Incidental diagnosis of cardiac fibroma in an infant with acute viral bronchiolitis / Diagnóstico incidental de fibroma cardíaco em um lactente com bronquiolite viral aguda

ABSTRACT Objective: Pediatric cardiac tumors are rare and, among them, 90% are benign. Cardiac fibroma is the second most frequent tumor, after rhabdomyoma. The objective of this study is to report a case of cardiac fibroma diagnosed incidentally in a patient admitted with acute viral bronchiolitis. Case description: A 5-month-old male infant was admitted to the pediatric emergency department with acute viral bronchiolitis requiring hospitalization. He presented a detectable respiratory syncytial virus in oropharyngeal swab, blood test with lymphocytosis and a chest radiography revealed cardiomegaly. Further cardiologic testing was performed detecting elevation of cardiac biomarkers, an electrocardiogram with alteration of left ventricular repolarization and echocardiogram with a heterogeneous mass in the left ventricular, with areas of calcification. A chest angiotomography suggested rhabdomyosarcoma or cardiac fibroma and a magnetic resonance showed a mass, with characteristics suggesting fibroma. The final diagnosis was made after two cardiac catheterizations for biopsy of the lesion, confirming cardiac fibroma by anatomopathological examination. Because the patient had moderate to severe systolic dysfunction, he was submitted to heart transplant. Comments: One third of cardiac fibromas are asymptomatic, generally diagnosed late through tests ordered for other reasons. The gold-standard test for definitive diagnosis is biopsy. Cardiac fibroma usually does not present spontaneous regression and, in most cases, partial or total surgical resection is necessary. When tumors are unresectable, heart transplantation should be indicated. It is essential to have detailed characterization of the cardiac mass to establish the most appropriate therapeutic approach for each patient.

RESUMO Objetivo: Tumores cardíacos pediátricos são raros e, entre eles, 90% são benignos. O fibroma cardíaco é o segundo mais frequente, após o rabdomioma. O objetivo deste trabalho é relatar um caso de fibroma cardíaco, cujo diagnóstico foi incidental em um paciente internado por bronquiolite viral aguda. Descrição do caso: Lactente do sexo masculino com cinco meses foi atendido em um pronto atendimento pediátrico com quadro de bronquiolite viral aguda, necessitando de hospitalização. Em exames complementares, apresentou vírus sincicial respiratório detectável, hemograma com linfocitose, além de radiografia de tórax com cardiomegalia. Em investigação cardiológica, as enzimas cardíacas encontravam-se elevadas, o eletrocardiograma apresentava alteração de repolarização de parede lateral de ventrículo esquerdo e o ecocardiograma demonstrou massa heterogênea em ventrículo esquerdo, com áreas de calcificação. A angiotomografia de tórax sugeriu rabdomiossarcoma ou fibroma cardíaco e a ressonância magnética demonstrou massa cuja localização e características sugeriram fibroma. O diagnóstico foi conclusivo após dois cateterismos para biópsia da lesão, confirmando fibroma cardíaco pelo anatomopatológico. Em razão da disfunção sistólica moderada a grave, o paciente foi submetido a transplante cardíaco. Comentários: Um terço dos fibromas cardíacos é assintomático, geralmente diagnosticado tardiamente por meio de exames solicitados por outro motivo. O padrão-ouro para o diagnóstico definitivo é a biópsia. O fibroma cardíaco não costuma apresentar regressão espontânea, sendo submetido, na maioria dos casos, a ressecção cirúrgica parcial ou total. Nos tumores irressecáveis, o transplante cardíaco deve ser indicado. A caracterização detalhada da massa cardíaca é fundamental para traçar a conduta terapêutica mais adequada para cada paciente.

Abernethy Malformation: Possible Diagnosis for Patients with Congenital Heart Disease and Persistent Cyanosis.

CLINICAL DATA: Infant, nine months of age, female, diagnosed with congenital heart disease, with signs of heart failure associated with cyanosis and difficulty in gaining weight. CHEST RADIOGRAPHY: Cardiomegaly with prevalence of pulmonary vascular network. ELECTROCARDIOGRAM: Ectopic atrial rhythm with right ventricular overload and left anterosuperior divisional block. ECHOCARDIOGRAM: Single atrium with absent interatrial septum, atrioventricular connection with a single valve and two orifices, with increased pulmonary pressure and high Qp/Qs. COMPUTED TOMOGRAPHY: Absence of portal vein and intrahepatic segment of the inferior vena cava. Infrahepatic portion continuing with the azygos system at the level of the thoracic cavity, presence of mesenteric-caval communication associated with signs suggestive of hepatic peribiliary fibrosis. DIAGNOSIS: Abernethy malformation is a rare condition and represents an extrahepatic portosystemic shunt that develops between the mesenteric-portal vasculature and the systemic veins. It may be associated with cardiac malformations and advance with pulmonary hypertension and even the need for liver transplantation. Persistent cyanosis after corrective surgery led to a deeper investigation and correct diagnosis of this malformation. OPERATION: Sternotomy with 68 minutes of cardiopulmonary bypass and nine minutes of total circulatory arrest. In the postoperative period, persistence of cyanosis was evident, even though there were no immediate complications. Patient was discharged on the 10th postoperative day. An abdominal computed tomography angiography confirmed the diagnosis of Abernethy type I malformation, and the patient was transferred for liver transplantation after congenital heart disease treatment.

SLC26A4-AS1 Agrava a Hipertrofia Cardíaca Induzida por AngII Aumentando a Expressão de SLC26A4 / SLC26A4-AS1 Aggravates AngII-induced Cardiac Hypertrophy by Enhancing SLC26A4 Expression

Resumo Fundamento Foi relatado que o RNA 1 antisenso 1 (SLC26A4-AS1) do membro 4 da família de transportadores de soluto 26 está altamente relacionado à hipertrofia cardíaca. Objetivo Esta pesquisa visa investigar o papel e o mecanismo específicos de SLC26A4-AS1 na hipertrofia cardíaca, fornecendo um novo marcador para o tratamento da hipertrofia cardíaca. Métodos Angiotensina II (AngII) foi infundida em cardiomiócitos ventriculares (NMVCs) de camundongos neonatos para induzir hipertrofia cardíaca. A expressão gênica foi detectada por PCR quantitativo em tempo real (RT-qPCR). Os níveis de proteína foram avaliados por western blot. Ensaios funcionais analisaram o papel de SLC26A4-AS1. O mecanismo de SLC26A4-AS1 foi avaliado por imunoprecipitação de proteína de ligação a RNA (RIP), pull-down de RNA e ensaios de luciferase repórter. O valor de p < 0,05 foi identificado como significância estatística. O teste t de Student avaliou a comparação dos dois grupos. A diferença entre os diferentes grupos foi analisada por análise de variância (ANOVA) de uma via. Resultados SLC26A4-AS1 é regulado para cima em NMVCs tratados com AngII e promove hipertrofia cardíaca induzida por AngII. SLC26A4-AS1 regula o membro 4 da família de transportadores de soluto 26 (SLC26A4) por meio do funcionamento como um RNA endógeno competitivo (ceRNA) para modular o microRNA (miR)-301a-3p e o miR-301b-3p em NMVCs. SLC26A4-AS1 promove hipertrofia cardíaca induzida por AngII via regulação para cima de SLC26A4 ou absorção de miR-301a-3p/miR-301b-3p. Conclusão SLC26A4-AS1 agrava a hipertrofia cardíaca induzida por AngII via absorção de miR-301a-3p ou miR-301b-3p para aumentar a expressão de SLC26A4.

Abstract Background It has been reported that solute carrier family 26 members 4 antisense RNA 1 (SLC26A4-AS1) is highly related to cardiac hypertrophy. Objective This research aims to investigate the role and specific mechanism of SLC26A4-AS1 in cardiac hypertrophy, providing a novel marker for cardiac hypertrophy treatment. Methods Angiotensin II (AngII) was infused into neonatal mouse ventricular cardiomyocytes (NMVCs) to induce cardiac hypertrophy. Gene expression was detected by quantitative real-time PCR (RT-qPCR). Protein levels were evaluated via western blot. Functional assays analyzed the role of SLC26A4-AS1. The mechanism of SLC26A4-AS1 was assessed by RNA-binding protein immunoprecipitation (RIP), RNA pull-down, and luciferase reporter assays. The P value <0.05 was identified as statistical significance. Student's t-test evaluated the two-group comparison. The difference between different groups was analyzed by one-way analysis of variance (ANOVA). Results SLC26A4-AS1 is upregulated in AngII-treated NMVCs and promotes AngII-induced cardiac hypertrophy. SLC26A4-AS1 regulates its nearby gene solute carrier family 26 members 4 (SLC26A4) via functioning as a competing endogenous RNA (ceRNA) to modulate the microRNA (miR)-301a-3p and miR-301b-3p in NMVCs. SLC26A4-AS1 promotes AngII-induced cardiac hypertrophy via upregulating SLC26A4 or sponging miR-301a-3p/miR-301b-3p. Conclusion SLC26A4-AS1 aggravates AngII-induced cardiac hypertrophy via sponging miR-301a-3p or miR-301b-3p to enhance SLC26A4 expression.

Abernethy Malformation: Possible Diagnosis for Patients with Congenital Heart Disease and Persistent Cyanosis

ABSTRACT Clinical data: Infant, nine months of age, female, diagnosed with congenital heart disease, with signs of heart failure associated with cyanosis and difficulty in gaining weight. Chest radiography: Cardiomegaly with prevalence of pulmonary vascular network. Electrocardiogram: Ectopic atrial rhythm with right ventricular overload and left anterosuperior divisional block. Echocardiogram: Single atrium with absent interatrial septum, atrioventricular connection with a single valve and two orifices, with increased pulmonary pressure and high Qp/Qs. Computed tomography: Absence of portal vein and intrahepatic segment of the inferior vena cava. Infrahepatic portion continuing with the azygos system at the level of the thoracic cavity, presence of mesenteric-caval communication associated with signs suggestive of hepatic peribiliary fibrosis. Diagnosis: Abernethy malformation is a rare condition and represents an extrahepatic portosystemic shunt that develops between the mesenteric-portal vasculature and the systemic veins. It may be associated with cardiac malformations and advance with pulmonary hypertension and even the need for liver transplantation. Persistent cyanosis after corrective surgery led to a deeper investigation and correct diagnosis of this malformation. Operation: Sternotomy with 68 minutes of cardiopulmonary bypass and nine minutes of total circulatory arrest. In the postoperative period, persistence of cyanosis was evident, even though there were no immediate complications. Patient was discharged on the 10th postoperative day. An abdominal computed tomography angiography confirmed the diagnosis of Abernethy type I malformation, and the patient was transferred for liver transplantation after congenital heart disease treatment.

An unusual umbilical venous connection to a left posterior intercostal vein.

A foetal echocardiogram, in a 27-week foetus referred for cardiomegaly, demonstrated dextrocardia, absence of the ductus venosus, and an unrestricted unusual umbilical venous drainage to a left posterior intercostal vein, which continued to left hemiazygos vein and drained into the coronary sinus. Progressive cardiomegaly led to early delivery. To the best of our knowledge, no case with similar umbilical venous drainage has been previously reported.

Insuficiência Cardíaca com Fração de Ejeção Ventricular Esquerda Supranormal - Estado da Arte / Heart Failure with Supra-normal Left Ventricular Ejection Fraction - State of the Art

Resumo Em 2019, um artigo publicado no European Heart Journal reconheceu pela primeira vez a insuficiência cardíaca (IC) com fração de ejeção do ventrículo esquerdo (FEVE) ≥ 65% como um novo fenótipo de IC, ou a insuficiência cardíaca com fração de ejeção supranormal (ICFEsn), com o objetivo principal de promover a investigação desta nova categoria. Eles analisaram a mortalidade em pessoas com IC e descobriram que havia uma relação em forma de U entre a mortalidade e a FEVE. Sendo assim, os pacientes com ICFEsn tinham uma mortalidade geral mais alta em comparação com outros pacientes diagnosticados com IC com fração de ejeção preservada (ICFEp). Este artigo descreve a situação atual da ICFEsn e discute as perspectivas futuras com base nos resultados preliminares de nosso grupo. Para melhor tratar os pacientes com ICFEsn, é fundamental que cardiologistas e médicos entendam as diferenças e semelhanças desse novo fenótipo.

Abstract In 2019, an article published in the European Heart Journal recognized for the first time heart failure (HF) with left ventricular ejection fraction (LVEF)≥ 65% as a new HF phenotype, heart failure with supra-normal left ventricular ejection fraction (HFsnEF), with the main purpose of promoting research on this new category. They analyzed mortality in people with HF and found that there was a u-shaped relationship between mortality and LVEF. Accordingly, HFsnEF patients had a higher all-cause mortality compared with other patients diagnosed with HF with preserved ejection fraction (HFpEF). This article describes the current situation of HFsnEF and discusses future perspectives based on the preliminary results of our group. To better treat patients with HFsnEF, it is fundamental that cardiologists and physicians understand the differences and similarities of this new phenotype.

Agenesia Pericárdica Completa. Presentación de una caso y revisión de la literatura / Complete pericardial agenesis. Presentation of a case and review of the literature

Resumen Paciente masculino de 18 años, quien es valorado en el Servicio de Cardiología del Hospital Víctor Manuel Sanabria Martínez referido del primer nivel de atención por cuadro crónico de dolor torácico atípico acompañado de pectus excavatum y desplazamiento izquierdo del latido de punta a la exploración física. La radiografía de tórax posteroanterior evidencia una cardiomegalia moderada con levocardia máxima. El ecocardiograma transtorácico con función sistólica biventricular conservada, dilatación moderada del ventrículo derecho, sin signos de hipertensión pulmonar e imagen cardiaca de "corazón en lágrima". Angiotomografía computarizada de tórax con contraste que documenta malformación de la caja torácica con hundimiento de la región esternal, en relación con pectus excavatum. Corazón aumentado de tamaño en relación con cardiomegalia grado I y desplazamiento hacia el hemitórax izquierdo. No se observa pericardio en ninguna región. Aurícula derecha levemente dilatada con un ventrículo derecho con diámetro aumentado en su porción media y deformidad de su tracto de salida debido a la forma de la caja torácica, de tal manera que se corrobora el diagnóstico de una agenesia pericárdica completa.

Abstract An 18-year-old male patient who is evaluated in the Cardiology Department of the Víctor Manuel Sanabria Martínez Hospital, referred to the first level of attention due to chronic symptoms of atypical chest pain accompanied by pectus excavatum and left displacement of the peak beat. Chest X-ray Posteroanterior with moderate cardiomegaly with maximum levocardia. Transthoracic echocardiogram with preserved biventricular systolic function, moderate dilatation of the right ventricle, without signs of pulmonary hypertension and cardiac image of "tear heart". Thoracic Computed Angiotomography with contrast documenting malformation of the rib cage with sinking of the external region, in relation to pectus excavatum. Heart enlarged in relation to grade I cardiomegaly and displacement towards the left hemithorax. No pericardium is observed in any region. Slightly dilated right atrium with a right ventricle with an increased diameter in its middle portion and deformity of its outflow tract due to the shape of the rib cage. Corroborating the diagnosis of complete pericardial agenesis.

Diferencias de sexo entre deportistas de ultramaratón preesfuerzo y posesfuerzo / Sex differences between pre and post effort ultra marathon athletes

RESUMEN Introducción: La presencia de mujeres en las competencias de ultramaratón se observa cada vez con más frecuencia. Las adaptaciones fisiológicas y la respuesta al máximo esfuerzo se diferencian influenciados por el sexo. Objetivos: Evaluar las diferencias observadas en los deportistas de ultramaratón o ultratrail (carreras de montaña de más de 42 km) en reposo (adaptaciones fisiológicas) y en el posesfuerzo (fatiga cardíaca inducida por el ejercicio [FCIE]), estratificado por parámetros de entrenamiento. Material y métodos: Se reclutaron veinticinco deportistas (mujeres n 6) que participaron de la carrera cruce Mendoza (55 km en montaña); fueron evaluados antes y después de la finalización de la carrera mediante ecocardiografía Doppler y técnicas de deformación miocárdica (posprocesamiento). Mediante relojes deportivos se documentaron parámetros durante el entrenamiento y la carrera. Se realizó extracción de sangre posesfuerzo inmediato para documentar variables asociadas con fatiga cardíaca. Resultados: Completaron la carrera 24 deportistas, 19 hombres (42 ± 12 años) y 5 mujeres (38 ± 4 años). Las mujeres presentaban parámetros similares de entrenamiento y completaron la prueba sin diferencia en tiempos respecto a los hombres. Se observó disminución de los parámetros de función miocárdica izquierda (fatiga cardíaca inducida por el ejercicio) en el 50% de los hombres y el 5% de las mujeres. Conclusiones: A pesar de no encontrar diferencias en las características del entrenamiento, se observó en las mujeres menos adaptación fisiológica basal y menor incidencia de fatiga cardíaca inducida por el ejercicio.

ABSTRACT Introduction: the presence of women in ultramarathon competitions is observed with increasing frequency. Physiological adaptations and response to maximum effort are differentiated influenced by sex. Objectives: to evaluate the differences observed in ultramarathon or ultratrail athletes (mountain races over 42 km) at rest (physiological adaptations) and at post-effort (exercise-induced cardiac fatigue-FCIE), stratified by training parameters. Material and methods: twenty-five athletes (women n 6) who participated in the Mendoza crossing race (55 km in the mountains) were recruited, being evaluated before and after the end of the race using Doppler echocardiography and myocardial deformation techniques (post-processing). Through sports watches, parameters during training and running are documented. Immediate post-effort blood collection was performed to document variables associated with cardiac fatigue. Results: 24 athletes completed the race, 19 men (42 ± 12 years) and 5 women (38 ± 4 years). The women presented similar training loads and completed the test with no difference in time compared to the men. Decreased left myocardial function parameters (exercise-induced cardiac fatigue) were observed in 50% of men and 5% of women. Conclusions: Despite not finding differences in training characteristics, less baseline physiological adaptation and a lower incidence of exercise-induced cardiac fatigue were observed in women.

Correlação entre Cardiomegalia pela Radiografia de Tórax e Diâmetro do Ventrículo Esquerdo pela Ecocardiografia em Pacientes com Doença de Chagas / Correlation between Cardiomegaly on Chest X-Ray and Left Ventricular Diameter on Echocardiography in Patients with Chagas Disease

Resumo Fundamento Cardiomegalia pela radiografia de tórax (RXT) é preditor independente de morte em indivíduos com cardiomiopatia crônica da doença de Chagas (CCDC). Contudo, a correlação entre o aumento do índice cardiotorácico (ICT) na RXT e do diâmetro telediastólico do ventrículo esquerdo (DDVE) pela ecocardiografia (ECO) nessa população não está bem definida. Objetivos Analisar a relação entre cardiomegalia pela RXT e DDVE pela ECO em pacientes com doença de Chagas (DC) e sua aplicabilidade ao escore de Rassi. Métodos Estudo retrospectivo incluiu 63 pacientes ambulatoriais com DC avaliados por RXT e ECO. Cardiomegalia na RXT foi definida como ICT > 0,5. DDVE foi avaliado como variável contínua. Curva ROC foi utilizada para avaliar o potencial do DDVE para identificação de cardiomegalia pela RXT, com ponto de corte definido pela maior somatória de sensibilidade e especificidade. Resultados Idade mediana = 61 anos [intervalo interquartil: 48-68], 56% mulheres. CCDC foi identificada em 58 pacientes; 5 tinham a forma indeterminada da DC. Cardiomegalia foi detectada em 28 indivíduos. A área sob a curva ROC do DDVE para identificação de cardiomegalia foi de 0,806 (IC 95%: 0,692-0,919). O ponto de corte ótimo para DDVE foi de 60 mm (sensibilidade = 64%, especificidade = 89%). O uso do DDVE pela ECO em substituição ao ICT pela RXT alterou o escore de Rassi em 14 pacientes, e em 10 deles houve redução do risco presumido. Conclusão DDVE pela ECO é parâmetro adequado e com alta especificidade para distinguir entre presença e ausência de cardiomegalia na RXT na DC. (Arq Bras Cardiol. 2021; 116(1):68-74)

Abstract Background Cardiomegaly on chest X-ray is an independent predictor of death in individuals with chronic Chagas cardiomyopathy (CCC). However, the correlation between increased cardiothoracic ratio (CTR) on chest X-ray and left ventricular end-diastolic diameter (LVEDD) on echocardiography is not well established in this population. Objectives To assess the relationship between chest X-ray and LVEDD on echocardiography in patients with Chagas disease and its applicability to the Rassi score. Methods Retrospective study on 63 Chagas disease outpatients who underwent chest X-ray and echocardiography. Cardiomegaly on chest X-ray was defined as a CTR>0.5. LVEDD was analyzed as a continuous variable. ROC curve was used to evaluate the ability of LVEDD in detecting cardiomegaly by chest X-ray, with a cut-off point defined by the highest sum of sensitivity and specificity. Results Median age 61 years [interquartile range 48-68], 56% were women. CCC was detected in 58 patients, five patients had the indeterminate form of Chagas disease. Cardiomegaly was detected in 28 patients. The area under the ROC curve for LVEDD was 0.806 (95%CI: 0.692-0.919). The optimal cut-off for LVEDD was 60 mm (sensitivity = 64%, specificity = 89%). The use of LVEDD on echocardiography as a surrogate for CTR on chest X-ray changed the Rassi score values of 14 patients, with a reduction in the presumed risk in 10 of them. Conclusion LVEDD on echocardiography is an appropriate, highly specific parameter to distinguish between the presence and absence of cardiomegaly on chest X-ray in Chagas disease. (Arq Bras Cardiol. 2021; 116(1):68-74)

Genomic Binding Patterns of Forkhead Box Protein O1 Reveal Its Unique Role in Cardiac Hypertrophy.

BACKGROUND: Cardiac hypertrophic growth is mediated by robust changes in gene expression and changes that underlie the increase in cardiomyocyte size. The former is regulated by RNA polymerase II (pol II) de novo recruitment or loss; the latter involves incremental increases in the transcriptional elongation activity of pol II that is preassembled at the transcription start site. The differential regulation of these distinct processes by transcription factors remains unknown. Forkhead box protein O1 (FoxO1) is an insulin-sensitive transcription factor that is also regulated by hypertrophic stimuli in the heart. However, the scope of its gene regulation remains unexplored. METHODS: To address this, we performed FoxO1 chromatin immunoprecipitation-deep sequencing in mouse hearts after 7 days of isoproterenol injections (3 mg·kg-1·mg-1), transverse aortic constriction, or vehicle injection/sham surgery. RESULTS: Our data demonstrate increases in FoxO1 chromatin binding during cardiac hypertrophic growth, which positively correlate with extent of hypertrophy. To assess the role of FoxO1 on pol II dynamics and gene expression, the FoxO1 chromatin immunoprecipitation-deep sequencing results were aligned with those of pol II chromatin immunoprecipitation-deep sequencing across the chromosomal coordinates of sham- or transverse aortic constriction-operated mouse hearts. This uncovered that FoxO1 binds to the promoters of 60% of cardiac-expressed genes at baseline and 91% after transverse aortic constriction. FoxO1 binding is increased in genes regulated by pol II de novo recruitment, loss, or pause-release. In vitro, endothelin-1- and, in vivo, pressure overload-induced cardiomyocyte hypertrophic growth is prevented with FoxO1 knockdown or deletion, which was accompanied by reductions in inducible genes, including Comtd1 in vitro and Fstl1 and Uck2 in vivo. CONCLUSIONS: Together, our data suggest that FoxO1 may mediate cardiac hypertrophic growth via regulation of pol II de novo recruitment and pause-release; the latter represents the majority (59%) of FoxO1-bound, pol II-regulated genes after pressure overload. These findings demonstrate the breadth of transcriptional regulation by FoxO1 during cardiac hypertrophy, information that is essential for its therapeutic targeting.

Determination of the value of vertebral heart size regarding the weight and body area in canines / Determinação dos valores do vertebral heart size em relação ao peso e área corporal canina

The vertebral heart size is a method used to measure the cardiac dimension in order to identify the remodeling of the chambres in heart disease. This study aims to determinate the vertebral heart size values at right lateral and ventrodorsal radiographs views relating to canines weight and body area variations. For the purpose of the study 40 healthy dogs within the age of 1 to 6 years, males and females, with deep or intermediated thorax were selected, brachycephalic dogs were not included in the study; the dogs were separated in four groups: group 1(n=9) compound of dogs up to 5 kg; group 2 (n=8) with dogs from 5,1 to 10 kg; group 3 (n=12) with dogs from 10,1 to19 kg and group 4 (n=11) with dogs weighing more than 19,1 kg. The values of body score, body mass index and the thorax configuration where previously measured, as well as the vertebral heart size and the depth width ratio from the radiographs. The results demonstrated intervals of right lateral-lateral vertebral heart size 9.9 to 10.4v and ventro-dorsal vertebral heart size of 9.8-10.3v. The study results show that the vertebral heart size numbers did not correlate with weight or body area, regardless the type of radiography view. Therefore, it can be concluded that the vertebral heart size in right lateral and ventrodorsal radiography can be used to rate the cardiac area, not suffering influence by the dog's weight or body area.

O vertebral heart size é um método utilizado para mensurar a dimensão cardíaca visando identificar os remodelamentos das câmaras nas cardiopatias. O objetivo do estudo foi determinar os valores de vertebral heart size nas projeções radiográficas latero-lateral direita e ventro-dorsal conforme as variações do peso e área corporal. Para isso, foram selecionados 40 cães hígidos com idade entre 1 e 6 anos, machos e fêmeas, com padrão torácico intermediário e profundo, com exclusão dos braquicefálicos; os cães foram divididos em quatro grupos: grupo 1 (n=9) composto por cães de até 5 kg; grupo 2 (n=8) com cães de 5,1 a 10 kg; grupo 3 (n=12) com cães de 10,1 a 19 kg e grupo 4 (n=11) com cães acima de 19,1 kg. Os valores de escore corporal, índice de massa corporal e conformação torácica foram previamente mensurados, bem como os valores dos vertebral heart size a relação profundidade/largura torácica das radiografias. Os resultados demonstraram intervalos de vertebral heart size latero-lateral 9.9 a 10.4v e vertebral heart size ventro dorsal de 9.8-10.3v. Os valores não apresentaram correlação com o peso e área corporal nos grupos estudados, independente das projeções estudas. Assim, pode-se concluir que método vertebral heart size nas projeções estudadas é aplicável na avaliação da área cardíaca, não sofrendo influências do peso e área corporal canina.

Determination of the value of vertebral heart size regarding the weight and body area in canines / Determinação dos valores do vertebral heart size em relação ao peso e área corporal canina

The vertebral heart size is a method used to measure the cardiac dimension in order to identify the remodeling of the chambres in heart disease. This study aims to determinate the vertebral heart size values at right lateral and ventrodorsal radiographs views relating to canines weight and body area variations. For the purpose of the study 40 healthy dogs within the age of 1 to 6 years, males and females, with deep or intermediated thorax were selected, brachycephalic dogs were not included in the study; the dogs were separated in four groups: group 1(n=9) compound of dogs up to 5 kg; group 2 (n=8) with dogs from 5,1 to 10 kg; group 3 (n=12) with dogs from 10,1 to19 kg and group 4 (n=11) with dogs weighing more than 19,1 kg. The values of body score, body mass index and the thorax configuration where previously measured, as well as the VHS and the depth width ratio from the radiographs. The results demonstrated intervals of right lateral-lateral vertebral heart size 9.9 to 10.4v and ventro-dorsal vertebral heart size of 9.8-10.3v. The study results show that the vertebral heart size numbers did not correlate with weight or body area, regardless the type of radiography view. Therefore, it can be concluded that the vertebral heart size in right lateral and ventrodorsal radiography can be used to rate the cardiac area, not suffering influence by the dog's weight or body area.

O vertebral heart size é um método utilizado para mensurar a dimensão cardíaca visando identificar os remodelamentos das câmaras nas cardiopatias. O objetivo do estudo foi determinar os valores de vertebral heart size nas projeções radiográficas latero-lateral direita e ventro-dorsal conforme as variações do peso e área corporal. Para isso, foram selecionados 40 cães hígidos com idade entre 1 e 6 anos, machos e fêmeas, com padrão torácico intermediário e profundo, com exclusão dos braquicefálicos; os cães foram divididos em quatro grupos: grupo 1 (n=9) composto por cães de até 5 kg; grupo 2 (n=8) com cães de 5,1 a 10 kg; grupo 3 (n=12) com cães de 10,1 a 19 kg e grupo 4 (n=11) com cães acima de 19,1 kg. Os valores de escore corporal, índice de massa corporal e conformação torácica foram previamente mensurados, bem como os valores dos vertebral heart size a relação profundidade/largura torácica das radiografias. Os resultados demonstraram intervalos de vertebral heart size latero-lateral 9.9 a 10.4v e vertebral heart size ventro dorsal de 9.8-10.3v. Os valores não apresentaram correlação com o peso e área corporal nos grupos estudados, independente das projeções estudas. Assim, pode-se concluir que método vertebral heart size nas projeções estudadas é aplicável na avaliação da área cardíaca, não sofrendo influências do peso e área corporal canina.

Expression of microRNAs (133b and 138) and Correlation with Echocardiographic Parameters in Patients with Alcoholic Cardiomyopathy.

INTRODUCTION: Alcoholic Cardiomyopathy (ACM) is a disease with a difficult diagnosis. The real mechanisms related to its pathophysiology are not fully understood. OBJECTIVE: The aims of this study were to investigate whether miR-133b and miR-138 could be associated with ACM. METHODS: Forty-four patients were included comprising 24 with ACM and 20 with cardiomyopathies of different etiologies (control group). Real-time PCR was performed to verify the relative expression among the studied groups. In the statistical analysis, the quantitative variables t-student Mann- Whitney and correlation of Pearson tests were carried out, while the qualitative variable comprised the chi-square test, with p<0.05 being considered statistically significant. RESULTS: There was no association between clinical and sociodemographic characteristics of the groups. The patients with ACM presented downregulation of miR-133b in comparison with control patients (p=0.004). On the other hand, for the miR-138, there was no association when the ACM group was compared with the control group. The presence of miR-133b among cases and controls was not correlated with any of the echocardiographic parameters. However, the increase in the expression of miR-138 was correlated with an increase in the ejection fraction (r=0.28, p=0.01) and the diameter of the left atrium (r=0.23, p=0.04) in patients with ACM. CONCLUSION: The downregulation of miR-133b might be a marker for ACM and, in addition, miR- 138 could be used to correlate the increase in ejection fraction with and normalization of the diameter of the left atrium diameter in patients with this disease.

Determination of the value of vertebral heart size regarding the weight and body area in canines / Determinação dos valores do vertebral heart size em relação ao peso e área corporal canina

The vertebral heart size is a method used to measure the cardiac dimension in order to identify the remodeling of the chambres in heart disease. This study aims to determinate the vertebral heart size values at right lateral and ventrodorsal radiographs views relating to canines weight and body area variations. For the purpose of the study 40 healthy dogs within the age of 1 to 6 years, males and females, with deep or intermediated thorax were selected, brachycephalic dogs were not included in the study; the dogs were separated in four groups: group 1(n=9) compound of dogs up to 5 kg; group 2 (n=8) with dogs from 5,1 to 10 kg; group 3 (n=12) with dogs from 10,1 to19 kg and group 4 (n=11) with dogs weighing more than 19,1 kg. The values of body score, body mass index and the thorax configuration where previously measured, as well as the VHS and the depth width ratio from the radiographs. The results demonstrated intervals of right lateral-lateral vertebral heart size 9.9 to 10.4v and ventro-dorsal vertebral heart size of 9.8-10.3v. The study results show that the vertebral heart size numbers did not correlate with weight or body area, regardless the type of radiography view. Therefore, it can be concluded that the vertebral heart size in right lateral and ventrodorsal radiography can be used to rate the cardiac area, not suffering influence by the dog's weight or body area.(AU)

O vertebral heart size é um método utilizado para mensurar a dimensão cardíaca visando identificar os remodelamentos das câmaras nas cardiopatias. O objetivo do estudo foi determinar os valores de vertebral heart size nas projeções radiográficas latero-lateral direita e ventro-dorsal conforme as variações do peso e área corporal. Para isso, foram selecionados 40 cães hígidos com idade entre 1 e 6 anos, machos e fêmeas, com padrão torácico intermediário e profundo, com exclusão dos braquicefálicos; os cães foram divididos em quatro grupos: grupo 1 (n=9) composto por cães de até 5 kg; grupo 2 (n=8) com cães de 5,1 a 10 kg; grupo 3 (n=12) com cães de 10,1 a 19 kg e grupo 4 (n=11) com cães acima de 19,1 kg. Os valores de escore corporal, índice de massa corporal e conformação torácica foram previamente mensurados, bem como os valores dos vertebral heart size a relação profundidade/largura torácica das radiografias. Os resultados demonstraram intervalos de vertebral heart size latero-lateral 9.9 a 10.4v e vertebral heart size ventro dorsal de 9.8-10.3v. Os valores não apresentaram correlação com o peso e área corporal nos grupos estudados, independente das projeções estudas. Assim, pode-se concluir que método vertebral heart size nas projeções estudadas é aplicável na avaliação da área cardíaca, não sofrendo influências do peso e área corporal canina.(AU)