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1.
Microcirculation ; 21(2): 131-47, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25279425

RESUMO

OBJECTIVE: To provide insight into mitochondrial function in vivo, we evaluated the 3D spatial relationship between capillaries, mitochondria, and muscle fibers in live mice. METHODS: 3D volumes of in vivo murine TA muscles were imaged by MPM. Muscle fiber type, mitochondrial distribution, number of capillaries, and capillary-to-fiber contact were assessed. The role of Mb-facilitated diffusion was examined in Mb KO mice. Distribution of GLUT4 was also evaluated in the context of the capillary and mitochondrial network. RESULTS: MPM revealed that 43.6 ± 3.3% of oxidative fiber capillaries had ≥50% of their circumference embedded in a groove in the sarcolemma, in vivo. Embedded capillaries were tightly associated with dense mitochondrial populations lateral to capillary grooves and nearly absent below the groove. Mitochondrial distribution, number of embedded capillaries, and capillary-to-fiber contact were proportional to fiber oxidative capacity and unaffected by Mb KO. GLUT4 did not preferentially localize to embedded capillaries. CONCLUSIONS: Embedding capillaries in the sarcolemma may provide a regulatory mechanism to optimize delivery of oxygen to heterogeneous groups of muscle fibers. We hypothesize that mitochondria locate to PV regions due to myofibril voids created by embedded capillaries, not to enhance the delivery of oxygen to the mitochondria.


Assuntos
Capilares/metabolismo , Mitocôndrias Musculares/metabolismo , Fibras Musculares Esqueléticas/metabolismo , Oxigênio/metabolismo , Sarcolema/metabolismo , Animais , Transporte Biológico Ativo/fisiologia , Transportador de Glucose Tipo 4/metabolismo , Camundongos , Camundongos Knockout , Microscopia de Vídeo , Mitocôndrias Musculares/genética
2.
Biochemistry ; 52(16): 2793-809, 2013 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-23547908

RESUMO

Calcium is believed to regulate mitochondrial oxidative phosphorylation, thereby contributing to the maintenance of cellular energy homeostasis. Skeletal muscle, with an energy conversion dynamic range of up to 100-fold, is an extreme case for evaluating the cellular balance of ATP production and consumption. This study examined the role of Ca(2+) in the entire oxidative phosphorylation reaction network in isolated skeletal muscle mitochondria and attempted to extrapolate these results back to the muscle, in vivo. Kinetic analysis was conducted to evaluate the dose-response effect of Ca(2+) on the maximal velocity of oxidative phosphorylation (V(maxO)) and the ADP affinity. Force-flow analysis evaluated the interplay between energetic driving forces and flux to determine the conductance, or effective activity, of individual steps within oxidative phosphorylation. Measured driving forces [extramitochondrial phosphorylation potential (ΔG(ATP)), membrane potential, and redox states of NADH and cytochromes b(H), b(L), c(1), c, and a,a(3)] were compared with flux (oxygen consumption) at 37 °C; 840 nM Ca(2+) generated an ~2-fold increase in V(maxO) with no change in ADP affinity (~43 µM). Force-flow analysis revealed that Ca(2+) activation of V(maxO) was distributed throughout the oxidative phosphorylation reaction sequence. Specifically, Ca(2+) increased the conductance of Complex IV (2.3-fold), Complexes I and III (2.2-fold), ATP production/transport (2.4-fold), and fuel transport/dehydrogenases (1.7-fold). These data support the notion that Ca(2+) activates the entire muscle oxidative phosphorylation cascade, while extrapolation of these data to the exercising muscle predicts a significant role of Ca(2+) in maintaining cellular energy homeostasis.


Assuntos
Cálcio/metabolismo , Mitocôndrias Musculares/metabolismo , Fosforilação Oxidativa , Difosfato de Adenosina/metabolismo , Animais , Cálcio/farmacologia , Respiração Celular , Citocromos/metabolismo , Relação Dose-Resposta a Droga , Técnicas In Vitro , Cinética , Potencial da Membrana Mitocondrial , Músculo Esquelético/citologia , Músculo Esquelético/metabolismo , Fosforilação Oxidativa/efeitos dos fármacos , Suínos , Termodinâmica
3.
Anal Biochem ; 439(2): 161-72, 2013 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-23665273

RESUMO

Recent evidence suggests that the activity of mitochondrial oxidative phosphorylation complexes (MOPCs) is modulated at multiple sites. Here, a method of optically monitoring electron distribution within and between MOPCs is described using a center-mounted sample in an integrating sphere (to minimize scattering effects) with a rapid-scanning spectrometer. The redox-sensitive MOPC absorbances (∼465-630 nm) were modeled using linear least squares analysis with individual chromophore spectra. Classical mitochondrial activity transitions (e.g., ADP-induced increase in oxygen consumption) were used to characterize this approach. Most notable in these studies was the observation that intermediates of the catalytic cycle of cytochrome oxidase are dynamically modulated with metabolic state. The MOPC redox state, along with measurements of oxygen consumption and mitochondrial membrane potential, was used to evaluate the conductances of different sections of the electron transport chain. This analysis then was applied to mitochondria isolated from rabbit hearts subjected to ischemia/reperfusion (I/R). Surprisingly, I/R resulted in an inhibition of all measured MOPC conductances, suggesting a coordinated down-regulation of mitochondrial activity with this well-established cardiac perturbation.


Assuntos
Mitocôndrias/química , Óptica e Fotônica/métodos , Análise Espectral/métodos , Trifosfato de Adenosina/biossíntese , Animais , Carbono/metabolismo , Meios de Cultura , Metabolismo Energético , Coração/fisiologia , Mitocôndrias/metabolismo , Oxirredução , Consumo de Oxigênio , Perfusão , Coelhos , Traumatismo por Reperfusão , Reprodutibilidade dos Testes
4.
Am J Physiol Regul Integr Comp Physiol ; 302(9): R1034-48, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22378775

RESUMO

The concentration of mitochondrial oxidative phosphorylation complexes (MOPCs) is tuned to the maximum energy conversion requirements of a given tissue; however, whether the activity of MOPCs is altered in response to acute changes in energy conversion demand is unclear. We hypothesized that MOPCs activity is modulated by tissue metabolic stress to maintain the energy-metabolism homeostasis. Metabolic stress was defined as the observed energy conversion rate/maximum energy conversion rate. The maximum energy conversion rate was assumed to be proportional to the concentration of MOPCs, as determined with optical spectroscopy, gel electrophoresis, and mass spectrometry. The resting metabolic stress of the heart and liver across the range of resting metabolic rates within an allometric series (mouse, rabbit, and pig) was determined from MPOCs content and literature respiratory values. The metabolic stress of the liver was high and nearly constant across the allometric series due to the proportional increase in MOPCs content with resting metabolic rate. In contrast, the MOPCs content of the heart was essentially constant in the allometric series, resulting in an increasing metabolic stress with decreasing animal size. The MOPCs activity was determined in native gels, with an emphasis on Complex V. Extracted MOPCs enzyme activity was proportional to resting metabolic stress across tissues and species. Complex V activity was also shown to be acutely modulated by changes in metabolic stress in the heart, in vivo and in vitro. The modulation of extracted MOPCs activity suggests that persistent posttranslational modifications (PTMs) alter MOPCs activity both chronically and acutely, specifically in the heart. Protein phosphorylation of Complex V was correlated with activity inhibition under several conditions, suggesting that protein phosphorylation may contribute to activity modulation with energy metabolic stress. These data are consistent with the notion that metabolic stress modulates MOPCs activity in the heart.


Assuntos
Complexo de Proteínas da Cadeia de Transporte de Elétrons/metabolismo , Metabolismo Energético/fisiologia , Mitocôndrias Cardíacas/metabolismo , Mitocôndrias Hepáticas/metabolismo , Fatores Acopladores da Fosforilação Oxidativa/metabolismo , Estresse Oxidativo/fisiologia , Animais , Células Cultivadas , Homeostase/fisiologia , Camundongos , Especificidade de Órgãos/fisiologia , Fosforilação Oxidativa , Coelhos , Especificidade da Espécie , Suínos
5.
Anal Biochem ; 431(1): 30-9, 2012 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-22975200

RESUMO

Native gel electrophoresis allows the separation of very small amounts of protein complexes while retaining aspects of their activity. In-gel enzymatic assays are usually performed by using reaction-dependent deposition of chromophores or light-scattering precipitates quantified at fixed time points after gel removal and fixation, limiting the ability to analyze the enzyme reaction kinetics. Herein, we describe a custom reaction chamber with reaction medium recirculation and filtering and an imaging system that permits the continuous monitoring of in-gel enzymatic activity even in the presence of turbidity. Images were continuously collected using time-lapse high-resolution digital imaging, and processing routines were developed to obtain kinetic traces of the in-gel activities and analyze reaction time courses. This system also permitted the evaluation of enzymatic activity topology within the protein bands of the gel. This approach was used to analyze the reaction kinetics of two mitochondrial complexes in native gels. Complex IV kinetics showed a short initial linear phase in which catalytic rates could be calculated, whereas Complex V activity revealed a significant lag phase followed by two linear phases. The utility of monitoring the entire kinetic behavior of these reactions in native gels, as well as the general application of this approach, is discussed.


Assuntos
Complexo IV da Cadeia de Transporte de Elétrons/metabolismo , Eletroforese em Gel de Poliacrilamida , Mitocôndrias/metabolismo , ATPases Mitocondriais Próton-Translocadoras/metabolismo , Fosforilação Oxidativa , Trifosfato de Adenosina/metabolismo , Animais , Hidrólise , Cinética , Fotografação , Suínos , Fatores de Tempo
6.
J Microsc ; 246(3): 237-247, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22582797

RESUMO

When conducting optical imaging experiments, in vivo, the signal to noise ratio and effective spatial and temporal resolution is fundamentally limited by physiological motion of the tissue. A three-dimensional (3D) motion tracking scheme, using a multiphoton excitation microscope with a resonant galvanometer, (512 × 512 pixels at 33 frames s(-1)) is described to overcome physiological motion, in vivo. The use of commercially available graphical processing units permitted the rapid 3D cross-correlation of sequential volumes to detect displacements and adjust tissue position to track motions in near real-time. Motion phantom tests maintained micron resolution with displacement velocities of up to 200 µm min(-1), well within the drift observed in many biological tissues under physiologically relevant conditions. In vivo experiments on mouse skeletal muscle using the capillary vasculature with luminal dye as a displacement reference revealed an effective and robust method of tracking tissue motion to enable (1) signal averaging over time without compromising resolution, and (2) tracking of cellular regions during a physiological perturbation.


Assuntos
Imageamento Tridimensional/métodos , Locomoção , Microscopia de Fluorescência/métodos , Microscopia de Vídeo/métodos , Músculo Esquelético/fisiologia , Animais , Camundongos
7.
BMC Musculoskelet Disord ; 12: 199, 2011 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-21910917

RESUMO

BACKGROUND: Maximal isometric quadriceps strength deficits have been widely reported in studies of knee osteoarthritis (OA), however little is known about the effect of osteoarthritis knee pain on submaximal quadriceps neuromuscular function. The purpose of this study was to measure vastus medialis motor unit (MU) properties in participants with knee OA, during submaximal isometric contractions. METHODS: Vastus medialis motor unit potential (MUP) parameters were assessed in 8 patients with knee OA and 8 healthy, sex and age-matched controls during submaximal isometric contractions (20% of maximum isometric torque). Unpaired t-tests were used to compare groups for demographic and muscle parameters. RESULTS: Maximum knee extension torque was ~22% lower in the OA group, a difference that was not statistically significantly (p = 0.11). During submaximal contractions, size related parameters of the needle MUPs (e.g. negative peak duration and amplitude-to-area ratio) were greater in the OA group (p < 0.05), with a rightward shift in the frequency distribution of surface MUP negative peak amplitude. MUP firing rates were significantly lower in the OA group (p < 0.05). CONCLUSIONS: Changes in MU recruitment and rate coding strategies in OA may reflect a chronic reinnervation process or a compensatory strategy in the presence of chronic knee pain associated with OA.


Assuntos
Contração Isométrica/fisiologia , Osteoartrite do Joelho/fisiopatologia , Músculo Quadríceps/fisiopatologia , Recrutamento Neurofisiológico/fisiologia , Potenciais de Ação/fisiologia , Eletromiografia , Feminino , Humanos , Articulação do Joelho/inervação , Articulação do Joelho/fisiopatologia , Masculino , Pessoa de Meia-Idade , Neurônios Motores/patologia , Neurônios Motores/fisiologia , Condução Nervosa/fisiologia , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/patologia , Dor/etiologia , Dor/fisiopatologia , Amplitude de Movimento Articular/fisiologia , Torque
8.
Am J Physiol Heart Circ Physiol ; 298(6): H1639-45, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20348222

RESUMO

Recent data suggest adiponectin, an adipocyte-derived hormone, affects development of heart failure in response to hypertension. Severe short-term pressure overload [1-3 wk of transverse aortic constriction (TAC)] in adiponectin(-/-) mice causes greater left ventricle (LV) hypertrophy than in wild-type (WT) mice, but conflicting results are reported regarding LV remodeling, with either increased or decreased LV end diastolic volume compared with WT mice. Here we assessed the effects of prolonged TAC on LV hypertrophy and remodeling. WT and adiponectin(-/-) mice were subjected to TAC and maintained for 6 wk. Regardless of strain, TAC induced similar LV hypertrophy ( approximately 70%) and upregulation of mRNA for heart failure marker genes. However, LV chamber size was dramatically different, with classic LV dilation in WT TAC mice but concentric LV hypertrophy in adiponectin(-/-) mice. LV end diastolic and systolic volumes were lower and ejection fraction higher in adiponectin(-/-) TAC mice compared with WT, indicating that adiponectin deletion prevented LV remodeling and deterioration in systolic function. The activities of marker enzymes of mitochondrial oxidative capacity were reduced in WT TAC mice by approximately 35%, whereas enzyme activities were maintained at sham levels in adiponectin(-/-) TAC mice. In conclusion, in WT mice, long-term pressure overload caused dilated LV hypertrophy accompanied by decreased activity of mitochondrial oxidative enzymes. Although adiponectin deletion did not affect LV hypertrophy, it prevented LV chamber remodeling and preserved mitochondrial oxidative capacity, suggesting that adiponectin plays a permissive role in mediating changes in cardiac structure and metabolism in response to pressure overload.


Assuntos
Insuficiência Cardíaca Sistólica/fisiopatologia , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Remodelação Ventricular/fisiologia , Adiponectina/deficiência , Adiponectina/fisiologia , Animais , Pressão Sanguínea/fisiologia , Modelos Animais de Doenças , Insuficiência Cardíaca Sistólica/etiologia , Hipertensão/complicações , Hipertrofia Ventricular Esquerda/etiologia , Masculino , Metaloproteases , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Mitocôndrias Cardíacas/enzimologia , Contração Miocárdica/fisiologia
9.
Lipids Health Dis ; 9: 95, 2010 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-20819225

RESUMO

BACKGROUND: Pathological left ventricular (LV) hypertrophy frequently progresses to dilated heart failure with suppressed mitochondrial oxidative capacity. Dietary marine ω-3 polyunsaturated fatty acids (ω-3 PUFA) up-regulate adiponectin and prevent LV dilation in rats subjected to pressure overload. This study 1) assessed the effects of ω-3 PUFA on LV dilation and down-regulation of mitochondrial enzymes in response to pressure overload; and 2) evaluated the role of adiponectin in mediating the effects of ω-3 PUFA in heart. METHODS: Wild type (WT) and adiponectin-/- mice underwent transverse aortic constriction (TAC) and were fed standard chow ± ω-3 PUFA for 6 weeks. At 6 weeks, echocardiography was performed to assess LV function, mice were terminated, and mitochondrial enzyme activities were evaluated. RESULTS: TAC induced similar pathological LV hypertrophy compared to sham mice in both strains on both diets. In WT mice TAC increased LV systolic and diastolic volumes and reduced mitochondrial enzyme activities, which were attenuated by ω-3 PUFA without increasing adiponectin. In contrast, adiponectin-/- mice displayed no increase in LV end diastolic and systolic volumes or decrease in mitochondrial enzymes with TAC, and did not respond to ω-3 PUFA. CONCLUSION: These findings suggest ω-3 PUFA attenuates cardiac pathology in response to pressure overload independent of an elevation in adiponectin.


Assuntos
Adiponectina/sangue , Adiponectina/fisiologia , Ácidos Graxos Ômega-3/uso terapêutico , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/dietoterapia , Mitocôndrias Cardíacas/enzimologia , Adiponectina/genética , Animais , Biomarcadores/metabolismo , Ácidos Graxos/metabolismo , Proteínas Fetais/genética , Proteínas Fetais/metabolismo , Óleos de Peixe/química , Óleos de Peixe/uso terapêutico , Regulação da Expressão Gênica , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/metabolismo , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/prevenção & controle , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/metabolismo , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Miocárdio/enzimologia , Miocárdio/metabolismo , Fosfolipídeos/metabolismo , RNA Mensageiro/metabolismo , Volume Sistólico , Ultrassonografia
10.
Biochemistry ; 48(30): 7140-9, 2009 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-19527071

RESUMO

Succinyl-CoA synthetase (SCS) is the only mitochondrial enzyme capable of ATP production via substrate level phosphorylation in the absence of oxygen, but it also plays a key role in the citric acid cycle, ketone metabolism, and heme synthesis. Inorganic phosphate (P(i)) is a signaling molecule capable of activating oxidative phosphorylation at several sites, including NADH generation and as a substrate for ATP formation. In this study, it was shown that P(i) binds the porcine heart SCS alpha-subunit (SCSalpha) in a noncovalent manner and enhances its enzymatic activity, thereby providing a new target for P(i) activation in mitochondria. Coupling 32P labeling of intact mitochondria with SDS gel electrophoresis revealed that 32P labeling of SCSalpha was enhanced in substrate-depleted mitochondria. Using mitochondrial extracts and purified bacterial SCS (BSCS), we showed that this enhanced 32P labeling resulted from a simple binding of 32P, not covalent protein phosphorylation. The ability of SCSalpha to retain its 32P throughout the SDS denaturing gel process was unique over the entire mitochondrial proteome. In vitro studies also revealed a P(i)-induced activation of SCS activity by more than 2-fold when mitochondrial extracts and purified BSCS were incubated with millimolar concentrations of P(i). Since the level of 32P binding to SCSalpha was increased in substrate-depleted mitochondria, where the matrix P(i) concentration is increased, we conclude that SCS activation by P(i) binding represents another mitochondrial target for the P(i)-induced activation of oxidative phosphorylation and anaerobic ATP production in energy-limited mitochondria.


Assuntos
Mitocôndrias Cardíacas/metabolismo , Proteínas Mitocondriais/metabolismo , Fosfatos/metabolismo , Subunidades Proteicas/metabolismo , Succinato-CoA Ligases/metabolismo , Trifosfato de Adenosina/metabolismo , Animais , Eletroforese em Gel Bidimensional , Ativação Enzimática , Guanosina Trifosfato/metabolismo , Concentração de Íons de Hidrogênio , Proteínas Mitocondriais/química , Fosfatos/química , Ligação Proteica , Desnaturação Proteica , Subunidades Proteicas/química , Proteômica/métodos , Dodecilsulfato de Sódio/química , Succinato-CoA Ligases/química , Tensoativos/química , Suínos
11.
Am J Physiol Heart Circ Physiol ; 297(5): H1585-93, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19767529

RESUMO

A high-fat diet can increase adiposity, leptin secretion, and plasma fatty acid concentration. In hypertension, this scenario may accelerate cardiac hypertrophy and development of heart failure but could be protective by activating peroxisome proliferator-activated receptors and expression of mitochondrial oxidative enzymes. We assessed the effects of a high-fat diet on the development of left ventricular hypertrophy, remodeling, contractile dysfunction, and the activity of mitochondrial oxidative enzymes. Mice (n = 10-12/group) underwent transverse aortic constriction (TAC) or sham surgery and were fed either a low-fat diet (10% of energy intake as fat) or a high-fat diet (45% fat) for 6 wk. The high-fat diet increased adipose tissue mass and plasma leptin and insulin. Left ventricular mass and chamber size were unaffected by diet in sham animals. TAC increased left ventricular mass (approximately 70%) and end-systolic and end-diastolic areas (approximately 100% and approximately 45%, respectively) to the same extent in both dietary groups. The high-fat diet increased plasma free fatty acid concentration and prevented the decline in the activity of the mitochondrial enzymes medium chain acyl-coenzyme A dehydrogenase (MCAD) and citrate synthase that was observed with TAC animals on a low-fat diet. In conclusion, a high-fat diet did not worsen cardiac hypertrophy or left ventricular chamber enlargement despite increases in fat mass and insulin and leptin concentrations. Furthermore, a high-fat diet preserved MCAD and citrate synthase activities during pressure overload, suggesting that it may help maintain mitochondrial oxidative capacity in failing myocardium.


Assuntos
Acil-CoA Desidrogenase/metabolismo , Adiposidade , Citrato (si)-Sintase/metabolismo , Gorduras na Dieta/administração & dosagem , Insuficiência Cardíaca/etiologia , Hipertensão/enzimologia , Hipertrofia Ventricular Esquerda/etiologia , Mitocôndrias Cardíacas/enzimologia , Miocárdio/enzimologia , Acil-CoA Desidrogenase/genética , Animais , Biomarcadores/sangue , Glicemia/metabolismo , Proteína C-Reativa/metabolismo , Citrato (si)-Sintase/genética , Modelos Animais de Doenças , Progressão da Doença , Ácidos Graxos não Esterificados/sangue , Insuficiência Cardíaca/enzimologia , Insuficiência Cardíaca/patologia , Insuficiência Cardíaca/fisiopatologia , Hipertensão/complicações , Hipertensão/patologia , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/enzimologia , Hipertrofia Ventricular Esquerda/patologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Mediadores da Inflamação/sangue , Insulina/sangue , Interleucina-6/sangue , Leptina/sangue , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Mitocôndrias Musculares/enzimologia , Músculo Esquelético/enzimologia , Contração Miocárdica , Miocárdio/patologia , Oxirredução , RNA Mensageiro/sangue , Fatores de Tempo , Triglicerídeos/sangue , Fator de Necrose Tumoral alfa/sangue , Remodelação Ventricular
12.
Catheter Cardiovasc Interv ; 73(7): 899-901, 2009 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-19455658

RESUMO

Diagnostic cardiac catheterizations are predominantly performed using access through the femoral artery. To improve patient comfort and early mobilization, a number of percutaneous closure devices have been developed. One such device using the nitinol clip was developed by Abbott Vascular Devices and was approved for use on the basis of the results of the Clip Closure In Percutaneous Procedures (CLIP) study. The safety of repuncture through a previously deployed device has not been established in humans. We present the case of a patient who had an arterial line placed for post-operative monitoring after cardiac surgery at the site of a previous arteriotomy closed with the Starclose device. The catheter traversed through the central portion, tethered to the periphery of the ninitol clip, and required surgery for extraction.


Assuntos
Cateterismo Cardíaco/efeitos adversos , Cateterismo Periférico/efeitos adversos , Artéria Femoral , Migração de Corpo Estranho/etiologia , Hemorragia/prevenção & controle , Técnicas Hemostáticas/efeitos adversos , Idoso , Ligas , Procedimentos Cirúrgicos Cardíacos , Cateterismo Periférico/instrumentação , Remoção de Dispositivo , Desenho de Equipamento , Migração de Corpo Estranho/diagnóstico por imagem , Migração de Corpo Estranho/cirurgia , Hemorragia/etiologia , Técnicas Hemostáticas/instrumentação , Humanos , Masculino , Cuidados Pós-Operatórios , Punções , Radiografia , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares
13.
Cardiovasc Res ; 79(2): 269-78, 2008 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-18343896

RESUMO

Under physiological conditions, the human heart derives energy from glucose, fatty acids, and/or lactate depending upon substrate availability, circulating hormone levels, and nutritional status. Circulating free fatty acid and glucose levels often exceed the normal range, as observed with type 2 diabetes, obesity, or physical inactivity. Chronic exposure of the heart to high plasma levels of free fatty acids may cause accumulation of toxic lipid intermediates within cardiomyocytes. Furthermore, suppression of glucose oxidation by increased fatty acid uptake shunts glucose into the oxidative pentose phosphate and hexosamine biosynthetic pathways, both of which yield potentially harmful products. Noxious derivatives of aberrant glucose and fatty acid oxidation can activate signalling cascades leading to myocyte dysfunction or death, processes termed 'glucotoxicity' and 'lipotoxicity'. This review discusses the effects of dietary extremes (e.g. high fat and high carbohydrate consumption) and substrate overabundance in the context of heart failure (HF) development and progression. Emerging data suggest that substrate excess leads to cardiac dysfunction and HF, which may be prevented or slowed by maintaining low body fat and high insulin sensitivity and consuming a diet of low glycaemic load that is high in mono- and polyunsaturated fatty acids.


Assuntos
Dieta , Ingestão de Alimentos/fisiologia , Insuficiência Cardíaca/fisiopatologia , Animais , Carboidratos da Dieta/efeitos adversos , Gorduras na Dieta/efeitos adversos , Progressão da Doença , Insuficiência Cardíaca/etiologia , Humanos
14.
J Mol Cell Cardiol ; 45(3): 404-10, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18639556

RESUMO

AMP-activated protein kinase (AMPK), is an important regulator of cardiac metabolism, but its role is not clearly understood in pressure overload induced hypertrophy. In addition, the relationship between AMPK and other important protein kinases such as p38 MAP kinase, Akt and Pim-1 is unclear. Thus we studied the time course of AMPK activity and phosphorylation of Thr-172 of its alpha-subunit during the development of cardiac hypertrophy. In parallel, we examined the expression and activation of key kinases known to be involved in cardiac hypertrophy that could interact with AMPK (i.e. p38 MAP kinase, Akt and Pim-1). Male C57BL/6J mice underwent sham or transverse aortic constriction (TAC) surgery and the hearts were harvested 2, 4, 6 and 8 weeks later. Despite significant left ventricular (LV) hypertrophy, LV dilation and impaired LV contractile function at all time points in TAC compared to sham mice, the activity and phosphorylation of AMPK were similar to sham. In contrast, p38 and Pim-1 protein expression was transiently increased in TAC mice at 2 and 4 weeks and at 2, 4 and 6 weeks, respectively. In addition, p38 activation by phosphorylation was also transiently increased at 2 to 6 weeks. There were no differences between sham and TAC mice in p38, Akt or Pim-1 at 8 weeks. In conclusion, TAC resulted in a transient up-regulation in the expression of p38 and Pim-1 despite no activation of AMPK or Akt.


Assuntos
Proteínas Quinases Ativadas por AMP , Hipertrofia Ventricular Esquerda/enzimologia , Proteínas Proto-Oncogênicas c-pim-1/biossíntese , Regulação para Cima/fisiologia , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , Proteínas Quinases Ativadas por AMP/metabolismo , Sequência de Aminoácidos , Animais , Modelos Animais de Doenças , Ativação Enzimática , Hipertrofia Ventricular Esquerda/mortalidade , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Dados de Sequência Molecular , Proteínas Proto-Oncogênicas c-pim-1/genética , Proteínas Proto-Oncogênicas c-pim-1/fisiologia , Fatores de Tempo
15.
J Card Fail ; 14(1): 82-8, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18226777

RESUMO

BACKGROUND: Dietary lipid content effects activation of peroxisome proliferator-activated receptor-alpha (PPAR-alpha) and may accelerate cardiac hypertrophy and dysfunction in response to pressure overload. This study investigated the effects of a high-fat diet on the development of cardiac hypertrophy. METHODS AND RESULTS: C57BL/6J mice (n = 14-16/group) underwent transverse aortic constriction (TAC) or sham surgery and were fed either standard low-fat diet (STD; 10% fat) or a high-fat diet (HFD; 60% fat) for 16 weeks. Sham mice showed no differences between STD and HFD for heart mass or echocardiographic parameters despite greater plasma free fatty acid and leptin concentrations with HFD. TAC increased heart mass and decreased ejection fraction similarly in both groups. Left ventricular end systolic and diastolic diameters with TAC were increased compared with shams on the HFD (P < .05), but were not different from STD TAC mice. High-fat feeding increased expression of PPAR-alpha-regulated genes. The activity of medium chain acyl-coenzyme A dehydrogenase (MCAD), a marker of fatty acid oxidation capacity, was increased in HFD TAC mice compared with STD, consistent with PPAR-alpha activation. CONCLUSIONS: Increased fat intake prevented the fall in MCAD activity and did not exacerbate the hypertrophic response to TAC compared with a low-fat diet.


Assuntos
Cardiomiopatia Hipertrófica/dietoterapia , Dieta com Restrição de Gorduras , Gorduras na Dieta/farmacologia , PPAR alfa/metabolismo , Disfunção Ventricular Esquerda/metabolismo , Animais , Western Blotting , Cardiomiopatia Hipertrófica/mortalidade , Cardiomiopatia Hipertrófica/fisiopatologia , Distribuição de Qui-Quadrado , Modelos Animais de Doenças , Ácidos Graxos não Esterificados/metabolismo , Ácidos Graxos não Esterificados/farmacologia , Hipertensão/metabolismo , Hipertensão/fisiopatologia , Camundongos , Camundongos Endogâmicos C57BL , Análise Multivariada , PPAR alfa/genética , Probabilidade , RNA Mensageiro/análise , Distribuição Aleatória , Valores de Referência , Medição de Risco , Sensibilidade e Especificidade , Volume Sistólico/fisiologia , Taxa de Sobrevida , Disfunção Ventricular Esquerda/mortalidade , Disfunção Ventricular Esquerda/fisiopatologia
16.
Cardiovasc Res ; 73(2): 257-68, 2007 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-17166490

RESUMO

Currently, a high carbohydrate/low fat diet is recommended for patients with hypertension; however, the potentially important role that the composition of dietary fat and carbohydrate plays in hypertension and the development of pathological left ventricular hypertrophy (LVH) has not been well characterized. Recent studies demonstrate that LVH can also be triggered by activation of insulin signaling pathways, altered adipokine levels, or the activity of peroxisome proliferator-activated receptors (PPARs), suggesting that metabolic alterations play a role in the pathophysiology of LVH. Hypertensive patients with high plasma insulin or metabolic syndrome have a greater occurrence of LVH, which could be due to insulin activation of the serine-threonine kinase Akt and its downstream targets in the heart, resulting in cellular hypertrophy. PPARs also activate cardiac gene expression and growth and are stimulated by fatty acids and consumption of a high fat diet. Dietary intake of fats and carbohydrate and the resultant effects of plasma insulin, adipokine, and lipid concentrations may affect cardiomyocyte size and function, particularly in the setting of chronic hypertension. This review discusses potential mechanisms by which dietary carbohydrates and fats ca affect cardiac growth, metabolism, and function, mainly in the context of pressure overload-induced LVH.


Assuntos
Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Hipertrofia Ventricular Esquerda/etiologia , Adiponectina/metabolismo , Animais , Glicemia/metabolismo , Humanos , Hipertensão/dietoterapia , Hipertensão/etiologia , Resistência à Insulina , Leptina/metabolismo , Metabolismo dos Lipídeos , Modelos Animais
17.
Am J Manag Care ; 24(8): 385-388, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30130033

RESUMO

Skilled nursing facilities (SNFs) are increasingly being called upon to prevent avoidable hospitalizations. Primary care provider (PCP) bedside assessment for change of condition in SNF patients is believed to improve care and reduce unnecessary hospitalizations, but PCPs are not always available on site in an SNF. This study addresses the potential clinical and financial impacts of an after-hours physician coverage service enabled by technology, TripleCare (TC), to prevent avoidable hospitalizations. TC was launched in a 365-bed SNF in Brooklyn, New York, in March 2015. Outcomes were tracked and evaluated for the initial year. Avoided hospitalizations were identified as such by the covering physicians and confirmed by the facility's medical director. Of the 313 patients cared for by the telemedicine-enabled covering physicians during the year of service, 259 (83%) were treated on site, including 91 who avoided hospitalizations as verified by a third party, and 54 were transferred to the hospital. It is estimated that the associated cost savings to Medicare and other payers exceeded $1.55 million, approximately $500,000 of which went to a managed care Medicare payer, in this 1 SNF during this period. Medicare would annually save $500,000 in an average 120-bed facility, or $4167 per bed. Use of a dedicated virtual after-hours physician coverage service in an SNF demonstrated a significant reduction in avoidable hospitalizations.


Assuntos
Plantão Médico , Hospitalização/estatística & dados numéricos , Instituições de Cuidados Especializados de Enfermagem , Telemedicina , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque , Estudos de Casos Organizacionais
18.
J Ambul Care Manage ; 30(1): 30-8, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17170636

RESUMO

There is a small subgroup of Medicare and Medicaid patients (2%-4%) who have complex illnesses, frailties, and often disabilities. The medical problems of these patients are characterized by multiple diagnoses, complex medication routines, frequent hospitalizations, many physicians and physician visits, impairment of activities of daily life (including cognitive disabilities), and reliance on a caregiver for support and keeping them in the community. The cost of their care increases year after year averaging $40,000 per year. Strongly associated with these multiple problems is isolation and often depression, which compounds their medical problems resulting in nonadherence to their prescribed medical regimes which might otherwise keep them out of the hospital. This article describes a new approach to providing both a wellness program and medical safety net for this unstable population.


Assuntos
Promoção da Saúde/organização & administração , Desenvolvimento de Programas , Administração de Caso , Comorbidade , Custos e Análise de Custo , Custos de Cuidados de Saúde , Sistemas Pré-Pagos de Saúde/economia , Humanos , Medicaid , Medicare , Estados Unidos
19.
J Shoulder Elbow Surg ; 16(3 Suppl): S96-101, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17097310

RESUMO

An understanding of the morphology of the glenoid is important from the viewpoint of implant design and selection. This study describes the endosteal dimensions and shape of the glenoid and correlates these results with age, gender, and the presence of osteoarthritis. This study used 72 scapulae. Data were obtained from computed tomography scans of both cadaveric and in vivo glenoids. The glenoid is relatively straight-sided in the coronal plane and more highly fluted in the transverse plane. The endosteal dimensions were larger for male specimens, but there was no difference in endosteal shape with respect to gender. These findings were not influenced by age or the presence of osteoarthritis. This study suggests that traditional glenoid component designs may not be optimal. To maximize fixation, a rectangular keel may be most effective in the coronal plane and a triangular keel may be most effective in the transverse plane.


Assuntos
Osteoartrite/diagnóstico por imagem , Escápula/diagnóstico por imagem , Articulação do Ombro/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Antropometria , Cadáver , Feminino , Humanos , Prótese Articular , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Tomografia Computadorizada por Raios X
20.
J Shoulder Elbow Surg ; 16(5): 631-9, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17507251

RESUMO

The objective of this study was to determine the effect of implant thickness and glenohumeral conformity on fixation of an all-metal glenoid component. A stainless steel glenoid component was designed and implanted in 10 cadaveric scapulae. A testing apparatus capable of producing a loading vector at various angles, magnitudes, and directions was used. The independent variables included 6 directions and 3 angles of joint load, 3 implant thicknesses, and 4 glenohumeral conformities. Implant micromotion relative to bone was measured by use of 4 displacement transducers at the superior, inferior, anterior, and posterior sites. The components displayed a consistent response to loading of ipsilateral compression and contralateral distraction. Stability decreased as the load application angle increased (P < .05). A decrease in the implant thickness and glenohumeral conformity resulted in increased implant stability (P < .05). Decreasing implant thickness and glenohumeral conformity reduce the eccentric component of loading and may improve the durability of glenoid implants.


Assuntos
Prótese Articular , Desenho de Prótese , Fenômenos Biomecânicos , Cadáver , Força Compressiva , Humanos , Instabilidade Articular/prevenção & controle , Teste de Materiais , Probabilidade , Sensibilidade e Especificidade , Articulação do Ombro/cirurgia
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