RESUMEN
Sixty-two patients underwent simultaneous right atrial pressure measurement and Doppler echo including tissue Doppler to evaluate the utility of this technique in the estimation of right ventricular filling pressure. Mean right atrial pressure related weakly to the ratio of tricuspid peak early inflow velocity to annular early diastolic velocity (r = 0.75, p <0.0001), with a mean difference between Doppler and catheter pressures of 0.3 +/- 3.7 mm Hg.
Asunto(s)
Función del Atrio Derecho/fisiología , Velocidad del Flujo Sanguíneo/fisiología , Presión Sanguínea/fisiología , Enfermedades Cardiovasculares/diagnóstico por imagen , Sístole/fisiología , Ultrasonografía Doppler , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/fisiopatología , Enfermedad Coronaria/diagnóstico por imagen , Enfermedad Coronaria/fisiopatología , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Persona de Mediana Edad , Presión Esfenoidal Pulmonar/fisiología , Válvula Tricúspide/diagnóstico por imagen , Válvula Tricúspide/fisiopatologíaRESUMEN
Leukocyte and endothelial cell adhesion molecules (CAMs) are essential for emigration of leukocytes, with the selectins mediating the initial step of leukocyte "rolling" and the beta 2-(CD18) integrins and intercellular adhesion molecule-1 (ICAM-1) being important for firm adhesion and emigration. On the basis of evidence for an inflammatory component in the pathogenesis of atherosclerosis, including increased expression of CAMs, cytokines, and growth factors, we tested the hypothesis that decreased expression of inflammatory CAMs would reduce susceptibility to atherosclerosis. Using C57BL/6 mice fed a high-fat diet, we observed a 50% to 75% reduction in atherosclerotic fatty streaks in mice with homozygous mutations for ICAM-1, P-selectin, CD18, both ICAM-1 and CD18, or both ICAM-1 and P-selectin. In contrast to previous evidence of increased expression of CAMs in atherosclerotic lesions, which does not prove a cause-and-effect relationship, these data indicate directly that the level of expression of CAMs can determine the susceptibility to the formation of atherosclerotic fatty streaks. The results suggest that genetic variation at these loci could influence susceptibility to atherosclerosis and that pharmacological reduction of the expression or function of these CAMs might protect against atherosclerosis.