¿son la velocidad de la onda del pulso y la rigidez arterial marcadores para evaluar aterosclerosis pre-clínica en pacientes con hipertensión resistente? / Are pulse wave velocity and arterial stiffness markers for early pre-clinical atherosclerosis detection in resistant hypertensive patients?

Introducción: La velocidad de la onda de pulso y la rigidez arterial se considera estándar de oro para evaluar daño a órganos diana que haya surgido subclinicamente. La disfunción endotelial es directamente proporcional al desarrollo de la aterosclerosis preclínica. Estos marcadores sustitutos mencionados anteriormente son relativamente más altos en pacientes con hipertensión no controlada o resistente. El objetivo fue evaluar si la rigidez arterial y la velocidad de la onda del pulso también son marcadores sustitutos del desarrollo de la aterosclerosis preclínica en pacientes con hipertensión resistente. Métodos y materiales: Se incluyeron en el estudio un total de 160 pacientes con hipertensión resistente de Croacia e India. La presión arterial central y otros valores clínicos se evaluaron utilizando un dispositivo no invasivo. Resultados: Las estadísticas del grupo se hicieron con perspectiva de género, los valores de la presión arterial sistólica (PA-S), la presión arterial diastólica (PA-D), la presión arterial media (PAM), la presión central sistólica (PC-S) ,la presión central diastólica ( PC-D), la presión de pulso central (cPP) y la velocidad de la onda de pulso (VOP) han sido descritas. Los valores de PA-S en hombres / mujeres fueron 147.26 ±22.12/ 144.10 ± 21.29; los valores de PA-D en hombres/mujeres fueron 94.98 ± 13.36 / 88.57 ± 12.25 respectivamente. Conclusiones: con los resultados obtenidos se puede concluir que la rigidez arterial es un marcador independiente que es directamente proporcional a la disfunción endotelial y al desarrollo de aterosclerosis preclínica.

Introduction: Pulse wave velocity and arterial stiffness are considered a gold standard for evaluating target organ damage that has arisen subclinically. Endothelial dysfunction is directly proportional to the development of preclinical atherosclerosis. These surrogate markers mentioned above are relatively higher in patients with uncontrolled or resistant hypertension. The objective was to assess whether arterial stiffness and pulse wave velocity are also surrogate markers for the development of preclinical atherosclerosis in patients with resistant hypertension. Methods and materials: A total of 160 patients with resistant hypertension from Croatia and India were included in the study. Central blood pressure and other clinical values were evaluated using a non-invasive device. Results: The statistics of the group were made with gender perspective, the values of the systolic blood pressure (PA-S), the diastolic blood pressure (PA-D), the mean arterial pressure (MAP), the central systolic pressure (PC-S), central diastolic pressure (PC-D), central pulse pressure (cPP) and pulse wave velocity (VOP) have been described.The PA-S values in men / women were 147.26 ± 22.12 / 144.10 ± 21.29; PA-D values in men / women were 94.98 ± 13.36/88.57 ± 12.25 respectively. Conclusions: with the results obtained, it can be concluded that arterial stiffness is an independent marker that is directly proportional to endothelial dysfunction and the development of preclinical atherosclerosis.

Factors Correlating with Severity of Coronary Artery Disease in Type 2 Diabetic Patients on Treatment for More Than 5 Years.

Aims: To evaluate the correlation between insulin resistance and other conventional risk factors with respect to severity of coronary artery disease (CAD) in patients with more than 5 years of treatment for type 2 diabetes mellitus. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medicine and Department of Cardiology, Kasturba Medical College, Hospital Mangalore, between February 2013 and December 2013. Methodology: 61 people with more than 5 years of type 2 diabetes who underwent Original Research Article British Journal of Medicine & Medical Research, 4(26): 4364-4372, 2014 4365 coronary angiogram for the evaluation of CAD were recruited in this study. Insulin resistance (HOMA-IR), anthropometric and biochemical parameters were determined, and was correlated with severity of CAD which was assessed by syntax score. Results: There was significant positive linear correlation between log HOMA-IR and syntax score in people with more than 5 years of type 2 diabetes [r=0.605 (95%CI 0.417–0.744), P<0.001]. The correlation of syntax score with other known risk factors of CAD was not significant. Further multivariate analysis after adjusting for conventional risk factors showed a significant association of Log-IR with severity of CAD in people with type 2 diabetes mellitus of more than 5 years of duration (β=0.667, P<0.001) Conclusion: In type 2 diabetes mellitus with treatment more than 5 years of duration, high HOMA-IR appears to be a good indicator of severity of CAD in Type 2 diabetes mellitus and might be a marker of severity of disease, thus helping us in identifying high risk type 2 diabetes mellitus subjects.

Exclusive carbon dioxide-guided renal artery stenting in a case of Takayasu's arteritis with a solitary functioning kidney.

We report the case of a 28-year-old female with type II Takayasu's arteritis affecting her single functioning kidney. Impaired renal function precluded the use of conventional contrast media. We used carbon dioxide-guided renal angioplasty to successfully treat the patient.