Subject(s)
Myocardial Infarction/complications , Reperfusion/methods , Stroke/complications , Aged , Brain Ischemia/complications , Brain Ischemia/diagnostic imaging , Brain Ischemia/drug therapy , Electrocardiography , Emergency Service, Hospital , Female , Fibrinolytic Agents/therapeutic use , Humans , Myocardial Infarction/therapy , Neuroimaging , Stroke/diagnostic imaging , Stroke/drug therapy , Thrombolytic Therapy/methods , Tissue Plasminogen Activator/therapeutic use , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: CDP-choline is a key intermediate in the biosynthesis of phosphatidylcholine, which is an essential component of cellular membranes, and a cell signalling mediator. CDP-choline has been used for the treatment of cerebral ischaemia, showing beneficial effects. However, its potential benefit for the treatment of myocardial ischaemia has not been explored yet. AIM: In the present work, we aimed to evaluate the potential use of CDP-choline as a cardioprotector in an in vitro model of ischaemia/reperfusion injury. METHODS: Neonatal rat cardiac myocytes were isolated and subjected to hypoxia/reperfusion using the coverslip hypoxia model. To evaluate the effect of CDP-choline on oxidative stress-induced reperfusion injury, the cells were incubated with H2O2 during reperfusion. The effect of CDP-choline pre- and postconditioning was evaluated using the cell viability MTT assay, and the proportion of apoptotic and necrotic cells was analyzed using the Annexin V determination by flow cytometry. RESULTS: Pre- and postconditioning with 50 mg/mL of CDP-choline induced a significant reduction of cells undergoing apoptosis after hypoxia/reperfusion. Preconditioning with CDP-choline attenuated postreperfusion cell death induced by oxidative stress. CONCLUSION: CDP-choline administration reduces cell apoptosis induced by oxidative stress after hypoxia/reperfusion of cardiac myocytes. Thus, it has a potential as cardioprotector in ischaemia/reperfusion-injured cardiomyocytes.
Subject(s)
Apoptosis/drug effects , Cardiotonic Agents/pharmacology , Cytidine Diphosphate Choline/pharmacology , Myocardial Reperfusion Injury/prevention & control , Myocytes, Cardiac/metabolism , Oxidative Stress/drug effects , Animals , Cell Hypoxia/drug effects , Hydrogen Peroxide/pharmacology , Male , Myocardial Reperfusion Injury/metabolism , Myocardial Reperfusion Injury/pathology , Myocytes, Cardiac/pathology , Oxidants/pharmacology , Rats , Rats, WistarABSTRACT
OBJECTIVE: To review the epidemiological profile of stroke associated to rheumatic heart disease (RHD) in a Mexican Cardiovascular Center. Cardioembolic stroke is one of the most severe causes of death and disability and the spectrum of its neurological complications is diverse. PATIENTS AND METHODS: This is a 10-years retrospective study of 709 patients with stroke diagnosis from the National Institute of Cardiology "Ignacio Chávez" Stroke Data Bank from 1991 to 2000. Derived from this information, only the cases with RHD were selected along with those with a perfectly defined profile for cardioembolic mechanism, according to the Cerebral Embolism Task Force on Cardiogenic Brain Embolism. RESULTS: We selected 250 stroke patients; 163 of these cases (65.2%) presented cardioembolism criteria. This association was more frequent in women (126/77.3%) than in men (37/22.7%). Average age was of 50 years. The damage to valves in RHD was: DML with predominance of stenosis, 88/54%; MI, 56/34.3%; AVL, 19/11.7%. Atrial fibrillation was the most commonly associated arrhythmia. The presence of mechanical prosthetic mitral valves was of 59/36.19%. Sensor-motor syndrome and language disorders were the most common clinical neurological consequences. CONCLUSIONS: In our country, RHD continues being one of the most frequent causes of severe disability, specially when is associated to strokes in young people.
Subject(s)
Rheumatic Heart Disease/complications , Stroke/epidemiology , Stroke/etiology , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
OBJECTIVE: To review the epidemiological profile of stroke associated to rheumatic heart disease (RHD) in a Mexican Cardiovascular Center. Cardioembolic stroke is one of the most severe causes of death and disability and the spectrum of its neurological complications is diverse. PATIENTS AND METHODS: This is a 10-years retrospective study of 709 patients with stroke diagnosis from the National Institute of Cardiology [quot ]Ignacio Chávez[quot ] Stroke Data Bank from 1991 to 2000. Derived from this information, only the cases with RHD were selected along with those with a perfectly defined profile for cardioembolic mechanism, according to the Cerebral Embolism Task Force on Cardiogenic Brain Embolism. RESULTS: We selected 250 stroke patients; 163 of these cases (65.2%) presented cardioembolism criteria. This association was more frequent in women (126/77.3%) than in men (37/22.7%). Average age was of 50 years. The damage to valves in RHD was: DML with predominance of stenosis, 88/54%; MI, 56/34.3%; AVL, 19/11.7%. Atrial fibrillation was the most commonly associated arrhythmia. The presence of mechanical prosthetic mitral valves was of 59/36.19%. Sensor-motor syndrome and language disorders were the most common clinical neurological consequences. CONCLUSIONS: In our country, RHD continues being one of the most frequent causes of severe disability, specially when is associated to strokes in young people.
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Rheumatic Heart Disease , Stroke , Stroke , Retrospective StudiesABSTRACT
Se revisan las complicaciones neurológicas de 131 episodios de endocarditis infecciosa (EI) y la influencia de algunos factores considerados de riesgo en su presentación, tales como la presencia de vegetaciones detectadas por ecocardiografía, tipo y localización de la válvula infectada, germen aislado y pronóstico en este grupo de pacientes. Se encontraron complicaciones al sistema nervioso central (SNC) en 28 (21.3 por ciento) casos. Cuatro fueron excluidos por ausencia de estudios de nerodiagnóstico. En 21 pacientes la patología cardiaca subyacente fue valvulopatía y en los 3 restantes cardiopatía congénita. En 11 pacientes se demostró endocarditis de válvula nativa, y en 10 pacientes de válvula protésica. Los gérmenes causales más frecuentes fueron Estreptococo viridans en 8 casos, y Estafilococo aureus en 7. Las complicaciones encontradas con mayor frecuencia fueron las cerebrovasculares (70.8 por ciento), con incidencia de embolia y hemorragia cerebral del 62.5 por ciento y 8.3 por ciento, respectivamente. Doce de 18 pacientes con vegetaciones demostradas mediante ecocardiografía desarrollaron embolia cerebral. La mortalidad en el grupo de pacientes con complicaciones del SNC fue del 29 por ciento en contra de 27 por ciento en el grupo de pacientes sin complicaciones neurológicas. Dos de 9 pacientes, que fueron sometidos a recambio valvular después de desarrollar complicaciones neurológicas, murieron. Concluimos que no existe diferencia en la incidencia de complicaciones al SNC entre los grupos de infección de válvula mitral o aórtica o de válvula nativa vs protésica y que la cirugía cardiaca no incrementa la mortalidad en este grupo de pacientes
Subject(s)
Humans , Male , Adolescent , Adult , Middle Aged , Aortic Valve , Chi-Square Distribution , Endocarditis, Bacterial/complications , Endocarditis, Bacterial/surgery , Heart Valve Diseases/surgery , Heart Valve Diseases/complications , Staphylococcal Infections/surgery , Staphylococcal Infections/complications , Mitral Valve , Nervous System Diseases/etiology , Nervous System Diseases/mortality , Mexico/epidemiology , Retrospective StudiesABSTRACT
El infarto cerebral, durante o después del cateterismo cardiaco, puede ser secundario a diversos mecanismos. La formación y el desprendimiento de coágulos a partir de la pared del catéter y la ruptura de lesiones ateromatosas son las causas más frecuentes. La visualización de coágulos libres en el interior de un injerto aortocoronario es una condición extremadamente rara y escasamente documentada. Con evidencia angiográfica, presentamos un caso de isquemia cerebral aguda precipitada durante el cateterismo cardiaco por la migración de coágulos libres a partir de un injerto aortocoronario. Este caso ilustra uno más de los diversos mecanismos en la patogénesis de la isquemia cerebral.
Subject(s)
Humans , Male , Aged , Brain Ischemia/etiology , Embolism/complications , Aortic Valve Stenosis/complicationsABSTRACT
Se analizan 17 enfermos con patología vascular del sistema vértrebrobasilar que requirieron de angiografía por substracción digital (ASD) y/o resonancia magnética(RM) para su evaluación. Además, en la RM se realizó un nuevo método de cortes paralelos al eje del clivus,para obtener mejores imágenes de los vasos del sistema vértebrobasilar. Los hallazgos obtenidos por RM con la técnica propuesta nos permitieron observar el segmento V4 de las arterias vertebrales en un 82.4%; unión vértebrobasilar 82.4%; arteria basilar proximal 94.1%; arteria basilar medial 76.5%; arteria basilar distal 82.4%y bifurcación basilar 41.2%. Los resultados mostraron que dicha investigación mejora la visualización de las estructuras vasculares del sistema vértebrobasilar comparado con el plano de corte sagital y coronal. Los autores concluyen que el empleo de RM con cortes paralelos al eje del clivus justifica la realización de angiografía por substracción digital (ASD) en ciertos grupos de pacientes.
