Prevalencia de las diferentes causas de elevación de troponinas en un registro multicéntrico de Bariloche. Vinculación entre la magnitud de la elevación y la etiología / Prevalence of the Different Causes of Troponin Elevation in a Multicenter Registry in Bariloche. Link Between the Magnitude of Troponin Elevation and its Etiology

RESUMEN Objetivos: Establecer la prevalencia de infarto agudo de miocardio (IAM) y otras etiologías en pacientes con troponina elevada, relacionar su valor con la etiología y definir el mejor punto de corte para diferenciar un IAM de otras causas. Material y métodos: Se incluyeron todos los pacientes con troponina elevada internados en un año e incorporados al registro REGIBAR. Para analizar la magnitud utilizamos el valor dosado más elevado/valor de referencia. Para establecer el mejor punto de corte se realizó curva ROC y el índice Youden. Resultados: Ingresaron 150 casos (edad: 66,3 ± 13,8 años, 71% hombres); 109 IAM (edad: 71,1 años, 63,5% masculinos), 18 (12%) otras causas cardiacas, 15 (10%) causas no cardíacas y en 8 (5,3%) no se obtuvo etiología. El mejor punto de corte troponina dosada/valor de referencia para discriminar IAM fue >3,15. Conclusiones: En pacientes hospitalizados con troponina elevada el 73% de los casos fue IAM (>3,15veces el punto de corte). La segunda causa más frecuente de elevación fue la insuficiencia cardíaca.

ABSTRACT Objectives: To determine the prevalence of acute myocardial infarction (AMI) and other etiologies in patients with elevated troponin, to associate troponin values with the etiology, and to define the optimal cut-off point to differentiate AMI from other causes. Methods: All patients with elevated troponin who were hospitalized within 1 year and registered in the REGIBAR study were included. Magnitude was analyzed with the highest dose value/baseline value. The ROC curve and the Youden index were used to determine the optimal cut-off point. Results: A total of 150 cases were included (age: 66.3 ± 13.8 years, 71% male); 109 AMI (age: 71.1 years, 63.5% male), 18 (12%) with other cardiac causes, 15 (10%) with non-cardiac causes, and 8 (5.3%) with no evident etiology. The optimal cut-off point for troponin dose/baseline value to discriminate AMI was >3.15. Conclusions: A 73% of inpatients with elevated troponin were AMI cases (>3.15 times the cut-off point). Heart failure was the second most common cause of elevated troponin.

Diagnostic value of echocardiography in myocardial infarction and its complications / 重庆医学

Objective To study the value of echocardiography in the diagnosis of myocardial infarction(MI) and its complica tions.Methods The examination data in 140 cases of MI were collected from January 2012 to January 2016 and performed the analysis and comparison.Results In the ultrasound examination results in 140 cases,120 cases appeared varying degrees of segmental ventricular wall motion abnormalities,its diagnostic rate to MI was 85.71％,which of EKG was 78.57％,the MI detection rate of echocardiography and ECG combined examination was 90.71％,which was higher than that of single use of echocardiography or ECG.With the coronary angiogra-phy results as the control,the detection rate of echocardiography for the coronary arterial lesion sits was 82.86 ％.Among 140 cases of MI,22 cases of complications(15.71 ％) were de-tected out by echocardiography,including 7 cases of true ventricular aneurysm(5.00 ％),4 cases of left ventricular mural thrombosis(2.86 ％),1 case of ventricular septal perforation(0.71％) and 10 cases of ischemic mitral regurgitation(7.14％).Conclusion Echocardiography has higher accuracy in the MI diagnosis,com-bining with ECG can further improve the diagnostic rate.

Antioxidation effect of dihydroquercetin pretreatment in isolatedrat hearts during myocardial ischemia reperfusion injury / 中国药理学通报

Aim To investigate the protective effects of dihydroquercetin(DDQ) against myocardial ischemis reperfusion injury(MIRI) in rats.Methods Male Sprague-Dawley rats were randomly divided into 4 groups(n=10):normal,control,I/R model, and I/R model+DDQ(5,10 mg·L-1).This study used an isolated Langendorff rat heart model.The left ventricu-lar developed pressure(LVDP),heart rate(HR) and the maximum rise and fall rate of the left ventricular pressure(±dp/dtmax) were monitored and documented using a physiological recorder.The levels of lactate dehydrogenase(LDH) and creatine kinase(CK) were analyzed using enzyme-linked immunosorbent assay(ELISA).Infarct size was measured using 2,3,5-triphenyltetrazolium chloride staining.The levels of superoxide dismutase(SOD) and malondialdehyde(MDA), as well as the ratio of glutathione/glutathione disulfide(GSH/GSSG) were measured via ELISA.HE staining was used to observe the pathological changes of myocardial tissue.Results Compared with the I/R model group, the I/R model+DDQ groups raised hemodynamic parameters, SOD level, and GSH/GSSG ratio;and reduced the amount of CK, LDH, MDA levels.Moreover, the I/R model+DDQ groups had lower infarct size and pathological changes in myocardial tissue than I/R model group.Conclusion DDQ exertes cardioprotective effects against I/R via improving the oxygen free radical scavenging ability, the inhibition of oxygen free radical and reducing lipid peroxidation.

Disfunción ventricular post infarto: niveles de expresión de enzima convertidora de angiotensina I y homóloga / Ventricular dysfunction after miocardial infarction: expression levels of angiotensin converting enzyme I and its homologue

INTRODUCCION: Para mantener la funcionalidad del corazón luego de un infarto agudo al miocardio (IAM), se activa entre otros, el sistema renina-angiotensina (SRA). En condiciones fisiológicas existe un equilibrio enzimático dentro de este sistema entre la enzima convertidora de angiotensina I (ECA) y su homóloga (ECA-2). La primera aumenta el remodelamiento miocárdico (RM) contribuyendo a la disfunción del ventrículo y la segunda lo disminuye. Este equilibrio podría verse afectado frente a condiciones fisiopatológicas como el IAM. HIPOTESIS: La progresión de la disfunción ventricular post IAM se asocia a un aumento de los niveles de ARNm de la ECA y a una disminución del ARNm para ECA-2. OBJETIVO: Medir niveles de expresión génica, de ambas vías enzimáticas, en el ventrículo de ratas a corto y largo plazo post IAM. METODO: Se determinaron los niveles de ARNm de ECA y ECA-2 mediante RT-PCR a partir de ventrículos infartados en ratas Sprague Dawley sacrificadas1 y 8 semanas post IAM. RESULTADOS: Los niveles de ARNm para ECA-2 disminuyeron 8 semanas post IAM respecto a su grupo control (IAM=0.6+-0.1 v/s Sham=1.0+-0.1, p<0,008). Los niveles de expresión de ECA a las 8 semanas post IAM muestran un aumento significativo respecto del grupo control (IAM=4.7+- 0.9 v/s Sham=1.0+-0.3, p<0,05). CONCLUSIONES: Se puede concluir que luego de 8 semanas de sufrido un IAM, se produce un desbalance en la expresión de los componentes del SRA que favorece su vía enzimática de ECA y atenúa su vía enzimática de ECA-2 contribuyendo al RM y aumento de la disfunción miocárdica.

INTRODUCTION: To keep the heart function after a miocardial infarction (MI), there is an activation of the Renin-Angiotensin system (RAS). Under physiologic conditions this system has anenzymatic balance between the Angiotensin Converting EnzymeI (ACE) and its homologue (ACE-2). While ACE enhance the miocardial remodeling (MR), wich contributes to the ventricular dysfunction, ACE-2 decreases it. This balance could be afected in physiopathologic conditions like MI. HYPOTHESIS: The progression of the ventricular dysfunction after a MI is associated with an increase in the levels of mRNA of the ACE and a decrease in mRNA for ACE-2. OBJECTIVE: To measure gene expression levels of both enzymatic ways in rat ventricles at short and long term after a MI. METHOD: We established differences in the mRNA levels for ACE and ACE-2 by RT-PCR. We obtained them RNA from the infarcted ventricles of Sprague Dawley rats, sacrified 1 and 8 weeks after MI. RESULTS: The mRNA levels for ACE-2 were lower at 8 weeks after MI than the control group (MI=0.6+-0.1 v/s Control=1.0+-0.1, p<0.008). The expression levels of ACE show a significative increase at 8 weeks after MI in comparison with the control group (MI=4.7+-0.9 v/s Control=1.0+-0.3, p<0.05). CONCLUTIONS: After eight weeks of a MI there is an imbalance in the expression of the components of the RAS that favors the ACE enzymatic way and disfavor theACE-2 way. Thus, contributing to MR and miocardial dysfuntion.

Análisis de la polaridad estructural y funcional de estructuras tridimensionales (esferoides) de células hepáticas porcinas cultivadas in vitro / Structural and functional polarity of porcine hepatocyte cultured spheroids

Los hepatocitos son células epiteliales polarizadas que, al ser aisladas y cultivadas, pierden la polaridad y las propiedades de célula diferenciada. El cultivo de células hepáticas como esferoides permite obtener estructuras con organización de tipo tisular. En este trabajo se analizó estructural y funcionalmente la polaridad de esferoides porcinos. Para ello, las células hepáticas porcinas fueron aisladas y cultivadas en agitación constante. La actividad metabólica de los esferoides fue probada mediante el metabolismo de diazepam y de amonio, así como con síntesis de albúmina. Sus características estructurales mostraron la polaridad de las células. Fueron observados paquetes de fibras de colágeno distribuidas irregularmente y fibras reticulares en formahomogénea en todo el volumen del esferoide. Se hallaron células Ck19+ formando estructuras tipo ducto biliar, así como también _ y _-cateninas y pan-cadherinas en diferentes zonas, especialmente en las laminas externas, con características de epitelio cuboidal. Por microscopía electrónica de barrido se observaron estructuras muy compactas con superficie lisa, y por microscopía electrónica de transmisión, canalículos biliares con microvellosidades, uniones tight, zonula adherens y desmosomas. Las organelas celulares como mitocondrias, núcleos, nucleolos, peroxisomas, retículo endoplásmico estaban bien conservadas. Una compleja red de canalículos biliares fue observada mediante la incorporación y excreción de un análogo de sal biliar fluorescente. El análisis de los ácidos biliares excretados mostró un patrón normal. La morfología y funcionalidad de los esferoides puede aportar un modelo apropiado para aplicaciones en las que es primordial mantener las funciones específicas del hígado, como un dispositivo de hígado bioartificial.

Hepatocytes are epithelial cells that show a complex polarity in vivo. However, hepatocytes isolated and cultured in vitro normally lose both their differentiated properties and polarity. Culturing hepatocyte spheroids seems to be the accurate approach to maintain tissue level of organization. The structural and functional polaritiesof pig liver spheroids were analyzed in this work. Swine liver cells were isolated and cultured as spheroids. Their metabolic activity was proved through the metabolism of diazepam, ammonium and synthesis of albumin. Several structural features show the presence of polarity in the cells inside the spheroids. Reticular and collagen fibers, as well as Ck19(+) cells forming duct-like structures were found. _eta and _-catenins and pancadherins were positive in different regions of the spheroids, mainly in the outer cell layers, which have cuboidal epithelia features. The scanning electron microscopy showed a tightly compacted architecture, with smooth surface. The transmission electron microscopy analysis showed bile canaliculi with microvilli, tight junctions, zonula adherens and desmosome-like junctions. Wellmaintained cellular organelles, as mitochondria, nucleus,nucleolus, peroxisomes, endoplasmic reticulum, were seen in the spheroids. A complex inner bile canaliculinetwork was shown by using a fluorescent bile acid analogue incorporated and excreted by the spheroids. Furthermore, excretion of a normal pattern of bile acids was demonstrated. The morphology and functionality of the spheroids may provide an appropriate model for applications where the maintenance of liver-specific functions is crucial, as a bioartificial liver device.

Vaciamiento gástrico de líquidos en ratas sometidas a infarto del miocardio / Gastric emptying of liquids in rats submitted to acute myocardial infarction

El vaciamiento gástrico (VG) es la transferencia del contenido gástrico al intestino delgado. Las alteracioneshemodinámicas modifican el VG y la actividad motora gastroduodenal. El infarto del miocardio (IM) es una condición patológica en la que hay alteraciones hemodinámicas. Siendo así, el objetivo de este trabajo fue evaluar el efecto del infarto agudo del miocardio sobre el vaciamiento gástrico de una comida líquida isosmótica e inerte desde el punto de vista calórico (soluciónsalina). Fueron utilizadas ratas Wistar machos, con un peso de 220-250g, adaptados a condiciones de laboratorioy divididos en 3 grupos: grupo INF (N=17), ratas con infarto del miocardio por ligadura de la arteria coronaria descendiente anterior izquierda; grupoSH (N=15), Sham en las que fue simulado el proceso quirúrgico, sin ligadura de la arteria coronaria; grupoNA (N=15), ratas en las que no fue hecho ningún procedimiento de sedación o quirúrgico. Los animales, después de la constitución de los grupos, permanecieron en ayuno recibiendo agua ad libitum. Veinticuatro horas después fue evaluado el VG de 1,5 ml/100g de peso de animal de una comida de prueba (CP) salinamarcada con fenol rojo. El VG fue evaluado indirectamente en los animales despiertos a través de la determinacióndel porcentaje de retención gástrica (RG) de la CP, 10 minutos después de administración de oro gástrico.Los resultados mostraron que los animales del grupo INF presentaron RG (media=48,0%) significativamentemás alta con relación a los animales del grupo NA (30,6%,) y el grupo SH (36,6%). No hubo diferenciaentre animales del grupo SH con relación a los del grupo NA. El área de infarto, expresada en porcentaje,en los animales del grupo INF fue de 51,3±4,7% ( ±SE, N=17) y no presentó correlación con los resultadosde RG del mismo grupo (r=-0,05).

Gastric Emptying (GE) is food transition from the stomach to the upper small intestine. Haemodynamics changes modify gastric emptying and the gastroduodenal motor activity. Myocardial Infarction is a pathological condition in which there are haemodynamics changes. Therefore, the objective of the present investigation was to study the effect of acute myocardial infarction on rat gastric emptying of an isosmotic and inert liquid meal. We conducted a study involving male Wistar rats (varying in body weight from 220 g to 250 g), that were allowed to habituate in a laboratory environment and then divided into 3 groups: group INF, rats in which the myocardial infarction was produced by left anterior coronary artery ligation; group SH, rats in which the myocardial infarction was simulated without ligating the anterior coronary artery; and group NA, rats which were not given any anesthesia or surgical procedures. After group constitution, animals were fasted with access to water ad libitum. 24 hours later, the Gastric Retention (GR) of 1.5 ml/100 g animal weight of a test meal of 0.9% NaCl plus the marker phenol red was evaluated. GE was indirectly evaluated in conscious animals, through determining the percentage of gastric retention (% GR) of a test meal, measured 10 minutes after orogastric infusion. Results of the present study showed that animals from the INF group presented GR (median=48.0%), significantly higher than the NA group (30.6%) and SH group (36.6%). No statistical difference in GR was observed between the SH and NA groups. Infarcted area, expressed in percentages, in animals of the INF group was 51.3+/-4.7% (mean SEM, N=17) which not presented correlation with results of GR of the same group (r=-0.05). From a caloric viewpoint, the results suggested that acute myocardial infarct in rats induce delay of the gastric emptying of an isosmotic and inert liquid meal.

The Effect of Injecting?-acceptor Inhibitor on the Miocardial Infarction Prognosis / 医学研究杂志

Objective To investigate the effect of injecting?-acceptor inhibitor on the acute extensive miocardial infarction prognosis. Methods 53 cases patients with acute extensive miocardial infarction were injected Betaloc 5mg, after 3 times, taken Betaloc orally. Betaloc was not applied in another 49 cases patients with acute extensive miocardial infarction.The curative effect was compared between the two groups. Results The efficient or inefficient ratio of the group with Betaloc or the group without Betaloc was 48/53, 5/53 or 36/49, 13/49 respectively. The difference was significant by ?~2 test .Conclusions The patient with acute extensive miocardial infarction can get the extra good by means of early application of ?-acceptor inhibitor except the patient with no-no of the application of Betaloc.