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1.
Revista Digital de Postgrado ; 9(2): 217, ago. 2020. ilus, graf
Article in Spanish | LILACS (Americas), LIVECS | ID: biblio-1103536

ABSTRACT

Los primeros mil días de vida son parte del Curso de Vida, al tomar en consideración la Epigenética, término postulado por Waddington en 1942: modifica la expresión genética SIN cambiar la secuencia de las bases de ADN. El proyecto internacional llamado DOHaD (Developmental Origins of Health and Disease) u ODSE (Orígenes del Desarrollo de la Salud y Enfermedad), está inserto dentro de la Transición Alimentaria y Nutricional (TAN), que, en países en desarrollo­ocurre en forma muy rápida ­produce tanto la malnutrición por déficit como por exceso; es decir la doble carga nutricional. La TAN es producto en nuestro país, de una urbanización acelerada y anárquica, y de cambios socioculturales, como la incorporación de la mujer al mercado de trabajo con menos tiempo para cocinar; está acompañada de una transición epidemiológica con la emergencia y prevalencia de la obesidad y de las enfermedades crónicas como morbiletalidad. Esta doble carga nutricional se modificó, por la situación país, y prevalece más el déficit que el exceso. Se presenta el PROYECTO FUNDACIÓN BENGOA ­ SVPP ­ SOGV ­ CANIA, cuya meta es: Elaborar una agenda preventiva común contra la malnutrición tanto por déficit como por exceso y sus comorbilidades, bajo el enfoque de los primeros mil días de vida y su efecto sobre todo el curso de vida. Se realizó el diseño y aplicación de tres cuestionarios digitales, que se utilizaran para la elaboración de esta meta. Se consolidó un CONSENSO NACIONAL formado por profesionales de la salud involucrados en los primeros mil días de vida(AU)


The first 1000 days of life is the new paradigm that determines health and nutrition during the life course, based on epidemiological models that incorporate the concept of Epigenetics, term introduced by Waddington, that refers to changes that affect the genetic expression without changing the DNA sequence, within the international program DOHaD/ODSE as well as the Food and Nutrition Transition(FNT). This FNT, product of an accelerated and anarchic urbanization that led to sedentary activities, plus the incorporation of women to the work media, with less time for cooking, with the substitution of the traditional diet for one much more practical and efficient in time and effort. It is accompanied by demographic and epidemiologic changes and transitions. The Double Burden of Nutrition in VENEZUELA has changed due to the effect of the recent crisis with a rise in malnutrition and a fall in obesity/overweight. The current project: Fundación Bengoa- Pediatric Society Venezuela (SVPP) ­ CANIA - Obstetric Society of Venezuela (SOGV) is called Developmental Origins of Health and Disease in Venezuela (DOHaD Venezuela): and by means of a national consensus of medical societies and institutions, its goal is "To elaborate a Preventive Agenda both for Malnutrition and for Overweight and Obesity and its comorbidities, considering the First 1000 Days of life and its effect over the life course"


Subject(s)
Humans , Male , Female , Pregnancy in Adolescence , Population Characteristics , Infant, Low Birth Weight , Maternal Mortality , Epigenomics , Cardiovascular Diseases , Epidemiology , Malnutrition , Nutritional Transition
2.
J. Hum. Growth Dev. (Impr.) ; 30(2): 241-250, May-Aug. 2020. tab
Article in English | LILACS (Americas), INDEXPSI | ID: biblio-1114932

ABSTRACT

INTRODUCTION: Prematurity may be related to the early onset of obesity and metabolic syndrome in adolescence. Breastfeeding and feeding are crucial factors in the genesis of cardio metabolic riskOBJECTIVE: To analyze the relationship between the type of breastfeeding and eating habits with the blood pressure, lipid, glycemic and anthropometric profile of adolescents born prematurelyMETHODS: Cross-sectional study with 50 adolescents born prematurely in western Paraná, Brazil, aged 10 to 19 years. Data on birth, breastfeeding and feeding using the 24-hour Food Consumption Marker were evaluated. Weight, height, abdominal circumference (AC), blood pressure (BP) were verified; concentrations of glucose, total cholesterol (TC) and triglycerides (TG) were measured by capillary puncture. Data analysis using descriptive statistics and analysis of varianceRESULTS: Out of total, 78% eat in front of screens and 52% do not take the main meals during the day. Regardless of the amount of meals a day, the lipid, glycemic and AC profiles did not show a statistically significant difference between the groups. There is a statistically significant association between BP and number of meals (p = 0.01), TC and breastfeeding (p = 0.03) and TG with consumption of sausages (p = 0.02) and products rich in carbohydrates (p = 0.01). Most of them (72%) consumed cow's milk before completing one year and only 30% received exclusive breastfeeding until six months of age. Related other values, 30% had high BP, 22% and 41% high TC and TG, respectively. Of the 30% overweight, 60% had high BP, 53% high TG, 33% high TC and 33% percentile AC ≥90CONCLUSION: Breastfeeding did not influence the metabolic profile, but it was evidenced as risk factors for adolescents to develop future cardiovascular problems due to prematurity, inadequate eating habits, overweight, alterations in abdominal circumference, blood pressure and lipid profile


INTRODUÇÃO: A prematuridade pode estar relacionada à instalação precoce de obesidade e síndrome metabólica na adolescência. O aleitamento e a alimentação são fatores cruciais na gênese do risco cardiometabólicoOBJETIVO: Analisar a relação do tipo de aleitamento e hábitos alimentares com o perfil pressórico, lipídico, glicêmico e antropométrico de adolescentes nascidos prematurosMÉTODO: Estudo transversal com 50 adolescentes nascidos prematuros no oeste do Paraná, com idades entre 10 e 19 anos. Avaliaram-se dados do nascimento, aleitamento e alimentação (Marcador de Consumo Alimentar de 24 horas). Verificou-se peso, altura, circunferência abdominal (CA), pressão arterial (PA); dosadas concentrações de glicose, colesterol total (CT) e triglicerídeos (TG) por punção capilar. Análise de dados por estatística descritiva e análise de variânciaRESULTADOS: 78% realizavam alimentação em frente a telas e 52% não realizavam todas as principais refeições do dia; independentemente da quantidade de refeições diárias, os perfis lipídico, glicêmico e CA não apresentaram diferença estatística significante entre os grupos. Observou-se associação estatisticamente significante entre PA e número de refeições (p=0,01), CT e aleitamento materno (p=0,03) e TG com consumo de embutidos (p=0,02) e produtos ricos em carboidratos (p=0,01). Para 72% foi ofertado leite de vaca antes de completar um ano e somente 30% receberam aleitamento materno exclusivo até os seis meses de idade. Na amostra, 30% apresentaram PA elevada, 22% e 41% CT e TG elevados, respectivamente. Dos 30% com excesso de peso, 60% apresentaram PA elevada, 53% TG, 33% CT elevado e 33% percentil CA ≥90CONCLUSÃO: O aleitamento não influenciou no perfil metabólico, porém se evidenciou como fatores de risco para os adolescentes desenvolverem problemas cardiovasculares futuros à prematuridade, hábitos alimentares inadequados, excesso de peso, CA e perfil pressórico e lipídico alterados


Subject(s)
Humans , Male , Female , Adolescent , Infant, Premature , Cardiovascular Diseases , Adolescent , Metabolic Syndrome , Adolescent Health , Adolescent Nutrition , Feeding Behavior
4.
Rev. Soc. Peru. Med. Interna ; 33(2): 61-67, abr.-jun. 2020. ilus
Article in Spanish | LILACS (Americas), LIPECS | ID: biblio-1103675

ABSTRACT

El compromiso cardiovascular de los pacientes con COVID-19, especialmente en la subpoblación con factores de riesgo cardiovasculares, se asocia a la severidad de la enfermedad e inclusive a una mayor mortalidad en algunas series de casos. Los mecanismos fisiopatológicos descritos con mayor claridad son la injuria miocárdica directa y el proceso asociado a la inflamación sistémica.Las manifestaciones cardiovasculares son diversas e incluyen injuria miocárdica, miocarditis, miocardiopatías, insuficiencia cardíaca, síndromes coronarios agudos, arritmias, eventos tromboembólicos. Adicionalmente, debemos considerar los efectos adversos de los medicamentos utilizados para tratar la infección viral. (AU)


Cardiovascular compromise among COVID-19 patients, especially in the subpopulation with cardiovascular risk factors, is associated with severity of disease and a higher mortality in some case-series. The most clearly described pathophysiological mechanisms are direct myocardial injury and the process associated with systemic inflammation. Cardiovascular manifestations are diverse and include myocardial injury, myocarditis, cardiomyopathies, heart failure, acute coronary syndromes, arrhythmias, thromboembolic events. Moreover, we must consider the adverse effects of medications used to treat the viral infection. (AU)


Subject(s)
Humans , Arrhythmias, Cardiac , Cardiovascular Diseases , Coronavirus Infections , SARS Virus , Cardiomyopathies
7.
Rev. Odontol. Araçatuba (Impr.) ; 41(1): 9-14, jan.-abr. 2020. tab
Article in Portuguese | LILACS (Americas), BBO | ID: biblio-1102230

ABSTRACT

O objetivo desse estudo foi avaliar o conhecimento dos cirurgiões-dentistas que trabalham na atenção primária à saúde em um município do nordeste Brasileiro, frente ao atendimento de pacientes portadores de doenças cardiovasculares. Para tanto, de uma população de 36 dentistas, uma amostragem por conveniência de 25 profissionais (69,4%) foi analisada, sob a forma de um questionário autoaplicável. A maioria dos profissionais é formada há mais de 10 anos, sendo que todos se utilizam de artifícios para controle de ansiedade, principalmente a franca conversa (96%). Quanto à prevenção da endocardite infecciosa, foi demonstrada dúvida quanto aos procedimentos onde profilaxia antibiótica é necessária em cardiopatas graves. Outras questões que os profissionais demonstraram despreparo teórico foram quanto ao diagnóstico de hipertensão arterial sistêmica, a qual apenas 64% dos odontólogos assinalaram corretamente; tempo de estabilidade de angina de peito (36,9%) e quantidade de anestésicos com vasopressor à base de epinefrina seguro ao paciente em particular (54,2%). De acordo com a análise das respostas e sua comparação junto ao levante bibliográfico, tem-se claramente em vista a necessidade dos profissionais se atualizarem, sob alguma forma de educação permanente(AU)


The correct evaluation of patients with cardiovascular disease is based on a careful anamnesis and on the previous knowledge of the main coronary diseases and its sequels. This study aims to evaluate the knowledge of dentists working in primary health care in the city of Campina Grande about patients with cardiovascular disease. For this purpose, from a population of 36 dentists, a convenient sample of 25 professionals (69.4%) was analyzed in the form of a self-administered questionnaire. Most professionals is formed more than 10 years, all of which make use of anxiety handling, especially an honest conversation (96%). As for the prevention of infective endocarditis has been demonstrated doubt as to the procedures where antibiotic prophylaxis is needed in severe heart disease. Other issues that professionals demonstrated theoretical unpreparedness were the diagnosis of hypertension, which only 64% of dentists pointed out correctly; time of stable angina pectoris (36.9%) and the safe amount of anesthetic with vasoconstrictor epinephrine to the cardiac patient (54.2%). Conclusion: According to the analysis of the responses and its comparison with the literature, highlighting the need to implement a continuing education(AU)


Subject(s)
Humans , Male , Female , Primary Health Care , Cardiovascular Diseases , Dentists , Dentists/education , Endocarditis , Patient Care
8.
Rev. Asoc. Méd. Argent ; 133(1): 4-11, mar. 2020. graf
Article in Spanish | LILACS (Americas) | ID: biblio-1097695

ABSTRACT

Desde hace varias décadas se conocen los clásicos factores de riesgo cardiovascular (género, edad, hipertensión arterial, dislipidemias, tabaquismo, obesidad, sedentarismo). También existen factores de riesgo "no convencionales", es decir situaciones no descriptas ni contenidas en la mayoría de los puntajes de riesgo tradicionales, pero de las cuales existen evidencias científicas. En esta revisión se analizan algunos de ellos, tales como factores socioeconómicos, horarios prolongados de trabajo, factores ambientales, aislamiento social, cantidad y calidad del sueño. También hay factores de "protección" cardiovascular como la dieta mediterránea. La literatura cuenta con un número muy elevado de publicaciones que abarcan estos factores. En la presente descripción se incluyeron algunas que fuesen representativas, con buen diseño experimental y que hayan realizado análisis multivariado de los resultados para controlar potenciales confundidores que invaliden las conclusiones. Finalmente, se discuten los mecanismos fisiopatológicos involucrados en la generación de los eventos cardiovasculares finales. (AU)


The classical cardiovascular risk factors have been known for several decades (gender, age, arterial hypertension, dyslipidemia, smoking, obesity, sedentary lifestyle). There also exist "non conventional" risk factors, that are those not described or not included in the majority of the traditional cardiovascular risk scores, but for whom scientific evidence is available. In this review some of them are analyzed, such as socio economic factors, prolonged work schedules, environmental factors, social isolation, sleep quantity and quality. There are also some "preventive" cardiovascular factors as the Mediterranean diet. There exist considerable amount of publications in the literature analyzing these issues. In the present paper some of them are discussed. They have been selected as they were representative of the corresponding aspect, well designed and with multivariate statistical analysis of the results, in order to control potential confounders that could invalidate the conclusions. Finally, the pathophysiological mechanisms involved are discussed. (AU)


Subject(s)
Humans , Sleep Wake Disorders , Socioeconomic Factors , Cardiovascular Diseases/etiology , Cardiovascular Diseases/epidemiology , Psychological Distress , Social Isolation , Cardiovascular Diseases/prevention & control , Cardiovascular Diseases/psychology , Risk Factors , Workload , Diet, Mediterranean , Environment
10.
Nursing (Säo Paulo) ; 23(260): 3523-3528, jan.2020.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1095538

ABSTRACT

Esta pesquisa teve como objetivo cartografar a produção de cuidados da equipe de enfermagem a usuários que têm o coração em tratamento, em um hospital especializado do estado de São Paulo. O método escolhido foi o da cartografia, sob o referencial teórico da esquizoanálise. Os dados foram coletados por meio da observação participante, que possibilitou mapear o cuidado produzido pela equipe de enfermagem durante o caminhar da pesquisa. Pelas lentes cartográficas, avistaram-se mapas que revelaram um cuidado criativo, permeado por múltiplas tecnologias, emoções, subjetividades, afetos, ressentimentos e potencialidades. Observou-se que há uma produção de cuidados entre os profissionais de enfermagem junto ao paciente que sofre do coração, e neste cuidado há múltiplos fatores envolvidos, físicos, psíquicos, sociais, e que em um serviço de alta complexidade, os profissionais se apoiam em múltiplas tecnologias, articulando-as para promover um cuidado efetivo e individualizado.(AU)


This research aimed to map the care production of the nursing staff to users who have their heart in treatment, in a specialized hospital in the state of São Paulo. The method chosen was that of cartography, under the theoretical framework of schizoanalysis. Data were collected through participant observation, which made it possible to map the care produced by the nursing team during the research. Through the cartographic lenses, maps were revealed that revealed a creative care, permeated by multiple technologies, emotions, subjectivities, affections, resentments and potentialities. It was observed that there is a production of care among nursing professionals with the patient suffering from the heart, and in this care there are multiple factors involved, physical, mental, social, and that in a highly complex service, professionals rely on technologies, articulating them to promote effective and individualized care.(AU)


Esta investigación tuvo como objetivo mapear la producción de atención del personal de enfermería a los usuarios que tienen su corazón en tratamiento, en un hospital especializado en el estado de São Paulo. El método elegido fue el de cartografía, bajo el marco teórico del esquizoanálisis. Los datos fueron recolectados a través de la observación participante, lo que permitió mapear la atención producida por el equipo de enfermería durante la investigación. A través de las lentes cartográficas, se revelaron mapas que revelaron una atención creativa, impregnada de múltiples tecnologías, emociones, subjetividades, afectos, resentimientos y potencialidades. Se observó que existe una producción de atención entre los profesionales de enfermería con el paciente que sufre del corazón, y en esta atención hay múltiples factores involucrados, físicos, mentales, sociales y que en un servicio altamente complejo, los profesionales confían tecnologías, articulándolas para promover una atención eficaz e individualizada.(AU)


Subject(s)
Humans , Cardiovascular Diseases , Biomedical Technology , Cardiovascular Nursing , Heart Diseases , Access to Essential Medicines and Health Technologies
11.
Arch. med ; 20(1): 11-22, 2020-01-18.
Article in English | LILACS (Americas) | ID: biblio-1053172

ABSTRACT

Objective: to evaluate the correlation between a group of conventional biomarkers of cardiovascular risk with the Castelli-I and Castelli-II indices, and TG/HDL-C ratio in patients assigned to a program of cardiovascular risk for users of the clinical laboratory service of an institution that provides health services in the southwest of the Colombia.Materials and Methods: retrospective, descriptive multivariate exploratory study, carried out in 2 126 patients. Some sociodemographic variables were analyzed, as well as glucose and lipid profile. The Castelli-I and Castelli-II indices, and TG/HDL-C ratio were calculated. The correlation among the variables was evaluated through a matrix of correlations, the correlation index and the Bartlett's Test of Sphericity. The analysis ended with a study of main components, which allowed to identify how the variables studied were grouped into components that characterized the population. Results: the average age was 56 ± 11 years; 68.7% were women; 48% hypercholesterolemic and 49% hypertriglyceridemic; 22% with alterations in glucose. Total cholesterol correlated positively with LDL-C and triglycerides negatively with HDL-C. Two components characterized the population, one related to cardiovascular risk and the other to lipid alterations. Conclusions: conventional biomarkers reveal high prevalences in dyslipidemias, in contrast to atherogenic indices. The results highlight the importance of considering the evaluation of these indices in primary care and the need to strengthen the measurement systems of clinical laboratories for the reliability of the data on which decisions are made for the management of these patients..(AU)


Objetivo: evaluar la correlación entre un grupo de biomarcadores convencionales de riesgo cardiovascular con los índices de Castelli-I, Castelli-II y TG/cHDL en pacientes de riesgo cardiovascular usuarios del servicio de laboratorio clínico de una institución prestadora de servicios de salud del suroccidente de Colombia. Materiales y Métodos: estudio retrospectivo, descriptivo multivariado exploratorio, llevado a cabo en 2 126 pacientes. Se analizaron algunas variables sociodemográficas, glucosa y perfil lipídico. Se calcularon los índices de Castelli I/II y el índice de TG/cHDL. La correlación entre las variables se evaluó a través de una matriz de correlaciones, el índice de correlación y el Test de Esfericidad de Bartlet. El análisis finalizó con un estudio de componentes principales que permitió identificar como se agrupaban las variables estudiadas en componentes que caracterizaban a la población. Resultados: la edad promedio fue de 56±11 años, 68,7% fueron mujeres; 48% ipercolesterolemicos y 49% hipertrigliceridemicos; 22% con alteraciones en la glucosa. El colesterol total correlacionó positivamente con cLDL y los triglicéridos negativamente con cHDL. Dos componentes caracterizaron la población, uno relacionado con el riesgo cardiovascular y otro con las alteraciones lipídicas. Conclusiones: los biomarcadores convencionales develan altas prevalencias en las dislipidemias en contraste con los índices aterogénicos. Los resultados resaltan la importancia de considerar la evaluación de estos índices en atención primaria y la necesidad de fortalecer los sistemas de medición de los laboratorios clínicos para la confiabilidad de los datos sobre los cuales se toman decisiones en el manejo de estos pacientes.


Subject(s)
Humans , Biomarkers , Cardiovascular Diseases
12.
Article in English | WPRIM (Western Pacific) | ID: wprim-787137

ABSTRACT

Aging is one of the risk factors for the development of cardiovascular diseases. During the progression of cellular senescence, cells enter a state of irreversible growth arrest and display resistance to apoptosis. As a flavonoid, quercetin induces apoptosis in various cells. Accordingly, we investigated the relationship between quercetin-induced apoptosis and the inhibition of cellular senescence, and determined the mechanism of oxidative stress-induced vascular smooth muscle cell (VSMC) senescence. In cultured VSMCs, hydrogen peroxide (H₂O₂) dose-dependently induced senescence, which was associated with increased numbers of senescence-associated β-galactosidase-positive cells, decreased expression of SMP30, and activation of p53-p21 and p16 pathways. Along with senescence, expression of the anti-apoptotic protein Bcl-2 was observed to increase and the levels of proteins related to the apoptosis pathway were observed to decrease. Quercetin induced apoptosis through the activation of AMP-activated protein kinase. This action led to the alleviation of oxidative stress-induced VSMC senescence. Furthermore, the inhibition of AMPK activation with compound C and siRNA inhibited apoptosis and aggravated VSMC senescence by reversing p53-p21 and p16 pathways. These results suggest that senescent VSMCs are resistant to apoptosis and quercetin-induced apoptosis attenuated the oxidative stress-induced senescence through activation of AMPK. Therefore, induction of apoptosis by polyphenols such as quercetin may be worthy of attention for its anti-aging effects.


Subject(s)
Aging , AMP-Activated Protein Kinases , Apoptosis , Cardiovascular Diseases , Cellular Senescence , Hydrogen Peroxide , Muscle, Smooth, Vascular , Polyphenols , Quercetin , Risk Factors , RNA, Small Interfering
13.
Article in English | WPRIM (Western Pacific) | ID: wprim-786229

ABSTRACT

Cardiovascular disease (CVD) is considered a primary driver of global mortality and is estimated to be responsible for approximately 17.9 million deaths annually. Consequently, a substantial body of research related to CVD has developed, with an emphasis on identifying strategies for the prevention and effective treatment of CVD. In this review, we critically examine the existing CVD literature, and specifically highlight the contribution of Mendelian randomization analyses in CVD research. Throughout this review, we assess the extent to which research findings agree across a range of studies of differing design within a triangulation framework. If differing study designs are subject to non-overlapping sources of bias, consistent findings limit the extent to which results are merely an artefact of study design. Consequently, broad agreement across differing studies can be viewed as providing more robust causal evidence in contrast to limiting the scope of the review to a single specific study design. Utilising the triangulation approach, we highlight emerging patterns in research findings, and explore the potential of identified risk factors as targets for precision medicine and novel interventions.


Subject(s)
Artifacts , Bias , Cardiovascular Diseases , Mendelian Randomization Analysis , Mortality , Precision Medicine , Random Allocation , Risk Factors
14.
Article in English | WPRIM (Western Pacific) | ID: wprim-786211

ABSTRACT

BACKGROUND AND OBJECTIVES: 2018 ESC/ESH Hypertension guideline recommends 2-drug combination as initial anti-hypertensive therapy. However, real-world evidence for effectiveness of recommended regimens remains limited. We aimed to compare the effectiveness of first-line anti-hypertensive treatment combining 2 out of the following classes: angiotensin-converting enzyme (ACE) inhibitors/angiotensin-receptor blocker (A), calcium channel blocker (C), and thiazide-type diuretics (D).METHODS: Treatment-naïve hypertensive adults without cardiovascular disease (CVD) who initiated dual anti-hypertensive medications were identified in 5 databases from US and Korea. The patients were matched for each comparison set by large-scale propensity score matching. Primary endpoint was all-cause mortality. Myocardial infarction, heart failure, stroke, and major adverse cardiac and cerebrovascular events as a composite outcome comprised the secondary measure.RESULTS: A total of 987,983 patients met the eligibility criteria. After matching, 222,686, 32,344, and 38,513 patients were allocated to A+C vs. A+D, C+D vs. A+C, and C+D vs. A+D comparison, respectively. There was no significant difference in the mortality during total of 1,806,077 person-years: A+C vs. A+D (hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.97−1.20; p=0.127), C+D vs. A+C (HR, 0.93; 95% CI, 0.87−1.01; p=0.067), and C+D vs. A+D (HR, 1.18; 95% CI, 0.95−1.47; p=0.104). A+C was associated with a slightly higher risk of heart failure (HR, 1.09; 95% CI, 1.01−1.18; p=0.040) and stroke (HR, 1.08; 95% CI, 1.01−1.17; p=0.040) than A+D.CONCLUSIONS: There was no significant difference in mortality among A+C, A+D, and C+D combination treatment in patients without previous CVD. This finding was consistent across multi-national heterogeneous cohorts in real-world practice.


Subject(s)
Adult , Angiotensin Receptor Antagonists , Antihypertensive Agents , Calcium Channel Blockers , Calcium Channels , Cardiovascular Diseases , Cohort Studies , Diuretics , Heart Failure , Humans , Hypertension , Korea , Mortality , Myocardial Infarction , Propensity Score , Stroke
15.
Article in English | WPRIM (Western Pacific) | ID: wprim-786209

ABSTRACT

BACKGROUND AND OBJECTIVES: We aim to explore the additional discriminative accuracy of a deep learning (DL) algorithm using repeated-measures data for identifying people at high risk for cardiovascular disease (CVD), compared to Cox hazard regression.METHODS: Two CVD prediction models were developed from National Health Insurance Service-Health Screening Cohort (NHIS-HEALS): a Cox regression model and a DL model. Performance of each model was assessed in the internal and 2 external validation cohorts in Koreans (National Health Insurance Service-National Sample Cohort; NHIS-NSC) and in Europeans (Rotterdam Study). A total of 412,030 adults in the NHIS-HEALS; 178,875 adults in the NHIS-NSC; and the 4,296 adults in Rotterdam Study were included.RESULTS: Mean ages was 52 years (46% women) and there were 25,777 events (6.3%) in NHIS-HEALS during the follow-up. In internal validation, the DL approach demonstrated a C-statistic of 0.896 (95% confidence interval, 0.886–0.907) in men and 0.921 (0.908–0.934) in women and improved reclassification compared with Cox regression (net reclassification index [NRI], 24.8% in men, 29.0% in women). In external validation with NHIS-NSC, DL demonstrated a C-statistic of 0.868 (0.860–0.876) in men and 0.889 (0.876–0.898) in women, and improved reclassification compared with Cox regression (NRI, 24.9% in men, 26.2% in women). In external validation applied to the Rotterdam Study, DL demonstrated a C-statistic of 0.860 (0.824–0.897) in men and 0.867 (0.830–0.903) in women, and improved reclassification compared with Cox regression (NRI, 36.9% in men, 31.8% in women).CONCLUSIONS: A DL algorithm exhibited greater discriminative accuracy than Cox model approaches.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02931500


Subject(s)
Adult , Artificial Intelligence , Cardiovascular Diseases , Cohort Studies , Female , Follow-Up Studies , Humans , Insurance, Health , Learning , Male , Mass Screening , National Health Programs
16.
Article in English | WPRIM (Western Pacific) | ID: wprim-786085

ABSTRACT

The number of the elderly individuals is steeply increasing, and their absolute cardiovascular risk is higher than that of younger age groups. However, very few statin trials have included elderly patients alone. Recently, we published the SCOPE-75 study, which analyzed the effect of statins for primary prevention in elderly Koreans (>75 years). In this study, statin users showed significantly fewer cardiovascular events and a lower all-cause mortality rate, supporting more active use of statins in this population. In the current review, we further compare and discuss similar studies reported in the past decades and in recent years.


Subject(s)
Aged , Cardiovascular Diseases , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Mortality , Primary Prevention
17.
Article in English | WPRIM (Western Pacific) | ID: wprim-786084

ABSTRACT

Post-transcriptional regulations of mRNA transcripts such as alternative splicing and alternative polyadenylation can affect the expression of genes without changing the transcript levels. Recent studies have demonstrated that these post-transcriptional events can have significant physiological impacts on various biological systems and play important roles in the pathogenesis of a number of diseases, including cancers. Nevertheless, how cellular signaling pathways control these post-transcriptional processes in cells are not very well explored in the field yet. The mammalian target of rapamycin complex 1 (mTORC1) pathway plays a key role in sensing cellular nutrient and energy status and regulating the proliferation and growth of cells by controlling various anabolic and catabolic processes. Dysregulation of mTORC1 pathway can tip the metabolic balance of cells and is associated with a number of pathological conditions, including various types of cancers, diabetes, and cardiovascular diseases. Numerous reports have shown that mTORC1 controls its downstream pathways through translational and/or transcriptional regulation of the expression of key downstream effectors. And, recent studies have also shown that mTORC1 can control downstream pathways via post-transcriptional regulations. In this review, we will discuss the roles of post-transcriptional processes in gene expression regulations and how mTORC1-mediated post-transcriptional regulations contribute to cellular physiological changes. We highlight post-transcriptional regulation as an additional layer of gene expression control by mTORC1 to steer cellular biology. These emphasize the importance of studying post-transcriptional events in transcriptome datasets for gaining a fuller understanding of gene expression regulations in the biological systems of interest.


Subject(s)
Alternative Splicing , Cardiovascular Diseases , Dataset , Gene Expression , Polyadenylation , RNA, Messenger , Sirolimus , Social Control, Formal , Transcriptome
18.
Article in English | WPRIM (Western Pacific) | ID: wprim-786083

ABSTRACT

Cardiomyopathy is the leading cause of mortality worldwide. While the causes of cardiomyopathy continue to be elucidated, current evidence suggests that aberrant bioactive lipid signaling plays a crucial role as a component of cardiac pathophysiology. Sphingolipids have been implicated in the pathophysiology of cardiovascular disease, as they regulate numerous cellular processes that occur in primary and secondary cardiomyopathies. Experimental evidence gathered over the last few decades from both in vitro and in vivo model systems indicates that inhibitors of sphingolipid synthesis attenuate a variety of cardiomyopathic symptoms. In this review, we focus on various cardiomyopathies in which sphingolipids have been implicated and the potential therapeutic benefits that could be gained by targeting sphingolipid metabolism.


Subject(s)
Cardiomyopathies , Cardiovascular Diseases , Ceramides , In Vitro Techniques , Metabolism , Mortality , Myocytes, Cardiac , Pathology , Receptors, Lysosphingolipid , Sphingolipids
19.
Article in English | WPRIM (Western Pacific) | ID: wprim-786076

ABSTRACT

Cardiovascular disease (CVD), which is the leading cause of death worldwide, is strongly affected by diet. Diet can affect CVD directly by modulating the composition of vascular plaques, and indirectly by affecting the rate of aging. This review summarizes research on the relationships of fasting, meal timing, and meal frequency with CVD incidence and progression. Relevant basic research studies, epidemiological studies, and clinical studies are highlighted. In particular, we discuss both intermittent and periodic fasting interventions with the potential to prevent and treat CVD.


Subject(s)
Aging , Blood Pressure , Caloric Restriction , Cardiovascular Diseases , Cause of Death , Diet , Epidemiologic Studies , Fasting , Incidence , Meals
20.
Article in English | WPRIM (Western Pacific) | ID: wprim-786075

ABSTRACT

Cardiovascular disease remains a leading cause of morbidity and mortality worldwide. Aspects of disease severity that are associated with heightened inflammation, such as during atherosclerosis or after myocardial infarction, are correlated with macrophage activation and macrophage polarization of the transcriptome and secretome. In this setting, non-coding RNAs (ncRNAs) may be as abundant as protein-coding genes and are increasingly recognized as significant modulators of macrophage gene expression and cytokine secretion, although the functions of most ncRNAs—and in particular, long non-coding RNAs—remain unknown. Herein, we discuss a subset of specific ncRNAs of interest in macrophages in atherosclerosis and during myocardial inflammation.


Subject(s)
Atherosclerosis , Cardiovascular Diseases , Gene Expression , Inflammation , Macrophage Activation , Macrophages , Mortality , Myocardial Infarction , RNA, Long Noncoding , RNA, Untranslated , Transcriptome
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