tolerância a Glucose , Hipoglicemiantes/isolamento & purificação , Masculino , Extratos Vegetais/isolamento & purificação , Ratos Wistar
11.
Asian Pac J Trop Biomed ; 1(5): 395-400, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23569800

RESUMO

OBJECTIVE: To examine the antioxidant activity and total phenolic content of different solvent fractions of Pedalium murex (P. murex) Linn fruits (Family: Pedaliaceae) as well as the correlation between the total antioxidant capacity and total phenolic content. METHODS: In the present study, the antioxidant activities of P. murex were evaluated using six in-vitro assays, namely total antioxidant assay, DPPH assay, reducing power, nitric oxide scavenging, hydrogen peroxide scavenging and deoxyribose scavenging assays, and total phenol contents were also investigated. RESULTS: The ethyl acetate (EA) fraction was found to have high levels of phenolic content (298.72±2.09 mg GAE/g). The EA fraction exhibit higher total antioxidant capacity, higher percentage of DPPH radical scavenging activity (135.11±2.95µg/mL), nitric oxide (200.57±4.51µg/mL), hydrogen peroxide (217.91±6.12 µg/mL), deoxyribose (250.01±4.68µg/mL) and higher reducing power. Correlation coefficient (r(2) =0.914) was found to be significant between total phenolic content and total antioxidant activity. CONCLUSIONS: In general, the results indicate that the EA fractions are rich in phenolic antioxidants with potent free radical scavenging activity implying their importance to human health.


Assuntos
Antioxidantes/metabolismo , Frutas/química , Pedaliaceae/química , Extratos Vegetais/metabolismo , Antioxidantes/química , Compostos de Bifenilo/análise , Compostos de Bifenilo/metabolismo , Fenóis/química , Picratos/análise , Picratos/metabolismo , Extratos Vegetais/química
12.
Pharm Biol ; 48(12): 1397-404, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20822338

RESUMO

CONTEXT: Withania coagulans Dunal. (Solanaceae) has been shown to possess hypoglycemic, free radical scavenging and wound healing activity. Therefore, it may be worthwhile to study the effect of Withania coagulans in diabetic wound healing. OBJECTIVE: This study included determination of rate of wound contraction and estimation of various biochemical parameters such as collagen, hexosamine, total protein, total DNA, SOD and CAT levels in the granulation tissues. MATERIALS AND METHODS: The hydroalcoholic fraction of the methanolic extract (standardized by withaferin-A using high performance thin layer chromatography (HPTLC) )of Withania coagulans in the form of 10% w/w ointment topically and at a dose of 500 mg/kg per oral (p.o.) was administered to streptozotocin-induced diabetic rats. The results obtained were compared with diabetic control and Aloe barbadensis Miller (syn. Aloe vera L.) (Liliaceae) was used as a reference drug. RESULTS: The amount of withaferin-A present in the methanolic extract was 3.67 mg/g of the extract. The hydroalcoholic fraction in both the forms, i.e., topical (10% w/w ointment) and oral (500 mg/kg, p.o.) showed a significant increase in the rate of wound contraction (83.02% topical and 65.14% oral) topical and 93.18% oral) when compared to diabetic control (66 which was further justified with significant increase in the levels of collagen, protein, DNA, SOD, CAT, and decreased level of hexosamine. DISCUSSION AND CONCLUSION: The hydroalcoholic fraction of Withania coagulans in oral form is found to be more effective than the topical form. However, further studies are in progress to find the lead molecules responsible for the wound healing effect.


Assuntos
Diabetes Mellitus Experimental/complicações , Extratos Vegetais/farmacologia , Withania/química , Cicatrização/efeitos dos fármacos , Administração Oral , Administração Tópica , Aloe/química , Animais , Cromatografia em Camada Fina/métodos , Complicações do Diabetes/tratamento farmacológico , Complicações do Diabetes/patologia , Feminino , Masculino , Ratos , Estreptozocina , Vitanolídeos/isolamento & purificação
14.
J Cardiovasc Magn Reson ; 12: 15, 2010 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-20302618

RESUMO

There were 56 articles published in the Journal of Cardiovascular Magnetic Resonance in 2009. The editors were impressed with the high quality of the submissions, of which our acceptance rate was about 40%. In accordance with open-access publishing, the articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. We have therefore chosen to briefly summarise the papers in this article for quick reference for our readers in broad areas of interest, which we feel will be useful to practitioners of cardiovascular magnetic resonance (CMR). In some cases where it is considered useful, the articles are also put into the wider context with a short narrative and recent CMR references. It has been a privilege to serve as the Editor of the JCMR this past year. I hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality manuscripts to JCMR for publication.


Assuntos
Doenças Cardiovasculares/diagnóstico , Imageamento por Ressonância Magnética , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/terapia , Humanos , Publicações Periódicas como Assunto , Valor Preditivo dos Testes , Prognóstico
15.
Animal ; 3(2): 261-8, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22444229

RESUMO

This study was designed to test whether Mucuna pruriens, a natural source of l-dihydroxyphenylalanine (l-DOPA, a dopamine precursor) feeding, can influence development and reproductive conditions in the high food value bird, Japanese quail, Coturnix coturnix japonica. Experiments were performed in both male and female Japanese quail. One-week-old quail chicks were divided into three groups of 36 birds each. Group I was provided with normal diet and served as control. Group II was provided with food mixed with l-DOPA (50 mg/15 g food) and Group III was provided with food mixed with M. pruriens seed powder (480 g/kg food). At the age of 3 weeks (when birds were sexually distinguished) Group I was divided into two sub-groups IA (male) and IB (female) of six birds each. Similarly, Groups II and III were sub-divided into IIA (male), IIB (female) and IIIA (male), IIIB (female), respectively, of six birds each. Observations were made up to the age of 5 weeks. Male experimental groups (IIA and IIIA) showed significantly increased testicular activity, cloacal gland volume, body weight (BW), plasma testosterone and LH level in comparison to control (IA). Similarly female experimental groups (IIB and IIIB) showed significantly greater weight of reproductive organs (uterus, ovary, oviduct and ovarian follicle), BW, egg weight and size and number of follicles. On the other hand, plasma prolactin level was significantly low in comparison to control (IB). Results suggest that M. pruriens is a rich natural source of l-DOPA and the development and reproduction in Japanese quail might be associated with the dopaminergic system of the brain.

17.
J Cardiovasc Magn Reson ; 8(3): 417-26, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16755827

RESUMO

We used state of the art CMR to define ranges for normal left ventricular volumes and systolic/diastolic function normalized to the influence of gender, body surface area and age. New CMR normalized ranges were modeled and displayed in graphical form for clinical use, with normalization for body surface area, gender, and age. The determination of normality, or the severity of abnormality, depends on the use of the appropriate reference ranges normalized to all 3 variables. These novel data have particular importance for clinical practice and clinical trials using CMR.


Assuntos
Diástole/fisiologia , Imageamento por Ressonância Magnética/métodos , Sístole/fisiologia , Função Ventricular Esquerda/fisiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Valores de Referência , Fatores Sexuais , Estatísticas não Paramétricas
18.
Heart ; 92(6): 798-803, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16339819

RESUMO

OBJECTIVE: To compare the effect of the dual endothelin A/B receptor antagonist enrasentan with enalapril on left ventricular (LV) remodelling. METHODS: Multicentre, randomised, double blind, parallel group study of 72 asymptomatic patients with LV dysfunction. Patients received enrasentan (60-90 mg/day) or enalapril (10-20 mg/day). The primary end point was the change in LV end diastolic volume index (EDVI) after six months' treatment. RESULTS: LV EDVI increased with enrasentan but decreased with enalapril (3.9 (1.8) v -3.4 (1.4) ml/m2, p = 0.001). Enrasentan increased resting cardiac index compared with enalapril (0.11 (0.07) v -0.10 (0.07) l/m2, p = 0.04), as well as LV mass index (0.67 (1.6) v -3.6 (1.6) g/m2, p = 0.04). Other variables were comparable between groups. Enalapril lowered brain natriuretic peptide more than enrasentan (-19.3 (9.4) v -5.8 (6.9) pg/ml, p = 0.005). Noradrenaline (norepinephrine) (p = 0.02) increased more with enrasentan than with enalapril. Enrasentan was associated with more serious adverse events compared with enalapril (six (16.7%) patients v one (2.8%), p = 0.02); the rate of progression of heart failure did not differ. CONCLUSION: In asymptomatic patients with LV dysfunction, LV EDVI increased over six months with enrasentan compared with enalapril treatment, with adverse neurohormonal effects. This suggests that enrasentan at a dose of 60-90 mg/day over six months causes adverse ventricular remodelling despite an increase in the resting cardiac index.


Assuntos
Inibidores da Enzima Conversora de Angiotensina/administração & dosagem , Ácidos Carboxílicos/administração & dosagem , Enalapril/administração & dosagem , Indanos/administração & dosagem , Disfunção Ventricular Esquerda/tratamento farmacológico , Adulto , Idoso , Ácidos Carboxílicos/efeitos adversos , Progressão da Doença , Enalapril/efeitos adversos , Feminino , Insuficiência Cardíaca/etiologia , Humanos , Indanos/efeitos adversos , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neurotransmissores/efeitos adversos , Neurotransmissores/metabolismo , Resultado do Tratamento , Disfunção Ventricular Esquerda/sangue , Remodelação Ventricular/efeitos dos fármacos
19.
Heart ; 91(8): 1036-40, 2005 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16020591

RESUMO

OBJECTIVE: To examine the influence of genotype on late gadolinium enhancement (LGE) and the potential of cardiovascular magnetic resonance (CMR) to detect preclinical hypertrophic cardiomyopathy. DESIGN: Prospective, blinded cohort study of myocardial LGE in a genetically homogeneous population. PATIENTS: 30 patients with disease causing mutations in the recognised hypertrophic cardiomyopathy gene for cardiac troponin I (TNNI3): 15 with echocardiographically determined left ventricular hypertrophy (LVH+) and 15 without (LVH-). MAIN OUTCOME MEASURES: CMR measures of regional left ventricular function, wall thickness, and mass, and the extent and distribution of LGE. RESULTS: LGE was found in 12 (80%) LVH+ patients but with variable extent (mean 15%, range 3-48%). LGE was also found in two (13%) LVH- patients but the extent was limited (3.6%) and both patients were found to have an abnormal ECG and regional hypertrophy by cine CMR. The extent of LGE was positively associated with clinical markers of sudden death risk (21% with > or = 2 risk factors v 7% with < or = 1 risk factor, p = 0.02) and left ventricular mass (r = 0.56, p < 0.001) and was inversely associated with ejection fraction (r = -0.58, p < 0.001). Segmental analysis showed that as regional wall thickness increased, LGE was more prevalent (p < 0.0001) and more extensive (r = 0.98, p = 0.001). CONCLUSION: In patients with disease causing mutations in TNNI3, focal fibrosis was not detected by LGE CMR before LVH and ECG abnormalities were present. Once LVH is present, LGE is common and the extent correlates with adverse clinical parameters. This suggests that focal fibrosis is closely linked to disease development.


Assuntos
Cardiomiopatia Hipertrófica/genética , Mutação/genética , Troponina I/genética , Adolescente , Adulto , Idoso , Cardiomiopatia Hipertrófica/diagnóstico , Criança , Estudos de Coortes , Meios de Contraste , Feminino , Gadolínio DTPA , Genótipo , Humanos , Angiografia por Ressonância Magnética/métodos , Imagem Cinética por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Linhagem , Fenótipo , Estudos Prospectivos
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