[Renal function in heart failure patients. Prognostic influence and therapeutic implications]. / Función renal en pacientes con insuficiencia cardíaca. Influencia pronóstica e implicaciones terapéuticas.

A close relationship has been described between renal function and cardiovascular risk; renal dysfunction promotes cardiovascular disease and the different vascular diseases increase the risk of renal failure. Pathogenetic mechanisms common to both processes could justify this parallelism. These relationships are must closer in heart failure. We have carried out a recent literature review in which we describe the epidemiological and clinical situation of renal failure in patients with heart failure, as well as the diagnostic, therapeutic and prognostic implications. There is an increased prevalence of renal failure in patients with heart failure (with depressed ejection fraction as well as normal). This is accompanied by a greater clinical and diagnostic complexity, independently increases the risk of death and complications during follow up. It also has therapeutic implications, since in this group of patients the drugs that block the renin-angiotensin-aldosterone system have a particular prognostic benefit although strict clinical control must be followed. Renal failure in patients with heart failure is highly prevalent and has extremely significant clinical and therapeutic implications.

Función renal en pacientes con insuficiencia cardíaca. Influencia pronóstica e implicaciones terapéuticas / Renal function in heart failure patients. Prognostic influence and therapeutic implications

Se ha descrito una estrecha relación entre la función renal y el riesgo cardiovascular; la disfunción renal promueve enfermedad cardiovascular y las distintas enfermedades vasculares incrementan el riesgo de insuficiencia renal. Mecanismos patogenéticos comunes a ambos procesos podrían justificar dicho paralelismo. La insuficiencia cardíaca es una situación en la que son más estrechas estas relaciones. Hemos llevado a cabo una revisión de la literatura médica reciente en la que se describe la situación epidemiológica y clínica de la insuficiencia renal en pacientes con insuficiencia cardíaca, así como de las implicaciones diagnósticas terapéuticas y pronósticas. Existe una elevada prevalencia de insuficiencia renal en pacientes con insuficiencia cardíaca (tanto con fracción de eyección deprimida como normal), se acompaña de una mayor complejidad clínica y diagnóstica, empeora de forma independiente el riesgo de muerte y complicaciones durante el seguimiento y presenta implicaciones terapéuticas ya que en este grupo de pacientes los fármacos que bloquean el sistema renina- angiotensina-aldosterona ejercen un especial beneficio pronóstico aunque deben emplearse con un estricto control clínico. La insuficiencia renal en pacientes con insuficiencia cardíaca es muy prevalente y presenta implicaciones clínica y terapéuticas de la máxima relevancia (AU)

A close relationship has been described between renal function and cardiovascular risk; renal dysfunction promotes cardiovascular disease and the different vascular diseases increase the risk of renal failure. Pathogenetic mechanisms common to both processes could justify this parallelism. These relationships are must closer in heart failure. We have carried out a recent literature review in which we describe the epidemiological and clinical situation of renal failure in patients with heart failure, as well as the diagnostic, therapeutic and prognostic implications. There is an increased prevalence of renal failure in patients with heart failure (with depressed ejection fraction as well as normal). This is accompanied by a greater clinical and diagnostic complexity, independently increases the risk of death and complications during follow up. It also has therapeutic implications, since in this group of patients the drugs that block the renin-angiotensin-aldosterone system have a particular prognostic benefit although strict clinical control must be followed. Renal failure in patients with heart failure is highly prevalent and has extremely significant clinical and therapeutic implications (AU)

[Association between refractory hypertension and cardiometabolic risk. The HIPERFRE study]. / Asociación entre hipertensión refractaria y riesgo cardiometabólico. Estudio HIPERFRE.

BACKGROUND AND AIM: Resistant hypertension (R-HT) is defined by the presence of uncontrolled blood pressure in patients treated with three or more drugs, being one of them diuretic. We sough to evaluate the prevalence and features of patients with R-HT attended at Primary Care of our environment. METHOD: 1724 hypertensive patients attended by 35 physicians at 14 Primary Care Units were analyzed in this descriptive, transversal, multicentral study. RESULTS: Patients (41.5% males) with a mean age of 67+/-11 years, being half of them obese. Blood pressure is controlled in 41.6% and the prevalence of R-HT is of 13.2%. This later group of patients is characterized by an older age (69 vs 67 years, p<0.01) and more frequent obesity (62% vs 43%, p<0.001), diabetes (55% vs 11%, p<0.001), hyperlipidemia (68% vs 59%, p<0.05), and metabolic syndrome (68% vs 22%, p<0.001). At least half of them present some kind of end-organ damage. No pharmacologycal treatment is prescribed to 3% of these patients and 37% of them are on monotherapy. There is a higher prescription of angiotensin receptor, calcium channel, beta and alfa-blockers in the group of patients with R-HT. There is an independent and direct relationship between R-HT and age, male gender, diabetes, obesity, metabolic syndrome, and an inverse relationship with ischemic cardiopathy. CONCLUSIONS: The prevalence of R-HT at Primary Care Units is of 13% and is related with age, male gender and metabolic risk factors.

Lack of effect of the ghrelin gene-derived peptide obestatin on cardiomyocyte viability and metabolism.

Obestatin is a recently discovered peptide encoded by the ghrelin gene that opposes ghrelin effects on food intake and gastrointestinal function. The biological activity of obestatin depends on amidation at its carboxyl terminus and on its postulated binding to the orphan G protein-coupled receptor 39 (GPR39). We have previously demonstrated that ghrelin is synthesized by cardiomyocytes and has direct effects on its viability. Our aim was to know if obestatin, derived from the same gene as ghrelin, also affects cardiomyocyte physiology. By RT-PCR and immunocytochemistry we have demonstrated that murine cardiomyocytes cultured in vitro and human atrial tissue express GPR39 receptor. Competitive binding studies with radioiodine 125I-labeled obestatin recognized specific binding sites for this peptide in the murine cardiomyocyte cell line HL-1. However, obestatin did not modify the cell cycle or viability of these cells, and it was not able to prevent the cytosine arabinoside-induced apoptosis of HL-1 cardiomyocytes, as assessed by Hoechst dye vital staining, flow cytometry analysis and determination of lactate dehydrogenase in the culture media. Finally, treatment with obestatin did not affect fatty acid or glucose uptake by HL-1 cardiomyocytes. In conclusion, obestatin is not a relevant metabolic or viability modifier for cardiomyocytes.

Heart failure in patients with preserved and deteriorated left ventricular ejection fraction.

OBJECTIVES: To determine clinical and prognostic differences between preserved and deteriorated systolic function (defined as left ventricular (LV) ejection fractions > or = 50% and < 50%, respectively) in patients with heart failure satisfying modified Framingham criteria. PATIENTS AND METHODS: Records were studied of 1252 patients with congestive heart failure (CHF) (mean (SD) age 69.4 (11.7) years; 485 women, 767 men) who had been admitted to a cardiology service for CHF in the period 1991-2002 and whose LV systolic function had been echocardiographically evaluated within two weeks of admission. Data were collected on the main clinical findings, supplementary examinations, treatment, and duration of hospitalisation. Whether the patient was alive in the spring of 2003 was evaluated by searching the general archives of the hospital and by telephone survey. RESULTS: LV systolic function was preserved in 39.8% of patients. Age, female to male sex ratio, and prevalence of atrial fibrillation, valve disease, and other non-ischaemic, non-dilated cardiopathies were all significantly greater in the group with preserved systolic function. New York Heart Association functional class IV, third heart sound, jugular vein congestion, cardiomegaly, radiological signs of lung oedema, pathological Q waves, left bundle branch block, sinus rhythm, ischaemic cardiopathy, and dilated cardiomyopathy were all significantly more prevalent in the group with deteriorated systolic function, as was treatment with angiotensin converting enzyme inhibitors and most other antihypertensive drugs on discharge from hospital. There was no significant difference in survival between the groups with preserved and deteriorated systolic function (either survival regardless of age at admission or in subgroups aged < 75 and > or = 75 years at admission). In the whole group, survival rates after one, three, and five years were 84.0%, 66.7%, and 50.9%, respectively. CONCLUSION: In view of the poor prognosis of patients with CHF with preserved LV systolic function, who are currently treated empirically, it is to be hoped that relevant controlled clinical trials under way will afford information allowing optimisation of their treatment.

Atomic arrangement of iodine atoms inside single-walled carbon nanotubes

We report atomic resolution Z-contrast scanning transmission electron microscopy images that reveal the incorporation of I atoms in the form of helical chains inside single-walled carbon nanotubes. Density functional calculations and topological considerations provide a consistent interpretation of the experimental data. Charge transfer between the nanotube walls and the I chains is associated with the intercalation.

[Blood levels of 6-keto-prostaglandin F1alpha, thromboxane and prostaglandin F2alpha in patients with bronchial asthma]. / Soderzhanie 6-ketoprostaglandina F1alfa, tromboksana i prostaglandina F2alfa v krovi bolnykh bronkhialnoi astmoi.

The study revealed the relation of bronchial asthma (bacterial variant) clinical pattern to plasma levels of PGF2 alpha, 6-keto-PGF1 alpha and TxB2. In remission of the disease the above indices are lower. Severe asthma remission is characterized by higher levels of 6-keto-PGF1 alpha and TxB2 than moderate asthma one, demonstrates a tendency to growing PGF2 alpha levels. A rise in PGF2 alpha and TxB2 in manifest asthma points to their participation in bronchospasm formation suggesting an active role of these bronchoconstrictors in asthma pathogenesis. Higher levels of 6-keto-PGF1 alpha are of a compensary nature in the pathogenesis of PGF2 alpha and TxB2 bronchoconstrictory action, and of damaging nature contributing to the formation of bronchial mucosa edema and bronchial gland hypersecretion.

[Contents of 6-keto-prostaglandin F1 alpha and thromboxane B2 in the blood of patients with bronchial asthma]. / Soderzhanie 6-keto-prostaglandina F1 alfa i tromboksana B2 v krovi bol'nykh bronkhial'noi astmoi.

There is a relationship between severity of bacterial bronchial asthma clinical symptoms and plasma 6-keto-PGF1 alpha, TxB2: in moderate disease against grave one as well as in clinical versus subclinical forms (remission) relevant indices are reduced. On the one hand elevated content of blood 6-keto-PGF1 alpha seems compensatory rising in response to TxB2 bronchoconstriction. On the other hand, it impairs microcirculation and enhances mediators of inflammation, promotes exudation and edema of bronchoalveolar mucosa, thus contributing to obstruction.

[The action of heart factor H1 on the synthesis and uptake of dopamine and noradrenaline in the rat heart]. / Deistvie serdechnogo faktora H1 na sintez i zakhvat dofamina i noradrenalina v serdtse krys.

The action of heart factor H1 on the synthesis and uptake of dopamine and noradrenaline in the atria and ventricle of rat heart and also the participation of Ca2+ and ATP in the action of H1 was studied. It has been shown, that H1 in the doses of 2 and 20 mU/ml increases the synthesis of 14C-dopamine in the atria by 43-44% and does not effect on this process in ventricle. The synthesis of 14C-noradrenaline in the atria increases in the presence of H1 (2-20 mU/ml) by 64 and 40%. A dose-dependent decrease of 3H-dopamine uptake in the atria under the influence of H1 was observed. The uptake of 3H-noradrenaline in the ventricle as well as in the atria is not altered in the presence of H1. In the absence of Ca2+ H1 in not caused any stimulation of 14C-dopamine and 14C-noradrenaline synthesis in the atria. But in the absence of both Ca2+ and ATP the stimulating effect of H1 on the synthesis of 14C-noradrenaline is maintained.

[Effect of neurohormone C and hexapeptide on incorporation of labeled amino acids into the proteins of different organs]. / Vliianie neirogormona C i geksapeptida na vkliuchenie mechenykh aminokislot v belki razlichnykh organov.

The influence of two coronarodilatatory substances (neurohormone "C" and hexapeptide) on the rate of protein synthesis was investigated. The stimulation of incorporation of labelled (14C- and 3H-) leucine into proteins of rat brain, heart and liver tissues characterized the hormonal regulation of the protein synthesis in these organs in vivo. Activation of the protein synthesis depended on the dose of the hormone administered. 5 mg of hexapeptide markedly inhibited the amino acid incorporation into proteins, while 0.5 mg produced the effect, which was contrary to the effect caused by 5 mg of the hormone. The data obtained suggest that hypothalamic neurohormonal preparations exhibit an important effect on protein metabolism in different organs.

[Cytological and cytochemical characteristics of the metastases of undifferentiated cancer to the lymph nodes]. / Tsitologicheskaia i tsitokhimicheskaia kharakteristika metastazov nedifferentsirovannogo raka v limfaticheskie uzly.

Cytologic assay of metastatic involvement of lymph nodes may be used along with histological studies as a reliable adjunct for morphological diagnosis, that makes possible in many cases to determine not only the epithelial origin of the affection but also to characterize its histological pattern. However, the cytologic diagnosis of undifferentiated cancer metastases is frequently rather difficult in relation to establishing the differential diagnosis between the former and other affections of lymph nodes. A careful, and sometimes repeated analysis of the material, taking into account the clinical data and cytochemical findings, contributes to greater efficiency of a cytologic method. The perspective use of cytochemical reactions as additional criteria for the diagnosis of undifferentiated cancer necessitates their further elaboration and study.