RESUMO
Hypertension is a highly prevalent disease marked by vascular and cardiac maladaptive remodelling induced mainly by renin-angiotensin system activation followed by oxidative stress. Here, we briefly describe these damages and review the current evidence supporting a potential role for nitrate and nitrite as antihypertensive molecules that act via nitric oxide (NO) formation-dependent and NO formation-independent mechanisms and how nitrate/nitrite inhibits cardiovascular remodelling in hypertension. The renin-angiotensin system activation and oxidative stress converge to activate proteases involved in cardiovascular remodelling in hypertension. Besides these proteases, several investigations have demonstrated that reduced endogenous NO bioavailability is a central pathological event in hypertension. In this regard, nitrate/nitrite, long considered inert products of NO, is now known as physiological molecules able to reduce blood pressure in hypertensive patients and in different experimental models of hypertension. These effects are associated with the formation of NO and other NO-related molecules, which could induce S-nitrosylation of target proteins. However, it remains unclear whether S-nitrosylation is an essential mechanism for the anti-remodelling effects of nitrate/nitrite in hypertension. Moreover, nitrate/nitrite produces antioxidant effects associated with the inhibition of signalling pathways involved in cardiovascular remodelling. Together, these findings may help to establish nitrate and nitrite as effective therapies in hypertension-induced cardiovascular remodelling.
Assuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Hipertrofia Ventricular Esquerda/tratamento farmacológico , Nitratos/uso terapêutico , Nitritos/uso terapêutico , Remodelação Vascular/efeitos dos fármacos , Função Ventricular Esquerda/efeitos dos fármacos , Remodelação Ventricular/efeitos dos fármacos , Animais , Anti-Hipertensivos/efeitos adversos , Artérias/efeitos dos fármacos , Artérias/metabolismo , Artérias/fisiopatologia , Coração/efeitos dos fármacos , Coração/fisiopatologia , Humanos , Hipertensão/metabolismo , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/metabolismo , Hipertrofia Ventricular Esquerda/fisiopatologia , Miocárdio/metabolismo , Nitratos/efeitos adversos , Óxido Nítrico/metabolismo , Nitritos/efeitos adversos , Estresse Oxidativo/efeitos dos fármacos , Sistema Renina-Angiotensina/efeitos dos fármacosRESUMO
AIMS: Evaluate the effects of maternal high fat and high cholesterol (HFHC) diet consumption on blood pressure (BP), renal function and oxidative stress along the gut-kidney axis in male and female rat offspring. MATERIALS AND METHODS: Pregnant rats were fed with a control (CTL) or HFHC diet during pregnancy and lactation. At 90 days, BP was assessed by tail-cuff plethysmography, and urinary and biochemical variables were measured. Biomarkers for oxidative stress, enzymatic antioxidant defense (activity of superoxide dismutase-SOD, catalase, and glutathione-S-transferase-GST) and nonenzymatic antioxidant defense (thiols content) were evaluated in the colon and renal cortex. KEY FINDINGS: Male and female offspring from dams fed with a HFHC diet presented increased BP when compared to their respective CTL group. Male offspring from dams fed with HFHC diet showed reduced GST activity and thiols content in the colon, reduced SOD activity in the renal cortex and decreased urinary creatinine excretion when compared to the CTL group. Regarding female offspring, catalase activity and thiols content were reduced in the colon when compared to CTL group. Although lipid peroxidation had been increased in the renal cortex of HFHC female offspring, the CAT and SOD enzymatic antioxidant acitivities (CAT and SOD) were increased in the renal cortex of female offspring when compared with male offspring; and the renal function was not impaired by maternal HFHC diet consumption. SIGNIFICANCE: HFHC diet during pregnancy and lactation induces sex-specific oxidative stress along the gut-kidney axis in offspring, which might induce renal dysfunction and arterial hypertension in later life.
Assuntos
Artérias/patologia , Trato Gastrointestinal/patologia , Hipertensão/patologia , Rim/patologia , Exposição Materna , Estresse Oxidativo , Efeitos Tardios da Exposição Pré-Natal/patologia , Animais , Artérias/fisiopatologia , Biomarcadores/sangue , Pressão Sanguínea , Colesterol , Colo/patologia , Colo/fisiopatologia , Diástole , Dieta Hiperlipídica , Feminino , Trato Gastrointestinal/fisiopatologia , Frequência Cardíaca , Hipertensão/sangue , Hipertensão/fisiopatologia , Rim/fisiopatologia , Masculino , Gravidez , Ratos Wistar , SístoleRESUMO
Background The ambulatory arterial stiffness index (AASI), derived from 24 h ambulatory blood pressure monitoring (ABPM) can be a good indicator of arterial stiffness. Aim To assess the correlation between AASI and brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and cardio-ankle vascular index (CAVI) in patients with type 2 diabetes mellitus without hypertension. Material and Methods Cross sectional study in 28 diabetic patients aged 49 ± 7 years (40% women). AASI was calculated as 1 minus the regression slope of diastolic on systolic blood pressure, using ABPM data. ABPM was measured in the arm using an oscillometric device. ABI was calculated as the ratio between ankle and brachial systolic blood pressure. CAVI was derived from pulse wave velocity using the Vasera VS-1000 device. Correlations were calculated using a bivariate Spearman correlation. Results The mean values for AASI, ABI, baPWV and CAVI were 0.39 ± 0.14, 1.14 ± 0.09, 15.15 ± 2.71 m/s and 7.60 ± 1.90, respectively. There was a significant negative correlation between AASI and ABI (r = -0.491, p < 0.01). Conclusions In these diabetic patients, there was an association between AASI, an arterial stiffness marker and ABI, an indicator for the presence of atherosclerosis.
Assuntos
Tornozelo/irrigação sanguínea , Artérias/fisiopatologia , Pressão Sanguínea/fisiologia , Artéria Braquial/fisiopatologia , Diabetes Mellitus Tipo 2/complicações , Rigidez Vascular/fisiologia , Adulto , Idoso , Índice Tornozelo-Braço , Monitorização Ambulatorial da Pressão Arterial , Artérias Carótidas/diagnóstico por imagem , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Análise de Onda de PulsoRESUMO
ABSTRACT Background The ambulatory arterial stiffness index (AASI), derived from 24 h ambulatory blood pressure monitoring (ABPM) can be a good indicator of arterial stiffness. Aim To assess the correlation between AASI and brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and cardio-ankle vascular index (CAVI) in patients with type 2 diabetes mellitus without hypertension. Material and Methods Cross sectional study in 28 diabetic patients aged 49 ± 7 years (40% women). AASI was calculated as 1 minus the regression slope of diastolic on systolic blood pressure, using ABPM data. ABPM was measured in the arm using an oscillometric device. ABI was calculated as the ratio between ankle and brachial systolic blood pressure. CAVI was derived from pulse wave velocity using the Vasera VS-1000 device. Correlations were calculated using a bivariate Spearman correlation. Results The mean values for AASI, ABI, baPWV and CAVI were 0.39 ± 0.14, 1.14 ± 0.09, 15.15 ± 2.71 m/s and 7.60 ± 1.90, respectively. There was a significant negative correlation between AASI and ABI (r = -0.491, p < 0.01). Conclusions In these diabetic patients, there was an association between AASI, an arterial stiffness marker and ABI, an indicator for the presence of atherosclerosis.
Antecedentes El índice de rigidez arterial ambulatorio (AASI), derivado del monitoreo ambulatorio de presión arterial de 24 h (MAPA), puede ser un buen indicador de rigidez arterial. Objetivo Evaluar la correlación entre el AASI y la velocidad de onda de pulso braquial (VOP), el índice tobillo-brazo (ITB) y el índice vascular cardio-tobillo (CAVI) en pacientes con diabetes mellitus tipo 2 sin hipertensión arterial. Material y Métodos Estudio transversal en 28 pacientes con diabetes de 49 ± 7 años (40% mujeres). El AASI se calculó como 1 menos la pendiente de regresión de la presión arterial diastólica sobre la sistólica, usando datos del MAPA de 24 h, el cual se midió en el brazo, usando un dispositivo oscilométrico. El ITB se calculó como la razón entre la presión arterial sistólica del tobillo sobre la del brazo. El CAVI se derivó de la velocidad de onda de pulso medida con el dispositivo Vasera VS-1000. Para el análisis estadístico se utilizó el coeficiente de correlación bivariada de Spearman. Resultados Los valores de AASI, VOP, ITB y CAVI fueron 0.39 ± 0.14, 1.14 ± 0.09, 15.15 ± 2.71 m/s y 7.60 ± 1.90, respectivamente. Hubo una correlación negativa significativa entre AASI e ITB (r = -0.491, p < 0.01). Conclusiones Hay una asociación entre AASI, un marcador de rigidez arterial e ITB, un indicador de aterosclerosis, en estos pacientes con diabetes mellitus tipo 2.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Artérias/fisiopatologia , Pressão Sanguínea/fisiologia , Artéria Braquial/fisiopatologia , Diabetes Mellitus Tipo 2/complicações , Rigidez Vascular/fisiologia , Tornozelo/irrigação sanguínea , Artérias Carótidas/diagnóstico por imagem , Estudos Transversais , Valor Preditivo dos Testes , Monitorização Ambulatorial da Pressão Arterial , Diabetes Mellitus Tipo 2/sangue , Índice Tornozelo-Braço , Análise de Onda de PulsoRESUMO
Abstract: Introduction: T-wave inversion has always been considered as a natural progression sign of the non-perfunded myocardial infarction, however it is also seen after early succesful reperfusion via fibrinolysis or primary angioplasty; its role in predicting auto-reperfusion has not been established. Objective: Assess the patency of the infarct-related artery (IRA) in patients presenting with early (< 3 hours of symptoms onset) T-wave inversion (TWI) in leads with ST-segment elevation (STE) myocardial infarction (STEMI). Methods: We retrospectively analyzed 432 patients admitted at the emergency department of the National Cardiology Institute in Mexico City with a diagnosis of STEMI who arrived within three hours of symptoms onset and underwent primary percutaneous coronary intervention (p-PCI) from October 2005 to November 2015. Clinical data, electrocardiogram (ECG) and angiographic data were reviewed. The subjects were divided in two groups: those with TWI and those with positive T waves (PTW). Results: 386 (89.3%) patients presented with PTW and 46 (10.6%) with TWI. The presence of early TWI in anterior leads predicted patency of the anterior descending artery (LAD) (18 [69.2%] vs 41 [24%]; p < 0.001) but not in other arteries. Conclusions: The presence of early TWI in anterior leads with STE is associated with patency of the LAD. This relationship was not found in other infarct-related arteries.(AU)
Resumen: Introducción: La onda T invertida siempre se ha considerado como progresión natural de un infarto de miocardio no reperfundido, sin embargo, también se puede observar posterior a fibrinólisis o angioplastia primaria exitosas, su rol en predecir autorreperfusión no ha sido establecido. Objetivo: Valorar la permeabilidad de la arteria culpable del infarto (ACI) en pacientes que se presentan con onda T invertida (OTI) temprana (menos de tres horas de inicio de síntomas) en derivaciones con elevación del segmento ST (IAMCEST). Métodos: Se analizaron 432 pacientes de forma retrospectiva que fueron admitidos al Servicio de Urgencias del Instituto Nacional de Cardiología en la Ciudad de México con diagnóstico de IAMCEST dentro de las primeras tres horas de inicio de los síntomas y que fueran llevados a angioplastia primaria de octubre de 2005 a noviembre de 2015. Se revisaron datos clínicos, electrocardiogramas y angiografías coronarias. Los sujetos fueron divididos en dos grupos: aquéllos con OTI y aquéllos con onda T positiva (OTP). Resultados: Se presentaron 386 (89.3%) pacientes con OTP y 46 (10.6%) con OTI. La presencia de OTI temprana en derivaciones anteriores predijo permeabilidad de la descendente anterior (DA) (18 [69.2%] vs 41 [24%]; p < 0.001) pero no en las otras arterias. Conclusión: La presencia de OTI tempranas en derivaciones anteriores con elevación del segmento ST se asocia a permeabilidad de la DA. Este hallazgo no fue encontrado en otras arterias culpables de infarto.(AU)
Assuntos
Humanos , Artérias/fisiopatologia , Angioplastia/instrumentação , Eletrocardiografia/instrumentação , Infarto do Miocárdio/diagnóstico , MéxicoAssuntos
Pressão Arterial , Artérias/fisiopatologia , Hipertensão/fisiopatologia , Modelos Cardiovasculares , Animais , Anti-Hipertensivos/uso terapêutico , Pressão Arterial/efeitos dos fármacos , Artérias/efeitos dos fármacos , Determinação da Pressão Arterial/métodos , Humanos , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Hipertensão/mortalidade , Valor Preditivo dos Testes , Prognóstico , Fatores de Risco , Rigidez VascularRESUMO
Adaptive identification systems focus on dynamical approaches based on the observed data from an experiment and/or clinical data. These systems establish a relationship between an input (arterial or vein instantaneous pressure) and an output (instantaneous arterial or vein diameter). Several dynamics relationships and applications can be established because of this adaptive identification as an arterial dynamic range (frequency response), biomechanical behavior of cryopreserved arteries, regional differences in veins as artery substitution, role of vascular smooth muscle in human hypertension and time invariance in the biomechanics of wall arteries. The aim of this review is to summarize some of those relevant results obtained from adaptive filter identification in cardiovascular dynamics research and clinical evaluation.
Assuntos
Artérias/fisiopatologia , Hemodinâmica , Hipertensão/fisiopatologia , Modelos Cardiovasculares , Animais , Anti-Hipertensivos/uso terapêutico , Fenômenos Biomecânicos , Artérias Carótidas/fisiopatologia , Criopreservação , Módulo de Elasticidade , Hemodinâmica/efeitos dos fármacos , Humanos , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Músculo Liso Vascular/fisiopatologia , Fatores de Tempo , Veias/fisiopatologiaRESUMO
Vascular research in end-stage renal diseases is an interesting field in which the characterization of arterial stiffness proved to be valuable to predict morbidity and mortality. Particularly, patients on renal replacement therapy have been reported to have significant increases in arterial stiffness and cardiovascular mortality. The clinical relevance of the measurement of arterial stiffness is linked to therapeutical and preventive interventions. The purpose of this work is to analyze the results of the scientific research in the field of arterial stiffness, in which hemodialyzed patients were involved, emphasizing on clinical and in-vitro research carried out by our group compared to contributions previously reported in the specialized literature. These investigations are necessary to improve diagnostic strategies and monitor the arterial response to therapeutical interventions in chronic kidney disease.
Assuntos
Artérias/cirurgia , Derivação Arteriovenosa Cirúrgica , Doenças Cardiovasculares/fisiopatologia , Falência Renal Crônica/terapia , Modelos Cardiovasculares , Diálise Renal , Extremidade Superior/irrigação sanguínea , Rigidez Vascular , Animais , Artérias/fisiopatologia , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Derivação Arteriovenosa Cirúrgica/mortalidade , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/terapia , Humanos , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/mortalidade , Falência Renal Crônica/fisiopatologia , Diálise Renal/efeitos adversos , Diálise Renal/mortalidade , Medição de Risco , Fatores de Risco , Resultado do Tratamento , Equilíbrio HidroeletrolíticoRESUMO
To enhance the efficiency of patient-specific risk stratification and diagnosis, an assessment of arterial structural and functional changes associated to a vascular disease in both early and advanced stages have been proposed, with the objective of limiting the progression or revert vascular alterations. In this connection, an interdisciplinary international partnership made up by research institutions from France, Argentina, Uruguay and Spain was established, with the objective of contributing to the evaluation and follow-up of factors involved in the physiopathology of cardiometabolic diseases and human aging. Several studies, such as the effect of hypertension in large arteries, alterations in arterial wall viscosity, stiffness and inertia, endothelial function and vascular reactivity, cardiovascular risk improvement, vascular age assessment and cryografts vascular response evaluation were carried out as a result of this international collaboration during the last twenty-five years.
Assuntos
Pressão Arterial , Artérias/fisiopatologia , Doenças Cardiovasculares/diagnóstico , Técnicas de Diagnóstico Cardiovascular , Testes Imediatos , Animais , Fenômenos Biomecânicos , Doenças Cardiovasculares/fisiopatologia , Técnicas de Diagnóstico Cardiovascular/instrumentação , Humanos , Modelos Animais , Modelos Cardiovasculares , Sistemas Automatizados de Assistência Junto ao Leito , Valor Preditivo dos Testes , Prognóstico , Medição de Risco , Fatores de Risco , Rigidez VascularRESUMO
This paper illustrates the evolution of our knowledge of arterial mechanics from our initial research works up to the present time. Several techniques focusing on this topic in terms of our experience are discussed. An interdisciplinary team composed by different institutions from Argentina, Uruguay, France and Spain was created to conduct research, to train human resources and to fulfill the inevitable social role of gaining access to technological innovation to improve public health.