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1.
J Am Chem Soc ; 139(15): 5317-5320, 2017 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-28365998

RESUMO

Fungal polyketide synthases (PKSs) can function collaboratively to synthesize natural products of significant structural diversity. Here we present a new mode of collaboration between a highly reducing PKS (HRPKS) and a PKS-nonribosomal peptide synthetase (PKS-NRPS) in the synthesis of oxaleimides from the Penicillium species. The HRPKS is recruited in the synthesis of an olefin-containing free amino acid, which is activated and incorporated by the adenylation domain of the PKS-NRPS. The precisely positioned olefin from the unnatural amino acid is proposed to facilitate a scaffold rearrangement of the PKS-NRPS product to forge the maleimide and succinimide cores of oxaleimides.


Assuntos
Produtos Biológicos/metabolismo , Maleimidas/metabolismo , Penicillium/enzimologia , Policetídeo Sintases/metabolismo , Succinimidas/metabolismo , Produtos Biológicos/química , Maleimidas/química , Conformação Molecular , Policetídeo Sintases/química , Succinimidas/química
2.
Europace ; 17(12): 1840-7, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26045502

RESUMO

AIMS: The Mason-Likar modified electrocardiogram (ML-ECG) can be interchanged with standard 12 lead ECG electrode positions (standard ECG) without affecting the diagnostic interpretation during sinus rhythm, but the morphological differences during ventricular arrhythmias have not been sufficiently evaluated. This study aimed to elucidate the morphological changes in the ML-ECG precordial leads. METHODS AND RESULTS: In 53 consecutive patients with premature ventricular contractions predicted to originate from the outflow tract (OT-PVCs), the arrhythmias were analysed by those two ECG methods. The OT-PVC origin sites, which were predicted by currently published criteria with the respective ECG methods prior to catheter ablation, were compared with the successful ablation sites. Compared with the standard-ECG, S-waves in the ML-ECG became shallower in leads V1-4 (P < 0.05 in lead V1; P < 0.001 in leads V2-4), and pseudo-R-waves in lead V1 appeared in seven patients. The precordial leads transition zone shifted counter-clockwise in 18 patients in the ML-ECG. In leads I and aVL, the negative deflection amplitudes of the ML-ECG were greater than those of the standard ECG (P < 0.001), and polarity reversals in lead I appeared in 18 patients. The R-wave amplitudes in all ML-ECG inferior leads were greater than those in the standard-ECG leads (all for P < 0.001). Those changes had an effect on the diagnostic indexes for the localization, and the specificity of the criteria for the ML-ECG was poorer than that for the standard-ECG. CONCLUSION: Great differences were found between those two ECG methods. Predicting OT-PVC origins by diagnostic criteria with the ML-ECG might result in a misdiagnosis and inefficient ablation.


Assuntos
Ablação por Cateter , Eletrocardiografia/métodos , Sistema de Condução Cardíaco/cirurgia , Frequência Cardíaca , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/cirurgia , Complexos Ventriculares Prematuros/diagnóstico , Complexos Ventriculares Prematuros/cirurgia , Potenciais de Ação , Adulto , Idoso , Erros de Diagnóstico , Feminino , Sistema de Condução Cardíaco/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Taquicardia Ventricular/fisiopatologia , Fatores de Tempo , Resultado do Tratamento , Complexos Ventriculares Prematuros/fisiopatologia
3.
Oncol Rep ; 29(2): 425-9, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23229564

RESUMO

Caffeic acid esters have various biological activities, and we previously reported that undecyl caffeate (caffeic acid undecyl ester, CAUE), a new caffeic acid derivative, has strong pharmacological activity. The present study investigated the cytotoxicity of both CAUE and its parent compound, caffeic acid phenethyl ester (CAPE), and characterized the mechanisms by which they induce apoptosis in the human B cell leukemia cell line NALM-6. Treatment with CAUE reduced cell survival in NALM-6 cells but had no significant effect on the survival of normal lymphocytes. When assessing the 50% inhibitory concentration (IC(50)) for cytotoxicity, CAUE had 10-fold higher activity than CAPE in NALM-6 cells. CAUE treatment resulted in induction of apoptotic features in NALM-6 cells, including cleaved poly (ADP-ribose) polymerase and activated caspase-3. A caspase inhibitor completely blocked CAUE-induced apoptosis. CAUE treatment resulted in a concentration- and time-dependent decrease in both mitochondrial membrane potential and downregulation of Bcl-2 expression. Moreover, CAUE-induced apoptosis was enhanced in the Bcl-2 knockdown condition induced by small interfering RNA. These data suggest that CAUE-induced apoptosis was mediated via an apoptotic intrinsic pathway including mitochondrial damage and was caspase-dependent. These data also suggest that CAUE is a powerful anti-leukemic agent that acts via induction of apoptosis by mitochondrial damage and selective action in leukemia cells.


Assuntos
Apoptose/efeitos dos fármacos , Ácidos Cafeicos/farmacologia , Leucemia de Células B/tratamento farmacológico , Álcool Feniletílico/análogos & derivados , Análise de Variância , Caspase 3/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Regulação para Baixo/efeitos dos fármacos , Genes bcl-2/efeitos dos fármacos , Humanos , Concentração Inibidora 50 , Leucemia de Células B/metabolismo , Linfócitos/efeitos dos fármacos , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Álcool Feniletílico/farmacologia , Poli(ADP-Ribose) Polimerases/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Células Tumorais Cultivadas
4.
Phytochemistry ; 83: 25-33, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22898385

RESUMO

In plants, jasmonic acid (JA) and its derivatives are thought to be involved in mobile forms of defense against biotic and abiotic stresses. In this study, the distal transport of JA-isoleucine (JA-Ile) that is synthesized de novo in response to leaf wounding in tomato (Solanum lycopersicum) plants was investigated. JA-[¹³C6]Ile was recovered in distal untreated leaves after wounded leaves were treated with [¹³C6]Ile. However, as [¹³C6]Ile was also recovered in the distal untreated leaves, whether JA-Ile was synthesized in the wounded or in the untreated leaves was unclear. Hence, stem exudates were analyzed to obtain more detailed information. When [¹³C6]Ile and [²H6]JA were applied separately into the wounds on two different leaves, JA-[¹³C6]Ile and [²H6]JA-Ile were detected in the stem exudates but [²H6]JA-[¹³C6]Ile was not, indicating that JA was conjugated with Ile in the wounded leaf and that the resulting JA-Ile was then transported into systemic tissues. The [²H3]JA-Ile that was applied exogenously to the wounded tissues reached distal untreated leaves within 10 min. Additionally, applying [²H3]JA-Ile to the wounded leaves at concentrations of 10 and 60 nmol/two leaves induced the accumulation of PIN II, LAP A, and JAZ3 mRNA in the distal untreated leaves of the spr2 mutant S. lycopersicum plants. These results demonstrate the transportation of de novo synthesized JA-Ile and suggest that JA-Ile may be a mobile signal.


Assuntos
Ciclopentanos/metabolismo , Isoleucina/análogos & derivados , Solanum lycopersicum/metabolismo , Ciclopentanos/química , Isoleucina/biossíntese , Isoleucina/química , Isoleucina/metabolismo , Cinética , Conformação Molecular , Folhas de Planta/química , Folhas de Planta/metabolismo
5.
Cardiology ; 122(4): 230-6, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22906847

RESUMO

OBJECTIVES: Hypertension impairs coronary endothelial cell function, coronary microvascular function and the coronary flow (CF) reserve (CFR). Angiotensin II receptor blockers (ARBs) have been reported to possibly improve coronary endothelial function and coronary microvascular function. The purpose of this study was to determine whether treatment with the ARB olmesartan was more effective for improving CFR than the calcium channel blocker amlodipine. METHODS: Twenty patients with untreated essential hypertension (M/F = 13/7, aged 55.6 ± 11.6 years) were randomly assigned to treatment with either olmesartan (n = 10) or amlodipine (n = 10) for 6 months. CF was measured in the proximal left anterior descending artery by magnetic resonance imaging before and during intravenous infusion of adenosine. CFR was calculated as the ratio of the hyperemic to baseline diastolic peak flow before and after 6 months of treatment. RESULTS: The extent of systolic blood pressure reduction was similar in both groups (-40.0 ± 19.1 vs. -48.8 ± 14.7 mm Hg, p = 0.26). The olmesartan group showed significant improvement of CFR (from 1.9 ± 1.0 to 3.1 ± 1.1, p = 0.005), but this did not occur in the amlodipine group. CONCLUSION: Olmesartan, but not amlodipine, improves CFR in hypertensive patients.


Assuntos
Anlodipino/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Circulação Coronária/efeitos dos fármacos , Hipertensão/tratamento farmacológico , Imidazóis/uso terapêutico , Tetrazóis/uso terapêutico , Adenosina/farmacologia , Adulto , Idoso , Ecocardiografia/métodos , Feminino , Humanos , Hipertensão/fisiopatologia , Angiografia por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Volume Sistólico/efeitos dos fármacos , Vasodilatadores/farmacologia , Função Ventricular Esquerda/efeitos dos fármacos
6.
Acta Vet Scand ; 53: 52, 2011 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-21989155

RESUMO

A total of 318 Escherichia coli isolates obtained from different food-producing animals affected with colibacillosis between 2001 and 2006 were subjected to phylogenetic analysis: 72 bovine isolates, 89 poultry isolates and 157 porcine isolates. Overall, the phylogenetic group A was predominant in isolates from cattle (36/72, 50%) and pigs (101/157, 64.3%) whereas groups A (44/89, 49.4%) and D (40/89, 44.9%) were predominant in isolates from poultry. In addition, group B2 was not found among diseased food-producing animals except for a poultry isolate. Thus, the phylogenetic group distribution of E. coli from diseased animals was different by animal species. Among the 318 isolates, cefazolin resistance (minimum inhibitory concentrations: ≥32 µg/ml) was found in six bovine isolates, 29 poultry isolates and three porcine isolates. Of them, 11 isolates (nine from poultry and two from cattle) produced extended spectrum ß-lactamase (ESBL). The two bovine isolates produced bla(CTX-M-2), while the nine poultry isolates produced bla(CTX-M-25) (4), bla(SHV-2) (3), bla(CTX-M-15) (1) and bla(CTX-M-2) (1). Thus, our results showed that several types of ESBL were identified and three types of ß-lactamase (SHV-2, CTX-M-25 and CTX-M-15) were observed for the first time in E. coli from diseased animals in Japan.


Assuntos
Resistência às Cefalosporinas/genética , Infecções por Escherichia coli/veterinária , Escherichia coli/isolamento & purificação , Microbiologia de Alimentos , Animais , Bovinos/microbiologia , Primers do DNA , Escherichia coli/enzimologia , Escherichia coli/genética , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Proteínas de Escherichia coli/genética , Cadeia Alimentar , Japão/epidemiologia , Carne/microbiologia , Filogenia , Reação em Cadeia da Polimerase , Aves Domésticas/microbiologia , Suínos/microbiologia , beta-Lactamases/biossíntese , beta-Lactamases/genética
7.
Biosci Biotechnol Biochem ; 75(4): 761-3, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21512237

RESUMO

Treating the leaves of sweet pepper (Capsicum annuum L. var. grossum) with an aqueous solution of cellulase resulted in a four-fold increase in the salicylic acid level compared to a control plant. The level of endogenous azelaic acid was also elevated by the cellulase treatment. Azelaic acid has recently been reported to act as a mobile "priming" agent to arm plants against pathogenic attack. Our results are consistent with this and that the cellulase treatment enhanced the ability of sweet pepper to withstand viral attack.


Assuntos
Capsicum/efeitos dos fármacos , Capsicum/metabolismo , Celulase/farmacologia , Ácidos Dicarboxílicos/metabolismo , Folhas de Planta/efeitos dos fármacos , Folhas de Planta/metabolismo , Salicilatos/metabolismo
8.
Plant Cell Physiol ; 52(3): 509-17, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21266461

RESUMO

Determining the mobile signal used by plants to defend against biotic and abiotic stresses has proved elusive, but jasmonic acid (JA) and its derivatives appear to be involved. Using deuterium-labeled analogs, we investigated the distal transport of JA and jasmonoyl-isoleucine (JA-Ile) in response to leaf wounding in tobacco (Nicotiana tabacum) and tomato (Solanum lycopersicum) plants. We recovered [(2)H(2)-2]JA ([(2)H(2)]JA) and [(2)H(3)-12]JA-Ile ([(2)H(3)]JA-Ile) in distal leaves of N. tabacum and S. lycopersicum after treating wounded leaves with [(2)H(2)]JA or [(2)H(3)]JA-Ile. We found that JA-Ile had a greater mobility than JA, despite its lower polarity, and that application of exogenous JA-Ile to wounded leaves of N. tabacum led to a higher accumulation of JA and JA-Ile in distal leaves compared with wounded control plants. We also found that exudates from the stem of S. lycopersicum plants with damaged leaflets contained JA and JA-Ile at higher levels than in an undamaged plant, and a significant difference in the levels of JA-Ile was observed 30 min after wounding. Based on these results, it was found that JA-Ile is a transportable compound, which suggests that JA-Ile is a signaling cue involved in the resistance to biotic and abiotic stresses in plants.


Assuntos
Ciclopentanos/metabolismo , Ciclopentanos/farmacologia , Isoleucina/análogos & derivados , Estresse Fisiológico/efeitos dos fármacos , Transporte Biológico/efeitos dos fármacos , Ciclopentanos/química , Isoleucina/química , Isoleucina/metabolismo , Isoleucina/farmacologia , Marcação por Isótopo , Cinética , Solanum lycopersicum/efeitos dos fármacos , Solanum lycopersicum/metabolismo , Espectrometria de Massas , Oxilipinas/química , Oxilipinas/metabolismo , Exsudatos de Plantas/química , Folhas de Planta/efeitos dos fármacos , Folhas de Planta/metabolismo , Caules de Planta/efeitos dos fármacos , Caules de Planta/metabolismo , Nicotiana/efeitos dos fármacos , Nicotiana/metabolismo
9.
Gut Pathog ; 2(1): 17, 2010 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-21138594

RESUMO

A total of 225 isolates of Salmonella enterica serovar Typhimurium from food-producing animals collected between 2003 and 2007 were examined for the prevalence of plasmid-mediated quinolone resistance (PMQR) determinants, namely qnrA, qnrB, qnrC, qnrD, qnrS, qepA and aac(6')Ib-cr, in Japan. Two isolates (0.8%) of S. Typhimurium DT104 from different dairy cows on a single farm in 2006 and 2007 were found to have qnrS1 on a plasmid of approximately 9.6-kbp. None of the S. Typhimurium isolates had qnrA, qnrB, qnrC, qnrD, qepA and acc(6')-Ib-cr. Currently in Japan, the prevalence of the PMQR genes among S. Typhimurium isolates from food animals may remain low or restricted. The PFGE profile of two S. Typhimurium DT104 isolates without qnrS1 on the farm in 2005 had an identical PFGE profile to those of two S. Typhimurium DT104 isolates with qnrS1. The PFGE analysis suggested that the already existing S. Typhimurium DT104 on the farm fortuitously acquired the qnrS1 plasmid.

10.
Circ J ; 74(6): 1081-6, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20453390

RESUMO

BACKGROUND: Transesophageal echocardiography (TEE) is useful for detecting left atrial (LA) thrombus prior to percutaneous LA catheter ablation in patients with atrial fibrillation (AF). This study was designed to evaluate clinical predictors of LA thrombus and determine indications for TEE screening prior to LA ablation. METHODS AND RESULTS: The study consisted of 446 patients with drug-resistant AF who were scheduled to undergo initial LA ablation (age 59+/-11 years, 312 males, 136 persistent AF). TEE was performed in all cases within 24 h before ablation. We assessed clinical parameters including CHADS(2) score and echocardiographic parameters. LA thrombus was detected in 13 cases (2.9%) prior to LA ablation (67+/-8 years, 10 males, 12 persistent AF). In multiple logistic regression analysis, advanced age (odds ratio (OR) 1.1, 95% confidence interval (CI) 1.0-1.2; P<0.05), persistent AF (OR 38.1, 95%CI 1.4-988; P<0.05) and structural heart diseases (OR 29.8, 95%CI 2.8-383; P<0.01) were independent positive predictors of LA thrombus prior to ablation, while CHADS(2) score and LA volume were not significant predictors. None of the 136 patients with paroxysmal lone AF whose age was below 60 years had LA thrombus prior to ablation. CONCLUSIONS: It might be reasonable to omit TEE as a screening examination for LA thrombus prior to LA ablation in younger paroxysmal lone AF patients.


Assuntos
Fibrilação Atrial/cirurgia , Ablação por Cateter , Ecocardiografia Transesofagiana/estatística & dados numéricos , Átrios do Coração , Valor Preditivo dos Testes , Trombose/diagnóstico por imagem , Fatores Etários , Idoso , Fibrilação Atrial/epidemiologia , Ablação por Cateter/estatística & dados numéricos , Feminino , Cardiopatias , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Trombose/diagnóstico
11.
J Cardiovasc Electrophysiol ; 21(5): 494-500, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20021515

RESUMO

INTRODUCTION: Elimination of transient pulmonary vein recurrences (dormant PVs) induced by an ATP injection and ablation at the PV carina region is an effective strategy for atrial fibrillation (AF) ablation. The relationship between dormant PVs and the PV carina region has not been evaluated. METHODS: A total of 212 consecutive symptomatic AF patients underwent circumferential PV electrical isolation (CPVEI) with a double lasso technique. They were divided into 2 groups in a retrospective review; Group 1: those given an ATP injection during an intravenous isoproterenol infusion after the CPVEI (n = 106), and Group 2: those in which it was not given after the CPVEI (n = 106). Radiofrequency energy was applied at the earliest dormant PV activation site identified using a Lasso catheter on the CPVEI line and then PV carina region if it was ineffective. RESULTS: After a successful PVEI, 54 patients (51%) in Group 1 had PV reconnections during an ATP injection. Acute PVEI sites were observed on the carina region within the CPVEI line in the right PVs (16%) and left PVs (10%). Dormant PVs were reisolated at the carina region in the right PVs (23%) and left PVs (26%). The distribution of the dormant PV sites, except for the RIPV, significantly differed from that of the acute PVEI sites (P < 0.05). Further, AF recurred significantly in the Group 2 patients as compared to those in Group 1 during 16 +/- 6.1 months of follow-up (P < 0.05). CONCLUSION: PV carina region origins may partly be responsible for an acute PVEI and potential recurrences.


Assuntos
Trifosfato de Adenosina , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/terapia , Ablação por Cateter , Veias Pulmonares/efeitos dos fármacos , Trifosfato de Adenosina/administração & dosagem , Idoso , Resistência a Medicamentos , Eletrofisiologia , Feminino , Seguimentos , Humanos , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Condução Nervosa , Recidiva , Tomografia Computadorizada por Raios X
12.
Biosci Biotechnol Biochem ; 73(9): 1962-70, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19734678

RESUMO

In plants, the mobile signal needed for wound-induced systemic acquired resistance (WSR) has been elusive. The signal compound involved in WSR is supposed to be JA or its derivatives. On the basis of kinetic study of the accumulation of JA or its derivatives, it was discovered that JA, JA-Ile, tuberonic acid (TA, 12-OH epi-JA), and tuberonic acid glucoside (TAG) accumulated in systemic tissues in response to mechanical wounding stress in the tobacco plant (Nicotiana tabacum). Attempts to recover deuterium-labeled JA in systemic leaves after feeding the wounded leaves with deuterium-labeled JA were successfully done. It was also found that the translocated deuterium-labeled JA was metabolized to TA in systemic leaves under feeding of deuterium-labeled JA to the wounding leaves.


Assuntos
Ciclopentanos/metabolismo , Nicotiana/metabolismo , Oxilipinas/metabolismo , Folhas de Planta/metabolismo , Transporte Biológico , Cromatografia Líquida , Cinética , Espectrometria de Massas por Ionização por Electrospray , Espectrometria de Massas em Tandem
13.
Circ J ; 73(5): 838-45, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19336923

RESUMO

BACKGROUND: Some supraventricular tachycardias could be ablated from the non-coronary sinus of Valsalva (NSV). However, the characteristics of the NSV electrograms have not been clarified. METHODS AND RESULTS: A quantitative analysis of the NSV electrograms was performed in 5 patients with tachycardias arising from near the atrioventricular node (AVN) and the His-bundle region, and in 20 control subjects. In another 7 control subjects, the NSV electrograms were compared with those recorded at the left and right sinus of Valsalva (LSV and RSV). The NSV electrograms during sinus rhythm had a larger atrial amplitude than ventricular amplitude, and the ratio of the atrial amplitude to the ventricular amplitude was usually >1, which was apparently different from the LSV and RSV electrograms. A tiny but distinct His-bundle deflection was sometimes recorded at the NSV during sinus rhythm while it was not during the tachycardia. The distance to the His-bundle region in the anteroseptal right atrium was shorter from the NSV than from the RSV or LSV. CONCLUSIONS: The precise identification of the catheter position at the NSV is possible using the characteristics of the electrograms. Much attention should be paid during ablation to the NSV because of its vicinity to the AVN and His-bundle region.


Assuntos
Ablação por Cateter , Eletrocardiografia , Seio Aórtico/fisiopatologia , Taquicardia Supraventricular/fisiopatologia , Adulto , Idoso , Nó Atrioventricular/fisiopatologia , Fascículo Atrioventricular/fisiopatologia , Estudos de Casos e Controles , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Seio Aórtico/patologia , Seio Aórtico/cirurgia , Taquicardia Supraventricular/patologia , Taquicardia Supraventricular/cirurgia
14.
Circ J ; 73(2): 288-94, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19110507

RESUMO

BACKGROUND: The aim of this study was to retrospectively investigate the long-term effect of cardiac resynchronization therapy (CRT) and to clarify the useful predictors of clinical outcome. Methods and Results The study group comprised 43 patients with advanced heart failure who underwent CRT (10 females; 66+/-10 years): 23 were in sinus rhythm (SR group) and 20 had chronic atrial fibrillation (AF group). The clinical parameters and echocardiographic data were evaluated before and after CRT. There were no significant differences in the clinical parameters, echocardiographic data at baseline or frequency of responders between the 2 groups. In both groups, the clinical characteristics at baseline did not differ between the responders and non-responders. A prompt rise in systolic blood pressure (SBP) just after CRT was observed more often in responders than in non-responders, and SBP rise > or =5 mmHg was the only significant independent predictor of a CRT responder (P=0.0033). Furthermore, there was a significant difference in the event-free survival between patients with and without SBP rise > or =5 mmHg, demonstrated by Kaplan-Meier method, at 2 years of follow-up (P=0.045). Conclusion A prompt BP rise just after CRT may predict short- and long-term clinical improvement in CRT recipients.


Assuntos
Pressão Sanguínea/fisiologia , Desfibriladores Implantáveis , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/terapia , Índice de Gravidade de Doença , Idoso , Arritmia Sinusal/diagnóstico , Arritmia Sinusal/fisiopatologia , Arritmia Sinusal/terapia , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/terapia , Ecocardiografia , Feminino , Insuficiência Cardíaca/fisiopatologia , Ventrículos do Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento
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