In vitro properties and performance of glutaraldehyde-crosslinked bovine pericardial bioprostheses treated with glutamic acid.

Calcification is one of the major causes of failure of heart valve bioprostheses (HVBs) derived from glutaraldehyde (GA)-processed bovine pericardium (BP) or porcine aortic valves. New crosslinking reagent procedures are still far from giving satisfactory results, and this is the main reason why GA is still the reagent of choice for the fixation of native tissue intended for HVB manufacture. Nevertheless, two new findings with respect to GA processing may significantly improve HVB performance postimplantation: the finding that increasing concentrations of GA result in a decrease in calcification; the blocking of free aldehyde usually by nucleophyles or the treatment of processed material at low pH. This work investigates the in vitro properties of BP fixed with GA followed by the treatment with glutamic acid under alkaline conditions in order to prepare BP materials with lower calcification potential postimplantation. In comparison to conventional processing, except for the tensile strength that was slightly lower, elongation and toughness were higher than the accepted values. No significant differences were observed in the performance indexes (mean pressure gradient, mean effective area, regurgitant fraction, performance and efficiency indexes) with wear resistance over 150 × 106 cycles. These results indicate that the processing of BP described in this work may be of potential use in the manufacture of HVBs.

[Prevalence of metabolic syndrome using NCEP-ATPIII and IDF definitions in Brazilian individuals]. / Prevalência de síndrome metabólica em indivíduos brasileiros pelos critérios de NCEP-ATPIII e IDF.

OBJECTIVE: To analyze the biochemical profile and to characterize metabolic syndrome (MS) in patients with cardiologic medical assistance using NCEP-ATPIII and IDF definitions. METHODS: Two hundred patients and 140 controls were studied, considering total cholesterol (TC), HDL-cholesterol (HDLc), LDL-cholesterol (LDLc), VLDL-cholesterol (VLDLc), triglycerides (TG), fasting glycemia, abdominal waist and hypertension. Significance level was defined as P<0.05. RESULTS: Patients showed increased glycemia levels (103+/-31.4 mg/dL) and reduced HDLc levels (48+/-13.4 mg/dL) when compared to controls (88+/-29.7 mg/dL, P<0.0001 and 53+/-15.9 mg/dL, P=0.0075; respectively). Male controls 31-50 years old showed increased TC levels (215+/-40.4 mg/dL), LDL-cholesterol (134+/-34 mg/dL), VLDL-cholesterol (30+/-11.8 mg/dL) and TG (150+/-59.4 mg/dL) when compared to women (185+/-38.2 mg/dL, P=0.0137; 111+/-35.8 mg/dL; P=0.0324; 19+/-9.7 mg/dL; P=0.0009; 93+/-49 mg/dL, P=0.0010; respectively). Women over 50 years of age showed increased TC concentrations (216+/-35.9 mg/dL), HDL-cholesterol (54+/-12.8 mg/dL) and LDL-cholesterol (138+/-30.8 mg/dL) when compared to men (190+/-44.7 mg/dL, P=0.0103; 47+/-14.5 mg/dL, P=0.0229; 119+/-33.3 mg/dL; P=0.0176; respectively). NCEP-ATPIII and IDF definitions had characterized MS in 35.5% and 46% of patients, respectively, bolding glycemia, TG and hypertension. CONCLUSION: Elevated glycemia levels and reduced HDLc levels were detected in patients. Altered lipid profile observed in men 31-50 years old signals higher risk for cardiovascular diseases in young adults, while a similar profile in aged women can reflect hormonal physiological changes. Both definitions for MS diagnosis discriminate patients from controls, especially IDF, sometimes with lower capacity to determine high risk for cardiovascular complications. The high prevalence of MS in patients, even with cardiologic medical assistance, suggests predisposition for cardiovascular manifestations in Brazilian individuals.

Prevalência de síndrome metabólica em indivíduos brasileiros pelos critérios de NCEP-ATPIII e IDF / Prevalence of metabolic syndrome using NCEP-ATPIII and IDF definitions in Brazilian individuals

Objetivos. Analisar perfil bioquímico e caracterizar síndrome metabólica (SM) em pacientes com acompanhamento cardiológico, conforme critérios de NCEP-ATPIII e IDF. MÉTODOS: Foram estudados 200 pacientes e 140 controles, considerando colesterol total (CT), fração de colesterol de lipoproteína de alta (HDLc), baixa (LDLc) e muito baixa densidade (VLDLc), triglicérides (TG), glicemia de jejum, cintura abdominal e hipertensão arterial sistêmica (HAS). Admitiu-se nível de significância P<0,05. RESULTADOS: Pacientes apresentaram níveis elevados de glicemia (103±31,4mg/dL) e reduzidos de HDLc (48±13,4mg/dL) comparado aos controles (88±29,7mg/dL, P<0,0001; 53±15,9mg/dL, P=0,0075; respectivamente). Controles do sexo masculino, entre 31 e 50 anos, mostraram níveis aumentados de CT (215±40,4mg/dL), LDLc (134±34mg/dL), VLDLc (30±11,8mg/dL) e TG (150±59,4mg/dL) comparado às mulheres (185±38,2mg/dL, P=0,0137; 111±35,8mg/dL; P=0,0324; 19±9,7mg/dL; P=0,0009; 93±49mg/dL, P=0,0010; respectivamente). Mulheres acima dos 50 anos mostraram aumento de CT (216±35,9mg/dL), HDLc (54±12,8mg/dL) e LDLc (138±30,8mg/dL) comparado aos homens (190±44,7mg/dL, P=0,0103; 47±14,5mg/dL, P=0,0229; 119±33,3mg/dL; P=0,0176; respectivamente). Os critérios NCEP-ATPIII e IDF caracterizaram SM em 35,5 por cento e 46 por cento dos pacientes, respectivamente, com destaque para glicemia, TG e HAS. CONCLUSÃO: Níveis elevados de glicemia e reduzidos de HDLc destacam-se nos pacientes. Perfil lipídico alterado, em homens entre 31 e 50 anos, confere maior risco para doenças cardiovasculares em adulto jovem, enquanto padrão semelhante nas mulheres, após essa faixa etária, pode refletir alterações hormonais fisiológicas. Ambos os critérios para diagnóstico de SM distinguem pacientes de controles, destacando-se IDF, com parâmetros, no entanto, nem sempre associados a alto risco. Alta prevalência de SM em pacientes, mesmo com acompanhamento cardiológico, sugere predisposição para manifestações...

OBJECTIVE: To analyze the biochemical profile and to characterize metabolic syndrome (MS) in patients with cardiologic medical assistance using NCEP-ATPIII and IDF definitions. METHODS: Two hundred patients and 140 controls were studied, considering total cholesterol (TC), HDL-cholesterol (HDLc), LDL-cholesterol (LDLc), VLDL-cholesterol (VLDLc), triglycerides (TG), fasting glycemia, abdominal waist and hypertension. Significance level was defined as P<0.05. RESULTS: Patients showed increased glycemia levels (103±31.4mg/dL) and reduced HDLc levels (48±13.4mg/dL) when compared to controls (88±29.7mg/dL, P<0.0001 and 53±15.9mg/dL, P=0.0075; respectively). Male controls 31-50 years old showed increased TC levels (215±40.4mg/dL), LDL-cholesterol (134±34mg/dL), VLDL-cholesterol (30±11.8mg/dL) and TG (150±59.4mg/dL) when compared to women (185±38.2mg/dL, P=0.0137; 111±35.8mg/dL; P=0.0324; 19±9.7mg/dL; P=0.0009; 93±49mg/dL, P=0.0010; respectively). Women over 50 years of age showed increased TC concentrations (216±35.9mg/dL), HDL-cholesterol (54±12.8mg/dL) and LDL-cholesterol (138±30.8mg/dL) when compared to men (190±44.7mg/dL, P=0.0103; 47±14.5mg/dL, P=0.0229; 119±33.3mg/dL; P=0.0176; respectively). NCEP-ATPIII and IDF definitions had characterized MS in 35.5 percent and 46 percent of patients, respectively, bolding glycemia, TG and hypertension. CONCLUSION: Elevated glycemia levels and reduced HDLc levels were detected in patients. Altered lipid profile observed in men 31-50 years old signals higher risk for cardiovascular diseases in young adults, while a similar profile in aged women can reflect hormonal physiological changes. Both definitions for MS diagnosis discriminate patients from controls, especially IDF, sometimes with lower capacity to determine high risk for cardiovascular complications. The high prevalence of MS in patients, even with cardiologic medical assistance, suggests predisposition for cardiovascular manifestations in Brazilian...