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[PMID]:29310056
[Au] Autor:Karathanos C; Spanos K; Giannoukas A
[Ad] Endereço:Vascular Surgery Department, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
[Ti] Título:Residual pulmonary vascular obstruction as predictor of pulmonary embolism recurrence after a first unprovoked episode.
[So] Source:Thromb Res;162:77-78, 2018 02.
[Is] ISSN:1879-2472
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Embolia Pulmonar
Tromboembolia Venosa
[Mh] Termos MeSH secundário: Anticoagulantes
Seres Humanos
Pulmão
Recidiva
Fatores de Risco
Doenças Vasculares
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180109
[St] Status:MEDLINE


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[PMID]:29311469
[Au] Autor:Takai Y; Hiramoto K; Nishimura Y; Ooi K
[Ad] Endereço:Department of Pharmacy, Mie Heart Center Hospital.
[Ti] Título:[Sex Differences of the Inflammatory Mediator Level at the Time of Itch Onset in Patients with Chronic Venous Disease].
[So] Source:Yakugaku Zasshi;138(1):91-96, 2018.
[Is] ISSN:1347-5231
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:This study investigated the sex differences of the inflammatory mediator level at the time of itch onset in patients with chronic venous disease (CVD). Twenty-seven CVD patients (nineteen women, eight men) and nine healthy controls (five women, four men) participated. CVD-associated itching was observed in both men and women. Before sclerotherapy, both sexes had elevations in several itch-related mediators. Among these, women had significantly higher tryptase, whereas men had significantly higher ß-endorphin and adrenocorticotropic hormone. After sclerotherapy, all levels normalized in both sexes. In this study, itching was increased tryptase in women and increased adrenocorticotropic hormone and ß-endorphin in men.
[Mh] Termos MeSH primário: Hormônio Adrenocorticotrópico/metabolismo
Mediadores da Inflamação/metabolismo
Prurido/fisiopatologia
Caracteres Sexuais
Triptases/metabolismo
Doenças Vasculares/metabolismo
Doenças Vasculares/fisiopatologia
beta-Endorfina/metabolismo
[Mh] Termos MeSH secundário: Adulto
Idoso
Doença Crônica
Feminino
Seres Humanos
Masculino
Meia-Idade
Escleroterapia
Doenças Vasculares/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Inflammation Mediators); 60617-12-1 (beta-Endorphin); 9002-60-2 (Adrenocorticotropic Hormone); EC 3.4.21.59 (Tryptases)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1248/yakushi.17-00160


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[PMID]:29390464
[Au] Autor:Zhang X; Li X; Meng M; Cao J; Song X; Liu K; Fang S
[Ad] Endereço:Department of Neurology, Neuroscience Centre, the First Teaching Hospital of Jilin University, Changchun, China.
[Ti] Título:Vascular spinal cord obstruction associated with superior vena cava syndrome: A case report and literature review.
[So] Source:Medicine (Baltimore);96(51):e9196, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Superior vena cava syndrome (SVCS) is the obstruction of blood flow through the SVC, causing complete or partial blockade of the collateral circulation of returning venous blood. SVCS is frequently presented with facial, neck, trunk, and upper limbs swelling and so on. However, to the best of our knowledge, the obstruction of the venous return in the spinal veins is rarely a manifestation of SVCS. PATIENT CONCERNS: We presented a rare case of a 52-year-old male patient with 2-month history of progressive right upper limb numbness and swelling and 10-day history of extremities malfunctioning. Cervical magnetic resonance imaging (MRI) detected obstruction of the spinal venous return. Lung computed tomography (CT) revealed lesions in the esophagus, which indicated esophageal cancer with mediastinal lymph nodes metastasis and signified SVCS. DIAGNOSES: With the results of laboratory findings, cervical MRI, lung CT findings, and physical examination, the patient was diagnosed with SVCS manifesting as spinal vein obstruction. INTERVENTIONS AND OUTCOMES: The family abandoned further treatment, and the patient passed away 2 months after discharge. LESSONS: The case indicates that SVCS can induce systemic and spinal cord diseases affecting the venous return. Further studies are necessary to reveal the mechanism for SVCS inducing spinal veins obstruction and to explore whether SVCS patients with and without vascular spinal cord obstruction have different prognoses.
[Mh] Termos MeSH primário: Compressão da Medula Espinal/complicações
Compressão da Medula Espinal/diagnóstico por imagem
Síndrome da Veia Cava Superior/complicações
Síndrome da Veia Cava Superior/diagnóstico por imagem
Doenças Vasculares/complicações
[Mh] Termos MeSH secundário: Progressão da Doença
Evolução Fatal
Seres Humanos
Hipestesia/diagnóstico
Hipestesia/etiologia
Angiografia por Ressonância Magnética/métodos
Masculino
Meia-Idade
Doenças Raras
Medição de Risco
Índice de Gravidade de Doença
Compressão da Medula Espinal/fisiopatologia
Síndrome da Veia Cava Superior/fisiopatologia
Tomografia Computadorizada por Raios X/métodos
Extremidade Superior
Doenças Vasculares/diagnóstico por imagem
Doenças Vasculares/fisiopatologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009196


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[PMID]:29374935
[Au] Autor:Yu X; Ji FS; Xu F; Zhang WD; Wang XY; Lu D; Xu T
[Ad] Endereço:National Center of Gerontology, Department of Cardiology, Beijing Hospital, Beijing 100730, China.
[Ti] Título:[Therapeutic efficacy of paclitaxel-coated balloon for de novo coronary lesions with diameters larger than 2.8 mm].
[So] Source:Zhonghua Xin Xue Guan Bing Za Zhi;46(1):32-38, 2018 Jan 24.
[Is] ISSN:0253-3758
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To evaluate the efficacy of paclitaxel-coated balloon for de novo coronary lesions with diameters ≥ 2.8 mm. This prospective study included 215 consecutive patients with 238 de novo lesions, who received paclitaxel-coated balloon angioplasty in Beijing Hospital from May 2014 to June 2016. According to the reference vessel diameter, the patients were divided into large vessel disease (LVD) group (reference vessel diameter≥2.8 mm, 85 patients and 90 lesions) and small vessel disease (SVD) group (reference vessel diamete 2.8 mm, 130 patients and 148 lesions). Clinical characteristics, interventional procedures and major adverse cardiovascular events (includingall-cause mortality, non-fatal myocardial infarction and target lesion revascularization) after procedure were compared between the 2 groups. (1)Patients in LVD group were younger than SVD group ((60.1±11.1) years old vs. (65.0±10.6) years old, 0.01), and less patients had diabetes (24.7% (21/85) vs. 43.1%(56/130), 0.01).(2)Prevalence of three-vessel disease (35.5%(30/85) vs. 53.6%(67/130), 0.05) and complex lesions (type B2/C,34.4% (31/90) vs. 50.0%(74/148), 0.05) were significantly lower in LVD group than in SVD group.(3) During pre-dilation, the rate with plain balloons use was significantly higher in SVD group than in LVD group(76.4%(113/148) vs. 58.9%(53/90), 0.01), while the proportion of additional use of non-compliant balloons was significantly higher in LVD groupthan in SVD group(20.0% (18/90) vs. 3.4% (5/148) , 0.01). The ratio of paclitaxel-coated balloon diameter/RVD was significantly lower (0.87±0.12 vs. 0.96±0.15, 0.01) and the duration of dilationwas significantly shorter ((41.5±9.5) seconds vs. (45.1±9.1) seconds, 0.01) in LVD group than those in SVD group. Each group had 1 failure case that was bailout stented with drug-eluting stents. The success rate of paclitaxel-coated balloon treatment was similar in LVD group and SVD group (98.9% (89/90) vs. 99.3%(147/148), 0.05).(4) At the fourth day of procedure, there was 1 acute myocardial infarction requiring emergent target lesion revascularization in SVD group. No major adverse cardiovascular event was observed in LVD group during hospitalization. Forty-two patients with 53 lesions, including 27 LVD lesions and 26 SVD lesions,underwent coronary angiography at (9.4±4.6) months after paclitaxel-coated balloon intervention. The quantitative coronary angiography analysis showed that minimal lumen diameter significantlyincreased during follow-up than that of post-procedurein SVD group ((1.71±0.36)mm vs. (1.52±0.30)mm, 0.05) , while in LVD group the minimal lumen diameter was similar between during follow-up and post-procedure ((2.35±0.48)mm vs. (2.19±0.34)mm, 0.05). Major adverse cardiovascular event rate was 0 in LVD group and 2.3%(3/130) in SVD group ( 0.05) during follow up. No death was observed in this patient cohort. Treatment with paclitaxel-coated balloon for de novo coronary lesions with diameters≥2.8 mm is safe and effective.
[Mh] Termos MeSH primário: Angioplastia Coronária com Balão
Doença da Artéria Coronariana/terapia
Stents Farmacológicos
[Mh] Termos MeSH secundário: Idoso
Angiografia Coronária
Feminino
Seres Humanos
Masculino
Meia-Idade
Infarto do Miocárdio
Paclitaxel
Estudos Prospectivos
Stents
Resultado do Tratamento
Doenças Vasculares
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
P88XT4IS4D (Paclitaxel)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0253-3758.2018.01.006


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[PMID]:29247650
[Au] Autor:Li T; Gua C; Wu B; Chen Y
[Ad] Endereço:Department of Cardiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning, China. Electronic address: li-tiejun-cmu@outlook.com.
[Ti] Título:Increased circulating trimethylamine N-oxide contributes to endothelial dysfunction in a rat model of chronic kidney disease.
[So] Source:Biochem Biophys Res Commun;495(2):2071-2077, 2018 01 08.
[Is] ISSN:1090-2104
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Chronic kidney disease (CKD) is strongly associated with increased cardiovascular risk. Impaired endothelial function, a key initiating step in the pathogenesis of cardiovascular disease, has been reported in patients with CKD, but the mechanisms responsible for endothelial dysfunction in CKD remain elusive. Emerging evidence reveals that trimethylamine-N-oxide (TMAO), a gut microbiota-generated metabolite, is involved in the pathogenesis of many cardiovascular diseases. Circulating TMAO is elevated in CKD. Here we tested the hypothesis that elevated TMAO plays a contributory role in the pathogenesis of endothelial dysfunction in CKD. Rats underwent 5/6 nephrectomy to induce CKD or sham operation, and were treated with 1.0% 3,3-Dimethyl-1-butanol (DMB, an inhibitor of trimethylamine formation) or vehicle. Eight weeks after nephrectomy and DMB treatment, circulating TMAO levels were markedly elevated in CKD-vehicle rats compared with sham-vehicle rats, but were reduced in CKD-DMB rats. Acetylcholine-induced endothelium-dependent vasodilation was impaired in CKD-vehicle rats compared with sham-vehicle rats as indicated by reduced maximal relaxation (E ) and decreased area under the curve (AUC). E and AUC were both normalized in CKD-DMB rats. No difference in sodium nitroprusside-induced endothelial-independent vasodilation was observed across groups. Molecular studies revealed that endothelial nitric-oxide synthase activity was decreased, while superoxide production and proinflammatory cytokine expression were increased in the aorta of CKD-vehicle rats compared with sham-vehicle rats. Of note, the abnormalities in above molecular parameters were completely restored in CKD-DMB rats. These results suggest that CKD elevates circulating TMAO levels, which may reduce eNOS-derived NO production by increasing vascular oxidative stress and inflammation, contributing to CKD-associated endothelial dysfunction and cardiovascular disease.
[Mh] Termos MeSH primário: Endotélio Vascular/metabolismo
Endotélio Vascular/patologia
Metilaminas/sangue
Insuficiência Renal Crônica/sangue
Insuficiência Renal Crônica/patologia
Doenças Vasculares/sangue
Doenças Vasculares/patologia
[Mh] Termos MeSH secundário: Animais
Biomarcadores/sangue
Citocinas/sangue
Masculino
Ratos
Ratos Sprague-Dawley
Espécies Reativas de Oxigênio/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Biomarkers); 0 (Cytokines); 0 (Methylamines); 0 (Reactive Oxygen Species); FLD0K1SJ1A (trimethyloxamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE


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[PMID]:29381932
[Au] Autor:Xu Z; Li Y; Wang Z; Cai H
[Ad] Endereço:Department of Pediatric Orthopedics, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
[Ti] Título:Open reduction combined with CORA-based osteotomy of the ulna in the treatment of missed Bado type I Monteggia injury: A retrospective study of 5 cases.
[So] Source:Medicine (Baltimore);96(47):e8609, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Open reduction combined with ulnar osteotomy is the most common approach to treating missed Monteggia injuries. The osteotomy is usually performed at the proximal ulna to ensure better healing and fewer complications. The purpose of this study is to present a center of rotation angulation (CORA)-based osteotomy of the ulna for treating Bado type I Monteggia injuries.We retrospectively reviewed the cases of patients who were treated with open reduction combined with a CORA-based ulnar osteotomy between February 2014 and December 2016. Each patient provided his or her internal control, and paired data of the involved and uninvolved sides were analyzed to evaluate forearm rotation function.Five patients (3 male, 2 female) with median age 5.7 years (range, 3.4-6.8 years) were operated on by the senior author in our hospital. The median interval between the original injury and the corrective surgery was 3 months (range, 1-4 months). In a median follow-up of 10 months (range, 6-17 months), all patients obtained stable reduction of the radial head and uneventful healing of the ulnar osteotomy. All patients had pain-free elbows with no neurological or vascular complications and no implant breakage. Patients showed excellent outcomes evaluated using the Broberg and Morrey index.Open reduction with a CORA-based osteotomy of the ulna for the treatment of missed Bado type I Monteggia injury with an obvious ulnar bowing deformity resulted in stable reduction of the radial head and excellent forearm function.
[Mh] Termos MeSH primário: Fratura de Monteggia/cirurgia
Redução Aberta
Osteotomia
Complicações Pós-Operatórias/prevenção & controle
Ulna
[Mh] Termos MeSH secundário: Artralgia/etiologia
Artralgia/prevenção & controle
Criança
Pré-Escolar
China
Articulação do Cotovelo/fisiopatologia
Feminino
Seres Humanos
Masculino
Fratura de Monteggia/diagnóstico
Doenças do Sistema Nervoso/etiologia
Doenças do Sistema Nervoso/prevenção & controle
Redução Aberta/instrumentação
Redução Aberta/métodos
Osteotomia/efeitos adversos
Osteotomia/métodos
Avaliação de Processos e Resultados (Cuidados de Saúde)
Radiografia/métodos
Rádio (Anatomia)/cirurgia
Recuperação de Função Fisiológica
Estudos Retrospectivos
Ulna/diagnóstico por imagem
Ulna/lesões
Ulna/fisiopatologia
Ulna/cirurgia
Doenças Vasculares/etiologia
Doenças Vasculares/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008609


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[PMID]:29332916
[Au] Autor:Lu X; Yin D; Zhou B; Li T
[Ad] Endereço:Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital.
[Ti] Título:MiR-135a Promotes Inflammatory Responses of Vascular Smooth Muscle Cells From db/db Mice via Downregulation of FOXO1.
[So] Source:Int Heart J;59(1):170-179, 2018 Jan 27.
[Is] ISSN:1349-3299
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:It has been shown that microRNAs (miRNAs) greatly affect the functions of vascular smooth muscle cells (VSMC), but the effects of mRNAs under diabetic conditions remain unclear.Using a model of diabetic db/db mice, we studied the functions of microRNA-135a (miR-135a) during VSMC dysfunction.Compared to control WT mice, miR-135a expression in VSMC was significantly increased while the level of forkhead box O1 (FOXO1) protein decreased significantly. After transfecting miR-135a mimics into VSMC, the expression of FOXO1 was decreased, while cyclooxygenase-2 (COX-2) and monocyte chemoattractant protein-1 (MCP-1) expression levels were increased, thus promoting the interaction between monocytes and WT VSMC. On the other hand, transfection of an miR-135a inhibitor reversed the activated interaction between monocytes and db/db VSMC. The pro-inflammatory responses could also be enhanced by using siRNAs to silence the FOXO1 gene in WT VSMC, suggesting a negative regulatory role of FOXO1. FOXO1 siRNAs and miR-135a mimics could both enhance the transcriptional activity of COX-2 promoter. Using chromatin immunoprecipitation, we found that in db/db VSMC, the occupancy in promoter regions of inflammatory genes by FOXO1 was reduced.miR-135a increased the inflammatory responses of VSMC involved in complications of vascular diseases by downregulating the expression of FOXO1.
[Mh] Termos MeSH primário: Regulação para Baixo
Proteína Forkhead Box O1/genética
Regulação da Expressão Gênica
Inflamação/genética
MicroRNAs/genética
Miócitos de Músculo Liso/metabolismo
Doenças Vasculares/genética
[Mh] Termos MeSH secundário: Animais
Western Blotting
Células Cultivadas
DNA/genética
Modelos Animais de Doenças
Proteína Forkhead Box O1/biossíntese
Imuno-Histoquímica
Inflamação/metabolismo
Inflamação/patologia
Masculino
Camundongos
Camundongos Knockout
MicroRNAs/biossíntese
Miócitos de Músculo Liso/patologia
Reação em Cadeia da Polimerase Via Transcriptase Reversa
Doenças Vasculares/metabolismo
Doenças Vasculares/patologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Forkhead Box Protein O1); 0 (Foxo1 protein, mouse); 0 (MicroRNAs); 0 (Mirn135 microRNA, mouse); 9007-49-2 (DNA)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180116
[St] Status:MEDLINE
[do] DOI:10.1536/ihj.17-040


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[PMID]:29261735
[Au] Autor:Boivin A; Burban M; Clere-Jehl R; Le Borgne P; Merdji H; Auger C; Schini-Kerth V; Meziani F; Helms J
[Ad] Endereço:Université de Strasbourg (UNISTRA), Faculté de Médecine, Hôpitaux universitaires de Strasbourg, service de réanimation, nouvel hôpital civil, Strasbourg, France.
[Ti] Título:Docosahexaenoic acid, but not eicosapentaenoic acid, improves septic shock-induced arterial dysfunction in rats.
[So] Source:PLoS One;12(12):e0189658, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Long chain n-3 fatty acid supplementation may modulate septic shock-induced host response to pathogen-induced sepsis. The composition of lipid emulsions for parenteral nutrition however remains a real challenge in intensive care, depending on their fatty acid content. Because they have not been assessed yet, we aimed at determining the respective effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) during septic shock-induced vascular dysfunction. METHODS: In a peritonitis-induced septic shock model, rats were infused with EPA, DHA, an EPA/DHA mixture or 5% dextrose (D5) during 22 hours. From H18, rats were resuscitated and monitored during 4 hours. At H22, plasma, aorta and mesenteric resistance arteries were collected to perform ex vivo experiments. RESULTS: We have shown that septic rats needed an active resuscitation with fluid challenge and norepinephrine treatment, while SHAM rats did not. In septic rats, norepinephrine requirements were significantly decreased in DHA and EPA/DHA groups (10.6±12.0 and 3.7±8.0 µg/kg/min respectively versus 17.4±19.3 µg/kg/min in D5 group, p<0.05) and DHA infusion significantly improved contractile response to phenylephrine through nitric oxide pathway inhibition. DHA moreover significantly reduced vascular oxidative stress and nitric oxide production, phosphorylated IκB expression and vasodilative prostaglandin production. DHA also significantly decreased polyunsaturated fatty acid pro-inflammatory mediators and significantly increased several anti-inflammatory metabolites. CONCLUSIONS: DHA infusion in septic rats improved hemodynamic dysfunction through decreased vascular oxidative stress and inflammation, while EPA infusion did not have beneficial effects.
[Mh] Termos MeSH primário: Artérias/patologia
Ácidos Docosa-Hexaenoicos/uso terapêutico
Ácido Eicosapentaenoico/uso terapêutico
Choque Séptico/complicações
Doenças Vasculares/tratamento farmacológico
[Mh] Termos MeSH secundário: Animais
Epoprostenol/biossíntese
Masculino
Óxido Nítrico/biossíntese
Norepinefrina/administração & dosagem
Estresse Oxidativo
Ratos
Ratos Wistar
Doenças Vasculares/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
25167-62-8 (Docosahexaenoic Acids); 31C4KY9ESH (Nitric Oxide); AAN7QOV9EA (Eicosapentaenoic Acid); DCR9Z582X0 (Epoprostenol); X4W3ENH1CV (Norepinephrine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189658


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[PMID]:29189361
[Au] Autor:Chestnut DH
[Ad] Endereço:From the Division of Obstetric Anesthesia, VUH 4202, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.
[Ti] Título:The Aortocaval Compression Conundrum.
[So] Source:Anesth Analg;125(6):1838-1839, 2017 12.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Doenças Vasculares
Veia Cava Inferior
[Mh] Termos MeSH secundário: Aorta Abdominal
Seres Humanos
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180111
[Lr] Data última revisão:
180111
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002400


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[PMID]:29246897
[Au] Autor:Egbe AC; Connolly HM; Miranda WR; Ammash NM; Hagler DJ; Veldtman GR; Borlaug BA
[Ad] Endereço:From the Department of Cardiovascular Medicine (A.C.E., H.M.C., W.R.M., N.M.A., B.A.B.) and Division of Pediatric Cardiology (D.J.H.), Mayo Clinic, Rochester, MN; and Department of Pediatrics, Cincinnati Children's Hospital, OH (B.A.B.).
[Ti] Título:Hemodynamics of Fontan Failure: The Role of Pulmonary Vascular Disease.
[So] Source:Circ Heart Fail;10(12), 2017 Dec.
[Is] ISSN:1941-3297
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Nonpulsatile pulmonary blood flow in Fontan circulation results in pulmonary vascular disease, but the potential relationships between pulmonary vascular resistance index (PVRI) and Fontan failure have not been studied. The objective was to determine whether the absence of subpulmonary ventricle in the Fontan circulation would make patients more vulnerable to even low-level elevations in PVRI, and when coupled with low cardiac index, this would identify patients at increased risk of Fontan failure. METHODS AND RESULTS: Two hundred sixty-one adult Fontan patients underwent cardiac catheterization; age 26±3 years, men 146 (56%), atriopulmonary Fontan 144 (55%). Patients were divided into 2 groups: those with high PVRI (>2 WU·m ) and low cardiac index <2.5 L min m (group 1, n=70, 30%), and those with normal PVRI and normal cardiac index (group 2, n=182, 70%). Fontan failure was defined by the composite of all-cause mortality, listing for heart transplantation, or initiation of palliative care. There were 68 (26%) cases of Fontan failure during a mean follow-up of 8.6±2.4 years. When compared with group 2, freedom from Fontan failure was significantly lower in group 1: 66% versus 89% at 5 years. The combination of high PVRI and low cardiac index was an independent risk factor for Fontan failure (hazard ratio, 1.84; 95% confidence interval, 1.09-2.85). CONCLUSIONS: When coupled with low cardiac index, even mild elevations in PVRI identify patients at high risk of Fontan failure. This suggests that pulmonary vascular disease is a key mechanism underlying Fontan failure and supports further studies to understand the pathophysiology and target treatments to pulmonary vascular tone in this population.
[Mh] Termos MeSH primário: Velocidade do Fluxo Sanguíneo/fisiologia
Técnica de Fontan/efeitos adversos
Cardiopatias Congênitas/fisiopatologia
Artéria Pulmonar/fisiopatologia
Doenças Vasculares/complicações
Resistência Vascular/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Feminino
Seguimentos
Cardiopatias Congênitas/complicações
Cardiopatias Congênitas/cirurgia
Hemodinâmica/fisiologia
Seres Humanos
Masculino
Estudos Retrospectivos
Fatores de Tempo
Falha de Tratamento
Doenças Vasculares/fisiopatologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE



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