RESUMO

BACKGROUND AND AIMS: Systemic inflammatory diseases could act as an unfavorable condition in which epicardial adipose tissue (EAT) becomes harmful to cardiovascular health. The objectives were: (a) to quantitatively compare the presence of EAT between patients with systemic inflammatory diseases and controls; (b) to analyze the association between EAT and subclinical atheromatosis in individuals with systemic inflammatory diseases. METHODS: Studies that have quantified EAT in a population with systemic inflammatory diseases compared to a control group, or that describe the association between EAT and the presence of subclinical atheromatosis in patients with systemic inflammatory diseases were included. A quantitative analysis was performed for the first objective. This systematic review was performed according to PRISMA guidelines. RESULTS: Twenty-one studies including 1448 patients with systemic inflammatory diseases, were considered eligible for this study. Patients with systemic inflammatory disease have a higher volume (MD: 10.4cm3 [1.8-19.1]; p<0.01), higher thickness (MD: 1.0mm [0.8-1.2]; p<0.01), and a statistically non-significant higher area (MD: 3.1cm2 [1.0-5.2]; p=0.46) of EAT compared to the control group. Most studies reported a significant association between EAT and subclinical atheromatosis in patients with different systemic inflammatory diseases. CONCLUSION: This study demonstrated that EAT is increased in patients with systemic inflammatory diseases compared with healthy controls, and that EAT measurement is closely correlated with subclinical atherosclerosis in these patients. The causality of this association should be tested in prospective studies.

Assuntos

RESUMO

According to data from the American Heart Association and the World Health Organization, cardiovascular disease (CVD) is the most frequent cause of premature death. Several inflammatory and non-inflammatory skin diseases have been associated with metabolic syndrome and cardiovascular risk (CVR). Here, we classified these conditions into traditionally CVR-associated and those that have been linked to a lesser degree. Psoriasis and hidradenitis suppurativa are commonly associated with CVD, sharing common inflammatory pathways and a higher prevalence of traditional cardiovascular risk factors. Many other diseases could be associated indirectly - with no common pathogenic features with the atheromatous disease - but share a higher prevalence of standard cardiovascular risk and chronic inflammatory state. This review aims to highlight the associated cardiovascular risk that exists for some dermatologic diseases and sensitize cardiologists, dermatologists, and first care providers to implement risk factor control promptly.

Assuntos

RESUMO

RESUMEN Introducción: las enfermedades cardiovasculares constituyen la principal causa de muerte en la mayoría de los países. Se describen los factores de riesgo para enfermedad coronaria como no modificables: edad, sexo y antecedentes familiares; y modificables relacionados al estilo de vida: tabaquismo, dislipidemia, obesidad, sedentarismo, diabetes, uso abusivo de alcohol y la enfermedad hipertensiva. Objetivo: caracterizar los factores de riesgo asociados a la cardiopatía isquémica en Atención Secundaria de Salud. Materiales y métodos: estudio observacional, descriptivo transversal en pacientes ingresados en el Hospital "Mártires del 9 de Abril" de Sagua la Grande, en el periodo comprendido entre los años 2016 y 2017. Integraron la muestra 96 pacientes que ingresaron con diagnóstico de cardiopatía isquémica. Se describieron las características demográficas de los mismos; fueron identificados los factores de riesgo y se determinó la frecuencia de asociación de otras formas clínicas de ateromatosis. Resultados: los pacientes fueron mayores de 60 años de edad; la mayoría tenían color de la piel blanca; presentaban antecedentes patológicos familiares de cardiopatía isquémica; las principales formas de cardiopatía isquémica fueron: angina e insuficiencia cardiaca; todos los pacientes presentaron uno o más factores de riesgo cardiovascular, los más significativos fueron, hipertensión arterial, tabaquismo aumento de la circunferencia abdominal y personalidad tipo "A". Conclusiones: la mayoría de los pacientes exhibieron alteraciones en el electrocardiograma: descenso del segmento ST, bloqueo de rama izquierda del haz de His y fibrilación auricular; se observó hipertrigliceridemia y se apreció asociación entre enfermedad renal crónica y angina.

ABSTRACT Introduction: cardiovascular diseases are the main cause of death in most of the countries. The risk factors for coronary disease are described as unmodifiable: age, sex and family history; and modifiable related to lifestyle: smoking, dyslipidemia, obesity, sedentary lifestyle, diabetes, abusive use of alcohol and hypertensive disease. Objective: to characterize the risk factors associated to ischemic heart disease in secondary health care. Material and methods: observational, cross-sectional, descriptive study in patients admitted in "Mártires del 9 de Abril" Hospital, Sagua la Grande, between 2016 and 2017. The sample consisted of 96 patients admitted with a diagnosis of ischemic heart disease. Their demographic characteristics were described; the risk factors were identified and the frequency of association of other clinical forms of atheromatosis was determined. Results: the patients were aged more than 60 years; most of them were white people and had family pathological antecedents of ischemic heart disease; the main forms of ischemic heart disease were angina and heart failure; all patients showed one or more cardiovascular risk factors being arterial hypertension, smoking, increase of abdominal circumference and type A personality the most significant ones. Conclusions: the majority of patients showed alterations in the electrocardiogram: ST segment decrease, His bundle left branch blockage and atrial fibrillation; hypertriglyceridemia was observed and there was an association between chronic kidney disease and angina.

Assuntos

RESUMO

Si bien la ateromatosis intracraneal (AIC) es una entidad frecuente, está subvalorada en la práctica clínica. Los avances tecnológicos en los diferentes métodos radiológicos y especialmente el advenimiento de la tomografía computada multicorte (TCMC) han mejorado la precisión diagnóstica de esta patología. OBJETIVOS: Demostrar la utilidad de la TCMC en el diagnóstico de la AIC y determinar la frecuencia y localización de las placas ateromatosas, así como su distribución etaria y genérica. MATERIALES Y MÉTODOS: Se estudió retrospectivamente a 280 pacientes (140 mujeres y 140 hombres) entre octubre de 2011 y marzo de 2012. Todos eran mayores de 40 años y contaron con una TCMC de cerebro sin contraste, realizada con un tomógrafo Toshiba Aquilion de 16 filas de detectores. Se evaluaron solamente placas cálcicas (considerándose así a aquellas cuya densidad superaba las 80 unidades Hounsfield). RESULTADOS: Se encontró AIC en un 65% de los pacientes examinados, con una incidencia no significativa en el sexo masculino (relación: 1,16/1). Los vasos más comprometidos, en orden de frecuencia, fueron el sifón carotídeo y la arteria vertebral en su segmento V4. CONCLUSIÓN: La ateromatosis es una de las causas frecuentes de ictus cerebral. La TCMC es el método de elección para determinar la localización y frecuencia de las calcificaciones intracraneales de manera no invasiva. Al igual que el score de calcio, la determinación del calcio a nivel de las arterias permitiría establecer el riesgo que tiene el paciente de desarrollar complicaciones vasculares, en este caso en el territorio cerebral.

Even though intracranial atheromatosis (IA) is a frequent entity, it is undervalued in clinical practice. The technological advances in different radiological methods and especially multislice computed tomography (MSCT) have improved the diagnostic accuracy of this pathology. OBJECTIVES: To prove the multislice computed tomography usefulness in intracranial atheromatosis diagnostic, and establish the frequency and location of atheromatous plaques, and also the age and gender distribution. MATERIALS AND METHODS: Two hundred and eighty patients (140 male and 140 female) were studied retrospectively, between October 2011 and March 2012. All of them were more than 40 years old and counted with a brain MSCT without contrast, made it with a Toshiba Aquilion 16 multidetector computer tomograph. Calcium plaques were only evaluated (considering calcium plaques those whose density was over 80 Hounsfield units). RESULTS: It was showed the presence of IA in 65% of the examined patients, being the male gender the mostly affected in a 1.16:1, non significant relation. The most affected vessels in frequency order were carotid siphon and vertebral artery in their V4 segment. CONCLUSION: The atheromatosis is one of the frequent causes of cerebral stroke. The MSCT is the selected method to determine the location and frequency of the intracranial calcification in a noninvasive way. In the same way as the calcium score, determining the level of calcium in the arteries allows to determine the risk that the patient has of developing vascular complications, in this case in the cerebral territory.

Assuntos

RESUMO

Si bien la ateromatosis intracraneal (AIC) es una entidad frecuente, está subvalorada en la práctica clínica. Los avances tecnológicos en los diferentes métodos radiológicos y especialmente el advenimiento de la tomografía computada multicorte (TCMC) han mejorado la precisión diagnóstica de esta patología. Objetivos: Demostrar la utilidad de la TCMC en el diagnóstico de la AIC y determinar la frecuencia y localización de las placas ateromatosas, así como su distribución etaria y genérica. Materiales y métodos: Se estudió retrospectivamente a 280 pacientes (140 mujeres y 140 hombres) entre octubre de 2011 y marzo de 2012. Todos eran mayores de 40 años y contaron con una TCMC de cerebro sin contraste, realizada con un tomógrafo Toshiba Aquilion de 16 filas de detectores. Se evaluaron solamente placas cálcicas (considerándose así a aquellas cuya densidad superaba las 80 unidades Hounsfield). Resultados: Se encontró AIC en un 65% de los pacientes examinados, con una incidencia no significativa en el sexo masculino (relación: 1,16/1). Los vasos más comprometidos, en orden de frecuencia, fueron el sifón carotídeo y la arteria vertebral en su segmento V4. Conclusión: La ateromatosis es una de las causas frecuentes de ictus cerebral. La TCMC es el método de elección para determinar la localización y frecuencia de las calcificaciones intracraneales de manera no invasiva. Al igual que el score de calcio, la determinación del calcio a nivel de las arterias permitiría establecer el riesgo que tiene el paciente de desarrollar complicaciones vasculares, en este caso en el territorio cerebral.(AU)

Even though intracranial atheromatosis (IA) is a frequent entity, it is undervalued in clinical practice. The technological advances in different radiological methods and especially multislice computed tomography (MSCT) have improved the diagnostic accuracy of this pathology. Objectives: To prove the multislice computed tomography usefulness in intracranial atheromatosis diagnostic, and establish the frequency and location of atheromatous plaques, and also the age and gender distribution. Materials and methods: Two hundred and eighty patients (140 male and 140 female) were studied retrospectively, between October 2011 and March 2012. All of them were more than 40 years old and counted with a brain MSCT without contrast, made it with a Toshiba Aquilion 16 multidetector computer tomograph. Calcium plaques were only evaluated (considering calcium plaques those whose density was over 80 Hounsfield units). Results: It was showed the presence of IA in 65% of the examined patients, being the male gender the mostly affected in a 1.16:1, non significant relation. The most affected vessels in frequency order were carotid siphon and vertebral artery in their V4 segment. Conclusion: The atheromatosis is one of the frequent causes of cerebral stroke. The MSCT is the selected method to determine the location and frequency of the intracranial calcification in a noninvasive way. In the same way as the calcium score, determining the level of calcium in the arteries allows to determine the risk that the patient has of developing vascular complications, in this case in the cerebral territory.(AU)

RESUMO

Objetivos: Determinar la relación entre la formación de placas ateromatosas arteriales con factores de riesgo cardiovascular (FRCV). Material y métodos: Estudio descriptivo, transversal y correlacional en el que se determinó la relación entre obesidad y diabetes mellitus (DM), hipertensión arterial (HTA) y/o dislipoproteinemia basal y postprandial y la formación de placas ateromatosas en 42 pacientes, 17 varones y 25 mujeres, de 30 a 71 años (promedio 53.2 +- 9.30 años). Se efectuo medidas antropométricas, exámenes clínicos, determinaciones en sangre de colesterol total (CT), triglicéridos (Tg), colesterol HDL (HDL), glucosa (G), ácidos grasos no esterificados (AGNE), insulina (I) en ayunas y durante 6 horas después de administrar una comida mixta y una ultrasonografía bimodal de las arterias carótidas. Resultados: En los 42 pacientes se encontró placas ateromatosas que disminuyen la luz de las carótidas en un rango promedio de 11.1% a 58.2%. Hubo correlación significativa entre el grado de obstrucción con la edad, la circunferencia abdominal, presión arterial diastólica y la glicemia. Conclusiones. Se demuestra la existencia de una relación significativa entre la formación de ateromas con disminución de la luz de las carótidas con la edad de los pacientes, la obesidad central, presión arterial diastólica y la glicemia.

Objectives: To determine the possible relationship between the formation of arterial atheromatous plaques and cardiovascular risk factors (CVRF). Methods: A descriptive, transversal, correlative study to find uot the relationship between obesity, diabetes mellitus (DM), high blood pressure (HBP) and/or dislipoproteinemia and arterial atheromatous plaques formation was conducted. A total of 42 patients, 17 male and 25 female, 30 to 71 years old, mean 53.2 +- 9.30, were included. Antrophometric meassures, clinical examinations, blood determinations of total cholesterol (TC), HDL, triglycerides (Tg), glucose (G), insulin (I) and non-sterified fatty acids (NEFA) were performed both at fasting as well as during 6 hours after a standarized mixed meal, a bimodal ultrasound examination of carotid arteries was done. Results: In all 42 patients atheromatous plaques stenosing the carotid arteries in a mean range of 11.1% to 58.2 were found. A significantly coorrelation between the mean arterial obstruction degree and the patient's age, abdominal circunference, diastolic blood pressure and blood glucose was found. Conclusions: There is a significantly relationship between the atheromatous plaques formation in carotid arteries with the patient's age, abdominalcircunference, diastolic blood pressure and blood glucose.

Assuntos

RESUMO

Introducción: el estilo de vida es la manera personal de vivir. Las decisiones que se tomen al trabajar, alimentarse, afrontar las situaciones difíciles, realizar ejercicios físicos, entre otras, lo van a conformar y afectarán de forma positiva o negativa el estado de salud del individuo. Objetivo: identificar la presencia de ateromatosis de la aorta abdominal en dos grupos de pacientes con estilos de vida diferentes. Métodos: se realizó una investigación de tipo comparativa entre dos grupos de pacientes con estilos de vida diferentes, uno saludable 115 pacientes y otro grupo con estilo de vida no saludable 254 pacientes, lo cual fue determinado mediante una encuesta. A todos los pacientes involucrados en el estudio se les realizó ultrasonido abdominal para dar salida a los objetivos del mismo junto a los resultados de la encuesta. Resultados: hubo un predominio del sexo femenino en las edades de 40 a 61 años en ambos grupos. Los pacientes que exhibían un estilo de vida no saludable, con una dieta predominantemente omnívora y con una actividad física sedentaria presentaron ateromatosis de la aorta abdominal en un 99 por ciento. En el grupo de estudio que tenía un estilo de vida saludable, solo se encontraron placas de ateroma en dos pacientes, lo que equivale a un 1,7 por ciento. Las principales enfermedades crónicas asociadas fueron la diabetes mellitus y la hipertensión arterial, y los factores de riesgo como el hábito de fumar, las hiperlipidemias, así como la esteatosis hepática y pancreática, predominaron en el grupo con un estilo de vida no saludable. Conclusión: los hábitos que determinan un estilo de vida no saludable van a determinar que se desarrollen factores de riesgo y enfermedades en el individuo...

Introduction: lifestyle is the individual way of life. The decisions that an individual makes on working, feeding, facing difficult situations, exercising, and others, will shape his health status and will affect it positively or negatively. Objective: to identify the presence of atheromatosis of the abdominal aorta in two groups of patients with different lifestyles. Methods: a comparative-type research study was conducted in two groups of patients with different lifestyles, one healthy 115 patients and the other unhealthy 254 patients. The lifestyle was identified through a survey. All the involved patients were performed an abdominal ultrasound to meet the objectives of the study along with the results of the survey. Results: females aged 40 to 61 years were predominant in both groups. The patients with unhealthy, predominantly omnivorous diet and sedentary lifestyles developed atheromatosis in the abdominal aorta in 99 percent of cases. In the study group with healthy lifestyle, atheroma plaques were found in two patients accounting for 1.7 percent. The main associated chronic diseases were diabetes mellitus, and blood hypertension. Risk factors such as smoking, hyperlipidemias, hepatic and pancreatic steatosis prevailed in the study group with unhealthy lifestyle. Conclusions: unhealthy lifestyle habits will determine the development of risk factors and diseases in an individual...

Assuntos

RESUMO

Objectives: to demonstrate the correlation between the presence or absence of established coronary disease (as measured by the Agatston index) and hepatic steatosis visualized in liver segments when calculating calcium score. Material and Methods: retrospective study that included 229 patients with risk factors for coronary disease who underwent multislice computed tomography of coronary arteries or calcium score. We evaluated the presence of atherosclerotic disease in coronary arteries and thoracic aorta and liver attenuation in visualized liver segments. Statistical analysis included linear regression models, association studies of multiple variables and CARTmodel. Results: 229 patients, 78 percent male, average age 56 years. It values statistically significant association was found between higher levels of calcium score and lower hepatic attenuation in older patients and males. We were to define two types of patients with high calcium score, a group with hypertension - hepatic steatosis and another groups with hypertension and type 2 diabetes; patients that were only obese did not have higher levels of calcium score. Conclusions: a relationship exists between calcified atheromatosis disease and hepatics steatosis. Patients with hepatics steatosis as part of a metabolic syndrome are at increased risk of atherosclerosis. It may be useful to incorporate the assessment of hepatics steatosis in cardiovascular risk stratification.

Objetivos: demostrar la correlación que existe entre presencia o no de enfermedad coronaria establecida (medida a través del índice de Agatston) y esteatosis hepática en los segmentos visualizados del hígado al momento de realizar el score de calcio. Material y Métodos: estudio retrospectivo que incluyó 229 pacientes con factores de riesgo para enfermedad coronaria a los que se les realizó tomografía computada multicorte de arterias coronarias o score de calcio. Se evaluó la presencia de enfermedad ateromatosa en arterias coronarias y aorta torácica y atenuación hepática en los segmentos visualizados del hígado. El análisis estadístico incluyó modelos de regresión lineal, estudio por asociación de múltiples variables y modelo CART. Resultados: 229 pacientes, 78 por ciento de sexo masculino y 22 por ciento femenino, con edad promedio 56 años. Se demostró asociación estadísticamente significativa entre mayor nivel de score de calcio y menor atenuación hepática, en pacientes de mayor edad y sexo masculino. Se logró definir dos tipos de pacientes con score de calcio elevado, un grupo con hipertensión arterial - esteatosis hepática y otro grupo con hipertensión arterial y diabetes tipo 2; los pacientes solamente obesos no tenían mayores niveles de score de calcio. Conclusiones: existe asociación entre ateromatosis calcificada y esteatosis hepática. Los pacientes con esteatosis hepática como parte de un síndrome metabólico, tienen mayor riesgo de ateroesclerosis. Puede ser útil incorporar la evaluación de esteatosis hepática en la estratificación de riesgo cardiovascular.

Assuntos