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Biomédica (Bogotá) ; 41(2): 225-233, abr.-jun. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1339261


Resumen | El síndrome de vasoconstricción cerebral reversible se produce por la constricción variable, segmentaria y multifocal, de las arterias cerebrales y, generalmente, es de curso benigno. Se describe el caso de una mujer de 49 años que consultó por cefalea, síntomas visuales y convulsiones; tres días después, presentaba áreas de vasoconstricción en, por lo menos, dos territorios vasculares y dos segmentos de las mismas arterias. Fue internada en la unidad de cuidados intensivos para controlarle la presión arterial y recibir tratamiento médico. Tuvo una evolución tórpida y, en el séptimo día de hospitalización, desarrolló edema cerebral maligno, tras lo cual ocurrió la muerte cerebral. Se inició entonces el plan de donación de órganos y, posteriormente, se practicó una autopsia guiada del cerebro. El estudio de patología descartó vasculitis y reveló áreas de hemorragia en la convexidad cerebral. Se discuten los aspectos más relevantes de los casos con evolución fulminante informados en la literatura científica. El síndrome de vasoconstricción cerebral reversible se asocia con resultados fatales cuando los pacientes tienen una deficiencia neurológica focal, la neuroimagen inicial muestra alteraciones y hay un deterioro clínico rápido. Es importante conocer los factores asociados con un mal pronóstico, y establecer estrategias tempranas de intervención y prevención.

Abstract | The reversible cerebral vasoconstriction syndrome is a variable, segmental, and multifocal constriction of brain arteries, usually with a benign course. We describe the case of a 49-year-old woman who presented with headaches, visual symptoms, and seizures. Three days after admission, vasoconstriction areas were found in at least two vascular territories in two segments of the same arteries. The patient was admitted to the intensive care unit where her blood pressure was monitored and she received medical treatment. Surprisingly, the patient presented an unpredicted evolution in developing malignant cerebral edema on the seventh day after admission. She then suffered brain death and was taken to organ donation. A guided nervous system necropsy was later performed. The pathology discarded vasculitis and exhibited hemorrhage areas in the cerebral convexity. Herein, we discuss the most relevant aspects of cases with fulminant evolution reported in the literature. The reversible cerebral vasoconstriction syndrome is usually associated with fatal outcomes when patients exhibit focalization, their first neuroimaging typically shows disturbances, and a rapid clinical deterioration occurs. It is crucial to identify factors linked to poor prognosis and set intervention strategies and early prevention.

Vasoconstriction , Stroke , Prognosis , Cerebral Hemorrhage , Mortality
Acta Physiologica Sinica ; (6): 631-645, 2021.
Article in Chinese | WPRIM | ID: wpr-887698


Arachidonic acids (AA) widely exist in multiple organs and can be metabolized into small lipid molecules with strong biological functions through several pathways. Among them, epoxyeicosatrienoic acids (EETs) and 20-hydroxyeicosatetraenoic acid (20-HETE), which are produced by cytochrome P450 enzymes, have attracted a lot of attentions, especially in vascular homeostasis. The regulation of vascular function is the foundation of vascular homeostasis, which is mainly achieved by manipulating the vascular structure and biological function. In the past 30 years, the roles of EETs and 20-HETE in the regulation of vascular function have been widely explored. In this review, we discussed the effects of EETs and 20-HETE on angiogenesis and vascular inflammation, respectively. Generally, EETs can dilate blood vessels and inhibit vascular inflammation, while 20-HETE can induce vasoconstriction and vascular inflammation. Interestingly, both EETs and 20-HETE can promote angiogenesis. In addition, the roles of EETs and 20-HETE in several vascular diseases, such as hypertension and cardiac ischemia, were discussed. Finally, the therapeutic perspectives of EETs and 20-HETE for vascular diseases were also summarized.

Arachidonic Acid , Arachidonic Acids , Cytochrome P-450 Enzyme System , Humans , Hydroxyeicosatetraenoic Acids , Hypertension , Vasoconstriction
Article in English | WPRIM | ID: wpr-878338


Objective@#Exposure to microgravity results in postflight cardiovascular deconditioning in astronauts. Vascular oxidative stress injury and mitochondrial dysfunction have been reported during this process. To elucidate the mechanism for this condition, we investigated whether mitochondrial oxidative stress regulates calcium homeostasis and vasoconstriction in hindlimb unweighted (HU) rat cerebral arteries.@*Methods@#Three-week HU was used to simulate microgravity in rats. The contractile responses to vasoconstrictors, mitochondrial fission/fusion, Ca @*Results@#An increase of cytoplasmic Ca @*Conclusion@#The present results suggest that mitochondrial oxidative stress enhances cerebral vasoconstriction by regulating calcium homeostasis during simulated microgravity.

Animals , Calcium/metabolism , Cerebral Arteries , Homeostasis , Male , Mitochondria/physiology , Myocytes, Smooth Muscle/physiology , Oxidative Stress , Rats , Rats, Sprague-Dawley , Vasoconstriction/physiology , Weightlessness Simulation
Pesqui. vet. bras ; 40(3): 197-201, Mar. 2020. tab
Article in English | LILACS, VETINDEX | ID: biblio-1135609


The temperature gradients are dynamic and noninvasive monitoring techniques that provide information on peripheral blood flow and have been related to the prognosis of patients with circulatory shock. This study evaluated 47 elderly domestic cats' temperature gradients, and we measured central (rectal) and peripheral (palmar, plantar and medial region of the radio) temperatures. Values found in this study are compatible with studies in young felines and differ from dogs and humans. The mean gradients found were 7.5°C for the central-peripheral; 5.6°C for the peripheral-environmental; 2.7°C for the skin-diff; and 0°C for the member-diff and the variables age and gender do not seem to influence these measurements. To the authors' knowledge, there is no description of temperature gradients in elderly domestic cats, so this study pretends to clarify the vasoconstriction response in this group of animals.(AU)

Os gradientes de temperatura são técnicas de monitoração dinâmicas e não-invasivas que fornecem informações sobre o fluxo sanguíneo periférico, e têm sido relacionados ao prognóstico de paciente com choque circulatório. O presente estudo avaliou os gradientes de temperatura em 47 felinos domésticos idosos aferindo as temperaturas central (retal) e periférica (palmar, plantar e região medial do rádio). Os gradientes encontrados foram 7,5°C para o centro-periférico; 5,6°C para o periférico-ambiental; 2,7°C para o skin-diff; e 0°C para o member-diff. As variáveis idade e sexo não pareceram influenciar as mensurações. Não há, em conhecimento dos autores, descrição prévia dos gradientes de temperatura em felinos domésticos idosos, e por isso esse estudo pretende contribuir com o entendimento sobre a capacidade de resposta de vasoconstrição nesse grupo de animais.(AU)

Animals , Cats , Shock/diagnosis , Shock/prevention & control , Skin/blood supply , Vasoconstriction , Body Temperature , Thermometers
Vitae (Medellín) ; 27(2): 1-11, 2020. Ilustraciones
Article in English | LILACS, COLNAL | ID: biblio-1120320


Background: Passiflora quadrangularis L. has antihypertensive and anxiolytic properties observed in experimental models. Objectives: The aim of this work was to establish the vascular effects exerted by two known monodesmosidic triterpene saponins, 3-O-ß-D-glucopyranosyloleanolic acid (Compound 1) (not previously described for this plant) and, 3-O-[ß-D-glucopyranosyl-(1→2)-ß-D-glucopyranosyl] oleanolic acid (Compound 2), isolated from the ethanolic extract of Passiflora quadrangularis L. leaves. Methods: The structural elucidation was achieved by Nuclear Magnetic Resonance (NMR) experiments and High-Resolution Mass Spectrometry (HRMS). Aortic rings from Wistar rats, previously stimulated with phenylephrine (PE, 1µM) and washed, were exposed to cumulatively concentrations of compound 1 and compound 2 (10 to 400 µM). Ethanolic extract from leaves of P. quadrangularis L. (10 to 320 µg/ mL) and clonidine (1nM to 100µM) were also used for comparison. Concentration response curves of compounds 1 and 2 were examined in presence and absence of: endothelium, the alpha-2 antagonist yohimbine (1 and 100 µM), the alpha non selective antagonist phentolamine (1µM), the alpha-1 antagonist prazosin (1µM) and the calcium channel blocker verapamil (10 and 100 µM). In addition, cumulatively response curve of acetylcholine (ACh, 10nM to 10µM) and sodium nitroprusside (SNP, 1nM to 100µM) were assayed in rings precontracted with compounds 1 and 2 (400 µM). Results: Compounds 1 and 2 elicited a vasoconstriction response in intact aorta rings in similar way (pEC50: 3.92±0.01 and 4.09±0.01, respectively), effect that did not change in denuded rings (pEC50: 3.90±0.01 and 4.11±0.01). The potency order (pEC50) of compounds 1 and 2 decreased according to the following: verapamil (3.53±0.01 and 3.90±0.02; p<0.05) < yohimbine (3.65±0.01 and 3.94±0.02; p<0.05) < prazosin (3.86±0.01 and 4.30±0.02) < phentolamine (4.05±0.02 and 4.05±0.01). SNP but not ACh, was able to decrease the vasopressor effect of compounds 1 and 2 (pIC50: 8.61±0.01 and 8.24 ± 0.15, respectively). Conclusions: Compounds 1 and 2 are key metabolites responsible for the ex vivo vasoconstrictor response induced by P. quadrangularis L. Activation of voltage-dependent calcium channels and/or α2-adrenergic receptors stimulation could be mechanisms implicated.

Antecedentes: Passiflora quadrangularis L. tiene propiedades antihipertensivas y ansiolíticas observadas en modelos animales. Objetivos: El objetivo de este trabajo fue establecer los efectos vasculares ejercidos por dos conocidas saponinas triterpénicas monodesmosídicas: el ácido 3-O-ß-D glucopiranosiloleanólico (Compuesto 1) (no descrito previamente para esta especie vegetal) y el ácido 3-O-[ß-D-glucopiranosil- (1→2)-ß-D-glucopiranosil]oleanólico (Compuesto 2), aisladas del extracto etanólico de las hojas de Passiflora quadrangularis L. Métodos: La elucidación estructural se llevó a cabo mediante experimentos de Resonancia Magnética Nuclear (NMR) y determinaciones de Espectrometría de Masas de Alta Resolución (HRMS). Los anillos aórticos de ratas Wistar, previamente estimulados con fenilefrina (PE, 1 µM) y lavados, fueron expuestos a concentraciones acumulativas del compuesto 1 y compuesto 2 (10 a 400 µM). El extracto etanólico de las hojas de P. quadrangularis L. (10 a 320 µg / ml) y clonidina (1 nM a 100 µM) se utilizaron para la comparación. Las curvas de concentración respuesta de los compuestos 1 y 2 se examinaron en presencia y ausencia de: endotelio, el antagonista alfa-2 yohimbina (1 y 100 µM), el antagonista alfa no selectivo fentolamina (1 µM), el antagonista alfa-1 prazosina (1 µM) y el bloqueador de canales de calcio verapamilo (10 y 100 µM). Además, la curva de concentraciones acumulativas de acetilcolina (ACh, 10 nM a 10 µM) y nitroprusiato de sodio (SNP, 1 nM a 100 µM) se ensayó en anillos pre-contraídos con los compuestos 1 y 2 (400 µM). Resultados: Los compuestos 1 y 2 provocaron una respuesta de vasoconstricción en los anillos de aorta intactos de manera similar (pEC50: 3.92 ± 0.01 y 4.09 ± 0.01, respectivamente), este efecto no cambió en los anillos denudados (pEC50: 3.90 ± 0.01 y 4.11 ± 0.01). El orden de potencia (pEC50) de los compuestos 1 y 2 disminuyó de la siguiente manera: verapamilo (3.53 ± 0.01 y 3.90 ± 0.02; p <0.05) < yohimbina (3.65 ± 0.01 y 3.94 ± 0.02; p <0.05) < prazosina (3.86 ± 0.01 y 4.30 ± 0.02)

Humans , Saponins , Vasoconstriction , Passiflora , Oleanolic Acid , Antihypertensive Agents
Article in Chinese | WPRIM | ID: wpr-878683


Kidney is one of the important organs of the body.With both excretory and endocrine functions,it plays a vital role in regulating the normal physiological state.As a precursor of the nitric oxide(NO)synthesis

Animals , Arginine/physiology , Kidney/physiology , Muscle, Smooth, Vascular , Nitric Oxide/physiology , Rats , Receptors, Adrenergic, alpha-1/physiology , Renal Insufficiency/physiopathology , Signal Transduction , Vasoconstriction
Rev. chil. neuro-psiquiatr ; 57(4): 357-364, dic. 2019. tab, ilus
Article in Spanish | LILACS | ID: biblio-1092732


Resumen Introducción: El síndrome de vasoconstricción cerebral reversible es una entidad clínica y radiológica caracterizada por cefalea en estallido recurrente y vasoconstricción segmental multifocal de las arterias cerebrales, acompañado o no de otros déficits neurológicos, el cual resuelve espontáneamente en uno a tres meses. Métodos: Se reporta el caso clínico de una paciente que fue diagnosticada de síndrome de vasoconstricción cerebral reversible secundario a fármacos vasoactivos. Se plantea una búsqueda bibliográfica y una puesta al día de las últimas actualizaciones en relación a esta patología. Conclusión: Al menos la mitad de los casos de este síndrome son secundarios, sobre todo postparto y/o por la exposición a sustancias vasoactivas tales como drogas ilícitas, simpaticomiméticos y serotoninérgicos. Es trascendental identificar este cuadro a fin de retirar los posibles agentes causales, o evitar las complicaciones potenciales

Introduction: Reversible cerebral vasoconstriction syndrome is a clinical-radiologic syndrome characterized by recurrent thunderclap headache, with or without other acute neurological symptoms, and diffuse segmental constriction of cerebral arteries that resolves spontaneously within 3 months. Methods: It is described a clinic case of a woman, who was diagnosed with reversible cerebral vasoconstriction syndrome. A literature search and an update of the latest updates regarding this disease was done. Conclusion: At least half of the cases of this syndrome are secondary, especially postpartum and/or exposure to vasoactive substances such as illicit drugs, sympathomimetics and serotonergic drugs. It is crucial to identify this disorder in order to remove possible causative agents, or avoid potential complications.

Humans , Female , Middle Aged , Syndrome , Vasoconstriction , Illicit Drugs , Cerebral Arteries , Neurologic Manifestations
Acta méd. colomb ; 44(3): 34-38, July-Sept. 2019. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1098024


Abstract Reversible vasoconstriction syndrome is a group of clinical-radiological alterations that are characterized by severe sudden-onset headaches and reversible multifocal narrowing of the cerebral arteries. Most patients do not present with focal neurological deficit, although it can be seen in a small group, associated with cerebral edema, stroke or seizures. It is considered to be a benign process that causes disability and death in a minority of patients. The term 'reversible vasoconstriction syndrome' has been proposed to unify a variety of clinical syndromes which are similar, but have different etiologies, and have originated various eponyms. The apparently low frequency of reversible vasoconstriction syndrome and the way it presents make it a diagnostic challenge in the emergency room, and it may go unnoticed without an adequate medical history. A case probably related to the use of isometeptene is presented. (Acta Med Colomb 2019; 44. DOI:

Resumen El síndrome de vasoconstricción reversible es un grupo de alteraciones clínico-radiológicas que se caracterizan por cefaleas intensas de inicio brusco y estrechamiento multifocal reversible de las arterias cerebrales. La mayoría de los pacientes no presentan déficit neurológico focal, aunque puede verse en un grupo reducido asociándose con edema cerebral, ataque cerebrovascular o convulsiones. Es considerado un proceso benigno, en pocos casos originan discapacidad y muerte en una minoría de pacientes. El término de síndrome de vasoconstricción reversible se ha propuesto para unificar a una variedad de síndromes clínicos similares, pero de etiología diferentes y han originados diversos epónimos. La aparente baja frecuencia del síndrome de vasoconstricción reversible y su forma de presentación hace que se convierta en un reto diagnóstico en los servicios de urgencias y puede pasar desapercibido si no se tiene una historia clínica adecuada. Presentamos un caso probablemente relacionado al uso de isometepteno. (Acta Med Colomb 2019; 44. DOI:

Humans , Female , Middle Aged , Syndrome , Vasoconstriction , Brain Edema , Cerebral Arteries , Stroke , Headache
Rev. bras. anestesiol ; 69(3): 311-314, May-June 2019. graf
Article in English | LILACS | ID: biblio-1013425


Abstract Reversible cerebral vasoconstriction syndrome is a cerebrovascular disorder leading to multifocal arterial constriction and dilation. Reversible cerebral vasoconstriction syndrome is possibly caused by transient deregulation of cerebral vascular tone. We report a rare case of a patient with chief complain of postpartum headache, was later diagnosed as a case of reversible cerebral vasoconstriction syndrome. A young full term primigravida with good uterine contraction admitted to labour room. Later she complained of leaking per vagina and on examination meconium stained liquor was noted. Caesarean delivery under spinal anesthesia was done and intra-operative period was uneventful. Both mother and baby were normal and shifted to postoperative ward and nursery respectively. In postoperative ward, mother complained of severe headache after 1 h and later developed seizure. Midazolam was given intravenously and was intubated and transferred to critical care unit for further investigation and management. Non contrast computerised tomography scan of brain showed right occipital intracerebral as well as subarachnoid bleed. CT angiography showed right vertebral artery narrowing without any other vascular malformation. Patient was managed in critical care unit for 2 days and then extubated and shifted to high dependency ward after a day observation and discharged 3 days later after a full uneventful recovery.

Resumo A síndrome de vasoconstrição cerebral reversível é uma doença cerebrovascular que leva à constrição e dilatação arterial multifocal. A síndrome de vasoconstrição cerebral reversível é possivelmente causada pela desregulação transitória do tônus vascular cerebral. Relatamos um caso raro de uma paciente com queixa principal de cefaleia pós-parto, posteriormente diagnosticada como um caso de síndrome de vasoconstrição cerebral reversível. A jovem primigesta a termo apresentando boa contração uterina foi internada em sala de parto. Mais tarde, a parturiente queixou-se de perda de líquido pela vagina e, ao exame, líquido amniótico manchado foi observado. O parto cesariano sob raquianestesia foi realizado, e não houve intercorrência no período intraoperatório. Tanto a mãe quanto o bebê estavam normais e foram transferidos para a sala de recuperação pós-operatória e berçário, respectivamente. Na sala de recuperação, a mãe queixou-se de forte dor de cabeça após uma hora e depois desenvolveu convulsão. Midazolam foi administrado por via intravenosa, e a paciente foi intubada e transferida para uma unidade de terapia intensiva para posterior investigação e tratamento. A tomografia computadorizada sem contraste do cérebro mostrou hemorragia intracerebral occipital direita e subaracnoide. A angiotomografia mostrou estreitamento da artéria vertebral direita, sem qualquer outra malformação vascular. A paciente foi tratada em unidade de terapia intensiva por dois dias e, em seguida, foi extubada e transferida para a ala de alta dependência onde permaneceu um dia em observação, recebendo alta hospitalar três dias depois, após uma recuperação completa e sem intercorrências.

Humans , Female , Pregnancy , Adult , Vasoconstriction , Cerebrovascular Disorders/diagnostic imaging , Postpartum Period , Headache/etiology , Syndrome , Computed Tomography Angiography/methods , Headache/diagnostic imaging , Anesthesia, Obstetrical/methods , Anesthesia, Spinal/methods
Acta Physiologica Sinica ; (6): 783-791, 2019.
Article in Chinese | WPRIM | ID: wpr-777132


Circadian rhythms widely exist in living organisms, and they are regulated by the biological clock. Growing evidence has shown that circadian rhythms are tightly related to the physiological function of the cardiovascular system, including blood pressure, heart rate, metabolism of cardiomyocytes, function of endothelial cells, and vasoconstriction and vasodilation. In addition, disruption of circadian rhythms has been considered as one of the important risk factors for cardiovascular diseases, such as myocardial infarction. This review summarizes the recent research advances in the relationship between circadian clock and cardiovascular diseases, hoping to improve treatment strategies for patients with cardiovascular diseases according to the theory of biological clock.

Blood Pressure , Cardiovascular Diseases , Circadian Clocks , Circadian Rhythm , Endothelial Cells , Cell Biology , Heart Rate , Humans , Myocytes, Cardiac , Metabolism , Vasoconstriction , Vasodilation
Article in English | WPRIM | ID: wpr-762814


BACKGROUND: The aim of this study was to assess the safety of one-per-mil tumescent injections into viable skin flaps that had survived an ischemic insult, in order to assess the potential suitability of one-per-mil tumescent injections in future secondary reconstructive procedures such as flap revision and refinements after replantation. METHODS: Forty groin flaps harvested from 20 healthy Wistar rats weighing 220 to 270 g were subjected to acute ischemia by clamping the pedicle for 15 minutes. All flaps showing total survival on the 7th postoperative day were randomly divided into group A (one-per-mil tumescent infiltration; n=14), group B (normal saline infiltration; n=13), and group C (control, with no infiltration; n=13) before being re-elevated. Transcutaneous oxygen tension (TcPO₂) was measured before and after infiltration, and changes in TcPO₂ were statistically analyzed using analysis of variance, the paired t-test, and the independent t-test. The viability of flaps was also assessed using the Analyzing Digital Images software at 7 days after the second elevation. RESULTS: Thirty-nine flaps survived to the final assessment, with the sole exception of a flap from group A that did not survive the first elevation. TcPO₂ readings showed significant decreases (P<0.05) following both one-per-mil tumescent (99.9±5.7 mmHg vs. 37.2±6.3 mmHg) and normal saline (103±8.5 mmHg vs. 48.7±5.9 mmHg) infiltration. Moreover, all groin flaps survived with no signs of tissue necrosis. CONCLUSIONS: One-per-mil tumescent infiltration into groin flap tissue that had survived ischemia did not result in tissue necrosis, although the flaps experienced a significant decrease of cutaneous oxygenation.

Constriction , Epinephrine , Groin , Hand Injuries , Ischemia , Necrosis , Oxygen , Rats, Wistar , Reading , Reperfusion Injury , Replantation , Skin , Vasoconstriction
Article in English | WPRIM | ID: wpr-761796


Free fatty acid (FFA) intake regulates blood pressure and vascular reactivity but its direct effect on contractility of systemic arteries is not well understood. We investigated the effects of saturated fatty acid (SFA, palmitic acid), polyunsaturated fatty acid (PUFA, linoleic acid), and monounsaturated fatty acid (MUFA, oleic acid) on the contractility of isolated mesenteric (MA) and deep femoral arteries (DFA) of Sprague–Dawley rats. Isolated MA and DFA were mounted on a dual wire myograph and phenylephrine (PhE, 1–10 µM) concentration-dependent contraction was obtained with or without FFAs. Incubation with 100 µM of palmitic acid significantly increased PhE-induced contraction in both arteries. In MA, treatment with 100 µM of linoleic acid decreased 1 µM PhE-induced contraction while increasing the response to higher PhE concentrations. In DFA, linoleic acid slightly decreased PhE-induced contraction while 200 µM oleic acid significantly decreased it. In MA, oleic acid reduced contraction at low PhE concentration (1 and 2 µM) while increasing it at 10 µM PhE. Perplexingly, depolarization by 40 mM KCl-induced contraction of MA was commonly enhanced by the three fatty acids. The 40 mM KCl-contraction of DFA was also augmented by linoleic and oleic acids while not affected by palmitic acid. SFA persistently increased alpha-adrenergic contraction of systemic arteries whereas PUFA and MUFA attenuated PhE-induced contraction of skeletal arteries. PUFA and MUFA concentration-dependent dual effects on MA suggest differential mechanisms depending on the types of arteries. Further studies are needed to elucidate underlying mechanisms of the various effects of FFA on systemic arteries.

Animals , Arteries , Blood Pressure , Fatty Acids , Fatty Acids, Unsaturated , Femoral Artery , Linoleic Acid , Mesenteric Arteries , Oleic Acid , Oleic Acids , Palmitic Acid , Phenylephrine , Rats , Receptors, Adrenergic, alpha , Vasoconstriction
Article in English | WPRIM | ID: wpr-764979


BACKGROUND: Patients with acute myocardial infarction (AMI) have worse clinical outcomes than those with stable coronary artery disease despite revascularization. Non-culprit lesions of AMI also involve more adverse cardiovascular events. This study aimed to investigate the influence of AMI on endothelial function, neointimal progression, and inflammation in target and non-target vessels. METHODS: In castrated male pigs, AMI was induced by balloon occlusion and reperfusion into the left anterior descending artery (LAD). Everolimus-eluting stents (EES) were implanted in the LAD and left circumflex (LCX) artery 2 days after AMI induction. In the control group, EES were implanted in the LAD and LCX in a similar fashion without AMI induction. Endothelial function was assessed using acetylcholine infusion before enrollment, after the AMI or sham operation, and at 1 month follow-up. A histological examination was conducted 1 month after stenting. RESULTS: A total of 10 pigs implanted with 20 EES in the LAD and LCX were included. Significant paradoxical vasoconstriction was assessed after acetylcholine challenge in the AMI group compared with the control group. In the histologic analysis, the AMI group showed a larger neointimal area and larger area of stenosis than the control group after EES implantation. Peri-strut inflammation and fibrin formation were significant in the AMI group without differences in injury score. The non-target vessel of the AMI also showed similar findings to the target vessel compared with the control group. CONCLUSION: In the pig model, AMI events induced endothelial dysfunction, inflammation, and neointimal progression in the target and non-target vessels.

Acetylcholine , Arteries , Balloon Occlusion , Constriction, Pathologic , Coronary Artery Disease , Drug-Eluting Stents , Endothelium , Fibrin , Follow-Up Studies , Humans , Inflammation , Male , Myocardial Infarction , Reperfusion , Stents , Swine , Vasoconstriction
Article in Korean | WPRIM | ID: wpr-766745


Reversible cerebral vasoconstriction syndrome (RCVS) is a disease characterized by reversible and multiple stenoses of cerebral blood vessels that improve within 3 months, accompanied by thunderclap headache. Here, we report an interesting case of RCVS initially misdiagnosed as Moyamoya disease with transient ischemic attack. A 45-year-old woman visited the Neurology Department of Eulji University Hospital. The patient was initially diagnosed with Moyamoya disease with transient ischemic attack. However, follow-up magnetic resonance angiography performed 12 months after the patient was appropriately diagnosed as having RCVS.

Blood Vessels , Constriction, Pathologic , Female , Follow-Up Studies , Headache Disorders, Primary , Humans , Ischemic Attack, Transient , Magnetic Resonance Angiography , Middle Aged , Moyamoya Disease , Neurology , Vasoconstriction
Rev. colomb. reumatol ; 25(4): 292-297, oct.-dic. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-990961


RESUMEN El síndrome de dedo azul (SDA) se caracteriza por la coloración violácea o azul de uno o más dedos, puede serla primera manifestación de múltiples enfermedades, tanto las que presentan alteraciones directamente en los dedos o ser la expresión de enfermedades sistémicas; los mecanismos fisiopatológicos más comunes son trombosis, embolia, vasoconstricción grave o afección del lecho vascular que puede ser inflamatoria o no inflamatoria. Describimos 5 casos de SDA, donde resaltamos la importancia del diagnóstico temprano y enfatizamos en el concepto de evaluación y abordaje como una urgencia médica, sin importar la causa, ya que su manejo y tratamiento inicial, más el intento de lograr un tratamiento dirigido a una etiología podría disminuir complicaciones irreversibles como la necrosis o amputación.

ABSTRACT Blue finger syndrome (BFS), usually noted by the violet or blue coloration of one or more fingers, may be the first manifestation of several diseases. These may present with alterations directly on the fingers or be the expression of systemic diseases. The most common pathophysiological causes are thrombosis, embolism, severe vasoconstriction, or vasculature involvement that may be inflammatory or non-inflammatory. A description is presented of 5 cases of BFS, where the emphasis is placed on the importance of early diagnosis. The concept of evaluation and approach as a medical emergency is also stressed, because depending on this, it could reduce irreversible complications, such as necrosis and/or amputation.

Humans , Male , Female , Middle Aged , Aged , Blue Toe Syndrome , Embolism , Vasoconstriction , Early Diagnosis , Necrosis
Rev. bras. cir. cardiovasc ; 33(6): 553-558, Nov.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-977479


Abstract Objective: The aim of this study was to compare the efficacy of two different papaverine concentrations (0.5 mg/ml and 2 mg/ml) for vasospasm prevention and their impact on endothelium integrity. Methods: We have studied distal segments of radial arteries obtained by no-touch technique from coronary artery bypass graft (CABG) patients (n=10). The vasodilatory effect of papaverine (concentrations of 0.5 mg/ml and 2 mg/ml) was assessed in vitro, in isometric tension studies using ex vivo myography (organ bath technique) and arterial rings precontracted with potassium chloride (KCl) and phenylephrine. The impact of papaverine on endothelial integrity was studied by measurement of the percentage of vessel's circumference revealing CD34 endothelial marker. Results: 2 mg/ml papaverine concentration showed stronger vasodilatatory effect than 0.5 mg/ml, but it caused significantly higher endothelial damage. Response to KCl was 7.35±3.33 mN for vessels protected with papaverine 0.5 mg/ml and 2.66±1.96 mN when papaverine in concentration of 2 mg/ml was used. The histological examination revealed a significant difference in the presence of undamaged endothelium between vessels incubated in papaverine 0.5 mg/ml (72.86±9.3%) and 2 mg/ml (50.23±13.42%), P=0.002. Conclusion: Papaverine 2 mg/ml caused the higher endothelial damage. Concentration of 0.5 mg/ml caused better preservation of the endothelial lining.

Humans , Male , Female , Aged , Papaverine/administration & dosage , Vasodilator Agents/administration & dosage , Coronary Artery Disease/surgery , Endothelium, Vascular/drug effects , Radial Artery/drug effects , Coronary Vasospasm/prevention & control , Papaverine/adverse effects , Papaverine/pharmacology , Vasoconstriction/drug effects , Vasodilation/drug effects , Vasodilator Agents/adverse effects , Vasodilator Agents/pharmacology , Coronary Artery Disease/physiopathology , Coronary Artery Bypass/methods
Rev. chil. cir ; 70(5): 425-431, 2018. graf, ilus
Article in Spanish | LILACS | ID: biblio-978009


Resumen Introducción: Prolongar la permeabilidad de los injertos utilizados en bypass coronario es un desafío constante. Objetivo: Comparar anatomofuncionalmente venas safenas humanas (VSH) extraídas con técnica convencional (TC) vs técnica "no-touch" (NT). Material y Método: Estudio experimental. Se diseccionó VSH con TC y NT en el pabellón de cirugía cardiaca del Hospital Regional de Antofagasta. Las muestras de VSH fueron seccionadas en anillos de 3 mm y conservados en cámaras de órganos aislados con solución Ringer-Krebs. Para evaluar la vasomotilidad se administró norepinefrina (10-6M), papaverina (10-4M), acetilcolina (10-6M) y nitroprusiato de sodio (10-5M). Un segmento de las muestras fue fijado en formalina al 10%, procesado con técnica histológica y analizado bajo microscopía óptica. Las muestras fueron teñidas con hematoxilina-eosina, Verhoeff y orceína. El análisis estadístico fue realizado mediante el software Prism Graphad. Resultados: Reactividad vascular: La vasoconstricción inducida por noradrenalina fue significativamente superior en anillos del grupo NT vs TC (p < 0,0001). La vasodilatación producida por papaverina y acetilcolina fue superior en el grupo NT (p < 0,004) y (p < 0,0003), respectivamente. Estudio morfométrico: El grupo NT presentó túnica muscular (0,755 vs 0,680 mm), adventicia (0,5600 vs 0,4663 mm) y pared total (1,344 vs 0,962 mm) más gruesa que el grupo TC. No hubo diferencias significativas respecto el número de vasa vasorum. Conclusión: El grupo NT responde significativamente mejor a estímulos vasoconstrictores y vasodilatadores. Los resultados se asocian con las diferencias morfométricas.

Introduction: Prolonging of the grafts permeability used in coronary bypass is a constant challenge. Objective: To compare anatomical and functional human saphenous veins (VSH) extracted "No touch" (NT) technique vs conventional technique (TC). Materials and Methods: Experimental study. VSH dissected with CT and NT in the Regional Hospital of Antofagasta cardiac surgery ward. VSH samples were sectioned into 3 mm rings and preserved in isolated organs chambers with Krebs-Ringer solution. To evaluate the vasomotor activity, norepinephrine (10-6M), papaverine (10-4M), acetylcholine (10-6M) and sodium nitroprusside (10-5M) was administered. A segment of samples was fixed in 10% formalin, processed and histological analyzed under light microscopy technique with hematoxylin-eosin, Verhoeff and orceína. Statistical analysis was performed using the Prism software Graphad. Results: Vascular Reactivity: norepinephrine-induced vasoconstriction was significantly higher in the group rings NT vs TC (p < 0.0001). Vasodilation was higher with papaverine and acetylcholine in the NT group (p < 0.004) and (p < 0.0003), respectively. Morphometric study: The NT group presented muscularis (0.755 vs 0.680 mm), adventitious (0.5600 vs 0.4663 mm), and total wall (1.344 vs 0.962 mm) thicker than the TC group. No significant differences in vasa vasorum number identified. Conclusion: The NT group vasoconstrictor and vasodilator responds significantly better. Results correlate with morphometric differences.

Humans , Saphenous Vein/drug effects , Saphenous Vein/transplantation , Tissue and Organ Harvesting/methods , Vasoconstriction/drug effects , Vasoconstrictor Agents/pharmacology , Vasodilation/drug effects , Vasodilator Agents/pharmacology , In Vitro Techniques , Coronary Artery Bypass