RESUMO
Heart failure (HF) is a major public health issue affecting more than 26 million people worldwide. HF is the most common cardiovascular disease in elder population; and it is associated with neurocognitive function decline, which represent underlying brain pathology diminishing learning and memory faculties. Both HF and neurocognitive impairment are associated with recurrent hospitalization episodes and increased mortality rate in older people, but particularly when they occur simultaneously. Overall, the published studies seem to confirm that HF patients display functional impairments relating to attention, memory, concentration, learning, and executive functioning compared with age-matched controls. However, little is known about the molecular mechanisms underpinning neurocognitive decline in HF. The present review round step recent evidence related to the possible molecular mechanism involved in the establishment of neurocognitive disorders during HF. We will make a special focus on cerebral ischemia, neuroinflammation and oxidative stress, Wnt signaling, and mitochondrial DNA alterations as possible mechanisms associated with cognitive decline in HF. Also, we provide an integrative mechanism linking pathophysiological hallmarks of altered cardiorespiratory control and the development of cognitive dysfunction in HF patients. Graphical Abstract Main molecular mechanisms involved in the establishment of cognitive impairment during heart failure. Heart failure is characterized by chronic activation of brain areas responsible for increasing cardiac sympathetic load. In addition, HF patients also show neurocognitive impairment, suggesting that the overall mechanisms that underpin cardiac sympathoexcitation may be related to the development of cognitive disorders in HF. In low cardiac output, HF cerebral infarction due to cardiac mural emboli and cerebral ischemia due to chronic or intermittent cerebral hypoperfusion has been described as a major mechanism related to the development of CI. In addition, while acute norepinephrine (NE) release may be relevant to induce neural plasticity in the hippocampus, chronic or tonic release of NE may exert the opposite effects due to desensitization of the adrenergic signaling pathway due to receptor internalization. Enhanced chemoreflex drive is a major source of sympathoexcitation in HF, and this phenomenon elevates brain ROS levels and induces neuroinflammation through breathing instability. Importantly, both oxidative stress and neuroinflammation can induce mitochondrial dysfunction and vice versa. Then, this ROS inflammatory pathway may propagate within the brain and potentially contribute to the development of cognitive impairment in HF through the activation/inhibition of key molecular pathways involved in neurocognitive decline such as the Wnt signaling pathway.
Assuntos
Insuficiência Cardíaca/psicologia , Deficiências da Aprendizagem/psicologia , Transtornos da Memória/psicologia , Transtornos Neurocognitivos/psicologia , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/metabolismo , Humanos , Deficiências da Aprendizagem/epidemiologia , Deficiências da Aprendizagem/metabolismo , Transtornos da Memória/epidemiologia , Transtornos da Memória/metabolismo , Transtornos Neurocognitivos/epidemiologia , Transtornos Neurocognitivos/metabolismo , Testes NeuropsicológicosRESUMO
Climate change scenarios are computed on a large scale, not accounting for local variations presented in historical data and related to human scale. Based on historical records, we validate a baseline (1962-1990) and correct the bias of A2 and B2 regional projections for the end of twenty-first century (2070-2100) issued from a high resolution dynamical downscaled (using PRECIS mesoscale model, hereinafter DGF-PRECIS) of Hadley GCM from the IPCC 3rd Assessment Report (TAR). This is performed for the Araucanía Region (Chile; 37°-40°S and 71°-74°W) using two different bias correction methodologies. Next, we study high-resolution precipitations to find monthly patterns such as seasonal variations, rainfall months, and the geographical effect on these two scenarios. Finally, we compare the TAR projections with those from the recent Assessment Report 5 (AR5) to find regional precipitation patterns and update the Chilean `projection. To show the effects of climate change projections, we compute the rainfall climatology for the Araucanía Region, including the impact of ENSO cycles (El Niño and La Niña events). The corrected climate projection from the high-resolution dynamical downscaled model of the TAR database (DGF-PRECIS) show annual precipitation decreases: B2 (-19.19 %, -287 ± 42 mm) and A2 (-43.38 %, -655 ± 27.4 mm per year. Furthermore, both projections increase the probability of lower rainfall months (lower than 100 mm per month) to 64.2 and 72.5 % for B2 and A2, respectively.
RESUMO
Subterranean rodents construct large and complex burrows and spend most of their lives underground, while fossorial species construct simpler burrows and are more active above ground. An important constraint faced by subterranean mammals is the chronic hypoxia and hypercapnia of the burrow atmosphere. The traits, regarded as "adaptations of rodents to hypoxia and hypercapnia", have been evaluated in only a few subterranean species. In addition, well-studied subterranean taxa are very divergent to their sister groups, making it difficult to assess the adaptive path leading to subterranean life. The closely related sister genera Octodon and Spalacopus of Neotropical rodents offer a unique opportunity to trace the evolution of physiological mechanisms. We studied the ventilatory responses of selected octodontid rodents to selective pressures imposed by the subterranean niche under the working hypothesis that life underground, in hypoxic and hypercapnic conditions, promotes convergent physiological changes. To perform this study we used the following species: Spalacopus cyanus (the subterranean coruros) and Octodon degus (the fossorial degus) from central Chile. Ventilatory tidal volume and respiratory frequency were measured in non-anaesthetized spontaneously breathing animals. Acute hypoxic challenges (O(2) 1-15%) and hypercapnia (CO(2) 10%) were induced to study respiratory strategies using non-invasive whole body pletismography techniques. Our results show that coruros have a larger ventilatory response to acute hypoxia as than degus. On the other hand, hypercapnic respiratory responses in coruros seem to be attenuated when compared to those in degus. Our results suggest that coruros and degus have different respiratory strategies to survive in the hypoxic and hypercapnic atmospheres present in their burrows.
Assuntos
Adaptação Fisiológica/fisiologia , Hipercapnia/fisiopatologia , Hipóxia/fisiopatologia , Octodon/fisiologia , Mecânica Respiratória/fisiologia , Roedores/fisiologia , Animais , Índice de Massa Corporal , Dióxido de Carbono/metabolismo , Humanos , Masculino , Nitrogênio/metabolismo , Oxigênio/metabolismo , Ventilação Pulmonar/fisiologiaRESUMO
Intermittent hypoxia, a feature of obstructive sleep apnoea, potentiates ventilatory hypoxic responses, alters heart rate variability and produces hypertension, partially owing to an enhanced carotid body responsiveness to hypoxia. Since oxidative stress is a potential mediator of both chemosensory and cardiorespiratory alterations, we hypothesised that an antioxidant treatment may prevent these alterations. Accordingly, we studied the effects of ascorbic acid (1.25 g.L(-1) drinking water) on plasma lipid peroxidation, nitrotyrosine and inducible nitric oxide synthase (iNOS) immunoreactivity in the carotid body, ventilatory and carotid chemosensory responses to acute hypoxia, heart rate variability and arterial blood pressure in male Sprague-Dawley rats exposed to 5% O(2); 12 episodes.h(-1); 8 h.day(-1) or sham condition for 21 days. Intermittent hypoxia increased plasma lipid peroxidation, nitrotyrosine and iNOS expression in the carotid body, enhanced carotid chemosensory and ventilatory hypoxic responses, modified heart rate variability and produced hypertension. Ascorbic acid prevented the increased plasma lipid peroxidation and nitrotyrosine formation within the carotid body, and the enhanced carotid chemosensory and ventilatory responses to hypoxia, as well as heart rate variability alterations and hypertension. The present results support an essential role for oxidative stress in the generation of carotid body chemosensory potentiation and systemic cardiorespiratory alterations induced by intermittent hypoxia.
Assuntos
Antioxidantes/uso terapêutico , Ácido Ascórbico/uso terapêutico , Corpo Carotídeo/efeitos dos fármacos , Hipóxia/prevenção & controle , Apneia Obstrutiva do Sono/complicações , Animais , Ácido Ascórbico/administração & dosagem , Corpo Carotídeo/fisiopatologia , Células Quimiorreceptoras/metabolismo , Células Quimiorreceptoras/fisiologia , Frequência Cardíaca/efeitos dos fármacos , Frequência Cardíaca/fisiologia , Hipertensão/tratamento farmacológico , Hipertensão/metabolismo , Hipertensão/fisiopatologia , Hipóxia/etiologia , Peroxidação de Lipídeos , Lipídeos/sangue , Masculino , Malondialdeído/análise , Óxido Nítrico Sintase Tipo II/análise , Nitrosaminas/análise , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/fisiologia , Ventilação Pulmonar/efeitos dos fármacos , Ventilação Pulmonar/fisiologia , Ratos , Tirosina/análogos & derivados , Tirosina/análiseRESUMO
It has been proposed that chronic intermittent hypoxia (CIH) contributes to generate hypertension in patients with obstructive sleep apnea syndrome and animal models, due to an enhanced sympathetic outflow. A possible contributing mechanism to the CIH-induced hypertension is a potentiation of carotid body (CB) chemosensory responses to hypoxia, but early changes that precede the CIH-induced hypertension are not completely known. Since the variability of heart rate (HRV) has been used as an index of autonomic influences on cardiovascular system, we studied the effects of short and long-term CIH exposure on HRV in animals with or without hypertension. In cats exposed to CIH (PO(2) approximately 75 Torr, 10 times/hr during 8 hr) for 4 days, the ventilatory response to acute hypoxia was potentiated, the arterial pressure remained unchanged, but the HRV power spectrum showed a shift towards the low frequency band. Exposure of rats to CIH (PO(2) approximately 37.5 Torr, 12 times/hr during 8 hr) for 12 days enhanced the ventilatory response to acute hypoxia, but did not increase the arterial pressure. After 21 days of CIH, we found a significant increase of arterial pressure and a shift of the HRV power spectrum towards the low frequency band. Thus, our results support the idea that hypertension induced by long-term CIH was preceded by alterations in the autonomic balance of HRV, associated with an enhance CB chemoreflex sensitivity to hypoxia. Therefore, few days of CIH are enough to enhance the CB reactivity to hypoxia, which contribute to the augmented ventilatory response to hypoxia, and to the early alterations in the autonomic balance of HRV.