RESUMO
Severe degenerative mitral regurgitation (DMR) is one cardiac manifestation of the multiorgan metabolic enzyme disorder Anderson-Fabry Disease (AFD). Although DMR is normally managed surgically, many patients with AFD are unsuitable for this. We present the first case of mitral transcatheter edge-to-edge repair in a patient with AFD.
RESUMO
Sympathetic hyper-activity and diminished parasympathetic activity are a consequence of many primary cardiovascular disease states and can trigger arrhythmias. Emerging evidence suggests that reactive oxygen species (ROS) including nitric oxide, superoxide, and peroxynitrite may contribute to cardiac sympathovagal imbalance in the brainstem, peripheral neurons, and in cardiomyocytes since all experience increased oxidative stress as a result of cardiac disease processes and aging. This article reviews the roles of ROS in autonomic dysfunction and arrhythmia. In addition, novel research directed toward finding targets for modulating sympathovagal balance in cardiac disease is discussed.
Assuntos
Potenciais de Ação/fisiologia , Sistema Nervoso Autônomo/fisiologia , Sistema de Condução Cardíaco/fisiologia , Coração/inervação , Coração/fisiologia , Contração Miocárdica/fisiologia , Espécies Reativas de Oxigênio/metabolismo , Animais , Simulação por Computador , Retroalimentação/fisiologia , Humanos , Modelos Cardiovasculares , Miócitos Cardíacos/fisiologiaAssuntos
Baixo Débito Cardíaco/tratamento farmacológico , Doadores de Óxido Nítrico/uso terapêutico , Nitroglicerina/uso terapêutico , Administração Cutânea , Animais , Baixo Débito Cardíaco/fisiopatologia , Coração/inervação , Humanos , Doadores de Óxido Nítrico/administração & dosagem , Nitroglicerina/administração & dosagem , Falha de Tratamento , Nervo Vago/efeitos dos fármacos , Nervo Vago/fisiopatologiaRESUMO
Parasympathetic control of heart rate involves the exocytotic release of acetylcholine and muscarinic receptor regulation of pacemaking currents. Endogenous nitric oxide can potentially regulate all of these processes; however, recent work suggests that the main functional role of nitric oxide lies in the modulation of acetylcholine release.