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1.
Int. j. morphol ; 42(1): 98-106, feb. 2024. ilus, tab
Artículo en Inglés | LILACS | ID: biblio-1528842

RESUMEN

SUMMARY: Papillary muscles in the left ventricle present multiple anatomic expressions that are relevant for medical fields focusing on the understanding of clinical events involving these structures. Here, the aim was to perform a morphological characterization of the left ventricle papillary muscles in a sample of Colombian population. In the study were included eighty-two hearts from male individuals who underwent autopsy at the Institute of Legal Medicine and Forensic Sciences in Bucaramanga, Colombia. In each heart was carefully performed a longitudinal incision on the obtuse margin to visualize the papillary muscles. Data set was registered, and analysis of the continuous and categorical variables was carried out. Single anterior papillary muscle was observed in 74 samples (90.2 %) whereas this represented only 48 specimens (58.5 %) for the posterior papillary muscle (p = 0.3). Mean length and breadth of the anterior muscle were 29.9 ± 4.94 and 11.74 ± 2.75 mm, and those for the posterior muscle were 27.42 ± 7.08 and 10.83 ± 4.08 mm. Truncated apical shape was the most frequent type observed on the papillary muscles, anterior 41 (50 %) and posterior 37 (45.1 %), followed by flat-topped in the anterior 25 (30.5 %) and bifurcated in posterior muscle 14 (17.1 %). A mean of 9.04 ± 2.75 chordae raised from the anterior and 7.50 ± 3.3 from posterior papillary muscle. In our study we observed a higher incidence of single papillary muscles and slightly larger dimensions than information reported in the literature. The anatomic diversity of the papillary muscles should be considered for the correct image interpretation, valve implantation and performance evaluation on myocardial ischemic events.


Los músculos papilares del ventrículo izquierdo presentan múltiples expresiones anatómicas que son relevantes para las áreas médicas que se centran en la comprensión de los eventos clínicos que involucran estas estructuras. El objetivo fue realizar una caracterización morfológica de los músculos papilares del ventrículo izquierdo en una muestra de población colombiana. En el estudio se incluyeron ochenta y dos corazones de individuos masculinos a los que se les realizó autopsia en el Instituto de Medicina Legal y Ciencias Forenses de Bucaramanga, Colombia. En cada corazón se realizó cuidadosamente una incisión longitudinal en el margen obtuso para visualizar los músculos papilares. Se registró el conjunto de datos y se realizó el análisis de las variables continuas y categóricas. Se observó un solo músculo papilar anterior en 74 muestras (90,2 %), mientras que este rasgo se presentó en 48 muestras (58,5 %) para el músculo papilar posterior (p = 0,3). La longitud y anchura media del músculo anterior fueron 29,9 ± 4,94 y 11,74 ± 2,75 mm, y las del músculo posterior fueron 27,42 ± 7,08 y 10,83 ± 4,08 mm. La forma apical truncada fue el tipo más frecuente observado en los músculos papilares, anterior 41 (50 %) y posterior 37 (45,1 %), seguido de la forma plana en los 25 anteriores (30,5 %) y bifurcada en el músculo posterior 14 (17,1 %). Una media de 9,04 ± 2,75 cuerdas elevadas desde el músculo papilar anterior y 7,50 ± 3,3 desde posterior. En nuestro estudio observamos una mayor incidencia de músculos papilares únicos y dimensiones ligeramente mayores que la información reportada en la literatura. La diversidad anatómica de los músculos papilares debe ser considerada para la correcta interpretación de imágenes, implantación valvular y evaluación del desempeño en eventos isquémicos miocárdicos.


Asunto(s)
Humanos , Masculino , Músculos Papilares/anatomía & histología , Ventrículos Cardíacos/anatomía & histología , Autopsia , Estudios Transversales , Colombia , Corazón/anatomía & histología
2.
Int. j. morphol ; 41(4): 1058-1065, ago. 2023. ilus
Artículo en Inglés | LILACS | ID: biblio-1514349

RESUMEN

SUMMARY: The existence of "transitional muscular structures" between subendocardial branches (Purkinje fibers) and ventricular working muscle fibers (WF) was first described by the German anatomist, Kurt Goerttler, in 1964. He designated them as "subendocardial nucleus organs." He supposed such fibers functioned as mechanoreceptors, controlling of the intensity of contraction of the ventricular musculature. Brazilian anatomist Ferraz de Carvalho described similar structures in 1993. A thorough literature search failed to identify any other research articles confirming or denying their existence. The objective of this work was to find such structures in subendocardial ventricular walls in human hearts. We collected fifteen formalin-preserved hearts from the Anatomy Department of São Paulo University and sectioned the apical portions on the right and left ventricles according to method used by Goerttler. We utilized conventional histology (light microscopy- LM), scanning electron microscopy (SEM), and a new preservation method called micro- plastination (MP). At the anterior wall of the right ventricle in the subendocardial region between the interventricular septum and moderator band, we found several bundles of fusiform and helicoidal fibers of similar histology to the WF. The bundles measured between 400 and 1150 µm in length and were separated from adjacent muscular fibers by thin collagen fiber, thus acting as a "pseudo capsule." Some structures seemed to be linked to PF and were appeared to be lymphatic and blood vessels and nerves. We called those structures "cardiac corpuscles" (CC). The observation of the previously "unknown" CC in this initial study confirmed the previous descriptions and its discovery may contribute to new perspectives in the study of cardiac muscle structure and function.


La existencia de "estructuras musculares de transición" entre los ramos subendocárdicos (fibras de Purkinje) y las fibras musculares ventriculares activas(FMV) fue descrita por primera vez por el anatomista alemán Kurt Goerttler en 1964, quien las denominó "órganos del núcleo subendocárdico". Supuso que tales fibras funcionaban como mecanoreceptores, controlando la intensidad de la contracción de la musculatura ventricular. El anatomista brasileño Ferraz de Carvalho describió estructuras similares en 1993. Una búsqueda bibliográfica exhaustiva no logró identificar ningún otro artículo de investigación que confirmara o negara su existencia. El objetivo de este trabajo fue encontrar dichas estructuras en las paredes ventriculares subendocárdicas de corazones humanos. Recolectamos 15 corazones conservados en formalina del Departamento de Anatomía de la Universidad de São Paulo y seccionamos las porciones apicales de los ventrículos derecho e izquierdo según el método utilizado por Goerttler. Utilizamos histología convencional (microscopía de luz-LM), microscopía electrónica de barrido (SEM) y un nuevo método de conservación llamado microplastinación (MP). En la pared anterior del ventrículo derecho en la región subendocárdica entre el tabique interventricular y la banda moderadora, encontramos varios haces de fibras fusiformes y helicoidales de histología similar a la FMV. Los haces medían entre 400 y 1150 µm de longitud y estaban separados de las fibras musculares adyacentes por una fina fibra de colágeno, actuando así como una "pseudocápsula". Algunas estructuras parecían estar vinculadas a la fibras de purkinje y parecían ser vasos linfáticos, sanguíneos y nerviosos. Llamamos a esas estructuras "corpúsculos cardíacos" (CC). La observación del CC previamente "desconocido" en este estudio inicial confirmó las descripciones anteriores y su descubrimiento puede contribuir a nuevas perspectivas en el estudio de la estructura y función del músculo cardíaco.


Asunto(s)
Humanos , Ramos Subendocárdicos/anatomía & histología , Corazón/anatomía & histología , Ventrículos Cardíacos/anatomía & histología , Microscopía Electrónica de Rastreo
3.
ABC., imagem cardiovasc ; 36(1): e282, abr. 2023. ilus
Artículo en Portugués | LILACS | ID: biblio-1509332

RESUMEN

Coração em criss-cross (ou coração entrecruzado) foi descrito pela primeira vez em 1974. Trata-se de uma malformação cardíaca congênita, rara, ocorrendo 8 casos a cada 1.000.000 de crianças, e representando somente 0,1% das malformações congênitas. Os métodos diagnósticos de escolha são o ecocardiograma transtorácico, a ressonância magnética cardíaca (RMC), a angiotomografia (TC) e, eventualmente, o cateterismo cardíaco. Neste relato, descreve-se o caso de um recém-nascido com coração em criss-cross somado à dupla via de saída do ventrículo direito (VD), com vasos mal posicionados, além de comunicação interatrial (CIA), comunicação interventricular (CIV), displasia de valva tricúspide e veia cava superior esquerda persistente. Não se sabe a etiologia exata dessa malformação, mas parece ocorrer pela rotação dos ventrículos em seu eixo longitudinal, não acompanhada das rotações atrial e das valvas atrioventriculares (AV). Esse movimento produz uma alteração das vias de entrada dos ventrículos, determinando que o VD se posicione em plano superior e o esquerdo em plano inferior. Apesar de ainda não se saber a exata causa dessa anomalia, acredita-se que uma alteração genética possa estar levando a esses casos: a mutação do gene Cx43. O diagnóstico do caso em questão foi dado pela ecocardiografia transtorácica e da TC de aorta e artérias pulmonares, que mostraram, além do criss-cross, outras alterações, como dupla via de saída do VD, CIA e CIV amplas.(AU)


Criss-cross heart was first described in 1974. It is a rare congenital heart malformation that occurs in 8 cases per 1,000,000 children, and represents only 0.1% of congenital malformations. The diagnostic methods of choice are transthoracic echocardiography, cardiac magnetic resonance (CMR), computed tomography angiography (CT) and, sometimes, cardiac catheterization. This report describes the case of a newborn with a criss-cross heart in addition to double-outlet right ventricle (RV), with poorly positioned vessels, in addition to atrial septal defect (ASD), interventricular septal defect, tricuspid valve dysplasia and persistent left superior vena cava. The exact etiology of this malformation is not known, but it seems to occur due to rotation of the ventricles in their longitudinal axis, not accompanied by rotation of the atrial and atrioventricular (AV) valves. This movement produces abnormal ventricular inlets, determining that the RV be positioned on a superior plane and the left ventricle on an inferior plane. Although the exact cause of this anomaly is still unknown, it is believed that a genetic abnormality may be leading to these cases: mutation of the Cx43 gene. Diagnosis of the case concerned was given by transthoracic echocardiography and computed CT of the aorta and pulmonary arteries, which showed, in addition to the criss-cross heart, other abnormalities, such as double-outlet RV, large ASD and ventricular septal defect (VSD).(AU)


Asunto(s)
Humanos , Masculino , Recién Nacido , Corazón con Ventrículos Entrecruzados/etiología , Corazón con Ventrículos Entrecruzados/diagnóstico por imagen , Cardiopatías Congénitas/diagnóstico , Ventrículos Cardíacos/anomalías , Ventrículo Derecho con Doble Salida/diagnóstico , Ecocardiografía/métodos , Cateterismo Cardíaco/métodos , Espectroscopía de Resonancia Magnética/métodos , Tomografía Computarizada por Rayos X/métodos , Vena Cava Superior Izquierda Persistente/diagnóstico , Defectos del Tabique Interatrial/diagnóstico
4.
ABC., imagem cardiovasc ; 36(1): e20230010, abr. 2023. ilus
Artículo en Portugués | LILACS | ID: biblio-1517893

RESUMEN

A análise da deformação miocárdica ventricular direita tem surgido como uma ferramenta diagnóstica importante na detecção de disfunção sistólica ventricular direita inicial não detectada pelas técnicas ecocardiográficas convencionais. Além disso, é capaz de trazer informações diagnósticas e prognósticas adicionais aos parâmetros tradicionais de avaliação da função sistólica ventricular direita em diversas patologias. O método ecocardiográfico de escolha para sua avaliação é o strain longitudinal derivado do speckletracking. Ele tem se mostrado mais sensível para pequenas mudanças na função sistólica quando comparado à excursão sistólica do plano do anel tricúspide, estudo da onda s´ ao Doppler tecidual do anel tricúspide e variação da área fracional do ventrículo direito. O avanço da inteligência artificial e a presença de softwares com análise automatizada entram neste cenário visando tornar a aplicabilidade do método mais simples, rápida e com menor variabilidade inter e intraobservador. O objetivo deste artigo de revisão é demonstrar o passo a passo da técnica, desde a otimização e aquisição de imagens até a interpretação dos resultados, com figuras ilustrativas de casos selecionados.(AU)


Right ventricular strain analysis has emerged as an important diagnostic tool in the detection of early right ventricular systolic dysfunction not detected by conventional echocardiography techniques. Furthermore, it is capable of providing additional diagnostic and prognostic information to the traditional parameters for evaluating right ventricular systolic function in various pathologies. The echocardiography method of choice for its assessment is longitudinal strain derived from speckletracking. This method has been shown to be more sensitive for small changes in systolic function when compared to tricuspid annular plane systolic excursion, tissue Doppler imaging of the tricuspid annular s' wave, and right ventricular fractional area change. Advances in artificial intelligence and software with automated analysis have been introduced to this scenario with the aim of making the method simpler and quicker to apply, with lower inter- and intra-observer variability. The objective of this review article is to demonstrate the technique step by step, from image optimization and acquisition to interpretation of results, with illustrative figures of selected cases.(AU)


Asunto(s)
Humanos , Función Ventricular Derecha/fisiología , Disfunción Ventricular Derecha/diagnóstico por imagen , Ventrículos Cardíacos/anatomía & histología , Ecocardiografía/métodos , Espectroscopía de Resonancia Magnética/métodos , Tensión Longitudinal Global/efectos de la radiación , Insuficiencia Cardíaca/etiología
5.
Journal of Central South University(Medical Sciences) ; (12): 285-293, 2023.
Artículo en Inglés | WPRIM | ID: wpr-971396

RESUMEN

The cardiovascular patch, served as artificial graft materials to replace heart or vascular tissue defect, is still playing a key role in cardiovascular surgeries. The defects of traditional cardiovascular patch materials may determine its unsatisfactory long-term effect or fatal complications after surgery. Recent studies on many new materials (such as tissue engineered materials, three-dimensional printed materials, etc) are being developed. Patch materials have been widely used in clinical procedures of cardiovascular surgeries such as angioplasty, cardiac atrioventricular wall or atrioventricular septum repair, and valve replacement. The clinical demand for better cardiovascular patch materials is still urgent. However, the cardiovascular patch materials need to adapt to normal coagulation mechanism and durability, promote short-term endothelialization after surgery, and inhibit long-term postoperative intimal hyperplasia, its research and development process is relatively complicated. Understanding the characteristics of various cardiovascular patch materials and their application in cardiovascular surgeries is important for the selection of new clinical surgical materials and the development of cardiovascular patch materials.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Ingeniería de Tejidos , Ventrículos Cardíacos , Atrios Cardíacos , Resultado del Tratamiento
6.
Rev. cuba. invest. bioméd ; 422023. ilus, tab
Artículo en Español | LILACS, CUMED | ID: biblio-1536303

RESUMEN

Introducción: Pese al incremento en conocimientos de la morfogénesis cardiaca humana, se conoce poco sobre los detalles cuantitativos en ello. Objetivo: Describir cuantitativamente el desarrollo del miocardio ventricular compacto y no compacto y su correlación con la longitud cráneo rabadilla. Métodos: Estudio descriptivo, transversal en 18 embriones humanos de los estadios 17 al 23 de Carnegie, pertenecientes a la Embrioteca de la Universidad de Ciencias Médicas de Villa Clara. Se midió la longitud del embrión, el grosor del miocardio compacto, trabecular y total en la pared lateral de ambos ventrículos y del vértice cardiaco. Resultados: El grosor de la pared lateral del miocardio compacto aumenta en ambos ventrículos desde los estadios 17 al 23 de Carnegie, de 0,06 mm hasta 0,17 mm en el derecho y de 0,09 mm hasta 0,23 mm en el izquierdo. El grosor de la pared lateral trabeculada disminuye con el avance de los estadios, de 0,43 mm a 0,34 mm en el derecho y de 0,45 mm a 0,37 mm en el izquierdo. El grosor de la pared lateral total aumenta de 0,48 mm a 0,51 mm en el ventrículo derecho y de 0,52 mm a 0,62 mm en el izquierdo. El grosor de la pared del vértice compacto aumenta de 0,19 mm a 0,25 mm. Conclusiones: La compactación de la pared ventricular aumenta con el desarrollo; la longitud cráneo raquis se relaciona con el grosor del miocardio ventricular(AU)


Introduction: Despite the increase in knowledge of human morphogenesis, especially cardiogenesis and the processes by which the morphology of the ventricular myocardium is defined, little is known about the quantitative details in it. Objectives: To quantitatively describe the development of compact and non-compact ventricular myocardium and its correlation with cranio-rump length. Methods: descriptive, cross-sectional study in 18 human embryos from Carnegie stages 17 to 23, belonging to the Embryoteca of the Villa Clara University of Medical Sciences. The length of the embryo, the thickness of the compact, trabecular and total myocardium were measured in the lateral wall of both ventricles and the cardiac apex. Results: The thickness of the lateral wall of the compact myocardium increases in both ventricles from Carnegie stages 17 to 23, from 0.06 mm to 0.17 mm in the right and from 0.09 to 0.23 mm in the left ventricles. The thickness of the trabeculated lateral wall decreases with the advancement of the stages, from 0.43 mm to 0.34 mm in the right and from 0.45 mm to 0.37 mm in the left. The total lateral wall thickness increases from 0.48 mm to 0.51 mm in the right ventricle and from 0.52 mm to 0.62 mm in the left. The wall thickness of the compact vertex increases from 0.19 mm to 0.25 mm. Conclusions: Ventricular wall compaction increases with development; the cranio-spinal length is related to the thickness of the ventricular myocardium(AU)


Asunto(s)
Humanos , Estructuras Embrionarias/embriología , Ventrículos Cardíacos/embriología , Morfogénesis/fisiología , Epidemiología Descriptiva , Estudios Transversales
7.
Cambios rev. méd ; 21(1): 719, 30 Junio 2022. ilus, grafs.
Artículo en Español | LILACS | ID: biblio-1402501

RESUMEN

INTRODUCCIÓN. La estimulación cardíaca temporal de larga duración con cable activo y marcapaso permanente externo es una técnica recientemente incluida en las guías de manejo de bradicardias sintomáticas. CASOS CLÍNICOS. Se describen 4 casos de pacientes sometidos a estimulación cardíaca temporal de larga duración con cable activo y marcapaso permanente externo de la unidad de Hemodinámica del Hospital de Especialidades Carlos Andrade Marín, con indicaciones diversas. DISCUSIÓN. El tiempo medio de permanencia con el cable activo y el marcapaso externalizado fue 23 días. No hubo complicaciones del procedimiento. Un paciente falleció por causas no relacionadas con la estimulación y 2 se recuperaron en sus domicilios. CONCLUSIÓN. La técnica de estimulación temporal utilizando marcapasos permanentes recuperados se muestra extremadamente útil para mantener un marcapaso cardíaco seguro, incluso ambulatorio y por largo tiempo, hasta el implante de dispositivos definitivos. Su limitación es la factibilidad de hacerlo solo en centros de tercer nivel.


INTRODUCTION. Long-duration temporary cardiac pacing with active lead and permanent external pacemaker is a technique recently included in the guidelines for the management of symptomatic bradycardias. CLINICAL CASES. We describe 4 cases of patients who underwent long-duration temporary cardiac pacing with active lead and external permanent pacemaker at the Hemodynamics Unit of the Hospital de Especialidades Carlos Andrade Marín, with different indications. DISCUSSION. The mean length of stay with the active lead and externalized pacemaker was 23 days. There were no procedural complications. One patient died of causes unrelated to pacing and 2 recovered at home. CONCLUSIONS. The technique of temporary pacing using retrieved permanent pacemakers is extremely useful for maintaining safe cardiac pacing, even on an outpatient basis and for a long period of time, until implantation of definitive devices. Its limitation is the feasibility of doing it only in third level centers.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Anciano , Anciano de 80 o más Años , Marcapaso Artificial , Bradicardia , Cardiología , Corazón , Frecuencia Cardíaca , Hemodinámica , Prótesis e Implantes , Atención Terciaria de Salud , Estimulación Cardíaca Artificial , Apoyo Vital Cardíaco Avanzado , Ecuador , Endocarditis , Atención Hospitalaria , Paro Cardíaco , Ventrículos Cardíacos , Antibacterianos
8.
Rev. méd. Chile ; 150(2): 232-240, feb. 2022. ilus
Artículo en Español | LILACS | ID: biblio-1389628

RESUMEN

Ejection fraction (EF) is defined by the ratio of end-systolic volume (ESV) and end-diastolic volume (EDV). The resulting fraction is a dimensionless number whose interpretation is ambiguous and most likely misleading. Despite this limitation, EF is widely accepted as a clinical marker of cardiac function. In this article we analyze the role of ESV, a fundamental variable of ventricular mechanics, compared with the popular EF. Common physiology-based mathematics can explain a simple association between EF and ESV. This concept is illustrated by a detailed analysis of the information obtained from angiocardiography, echocardiography and cardiac magnetic resonance studies. EF versus ESV produces a non-linear curve. For a small ESV, the EF approaches 100%, while for a large ESV, the EF gradually decreases toward zero. This elemental relationship is commonly observed in innervated natural hearts. Thus, the popularity of EF mostly derives from a fortuitous connection with the pivotal variable ESV. Alongside this finding, we unfold historical events that facilitated the emergence of EF as a result of serendipity. Our physiology-based approach denounces the circumstantial theories invoked to justify the importance of EF as an index of cardiac function, which are critically discussed. EF appears to be nothing more than a blessing in disguise. For this reason, we propose the ESV as a more logical metric for the analysis of ventricular function.


Asunto(s)
Humanos , Función Ventricular Izquierda , Ventrículos Cardíacos/diagnóstico por imagen , Volumen Sistólico , Imagen por Resonancia Magnética , Ecocardiografía
9.
Braz. J. Pharm. Sci. (Online) ; 58: e20218, 2022. graf
Artículo en Inglés | LILACS | ID: biblio-1403693

RESUMEN

Abstract Salidroside (SAL) has been confirmed to have some protective effects against inflammatory injury. However, little information was established as to the mechanism of these protective effects. To this effect, we designed this study to explore the protective effects and mechanisms of SAL against myocardial infarction (MI). A rat MI model was established and divided into five groups (n = 6): sham, MI, MI+SAL, MI+ LY294002 (PI3K inhibitor), and MI+SAL+ LY294002. The cardiac function and histological pathology were analyzed with a color Doppler ultrasonic diagnostic instrument. Anti-oxidative enzyme activities and the production of inflammatory media were assayed by biochemical kits and ELISA. MI size and fibrosis were assayed by Masson's trichrome staining while Bax/Bcl-2 and PI3K/Akt/Nrf2/HO-1 were assayed by Western blotting and immunofluorescence. The results showed that SAL significantly improved the left ventricle ejection fraction and fractional shortening, decreased the MI size and fibrosis, inhibited apoptosis and promoted blood vessel formation. SAL promoted anti-oxidative and anti-inflammatory abilities. Moreover, SAL enhanced PI3K/ Akt/Nrf2/HO-1 expression. To this effect, we designed this study suggested that SAL induced repair of MI via PI3K/A kt/ Nrf2/HO-1.


Asunto(s)
Animales , Masculino , Ratas , Ventrículos Cardíacos/anomalías , Infarto del Miocardio/tratamiento farmacológico , Fibrosis/clasificación , Ensayo de Inmunoadsorción Enzimática/métodos , Apoptosis
10.
ABC., imagem cardiovasc ; 35(1): eabc263, 2022. ilus
Artículo en Portugués | LILACS | ID: biblio-1378702

RESUMEN

As neoplasias cardíacas primárias são raras, e o diagnóstico correto é essencial para planejar o tratamento mais adequado. O objetivo deste estudo foi demonstrar o papel da ressonância magnética cardíaca na avaliação, no diagnóstico e no acompanhamento de fibroma cardíaco. Paciente do sexo feminino, 21 anos, com massa miocárdica ao ecocardiograma. Realizou ressonância magnética com diagnóstico de fibroma cardíaco. Foi acompanhada durante 6 anos com estabilidade do quadro. Fibromas cardíacos correspondem à segunda neoplasia mais comum em crianças e jovens. À ressonância magnética, caracterizam-se por realce tardio intenso e homogêneo.(AU)


Asunto(s)
Humanos , Femenino , Adulto , Adulto Joven , Fibroma/ultraestructura , Fibroma/diagnóstico por imagen , Ventrículos Cardíacos/anomalías , Neoplasias/diagnóstico , Factores de Tiempo , Imagen por Resonancia Magnética , Ecocardiografía/métodos , Espectroscopía de Resonancia Magnética/métodos , Tomografía/métodos , Estudios de Seguimiento
13.
ABC., imagem cardiovasc ; 35(4): eabc346, 2022. tab, ilus
Artículo en Portugués | LILACS | ID: biblio-1425557

RESUMEN

Introdução: A avaliação dos índices de trabalho miocárdico global em condições basais pode ser útil para a estratificação clínica de pacientes com suspeita de obstrução coronariana. Objetivo: Correlacionar o valor do índice de trabalho miocárdico global e a presença de lesões obstrutivas coronarianas significativas. Método: Estudo transversal, com pacientes encaminhados para cinecoronarioangiografia eletiva. Foi realizado ecocardiograma com obtenção das medidas para cálculo do valor do trabalho miocárdico, sendo avaliada a presença de lesões obstrutivas coronarianas significativas à cinecoronarioangiografia. Resultados: A amostra foi composta de 30 pacientes, com a idade média de 64,2±12,8 anos, sendo a maioria do sexo masculino (63,3%), dos quais 68,4% apresentaram lesões obstrutivas coronarianas significativas. O índice de trabalho miocárdico global foi de 1.876mmHg%±253,8 no grupo com lesões obstrutivas coronarianas significativas e de 2.054,2mmHg%±417,3 naqueles sem lesões significativas (p=0,089). O trabalho miocárdio construtivo global nos pacientes sem lesões obstrutivas coronarianas significativas foi maior (2.329,3mmHg%±462,9) do que naqueles com lesões obstrutivas coronarianas significativas (2.109,5mmHg%±332,3; p=0,064). O trabalho miocárdio desperdiçado global foi maior nos pacientes com lesões obstrutivas coronarianas significativas (103,7mmHg%±47,1 versus 68,3mmHg%±33,8; p=0,038). O ponto de corte de 115mmHg% foi aquele com a melhor área sob a curva (0,625), com sensibilidade de 83,3%. Conclusão: O aumento do trabalho miocárdio desperdiçado global se correlacionou com a presença de lesões obstrutivas coronarianas significativas em nossa amostra.(AU)


Introduction: The assessment of global myocardial work indices under baseline conditions may be useful for the clinical stratification of patients with suspected coronary obstruction. Objective: To correlate the value of global myocardial work indices and the presence of significant obstructive coronary lesions. Method: Cross-sectional study, with patients referred for elective coronary angiography. An echocardiogram was performed to obtain measurements to calculate the value of myocardial work and evaluated the presence or presence of significant obstructive coronary lesions at coronary angiography. Results: The sample consisted of 30 patients, with a mean age of 64.2±12.8 years, the majority being male (63.3%), of which 68.4% had significant obstructive coronary lesions. The global myocardial work indices was 1,876mmHg%±253.8 in the group with significant obstructive coronary lesions and 2,054.2mmHg%±417.3 in those without significant lesions (p=0.089). Global constructive myocardial work in patients without significant obstructive coronary lesions was higher (2,329.3mmHg%±462.9) than in those with significant obstructive coronary lesions (2,109.5mmHg%±332.3; p=0.064). Global wasted myocardial work was higher in patients with significant obstructive coronary lesions (103.7mmHg%±47.1 versus 68.3mmHg%±33.8; p=0.038). The cutoff point of 115 mmHg% was the one with the best area under the curve (0.625), with a sensitivity of 83.3%. Conclusion: The increase in global wasted myocardial work correlated with the presence of significant obstructive coronary lesions in our sample. (AU)


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Cardiopatías Congénitas/complicaciones , Cardiopatías Congénitas/diagnóstico por imagen , Ventrículos Cardíacos/lesiones , Ecocardiografía/métodos , Cateterismo Cardíaco/métodos , Estenosis Coronaria/fisiopatología , Ecocardiografía de Estrés/métodos , Pruebas de Función Cardíaca/métodos
14.
ABC., imagem cardiovasc ; 35(4): erer_15, 2022. ilus, tab
Artículo en Portugués | LILACS | ID: biblio-1426045

RESUMEN

A cardiomiopatia hipertrófica é a cardiopatia genética mais frequente na população geral e é caracterizada por uma hipertrofia ventricular esquerda assimétrica. Entretanto, as alterações fenotípicas desta cardiomiopatia vão muito além da hipertrofia ventricular, e incluem alterações do aparato valvar mitral, dos músculos papilares e do ventrículo direito. Devido à dificuldade no diagnóstico diferencial entre as múltiplas causas de hipertrofia, a ressonância magnética cardíaca vem cumprindo um papel fundamental na avaliação diagnóstica e prognóstica desta cardiomiopatia. A cineressonância magnética na definição da localização e extensão da hipertrofia, o realce tardio, na detecção das áreas de fibrose miocárdica e técnicas mais recentes como o Mapa de T1 que avalia a fibrose intersticial e o volume extracelular; e finalmente o Tissue Tracking na análise da deformação miocárdica.(AU)


Hypertrophic cardiomyopathy, the most common genetic cardiopathy in the general population, is characterized by asymmetric left ventricular hypertrophy. However, the phenotypic changes in this cardiomyopathy extend beyond ventricular hypertrophy and include changes in the mitral valve apparatus, papillary muscles, and right ventricle. Due to the difficult differential diagnosis among multiple causes of hypertrophy, cardiac magnetic resonance has played a fundamental role in its diagnostic and prognostic evaluation; magnetic cine-resonance in defining the location and extent of hypertrophy; late enhancement, in the detection of areas of myocardial fibrosis; more recent techniques such as T1 mapping that assesses interstitial fibrosis and extracellular volume; and finally tissue tracking in the analysis of myocardial deformation. (AU)


Asunto(s)
Humanos , Masculino , Femenino , Cardiomiopatía Hipertrófica/congénito , Hipertrofia Ventricular Izquierda/diagnóstico , Ventrículos Cardíacos/anomalías , Cardiomiopatía Hipertrófica/patología , Espectroscopía de Resonancia Magnética/métodos , Técnicas de Imagen Cardíaca/métodos , Variación Biológica Poblacional/genética , Válvula Mitral/anomalías
16.
Braz. J. Pharm. Sci. (Online) ; 58: e19652, 2022. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1384005

RESUMEN

Abstract Background and aim: Stingless bee propolis, a resinous compound processed by mandibular secretion of stingless bees, is used for maintenance of hygiene and stability of beehives. Research on stingless bee propolis shows therapeutic properties attributed to polyphenols exhibiting antioxidative, antihyperglycemic and antiischemic effect. However, the cardioprotective effect of stingless bee propolis on diabetic cardiomyopathy is unknown. Methods: Adult male Sprague Dawley rats were randomised to five groups: normal group, diabetic group, diabetic given metformin (DM+M), diabetic given propolis (DM+P) and diabetic given combination therapy (DM+M+P) and treated for four weeks. Body weight, fasting blood glucose, food and water intake were taken weekly. At the end of experiment, biomarkers of oxidative damage were measured in serum and heart tissue. Antioxidants in heart tissue were quantified. Part of left ventricle of heart was processed for histological staining including Haematoxylin and Eosin (H&E) stain for myocyte size and Masson's Trichrome (MT) stain for heart fibrosis and perivascular fibrosis. Results: Propolis alleviated features of diabetic cardiomyopathy such as myocyte hypertrophy, heart fibrosis and perivascular fibrosis associated with improvement in antioxidative status. Conclusion: This study reports beneficial effect of propolis and combination with metformin in alleviating histopathological feature of diabetic cardiomyopathy by modulating antioxidants, making propolis an emerging complementary therapy.


Asunto(s)
Animales , Masculino , Ratas , Própolis/efectos adversos , Abejas/clasificación , Cardiomiopatías Diabéticas/patología , Coloración y Etiquetado/instrumentación , Glucemia/metabolismo , Ratas Sprague-Dawley/clasificación , Cardiomegalia/patología , Eosina Amarillenta-(YS) , Ingestión de Líquidos , Ventrículos Cardíacos/anomalías , Hipoglucemiantes , Metformina/agonistas , Antioxidantes/efectos adversos
18.
ABC., imagem cardiovasc ; 35(3): eabc300, 2022. ilus
Artículo en Portugués | LILACS | ID: biblio-1411512

RESUMEN

A disjunção do anel mitral (DAM) é uma inserção anormal da linha de flexão do anel mitral na parede atrial. O anel mostra uma separação (disjunção) entre a junção folheto posterior-parede atrial e a crista miocárdica ventricular esquerda.1 A DAM foi descrita pela primeira vez há mais de 30 anos em estudo de autópsia, estando relacionada com prolapso da valva mitral (PVM) em 92% dos casos.2 Desde então, foram realizados diversos estudos, sendo a prevalência de DAM em pacientes com PVM reportada de forma variável, podendo ou não estar associada à insuficiência mitral. O ecocardiograma transtorácico (ETT) faz parte da avaliação inicial do prolapso valvar mitral, permitindo o diagnóstico e a avaliação de complicações relacionadas. Com a evolução de novos métodos diagnósticos, a ressonância magnética cardíaca (RMC) e o ecocardiograma transesofágico (ETE) passaram a aprimorar a avaliação dessa patologia, bem como de sua extensão e localização. Contudo, as características fenotípicas do PVM que estão mais associadas a DAM permanecem incertas, sobretudo devido ao número limitado de pacientes, nos estudos clássicos sobre o tema. Portadores de DAM podem desenvolver sintomas relacionados a arritmias ventriculares, configurando a síndrome arrítmica da DAM (SDAM), podendo evoluir para morte súbita. Na literatura, os dados prognósticos ainda são conflitantes entre os diversos estudos acerca do tema, indo desde critérios claros de diagnóstico, o melhor método de imagem a ser aplicado, o tratamento e o prognóstico. Esta revisão descreve as características da DAM associada ou não ao prolapso valvar, auxiliando no diagnóstico e na conduta dessa importante patologia. (AU)


Mitral annulus disjunction (MAD) is an abnormal insertion of the flexion line of the mitral annulus into the atrial wall. The annulus presents a separation (disjunction) between the posterior leaflet­atrial wall junction and the left ventricular myocardial crest.1 MAD was first described more than 30 years ago in an autopsy study and is reportedly related to mitral valve prolapse (MVP) in 92% of cases.2 Since then, several studies have been conducted, and reports on the prevalence of MAD in patients with MVP have varied. Ultimately, it may or may not be associated with mitral regurgitation. Transthoracic echocardiography is part of initial MVP assessment, allowing its diagnosis and the assessment of related complications. As new diagnostic methods emerged, cardiac magnetic resonance imaging and transesophageal echocardiography improved the assessment of this pathology in terms of its diagnosis, extension, and location. However, the phenotypic characteristics of MVP that are more closely associated with MAD remain uncertain mainly due to the limited number of patients in classic studies on the subject. Patients with MAD may develop symptoms related to ventricular arrhythmias, configuring the MAD arrhythmic syndrome, which may progress to sudden death. The literature presents conflicting prognostic data among several studies on the subject from clear diagnostic criteria and best imaging method to be used to treatment and prognosis. This review describes MAD characteristics associated (or not) with valve prolapse to improve the diagnosis and management of this important pathology. (AU)


Asunto(s)
Humanos , Masculino , Femenino , Prolapso de la Válvula Mitral/complicaciones , Prolapso de la Válvula Mitral/diagnóstico por imagen , Insuficiencia de la Válvula Mitral/diagnóstico , Arritmias Cardíacas/complicaciones , Pronóstico , Ecocardiografía/métodos , Espectroscopía de Resonancia Magnética/métodos , Muerte Súbita Cardíaca , Ecocardiografía Transesofágica/métodos , Atrios Cardíacos/patología , Ventrículos Cardíacos/anomalías
20.
ABC., imagem cardiovasc ; 35(1): eabc245, 2022. ilus, tab
Artículo en Portugués | LILACS | ID: biblio-1369683

RESUMEN

Introdução: A excursão sistólica do anel tricúspide e a do anel mitral são parâmetros utilizados para se avaliar a função contrátil do ventrículo direito e do ventrículo esquerdo, respectivamente. Pouco se conhece sobre sua relação com a função diastólica ventricular esquerda. Objetivo: Avaliar se os valores de excursão sistólica do anel tricúspide e do anel mitral se correlacionam com parâmetros utilizados na avaliação da função diastólica ventricular esquerda. Métodos: Estudo observacional transversal. Foram selecionados 219 indivíduos, sendo 116 mulheres, com função sistólica preservada de ambos os ventrículos. As análises foram feitas separadamente para os sexos masculino e feminino, por meio dos coeficientes de correlação de Pearson e de Sperman. Foram obtidos: excursão sistólica do anel tricúspide, excursão sistólica do anel mitral, volumes atriais e medidas relacionadas à avaliação da função diastólica do ventrículo esquerdo ao ecocardiograma transtorácico. Resultados: No sexo feminino, a excursão sistólica do anel mitral se correlacionou positivamente com o e' lateral (coeficiente de correlação de Sperman de 0,22; p=0,016) e a excursão sistólica do anel tricúspide se correlacionou positivamente com a relação E/A (coeficiente de correlação de Sperman de 0,23, p=0,037), com o e' lateral (coeficiente de correlação de Sperman de 0,28; p=0,012), com o e' septal (coeficiente de correlação de Sperman de 0,28; p=0,012) e negativamente com a relação E/e' (coeficiente de correlação de Pearson de -0,27; p=0,018) e onda A (coeficiente de correlação de Pearson de -0,29; p= 0,009). No sexo masculino, apenas a excursão sistólica do anel mitral se correlacionou positivamente com a onda E (coeficiente de correlação de Pearson de 0,21; p=0,037), e' lateral (coeficiente de correlação de Sperman de 0,34; p <0,001) e e' septal (coeficiente de correlação de Sperman de 0,26; p=0,008). Não houve correlação entre excursão sistólica do anel mitral e do anel tricúspide e volumes atriais. A presença de hipertensão arterial sistêmica e diabetes melito influenciou nos valores de excursão sistólica do anel tricúspide e do anel mitral correlacionados a ondas E e A, relação E/A, ondas e' septal e lateral e relação E/e'. Conclusão: No presente estudo, os valores da excursão sistólica do anel mitral e do anel tricúspide apresentaram correlação significativa com algumas variáveis da função diastólica ventricular esquerda com maior evidência no sexo feminino.(AU)


Introduction: Tricuspid annular plane systolic excursion and mitral annular systolic excursion are parameters used to assess the systolic function of the right ventricle and left ventricle, respectively. Little is known about its relationship with left ventricular diastolic function. Objective: To assess whether the values of mitral annular systolic excursion and tricuspid annular plane systolic excursion correlate with parameters used in the evaluation of left ventricular diastolic function. Method: Observational cross-sectional study. Two hundred nine individuals were selected, 116 women, with both ventricles normal systolic function. The analyzes were performed for men and women, through Pearson correlation coefficient and Sperman correlation coefficient. Tricuspid annular plane systolic excursion, mitral annular systolic excursion, atrial volumes and left ventricular diastolic function parameters on transthoracic echocardiogram were obtained. Results: In women, mitral annular systolic excursion was positively correlated with lateral e '(Sperman correlation coefficient of 0.22; p=0.016) and tricuspid annular plane systolic excursion was positively correlated with E / A ratio (Sperman correlation coefficient of 0.23; p=0.037), lateral e' (Sperman correlation coefficient of 0.28; p=0.012), and septal e' (Sperman correlation coefficient of 0.28; p=0.012), and negatively with the E/e' ratio (Pearson correlation coefficient of -0.27; p=0.018), and A wave (Pearson correlation coefficient of -0.29; p=0.009). In men, only mitral annular systolic excursion correlated positively with E wave (Pearson correlation coefficient of 0.21; p=0.037), lateral e' (Sperman correlation coefficient of 0.34; p <0.001) and the septal e' (Sperman correlation coefficient of 0.26; p=0.008). There was no correlation between mitral annular systolic excursion E and tricuspid annular plane systolic excursion and atrial volumes. Hypertension and diabetes mellitus influenced tricuspid annular plane systolic excursion and mitral annular systolic excursion values correlated to E and A waves, E/A ratio, septal and lateral e' waves, and E/e' ratio. Conclusion: In the present study, mitral annular systolic excursion and tricuspid annular plane systolic excursion values showed a significant correlation with some parameters of left ventricular diastolic function, with stronger evidence on female sex.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Válvula Tricúspide/anatomía & histología , Función Ventricular Izquierda/fisiología , Disfunción Ventricular Izquierda/complicaciones , Válvula Mitral/anatomía & histología , Ecocardiografía/métodos , Disfunción Ventricular Izquierda/diagnóstico por imagen , Diabetes Mellitus/etiología , Ventrículos Cardíacos/fisiopatología , Hipertensión/complicaciones
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