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1.
J Comput Assist Tomogr ; 44(1): 1-6, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31855880

RESUMO

OBJECTIVES: To investigate the coronary venous system (CVS) and its spatial relationship with coronary arteries by using 256-slice computed tomography (CT). METHODS: One hundred one patients underwent coronary CT angiography by using a 256-slice CT. In each patient, the CVS and its spatial relationship with coronary arteries were analyzed. We measured the diameters and angulations of the coronary sinus (CS), great cardiac vein, anterior interventricular vein (AIV), left marginal vein, posterior vein of the left ventricle (PVLV), and posterior interventricular vein (PIV), and the distances, respectively, from the CS ostium and from the crossing point to the ostium of corresponding tributaries. RESULTS: The following 5 pairs of veins and arteries had a higher frequency of intersecting compared with others: the CS/great cardiac vein and the left circumflex coronary artery (97.1%), the AIV and the diagonal or ramus branch (92.1%), the PIV and the posterior branch of left ventricle artery (88.1%), the left marginal vein and the circumflex or circumflex marginal (73.9%), and the PVLV and the circumflex or circumflex marginal (31.6%). The other 2 pairs had a higher frequency of running parallel to each other: the AIV and the left anterior descending artery (76.2%) and the PIV and the posterior descending artery (54.4%). Most tributaries were lateral to their corresponding arteries at the crossing point except for the AIV. For the PVLV and PIV, the distances from the crossing point to the ostium of corresponding veins when the veins were lateral to the arteries were smaller than those when the veins were medial to the arteries (P < 0.05). CONCLUSIONS: The CVS and its anatomical relationship with the coronary arterial system can be examined with details by using a 256-slice CT, which has important clinical implications.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/instrumentação , Vasos Coronários/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia por Tomografia Computadorizada/métodos , Doença da Artéria Coronariana , Vasos Coronários/anatomia & histologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
2.
Rev Med Suisse ; 15(674): 2229-2231, 2019 Dec 04.
Artigo em Francês | MEDLINE | ID: mdl-31804033

RESUMO

Cardiovascular (CV) diseases are still one of the most important -killers in developed countries. In the last 40 years, great progresses have been achieved in recognizing and treating these diseases and their underlying risk factors. Risk assessment models using tradi-tional risk factors estimate the probability of a cardiovascular event in most cases and drive preventive treatment. However, these risk assessment models have weaknesses, and it is estimated that about 30 % of cardiovascular events are related to undetected risks. Many surrogate parameters have been investigated and have the potential to better predict CV risk beyond classical risk factors. The aim of this article is to assess the value of measuring the intima-media thickness and the detection of atheroma of the carotid and femoral bifurcation by ultrasound.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/patologia , Espessura Intima-Media Carotídea , Humanos , Medição de Risco , Ultrassonografia
4.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(4): 461-465, 2019 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-31642219

RESUMO

Cardiac magnetic resonance (CMR) is a non-invasive imaging technology, which has been used widely in clinical and basic researches on cardiovascular disease in recent years. With the innovation and optimization of CMR technologies, significant progress has been developed in the evaluation of myocardial viability, the function of regions and global myocardium, and the myocardial texture characteristics. Therefore, with the discussion on the progress of CMR to draw more and more attention in clinics, we hope to improve the application of CMR not only in the basic research but also in the diagnosis and precise evaluation aspects of cardiovascular disease.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Imagem por Ressonância Magnética , Meios de Contraste , Coração/diagnóstico por imagem , Humanos , Miocárdio
5.
J Comput Assist Tomogr ; 43(5): 679-685, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31609291

RESUMO

PURPOSE: The aim of this study was to compare coronary and carotid artery imaging and determine which one shows the strongest association with atherosclerotic cardiovascular disease (ASCVD) score. PATIENTS AND METHODS: Two separate series patients who underwent either coronary computed tomography angiography (CTA) or carotid CTA were included. We recorded the ASCVD scores and assessed the CTA imaging. Two thirds were used to build predictive models, and the remaining one third generated predicted ASCVD scores. The Bland-Altman analysis analyzed the concordance. RESULTS: A total of 110 patients were included in each group. There was no significant difference between clinical characteristics. Three imaging variables were included in the carotid model. Two coronary models (presence of calcium or Agatston score) were created. The bias between true and predicted ASCVD scores was 0.37 ± 5.72% on the carotid model, and 2.07 ± 7.18% and 2.47 ± 7.82% on coronary artery models, respectively. CONCLUSIONS: Both carotid and coronary artery imaging features can predict ASCVD score. The carotid artery was more associated to the ASCVD score than the coronary artery.


Assuntos
Aterosclerose/diagnóstico por imagem , Doenças Cardiovasculares/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Vasos Coronários/diagnóstico por imagem , Idoso , Meios de Contraste , Feminino , Humanos , Iopamidol , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença
6.
Expert Rev Cardiovasc Ther ; 17(8): 625-632, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31403364

RESUMO

Introduction: Transcatheter mitral valve replacement (TMVR) is still a recent technology with numerous unknowns but also great promises. The risk of complications reported in observational studies have limited its adoption by interventional cardiology and surgical communities. Areas covered: Some of the major setbacks of TMVR are complications related to the devices and those related to the pathway. Device-related complications include left ventricle outflow tract (LVOT) obstruction, transcatheter heart valve (THV) dislocation or embolization, thrombosis, and stroke. The transapical approach currently remains the main pathway for TMVR but is associated with high risk of major bleeding and residual apical myocardial scarring. Complication prediction and prevention seem possible. Device-related complication prediction is based on pre-operative imaging including multi-slice computed tomography with 3-dimensional reconstructions and echocardiography which allow LVOT obstruction prediction and appropriate sizing aiming at avoiding dislocation. Industry should aim at the development of transfemoral delivery systems. Nevertheless, several recent feasibility observational studies suggested acceptable safety and efficacy of transcatheter mitral valve replacement. Expert opinion: TMVR complications and transapical delivery are some of the main setbacks which need to be addressed for TMVR to be adopted for broad clinical use.


Assuntos
Doenças Cardiovasculares/diagnóstico , Implante de Prótese de Valva Cardíaca/efeitos adversos , Insuficiência da Valva Mitral/cirurgia , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/diagnóstico por imagem , Feminino , Humanos , Masculino , Valva Mitral/cirurgia , Prognóstico
7.
Vasc Health Risk Manag ; 15: 229-251, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31413582

RESUMO

Purpose: Left ventricular (LV) mechanics by speckle-tracking echocardiography (STE) is prognostic in patients with cardiovascular diseases, but evidence related to community-dwelling individuals is uncertain. We therefore performed a systematic review and meta-analysis of STE as a predictor of adverse outcomes in the general population. Methods: PRISMA guidelines were followed and MEDLINE and EMBASE were searched to identify eligible studies. Primary outcome was all-cause mortality and secondary outcomes were composite cardiac and cardiovascular end-point. Random effects meta-analysis was performed, and a modified Newcastle-Ottawa Assessment Scale was used for quality assessment. Results: Eight papers matched the predefined criteria (total number of individuals studied=11,744). All publications assessed global longitudinal strain (GLS) by two-dimensional speckle-tracking echocardiography (2D-STE), one assessed circumferential, radial and transverse strains, and one assessed GLS-derived post-systolic shortening. None assessed LV rotational measures in association with outcomes. Two studies reported associations between GLS and all-cause mortality and composite cardiovascular end-point. Six papers reported an association between GLS and composite cardiac end-point, three of which were from the same study. Four papers were suitable for meta-analysis. GLS predicted all-cause mortality (pooled minimally adjusted HR per unit strain (%)=1.07 [95% CI 1.03-1.11], p=0.001), and composite cardiovascular (pooled maximally adjusted HR=1.18 [1.09-1.28], p<0.0001) and cardiac (HR=1.08 [1.02-1.14], p=0.006) end-points. GLS also predicted coronary heart disease (HR=1.15 [1.03-1.29], p=0.017) and heart failure (HR=1.07 [1.02-1.13], p=0.012). The quality of all studies was good. Conclusions: This study provides some evidence that STE may have utility as a measure of cardiac function and risk in the general population. 2D-STE-based GLS predicts total mortality, major adverse cardiac and cardiovascular end-points in community-dwelling individuals in a limited number of studies. Despite this, this systematic review also highlights important knowledge gaps in the current literature and further evidence is needed regarding the prognostic value of LV mechanics in unselected older populations.Registration number: CRD42018090302.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Ecocardiografia/métodos , Ventrículos do Coração/diagnóstico por imagem , Contração Miocárdica , Função Ventricular Esquerda , Adulto , Idoso , Idoso de 80 Anos ou mais , Fenômenos Biomecânicos , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/fisiopatologia , Feminino , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Medição de Risco , Fatores de Risco
8.
Molecules ; 24(16)2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31426440

RESUMO

Matrix metalloproteinases (MMPs) are a family of zinc- and calcium-dependent endopeptidases which are secreted or anchored in the cell membrane and are capable of degrading the multiple components of the extracellular matrix (ECM). MMPs are frequently overexpressed or highly activated in numerous human diseases. Owing to the important role of MMPs in human diseases, many MMP inhibitors (MMPIs) have been developed as novel therapeutics, and some of them have entered clinical trials. However, so far, only one MMPI (doxycycline) has been approved by the FDA. Therefore, the evaluation of the activity of a specific subset of MMPs in human diseases using clinically relevant imaging techniques would be a powerful tool for the early diagnosis and assessment of the efficacy of therapy. In recent years, numerous MMPIs labeled imaging agents have emerged. This article begins by providing an overview of the MMP subfamily and its structure and function. The latest advances in the design of subtype selective MMPIs and their biological evaluation are then summarized. Subsequently, the potential use of MMPI-labeled diagnostic agents in clinical imaging techniques are discussed, including positron emission tomography (PET), single-photon emission computed tomography (SPECT) and optical imaging (OI). Finally, this article concludes with future perspectives and clinical utility.


Assuntos
Aterosclerose/diagnóstico por imagem , Doenças Cardiovasculares/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Inibidores de Metaloproteinases de Matriz/farmacocinética , Metaloproteinases da Matriz/química , Sondas Moleculares/farmacocinética , Neoplasias/diagnóstico por imagem , Osteoartrite/diagnóstico por imagem , Animais , Aterosclerose/metabolismo , Aterosclerose/patologia , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/patologia , Domínio Catalítico/genética , Modelos Animais de Doenças , Encefalomielite Autoimune Experimental/diagnóstico por imagem , Encefalomielite Autoimune Experimental/metabolismo , Encefalomielite Autoimune Experimental/patologia , Matriz Extracelular/metabolismo , Matriz Extracelular/patologia , Humanos , Pneumopatias/metabolismo , Pneumopatias/patologia , Inibidores de Metaloproteinases de Matriz/síntese química , Metaloproteinases da Matriz/genética , Metaloproteinases da Matriz/metabolismo , Imagem Molecular/métodos , Sondas Moleculares/síntese química , Esclerose Múltipla/diagnóstico por imagem , Esclerose Múltipla/metabolismo , Esclerose Múltipla/patologia , Neoplasias/metabolismo , Neoplasias/patologia , Osteoartrite/metabolismo , Osteoartrite/patologia , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada de Emissão de Fóton Único/métodos
9.
Rev Fac Cien Med Univ Nac Cordoba ; 76(3): 174-179, 2019 08 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31465186

RESUMO

Background: Mortality from cardiovascular disease (CVD) is increased in rheumatoid arthritis, not explained by traditional cardiovascular risk factors (CVRF), suggesting a role of inflammation. This process would occur early. The common sonographic markers of subclinical atherosclerosis (SA), are increased carotid intima-media thickness (cIMT) or the presence of carotid atherosclerotic plaque and they are closely related to CVD. Aims: To evaluate sonographic markers and cardiovascular risk factors in early Arthritis (EA). Methods: A case control study of patients with EA, defined by 3 joints swollen with <1 year of evolution, served consecutively from January 2011 to may 2013, matched with healthy controls, by sex, age and cardiovascular risk factors (hypertension, diabetes mellitus, cardiovascular disease -IAM and ACV, dyslipidemia, family history of CVD) was conducted. We studied demographics data, cardiovascular risk factors, carotid ultrasound measuring increased cIMT or the presence of carotid atherosclerotic plaque in Common Carotid Artery (CCA) and Carotid Bulb (BC), laboratory test that included cholesterol, LDL, HDL, triglycerides in mg%, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR ), anti citrullinated peptide (ACCP), rheumatoid factor (RF), antinuclear antibodies (ANA). EA activity was measured by DAS 28, considering high disease activity (HDA) 5.1; moderate (MDA) from 5.1 to 3.2; and low (LDA) <3.2. Statistics: test Mann-Whitney and chi-square were used, p <0.05 was significant. Results: 25 women, 5 men, average age 43 years (DS 14.7) and 30 controls were included. The average DAS 28 was 4, 8 ± 1. 8; 47% had HDA, 33%MDA and 20%BDA. Both groups had similar values cIMT CCA (0, 57 ± 0.10 mm vs. 0.58 ± 0.15 mm, respectively, P = 0.82) and cIMT BC (0.18mm ± 0.67 vs 0.62 ± 0.15 mm respectively, P = 0.47). There were no carotid plaques. The median total cholesterol was 181,5 vs 183,5 (p = 0.35); triglycerides 99 vs 92,5 (p = 0.68); HDL 54,5 vs 52,5 (p = 0.921 and LDL 105 vs 110 (p = 0.27) in EA and controls respectively. The cIMT CCA and CB were not related to RF, ACCP, CRP, DAS 28 and smoking (NS). There was no difference in other cardiovascular risk factors Conclusions: Ultrasound evidence of atherosclerosis subclinical markers was not found in this study, suggesting that this process may occur after a year of diagnosis.


Assuntos
Artrite Reumatoide/diagnóstico por imagem , Aterosclerose/diagnóstico por imagem , Biomarcadores/sangue , Adulto , Artrite Reumatoide/sangue , Artrite Reumatoide/complicações , Aterosclerose/sangue , Aterosclerose/complicações , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/etiologia , Artéria Carótida Primitiva/diagnóstico por imagem , Artéria Carótida Primitiva/patologia , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Ultrassonografia
10.
Neurology ; 93(11): e1045-e1057, 2019 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-31444241

RESUMO

OBJECTIVE: To investigate whether cardiometabolic factors were associated with age-related differences in cortical thickness in relation to sex. METHODS: In this cross-sectional study, we enrolled 1,322 cognitively normal elderly (≥65 years old) individuals (774 [58.5%] men, 548 [41.5%] women). We measured cortical thickness using a surface-based analysis. We analyzed the associations of cardiometabolic risk factors with cortical thickness using multivariate linear regression models after adjusting for possible confounders and interactions with age. RESULT: Among women, hypertension (ß = -1.119 to -0.024, p < 0.05) and diabetes mellitus (ß = -0.920, p = 0.03) were independently associated with lower mean cortical thickness. In addition, there was an interaction effect between obesity (body mass index [BMI] ≥27.5 kg/m2) and age on cortical thickness in women (ß = -0.324 to -0.010, p < 0.05), suggesting that age-related differences in cortical thickness were more prominent in obese women compared to women with normal weight. Moreover, low education level (<6 years) was correlated with lower mean cortical thickness (ß = -0.053 to -0.046, p < 0.05). Conversely, among men, only being underweight (BMI ≤18.5 kg/m2, ß = -2.656 to -0.073, p < 0.05) was associated with lower cortical thickness. CONCLUSIONS: Our findings suggest that cortical thickness is more vulnerable to cardiometabolic risk factors in women than in men. Therefore, sex-specific prevention strategies may be needed to protect against accelerated brain aging.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/epidemiologia , Córtex Cerebral/diagnóstico por imagem , Síndrome Metabólica/diagnóstico por imagem , Síndrome Metabólica/epidemiologia , Caracteres Sexuais , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Doenças Cardiovasculares/metabolismo , Córtex Cerebral/metabolismo , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/metabolismo , Obesidade/diagnóstico por imagem , Obesidade/epidemiologia , Obesidade/metabolismo , Fatores de Risco
11.
Hypertension ; 74(3): 705-715, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31352818

RESUMO

Commonly used in vitro fertilization protocols produce pregnancies without a corpus luteum (CL), a major source of reproductive hormones. In vitro fertilization pregnancies without a CL showed deficient gestational increases of central (aortic) arterial compliance during the first trimester and were at increased risk for developing preeclampsia. Here, we investigated whether there was generalized impairment of cardiovascular adaptation in in vitro fertilization pregnancies without a CL compared with pregnancies conceived spontaneously or through ovarian stimulation, which lead to 1 and >1 CL, respectively (n=19-26 participants per cohort). Prototypical maternal cardiovascular adaptations of gestation were serially evaluated noninvasively, initially during the follicular phase before conception, 6× in pregnancy, and then, on average, 1.6 years post-partum. The expected increases of cardiac output, left atrial dimension, peak left ventricular filling velocity in early diastole (E wave velocity), peripheral/central arterial pulse pressure ratio, and global AC, as well as decrease in augmentation index were significantly attenuated or absent during the first trimester in women who conceived without a CL, when compared with the 1 and >1 CL cohorts, which were comparable. Thereafter, these cardiovascular measures showed recovery in the 0 CL group except for E wave velocity, which remained depressed. These results provided strong support for a critical role of CL factor(s) in the transformation of the maternal cardiovascular system in early gestation. Regimens that lead to the development of a CL or replacement of missing CL factor(s) may be indicated to improve cardiovascular function and reduce preeclampsia risk in in vitro fertilization pregnancies.


Assuntos
Doenças Cardiovasculares/etiologia , Sistema Cardiovascular/fisiopatologia , Corpo Lúteo/patologia , Fertilização In Vitro/efeitos adversos , Saúde Materna , Adulto , Análise de Variância , Débito Cardíaco/fisiologia , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/epidemiologia , Estudos de Coortes , Feminino , Testes de Função Cardíaca , Humanos , Modelos Lineares , Gravidez , Primeiro Trimestre da Gravidez , Estudos Prospectivos , Análise de Onda de Pulso
14.
Chem Asian J ; 14(18): 3048-3084, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31347256

RESUMO

In recent decades, HOCl research has attracted a lot of scientists from around the world. This chemical species is well known as an important player in the biological systems of eukaryotic organisms including humans. In the human body, HOCl is produced by the myeloperoxidase enzyme from superoxide in very low concentrations (20 to 400 µm); this species is secreted by neutrophils and monocytes to help fight pathogens. However, in the condition called "oxidative stress", HOCl has the capability to attack many important biomolecules such as amino acids, proteins, nucleotides, nucleic acids, carbohydrates, and lipids; these reactions could ultimately contribute to a number of diseases such as neurodegenerative diseases (AD, PD, and ALS), cardiovascular diseases, and diabetes. In this review, we discuss recent efforts by scientists to synthesize various fluorophores which are attached to receptors to detect HOCl such as: chalcogen-based oxidation, oxidation of 4-methoxyphenol, oxime/imine, lactone ring opening, and hydrazine. These synthetic molecules, involving rational synthetic pathways, allow us to chemoselectively target HOCl and to study the level of HOCl selectivity through emission responses. Virtually all the reports here deal with well-defined and small synthetic molecular systems. A large number of published compounds have been reported over the past years; this growing field has given scientists new insights regarding the design of the chemosensors. Reversibility, for example is considered important from the stand point of chemosensor reuse within the biological system; facile regenerability using secondary analytes to obtain the initial probe is a very promising avenue. Another aspect which is also important is the energy of the emission wavelength of the sensor; near-infrared (NIR) emission is favorable to prevent autofluorescence and harmful irradiation of tissue; thus, extended applicability of such sensors can be made to the mouse model or animal model to help image internal organs. In this review, we describe several well-known types of receptors that are covalently attached to the fluorophore to detect HOCl. We also discuss the common fluorophores which are used by chemist to detect HOCl, Apart from the chemical aspects, we also discuss the capabilities of the compounds to detect HOCl in living cells as measured through confocal imaging. The growing insight from HOCl probing suggests that there is still much room for improvement regarding the available molecular designs, knowledge of interplay between analytes, biological applicability, biological targeting, and chemical switching, which can also serve to further sensor and theurapeutic agent development alike.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Diabetes Mellitus/diagnóstico por imagem , Corantes Fluorescentes/química , Ácido Hipocloroso/química , Doenças Neurodegenerativas/diagnóstico por imagem , Imagem Óptica , Fluorescência , Humanos , Microscopia Confocal
15.
J Cardiovasc Magn Reson ; 21(1): 41, 2019 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-31315625

RESUMO

BACKGROUND: The associations between cardiovascular disease (CVD) risk factors and the biventricular geometry of the right ventricle (RV) and left ventricle (LV) have been difficult to assess, due to subtle and complex shape changes. We sought to quantify reference RV morphology as well as biventricular variations associated with common cardiovascular risk factors. METHODS: A biventricular shape atlas was automatically constructed using contours and landmarks from 4329 UK Biobank cardiovascular magnetic resonance (CMR) studies. A subdivision surface geometric mesh was customized to the contours using a diffeomorphic registration algorithm, with automatic correction of slice shifts due to differences in breath-hold position. A reference sub-cohort was identified consisting of 630 participants with no CVD risk factors. Morphometric scores were computed using linear regression to quantify shape variations associated with four risk factors (high cholesterol, high blood pressure, obesity and smoking) and three disease factors (diabetes, previous myocardial infarction and angina). RESULTS: The atlas construction led to an accurate representation of 3D shapes at end-diastole and end-systole, with acceptable fitting errors between surfaces and contours (average error less than 1.5 mm). Atlas shape features had stronger associations than traditional mass and volume measures for all factors (p < 0.005 for each). High blood pressure was associated with outward displacement of the LV free walls, but inward displacement of the RV free wall and thickening of the septum. Smoking was associated with a rounder RV with inward displacement of the RV free wall and increased relative wall thickness. CONCLUSION: Morphometric relationships between biventricular shape and cardiovascular risk factors in a large cohort show complex interactions between RV and LV morphology. These can be quantified by z-scores, which can be used to study the morphological correlates of disease.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Imagem Cinética por Ressonância Magnética/normas , Função Ventricular Esquerda , Função Ventricular Direita , Remodelação Ventricular , Idoso , Pontos de Referência Anatômicos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Feminino , Ventrículos do Coração/fisiopatologia , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Valores de Referência , Reprodutibilidade dos Testes , Fatores de Risco , Reino Unido/epidemiologia
16.
Pediatrics ; 144(2)2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31315916

RESUMO

BACKGROUND AND OBJECTIVES: Whether BMI captures adiposity and cardiometabolic risk in Down syndrome (DS), a condition associated with obesity, short stature, and altered body proportions, is not known. We compared cardiometabolic risk measures in youth with DS and typically developing matched controls. METHODS: Youth with (n = 150) and without (n = 103) DS of comparable age (10-20 years), sex, race, ethnicity, and BMI percentile underwent whole-body dual-energy X-ray absorptiometry, fasting glucose, insulin, lipids, lipoprotein particles, inflammatory factors, and when BMI percentile ≥85, an oral glucose tolerance test. RESULTS: Sixty-four percent of youth with DS had BMI percentile ≥85. Among these, no difference in glucose, insulin, or insulin resistance was detected, but prediabetes was more prevalent with DS (26.4% vs 10.3%; P = .025) after adjustment for demographics, pubertal status, and BMI z score (odds ratio = 3.2; P = .026). Among all participants, those with DS had higher low-density lipoprotein cholesterol (median 107 [interquartile range 89-128] vs 88.5 [79-103] mg/dL; P < .00005), triglycerides (89.5 [73-133] vs 71.5 [56-104] mg/dL; P < .00005), non-high-density lipoprotein cholesterol (non-HDL-C; 128 [104-153] vs 107 [92-123] mg/dL; P < .00005), and triglycerides/HDL-C (2.2 [1.6-3.4] vs 1.7 [1.1-2.5] mg/dL; P = .0003) and lower levels of HDL-C (41 [36.5-47] vs 45 [37-53] mg/dL; P = .012). DS youth had higher high-sensitivity C-reactive protein, interleukin-6, small low-density lipoprotein particles (LDL-P), and total LDL-P, but similar LDL-P size. Youth with DS had less visceral fat (VFAT), fat mass, and lean mass for BMI z score, but greater VFAT at higher fat mass. However, VFAT did not fully explain the increased prevalence of dyslipidemia or prediabetes in youth with DS. CONCLUSIONS: Despite similar insulin resistance, youth with DS had greater prevalence of dyslipidemia and prediabetes than typically developing youth, which was not fully explained by VFAT.


Assuntos
Composição Corporal/fisiologia , Doenças Cardiovasculares/sangue , Síndrome de Down/sangue , Doenças Metabólicas/sangue , Obesidade/sangue , Adolescente , Índice de Massa Corporal , Doenças Cardiovasculares/diagnóstico por imagem , Criança , Estudos Transversais , Síndrome de Down/diagnóstico por imagem , Feminino , Humanos , Resistência à Insulina/fisiologia , Masculino , Doenças Metabólicas/diagnóstico por imagem , Obesidade/diagnóstico por imagem , Fatores de Risco , Adulto Jovem
17.
Scand Cardiovasc J ; 53(6): 317-322, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31321990

RESUMO

Objectives. Left atrial fibrosis represents a substrate for atrial fibrillation (AF) and cardioembolic events. White matter hyperintensities (WMH) are commonly found on magnetic resonance imaging (MRI) and are regarded, at least partly as ischemic brain lesions. Aortic excess pressure (excessPTI) represents an extra work performed by the left ventricle and is a new risk metric associated with cardiovascular complications. The aim of our study was to assessed whether there is a correlation between the degree of LA fibrosis, aortic excess pressure, and WMH in patients without a history of atrial fibrillation but the presence of risk factors for cardiovascular complications. Design. Thirty-eight subjects (10, females, 28 males, median age 64 years) with risk factors (hypertension, diabetes, heart failure, vascular disease) but no history of AF were recruited. Left atrial fibrosis and brain WMH were estimated by MRI. Aortic excess pressure was obtained non-invasively. Results. Atrial fibrosis correlated significantly with aortic excess pressure (r = 0.65, p < .0001) and was significantly associated with periventricular white matter lesion volume (r = 0.34, p = .036). In multiple regression analysis, atrial fibrosis and age were positively associated with periventricular white matter lesions, while aortic excess pressure was not quite significant associated with WMH. This model explains the 30% variance in white matter lesions volume observed in the study. Left atrial fibrosis was independently associated with excessPTI but not with age and mean BP. This model explained 42% of the variance in an area of atrial fibrosis. Conclusions. Atrial fibrosis in subjects with cardiovascular risk factors and no history of AF is associated with white matter hyperintensities and aortic excess pressure.


Assuntos
Aorta/fisiopatologia , Pressão Arterial , Função do Átrio Esquerdo , Remodelamento Atrial , Doenças Cardiovasculares/complicações , Átrios do Coração/fisiopatologia , Leucoencefalopatias/etiologia , Idoso , Aorta/diagnóstico por imagem , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/fisiopatologia , Feminino , Fibrose , Átrios do Coração/diagnóstico por imagem , Humanos , Leucoencefalopatias/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Fatores de Risco , Função Ventricular Esquerda
18.
Curr Top Med Chem ; 19(16): 1445-1463, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31284861

RESUMO

Adenosine receptors (ARs) are a class of purinergic G-protein-coupled receptors (GPCRs). Extracellular adenosine is a pivotal regulation molecule that adjusts physiological function through the interaction with four ARs: A1R, A2AR, A2BR, and A3R. Alterations of ARs function and expression have been studied in neurological diseases (epilepsy, Alzheimer's disease, and Parkinson's disease), cardiovascular diseases, cancer, and inflammation and autoimmune diseases. A series of Positron Emission Tomography (PET) probes for imaging ARs have been developed. The PET imaging probes have provided valuable information for diagnosis and therapy of diseases related to alterations of ARs expression. This review presents a concise overview of various ARs-targeted radioligands for PET imaging in diseases. The most recent advances in PET imaging studies by using ARs-targeted probes are briefly summarized.


Assuntos
Doenças Autoimunes/metabolismo , Doenças Cardiovasculares/metabolismo , Inflamação/metabolismo , Doenças do Sistema Nervoso/metabolismo , Tomografia por Emissão de Pósitrons , Receptores Purinérgicos P1/análise , Animais , Doenças Autoimunes/diagnóstico por imagem , Doenças Cardiovasculares/diagnóstico por imagem , Humanos , Inflamação/diagnóstico por imagem , Sondas Moleculares/química , Doenças do Sistema Nervoso/diagnóstico por imagem
20.
Vasc Med ; 24(5): 405-413, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31195916

RESUMO

Novel technology permits quantification of common carotid artery (CCA) displacement, which is traditionally ignored. We evaluated associations with CCA displacement and cardiovascular disease (CVD) risk and events in a large, multi-ethnic cohort. Right CCA longitudinal displacement (LD), transverse displacement (TD), and grayscale median (GSM) were evaluated using ultrasound speckle-tracking and texture analysis software in 2050 participants. Regression analyses were used to define relationships between CCA LD, TD, GSM, and CVD risk factors. Cox proportional hazards models were used to assess relationships between LD, TD, and incident CVD events. Participants were mean (SD) 64 (10) years old. There were 791 cases with a CVD event over a 12-year median follow-up. The mean LD was 0.29 (0.20) mm. In multivariable models including age, sex, race/ethnicity, heart rate, and CVD risk factors, LD was associated positively with active smoking (ß = 0.08, p < 0.001) and inversely with black (ß = -0.08, p < 0.001), Chinese (ß = -0.05, p < 0.001), and Hispanic (ß = -0.04, p < 0.05) race/ethnicities relative to white individuals, heart rate (ß = -0.03/10 beats/min, p < 0.001), and diastolic blood pressure (ß = -0.01/5 mmHg, p < 0.05). In fully adjusted models, LD and TD were associated with GSM (p < 0.01), but neither predicted incident CVD events (LD: hazard ratio (HR) 0.77 [0.48 to 1.24], p = 0.3; TD: HR 1.12 [0.8 to 1.57], p = 0.5). CCA LD and TD are associated with race/ethnicity and CVD risk factors but not incident CVD events. LD and TD are not measures of arterial stiffness but their association with GSM suggests that lower LD and TD may be related to structural changes within the carotid arterial wall.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Artéria Carótida Primitiva/diagnóstico por imagem , Ultrassonografia , Rigidez Vascular , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/fisiopatologia , Artéria Carótida Primitiva/fisiopatologia , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Estados Unidos
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