Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.217
Filtrar
1.
Niger J Clin Pract ; 22(8): 1120-1125, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31417056

RESUMO

Aim: Wilson's disease (WD) presents with different phenotypes. Neurologic and liver involvement in WD are well documented. Few reports demonstrated cardiac and vascular involvement. Several studies showed an association between serum copper levels and atherosclerosis. Although WD is the prototype disease of copper metabolism, atherosclerosis has not been studied yet. The aim of this study is to assess aortic stiffness in WD. Materials and Methods: Aortic pulse wave velocity (PWV), augmentation pressure (AP), augmentation index (AIx), central aortic systolic, diastolic, mean, and pulse pressures were measured using SphygmoCor (AtCor Medical) device in 32 patients with WD and 24 healthy controls. Results: Patients with WD and healthy controls were similar in terms of age sex, body mass index (BMI), and liver and kiney functions. However, patients with WD were anemic and thrombocytopenic. Echocardiographic parameters including left ventricular, atrial dimensions, and systolic and diastolic functions were similar between two groups. Patients with WD and healthy controls were compared. Baseline characteristics including age, sex, and BMI did not differ between groups. Central aortic systolic, diastolic, mean, and pulse pressures were similar between the groups. AP, AIx, and PWV did not differ between groups as well. Conclusion: Aortic stiffness in WD was similar in healthy controls.


Assuntos
Pressão Sanguínea/fisiologia , Cobre/metabolismo , Ecocardiografia/métodos , Degeneração Hepatolenticular/diagnóstico por imagem , Análise de Onda de Pulso , Rigidez Vascular/fisiologia , Adulto , Anemia/epidemiologia , Pressão Arterial , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Degeneração Hepatolenticular/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Trombocitopenia/epidemiologia , Turquia/epidemiologia
2.
Medicine (Baltimore) ; 98(33): e16802, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415390

RESUMO

Impact of arterial stiffness on aortic morphology has not been well evaluated. We sought to investigate the association of brachial-ankle pulse wave velocity (baPWV) with aortic calcification and tortuosity.A total of 181 patients (65.4 ±â€Š10.4 years, males 59.7%) who underwent computed tomographic angiography and baPWV measurement within 1 month of study entry were retrospectively reviewed. Aortic calcification was quantified by the calcium scoring software system. Aortic tortuosity was defined as the length of the midline in the aorta divided by the length of linear line from the aortic root to the distal end of the thoraco-abdominal aorta. In simple correlation analyses, baPWV was correlated with aortic calcification (r = 0.36, P < .001) and tortuosity (r = 0.16, P = .030). However, these significances disappeared after controlling for confounders in multivariate analyses. Factors showing an independent association with aortic calcification were age (ß = 0.37, P < .001), hypertension (ß = 0.19, P = .003), diabetes mellitus (ß = 0.12, P = .045), smoking (ß = 0.17, P = .016), and estimated glomerular filtration rate (ß = -0.25, P = .002). Factors showing an independent association with aortic tortuosity were age (ß = 0.34, P < .001), body mass index (ß = -0.19, P = .018), and diabetes mellitus (ß = -0.21, P = .003).In conclusion, baPWV reflecting arterial stiffness was not associated with aortic calcification and tortuosity. Traditional cardiovascular risk factors were more influential to aortic geometry. Further studies with a larger sample size are needed to confirm our results.


Assuntos
Aorta/patologia , Artérias/anormalidades , Instabilidade Articular/fisiopatologia , Dermatopatias Genéticas/fisiopatologia , Calcificação Vascular/fisiopatologia , Malformações Vasculares/fisiopatologia , Rigidez Vascular/fisiologia , Idoso , Índice Tornozelo-Braço , Aorta/fisiopatologia , Artérias/patologia , Artérias/fisiopatologia , Índice de Massa Corporal , Angiografia por Tomografia Computadorizada , Feminino , Humanos , Instabilidade Articular/patologia , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Estudos Retrospectivos , Dermatopatias Genéticas/patologia , Calcificação Vascular/patologia , Malformações Vasculares/patologia
3.
Int J Sports Med ; 40(9): 601-608, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31307097

RESUMO

There is a dearth of information regarding the reliability of non-invasive measures of vascular function taken in a single testing session. This study aimed to determine the test-retest reliability of a test battery of vascular function measures: automated blood pressure (BP), laser Doppler imaging with iontophoresis (LDI), digital volume pulse (DVP), pulse wave velocity (PWV), augmentation index (AIx) measured by pulse wave analysis (PWA) and flow-mediated dilation (FMD) taken within and between sessions. Measures were taken in 21 non-smoking males intra-session and again inter-session (one week apart) to determine repeatability and reproducibility, respectively. There was moderate to excellent repeatability (ICC: 0.53-0.93; CV=2.2-18.1%) and reproducibility (ICC: 0.71-0.96; CV 1.9-14.2%) for BP, DVP stiffness index, PWV, AIx, AIx normalised to heart rate (75 bpm), absolute and percentage FMD. Repeatability of the DVP reflection index was moderate (ICC: 0.64; CV=9.5%) but there was poor reproducibility (ICC: 0.17; CV=15.1%). Moreover, the repeatability and reproducibility of the LDI measures ranged from poor to good (ICC: 0.31-0.84; CV=28.4-36.7%). These data indicated that there was considerable variability in the repeatability and reproducibility of measurements of endothelial function and arterial stiffness taken in a battery of measurements, which needs careful consideration in future research designs.


Assuntos
Determinação da Pressão Arterial/métodos , Determinação da Pressão Arterial/normas , Análise de Onda de Pulso , Adulto , Dilatação , Frequência Cardíaca , Humanos , Iontoforese , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto Jovem
4.
Pol Merkur Lekarski ; 46(276): 257-262, 2019 Jun 28.
Artigo em Polonês | MEDLINE | ID: mdl-31260435

RESUMO

Measurement of pulse wave velocity (PWV) is a simple and noninvasive way to assess stiffness of the arteries. PWV measurement can refer to both the aorta and peripheral arterial vessels. Currently, the most clinically significant is the measurement of PWV between the carotid artery and the femoral artery, which is defined as the speed of the aortic pulse wave. Numerous studies have demonstrated the significance of prognostic PWV aortic measurement as a recognized exponent of subclinical organ damage both among the general population as well as among patients with increased cardiovascular risk, examining patients in detail with hypertension, diabetes, chronic renal failure. The prognostic value of PWV aortic measurement was reflected in the guidelines of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). In clinical trials, the repeatability and reproducibility of PWV measurements were also evaluated, both parameters being considered satisfactory. The paper presents reports from studies on the significance of pulse wave velocity results in the prognosis assessment in different disease entities as well as in age groups.


Assuntos
Hipertensão , Análise de Onda de Pulso , Rigidez Vascular , Aorta , Artérias Carótidas , Humanos , Hipertensão/diagnóstico , Reprodutibilidade dos Testes
5.
Eur Biophys J ; 48(5): 407-411, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31201474

RESUMO

Biophysical understanding of arterial hemodynamics plays an important role in proper medical diagnosis and investigation of cardiovascular disease pathogens. One of the major cardiovascular parameters is pulse wave velocity (PWV), which depends on the mechanical properties of the arterial wall. The PWV contains information on the condition of the cardiovascular system as well as its physiological age. In humans and most animals, blood flow through the blood vessels is affected by several internal and external forces. The most influencing external force on blood flow is gravity. In the upright position of the body, blood moves from heart to head, opposite to gravity, and from the heart to the legs, in direction of the gravitational force. To investigate how gravity affects PWV, we have developed a biophysical model of cardiovascular system that simulates blood flow in the upright position of the body. The paper presents the results of measurement of PWV in an elastic tube filled with fluids of different viscosities in the gravitational field.


Assuntos
Elasticidade , Gravitação , Modelos Biológicos , Análise de Onda de Pulso , Viscosidade
6.
Angiology ; 70(10): 929-937, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31234636

RESUMO

The morphology and function of the arteries can be directly measured using different established methods. This prospective cohort study aimed to translate 2 of these, aortic pulse wave velocity (aPWV) and carotid intima-media thickness (cIMT), into a combined Vascular Aging Index (VAI) and then evaluate the predictive power of aPWV, cIMT, and VAI. Patients (n = 2718) were included from the cardiovascular arm of the Malmö Diet and Cancer Study (median age 71.9 years, 62.2% females). Total follow-up time was 16 448 person-years and a composite cardiovascular disease (CVD) end point was used. Cox regressions yielded adjusted hazard ratios (95% confidence interval) per 1 standard deviation increment of loge aPWV, loge cIMT, and loge VAI of 1.25 (1.08-1.45, P = .003), 1.27 (1.13-1.44, P < .001), and 1.45 (1.26-1.68, P < .001), respectively. The C-statistics increased from 0.714 to 0.734 when adding aPWV and cIMT to a model of conventional risk factors. Net Reclassification Index also showed a significant (P < .001) improvement for the classification of event-free patients and no change for patients with events. A VAI based on aPWV and cIMT had a good predictive performance. Used together, aPWV and cIMT incrementally and significantly improve the prediction of CVD events by correctly down-adjusting the predicted risk for noncases.


Assuntos
Envelhecimento , Aorta/fisiopatologia , Doenças Cardiovasculares/mortalidade , Espessura Intima-Media Carotídea/mortalidade , Idoso , Doenças Cardiovasculares/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Análise de Onda de Pulso/métodos , Fatores de Risco , População Urbana/estatística & dados numéricos
7.
Vestn Oftalmol ; 135(2): 55-61, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31215535

RESUMO

PURPOSE: To evaluate the properties of the microvasculature of bulbar conjunctiva and to assess the function of endothelium of the main arteries in type 1 diabetes mellitus (T1DM). MATERIAL AND METHODS: The study included 35 patients with T1DM and initial nonproliferative diabetic retinopathy (NPDR). The control group consisted of 30 subjects. In addition to standard ophthalmic examination, all participants underwent digital bulbar capillaroscopy (DBC), pulse wave velocity (PWV) test, and plethysmography for assessment of endothelium function. RESULTS: According to DBC, in comparison to the control group, diabetic patients with even initial NPDR had disturbances of blood microcirculation manifested as increased average venous vessel width (p=0.04), reduced arterial capillary blood flow (p=0.02), increased blood sludging (p=0.001), and increased duration of blood stasis (p=0.03). Evaluation of vessel endothelium in T1DM patients with NPDR showed increased PWV (p=0.03). CONCLUSION: Diabetic patients with NPDR showed marked changes of capillary blood flow alongside signs of endothelial dysfunction. The most significant change was increased venous vessel width.


Assuntos
Diabetes Mellitus Tipo 1 , Retinopatia Diabética , Endotélio , Humanos , Microcirculação , Angioscopia Microscópica , Pletismografia , Análise de Onda de Pulso
8.
J Vet Emerg Crit Care (San Antonio) ; 29(4): 391-398, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31222978

RESUMO

OBJECTIVE: To investigate whether percentage changes in pulse wave transit time (PWTT%Δ) induced by mini-fluid challenges predict fluid responsiveness in mechanically ventilated anesthetized dogs. DESIGN: Prospective experimental trial. SETTING: University teaching hospital. ANIMALS: Twelve Harrier hounds. INTERVENTION: Each dog was anesthetized with propofol and isoflurane after premedication with acepromazine, mechanically ventilated, and had a fluid challenge. This was repeated 4 weeks later. The fluid challenge, 10 mL/kg of colloid administration over 13 minutes, consisted of 3 intermittent mini-fluid challenges (1 mL/kg of each over a minute) with a minute interval, and the remaining colloid administration (7 mL/kg) over 7 minutes. MEASUREMENTS AND MAIN RESULTS: Percentage change in velocity time integral of pulmonary arterial flow by echocardiography was calculated as an indication of change in stroke volume. Fluid responsiveness was defined as percentage change in velocity time integral ≥ 15% after 10 mL/kg colloid. Dogs responded on 14 fluid challenges and did not on 10. After 1, 2, 3, and 10 mL/kg of fluid challenge, PWTT%Δ1, 2, 3, 10 were measured. Receiver operator characteristic (ROC) curves were generated and areas under ROC curve were calculated for PWTT%Δ1, 2, 3 . A gray zone approach was used to identify the clinically inconclusive range. The area under the ROC curve for PWTT%Δ3 was 0.91 (P = 0.001). Cutoff value for PWTT%Δ3 was -2.5% (sensitivity: 86%, specificity: 90%). The gray zone for PWTT%Δ3 was identified as between -2.9% to -1.9% for which fluid responsiveness could not be predicted reliably in 6 out of 24 fluid challenges. CONCLUSIONS: In mechanically ventilated anesthetized dogs given a mini-fluid challenge of 3 mL/kg of colloid, PWTT%Δ could predict fluid responsiveness although the gray zone should be considered.


Assuntos
Cães/fisiologia , Hidratação/veterinária , Hemodinâmica/fisiologia , Análise de Onda de Pulso/veterinária , Respiração Artificial/veterinária , Anestesia/veterinária , Animais , Ecocardiografia/veterinária , Feminino , Humanos , Masculino , Estudos Prospectivos , Curva ROC , Sensibilidade e Especificidade , Volume Sistólico
9.
Phytother Res ; 33(7): 1898-1911, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31155769

RESUMO

Diabetes mellitus is characterized by increased central arterial stiffness and endothelial dysfunction leading to increased risk of cardiovascular complications. The aim of this study is to evaluate the effect of Curcuma longa on arterial stiffness and endothelial dysfunction in patients with type 2 diabetes mellitus. This randomized controlled trial was conducted in 136 patients of type 2 diabetes. Among them, 114 completed at least one follow-up visit and included for data analysis. Arterial stiffness parameters were measured at baseline and every month for 3 months and endothelial dysfunction markers at baseline and after 3 months of treatment with C. longa or placebo. These parameters were compared between the two groups. Both C. longa and placebo groups were comparable at baseline. After 3 months of treatment, C. longa produced significant reduction from baseline in carotid-femoral pulse wave velocity (p = .002), left brachial-ankle pulse wave velocity (p = .001), aortic augmentation pressure (p = .007), aortic augmentation index (p = .007), and aortic augmentation index at heart rate 75 (p = .018) as compared with the placebo group. Three months treatment with C. longa significantly decreases arterial stiffness as compared with placebo in type 2 diabetes mellitus patients.


Assuntos
Curcuma , Diabetes Mellitus Tipo 2/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Rigidez Vascular/efeitos dos fármacos , Adulto , Índice Tornozelo-Braço , Pressão Sanguínea/efeitos dos fármacos , Diabetes Mellitus Tipo 2/fisiopatologia , Método Duplo-Cego , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Grupos Populacionais , Análise de Onda de Pulso
10.
J Stroke Cerebrovasc Dis ; 28(9): 2580-2584, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31239221

RESUMO

BACKGROUND: Pulse wave velocity is commonly regarded as the most effective and noninvasive indicator for evaluating arterial stiffness, while increased arterial stiffness is known to be related to atherosclerosis, which has been proved to play a significant role on the onset of acute ischemic stroke. However, it is still only used in the assessment of central and peripheral arteries. Our previous studies have found that carotid-cerebral pulse wave velocity measured using transcranial Doppler may be a promising method for the assessment of human cerebral arterial stiffness. This trial was designed to examine the association between carotid-cerebral pulse wave velocity and acute ischemic stroke. METHODS: In a single-center, single-arm, prospective clinical trial, patients with acute ischemic stroke who had anterior circulation infarcts confirmed by magnetic resonance imaging are eligible to receive measurement of carotid-cerebral pulse wave velocity, which is measured in the supine position with transcranial Doppler that using 2-MHz and 4-MHz ultrasound probes by 2 experienced operators. Subjects will be received follow-up for 1 year. Vascular and nonvascular death at follow-up will be assessed as primary outcomes. Secondary outcomes include intracerebral hemorrhage, subarachnoid hemorrhage, transient ischemic attack, recurrence or aggravation of ischemic stroke. CONCLUSION: This trial will be the first to evaluate carotid-cerebral pulse wave velocity in patients with acute ischemic stroke using transcranial Doppler. The results may provide more valuable theoretical basis for the prevention, treatment, and prognosis of acute ischemic stroke.


Assuntos
Isquemia Encefálica/diagnóstico por imagem , Artéria Carótida Primitiva/diagnóstico por imagem , Artéria Cerebral Média/diagnóstico por imagem , Análise de Onda de Pulso/métodos , Acidente Vascular Cerebral/diagnóstico por imagem , Ultrassonografia Doppler Transcraniana/métodos , Rigidez Vascular , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/fisiopatologia , Artéria Carótida Primitiva/fisiopatologia , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Cerebral Média/fisiopatologia , Posicionamento do Paciente/métodos , Valor Preditivo dos Testes , Estudos Prospectivos , Acidente Vascular Cerebral/fisiopatologia , Decúbito Dorsal , Adulto Jovem
11.
Zhonghua Xin Xue Guan Bing Za Zhi ; 47(5): 381-387, 2019 May 24.
Artigo em Chinês | MEDLINE | ID: mdl-31142082

RESUMO

Objective: To explore the characteristics of postural blood pressure changes in elderly inpatients and the related factors of orthostatic hypotension (OH). Methods: This study was a clinical case control study. Two hundred and sixty-six elderly patients (≥60 years old), who were hospitalized between April 2016 and November 2017 in Geriatric Department of Peking University First Hospital, were included. They were divided into direct standing group and indirect standing group. Direct standing group involved 102 patients, they changed posture from supine directly to standing position, and the blood pressures at the moments of supine, immediately after standing and the first, second, and third minute after standing were recorded by continuous noninvasive arterial pressure (CNAP) system. Indirect standing group involved 164 patients, and they changed posture from supine to sitting for 3 minutes, and then changed to standing position. Blood pressures at the moments of supine, immediately after sitting, the third minute after sitting, immediately after standing and the third minute after standing was recorded by CNAP. Blood pressure changes after different postural changes mode and the rates of OH were compared. The related factors of OH was analyzed by binary logistic regression analysis. Results: The lowest systolic blood pressures (SBP) mostly occurred immediately after postural change: immediately after standing for direct standing group (86.3%(88/102)), and immediately after sitting for indirect standing group (59.1%(97/164)). The lowest diastolic blood pressures (DBP) mostly occurred immediately after standing in the two groups: 87.3%(89/102) for direct standing group and 43.3% (71/164) for indirect standing group. The maximum SBP drop (SBP of supine minus the lowest SBP during postural changes) of direct standing group was significantly higher than indirect standing group (median 20.5(14.0, 29.3) vs. 18.0(11.0, 26.0) mmHg (1 mmHg=0.133 kPa, P<0.05). The rates of OH occurred immediately and within 3 minutes from supine to standing position were significantly higher in direct standing group than in indirect standing group (65.7% (67/102) vs. 43.9% (72/164), and 70.6% (72/102) vs. 49.4% (81/164), both P<0.05). Binary logistic regression analysis showed that brachial-ankle pulse wave velocity was positively associated with OH after a transition from supine to standing position (immediately and within 3 minutes, OR=1.002 (95%CI 1.000-1.004), 1.003 (95%CI 1.001-1.006), P=0.014, 0.006) in direct standing group. Conclusions: OH is common in elderly hospitalized patients. The most obvious blood pressure changes are likely to occur immediately after position changes. Adding a sitting position during the transition of supine to standing position may decrease the amplitude of SBP drop. Brachial-ankle pulse wave velocity is associated with OH after the transition from the supine to standing position in the elderly inpatients.


Assuntos
Pressão Arterial , Hipotensão Ortostática , Idoso , Índice Tornozelo-Braço , Pressão Sanguínea , Determinação da Pressão Arterial , Estudos de Casos e Controles , Humanos , Hipotensão Ortostática/diagnóstico , Pessoa de Meia-Idade , Postura , Análise de Onda de Pulso
13.
High Blood Press Cardiovasc Prev ; 26(3): 175-182, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31054064

RESUMO

Structural and functional arterial properties commonly impair with aging process. These effects on vasculature could act at many levels from microcirculation to large vessels. Above normal aging process classic cardio-vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, etc.) accelerate the physiological process leading to premature structural and functional alterations that has also been termed early vascular aging. Target organ damage evaluation could be clinically important since these alterations precede by many years' cardiovascular events and so their assessment can predict the onset of more serious and costly events giving the opportunity to prevent CV events by earlier therapeutic intervention. This review will focus on large artery functional properties and particularly on the role of inflammation on the aortic stiffening process.


Assuntos
Envelhecimento , Artérias/fisiopatologia , Inflamação/fisiopatologia , Doenças Vasculares/fisiopatologia , Remodelação Vascular , Rigidez Vascular , Fatores Etários , Animais , Artérias/metabolismo , Artérias/patologia , Humanos , Inflamação/diagnóstico , Inflamação/metabolismo , Inflamação/patologia , Mediadores da Inflamação/metabolismo , Prognóstico , Análise de Onda de Pulso , Fatores de Risco , Transdução de Sinais , Doenças Vasculares/diagnóstico , Doenças Vasculares/metabolismo , Doenças Vasculares/patologia
14.
Arch Endocrinol Metab ; 63(3): 235-240, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31038594

RESUMO

OBJECTIVE: To evaluate whether hormonal profile, arterial function, and physical capacity are predictors of fatigue in patients with acromegaly. Subjects and methods: This is a cross-sectional study including 23 patients. The subjects underwent a Modified Fatigue Impact Scale (MFIS) assessment; serum growth hormones (GH) and IGF-1 measurements; pulse wave analysis comprising pulse wave velocity (PWV), arterial compliance (AC), and the reflection index (IR1,2); dominant upper limb dynamometry (DYN); and the six-minute walking distance test (6MWT). Multiple linear regression models were used to identify predictors for MFIS. The coefficient of determination R2 was used to assess the quality of the models' fit. The best model was further analyzed using a calibration plot and a limits of agreement (LOA) plot. RESULTS: The mean ± SD values for the participants' age, MFIS, PWV, AC, IR1,2, DYN, and the distance in the 6MWT were 49.4 ± 11.2 years, 31.2 ± 18.9 score, 10.19 ± 2.34 m/s, 1.08 ± 0.46 x106 cm5/din, 85.3 ± 29.7%, 33.9 ± 9.3 kgf, and 603.0 ± 106.1 m, respectively. The best predictive model (R2 = 0.378, R2 adjusted = 0.280, standard error = 16.1, and P = 0.026) comprised the following regression equation: MFIS = 48.85 - (7.913 × IGF-I) + (1.483 × AC) - (23.281 × DYN). CONCLUSION: Hormonal, vascular, and functional variables can predict general fatigue in patients with acromegaly.


Assuntos
Acromegalia/complicações , Fadiga/diagnóstico , Fadiga/etiologia , Adulto , Brasil , Estudos Transversais , Tolerância ao Exercício , Feminino , Humanos , Fator de Crescimento Insulin-Like I/análise , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Valor Preditivo dos Testes , Análise de Onda de Pulso , Teste de Caminhada
15.
Arch Endocrinol Metab ; 63(3): 258-264, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31066760

RESUMO

OBJECTIVE: The aim of this study is to evaluate and compare arterial stiffness, which is an independent risk indicator for cardiovascular diseases (CVDs), between patients with overt hyperthyroidism, subclinical hyperthyroidism, euthyroidism by antithyroid therapy and healthy volunteers with pulse wave analysis (PWA). SUBJECTS AND METHODS: A total of 102 volunteers were included in the study (30 in the overt hyperthyroid group, 28 in the subclinical hyperthyroid group and 14 with euthyroidism by antithyroid therapy and 30 healthy). The arterial stiffness measurements of the participants in the study were performed with the Mobil-O-Graph PWA device (I.E.M. GmBH, Stolberg, Germany), which makes cuff based oscillometric measurement from the brachial artery. RESULTS: Systolic blood pressure, pulse rate, central systolic blood pressure, cardiac output, heart rate-corrected augmentation index (Aix@75) and pulse wave velocity (PWV) measurements were significantly higher in the hyperthyroid group than in the control group. The heart rate and PWV in the subclinical hyperthyroid group were significantly higher than the control group. In the euthyroid group, systolic blood pressure, central systolic blood pressure, cardiac output, cardiac index and PWV were found significantly higher than the control group. There was also a negative correlation between Aix@75 and thyroid-stimulating hormone (TSH), and a positive correlation between Aix@75 and free thyroid hormones. CONCLUSION: In our study, we observed that the arterial stiffness was adversely affected by an overt or subclinical increase in thyroid hormones and this correlated with thyroid hormone levels. We recommend that PWV measurement, which is a simple method for detecting CVD risk, can be used in these patients.


Assuntos
Doenças Cardiovasculares/etiologia , Hipertireoidismo/fisiopatologia , Tireotropina/efeitos adversos , Rigidez Vascular/fisiologia , Adulto , Idoso , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Estudos de Casos e Controles , Feminino , Humanos , Hipertireoidismo/sangue , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Fatores de Risco , Turquia , Adulto Jovem
16.
Biomed Res Int ; 2019: 6274545, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31058190

RESUMO

Background: The reliability of blood pressure (BP) measurement in hospitalized patients is a topic of debate and the therapeutic implication of the routinely collected BP profiles is probably overestimated. When measurements are performed in elderly patients, further potential sources of misinterpretation occur. Methods: We conducted a subanalysis of a previous study including 79 over 80-year-old hypertensive patients, hospitalized in an internal medicine ward. Five modalities of BP evaluations (measurement by physicians and nurses, self-measurement by patients, Finometer® beat-to-beat finger monitoring, and 24h monitoring) were analyzed, considering agreement and accuracy. Results: The mean (SD) age of the patients was 86.9±4.9 years (50% women). Patients' self-measurements of both systolic and diastolic BP (SBP and DBP) did not differ significantly from daytime 24-hour monitoring (D24hBPM) (mean difference -1.52, SE 1.71; p: ns and -0.58, SE 1.19 mmHg; p: ns). Conversely, SBP and DBP registered by nurses did significantly differ (mean difference -7.34, SE 1.42; p=0.007 and -4.7, SE 1.05 mmHg; p=0.003). SBP and DBP measured by patients also showed the better concordance, with lowest biases, and narrowest limits of agreements (LoA) and for SBP higher Kappa statistic values (bias 1.5, LoA -28.9 to 31.9; κ 0.563 and bias 0.6, LoA -20.4 to 21.5 mmHg; κ 0.412). The patients' sensitivity and specificity in predicting hypertensive systolic D24hBPM were 84.8% and 69.7%, respectively. Conclusions: In elderly hospitalized patients an alternative to 24hBPM, self-measurements by patients offer the better agreement and reliability in detecting hypertensive values.


Assuntos
Determinação da Pressão Arterial , Pressão Sanguínea/fisiologia , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Idoso de 80 Anos ou mais , Feminino , Hospitais , Humanos , Hipertensão/diagnóstico , Masculino , Enfermeiras e Enfermeiros , Pacientes , Médicos , Análise de Onda de Pulso , Reprodutibilidade dos Testes
17.
Clin Interv Aging ; 14: 743-752, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31118595

RESUMO

Objective: The aim of this study was to confirm the potential role of testosterone in hypertension and target organ damage (TOD) in hypertensive postmenopausal women. Methods: A matched group study was conducted. One hundred sixty-one hypertensive postmenopausal women between 45 and 65 years of age were enrolled as group 1. Another 161 age-matched hypertensive men were enrolled as group 2. Ambulatory blood pressure monitoring, echocardiographic imaging, vascular function, sex hormones and clinical characteristics were evaluated. Quantitative data were analyzed using independent Student's t-test and multiple regression analysis. Results: The mean and load level of blood pressure were lower in women than in men (P<0.05), except for the mean level and load of the nocturnal systolic blood pressure (SBP) (123.77±15.72 mmHg vs 126.35±15.64 mmHg, and 50.43±30.31% vs 55.35±28.51%, P>0.05). However, the carotid-femoral pulse wave velocity (cf-PWV) in women was higher than that in men (9.68±2.23 m/s vs 8.03±2.82 m/s, P<0.05). The ratio of the early diastolic mitral peak flow velocity to early diastolic mitral annular velocity (E/Em) was obviously impaired (13.06±3.53 vs 12.05±3.68, P<0.05) in women. Furthermore, in women, a positive correlation was found between testosterone and cf-PWV (γ=0.157, P=0.046), and Cf-PWV was positively related to the mean level of nighttime SBP (γ=0.210, P=0.008). Moreover, nocturnal SBP was a risk factor for E/Em (γ=0.156, P=0.048, P<0.05). Conclusion: Testosterone may play a role in the correlation between hypertension and TOD in hypertensive postmenopausal women. Clinical Trial number: This research study was registered under the ClinicalTrials.gov PRS Website (NCT03451747).


Assuntos
Hipertensão/complicações , Hipertensão/fisiopatologia , Pós-Menopausa/fisiologia , Testosterona/sangue , Idoso , Pressão Sanguínea/fisiologia , Monitorização Ambulatorial da Pressão Arterial , Estudos Transversais , Eletrocardiografia , Feminino , Hormônios Esteroides Gonadais/sangue , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Fatores de Risco
18.
Clin Exp Rheumatol ; 37 Suppl 117(2): 65-71, 2019 Mar-Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31074717

RESUMO

OBJECTIVES: This study aims to investigate the association between arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV) and cardiovascular events (CVEs) in patients with Takayasu's arteritis (TAK). METHODS: A total of 240 TAK patients, who underwent baPWV measurement, were included in the study. The primary outcome was CVEs, which was defined as presently or previously diagnosed with myocardial infarction, unstable angina, congestive heart failure, aortic aneurysm/dissection, cerebral infarction/transient ischaemic attack (TIA), or cerebral haemorrhage. RESULTS: A total of 74 (30.8%) patients with CVEs were included in the present cohort. Compared with the patients without CVEs, those with CVEs had a higher prevalence of hyperlipidaemia (HL), smoking history, active stage, angiographic type V, renal dysfunction (RDF), higher baPWV and high sensitive C-reactive protein (hs-CRP) level (all, p<0.05). The multivariate logistic regression analysis showed that HL (OR: 2.465, 95%CI: 1.308-4.648, p=0.005), smoking history (OR: 4.764, 95%CI: 1.623-13.985, p=0.004), baPWV (OR: 1.132, 95%CI: 1.063-1.204, p<0.001), and hs-CRP (OR: 1.111, 95%CI: 1.040-1.188, p=0.002) were independently associated with the presence of CVEs. The multiple linear regression analysis revealed that age (ß=0.100, p=0.002), mean blood pressure (ß=0.071, p<0.001), angiographic type V (ß=3.681, p<0.001) and RDF (ß=1.800, p=0.048) were independently correlated with baPWV. CONCLUSIONS: Increased baPWV was independently associated with CVEs in patients with TAK. Age, angiographic type V, mean blood pressure and RDF were the strongest determinants for baPWV in TAK. BaPWV may be a potential maker to predict CVEs in patients with TAK.


Assuntos
Doenças Cardiovasculares/etiologia , Arterite de Takayasu/complicações , Rigidez Vascular , Adulto , Índice Tornozelo-Braço , Pressão Sanguínea , Doenças Cardiovasculares/epidemiologia , Feminino , Humanos , Masculino , Análise de Onda de Pulso , Fatores de Risco , Arterite de Takayasu/epidemiologia , Adulto Jovem
19.
World J Microbiol Biotechnol ; 35(6): 85, 2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31134456

RESUMO

Surface properties like hydrophobicity, aggregation ability, adhesion to mucosal surfaces and epithelial cells and transit time are key features for the characterization of probiotic strains. In this study, we used two Lactobacillus paracasei subsp. paracasei strains (BGNJ1-64 and BGSJ2-8) strains which were previously described with very strong aggregation capacity. The aggregation promoting factor (AggLb) expressed in these strains showed high level of binding to collagen and fibronectin, components of extracellular matrix. The working hypothesis was that strains able to aggregate have an advantage to resist in intestinal tract. So, we assessed whether these strains and their derivatives (without aggLb gene) are able to bind or not to intestinal components and we compared the transit time of each strains in mice. In that purpose parental strains (BGNJ1-64 and BGSJ2-8) and their aggregation negative derivatives (BGNJ1-641 and BGSJ2-83) were marked with double antibiotic resistance in order to be tracked in in vivo experiments in mice. Comparative analysis of binding ability of WT and aggregation negative strains to different human intestinal cell lines and mucin revealed no significant difference among them, excluding involvement of AggLb in interaction with surface of intestinal cells and mucin. In vivo experiments showed that surviving and transit time of marked strains in mice did not drastically depend on the presence of the AggLb aggregation factor.


Assuntos
Moléculas de Adesão Celular/metabolismo , Células Epiteliais/microbiologia , Intestinos/microbiologia , Lactobacillus paracasei/crescimento & desenvolvimento , Lactobacillus paracasei/fisiologia , Ligação Proteica , Animais , Aderência Bacteriana/fisiologia , Células CACO-2 , Moléculas de Adesão Celular/fisiologia , Colágeno/metabolismo , Fibronectinas/metabolismo , Células HT29 , Interações entre Hospedeiro e Microrganismos/fisiologia , Humanos , Interações Hidrofóbicas e Hidrofílicas , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Mucinas/metabolismo , Probióticos , Análise de Onda de Pulso , Propriedades de Superfície
20.
Eur J Vasc Endovasc Surg ; 57(6): 868-875, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31126835

RESUMO

OBJECTIVES: The main aim of this study was to evaluate the effect of remote ischaemic preconditioning (RIPC) on arterial stiffness in patients undergoing vascular surgery. METHODS: This was a randomised, sham controlled, double blind, single centre study. Patients undergoing open abdominal aortic aneurysm repair, surgical lower limb revascularisation surgery or carotid endarterectomy were recruited. A RIPC or a sham procedure was performed, using a blood pressure cuff, along with preparation for anaesthesia. The RIPC protocol consisting of four cycles of 5 min of ischaemia, followed by 5 min of reperfusion was applied. Arterial stiffness and haemodynamic parameters were measured pre-operatively and 20-28 h after surgery. Two primary outcomes were selected: augmentation index and pulse wave velocity. RESULTS: Ninety-eight patients were randomised. After dropouts 44 and 46 patients were included in the RIPC and sham groups, respectively. Both groups were comparable. There were no statistically significant differences in augmentation index (p = .8), augmentation index corrected for heart rate of 75 beats per minute (p = .8), pulse wave velocity (p = .7), large artery elasticity indices (p = .8), small artery elasticity indices (p = .6), or mean arterial pressure (p = .7) changes between the RIPC and sham groups. There occurred statistically significant (p ≤ .01) improvement in augmentation index (-5.8% vs. -5.5%), augmentation index corrected for a heart rate of 75 beats per minute (-2.5% vs. -2%), small artery elasticity indices (0.7 mL/mmHg × 100 vs. 0.9 mL/mmHg × 100), and mean arterial pressure post-operatively in both the RIPC and the sham groups (change median values in RIPC and sham groups, respectively). CONCLUSIONS: RIPC had no significant effect on arterial stiffness, but there was significant improvement in arterial stiffness after surgery in both groups. Arterial stiffness and haemodynamics may be influenced by surgery or anaesthesia or oxidative stress or all factors combined. Further studies are needed to clarify these findings. CLINICALTRIALS.GOV: NCT02689414.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Doenças das Artérias Carótidas/cirurgia , Precondicionamento Isquêmico/métodos , Extremidade Inferior/irrigação sanguínea , Doença Arterial Periférica/cirurgia , Oclusão Terapêutica/métodos , Extremidade Superior/irrigação sanguínea , Rigidez Vascular , Procedimentos Cirúrgicos Vasculares/métodos , Idoso , Aneurisma da Aorta Abdominal/diagnóstico , Aneurisma da Aorta Abdominal/fisiopatologia , Pressão Arterial , Doenças das Artérias Carótidas/diagnóstico , Doenças das Artérias Carótidas/fisiopatologia , Método Duplo-Cego , Estônia , Feminino , Humanos , Precondicionamento Isquêmico/efeitos adversos , Precondicionamento Isquêmico/instrumentação , Masculino , Manometria , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico , Doença Arterial Periférica/fisiopatologia , Análise de Onda de Pulso , Oclusão Terapêutica/efeitos adversos , Oclusão Terapêutica/instrumentação , Fatores de Tempo , Torniquetes , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/efeitos adversos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA