Inhibition on cholinesterase and tyrosinase by alkaloids and phenolics from Aristotelia chilensis leaves.

It is reported in this study the effect of isolates from leaves of Aristotelia chilensis as inhibitors of acetylcholinesterase (AChE), butyrylcholinesterase (BChE) and tyrosinase enzymes. The aim of the paper was to evaluate the activity of A. chilensis towards different enzymes. In addition to pure compounds, extracts rich in alkaloids and phenolics were tested. The most active F5 inhibited AChE (79.5% and 89.8% at 10.0 and 20.0 µg/mL) and against BChE (89.5% and 97.8% at 10.0 and 20.0 µg/mL), showing a strong mixed-type inhibition against AChE and BChE. F3 (a mixture of flavonoids and phenolics acids), showed IC50 of 90.7 and 59.6 µg/mL of inhibitory activity against AChE and BChE, inhibiting the acetylcholinesterase competitively. Additionally, F3 showed and high potency as tyrosinase inhibitor with IC50 at 8.4 µg/mL. Sample F4 (anthocyanidins and phenolic composition) presented a complex, mixed-type inhibition of tyrosinase with a IC50 of 39.8 µg/mL. The findings in this investigation show that this natural resource has a strong potential for future research in the search of new phytotherapeutic treatments for cholinergic deterioration ailments avoiding the side effects of synthetic drugs. This is the first report as cholinesterases and tyrosinase inhibitors of alkaloids and phenolics from A. chilensis leaves.

The chilean superfruit black-berry Aristotelia chilensis (Elaeocarpaceae), Maqui as mediator in inflammation-associated disorders.

The effects of phytochemicals occurred in fractions and extracts of fruits of "Maqui-berry" (Aristotelia chilensis), on the expression of cyclooxygenase-2 (COX-2), inducible-nitric oxide synthases (iNOS) and the production of proinflammatory mediators were investigated in lipopolysaccharide (LPS)-activated murine macrophage RAW-264 cells, as well as their antioxidant activities. The MeOH extract (A), acetone/methanol extract (B), fractions F3, F4, subfractions (SF4-SF6, SF7, SF8-SF10, SF11-SF15, SF16-SF20), quercetin, gallic acid, luteolin, myricetin, mixtures M1, M2 and M3 exhibited potent anti-inflammatory and antioxidant activities. The results indicated that anthocyanins, flavonoids and its mixtures suppressed the LPS induced production of nitric oxide (NO), through the down-regulation of iNOS and COX-2 protein expressions and showed a potent antioxidant activity against SOD, ABTS, TBARS, ORAC, FRAP and DCFH. The inhibition of enzymes and NO production by selected fractions and compounds was dose-dependent with significant effects seen at concentration as low as 1.0-50.0 (ppm) and 5.0-10.0 µM, for samples (extracts, fractions, subfractions and mixtures) and pure compounds, respectively. Thus, the phenolics (anthocyanins, flavonoids, and organic acids) as the fractions and mixtures may provide a potential therapeutic approach for inflammation associated disorders and therefore might be used as antagonizing agents to ameliorate the effects of oxidative stress.

New environmentally-friendly antimicrobials and biocides from Andean and Mexican biodiversity.

Persistent application of pesticides often leads to accumulation in the environment and to the development of resistance in various organisms. These chemicals frequently degrade slowly and have the potential to bio-accumulate across the food chain and in top predators. Cancer and neuronal damage at genomic and proteomic levels have been linked to exposure to pesticides in humans. These negative effects encourage search for new sources of biopesticides that are more "environmentally-friendly" to the environment and human health. Many plant or fungal compounds have significant biological activity associated with the presence of secondary metabolites. Plant biotechnology and new molecular methods offer ways to understand regulation and to improve production of secondary metabolites of interest. Naturally occurring crop protection chemicals offer new approaches for pest management by providing new sources of biologically active natural products with biodegradability, low mammalian toxicity and environmentally-friendly qualities. Latin America is one of the world's most biodiverse regions and provide a previously unsuspected reservoir of new and potentially useful molecules. Phytochemicals from a number of families of plants and fungi from the southern Andes and from Mexico have now been evaluated. Andean basidiomycetes are also a great source of scientifically new compounds that are interesting and potentially useful. Use of biopesticides is an important component of integrated pest management (IPM) and can improve the risks and benefits of production of many crops all over the world.

Biopesticides from plants: Calceolaria integrifolia s.l.

The effects of persistent organic pollutants (POPs) on humans and biodiversity are multiple and varied. Nowadays environmentally-friendly pesticides are strongly preferred to POPs. It is noteworthy that the crop protection role of pesticides and other techniques, i.e. biopesticides, plant extracts, prevention methods, organic methods, evaluation of plant resistance to certain pests under an integrated pest management (IPM), could improve the risks and benefits which must be assessed on a sound scientific basis. For this directive it is crucial to bring about a significant reduction in the use of chemical pesticides, not least through the promotion of sustainable alternative solutions such as organic farming and IPM. Biopesticides are derived from natural materials such as animals, plants, bacteria, and certain minerals. Most of them are biodegradable in relatively short periods of time. On this regard, substances from Calceolaria species emerge as a strong alternative to the use of POPs. The American genus Calceolaria species are regarded both as a notorious weeds and popular ornamental garden plants. Some have medicinal applications. Other taxa of Calceolaria are toxic to insects and resistant to microbial attack. These properties are probably associated with the presence of terpenes, iridoids, flavonoids, naphthoquinones and phenylpropanoids previously demonstrated to have interesting biological activities. In this article a comprehensive evaluation of the potential utilization of Calceolaria species as a source of biopesticides is made. The chemical profile of selected members of the Chilean Calceolaria integrifolia sensu lato complex represents a significant addition to previous studies. New secondary metabolites were isolated, identified and tested for their antifeedant, insect growth regulation and insecticidal activities against Spodoptera frugiperda and Drosophila melanogaster. These species serve as a model of insect pests using conventional procedures. Additionally, bactericidal and fungicidal activity were determined. Dunnione mixed with gallic acid was the most active fungistatic and fungicidal combination encountered. Several compounds as isorhamnetin, combined with ferulic and gallic acid quickly reduced cell viability, but cell viability was recovered quickly and did not differ from that of the control. The effect of these mixtures on cultures of Aspergillus niger, Fusarium moniliforme, Fusarium sporotrichum, Rhizoctonia solani, and Trichophyton mentagrophytes, was sublethal. However, when fungistatic isorhamnetin and dunnione were combined with sublethal amounts of both ferulic and gallic acid, respectively, strong fungicidal activity against theses strains was observed. Thus, dunnione combined with gallic acid completely restricted the recovery of cell viability. This apparent synergistic effect was probably due to the blockade of the recovery process from induced-stress. The same series of phenolics (iridoids, flavonoids, naphthoquinones and phenylpropanoids) were also tested against the Gram-negative bacteria Escherichia coli, Enterobacter agglomerans, and Salmonella typhi, and against the Gram-positive bacteria Bacillus subtilis, Sarcinia lutea, and Staphylococcus aureus and their effects compared with those that of kanamycin. Mixtures of isorhamnetin/dunnione/kaempferol/ferulic/gallic acid in various combinations were found to have the most potent bactericidal and fungicidal activity with MFC between 10 and 50 µg/ml. Quercetin was found to be the most potent fungistatic single compound with an MIC of 15 µg/ml. A time-kill curve study showed that quercetin was fungicidal against fungi assayed at any growth stage. This antifungal activity was slightly enhanced by combination with gallic acid. The primary antifungal action of the mixtures assayed likely comes from their ability to act as nonionic surfactants that disrupt the function of native membrane-associated proteins. Hence, the antifungal activity of isorhamnetin and other O-methyl flavonols appears to be mediated by biophysical processes. Maximum activity is obtained when the balance between hydrophilic and hydrophobic portions of the molecules of the mixtures becomes the most appropriate. Diterpenes, flavonoids, phenylpropanoids, iridoids and phenolic acids were identified by chromatographic procedures (HPLC-DAD), ESI-MS, and NMR hyphenated techniques.

Tyrosinase inhibitors from Calceolaria integrifolia s.l.: Calceolaria talcana aerial parts.

As a defense mechanism of the aerial parts of Calceolaria talcana (Calceolariaceae; formerly Scrophulariaceae) against herbivore offenses and insect pest attack, diterpenoids, triterpenoids, phenylethanoids, flavonoids, and iridoids are rapidly accumulated along the aerial parts, resulting in a unique natural biopesticide complex from this plant. In addition to verbascoside a series of known compounds were screened for their inhibitory activity against mushroom tyrosinase and protease enzymes. Ethyl acetate and n-hexane extracts, together with cyclopropyl-7,15-ent-pimaradiene (1), abietatriene (2), ursolic acid (3), α-lupeol (4), ß-sitosterol (5), 2-hydroxy-3-(1,1-dimethylallyl)-1,4-naphthoquinone (6), α-dunnione (7), verbascoside (8), martynoside (9), and some known model compounds proved to be inhibitors of oxidation of L-3,4-dihydroxyphenylalanine (L-DOPA) catalyzed by tyrosinase (EC 1.14.18.1) with an IC50 between 10.0 and 200 ppm or µM, respectively, suggesting that phenolic moieties in the molecules assayed are important for the activity.

Anti-inflammatory activity of Penstemon gentianoides and Penstemon campanulatus.

CONTEXT: Penstemon gentianoides (Kunth) Poir. and Penstemon campanulatus (Cav.) Willd. (Plantaginaceae) are important medicinal plants in Mexico used by indigenous people for their anti-inflammatory effects and to also reduce rheumatic pains. OBJECTIVE: In addition to radical scavenging activity, the anti-inflammatory activity of the extracts, fractions and compounds of these plants were investigated and reported here for the first time. MATERIALS AND METHODS: The anti-inflammatory activities of MeOH, CH(2)Cl(2), and ethyl acetate extracts and iridoid, flavonoids, and phenylpropanoids from Penstemon gentianoides and P. campanulatus were studied in the TPA-induced mouse ear edema model. In addition, antioxidant activity against DPPH, crocin and ß-carotene were investigated. RESULTS: All extracts were tested and a selection of known compounds significantly (p <0.05) inhibited mouse ear edema. The results showed that CH(2)Cl(2) extracts of roots and stems from P. gentianoides and ethyl acetate extracts of leaves from P. gentianoides and P. campanulatus, as well as luteolin, diosmetin, penstemide and verbascoside produced the most positive results. Of all substances tested, the CH(2)Cl(2) extract of P. gentianoides roots was the most powerful inhibitor (ED(50)=0.07 mg/ear), with activity comparable to that of indomethacin. These extracts, compounds purified, as well as known compounds, inhibited oxidation of ß-carotene and crocin. DISCUSSION AND CONCLUSION: These findings showed that the iridoid monoterpenes, flavonoids and phenylpropanoids present in these plants species may all contribute to the observed anti-inflammatory activity. Additionally, the observed antioxidant activity is correlated with the anti-inflammatory activity of these plants and the phytochemicals derived from them.

LFA-1-specific therapy prolongs allograft survival in rhesus macaques.

Outcomes in transplantation have been limited by suboptimal long-term graft survival and toxicities associated with current immunosuppressive approaches. T cell costimulation blockade has shown promise as an alternative strategy to avoid the side effects of conventional immunosuppressive therapies, but targeting CD28-mediated costimulation alone has proven insufficient to prevent graft rejection in primates. Donor-specific memory T (TM) cells have been implicated in costimulation blockade-resistant transplant rejection, due to their enhanced effector function and decreased reliance on costimulatory signaling. Thus, we have tested a potential strategy to overcome TM cell-driven rejection by targeting molecules preferentially expressed on these cells, such as the adhesion molecule lymphocyte function-associated antigen 1 (LFA-1). Here, we show that short-term treatment (i.e., induction therapy) with the LFA-1-specific antibody TS-1/22 in combination with either basiliximab (an IL-2Rα-specific mAb) and sirolimus (a mammalian target of rapamycin inhibitor) or belatacept (a high-affinity variant of the CD28 costimulation-blocker CTLA4Ig) prolonged islet allograft survival in nonhuman primates relative to control treatments. Moreover, TS-1/22 masked LFA-1 on TM cells in vivo and inhibited the generation of alloproliferative and cytokine-producing effector T cells that expressed high levels of LFA-1 in vitro. These results support the use of LFA-1-specific induction therapy to neutralize costimulation blockade-resistant populations of T cells and further evaluation of LFA-1-specific therapeutics for use in transplantation.

Anti-inflammatory, antioedema and gastroprotective activities of aristotelia chilensis extracts, part 2

Context: “Chilean black-berry” Aristotelia chilensis is a wild fruit that grows in Southern Chile. This fruit possesses a strong antioxidant activity and is commonly used in foods and beverages in Chile. Objective: The gastroprotective and anti-inflammatory activities of the extracts, fractions and subfractions as carrageenan – induced paw oedema in rats are reported here for the first time. Materials and methods: Extracts, fractions, subfractions and several compounds werer used for measuring the effects in carrageenan-induced paw oedema inflammation of rat model and the gastroprotective activity was analyzed. Results: The results showed that extract B, fraction F-4, and ovatofolin, quercetin, myricetin, luteolin and diosmetin used as pattern compounds were the most active samples together with those subfractions rich in aglycone and phenolic compounds. Thus, SF11-SF15, SF16-SF20, and SF21-SF25 showed the best subfractions inhibitors in similar form to indomethacin, a known selective COX inhibitor. Results demonstrated that these samples strongly inhibited the carrageenan-induced inflammation in paw of the rat oedema model. Discussion and conclusion: These findings demonstrate that the fruits and their constituents of A. chilensis are anti-inflammatory and gastroprotective and thus have grat potential nutraceuticals.

Contexto: Chilean Black-berry Aristotelia chilensis es un fruto silvestre que crece en el sur de Chile. Este fruto posee uan fuerte actividad antioxidante y comúnmente es usado en alimentos y bebidas en Chile. Objetivo: Se investigó la actividad anti-inflamatoria y gastroprotectora de los extractos, fracciones y subfracciones de este fruto y son informados aquí por primera vez. Materiales y métodos: Los extractos, fracciones y subfracciones fueron analizados por su efecto sobre la inflamación en pata de rata a través de la inducción con carragenina en dosis sencillas. Además se investigó la actividad gastroprotectora sobre la mucosa del estómago de rata. Resultados: Los resultados muestran que el extracto B, la fracción F-3, F4 y ovatifolina, quercetina, myricetina, luteolina y diosmetina que se usaron como muestras patrones, fueron las más activas junto con aquellas subfracciones ricas en compuestos fenólicos. Así SF11-SF15, SF16-SF20, y SF21-SF25 mostraron ser las mejores subfracciones inhibitorias en una forma similar a indometacina en conocido inhibidor selectivo de COX. Los resultados demuestran que estas muestras inhiben fuertemente la inflamación inducida en el modelo del edema de pata de rata. Discusión y conclusión. Estos hallazgos demuestran que los frutos y sus constituyentes de A. chilensis poseen una excelente actividad anti-inflamatoria y gastroprotectora, y así tienen un gran potencial como una fuente de productos naturales saludables. Adicionalmente, estos hallazgos muestran que los flavonoides, ácidos fenólicos y antiocianinas presentes en este fruto podrían ser los responsables de la actividad nutracéutica.

Human islet isolation outcomes from pancreata preserved with Histidine-Tryptophan Ketoglutarate versus University of Wisconsin solution.

This study was designed to compare Histadine-Tryptophan-Ketogluterate (HTK) with University of Wisconsin (UW) solution. Pancreata from extended criteria donors were flushed and transported with HTK (n=41) or UW (n=45). Isolation outcomes were determined by islet yields, viability and in vitro and in vivo function. Final yields were similar between two groups (HTK: 383,085 vs. UW: 328,514 EIN, P=0.14). In the HTK group, 63.4% (26/41) of isolations resulted in a yield of over 300,000, and in the UW group this was achieved in 46.7% (21/45; P=0.12). Viability results were similar (HTK: 82.9 vs. UW: 82.7%, P=0.93). Stimulation index in the HTK and UW groups were comparable (5.28 vs. 4.91, P=0.62). Ten out of 41 islet preparations in HTK and 4 of 45 in UW group were suitable for clinical transplantation (P=0.05). Our study shows HTK is equivalent to UW solution in the preservation of pancreata for islet isolation.

Influence of pancreas preservation on human islet isolation outcomes: impact of the two-layer method.

BACKGROUND: Human pancreas preservation for islet transplantation holds additional challenges and considerations compared with whole pancreas transplantation. The purpose of this study was to clarify the limitations of the University of Wisconsin (UW) solution and the potentials of the two-layer method (TLM) for pancreas preservation before human islet isolation. METHODS: We retrospectively evaluated human islet isolation records between January 2001 and February 2003. One hundred forty-two human pancreata were procured from cadaveric donors and preserved by means of the UW solution (n=112) or TLM (n=30). Human islet isolations were performed using a standard protocol and assessed by islet recovery and in vitro function of islets. RESULTS: Eight to ten hours of cold ischemia in the UW solution is a critical point for successful islet isolations. It is difficult to recover a sufficient number of viable islets for transplantation from human pancreata with more than 10 hours of cold storage in the UW solution. The overall islet recovery in the TLM group was significantly higher than in the UW group. With 10 to 16 hours of cold storage, the success rates of islet isolations remained at 62% in the TLM group but decreased to 22% in the UW group. Transplanted islets in the TLM group worked well in the recipients. CONCLUSIONS: There are time limitations for using the UW solution for pancreas preservation before human islet isolation. The TLM is a potential method to prolong the optimal cold storage time for successful islet isolations.

Short-term storage of the ischemically damaged human pancreas by the two-layer method prior to islet isolation.

A two-layer cold storage method (TLM) allows sufficient oxygen delivery to pancreata during preservation and resuscitates the viability of ischemically damaged pancreata in the canine pancreas transplant model. In this study, we applied a short-term preservation of the TLM to human pancreata after prolonged cold ischemia prior to islet isolation, and investigated the mechanisms of resuscitation of the ischemically damaged human pancreas by the TLM. Human pancreata were procured from cadaveric donors and preserved by the TLM for 3.2 +/- 0.5 h after 11.1 +/- 0.9 h of cold storage in UW (TLM group), or by cold UW alone for 11.0 +/- 0.3 h (UW group). Islet isolations of all pancreata were performed using the Edmonton protocol. Islet recovery and in vitro functional viability of isolated islets were significantly increased in the TLM group compared with the UW group. According to the criteria of the Edmonton protocol, 10/14 cases (71%) in the TLM group were transplanted to patients with type I diabetes mellitus compared with only 5/21 cases (24%) in the UW group. In the metabolic assessment of human pancreata, levels of energetic parameters (ATP, total adenylates, and energy charge) were significantly increased, and malondialdehyde (MDA) levels were significantly decreased after the TLM preservation. There was no observable change in the incidence or degree of mitochondrial injury after the TLM preservation. Additional short-term storage by the TLM resuscitates the ischemically damaged human pancreas by regenerating the energetic status and prevents further damage by oxidative stress, ultimately leading to improvements of islet recovery and in vitro function. Use of the TLM following prolonged storage in UW provides an excellent adjunctive protocol for treating human pancreata for the rigors of the islet isolation process.

Human islet transplantation from pancreases with prolonged cold ischemia using additional preservation by the two-layer (UW solution/perfluorochemical) cold-storage method.

BACKGROUND: A two-layer (University of Wisconsin solution/perfluorochemical [UW/PFC]) cold-storage method delivers sufficient oxygen to the pancreas during preservation and restores the ischemically damaged pancreas. In this study, we determined whether the additional preservation by the two-layer method could improve islet recovery from human pancreases with prolonged cold storage in UW. METHODS: Human pancreases were procured from cadaveric organ donors and preserved by the two-layer method (UW/PFC) for 2.9+/-0.7 hours (mean+/-SEM) at 4 degrees C after 11.8+/-1.5 hours of cold storage in UW (UW/PFC group, n=7), or by cold UW alone for 11.3+/-0.3 hours (UW group, n=14). The selected pancreases met the criteria of having at least 10 hours of cold storage in UW. All were processed by using a standard protocol of Liberase perfusion with Pefabloc by way of the duct, gentle mechanical dissociation, and Ficoll gradient purification. Transplanted islets were selected with the criteria of the Edmonton protocol (>5,000 islet equivalents [IE]/kg recipient body weight). RESULTS: The islet recovery was significantly increased in the UW/PFC group compared with the UW group (349.2+/-44.1 x 10 and 214.0+/-31.0 x 10 IE, respectively; <0.05). This resulted in islet yields of 4.6+/-1.0 x 10 IE/g of pancreas in the UW/PFC group compared with 2.0+/-0.3 x 10 IE/g of pancreas in the UW group ( <0.05). Five of 7 cases (71%) in the UW/PFC group and 5 of 14 cases (36%) in the UW group were transplanted. The islet grafts in the UW/PFC group improved the ability of glycemic control and decreased exogenous insulin administration in all recipients. CONCLUSIONS: Improvements in methods to preserve and recover ischemically damaged human pancreases before islet isolation and transplant could be extremely beneficial to the field of clinical islet transplantation. This preliminary study shows that additional short preservation by the two-layer (UW/PFC) cold-storage method can significantly improve islet recovery and increase opportunities of islet transplantation from human pancreases after prolonged cold ischemia.

Evaluación del aneurisma apical del ventrículo izquierdo por ecocardiografía bidimensional / Evaluation of apical left ventricular aneurysm with two-dimensional echocardiography

Una complicación frecuente del infarto del miocardio es el aneurisma apical del ventrículo izquierdo (AAVI) que se distiende durante la contracción y secuestra parte del volumen latido y predispone a complicaciones graves. Se estudiaron 20 pacientes postinfarto del miocardio, 10 con AAVI y 10 sin esta complicación, con evaluación cardiológica completa y especial enfoque en la ecocardiografía bidimensional (E 2-D), para el análisis de la contracción ventricular izquierda global, regional y segmentaria. En el grupo con AAVI fue más frecuente el infarto anteroseptal, la regurgitación mitral y la insuficiencia cardiaca (P <0.05). Fue mayor el número de segmentos discinéticos, con valores negativos del acortamiento radial segmentario (P <0.01), con fracción de expulsión global similar en ambos grupos, pero la región apical fue mucho menor (P <0.01). El seguimeinto por dos años mostró que la mortalidad fue mayor en presencia de AAVI (P <0.01) y de los sobrevivientes el 60 por ciento presentaba insuficiencia cardiaca. Se demuestra que la evolución depende principalmente de la cantidad de músculo no afectado, que sea capaz de mantener adecuado gasto después de la resección quirúrgica del AAVI, lo cual es evaluable satisfactoriamente mediante la E 2-D.

Derrame pericárdico que simula un tumor. Valor de la ecocardiografía Doppler a color para su diferenciación / Pericardial effusion simulating pericardial tumor. Color codified Doppler study

Existen múltiples publicaciones sobre el valor de la ecocardiografía para el reconocimiento de las masas pericárdicas, y algunas de ellas señalan cómo un derrame puede ocultar un tumor. Se describe el caso de un paciente de 64 años, portador de una valvulopatía aórtica y un derrame pericárdico, diagnosticado por ecocardiografía. En dicho estudio además de la confirmación diagnóstica, se observó una masa intrapericárdica, de unos 7 cm de diámetro, de aspecto grumoso, adherida a la hoja visceral, a nivel de la unión aurículo-ventricular derecha. Con motivo de tal hallazgo, se realizó estudio con Doppler codificado a color, observándose que dicha masa adquiría una tonalidad azul durante la diástole y una tonalidad en mosaico al final de la sístole. Así pudo concluirse que era debido a remanso de líquido y simulaba un tumor dentro de la cavidad pericárdica. En la intervención quirúrgica se demostró la ausencia de dicha masa

Influencia de la hipertrofia del ventrículo izquierdo sobre su función en la hipertensión arterial esencial, análisis por ecocardiografía doppler / Left ventricular hypertrophy and arterial hypertension. Doppler echocardiographic

Para valorar la influencia de la hipertrofia ventricular izquierda (HVI) sobre la función de éste ventrículo, se estudiaron 20 pacientes con hipertensión arterial esencial (HAE) mediante Ecocardiografía Doppler. Se incluyeron pacientes con presión arterial diastólica mayor de 91 mm Hg, sin tratamiento farmacológico por lo menos dos semanas antes del estudio, sin enfermedad arterial coronaria ni otro tipo de cardiopatía o nefropatía. Se midieron los diámetros ventriculares, se calculó: volúmen latido, fracción de acortamiento circunferencial, masa ventricular, velocidad media de relajación circunferencial, velocidad media del flujo transaórtico y velocidades máximas E y A del flujo transmitral, así como la relación E/A. Con los valores anteriores se calcularon las medias aritméticas para formar 2 subgrupos, el de valor superior a la media y el de inferior a esta para su comparación, de todas las mediciones y se efectuó correalción de los valores individuales. El espesor del septum interventricular y el diámetro diástolico final del ventrículo izquierdo fueron proporcionales a la presión arterial diastólica (p<0.05). La masa ventricular izquierda mostró la relación inversa con la fracción de acortamiento (p<0.01), con la velocidad media de acortamiento circunferencial (p<0.05) así como el diámetro distólico final del ventrículo izquierdo (r=-0889,p<0.01) y con el volúmen latido (r=-0.86 y p<0.01). La relación de la velocidad E y A del flujo mitral fue proporcional con la fracción de acortamiento (p<0.05) y la VMAC (r=0.903). La velocidad A mostró proporción inversa a la velocidad de acortamiento circunferencial (p<0.05). Se considera que, en el paciente con HEA, la HVI, es centripeta tendiente a ser inadecuada con disminución de la función contráctil por defecto de llenado diastólico consecutiva reducción de la cavidad ventricular, que a su vez abate la expulsión con depresión del volúmen latido. Los cambios de función diastólica, al parecer preceden a los sistólicos.

Valores normales en México de las mediciones ecocardiográficas del corazón izquierdo / Normal value in Mexico of the echocardiographic measurements of the left side of the hearth

Se estudiaron las dimensiones ecocardiográficas modo M, siguiendo los criterios internacionales de medíción, de 274 sujetos sanos, residentes en la ciudad de México, para conocer las variantes en esta población. De sexo masculino 131 (47.8%), de sexo femenino 143(52.2%). La edad varió de 1 a 73 años, con predominio entre la tercera y quinta décadas de la vida. Se correlacionaron las mediciones con la edad, el peso y la superficie corporal (SC), con mejor proporción para esta última, por lo que se tomó como base del análisis, formando 6 subgrupos a partir de SC de 0.5 m2 e incremento de 0.4 m2 para cada subgrupo hasta el de 2.1 m2 o más. Se observó aumento proporcional a la SC de la excursión D-E de la válvula mitral, del diámetro anteroposterior, la excursión y la apertura de la aorta, así como del diámetro anteroposterior de la aurícula izquierda, de los diámetros diastólicos y sistólico finales del ventrículo izquierdo y de los espesores del septum interventricular (SIV) y de la pared posterior (PP). Las dimensiones encontradas fueron inferiores a las informadas en la literatura. Los valores de la velocidad media de acortamiento circunferencial (VMAC), de la fracción de acortamiento (FA) y las velocidades normalizadas (VN) del SIV y la PP fueron inversamente proporcionales a la SC. La VMAC y la VN con valores muy similares a los establecidos; en cambio la FA y la fracción de expulsión dieron valores superiores a los informados. El estudio permite conocer los valores normales para la población de la ciudad de México de acuerdo con su desarrollo somático y la altitud a la que vive (AU) )