Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 16.885
Filtrar
1.
J Cardiovasc Magn Reson ; 23(1): 100, 2021 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479603

RESUMO

BACKGROUND: The prevalence of abnormal cardiovascular magnetic resonance (CMR) findings in recovered coronavirus disease 2019 (COVID-19) patients is unclear. This study aimed to investigate the prevalence of abnormal CMR findings in recovered COVID-19 patients. METHODS: A systematic literature search was performed to identify studies that report the prevalence of abnormal CMR findings in recovered COVID-19 patients. The number of patients with abnormal CMR findings and diagnosis of myocarditis on CMR (based on the Lake Louise criteria) and each abnormal CMR parameter were extracted. Subgroup analyses were performed according to patient characteristics (athletes vs. non-athletes and normal vs. undetermined cardiac enzyme levels). The pooled prevalence and 95% confidence interval (CI) of each CMR finding were calculated. Study heterogeneity was assessed, and meta-regression analysis was performed to investigate factors associated with heterogeneity. RESULTS: In total, 890 patients from 16 studies were included in the analysis. The pooled prevalence of one or more abnormal CMR findings in recovered COVID-19 patients was 46.4% (95% CI 43.2%-49.7%). The pooled prevalence of myocarditis and late gadolinium enhancement (LGE) was 14.0% (95% CI 11.6%-16.8%) and 20.5% (95% CI 17.7%-23.6%), respectively. Further, heterogeneity was observed (I2 > 50%, p < 0.1). In the subgroup analysis, the pooled prevalence of abnormal CMR findings and myocarditis was higher in non-athletes than in athletes (62.5% vs. 17.1% and 23.9% vs. 2.5%, respectively). Similarly, the pooled prevalence of abnormal CMR findings and LGE was higher in the undetermined than in the normal cardiac enzyme level subgroup (59.4% vs. 35.9% and 45.5% vs. 8.3%, respectively). Being an athlete was a significant independent factor related to heterogeneity in multivariate meta-regression analysis (p < 0.05). CONCLUSIONS: Nearly half of recovered COVID-19 patients exhibited one or more abnormal CMR findings. Athletes and patients with normal cardiac enzyme levels showed a lower prevalence of abnormal CMR findings than non-athletes and patients with undetermined cardiac enzyme levels. Trial registration The study protocol was registered in the PROSPERO database (registration number: CRD42020225234).


Assuntos
COVID-19/epidemiologia , Doenças Cardiovasculares/diagnóstico , Imagem Cinética por Ressonância Magnética/métodos , Miocárdio/patologia , COVID-19/diagnóstico , Doenças Cardiovasculares/epidemiologia , Comorbidade , Saúde Global , Humanos , Pandemias , Valor Preditivo dos Testes , Prevalência , SARS-CoV-2
2.
Molecules ; 26(17)2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34500838

RESUMO

Phenolic acids comprise a class of phytochemical compounds that can be extracted from various plant sources and are well known for their antioxidant and anti-inflammatory properties. A few of the most common naturally occurring phenolic acids (i.e., caffeic, carnosic, ferulic, gallic, p-coumaric, rosmarinic, vanillic) have been identified as ingredients of edible botanicals (thyme, oregano, rosemary, sage, mint, etc.). Over the last decade, clinical research has focused on a number of in vitro (in human cells) and in vivo (animal) studies aimed at exploring the health protective effects of phenolic acids against the most severe human diseases. In this review paper, the authors first report on the main structural features of phenolic acids, their most important natural sources and their extraction techniques. Subsequently, the main target of this analysis is to provide an overview of the most recent clinical studies on phenolic acids that investigate their health effects against a range of severe pathologic conditions (e.g., cancer, cardiovascular diseases, hepatotoxicity, neurotoxicity, and viral infections-including coronaviruses-based ones).


Assuntos
Anti-Inflamatórios/farmacologia , Antioxidantes/farmacologia , Cinamatos/farmacologia , Hidroxibenzoatos/farmacologia , Extratos Vegetais/farmacologia , Anti-Inflamatórios/uso terapêutico , Antioxidantes/uso terapêutico , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/tratamento farmacológico , Cinamatos/uso terapêutico , Ensaios Clínicos como Assunto , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Humanos , Hidroxibenzoatos/uso terapêutico , Hepatopatias/diagnóstico , Hepatopatias/tratamento farmacológico , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Índice de Gravidade de Doença , Resultado do Tratamento
3.
Int J Mol Sci ; 22(16)2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34445593

RESUMO

Growth and differentiation factor 15 (GDF15) belongs to the transforming growth factor-ß (TGF-ß) superfamily of proteins. Glial-derived neurotrophic factor (GDNF) family receptor α-like (GFRAL) is an endogenous receptor for GDF15 detected selectively in the brain. GDF15 is not normally expressed in the tissue but is prominently induced by "injury". Serum levels of GDF15 are also increased by aging and in response to cellular stress and mitochondrial dysfunction. It acts as an inflammatory marker and plays a role in the pathogenesis of cardiovascular diseases, metabolic disorders, and neurodegenerative processes. Identified as a new heart-derived endocrine hormone that regulates body growth, GDF15 has a local cardioprotective role, presumably due to its autocrine/paracrine properties: antioxidative, anti-inflammatory, antiapoptotic. GDF15 expression is highly induced in cardiomyocytes after ischemia/reperfusion and in the heart within hours after myocardial infarction (MI). Recent studies show associations between GDF15, inflammation, and cardiac fibrosis during heart failure and MI. However, the reason for this increase in GDF15 production has not been clearly identified. Experimental and clinical studies support the potential use of GDF15 as a novel therapeutic target (1) by modulating metabolic activity and (2) promoting an adaptive angiogenesis and cardiac regenerative process during cardiovascular diseases. In this review, we comment on new aspects of the biology of GDF15 as a cardiac hormone and show that GDF15 may be a predictive biomarker of adverse cardiac events.


Assuntos
Biomarcadores/metabolismo , Doenças Cardiovasculares/diagnóstico , Fator 15 de Diferenciação de Crescimento/metabolismo , Animais , Doenças Cardiovasculares/metabolismo , Humanos
4.
Medicina (Kaunas) ; 57(7)2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34356982

RESUMO

Atherosclerosis and its consequences are the leading cause of mortality in the world. For this reason, we have reviewed atherosclerosis biomarkers and selected the most promising ones for review. We focused mainly on biomarkers related to inflammation and oxidative stress, such as the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), and lipoprotein-associated phospholipase A2 (Lp-PLA2). The microRNA (miRNA) and the usefulness of the bone mineralization, glucose, and lipid metabolism marker osteocalcin (OC) were also reviewed. The last biomarker we considered was angiogenin (ANG). Our review shows that due to the multifactorial nature of atherosclerosis, no single marker is known so far, the determination of which would unambiguously assess the severity of atherosclerosis and help without any doubt in the prognosis of cardiovascular risk.


Assuntos
Biomarcadores , Doenças Cardiovasculares , 1-Alquil-2-acetilglicerofosfocolina Esterase , Aterosclerose , Proteína C-Reativa , Doenças Cardiovasculares/diagnóstico , Humanos , Interleucina-6 , Osteocalcina , Prognóstico , Ribonuclease Pancreático , Fatores de Risco
5.
AMIA Annu Symp Proc ; 2021: 384-393, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34457153

RESUMO

From electronic health records (EHRs), the relationship between patients' conditions, treatments, and outcomes can be discovered and used in various healthcare research tasks such as risk prediction. In practice, EHRs can be stored in one or more data warehouses, and mining from distributed data sources becomes challenging. Another challenge arises from privacy laws because patient data cannot be used without some patient privacy guarantees. Thus, in this paper, we propose a privacy-preserving framework using sequential pattern mining in distributed data sources. Our framework extracts patterns from each source and shares patterns with other sources to discover discriminative and representative patterns that can be used for risk prediction while preserving privacy. We demonstrate our framework using a case study of predicting Cardiovascular Disease in patients with type 2 diabetes and show the effectiveness of our framework with several sources and by applying differential privacy mechanisms.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Doenças Cardiovasculares/diagnóstico , Confidencialidade , Registros Eletrônicos de Saúde , Humanos , Privacidade
6.
PLoS One ; 16(8): e0256330, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34449773

RESUMO

BACKGROUND: COVID-19 has proved to have an indirect impact on essential health services in several parts of the world which could lead to increased morbidity and mortality and loss of the gains made in the past decades. There were no synthesized scientific evidences which could show the impact of COVID-19 epidemics/pandemic on essential health services in Tigray, Northern Ethiopia. Therefore, this study aimed to assess the impacts of COVID-19 epidemics/pandemic on essential health services provision in Tigray, Northern Ethiopia. METHODS: A pre-post study design was used to assess the impacts of COVID-19 on essential health services delivery in Tigray, Northern Ethiopia in the second quarter of 2020 (Post COVID-19) compared to similar quarter in 2019 (Pre COVID-19). The study focuses on five categories; namely; maternal, neonatal and child health care; communicable diseases with a focus on HIV and TB-HIV co-infection; prevention of mother to child transmission of HIV; basic emergency, outpatient, inpatient and blood bank services, non-communicable diseases and road traffic accidents (RTAs). Analysis was done using Stata version 14.0 software package. The effects of COVID-19 epidemics/pandemic were calculated taking the differences between post COVID -19 and pre COVID-19 periods and the levels of service disruptions presented using proportions. Wilcoxon sign rank test was done and a significance level of ≤0.05 was considered as having significant difference among the two quarters. RESULTS: There were significant increase in institutional delivery, delivery by Caesarian Section (CS), still birth, postnatal care within 7 days of delivery, the number of children who received all vaccine doses before 1st birthday, the number of under 5 children screened and had moderate acute malnutrition, the number of under 5 children screened and had severe acute malnutrition and children with SAM admitted for management. However, there were significant decrease in HIV testing and detection along with enrolment to antiretroviral therapy (ART) care, number of patients with cardiovascular disease (CVD) risk ≥ 30% received treatment, RTAs, total units of blood received from national blood transfusion service (NBTS) and regional blood banks, total number of units of blood transfused and emergency referral. There were no significant changes in outpatient visits and admissions. CONCLUSION: Despite commendable achievements in maintaining several of the essential health services, COVID-19 has led to an increase in under nutrition in under five children, decline in HIV detection and care, CVD, cervical cancer screening and blood bank services. Therefore, governments, local and international agencies need to introduce innovative ways to rapidly expand and deliver services in the context of COVID-19. Moreover, lower income countries have to customize comprehensive and coordinated community-based health care approaches, including outreach and campaigns. In addition, countries should ensure that NCDs are incorporated in their national COVID-19 response plans to provide essential health care services to people living with NCDs and HIV or HIV-TB co-infection during the COVID-19 pandemic period.


Assuntos
COVID-19/epidemiologia , Atenção à Saúde , Antirretrovirais/uso terapêutico , Transfusão de Sangue/estatística & dados numéricos , COVID-19/virologia , Doenças Cardiovasculares/diagnóstico , Parto Obstétrico/estatística & dados numéricos , Etiópia , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Humanos , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Pandemias , Cuidado Pós-Natal , SARS-CoV-2/isolamento & purificação , Vacinação/estatística & dados numéricos
8.
Eur J Vasc Endovasc Surg ; 62(3): 450-461, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34389230

RESUMO

OBJECTIVE: Statin therapy is indicated in patients with peripheral arterial disease (PAD). National Institute for Health and Care Excellence guidelines suggest the use of "high intensity" statins, although evidence with PAD specific data are lacking. The effect of statin therapy and dose on outcomes in PAD is investigated. DATA SOURCES: Studies measuring statin use in PAD patients and outcomes were identified based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The EMBASE and MEDLINE databases were interrogated from January 1957 until February 2020. Twenty-two observational cohort studies and two randomised control trials were included (n = 268 611). REVIEW METHODS: Pooled estimates of dichotomous outcome data were calculated using the odds/hazard ratios (OR/HR) and 95% confidence interval (CI). Meta-analysis was conducted using the inverse variance or Mantel-Haenszel method. Outcomes included all cause mortality (ACM), cardiovascular mortality (CVM), major adverse cardiac events (MACE), and amputation. Subgroup analysis was performed on studies comparing patients taking high dose vs. combined low and moderate doses of statins. The GRADE criteria assessed the quality of evidence for outcomes. RESULTS: Statin therapy (vs. no statins) was significantly protective for ACM: OR 0.68 (95% CI 0.60 - 0.76) (number needed to treat [NNT] = 48), HR 0.74 (95% CI 0.70 - 0.78) (NNT = 10 - 91); MACE: OR 0.84 (95% CI 0.78 - 0.92) (NNT = 53), HR 0.78 (95% CI 0.65 - 0.93) (NNT = 167); and amputations: OR 0.59 (95% CI 0.33 - 1.07) (NNT = 333), HR 0.74 (95% CI 0.62 - 0.89) (NNT = 50). High doses of statins (vs. combined low and moderate doses) were significantly better protective against ACM OR 0.69 (95% CI 0.43 - 1.09) (NNT = 17), HR 0.74 (95% CI 0.62 - 0.89) (NNT = 16 - 200) but work less significantly for MACE OR 0.77 (95% CI 0.49 - 1.21) (NNT = 25). Amputations were less frequent in patients on high doses HR 0.78 (95% CI 0.69 - 0.90) (NNT = 53 - 1 000). CONCLUSION: Higher dosing of statins confers a significant improvement in patient outcomes, especially ACM and amputations, although the quality of the evidence was variable. Such findings require confirmation in larger, PAD specific trials.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Dislipidemias/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Doença Arterial Periférica/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Amputação , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/mortalidade , Causas de Morte , Dislipidemias/diagnóstico , Dislipidemias/mortalidade , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico , Doença Arterial Periférica/mortalidade , Prevenção Primária , Medição de Risco , Prevenção Secundária , Resultado do Tratamento
9.
Medicine (Baltimore) ; 100(31): e26835, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397849

RESUMO

ABSTRACT: Nonalcoholic fatty liver disease (NAFLD) is associated with metabolic syndrome, which includes diabetes mellitus and hyperlipidemia. A fraction of NAFLD patients develop nonalcoholic steatohepatitis, leading to cirrhosis associated with various serious complications, including hepatocellular carcinoma, gastroesophageal varices, cardiovascular events, and other organ malignancy. Although the incidence of chronic viral hepatitis with associated complications has gradually decreased as highly effective antiviral therapies have been established, the number of patients with steatohepatitis has been increasing.This retrospective study examined data of 229 patients from 22 hospitals in our region. We examined 155 cases of chronological data and assessed the development of liver fibrosis and evaluated hepatic reserve-related markers such as platelet count, FIB-4 index, prothrombin time, and serum albumin concentration. We analyzed the relationship of these chronological changes and the incidence of NAFLD related serious complications.Data related to liver fibrosis progression, albumin, and prothrombin time were significantly associated with the occurrence of serious complications associated with cirrhosis. We compared 22 event and 133 nonevent cases of chronological changes in the data per year and found that serum albumin concentration was significantly lower in the group that developed serious complications (event cases: -0.21 g/dL/year, nonevent cases: -0.04 g/dL/year (P < .001)). This albumin decline was only the associated factor with the event incidence by multivariate analysis (P < .01).Annual decline in serum albumin concentration in patients with NAFLD is associated with serious events from the outcome of multicenter retrospective study. This highlights its potential utility as a surrogate marker to assess the efficacy of prediction of NAFLD related serious events.


Assuntos
Cirrose Hepática , Hepatopatia Gordurosa não Alcoólica , Albumina Sérica/análise , Idoso , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/patologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Progressão da Doença , Varizes Esofágicas e Gástricas/diagnóstico , Varizes Esofágicas e Gástricas/epidemiologia , Feminino , Seguimentos , Humanos , Japão/epidemiologia , Cirrose Hepática/diagnóstico , Cirrose Hepática/epidemiologia , Cirrose Hepática/etiologia , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Valor Preditivo dos Testes , Prognóstico , Medição de Risco , Fatores de Risco
10.
Medicine (Baltimore) ; 100(31): e26861, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397862

RESUMO

ABSTRACT: Cardiac rehabilitation (CR) can improve clinical indicators in patients with cardiovascular diseases. The literature reports a 20% reduction in all-cause mortality and a 27% reduction in heart-disease mortality following CR. Although its clinical efficacy has been established, there is uncertainty whether center-based (CBCR) is more effective than home-based (HBCR) programs in acute and subacute phases. We aimed to verify significant differences in their effectiveness for the improvement of cardiopulmonary function by analyzing cardiopulmonary exercise (CPX) with laboratory tests following both CR programs.A single-center cohort study of 37 patients, recently diagnosed with underlying cardiovascular diseases, underwent CBCR(18) and HBCR(19). CBCR group performed a supervised exercise regimen at the CR center, for 1 hour, 2 to 3 days a week, for a total of 12 to18 weeks. HBCR group completed a self-monitored exercise program at home under the same guidelines as CBCR. Participants were evaluated by CPX with laboratory tests at 1- and 6-month, following the respective programs.There was no statistical significance in clinical characteristics and laboratory findings. Pre-post treatment comparison showed significant improvement in VO2/kg, minute ventilation/carbon dioxide production slope, breathing reserve, tidal volume (VT), heart rate recovery, oxygen consumption per heart rate, low-density lipoprotein (LDL), LDL/HDL ratio, total cholesterol, ejection fraction (EF) (P < .05). CBCR approach showed greater improvement with significance in VO2/kg, metabolic equivalents, and EF on between groups analysis (P < .05).The time effect of CPX test and laboratory data showed improvement in cardiopulmonary function and serum indicators for both groups. VO2/kg, metabolic equivalents, and EF were among the variables that showed significant differences between groups. In the acute and subacute phases of 1 to 6 months, the CBCR group showed a greater cardiac output improvement than the HBCR group.


Assuntos
Biomarcadores/sangue , Reabilitação Cardíaca , Doenças Cardiovasculares , Terapia por Exercício , Serviços de Assistência Domiciliar/estatística & dados numéricos , Centros de Reabilitação/estatística & dados numéricos , Reabilitação Cardíaca/métodos , Reabilitação Cardíaca/normas , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/terapia , Pesquisa Comparativa da Efetividade , Teste de Esforço/métodos , Terapia por Exercício/métodos , Terapia por Exercício/organização & administração , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , República da Coreia/epidemiologia , Testes de Função Respiratória/métodos , Testes de Função Respiratória/estatística & dados numéricos , Resultado do Tratamento
11.
J Am Heart Assoc ; 10(16): e020255, 2021 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-34387100

RESUMO

Background The acuity and magnitude of the first wave of the COVID-19 epidemic in New York mandated a drastic change in healthcare access and delivery of care. Methods and Results We retrospectively studied patients admitted with an acute cardiovascular syndrome as their principal diagnosis to 13 hospitals across Northwell Health during March 11 through May 26, 2020 (first COVID-19 epidemic wave) and the same period in 2019. Three thousand sixteen patients (242 COVID-19 positive) were admitted for an acute cardiovascular syndrome during the first COVID-19 wave compared with 9422 patients 1 year prior (decrease of 68.0%, P<0.001). During this time, patients with cardiovascular disease presented later to the hospital (360 versus 120 minutes for acute myocardial infarction), underwent fewer procedures (34.6% versus 45.6%, P<0.001), were less likely to be treated in an intensive care unit setting (8.7% versus 10.8%, P<0.001), and had a longer hospital stay (2.91 [1.71-6.05] versus 2.87 [1.82-4.95] days, P=0.033). Inpatient cardiovascular mortality during the first epidemic outbreak increased by 111.1% (3.8 versus 1.8, P<0.001) and was not related to COVID-19-related admissions, all cause in-hospital mortality, or incidence of out-of-hospital cardiac deaths in New York. Admission during the first COVID-19 surge along with age and positive COVID-19 test independently predicted mortality for cardiovascular admissions (odds ratios, 1.30, 1.05, and 5.09, respectively, P<0.0001). Conclusions A lower rate and later presentation of patients with cardiovascular pathology, coupled with deviation from common clinical practice mandated by the first wave of the COVID-19 pandemic, might have accounted for higher in-hospital cardiovascular mortality during that period.


Assuntos
COVID-19 , Doenças Cardiovasculares/mortalidade , Mortalidade Hospitalar/tendências , Hospitalização , Pacientes Internados , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Adulto Jovem
12.
Atherosclerosis ; 331: 45-53, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34344526

RESUMO

BACKGROUND AND AIMS: An untargeted metabolomics approach allows for a better understanding and identification of new candidate metabolites involved in the etiology of vascular disease. We aimed to investigate the associations of cardiovascular (CV) risk factors with the metabolic fingerprint and macro- and microvascular health in an untargeted metabolomic approach in predefined CV risk groups of aged individuals. METHODS: The metabolic fingerprint and the macro- and microvascular health from 155 well-characterized aged (50-80 years) individuals, based on the EXAMIN AGE study, were analysed. Nuclear magnetic resonance spectroscopy was used to analyse the metabolic fingerprint. Carotid-femoral pulse wave velocity and retinal vessel diameters were assessed to quantify macro- and microvascular health. RESULTS: The metabolic fingerprint became more heterogeneous with an increasing number of risk factors. There was strong evidence for higher levels of glutamine [estimate (95% CI): -14.54 (-17.81 to -11.27), p < 0.001], glycine [-5.84 (-7.88 to -3.79), p < 0.001], histidine [-0.73 (-0.96 to -0.50), p < 0.001], and acetate [-1.68 (-2.91 to -0.46), p = 0.007] to be associated with a lower CV risk profile. Tryptophan, however, was positively associated with higher CV risk [0.31 (0.06-0.56), p = 0.015]. The combination of a priori defined CV risk factors explained up to 45.4% of the metabolic variation. The metabolic fingerprint explained 20% of macro- and 23% of microvascular variation. CONCLUSIONS: Metabolic profiling has the potential to improve CV risk stratification by identifying new underlying metabolic pathways associated with atherosclerotic disease development, from cardiovascular risk to metabolites, to vascular end organ damage.


Assuntos
Doenças Cardiovasculares , Análise de Onda de Pulso , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Fatores de Risco de Doenças Cardíacas , Humanos , Metabolômica , Fatores de Risco
13.
Nutrients ; 13(7)2021 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-34371871

RESUMO

Coronary Heart Disease (CHD) is a major mortality and morbidity cause in adulthood worldwide. The atherosclerotic process starts even before birth, progresses through childhood and, if not stopped, eventually leads to CHD. Therefore, it is important to start prevention from the earliest stages of life. CHD prevention can be performed at different interventional stages: primordial prevention is aimed at preventing risk factors, primary prevention is aimed at early identification and treatment of risk factors, secondary prevention is aimed at reducing the risk of further events in those patients who have already experienced a CHD event. In this context, CHD risk stratification is of utmost importance, in order to tailor the preventive and therapeutic approach. Nutritional intervention is the milestone treatment in pediatric patients at increased CHD risk. According to the Developmental Origin of Health and Disease theory, the origins of lifestyle-related disease is formed in the so called "first thousand days" from conception, when an insult, either positive or negative, can cause life-lasting consequences. Nutrition is a positive epigenetic factor: an adequate nutritional intervention in a developmental critical period can change the outcome from childhood into adulthood.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Transtornos da Nutrição Infantil/dietoterapia , Desnutrição/dietoterapia , Terapia Nutricional , Adolescente , Desenvolvimento do Adolescente , Fatores Etários , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Criança , Desenvolvimento Infantil , Transtornos da Nutrição Infantil/diagnóstico , Transtornos da Nutrição Infantil/fisiopatologia , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Fatores de Risco de Doenças Cardíacas , Humanos , Lactente , Recém-Nascido , Desnutrição/diagnóstico , Desnutrição/fisiopatologia , Estado Nutricional , Prevenção Primária , Medição de Risco , Resultado do Tratamento
14.
Tex Heart Inst J ; 48(3)2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34340244

RESUMO

Symptomatic coronavirus disease 2019 (COVID-19) typically affects the respiratory system but can involve the cardiovascular system. Cardiac complications of COVID-19 can result directly from myocarditis or indirectly from numerous other mechanisms. Differentiating between primary and secondary cardiovascular involvement-our focus in this review-may help to identify the long-term effects of COVID-19 on the heart in adults and children.


Assuntos
COVID-19 , Doenças Cardiovasculares , Sistema Cardiovascular , Miocardite , Adulto , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Criança , Coração , Humanos , Miocardite/diagnóstico , Miocardite/epidemiologia , SARS-CoV-2
15.
BMC Public Health ; 21(1): 1308, 2021 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-34217235

RESUMO

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic has led to a significant decline in Non Communicable Diseases (NCD) screening and early detection activities, especially Cardiovascular Disease (CVD). This study aims to assess the potential of community-based self-screening of CVD risk through the mhealth application. METHODS: This is operational research by actively involving the community to carry out self-screening through the mHealth application. Community health workers were recruited as facilitators who encourage the community to carry out self-screening. To evaluate the potential of community-based self-screening of CVD risk, we use several indicators: responses rate, level of CVD risk, and community acceptance. RESULTS: Of the 846 individuals reached by the cadres, 53% or 442 individuals carried out self-screening. Based on the results of self-screening of CVD risk, it is known that around 21.3% are at high risk of developing CVD in the next 10 years. The results of the evaluation of semi-structured questions showed that about 48% of the people had positive impressions, 22% assessed that this self-screening could increase awareness and was informative, 3% suggested improvements to self-screening tools. CONCLUSION: Cadres play an important role in reaching and facilitating the community in their environment to remain aware of their health conditions by conducting self-screening of CVD risk. The availability of the mHealth application that the public can easily access can simplify CVD risk prediction and expand screening coverage, especially during the COVID-19 pandemic, where there are social restrictions policies and community activities.


Assuntos
COVID-19 , Doenças Cardiovasculares , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Agentes Comunitários de Saúde , Humanos , Pandemias , SARS-CoV-2
17.
J Am Coll Cardiol ; 78(1): 56-65, 2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-34210415

RESUMO

An increasing number of people are now living with cardiovascular disease (CVD), with concomitant CVD-related hospitalizations, operations, and prescriptions. To ultimately deliver optimal cardiovascular care, access to population-based biobanks with data on multiomics, phenotypes, and lifestyle risk factors are crucial. UK Biobank is a cohort study that incorporated data between 2006 and 2010 from over half a million individuals (40 to 69 years of age) at recruitment from across the United Kingdom. As one of the most accessible, largest, and in-depth cohort studies in the world, UK Biobank continues to enhance the resource with the addition of data from various omics platforms (eg, genomics, metabolomics, proteomics), multimodal imaging, self-reported risk factors and health outcomes, and linkage to electronic health records. The vision of UK Biobank is to allow as many researchers as possible to apply their expertise and imagination to undertake research to prevent, diagnose, and treat a wide range of chronic conditions, including CVD.


Assuntos
Bancos de Espécimes Biológicos/organização & administração , Doenças Cardiovasculares , Registros Eletrônicos de Saúde , Genômica , Proteômica , Informática em Saúde Pública , Adulto , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/genética , Diagnóstico por Imagem , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Masculino , Pessoa de Meia-Idade , Reino Unido
18.
Am J Cardiol ; 152: 146-149, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34237610

RESUMO

The optimal screening strategy to prevent sudden cardiac death (SCD) in athletes remains unknown. Pre-participation screening with electrocardiogram (ECG) remains controversial. The utility and accuracy of limb-lead (LL) ECG alone in identifying cardiac abnormalities associated with SCD has not been studied. This study was a comparative secondary data analysis, comparing the interpretation accuracy of 4 physicians evaluating publicly available ECGs of the most common cardiac conditions associated with SCD in athletes. Each physician interpreted a total of 100 ECGs: 50 normal ECGs (25 LL and 25 standard 12L) and 50 abnormal ECGs (25 LL and 25 standard 12L). The agreement between LL ECGs and 12L ECGs was assessed by Cohen's kappa coefficient and the accuracy of identifying an abnormal ECG was compared across LL and 12L ECGs using a chi-squared test. Inter-rater reliability was assessed by estimating the Fleiss's kappa coefficient. The sensitivity of LL ECG and 12L ECG was identical at 86%. The specificity of LL ECG was 75% (95% CI = 65% to 83%) and 12L ECG was 82% (95% CI = 73% to 89%). Substantial agreement was seen between LL ECG and 12L ECG interpretation across all readers (k = 0.63; 95% CI = 0.49 to 0.77). Interpretation accuracy was 81% (95% CI = 74% to 86%) and 84% (95% CI 78% to 89%) using LL ECG and 12L ECG, respectively (p = 0.43). In conclusion, the accuracy, sensitivity, and specificity were high and comparable for both LL ECG and 12L ECG in identifying cardiovascular conditions associated with SCD. Agreement between LL ECG and 12L ECG was substantial.


Assuntos
Atletas , Doenças Cardiovasculares/diagnóstico , Morte Súbita Cardíaca/prevenção & controle , Eletrocardiografia/métodos , Displasia Arritmogênica Ventricular Direita/complicações , Displasia Arritmogênica Ventricular Direita/diagnóstico , Displasia Arritmogênica Ventricular Direita/fisiopatologia , Síndrome de Brugada/complicações , Síndrome de Brugada/diagnóstico , Síndrome de Brugada/fisiopatologia , Cardiomiopatia Dilatada/complicações , Cardiomiopatia Dilatada/diagnóstico , Cardiomiopatia Dilatada/fisiopatologia , Cardiomiopatia Hipertrófica/complicações , Cardiomiopatia Hipertrófica/diagnóstico , Cardiomiopatia Hipertrófica/fisiopatologia , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/fisiopatologia , Morte Súbita Cardíaca/etiologia , Humanos , Síndrome do QT Longo/complicações , Síndrome do QT Longo/diagnóstico , Síndrome do QT Longo/fisiopatologia , Programas de Rastreamento , Miocardite/complicações , Miocardite/diagnóstico , Miocardite/fisiopatologia , Síndrome de Wolff-Parkinson-White/complicações , Síndrome de Wolff-Parkinson-White/diagnóstico , Síndrome de Wolff-Parkinson-White/fisiopatologia
19.
Atherosclerosis ; 331: 20-27, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34303265

RESUMO

BACKGROUND AND AIMS: Trials of the fully human monoclonal antibody proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9) alirocumab in hypercholesterolemia demonstrated substantial low-density lipoprotein cholesterol (LDL-C) lowering, reduction in cardiovascular (CV) events and outcomes, and a generally acceptable safety and tolerability profile. The impact of maintaining low LDL-C levels on higher order brain function is unclear, with reports of neurocognitive disorders with other lipid-lowering therapies. METHODS: Patients (n = 2176) with heterozygous familial hypercholesterolemia (HeFH) or non-FH, at high or very-high CV risk despite maximally tolerated statin therapy, randomly received subcutaneous alirocumab 75/150 mg or placebo every 2 weeks in this double-blind, placebo-controlled trial. The primary outcome was prospectively evaluated every 24 weeks over 96 weeks by Cambridge Neuropsychological Test Automated Battery (CANTAB). RESULTS: Among 2086 patients with CANTAB cognitive domain Spatial Working Memory Strategy (SWMS) assessments, change from baseline to Week 96 in SWMS z-score (primary outcome) achieved noninferiority between alirocumab and placebo (least squares [LS] mean change at Week 96, -0.180 vs -0.200; LS mean difference vs placebo [95% confidence interval]: -0.020 [-0.094 to 0.055], p = 0.6055). Exploratory outcome measures, which further assessed neurocognitive function in the CANTAB domains, did not differ significantly over 96 weeks and achieved nominal noninferiority between treatment groups. Alirocumab resulted in nominally significant reductions in LDL-C and other lipid parameters, and was generally well tolerated. CONCLUSIONS: Confirming previous PCSK9 inhibitor data, alirocumab showed no effect on neurocognitive function over 96 weeks' treatment, substantially reduced LDL-C and was generally well tolerated in patients with HeFH or non-FH at high or very-high CV risk.


Assuntos
Anticolesterolemiantes , Doenças Cardiovasculares , Anticorpos Monoclonais Humanizados , Anticolesterolemiantes/efeitos adversos , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/prevenção & controle , Método Duplo-Cego , Fatores de Risco de Doenças Cardíacas , Humanos , Testes Neuropsicológicos , Pró-Proteína Convertase 9 , Estudos Prospectivos , Fatores de Risco , Resultado do Tratamento
20.
Curr Opin Ophthalmol ; 32(5): 439-444, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34231533

RESUMO

PURPOSE OF REVIEW: Systemic retinal biomarkers are biomarkers identified in the retina and related to evaluation and management of systemic disease. This review summarizes the background, categories and key findings from this body of research as well as potential applications to clinical care. RECENT FINDINGS: Potential systemic retinal biomarkers for cardiovascular disease, kidney disease and neurodegenerative disease were identified using regression analysis as well as more sophisticated image processing techniques. Deep learning techniques were used in a number of studies predicting diseases including anaemia and chronic kidney disease. A virtual coronary artery calcium score performed well against other competing traditional models of event prediction. SUMMARY: Systemic retinal biomarker research has progressed rapidly using regression studies with clearly identified biomarkers such as retinal microvascular patterns, as well as using deep learning models. Future systemic retinal biomarker research may be able to boost performance using larger data sets, the addition of meta-data and higher resolution image inputs.


Assuntos
Biomarcadores , Doenças Cardiovasculares/diagnóstico por imagem , Nefropatias/diagnóstico por imagem , Doenças Neurodegenerativas/diagnóstico por imagem , Retina/diagnóstico por imagem , Anemia/diagnóstico , Anemia/diagnóstico por imagem , Doenças Cardiovasculares/diagnóstico , Humanos , Processamento de Imagem Assistida por Computador , Nefropatias/diagnóstico , Doenças Neurodegenerativas/diagnóstico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...