Résumé
Resumen Antecedentes: En los pacientes con infarto agudo de miocardio con elevación del segmento ST (IAMCEST), el acondicionamiento isquémico puede ayudar a limitar la remodelación ventricular. Objetivos: Investigar el efecto del posacondicionamiento isquémico remoto (PAIR) en la función del ventrículo izquierdo durante la intervención coronaria percutánea primaria (ICPP) en pacientes con IAMCEST. Material y métodos: Estudio de intervención pre y posprueba con un total de 60 pacientes con IAMCEST. Los pacientes fueron divididos en dos grupos: con y sin PAIR. Resultados: En el seguimiento de seis meses se observó una diferencia significativa en la fracción de eyección del ventrículo izquierdo en pacientes con ICPP, la cual fue mayor en el grupo con PAIR en comparación con el grupo sin PAIR: 1.0 (−1.0 a 4.3) versus −1.0 (−4.0 a 1.3), p = 0.033. En la medición de seis meses, el volumen sistólico final del ventrículo izquierdo en los pacientes sin PAIR fue mayor en comparación con el grupo homólogo: 79.3 ± 30.5 mL versus 64.4 ± 21.4 mL, p = 0.032. Conclusiones: PAIR muestra efectos favorables en la función ventricular izquierda y, por lo tanto, en el futuro podría ser una estrategia cardioprotectora potencial contra la lesión por isquemia-reperfusión en pacientes con IAMCEST.
Abstract Background: Ischemic conditioning may help patients with ST-segment elevation myocardial infarction (STEMI) to limit ventricular remodeling. Objectives: To investigate the effect of remote ischemic postconditioning (RIPC) on left ventricular function during primary percutaneous coronary intervention (PPCI) in patients with STEMI. Material and methods: Pre- and post-test intervention study with a total of 60 STEMI patients. Patients were divided in two groups: with and without RIPC. Results: At 6-month follow-up evaluation, a significant difference in left ventricular ejection fraction was observed in patients who underwent PPCI, which was higher in the group with RIPC in comparison with the group without RIPC: 1.0 (−1.0 to 4.3) vs. −1.0 (−4.0 to 1.3), p = 0.033. In addition, at 6-month measurement, left ventricular end-systolic volume in patients without RIPC: was higher in comparison with their counterparts: 79.3 ± 30.5 mL versus 64.4 ± 21.4 mL, p = 0.032. Conclusions: RIPC shows favorable effects on left ventricular function and, therefore, in the future, it could be a potential cardioprotective strategy against ischemia-reperfusion injury in STEMI patients.
Résumé
Periodontal disease, also generally called periodontitis or gum disease, is a chronic infection-induced inflammatory disease that causes tooth loss if not properly treated, and is considered as a modifying factor in systemic health. Gingival crevicular fluid (GCF) matrix metalloproteinase-8 (MMP-8) is an inflammatory marker found in periodontal pathologic conditions. Gingivitis, a nondestructive type of periodontal disease, can progress to periodontitis if left untreated. Therefore, assessing the level of MMP-8 with comfortable methods and no tissue intervention can determine the progression of the periodontal disease for a better treatment. Objective: The purpose of the present study is to determine the relationship between MMP-8 in GCF and periodontal disease. Setting and Design: This is a cross-sectional study that took place in West Sumatra, Indonesia from June to December 2013. Materials and Methods: This study involves 60 respondents who are divided into three groups based on the periodontal disease index. The samples consist of 20 healthy individuals, 20 with mild gingivitis, and 20 periodontitis initial. GCF was collected from each group. MMP8 level in GCF was tested by using ELISA technique. Statistical Analysis: Data were analyzed with SPSS version 17 Software. ANOVA test was used to determine the differences in average levels of MMP-8. Bonferroni post hoc test was used to discover which spesific means differed. Results: The level of MMP-8 is significantly different between the healthy group and mild gingivitis group, between the healthy group with mild periodontitis group, and also between groups with mild gingivitis and mild periodontitis (P < 0.05). Conclusion: The findings of this study can be used by practitioners of dentistry to establish a proper diagnosis and appropriate treatment of periodontal disease by measuring the scale of MMP-8, to prevent or to minimize further complication in periodontitis patients.