RESUMEN
INTRODUCTION AND OBJECTIVES: Hepatorenal syndrome (HRS) is a serious complication of cirrhosis treated with various medications. We aim to evaluate terlipressin and albumin's effectiveness and safety compared to albumin and noradrenaline in adult hepatorenal disease patients. MATERIALS AND METHODS: Clinical trials from four databases were included. Cochrane's approach for calculating bias risk was utilized. We rated the quality evaluation by Grading of Recommendations Assessment, Development, and Evaluation (GRADE). We included the following outcomes: serum creatinine (mg/dl), urine output (ml/24 h), mean arterial pressure (mmHg), reversal rate of HRS, mortality rate, blood plasma renin activity (ng/ml/h), plasma aldosterone concentration (pg/ml), urine sodium (mEq/l), and creatinine clearance (ml/min). RESULTS: Our analysis of nine clinical studies revealed that the noradrenaline group was associated with higher creatinine clearance (MD = 4.22 [0.40, 8.05]), (P = 0.03). There were no significant differences in serum creatinine levels (MD = 0.03 [-0.07, 0.13]), urinary sodium (MD = -1.02 [-5.15, 3.11]), urine output (MD = 32.75 [-93.94, 159.44]), mean arterial pressure (MD = 1.40 [-1.17, 3.96]), plasma renin activity (MD = 1.35 [-0.17, 2.87]), plasma aldosterone concentration (MD = 55.35 [-24.59, 135.29]), reversal rate of HRS (RR = 1.15 [0.96, 1.37]), or mortality rate (RR = 0.87 [0.74, 1.01]) between the two groups (p-values > 0.05). CONCLUSIONS: Noradrenaline is a safe alternative medical therapy for HRS.
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Albúminas , Síndrome Hepatorrenal , Norepinefrina , Terlipresina , Vasoconstrictores , Humanos , Terlipresina/uso terapéutico , Síndrome Hepatorrenal/tratamiento farmacológico , Norepinefrina/uso terapéutico , Norepinefrina/orina , Norepinefrina/sangre , Albúminas/uso terapéutico , Resultado del Tratamiento , Vasoconstrictores/uso terapéutico , Vasoconstrictores/efectos adversos , Adulto , Creatinina/sangre , Lipresina/análogos & derivados , Lipresina/uso terapéutico , Lipresina/efectos adversosRESUMEN
Background: Chronic sympathetic nervous system activation is associated with endothelial dysfunction and cardiometabolic disease, which may be modulated by resveratrol (RSV) and energy restriction (ER). This study aimed to examine the effects of RSV and ER on plasma noradrenaline (NA), flow-mediated vasodilation (ed-FMD), and endothelium-independent nitrate-mediated vasodilation (ei-NMD). Methods: The study included 48 healthy adults randomized to 30-days intervention of RSV or ER. Results: Waist circumference, total cholesterol, HDL-c, LDL-c, apoA-I, and plasma NA decreased in the ER group, whilst RSV increased apoB and total cholesterol, without changing plasma NA. No effects on vascular reactivity were observed in both groups. Plasma NA change was positively correlated with total cholesterol (r = 0.443; p = 0.002), triglycerides (r = 0.438; p = 0.002), apoA-I (r = 0.467; p = 0.001), apoB (r = 0.318; p = 0.032) changes, and ei-NMD (OR = 1.294; 95%CI: 1.021-1.640). Conclusions: RSV does not improve cardiometabolic risk factors, sympathetic activity, and endothelial function. ER decreases plasma NA and waist circumference as well as improves blood lipids, but does not modify endothelial function. Finally, plasma NA was associated with ei-NMD, which could be attributed to a higher response to nitrate in patients with greater resting sympathetic vasoconstriction.
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Suplementos Dietéticos , Resveratrol/administración & dosificación , Sistema Nervioso Simpático/efectos de los fármacos , Anciano , Restricción Calórica , Colesterol/sangre , LDL-Colesterol/sangre , Endotelio Vascular/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Norepinefrina/sangre , Factores de Riesgo , Vasoconstricción , Vasodilatación , Circunferencia de la CinturaRESUMEN
A high sympathetic tone is observed in the development and maintenance of the polycystic ovary (PCO) phenotype in rats. Neosaxitoxin (NeoSTX) specifically blocks neuronal voltage-dependent Na+ channels, and we studied the capacity of NeoSTX administered into the ovary to block sympathetic nerves and PCO phenotype that is induced by estradiol valerate (EV). The toxin was administered with a minipump inserted into the bursal cavity using two protocols: (1) the same day as EV administration and (2) 30 days after EV to block the final step of cyst development and maintenance of the condition. We studied the estrous cycling activity, follicular morphology, steroid plasma levels, and norepinephrine concentration. NeoSTX administered together with EV decreased NA intraovarian levels that were induced by EV, increased the number of corpora lutea, decreased the number of follicular cyst found after EV administration, and decreased the previously increased testosterone plasma levels induced by the PCO phenotype. Estrous cycling activity also recovered. NeoSTX applied after 30 days of EV administration showed near recovery of ovary function, suggesting that there is a specific window in which follicular development could be protected from cystic development. In addition, plasma testosterone levels decreased while those of progesterone increased. Our data strongly suggest that chronic inhibition of sympathetic nerves by a locally applied long-lasting toxin is a new tool to manage the polycystic phenotype in the rat and could be applied to other mammals depending on sympathetic nerve activity.
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Ovario/inervación , Síndrome del Ovario Poliquístico/prevención & control , Saxitoxina/análogos & derivados , Sistema Nervioso Simpático/efectos de los fármacos , Animales , Dinoflagelados/química , Estradiol/sangre , Ciclo Estral , Estro/metabolismo , Femenino , Humanos , Norepinefrina/sangre , Ovario/efectos de los fármacos , Síndrome del Ovario Poliquístico/sangre , Síndrome del Ovario Poliquístico/fisiopatología , Progesterona/sangre , Ratas , Ratas Sprague-Dawley , Saxitoxina/administración & dosificación , Sistema Nervioso Simpático/fisiopatologíaRESUMEN
Objective: The objective of this study was to determine whether cardiovascular disease (CVD) risk factors and stress hormones are associated with cognitive performance in Mexican adolescents. Methods: This was a cross-sectional study including 139 Mexican adolescents 10-14 years old. Participants were divided into three categories: 0, 1-2, and ≥3 CVD risk factors. These factors included: high-density lipoprotein-cholesterol (HDL-C) <40 mg/dl; waist circumference (WC) ≥90th percentile for age and sex, systolic or diastolic blood pressure ≥90th percentile for age, sex, and height; and triacylglycerols (TGs) ≥110 mg/dl. Low-density lipoprotein-cholesterol (LDL-C), very low-density lipoprotein-cholesterol (VLDL-C), total cholesterol, cortisol, and plasma catecholamines were measured as well. Furthermore, attention, memory, and executive functions were evaluated using a validated test for Spanish-speaking individuals (Neuropsi). Results: Adolescents in the three risk categories did not show significant differences in Neuropsi test performance tasks; however, they presented different lipid and plasma norepinephrine concentrations. TG and VLDL-C were inversely associated with memory (r = -0.19, **p < .01). Multivariate regression analysis showed consistently that TG/HDL-C ratio was inversely related to attention-memory general score (standardized ß = -0.99, t = -2.30, p = .023), memory (standardized ß = -0.83, t = -2.08, p = .039), and attention-executive functions (standardized ß = -1.02, t = -2.42, p = .017). Plasma epinephrine levels presented an inverse and weak relation to the attention-executive functions score (standardized ß = -0.18, t = -2.19, p = .030). Conclusions: Cognitive performance is not completely dependent on the accumulation of risk factors, but instead on the combination of strong predictors of CVD like waist to height ratio, TG/HDL-C, and VLDL-C. Plasma norepinephrine and epinephrine have a stronger association with cognition and CVD risk than dopamine and cortisol.
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Enfermedades Cardiovasculares/sangre , Trastornos del Conocimiento/sangre , Trastornos del Conocimiento/fisiopatología , Lípidos/sangre , Norepinefrina/sangre , Adolescente , Presión Sanguínea/fisiología , Niño , Trastornos del Conocimiento/diagnóstico , Estudios Transversales , Femenino , Humanos , Masculino , Pruebas de Estado Mental y Demencia , México , Factores de Riesgo , Circunferencia de la Cintura/fisiologíaRESUMEN
Studies have shown that stress-related catecholamines may affect cancer progression. However, little is known about catecholamine secretion profiles in head and neck cancer patients. The present study investigated plasma norepinephrine and epinephrine levels in head and neck squamous cell carcinoma (HNSCC) patients and patients with oral leukoplakia, as well as their association with clinicopathological and biobehavioral variables and anxiety symptoms. A total of 93 patients with HNSCC and 32 patients with oral leukoplakia were included. Plasma norepinephrine and epinephrine levels were measured by high performance liquid chromatography with electrochemical detection (HPLC-ED), and psychological anxiety levels were measured by the Beck Anxiety Inventory (BAI). Plasma norepinephrine and epinephrine concentrations were significantly higher in patients with oral and oropharyngeal squamous cell carcinoma (SCC) compared to non-cancer patients. Oral SCC patients displayed plasma norepinephrine levels about six times higher than oropharyngeal SCC patients, and nine times higher than oral leukoplakia patients (p < .001). Plasma epinephrine levels in oral SCC patients were higher compared to the oropharyngeal SCC (p = .0097) and leukoplakia (p < .0001) patients. Oropharyngeal SCC patients had higher plasma norepinephrine (p = .0382) and epinephrine levels (p = .045) than patients with oral leukoplakia. Multiple regression analyses showed that a history of high alcohol consumption was predictive for reduced plasma norepinephrine levels in the oral SCC group (p < .001). Anxiety symptom of "hand tremor" measured by the BAI was an independent predictor for higher plasma norepinephrine levels in HNSCC patients (ß = 157.5, p = .0377), while the "heart pounding/racing" symptom was independently associated with higher plasma epinephrine levels in the oropharyngeal SCC group (ß = 15.8, p = .0441). In oral leukoplakia patients, sleep deprivation and worse sleep quality were independent predictors for higher plasma norepinephrine levels, while severe tobacco consumption and higher anxiety levels were factors for higher plasma epinephrine levels. These findings suggest that head and neck cancer patients display sympathetic nervous system hyperactivity, and that changes in circulating catecholamines may be associated with alcohol consumption, as well as withdrawal-related anxiety symptoms.
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Ansiedad/sangre , Catecolaminas/sangre , Leucoplasia Bucal/sangre , Carcinoma de Células Escamosas de Cabeza y Cuello/sangre , Adulto , Anciano , Ansiedad/complicaciones , Ansiedad/patología , Epinefrina/sangre , Femenino , Humanos , Leucoplasia Bucal/patología , Masculino , Persona de Mediana Edad , Norepinefrina/sangre , Carcinoma de Células Escamosas de Cabeza y Cuello/complicaciones , Carcinoma de Células Escamosas de Cabeza y Cuello/patología , Sistema Nervioso Simpático/patología , Temblor/sangre , Temblor/fisiopatologíaRESUMEN
BACKGROUND: Cirrhotic cardiomyopathy is characterized by an attenuated contractile response to stress. Long-term exposure of ß-adrenergic receptors to persistently high levels of catecholamines has been implicated in its pathogenesis. We hypothesized that ß-blockade with metoprolol could reverse the changes in heart function and morphology in cirrhotic cardiomyopathy. PATIENTS AND METHODS: In this prospective randomized trial, we included 78 patients aged between 18 and 60 years with abnormal cardiac output response under dobutamine stress echocardiography, without primary cardiac disease or a history of alcohol intake. Patients were assigned randomly to receive metoprolol or placebo for 6 months. The primary endpoint was the improvement in cardiac output response to stress, measured by an increase in the left ventricle stroke volume more than 30%. RESULTS: Three (7.3%) patients in the metoprolol group and nine (24.3%) patients in the placebo group showed improved stroke volume (P=0.057). Diastolic dysfunction was found in two (4.8%) patients before and in five (15.6%) patients after therapy in the metoprolol group, and in 10 (27%) patients before and nine (31%) patients after therapy in the placebo group (P=0.67). After treatment, no echocardiography parameter of morphology was significantly different between metoprolol or placebo groups. No significant differences were observed in noradrenaline, plasma renin activity, and troponin levels between groups. Cirrhosis-related clinical events, including hospitalizations and mortality, were not significantly different between the two groups. Six months of therapy with ß-blocker did not ameliorate heart function and morphology in patients with cirrhotic cardiomyopathy.
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Antagonistas de Receptores Adrenérgicos beta 1/uso terapéutico , Cardiomiopatías/tratamiento farmacológico , Cirrosis Hepática/tratamiento farmacológico , Metoprolol/uso terapéutico , Adolescente , Antagonistas de Receptores Adrenérgicos beta 1/efectos adversos , Adulto , Biomarcadores/sangre , Brasil , Gasto Cardíaco/efectos de los fármacos , Cardiomiopatías/diagnóstico por imagen , Cardiomiopatías/etiología , Cardiomiopatías/fisiopatología , Ecocardiografía de Estrés , Femenino , Humanos , Cirrosis Hepática/complicaciones , Cirrosis Hepática/diagnóstico , Masculino , Metoprolol/efectos adversos , Persona de Mediana Edad , Contracción Miocárdica/efectos de los fármacos , Norepinefrina/sangre , Estudios Prospectivos , Recuperación de la Función , Renina/sangre , Factores de Tiempo , Resultado del Tratamiento , Troponina/sangre , Función Ventricular Izquierda/efectos de los fármacos , Remodelación Ventricular/efectos de los fármacos , Adulto JovenRESUMEN
BACKGROUND AND AIMS: Chronic ethanol consumption is associated with hypertension and atherosclerosis. Vascular oxidative stress is described as an important mechanism whereby ethanol predisposes to atherosclerosis. We hypothesized that nebivolol would prevent ethanol-induced hypertension and vascular oxidative stress. METHODS: Male Wistar rats were treated with ethanol 20% (vol./vol.) or nebivolol (10â¯mg/kg/day, p. o., gavage), a selective ß1-adrenergic receptor antagonist. RESULTS: Ethanol-induced increase in blood pressure and in the circulating levels of adrenaline and noradrenaline was prevented by nebivolol. Similarly, nebivolol prevented ethanol-induced increase in plasma levels of renin, angiotensin I and II. Chronic ethanol consumption increased the aortic levels of superoxide anion (O2-), thiobarbituric acid reactive species (TBARS) as well as the expression of Nox1 and nitrotyrosine immunostaining in the rat aorta. Treatment with nebivolol prevented these responses. The decrease in aortic levels of nitrate/nitrite (NOx) induced by ethanol was prevented by the treatment with nebivolol. Finally, nebivolol attenuated ethanol-induced increase in phenylephrine- and noradrenaline-induced contraction of endothelium-intact and endothelium-denuded aortic rings. CONCLUSIONS: The novelty of our study is that nebivolol prevented ethanol-induced hypertension and vascular oxidative stress. Additionally, we showed that the sympathetic nervous system (SNS) and the renin-angiotensin system (RAS) are important endogenous mediators of the cardiovascular effects of ethanol.
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Antagonistas de Receptores Adrenérgicos beta 1/farmacología , Antihipertensivos/farmacología , Aorta Torácica/efectos de los fármacos , Presión Arterial/efectos de los fármacos , Etanol , Hipertensión/prevención & control , Nebivolol/farmacología , Estrés Oxidativo/efectos de los fármacos , Animales , Aorta Torácica/inervación , Aorta Torácica/metabolismo , Biomarcadores/metabolismo , Catalasa/metabolismo , Modelos Animales de Enfermedad , Epinefrina/sangre , Hipertensión/inducido químicamente , Hipertensión/metabolismo , Hipertensión/fisiopatología , Peroxidación de Lípido/efectos de los fármacos , Masculino , NADPH Oxidasas/metabolismo , Óxido Nítrico/metabolismo , Norepinefrina/sangre , Ratas Wistar , Sistema Renina-Angiotensina/efectos de los fármacos , Superóxido Dismutasa/metabolismo , Sistema Nervioso Simpático/efectos de los fármacos , Sistema Nervioso Simpático/metabolismo , Sistema Nervioso Simpático/fisiopatología , Tirosina/análogos & derivados , Tirosina/metabolismoRESUMEN
Although heart rate (HR) is one of the most important clinical parameters determined via physical examinations, little information is available on the normal HR in dogs, which may be related to the high variability of body weight (BW) in this species. HR is determined by the discharge rate of the sinus node, which is dependent on the autonomic nervous system and the release of catecholamines. The allometric relationship between BW and HR in different species has been described as inversely proportional; however, this relationship has been refuted. Certain authors have reported that the relationship between HR and BW in dogs is based on temperament as well as sympathetic autonomic stimulation of the sinus node in small breeds compared with large breeds. The aim of this study was to analyze the effects of weight, sex, age and temperament on the HR, heart rate variability and serum catecholamine (epinephrine and norepinephrine) levels in dogs. We evaluated 48 adult dogs of both sexes and various breeds and ages and divided the dogs into 5 BW groups: <5kg (n = 8), 5-10kg (n = 10), 10-25kg (n = 10), 25-45kg (n = 10), and >45kg (n = 10). The measured parameters were HR, breath rate (BR) and body temperature. We also performed an ambulatory electrocardiogram and electrocardiography (ECG) test for 24 hours (Holter monitor) and determined the serum levels of the catecholamines epinephrine and norepinephrine. We observed correlations between HR and sex; differences among the weight groups with respect to ECG variables and epinephrine levels; and differences among the temperament categories for certain clinical parameters, such as HR and BR. Age affected the R wave amplitude, and an allometric relationship was not observed between HR and BW in the dogs. Our results indicated that weight was associated with variations in the ECG variables; age and sex were associated with variations in HR; and temperament had a significant influence on the HR and BR of the dogs.
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Peso Corporal/fisiología , Electrocardiografía/veterinaria , Frecuencia Cardíaca/fisiología , Factores de Edad , Animales , Perros , Epinefrina/sangre , Femenino , Masculino , Norepinefrina/sangre , Factores Sexuales , TemperamentoRESUMEN
Chronic spinal cord injury (SCI) is often associated with reductions in left ventricular (LV) diastolic function. Impairments in sympathetic activity and activation of the renin-angiotensin system are reported in SCI individuals and may hypothetically be implicated in this association. Hence, the present study verified the relationship between these two neuro-hormonal and cardiac functional and structural characteristics in SCI individuals. Twenty-two men with SCI (injury level above T6 and no voluntary motion below the injury) and 11 able-bodied men were evaluated by clinical, hemodynamic, laboratory, and echocardiographic analysis and had plasmatic renin, angiotensin I (ANGI), angiotensin II (ANGII), angiotensin 1-7 (ANG1-7), and noradrenaline levels measured. SCI subjects had lower noradrenaline (p = 0.003) and higher ANG1-7 (p = 0.009), but similar renin, ANGI, and ANGII levels when compared with able-bodied individuals. In SCI individuals, results of multi-variable analysis showed that higher Em, a marker of better LV diastolic function, was directly associated with ANG1-7 (p = 0.05) or ANG1-7/ANGII ratio (p = 0.007), whereas lower noradrenaline levels were independently associated with worse LV diastolic function, as assessed by E/Em ratio (p = 0.028). In conclusion, these results suggest that reduced sympathetic activity and expression of ANG1-7 may be involved in SCI-related diastolic dysfunction.
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Traumatismos de la Médula Espinal/fisiopatología , Sistema Nervioso Simpático/fisiopatología , Función Ventricular Izquierda/fisiología , Adulto , Angiotensina I/sangre , Humanos , Masculino , Norepinefrina/sangre , Fragmentos de Péptidos/sangre , Sistema Renina-Angiotensina/fisiologíaRESUMEN
Background: The knowledge of the variables predicting mortality is important in clinical practice and for therapeutic monitoring in mitral valve disease. Objectives: To determine whether a quality of life score evaluated with the Functional Evaluation of Cardiac Health questionnaire would predict mortality in dogs with degenerative mitral valve disease (DMVD). Methods: Thirty-six client-owned dogs with mitral valve disease underwent clinical, laboratory, and echocardiographic evaluations at baseline and were monitored for 6 months. Cardiovascular death was the primary outcome. Results: The 36 dogs were classified as survivors or nonsurvivors. Higher values of the following variables were obtained at baseline in the nonsurviving group (12 dogs): amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, plasma norepinephrine, heart rate, quality of life score, diastolic left ventricular internal dimension to aortic root ratio, systolic left ventricular internal dimension to aortic root ratio, and left atrium to aortic root ratio. NT-proBNP levels and quality life score were independently associated with death in the multivariable analysis. Conclusion: The quality life score was an independent variable for cardiac death in dogs with DMVD. This result is encouraging, as this score is easy to apply and does not require any technology, only a veterinarian and an observant owner.
Fundamento: O conhecimento das variáveis preditoras de mortalidade é importante para a prática clínica e para o acompanhamento terapêutico na doença da valva mitral. Objetivos: Determinar se um escore de qualidade de vida avaliado com o Functional Evaluation of Cardiac Health poderia auxiliar na predição de mortalidade em cães com doença degenerativa da valva mitral (DDVM). Métodos: Trinta e seis cães de estimação com doença valvar mitral foram submetidos a avaliação clínica, laboratorial e ecocardiográfica no início do estudo e monitorizados durante 6 meses. A morte cardiovascular foi o desfecho primário. Resultados: Os 36 cães foram classificados como sobreviventes ou não sobreviventes. Os valores mais elevados das seguintes variáveis foram obtidos no início do estudo no grupo de não sobreviventes (12 cães): fragmento N-terminal do peptídeo natriurético tipo B (NT-proBNP), norepinefrina plasmática, frequência cardíaca, escore de qualidade de vida, razão da dimensão interna diastólica do ventrículo esquerdo e raiz aórtica, razão da dimensão interna sistólica do ventrículo esquerdo e raiz aórtica e a relação da dimensão do átrio esquerdo e a raiz aórtica. Concentrações de NT-proBNP e o escore de qualidade de vida foram independentemente associados com morte na análise multivariada. Conclusão: O escore de qualidade de vida foi uma variável independente para a morte por doença cardíaca em cães com DDVM. Este resultado é encorajador, pois este escore é de fácil aplicação e não requer o emprego de tecnologia, necessitando apenas de um veterinário e um dono observador.
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Enfermedades de los Perros/mortalidad , Enfermedades de las Válvulas Cardíacas/veterinaria , Válvula Mitral/anomalías , Calidad de Vida , Animales , Perros , Femenino , Frecuencia Cardíaca , Enfermedades de las Válvulas Cardíacas/mortalidad , Masculino , Péptido Natriurético Encefálico/sangre , Norepinefrina/sangre , Fragmentos de Péptidos/sangre , Estudios Prospectivos , Encuestas y CuestionariosRESUMEN
Abstract Background: The knowledge of the variables predicting mortality is important in clinical practice and for therapeutic monitoring in mitral valve disease. Objectives: To determine whether a quality of life score evaluated with the Functional Evaluation of Cardiac Health questionnaire would predict mortality in dogs with degenerative mitral valve disease (DMVD). Methods: Thirty-six client-owned dogs with mitral valve disease underwent clinical, laboratory, and echocardiographic evaluations at baseline and were monitored for 6 months. Cardiovascular death was the primary outcome. Results: The 36 dogs were classified as survivors or nonsurvivors. Higher values of the following variables were obtained at baseline in the nonsurviving group (12 dogs): amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, plasma norepinephrine, heart rate, quality of life score, diastolic left ventricular internal dimension to aortic root ratio, systolic left ventricular internal dimension to aortic root ratio, and left atrium to aortic root ratio. NT-proBNP levels and quality life score were independently associated with death in the multivariable analysis. Conclusion: The quality life score was an independent variable for cardiac death in dogs with DMVD. This result is encouraging, as this score is easy to apply and does not require any technology, only a veterinarian and an observant owner.
Resumo Fundamento: O conhecimento das variáveis preditoras de mortalidade é importante para a prática clínica e para o acompanhamento terapêutico na doença da valva mitral. Objetivos: Determinar se um escore de qualidade de vida avaliado com o Functional Evaluation of Cardiac Health poderia auxiliar na predição de mortalidade em cães com doença degenerativa da valva mitral (DDVM). Métodos: Trinta e seis cães de estimação com doença valvar mitral foram submetidos a avaliação clínica, laboratorial e ecocardiográfica no início do estudo e monitorizados durante 6 meses. A morte cardiovascular foi o desfecho primário. Resultados: Os 36 cães foram classificados como sobreviventes ou não sobreviventes. Os valores mais elevados das seguintes variáveis foram obtidos no início do estudo no grupo de não sobreviventes (12 cães): fragmento N-terminal do peptídeo natriurético tipo B (NT-proBNP), norepinefrina plasmática, frequência cardíaca, escore de qualidade de vida, razão da dimensão interna diastólica do ventrículo esquerdo e raiz aórtica, razão da dimensão interna sistólica do ventrículo esquerdo e raiz aórtica e a relação da dimensão do átrio esquerdo e a raiz aórtica. Concentrações de NT-proBNP e o escore de qualidade de vida foram independentemente associados com morte na análise multivariada. Conclusão: O escore de qualidade de vida foi uma variável independente para a morte por doença cardíaca em cães com DDVM. Este resultado é encorajador, pois este escore é de fácil aplicação e não requer o emprego de tecnologia, necessitando apenas de um veterinário e um dono observador.
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Animales , Masculino , Femenino , Perros , Calidad de Vida , Enfermedades de los Perros/mortalidad , Enfermedades de las Válvulas Cardíacas/veterinaria , Válvula Mitral/anomalías , Fragmentos de Péptidos/sangre , Norepinefrina/sangre , Estudios Prospectivos , Encuestas y Cuestionarios , Péptido Natriurético Encefálico/sangre , Frecuencia Cardíaca , Enfermedades de las Válvulas Cardíacas/mortalidadRESUMEN
Chronic cold stress produces adrenergic overload that can affect fetal development. The placental norepinephrine transporter (NET) clears norepinephrine (NE) from both maternal circulation and the fetus during gestation. If this system fails, NE clearance can be reduced, leading to high fetal exposure to NE. The main aim of this study was to determine the changes in NET expression during gestation and their relationship with the functional capacity of NET to transport NE under stressful conditions. Additionally, this study correlated these findings with the reproductive capacity of 2nd-generation progeny. Pregnant rats were subjected to chronic cold stress at 4°C for 3 h each day throughout their pregnancies. We found that exposure of pregnant rats to sympathetic stress caused the following effects: increased NE and corticosterone levels throughout pregnancy, decreased capacity of the placenta to clear NE from the fetus to the mother's circulation, altered NET protein levels depending on the sex of the fetus and increased placental and body weights of pups. For the first time, we also described the disrupted fertility of progeny as adults. Increased NE plasma levels during pregnancy under sympathetic stress conditions correlated with decreased NET functionality that provoked changes in the development of progeny and their fertility in adulthood.
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Fertilidad/fisiología , Proteínas de Transporte de Noradrenalina a través de la Membrana Plasmática/fisiología , Placenta/química , Complicaciones del Embarazo/fisiopatología , Efectos Tardíos de la Exposición Prenatal/fisiopatología , Estrés Fisiológico/fisiología , Animales , Frío , Corticosterona/sangre , Femenino , Masculino , Intercambio Materno-Fetal , Norepinefrina/sangre , Norepinefrina/metabolismo , Embarazo , Ratas , Ratas Sprague-Dawley , Factores SexualesRESUMEN
During the course of life, cyclic females face a state of midlife transition that occurs in a fully functioning neurological system, and results in reproductive senescence. The authors' hypothesis was that changes in the activity noradrenergic neurons may be one of the factors involved in this phenomenon. The aim of this study was to investigate the activity of the neurons in the anteroventral periventricular nucleus (AVPV) and locus coeruleus (LC), to analyze their role in determining reproductive senescence. Adult female Wistar rats in the diestrus phase (4months/cyclic) and old females (18-20months/acyclic) in persistent diestrus, were decapitated or perfused at three different time intervals (10, 14 and 18h) throughout the day. In acyclic rats, the gonadotropin-releasing hormone (GnRH) and noradrenaline (NE) content were reduced; Fos-related antigen (FRA) in AVPV and Fos-related antigen/Tyrosine hydroxylase (FRA/TH) in LC showed immunolabeling of a higher number of neurons in these animals. The 3-methoxy-4-hydroxyphenylglycol/noradrenaline (MHPG/NE) ratio was higher and plasma LH was lower in the acyclic rats. Furthermore, the estradiol level was higher, and the progesterone level was lower after 14h of persistent diestrus. These findings suggested that during the periestropause, there was a higher level of POA/AVPV and NE neuronal activity in the LC of acyclic rats, associated with a lower capacity of synthesis and storage of neurotransmitters and neurohormones contributed to changes in the temporal pattern of neuroendocrine signaling, thereby compromising the accuracy of inhibitory and stimulatory effects, causing irregularity in the estrous cycle and determining reproductive senescence.
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Envejecimiento/fisiología , Locus Coeruleus/fisiopatología , Neuronas/metabolismo , Norepinefrina/sangre , Área Preóptica/fisiopatología , Reproducción , Animales , Estradiol/sangre , Ciclo Estral , Femenino , Hormona Liberadora de Gonadotropina/sangre , Hormona Luteinizante/sangre , Ratas , Ratas WistarRESUMEN
The aim of the study was to assess the stress responses in drivers during an official rally car race and the influence of fitness and body composition on stress hormones. Fitness and body composition were assessed in 9 rally car drivers with an incremental exercise test for determination of maximum aerobic speed (MAS) and 6-site skinfold method, respectively. Before (pre) and after (post) the first stage of an official rally car race, data were collected for heart rate (HR), blood samples were collected for analysis of hormones (i.e., epinephrine [EPI], norepinephrine [NE], cortisol, and aldosterone) and metabolites (i.e., lactate [LA], glucose, and ammonia). There were significant (p ≤ 0.05) increases in all assessed variables except glucose at postrace. Heart rate increased 93% (p ≤ 0.05) at the end of the race stage, reaching 88.77 ± 4.96% of HRpeak. Also, EPI and NE significantly (p = 0.001) increased by 45 and 65%, respectively, and LA increased by 395% (p < 0.001). Significant correlations between percent body fat (%BF) and postrace EPI (r = 0.95; p < 0.001), and percentage change of EPI (r = 0.83; p = 0.012) were observed. The MAS was not associated to any metabolic or hormonal variable. These results suggest that psycho-physiological stress induced by the race elicited important changes in hormonal and metabolic variables and that %BF could be an important mediator of psycho-physiological stress in rally car drivers. Specific programs, including both strength and aerobic training, and nutritional plans should be implemented for appropriate conditioning of rally car drivers.
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Conducción de Automóvil , Aptitud Física/fisiología , Deportes/fisiología , Estrés Fisiológico , Estrés Psicológico/sangre , Adiposidad , Adulto , Aldosterona/sangre , Amoníaco/sangre , Biomarcadores/sangre , Glucemia/metabolismo , Epinefrina/sangre , Prueba de Esfuerzo , Frecuencia Cardíaca , Humanos , Hidrocortisona/sangre , Ácido Láctico/sangre , Persona de Mediana Edad , Norepinefrina/sangre , Grosor de los Pliegues Cutáneos , Adulto JovenRESUMEN
OBJECTIVE: To compare afternoon serum/plasma levels of hormones in four groups: (A) veterans with posttraumatic stress disorder (PTSD), (B) offspring of PTSD veterans, (C) veterans without PTSD, and (D) offspring of non-PTSD veterans. METHODS: Evaluation consisted of a semi-structured interview for axis I and II diagnoses, followed by measurement of afternoon serum cortisol and plasma epinephrine and norepinephrine by ELISA (Diametra) and LND (LDN Labor Diagnostika Nord GmbH & Co. KG) respectively. Data were analyzed using descriptive statistics and the Student t, Kolmogorov-Smirnov, and nonparametric Mann-Whitney tests. RESULTS: One hundred and sixty-eight volunteers were investigated across the four groups. The groups were similar in terms of demographic characteristics, war experience and traumatization, and psychiatric and medical conditions other than PTSD (group A was similar to group C and group B was similar to group D). Between-groups comparisons did not yield statistically significant differences. Post-hoc analyses revealed significant differences in afternoon cortisol level between the offspring of veterans with current/past history of PTSD and the offspring of veterans without a history of PTSD. CONCLUSION: We only found decreased cortisol levels in offspring of veterans after rearranging the groups to reflect previous history of PTSD. Further studies are required to investigate the relationship between cortisol levels and the transgenerational effects of trauma and parental PTSD.
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Padre/psicología , Hidrocortisona/sangre , Norepinefrina/sangre , Trastornos por Estrés Postraumático/sangre , Veteranos/psicología , Adulto , Biomarcadores/sangre , Relaciones Padre-Hijo , Femenino , Humanos , Guerra de Irak 2003-2011 , Masculino , Persona de Mediana Edad , Factores SocioeconómicosRESUMEN
Objective: To compare afternoon serum/plasma levels of hormones in four groups: (A) veterans with posttraumatic stress disorder (PTSD), (B) offspring of PTSD veterans, (C) veterans without PTSD, and (D) offspring of non-PTSD veterans. Methods: Evaluation consisted of a semi-structured interview for axis I and II diagnoses, followed by measurement of afternoon serum cortisol and plasma epinephrine and norepinephrine by ELISA (Diametra) and LND (LDN Labor Diagnostika Nord GmbH & Co. KG) respectively. Data were analyzed using descriptive statistics and the Student t, Kolmogorov-Smirnov, and nonparametric Mann-Whitney tests. Results: One hundred and sixty-eight volunteers were investigated across the four groups. The groups were similar in terms of demographic characteristics, war experience and traumatization, and psychiatric and medical conditions other than PTSD (group A was similar to group C and group B was similar to group D). Between-groups comparisons did not yield statistically significant differences. Post-hoc analyses revealed significant differences in afternoon cortisol level between the offspring of veterans with current/past history of PTSD and the offspring of veterans without a history of PTSD. Conclusion: We only found decreased cortisol levels in offspring of veterans after rearranging the groups to reflect previous history of PTSD. Further studies are required to investigate the relationship between cortisol levels and the transgenerational effects of trauma and parental PTSD. .
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Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Padre/psicología , Hidrocortisona/sangre , Norepinefrina/sangre , Trastornos por Estrés Postraumático/sangre , Veteranos/psicología , Biomarcadores/sangre , Relaciones Padre-Hijo , Factores SocioeconómicosRESUMEN
The aim of this study was to determine the effect of time of day on performance, pacing, and hormonal and metabolic responses during a 1000-m cycling time-trial. Nine male, recreational cyclists visited the laboratory four times. During the 1st visit the participants performed an incremental test and during the 2nd visit they performed a 1000-m cycling familiarization trial. On the 3rd and 4th visits, the participants performed a 1000-m TT at either 8 am or 6 pm, in randomized, repeated-measures, crossover design. The time to complete the time trial was lower in the evening than in the morning (88.2±8.7 versus 94.7±10.9 s, respectively, p<0.05), but there was no significant different in pacing. However, oxygen uptake and aerobic mechanical power output at 600 and 1000 m tended to be higher in the evening (p<0.07 and 0.09, respectively). There was also a main effect of time of day for insulin, cortisol, and total and free testosterone concentration, which were all higher in the morning (+60%, +26%, +31% and +22%, respectively, p<0.05). The growth hormone, was twofold higher in the evening (p<0.05). The plasma glucose was â¼11% lower in the morning (p<0.05). Glucagon, norepinephrine, epinephrine and lactate were similar for the morning and evening trials (p>0.05), but the norepinephrine response to the exercise was increased in the morning (+46%, p<0.05), and it was accompanied by a 5-fold increase in the response of glucose. Muscle recruitment, as measured by electromyography, was similar between morning and evening trials (p>0.05). Our findings suggest that performance was improved in the evening, and it was accompanied by an improved hormonal and metabolic milieu.
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Ciclismo/fisiología , Glucemia/metabolismo , Ritmo Circadiano/fisiología , Hormona del Crecimiento/sangre , Testosterona/sangre , Adulto , Estudios Cruzados , Electromiografía , Epinefrina/sangre , Ejercicio Físico/fisiología , Glucagón/sangre , Humanos , Hidrocortisona/sangre , Insulina/sangre , Ácido Láctico/sangre , Masculino , Músculo Esquelético/fisiología , Norepinefrina/sangre , Consumo de Oxígeno/fisiología , FotoperiodoRESUMEN
Increasing evidence suggests that alterations in early nutrition programme physiological changes in adulthood. In the present study, we determined the effects of undernutrition during gestation and lactation on the programming of thyroid function in adult rat offspring. Perinatal undernutrition was achieved by a 40% food restriction in female Wistar rats from the mating day to weaning. On postpartum day 21, the offspring of the control and food-restricted dams were weaned and given free access to a commercial diet until adulthood. The results showed that undernourished rats exhibited decreased 3,5,3'-triiodothyronine (T3) levels but had normal thyroxine (T4) and thyrotropin (TSH) levels at weaning; on day 90, these rats displayed a significant flip, exhibiting normalised T3 (total and free) and total T4 levels, but low free T4 and persistently higher TSH levels, which were maintained even on postnatal day 140. This profile was accompanied by a scarce fat depot, a lower RMR and an exacerbated sympathetic brown adipose tissue (BAT) tone (deiodinase type 2 expression) in basal conditions. Moreover, when a functional challenge (cold exposure) was applied, the restricted group exhibited partial changes in TSH (29 v. 100%) and T4 (non-response v. 17%) levels, a significant decrease in leptin levels (75 v. 32%) and the maintenance of a sympathetic BAT over-response (higher noradrenaline levels) in comparison with the control group. The findings of the present study suggest that undernutrition during the perinatal period produces permanent changes in the hypothalamus-pituitary-thyroid axis with consequent low body weight and decreased RMR and facultative thermogenesis. We hypothesise that these changes predispose individuals to exhibiting adult subclinical hypothyroidism.
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Hipotiroidismo/etiología , Fenómenos Fisiológicos Nutricionales del Lactante , Desnutrición/complicaciones , Fenómenos Fisiologicos de la Nutrición Prenatal , Glándula Tiroides/fisiopatología , Hormonas Tiroideas/sangre , Tejido Adiposo Pardo/metabolismo , Animales , Metabolismo Basal , Peso Corporal , Frío , Femenino , Humanos , Hipotiroidismo/sangre , Hipotiroidismo/metabolismo , Hipotiroidismo/fisiopatología , Recién Nacido , Lactancia , Leptina/sangre , Desnutrición/sangre , Desnutrición/fisiopatología , Norepinefrina/sangre , Embarazo , Efectos Tardíos de la Exposición Prenatal , Ratas , Ratas Wistar , TermogénesisRESUMEN
OBJECTIVE: A randomized clinical study to compare the stress response to laparoscopic cholecystectomy during spinal-general anaesthesia and epidural- general anaesthesia. METHODS: Women undergoing elective laparoscopic chole cystectomy were assigned to receive either spinal anaesthesia (SA group; n = 12) or epidural anaesthesia (EA group; n = 12), in addition to general anaesthesia. Plasma concentrations of cortisol, adrenocorticotrophic hormone (ACTH), noradrenaline, adrenaline and total catecholamines were measured pre- and intraoperatively. RESULTS: Intraoperative cortisol, noradrenaline and total catecholamine levels were significantly lower in the SA group compared with the EA group. When pre- and intraoperative values were compared, the SA group showed a decrease in adrenaline, noradrenaline and total catecholamine levels, and the EA group showed an increase in ACTH and noradrenaline levels. CONCLUSIONS: The type of regional anaesthesia significantly affected the stress response: spinal anaesthesia produced a more favourable endocrine response than epidural anaesthesia. Spinal-general anaesthesia may reduce postoperative morbidity in laparoscopic cholecystectomy.
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Anestesia Epidural , Anestesia General , Anestesia Raquidea , Colecistectomía Laparoscópica , Sistemas Neurosecretores/fisiología , Hormona Adrenocorticotrópica/sangre , Adulto , Catecolaminas/sangre , Epinefrina/sangre , Femenino , Humanos , Hidrocortisona/sangre , Norepinefrina/sangre , Estrés Fisiológico , Estrés Psicológico/sangreRESUMEN
FUNDAMENTO: Infusão de intralipid e heparina resulta em aumento da pressão arterial e também em anormalidades autonômicas em indivíduos normais e hipertensos. OBJETIVO: Avaliar a sensibilidade a insulina e o impacto da infusão de intralipid e de heparina (ILH) sobre a resposta hemodinâmica, metabólica e autonômica em pacientes com a forma indeterminada da doença de Chagas. MÉTODOS: Doze pacientes com a forma indeterminada da doença de Chagas e 12 voluntários saudáveis foram avaliados. RESULTADOS: A pressão arterial basal e a frequência cardíaca foram semelhantes nos dois grupos. Os níveis plasmáticos de noradrenalina encontravam-se ligeiramente aumentados no grupo de pacientes chagásicos. Após o Teste de Tolerância a Insulina (TTI), houve um declínio significativo na glicose dos dois grupos. A Infusão de ILH resultou em aumento da pressão arterial em ambos os grupos, mas não houve nenhuma mudança significativa na noradrenalina plasmática. O componente de Baixa Frequência (BF) mostrou-se semelhante e aumentou de forma semelhante em ambos os grupos. O componente de Alta Frequência (AF) apresentou-se menor no grupo chagásico. CONCLUSÃO: Pacientes com forma indeterminada da doença de Chagas apresentaram aumento da atividade simpática no momento basal e uma resposta inadequada à insulina. Eles também tiveram um menor componente de alta frequência e sensibilidade barorreflexa prejudicada no momento basal e durante a infusão de intralipid e heparina.
BACKGROUND: Intralipid and heparin infusion results in increased blood pressure and autonomic abnormalities in normal and hypertensive individuals. OBJECTIVE: To evaluate insulin sensitivity and the impact of Intralipid and heparin (ILH) infusion on hemodynamic, metabolic, and autonomic response in patients with the indeterminate form of Chagas' disease. METHODS: Twelve patients with the indeterminate form of Chagas' disease and 12 healthy volunteers were evaluated. RESULTS: Baseline blood pressure and heart rate were similar in both groups. Plasma noradrenaline levels were slightly increased in the Chagas' group. After insulin tolerance testing (ITT), a significant decline was noted in glucose in both groups. ILH infusion resulted in increased blood pressure in both groups, but there was no significant change in plasma noradrenaline. The low-frequency component (LF) was similar and similarly increased in both groups. The high-frequency component (HF) was lower in the Chagas' group. CONCLUSION: Patients with the indeterminate form of Chagas' disease had increased sympathetic activity at baseline and impaired response to insulin. They also had a lower high-frequency component and impaired baroreflex sensitivity at baseline and during Intralipid and heparin infusion.
FUNDAMENTO: La Infusión de intralipid® y de heparina trae como resultado un aumento de la presión arterial y también de las anormalidades autonómicas en los individuos normales e hipertensos. OBJETIVO: Evaluar la sensibilidad a la insulina y el impacto de la infusión de intralipid® y de heparina (ILH) sobre la respuesta hemodinámica, metabólica y autonómica en pacientes con la forma indefinida de la Enfermedad de Chagas. MÉTODOS: Fueron evaluados doce pacientes con la forma indefinida de la Enfermedad de Chagas y 12 voluntarios sanos. RESULTADOS: La presión arterial basal y la frecuencia cardíaca fueron similares en los dos grupos. Los niveles plasmáticos de noradrenalina estaban ligeramente más elevados en el grupo de pacientes chagásicos. Después del Test de Tolerancia a la Insulina (TTI), se produjo una ostensible disminución en la glucosa de los dos grupos. La Infusión de ILH trajo como consecuencia el aumento de la presión arterial en ambos grupos, pero no hubo ningún cambio significativo en la noradrenalina plasmática. El componente de Baja Frecuencia (BF), fue similar y aumentó de forma parecida en ambos grupos. El componente de Alta Frecuencia (AF) se presentó con un menor nivel en el grupo chagásico. CONCLUSIONES: Los pacientes con una forma indeterminada de la Enfermedad de Chagas, presentaron un aumento en la actividad simpática al momento basal y una respuesta inadecuada a la insulina. También tuvieron un menor componente de alta frecuencia y de sensibilidad barorrefleja, que fue perjudicado en el momento basal y durante la infusión de intralipid® y heparina.