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1.
Angiology ; 71(2): 139-149, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31694385

RESUMO

The relative superiority of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) on long-term clinical outcomes in patients with non-ST-segment elevation myocardial infarction (NSTEMI) with preserved left ventricular systolic function in the era of new generation drug-eluting stents is not well established. A total of 6436 patients with NSTEMI (ACEIs group: n = 3965 vs ARBs group: n = 2471) were enrolled. The major clinical end point was the occurrences of major adverse cardiac events (MACEs), defined as all-cause death, recurrent myocardial infarction (re-MI), and any repeat revascularization. After propensity score matching analysis, the cumulative incidences of MACEs (hazard ratio, 1.334; 95% confidence interval, 1.045-1.703; P = .021), any repeat revascularization, and target vessel revascularization (TVR) in the ARB group were significantly higher than that in the ACEI group. However, the cumulative incidences of all-cause death, cardiac death, re-MI, target lesion revascularization, and non-TVR were similar between the 2 groups. Hence, although the mortality and re-MI reduction benefits were similar between the 2 groups, the ACEIs group showed more prominent ability to decrease the occurrences of MACEs, any repeat revascularization, and TVR compared to the ARBs group in these patients during a 2-year follow-up period.


Assuntos
Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Stents Farmacológicos , Infarto do Miocárdio sem Supradesnível do Segmento ST/cirurgia , Intervenção Coronária Percutânea , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sístole/fisiologia , Função Ventricular Esquerda/fisiologia
2.
Medicine (Baltimore) ; 98(50): e18100, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852069

RESUMO

INTRODUCTION: Pulse wave analysis is an emerging approach that analyzes parameters comprising strong predictors of cardiovascular (CV) events and all-cause mortality, especially in patients with high CV risk based on established risk factors. This study used the oscillometric method, provided by the Mobil-o-Graph (PWA-EMI GmbH, Stolberg, Germany) device, to compare data regarding the pulse wave analysis parameters in hypertensive nondiabetic and diabetic patients. MATERIAL AND METHODS: In this cross-sectional study, 276 individuals were examined in the academic hypertension outpatient care unit of the Federal University of the Triângulo, in Mineiro, Brazil, from January to December 2016. The pulse wave analysis was performed by oscillometry, and its parameters were acquired from all patients. RESULTS: Of the 276 patients, 99 were diabetic and 177 nondiabetic. The mean systolic and pulse central blood pressure were significantly higher in diabetic patients than in nondiabetic patients (P = .008 and.0003, respectively). The mean peripheral systolic blood pressure and pulse pressure were also significantly higher in the diabetic group (P = .001 and P < .0001, respectively). The average pulse wave velocity (PWV, m/s) was 9.4 ±â€Š1.6 and 8.8 ±â€Š1.6 in the diabetic and nondiabetic groups, respectively (P = .003). CONCLUSION: The group of hypertensive diabetic patients had significantly higher central blood pressure, peripheral blood pressure, and PWV than the hypertensive nondiabetic patients. The patients with overlapping established CV risk factors presented values of the pulse wave analysis parameters consistent with higher central pressure and greater arterial stiffness.


Assuntos
Assistência Ambulatorial , Pressão Sanguínea/fisiologia , Diabetes Mellitus/fisiopatologia , Hipertensão/fisiopatologia , Oscilometria/métodos , Análise de Onda de Pulso/métodos , Rigidez Vascular/fisiologia , Brasil/epidemiologia , Estudos Transversais , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores de Risco , Sístole
3.
Rev. salud pública Parag ; 9(2): [P57-P63], Dic 2019.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1047096

RESUMO

Introducción: La dilatación de la aurícula izquierda (AI) se considera un marcador ecocardiográfico para la remodelación auricular y la fibrilación auricular. Por ende, hemos investigado la correlación entre la dilatación de la AI con las alteraciones hemodinámicas del ventrículo izquierdo en pacientes con hipertensión arterial. Metodología: En este estudio observacional y prospectivo hemos investigado las variaciones electrocardiográficas, mediciones ecocardiográficas y Holter ECG de 24 hs en pacientes hipertensos que acuden a un hospital terciario desde marzo a septiembre del 2018 en forma ambulatoria y a internados en el Hospital de Clínicas. Resultados: Se estudiaron 104 pacientes, 65 hipertensos conocidos y 39 no hipertensos como grupo control. El diámetro de la AI tuvo una media de 37±8 en pacientes hipertensos, mientras que en pacientes no hipertensos la media fue de 34±5 (p=0,03). Se encontró una asociación significativa entre hipertensión y aumento del diámetro de la AI (p=0,04 OR: 2,6 IC 0,88-7,7). En los pacientes hipertensos se observó una asociación significativa entre la aurícula izquierda dilatada y la fracción de eyección disminuida (p= 0,01 OR: 4,66 IC: 1,28-16,98). Además, una asociación significativa entre la AI dilatada y el diámetro diastólico aumentado del ventrículo izquierdo (VI) (p= 0,0004 OR: 8,75 IC 2,18-35,01). Se observó una asociación significativa entre la presencia de una AI dilatada y el diámetro sistólico del VI aumentado en hipertensos (p= 0,006 OR: 5,74 IC 1,5-21,91). Conclusiones: Hubo una relación significativa entre la hipertensión arterial y la dilatación de la aurícula izquierda. Los pacientes hipertensos con una dilatación de la AI tuvieron un aumento significativo de los diámetros sistólicos y diastólicos del ventrículo izquierdo, así como una disminución significativa de la funcionalidad sistólica del ventrículo izquierdo. Por ende, los pacientes hipertensos que tienen una dilatación de la aurícula izquierda presentaron además alteraciones hemodinámicas asociadas del ventrículo izquierdo. Palabras clave: Dilatación de la aurícula izquierda; Hipertensión arterial; Fracción de eyección del VI. Diámetro sistólico y diastólico del VI.


Introduction: Dilation of the left atrium (LA) is considered an echocardiographic marker for atrial remodeling and atrial fibrillation. Therefore, we have investigated the correlation between dilatation of the IA with hemodynamic alterations of the left ventricle in patients with arterial hypertension. Methodology: In this observational and prospective study we have investigated electrocardiographic variations, echocardiographic measurements and Holter ECG of 24 hours in hypertensive patients who attend a tertiary hospital from March 2018 to September 2018 as outpatients and inpatients. Results: 104 patients were studied, 65 known hypertensive patients and, 39 non-hypertensive as control group. The diameter of the AI had a mean of 37 ± 8 in hypertensive patients, while in non-hypertensive patients the mean was 34 ± 5 (p = 0.03). A significant association was found between hypertension and increased diameter of the LA (p = 0.04 OR: 2.6 CI 0.88-7.7). In hypertensive patients, a significant association was observed between the dilated left atrium and the decreased ejection fraction (p = 0.01 OR: 4.66 CI: 1.28-16.98). In addition, a significant association between dilated LA and the increased diastolic diameter of the LV (p = 0.0004 OR: 8.75 IC 2.18-35.01). A significant association was observed between the presence of dilated IA and the left ventricular systolic diameter increased in hypertensive patients (p = 0.006 OR: 5.74 CI 1.5-21.91). Conclusion: There was a significant relationship between arterial hypertension and dilatation of the left atrium. Hypertensive patients with dilatation of the IA had a significant increase in systolic and diastolic diameters of the left ventricle, as well as a significant decrease in systolic functionality of the left ventricle. Therefore, hypertensive patients who have dilation of the left atrium also had associated hemodynamic alterations of the left ventricle. Key words: Dilation of the left atrium; Arterial hypertension; LV ejection fraction. Systolic and diastolicdiameter of the LV.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Volume Sistólico/fisiologia , Dilatação Patológica , Ventrículos do Coração/patologia , Sístole , Diástole , Hipertensão
5.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(4): 466-470, 2019 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-31642220

RESUMO

OBJECTIVE: To detect cardiac amyloidosis (CA) using cardiac magnetic resonance feature tracking(CMR-FT). METHODS: Forty-three CA patients and 24 healthy volunteers underwent steady-state free precession cine sequence on 3.0T MRI after injection of Magnevist. Software cvi 42 was used for analyzing the left ventricular function including left ventricular mass (diastole) (LVMD), left ventricular mass (systole) (LVMS), left ventricle end-diastolic volume (LVEDV), left ventricle end-systolic volume (LVESV), left ventricle stroke volume (LVSV), and left ventricular ejection fraction (LVEF), as well as myocardial strains including 3D global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS), and 2D endocardial and epicardial longitudinal strain, circumferential strain, and radial strain (ENDO-LS, EPI-LS, ENDO-CS, EPI-CS, ENDO-RS, and EPI-RS). The global and layer-specific strains were compared between the CA patients with LVEF >50%, the CA patients with LVEF ≤50%, and the healthy controls. RESULTS: For the left ventricular function, the CA patients had greater myocardial mass than the healthy controls (P < 0.05); the CA patients with LVEF ≤50% had greater LVESV and lower LVSV than those with LVEF >50% (P < 0.05). For the global strains, significant differences also appeared in GLS and GCS among the three groups (all P < 0.05). The CA patients had lower GRS than the healthy controls (P < 0.05), while no significant difference was found in GRS between the CA patients with LVEF >50% and those with LVEF ≤50% (P>0.05). For the layer-specific strains, significant differences in ENDO-LS, EPI-LS, ENDO-CS, EPI-CS, ENDO-RS, and EPI-RS were found among the three groups (all P < 0.05). There were significant correlations between GLS and LVEF (r=-0.404, P=0.016), and between GCS and LVEF (r=-0.602, P < 0.001) in the CA patients. CONCLUSION: CMR-FT can assess not only global strains but also layer-specific strains for the myocardial function of CA patients.


Assuntos
Amiloidose/diagnóstico por imagem , Cardiopatias/diagnóstico por imagem , Imagem por Ressonância Magnética , Função Ventricular Esquerda , Estudos de Casos e Controles , Humanos , Reprodutibilidade dos Testes , Volume Sistólico , Sístole
6.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(4): 478-482, 2019 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-31642222

RESUMO

OBJECTIVE: To determine the potential value of the two-dimensional (2D) cardiac magnetic resonance imaging (CMR) tissue tracking (CMR-TT) method in assessing the cardiac function of tree shrew at 7T. METHODS: Healthy adult tree shrews (male, n=8) and spraguedawley rats(male, n=8) were selected for this study. CMR was performed to acquire the short-axis images of left ventricle at 7T using the same appropriative coil and cine sequence for all experimental animals. The CMR images were processed using the professional cardiac analysis software, calculating ejection fraction (EF), radial peak sysolic strain (Err), circumferential peak sysolic strain (Ecc), radial peak sysolic displacement (DR), and LVM/BM 〔the ratio of left ventricular mass (LVM) to body mass (BM)〕. RESULTS: Cine imaging for the tree shrews was 100% successful following the CMR protocol for the rats, with clearly visible main segments of cardiac. Significant differences in EF, Err, Ecc and DR were found between the two groups of animals (P < 0.01). The tree shrews has lower EF, Err and Ecc than the rats. Err and Ecc appeared in the fifteenth phase in left ventriclar systole in the tree shrews, compared with the tenth phase in the rats.The tree shrews also had higher LVM/BM than the rats. CONCLUSION: The cardiac function of tree shrew can be assessed using the 2D CMR-TT method despite significant differences across species.


Assuntos
Coração/diagnóstico por imagem , Imagem Cinética por Ressonância Magnética , Tupaiidae , Função Ventricular Esquerda , Animais , Imagem por Ressonância Magnética , Masculino , Ratos , Ratos Sprague-Dawley , Reprodutibilidade dos Testes , Volume Sistólico , Sístole
8.
11.
J Cardiothorac Surg ; 14(1): 168, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533759

RESUMO

OBJECTIVE: To identify the predictor factors of left ventricular (LV) dysfunction following patent ductus arteriosus (PDA) surgical ligation. BACKGROUND: PDA is viewed as a noticeable amongst the most widely recognized congenital heart defects in children and its closure is responsible for many hemodynamic changes that require intervention and care. METHODS: A retrospective study included fifty children with isolated PDA treated by surgical ligation from June 2015 to June 2018. The LV dimensions and systolic function were assessed by two-dimensional echocardiography pre and post PDA ligation. All cases were followed-up on the first-day, 1 month and 6 months post ligation. RESULTS: The mean age of cases was 15.78 ± 7.58 months and 72% were females. The mean duct size was 4.08 ± 1.25 mm. There was a marked decrease in LVEDd, LA/Ao, EF and FS in the first-day post ligation contrasted with pre ligation values. Moreover, an amazing decline in LVEDd and LA/Ao ratio was observed 1 month post ligation contrasted with the early post ligation status with asynchronous improvement of FS and EF at one and 6 months postoperatively. CONCLUSION: PDA ligation is associated with a noteworthy LV systolic dysfunction within the first day post ligation; that in a significant number of patients may require anti-failure measures, prolong the hospital stay and necessitate a regular follow up and monitoring of LV function. PDA size, age, preoperative LVEDd and FS can be considered as predictor factors for suspicion of acute decrease in the LV systolic function early post PDA ligation. TRIAL REGISTRATION: ClinTrial.Gov NCT04018079 .


Assuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Permeabilidade do Canal Arterial/cirurgia , Medição de Risco/métodos , Disfunção Ventricular Esquerda/etiologia , Pré-Escolar , Ecocardiografia , Feminino , Hemodinâmica , Humanos , Lactente , Masculino , Valor Preditivo dos Testes , Estudos Retrospectivos , Sístole , Disfunção Ventricular Esquerda/fisiopatologia , Função Ventricular Esquerda
12.
Int J Mol Sci ; 20(18)2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31514290

RESUMO

In salt-sensitive hypertension, reactive oxygen species (ROS) play a major role in the progression of renal disease partly through the activation of the mineralocorticoid receptor (MR). We have previously demonstrated that urinary vanin-1 is an early biomarker of oxidative renal tubular injury. However, it remains unknown whether urinary vanin-1 might reflect the treatment effect. The objective of this study was to clarify the treatment effect for renal tubular damage in Dahl salt-sensitive (DS) rats. DS rats (six weeks old) were given one of the following for four weeks: high-salt diet (8% NaCl), high-salt diet plus a superoxide dismutase mimetic, tempol (3 mmol/L in drinking water), high-salt diet plus eplerenone (100 mg/kg/day), and normal-salt diet (0.3% NaCl). After four-week treatment, blood pressure was measured and kidney tissues were evaluated. ROS were assessed by measurements of malondialdehyde and by immunostaining for 4-hydroxy-2-nonenal. A high-salt intake for four weeks caused ROS and histological renal tubular damages in DS rats, both of which were suppressed by tempol and eplerenone. Proteinuria and urinary N-acetyl-ß-D-glucosaminidase exhibited a significant decrease in DS rats receiving a high-salt diet plus eplerenone, but not tempol. In contrast, urinary vanin-1 significantly decreased in DS rats receiving a high-salt diet plus eplerenone as well as tempol. Consistent with these findings, immunohistochemical analysis revealed that vanin-1 was localized in the renal proximal tubules but not the glomeruli in DS rats receiving a high-salt diet, with the strength attenuated by tempol or eplerenone treatment. In conclusion, these results suggest that urinary vanin-1 is a potentially sensitive biomarker for ameliorating renal tubular damage in salt-sensitive hypertension.


Assuntos
Amidoidrolases/metabolismo , Túbulos Renais/patologia , Estresse Oxidativo , Amidoidrolases/urina , Animais , Biomarcadores/sangue , Biomarcadores/urina , Pressão Sanguínea/efeitos dos fármacos , Óxidos N-Cíclicos/farmacologia , Eplerenona/farmacologia , Túbulos Renais/efeitos dos fármacos , Túbulos Renais/fisiopatologia , Masculino , Estresse Oxidativo/efeitos dos fármacos , Ratos Endogâmicos Dahl , Marcadores de Spin , Sístole/efeitos dos fármacos
13.
Wiad Lek ; 72(7): 1281-1287, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31398156

RESUMO

OBJECTIVE: Introduction: Speed myocardial indicators and estimation of galectin-3 presented for estimation of myocardial dysfunction in children with congenital heart defects (CHD). The aim: Evaluate myocardial function while using tissue Doppler imaging (TDI) and galectin-3 in children with CHD after surgical correction. PATIENTS AND METHODS: Materials and methods: We examined 184 children. The study assessed both ventricle systolic and diastolic performance by TDI in combination with tricuspid annular plane systolic excursion (TAPSE). Additionally, systolic (S') and diastolic (ratio E/E') TDI measurements were obtained at the lateral part of mitral annular, interventricular part, and lateral part of tricuspid valve (S`ma lateral, S` ma septal, S`ta lateral та E/E' malateral, E/E' maseptal, E/E' talateral). Galectin-3 amount in serum was detected by immune enzyme method by kit «HumanGalectin-3¼. RESULTS: Results: Compared to results of the healthy children systolic TDI measurements in patients with CHD were significantly lower: S` ma lateral 7,81±0,10 сm/s vs 9,85±0,28 сm/s, S` ta lateral 9,70±0,12 сm/s vs 12,8±0,17 сm/s and TAPSE, 1,48±0,02 vs 2,14±0,03 сm/s (р<0,01). Ratio E/E' in patients with CHD were different from results of the healthy children in all myocardial segments: E/Е` ma lateral 7,45±0,21 vs 6,17±0,12, E/Е` ma septal 9,17±0,22 vs 7,54±0,13, E/Е` ta lateral 6,42 ± 0,14 vs 4,64±0,12, (р<0,05). Patients with CHD got galectin-3 content in serum 7,04±0,21 ng/ml vs 4,17±0,17 ng/ml (р<0,01) results of the healthy children. CONCLUSION: Conclusions: Analyze of TDI measurements and galectin-3 content allows evaluate myocardial dysfunction in asymptomatic patients with CHD after surgical correction.


Assuntos
Galectina 3/metabolismo , Cardiopatias Congênitas , Biomarcadores , Criança , Fibrose , Humanos , Sístole
14.
Blood Press Monit ; 24(5): 259-263, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31425157

RESUMO

OBJECTIVE: The arm with the higher blood pressure (BP) is assigned as the follow up arm for hypertensive patients (reference-arm). We evaluated the reproducibility of this assignment. METHODS: BP was measured simultaneously on both arms with a double cuff validated device in two visits separated <10 days (two sets of three readings per visit). Two reference-arms were assigned in each visit (the arm with higher BP, at least ≥1 mmHg). The intravisit and intervisit agreements of this assignment were evaluated. RESULTS: We included 313 hypertensive patients. First visit mean right arm BP was 131.6 (16.6)/75.3 (9.4) mmHg and left arm BP was 132.4 (16.9)/75.7 (9.7) mmHg (P = 0.002). Intravisit concordance at the first and second visits were κ = 0.60 [95% confidence interval (CI), 0.516-0.696] and κ = 0.45 [95% CI, 0.356-0.555], respectively. Therefore, 21.8% of patients (at the first visit) and 29.1% (at the second visit) with the right arm as the reference-arm in the first round of readings changed to the left arm in the same visit in the second round of readings. The intervisit κ index was 0.25 [95% CI, 0.147-0.365]. After that, 36.8% of patients with the right arm as the reference-arm at the first visit changed to the left arm at the second visit. The subgroup (9.5%) with an interarm systolic BP difference ≥10 mmHg at the first visit did not differ significantly from the rest of patients. CONCLUSION: The reference-arm assignment agreement is weak to moderate. The assignment of the reference-arm should be individualized and not considered as definitive.


Assuntos
Determinação da Pressão Arterial/métodos , Determinação da Pressão Arterial/normas , Pressão Sanguínea , Hipertensão/fisiopatologia , Idoso , Braço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto/normas , Padrões de Referência , Reprodutibilidade dos Testes , Sístole
15.
Expert Rev Med Devices ; 16(9): 829-834, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31432698

RESUMO

Background: After encouraging results with the Edwards Sapien and XT valves, this study aimed to review procedural data and early outcomes for the Sapien 3 valves for transcatheter pulmonary valve replacement (TPVR). Methods: We performed a multicenter, retrospective analysis of cases who underwent a Sapien 3 TPVR between 2015 and 2017 in 7 centers in Germany with a follow-up of up to 2 years. Results: 56 patients could be enrolled (weight 58,5 ± 25,0 kg; 53% Tetralogy of Fallot, 45% native RVOT). Most procedures were two-stage procedures (82,1%) with 100% prestenting. Valve sizes were 20 mm (n = 1), 23 mm (n = 15), 26 mm (n = 27), 29 mm (n = 13). Procedural success rate was 96.4%. Two patients underwent surgical valve implantation after balloon rupture during TPVR. Follow-up data were available up to 24-month post TPVR. The rate of patients with ? moderate and severe pulmonary regurgitation decreased to 0% after TPVR, peak systolic gradient decreased from 24,2 (SD±20,9) mmHg to 7,1 mmHg (SD±5,0). There were no endocarditis, severe tricuspid valve impairment or stent fractures. Conclusions: With the Edwards Sapien 3 valve, the patient pool for TPVR can be substantially extended. Continued data collection is necessary to verify long-term results.


Assuntos
Cateterismo Cardíaco , Implante de Prótese de Valva Cardíaca , Valva Pulmonar/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Seguimentos , Alemanha , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Valva Pulmonar/fisiopatologia , Estudos Retrospectivos , Sístole , Resultado do Tratamento , Adulto Jovem
16.
Braz J Cardiovasc Surg ; 34(4): 451-457, 2019 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-31454199

RESUMO

OBJECTIVE: To evaluate the aortic wall elasticity using the maximal rate of systolic distension (MRSD) and maximal rate of diastolic recoil (MRDR) and their correlation with the aortic size index (ASI). METHODS: Forty-eight patients with thoracic aortic aneurysm were enrolled in this study. A standard magnetic resonance imaging (MRI) protocol was used to calculate MRSD and MRDR. Both MRSD and MRDR were expressed as percentile of maximal area/10-3 sec. ASI (maximal aortic diameter/body surface area) was calculated. A correlation between MRSD, MRDR, ASI, and the patient's age was performed using regression plot. RESULTS: A significant correlation between MRSD (t=-4,36; r2=0.29; P≤0.0001), MRDR (t=3.92; r2=0.25; P=0.0003), and ASI (25±4.33 mm/m2; range 15,48-35,14 mm/m2) is observed. As ASI increases, aortic MRSD and MRDR decrease. Such inverse correlation between MRSD, MRDR, and ASI indicates increased stiffness of the ascending aorta. A significant correlation between the patient's age and the decrease in MRSD and MRDR is observed. CONCLUSION: MRSD and MRDR are significantly correlated with ASI and the patient's age. They seem to describe properly the increasing stiffness of aortas. These two new indexes provide a promising, accessible, and reproducible approach to evaluate the biomechanical property of the aorta.


Assuntos
Aneurisma Dissecante/diagnóstico por imagem , Aorta/fisiopatologia , Aneurisma da Aorta Torácica/diagnóstico por imagem , Imagem por Ressonância Magnética , Adulto , Idoso , Diástole/fisiologia , Dilatação Patológica , Elasticidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sístole/fisiologia
17.
Hypertension ; 74(4): 880-887, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31422691

RESUMO

Recent data suggest that visit-to-visit variability of blood pressure (BP) is associated with cardiovascular events. We evaluated the role of BP variability as a determinant of end-stage renal disease (ESRD). Using nationally representative data from the Korean National Health Insurance System, 8 199 089 subjects had been enrolled during 2009 to 2010 who were free of ESRD and underwent ≥3 health examinations during 2005 to 2010 were followed to the end of 2017. BP variability was measured using the coefficient of variation, SD, and variability independent of the mean. The primary outcome was the development of ESRD, defined as a combination of the relevant disease code and the initiation of renal replacement therapy. The χ2 test, t test, and log-rank test were used in the statistical analysis. There were 16 567 cases of ESRD during a median follow-up of 7.89±0.88 years. The highest quartile of systolic or diastolic BP showed a higher incident rate of ESRD compared with the other 3 quartiles. It was augmented in patients with the highest quartile of both systolic and diastolic BP variabilities. Among patients with the highest quartile of systolic and diastolic BP variabilities, the uncontrolled hypertension group (>140/90 mm Hg) taking antihypertensive medication showed the highest incidence rate of ESRD. These results were consistent when modeling variability of BP using coefficient of variation, SD, and variability independent of the mean and in various sensitivity analyses. Systolic and diastolic BP variabilities were independently associated with an increased incidence of ESRD, and it was augmented when both variabilities were present together.


Assuntos
Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/fisiologia , Hipertensão/fisiopatologia , Falência Renal Crônica/epidemiologia , Adulto , Determinação da Pressão Arterial , Diástole/fisiologia , Feminino , Taxa de Filtração Glomerular/fisiologia , Inquéritos Epidemiológicos , Humanos , Hipertensão/tratamento farmacológico , Incidência , Falência Renal Crônica/fisiopatologia , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Risco , Sístole/fisiologia
18.
Eur J Pharmacol ; 860: 172585, 2019 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-31376367

RESUMO

We previously reported that neonatal blockade of angiotensin II AT1 receptor prevents cardiac changes in 4 weeks rats with neonatal hyperoxia-induced cardiomyopathy, a recognized model of prematurity-related deleterious conditions. Considering the importance of AT1 receptor and the renin angiotensin system (RAS) in normal development, the present study aimed to investigate the adult effects of neonatal AT1 blockade on left ventricle (LV) in rats exposed to neonatal hyperoxia. Sprague-Dawley pups were exposed to 80% O2 or room air from days 3-10. AT1 blocker (losartan) or H2O were given by gavage from day 8-10. LV function (echo and intraventricular pressure), histology and expression of RAS components were examined in 15-16 weeks old adult males. Losartan treatment prevented myocardial fibrosis, LV wall thickening and stroke volume reduction in rats exposed to high O2 in the neonatal period. However, Losartan treatment of O2-exposed pups led to reduced ejection fraction (EF) and fractional shortening (FS), and did not prevent changes in diastolic function. Losartan also did not prevent increased LV AT2 and decreased angiotensin-(1-7) Mas receptors expression observed in high O2-exposed rats. Neonatal Losartan attenuated long-term impact of neonatal hyperoxia but also led to decreased EF and FS. Increased AT2 and decreased Mas receptor expression observed in O2-exposed group were unaffected by Losartan treatment. Our results show that early life Losartan treatment aimed at preventing cardiac consequences of neonatal deleterious conditions may also comprise detrimental effects that require further investigation prior to clinical translation in developing children.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacologia , Cardiomiopatias/patologia , Cardiomiopatias/fisiopatologia , Coração/efeitos dos fármacos , Oxigênio/efeitos adversos , Receptor Tipo 1 de Angiotensina/metabolismo , Sistema Renina-Angiotensina/efeitos dos fármacos , Animais , Animais Recém-Nascidos , Biomarcadores/metabolismo , Cardiomiopatias/induzido quimicamente , Cardiomiopatias/metabolismo , Diástole/efeitos dos fármacos , Modelos Animais de Doenças , Fibrose , Coração/fisiopatologia , Ventrículos do Coração/efeitos dos fármacos , Ventrículos do Coração/metabolismo , Losartan/farmacologia , Miocárdio/patologia , Ratos , Ratos Sprague-Dawley , Sístole/efeitos dos fármacos , Fatores de Tempo
19.
Res Vet Sci ; 126: 103-112, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31445396

RESUMO

Sepsis is associated with clinically relevant cardiovascular changes. The objectives of this study were to evaluate the clinical value of echocardiography for monitoring left ventricular (LV) systolic function in septic calves. A prospective longitudinal study was performed using a convenience sample. Twenty septic calves and 10 healthy calves were enrolled in the study. Arterial blood pressure (BP) was measured and M-mode echocardiography performed to characterize LV systolic function; the latter included measurement of ejection fraction, EF; stroke volume, SVI and cardiac output indexed to body weight, CI; E-point of septal separation, EPSS; pre-ejection period, PEP; ejection time, LVET; ratio of PEP to LVET; velocity of circumferential shortening, Vcf, LV end-diastolic volume index (LVEDVI) and LV end-systolic volume index (LVESVI) on admission and 6, 24, 48 and 72 h later in septic calves and once in healthy calves. Admission data were compared using the Mann-Whitney U test and P < .05 was considered significant. Decreased preload and afterload were present in septic calves, as indicated by marked decreases in BP, LVEDVI, LVESVI, SVI, CI, EPSS when compared to healthy calves. Systolic function appeared adequate in septic calves, based on EF and FS compared to control calves. There was no difference in heart rate, LVET, PEP:LVET, or Vcf between septic and health calves. We conclude that circulatory dysfunction, rather than systolic dysfunction predominates in septic calves. Positive associations on admission between CI and LVEDVI, LVESVI, and SVI support this conclusion. Echocardiographic determination of LVEDVI and CI appears useful in directing treatment in septic calves.


Assuntos
Doenças dos Bovinos/patologia , Diarreia/veterinária , Ecocardiografia/veterinária , Choque Séptico/veterinária , Disfunção Ventricular Esquerda/veterinária , Função Ventricular Esquerda , Animais , Animais Recém-Nascidos , Bovinos , Diarreia/complicações , Feminino , Frequência Cardíaca , Estudos Longitudinais , Masculino , Estudos Prospectivos , Choque Séptico/complicações , Volume Sistólico , Sístole , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/patologia
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