RESUMO
BACKGROUND AND AIMS: Chronic heart failure (HF) is characterised by a neurohormonal dysfunction associated with chronic inflammation. A role of metabolic derangement in the pathophysiology of HF has been recently reported. Adiponectin, an adipose-tissue-derived cytokine, seems to play an important role in cardiac dysfunction. We investigated the variation of circulating adiponectin in patients with coronary artery disease (CAD), with or without HF, in order to identify its independent predictors. METHODS AND RESULTS: A total of 107 outpatients with CAD were enrolled in the study and divided into three groups: CAD without left ventricular systolic dysfunction (group 1); CAD with left ventricular dysfunction without HF symptoms (group 2) and CAD with overt HF (group 3). Plasma adiponectin was determined by enzyme-linked immunosorbent assay. Adiponectin concentrations increased progressively from group 1 (7.6 ± 3.6 ng ml⻹) to group 2 (9.1 ± 6.7 ng ml⻹) and group 3 (13.7 ± 7.6 ng ml⻹), with the difference reaching statistical significance in group 3 versus 1 and 2 (p < 0.001). A multivariable model of analysis demonstrated that the best predictors of plasma adiponectin were body mass index, N-terminal pro-brain natriuretic peptide and high-density lipoprotein cholesterol. However, even after adjusting for all three independent predictors, the increase of adiponectin in group 3 still remained statistically significant (p = 0.015). CONCLUSION: Our data confirm the rise of adiponectin in overt HF. The levels of circulating adipokine seem to be mainly predicted by the metabolic profile of patients and by biohumoral indicators, rather than by clinical and echocardiographic indexes of HF severity.
Assuntos
Adiponectina/sangue , Doença da Artéria Coronariana/sangue , Insuficiência Cardíaca/sangue , Pacientes Ambulatoriais , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Índice de Massa Corporal , Distribuição de Qui-Quadrado , HDL-Colesterol/sangue , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/fisiopatologia , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/fisiopatologia , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Análise de Regressão , Medição de Risco , Fatores de Risco , Sístole , Regulação para Cima , Disfunção Ventricular Esquerda/sangue , Disfunção Ventricular Esquerda/fisiopatologia , Função Ventricular EsquerdaRESUMO
In the present study we have analyzed the genetic diversity pattern in a sample of 54 Italian maize landraces, using morphological traits and molecular markers. Although the 54 landraces surveyed in this study were restricted to Lombardy, the core region of maize production in Italy, our data revealed a large genetic heterogeneity for both morphological and molecular traits in the accessions analyzed. Additionally, our data confirm that the AFLP markers produced a high frequency of polymorphic bands and were able to unequivocally fingerprint each of the landraces considered. Cluster analysis based on AFLP markers displayed a clearer separation of the accessions in comparison to morphological data. Different populations were divided into four major clusters reflecting the geographical origin and seasonal employment of the landraces analyzed. Molecular analysis of variance showed significant (P < 0.01) differences among groups, among populations within groups, and among individuals within populations. Approximately 74% of the total variance could be attributed to differences within populations. Conversely, a lower level of differentiation was detected among groups (approximately 4%). Regarding population structures, the genetic distance between populations (FST = 0.25 +/- 0.3) and the degree of inbreeding within groups (FSC = 0.22 +/- 0.2), did not diverge significantly, while both significantly differed from the degree of relatedness between markers within groups (FCT = 0.04 +/- 0.03). Results are discussed in relation to a suitable conservation method.
Assuntos
Zea mays/genética , Análise do Polimorfismo de Comprimento de Fragmentos Amplificados , Cruzamento , DNA de Plantas/genética , Variação Genética , Itália , Fenótipo , Filogenia , Zea mays/classificaçãoRESUMO
Elderly patients are commonly excluded from cardiac rehabilitation after myocardial infarction (MI). The present controlled, non-randomized trial was undertaken as a preliminary study to compare some effects of cardiac rehabilitation between patients younger and older than 65 years without contraindications to physical exercise. Baseline total work capacity (TWC) was assessed by a maximal ergometric stress testing 4 weeks after MI. Patients were then prospectively enrolled into an 8-week ambulatory rehabilitation program (R-group: age < or = 65 N = 16; age > 65 N = 16). Those who refused or who could not participate in the program because of logistic difficulties served as controls (NR-group: age < or = 65 N = 16; age > 65 N = 14). In spite of non-randomized allocation, clinical characteristics did not differ between either treatment groups or age groups. TWC was re-assessed at 8 weeks from baseline evaluation in all patients. The number of completed training sessions in the R-group, and the proportion of sessions which were suspended for physiological or pathological (adverse events during exercise) causes were similar under and over 65 years. TWC increased (p < 0.001) in the R-group, the improvement being similar in the two age cohorts (< or = 65: +55% vs > 65: +65%, NS). A spontaneous enhancement of TWC (+37%, p < 0.001) occurred among younger controls as well. Only older controls did not improve their TWC; moreover, their +16% change was significantly (p < 0.05) less than the +65% increase obtained by the R-group of the same age.(ABSTRACT TRUNCATED AT 250 WORDS)