RESUMO
Ultrasound-measured inferior vena cava (IVC) and abdominal aorta (Ao)-associated parameters have been used to predict volume status for decades, yet research focusing on the impact of individual physical characteristics, including gender, height/weight, body surface area (BSA), and age, assessed simultaneously on those parameters in Chinese children is lacking. The aim of the present study was to explore the impact of individual characteristics on maximum IVC diameter (IVCmax), Ao, and IVCmax/Ao in healthy Chinese children. From September to December 2015, 200 healthy children from 1 to 13 years of age were enrolled. IVCmax and Ao diameters were measured by 2D ultrasound. We found that age (years), height (cm), weight (kg), waist circumference (cm), and BSA (m2) were positively correlated with IVCmax and Ao. Multivariate linear regression showed that age was the only independent variable for IVCmax (mm) in female children, height was the only independent variable for IVCmax in male children, and age was the only independent variable for Ao in both females and males. IVCmax/Ao was not significantly influenced by the subjects' characteristics. In conclusion, IVCmax and Ao were more susceptible to subjects' characteristics than IVCmax/Ao. IVCmax/Ao could be a reliable and practical parameter in Chinese children as it was independent of age, height, and weight.
Assuntos
Aorta Abdominal/diagnóstico por imagem , Ultrassonografia/métodos , Veia Cava Inferior/diagnóstico por imagem , Adolescente , Aorta Abdominal/fisiologia , Povo Asiático , Composição Corporal/fisiologia , Criança , Pré-Escolar , China , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Veia Cava Inferior/fisiologiaRESUMO
Ultrasound-measured inferior vena cava (IVC) and abdominal aorta (Ao)-associated parameters have been used to predict volume status for decades, yet research focusing on the impact of individual physical characteristics, including gender, height/weight, body surface area (BSA), and age, assessed simultaneously on those parameters in Chinese children is lacking. The aim of the present study was to explore the impact of individual characteristics on maximum IVC diameter (IVCmax), Ao, and IVCmax/Ao in healthy Chinese children. From September to December 2015, 200 healthy children from 1 to 13 years of age were enrolled. IVCmax and Ao diameters were measured by 2D ultrasound. We found that age (years), height (cm), weight (kg), waist circumference (cm), and BSA (m2) were positively correlated with IVCmax and Ao. Multivariate linear regression showed that age was the only independent variable for IVCmax (mm) in female children, height was the only independent variable for IVCmax in male children, and age was the only independent variable for Ao in both females and males. IVCmax/Ao was not significantly influenced by the subjects' characteristics. In conclusion, IVCmax and Ao were more susceptible to subjects' characteristics than IVCmax/Ao. IVCmax/Ao could be a reliable and practical parameter in Chinese children as it was independent of age, height, and weight.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Aorta Abdominal/diagnóstico por imagem , Veia Cava Inferior/diagnóstico por imagem , Ultrassonografia/métodos , Aorta Abdominal/fisiologia , Veia Cava Inferior/fisiologia , Composição Corporal/fisiologia , China , Estudos Transversais , Povo AsiáticoRESUMO
The biguanide metformin (MET) has been used during pregnancy for treatment of polycystic ovary syndrome and gestational diabetes. MET crosses the placenta and maternal treatment can expose the progeny to this drug during important phases of body development. Direct vascular protective effects have been described with the treatment of metformin. Nevertheless, it is unclear whether intrauterine exposure to metformin is safe for the vascular system of offspring. Thus, the present study aimed to investigate the intrinsic effects of metformin exposure in utero in the offspring abdominal aorta reactivity, in the presence and absence of perivascular adipose tissue (PVAT) and endothelium. For this, Wistar rats were treated with metformin 293â¯mg/kg/day (MET) or water (CTR) by gavage during the gestational period. The abdominal aorta reactivity to phenylephrine, acetylcholine, and sodium nitroprusside was evaluated in male adult offspring. It was observed that abdominal aorta relaxation was similar between MET and CTR groups in the presence or absence of PVAT. In addition, the contraction to phenylephrine was similar between MET and CTR groups in the presence and absence of PVAT and endothelium. Therefore, metformin exposure during pregnancy had no intrinsic effect on the offspring abdominal aorta PVAT and endothelial function, demonstrating it to be safe to the vascular system of the offspring.
Assuntos
Aorta Abdominal/fisiologia , Exposição Materna , Metformina/farmacologia , Tecido Adiposo/efeitos dos fármacos , Tecido Adiposo/fisiologia , Animais , Aorta Abdominal/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Relação Dose-Resposta a Droga , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/fisiologia , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/fisiologia , Feminino , Masculino , Nitroprussiato/farmacologia , Gravidez , Prenhez , Efeitos Tardios da Exposição Pré-Natal , Ratos , Ratos Wistar , Vasoconstrição/efeitos dos fármacos , Vasodilatação/efeitos dos fármacosRESUMO
Abstract Background Knowledge of testicular artery variations is vital to ensure that they are not neglected during a variety of different operative techniques, since damage can cause testicular atrophy. Objectives The present study was therefore intended to identify variants in the origin and course of the testicular arteries. An attempt was made to classify the arteries based on their various origins. Methods This study examined 42 formalin-fixed cadavers of 40 to 70-year-old adult males. Variant origins of the testicular artery were identified and classified. Variations in the origin and course of the artery were colored, photographed, and documented. The distances between the origins of the testicular arteries and the mid-points of the origins of the renal arteries were measured. Results Testicular arteries were classified into four categories on the basis of origin. This variability was defined in relation to the renal and inferior mesenteric arteries. The mean distance between the origin of the testicular artery and the mid-point of the origin of the renal artery were 3.08 and 3.47 cm, on the right and left sides respectively. Variations were almost exclusively found on the left side. The variations observed included multiple arterial twigs forming the testicular artery, suprarenal arteries arising from the testicular artery, and testicular artery duplication. Conclusion This study provides an insight into variations in the testicular artery and proposes a classification which could help surgeons during a variety of procedures on the male abdomen and pelvis.
Resumo Contexto O conhecimento de variações da artéria testicular é vital para assegurar que essas artérias não serão negligenciadas durante a realização de diferentes técnicas operatórias, já que qualquer dano poderia causar atrofia testicular. Objetivos Este estudo teve como objetivo identificar variações na origem e no trajeto das artérias testiculares. Foi feita uma tentativa de classificar as artérias com base em suas diferentes origens. Métodos Este estudo examinou 42 cadáveres de adultos do sexo masculino com idade entre 40 e 70 anos preservados em formol. As diferentes origens da artéria testicular foram identificadas e classificadas. Variações na origem e no trajeto da artérias foram coloridas, fotografadas e documentadas. Foram medidas as distâncias entre a origem das artérias testiculares e o ponto médio da origem das artérias renais. Resultados As artérias testiculares foram classificadas em quatro categorias com base em sua origem. Essa variabilidade foi definida com relação às artérias renal e mesentérica inferior. A distância média entre a origem da artéria testicular e o ponto médio da origem da artéria renal foi de 3,08 e 3,47 cm nos lados direito e esquerdo, respectivamente. As variações foram encontradas quase exclusivamente no lado esquerdo. As variações observadas incluíram múltiplos ramúsculos formando a artéria testicular, artérias suprarrenais surgindo a partir da artéria testicular, e duplicação da artéria testicular. Conclusão Este estudo traz informações sobre variações da artéria testicular e propõe uma classificação que poderia ajudar os cirurgiões durante diferentes procedimentos realizados no abdome e na pelve de pacientes do sexo masculino.
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Aorta Abdominal/anatomia & histologia , Aorta Abdominal/fisiologia , Artéria Renal/anatomia & histologia , Dissecação/classificação , Artéria Renal/diagnóstico por imagemRESUMO
OBJECTIVE: To describe and to characterize the relaxing effect of an extract of the bark of Combretum leprosum on isolated arterial rings from different animals. METHODS: Rings (3 to 4mm) from rabbit, rat, or porcine arteries rings were suspended in an organ bath (Krebs, 37°C, 95%O2/5%CO2) to record isometric contractions. After the stabilization period (2 to 3 hours) contractions were induced by the addition of phenylephrine (0.1 to 0.3µM) or U46619 (10 to 100nM), and Combretum leprosum extract was added on the plateau of the contractions. Experiments were performed to determine the potency, duration, reversibility, and to get insights on the potential mechanism involved in extract-induced relaxations. RESULTS: In all rings tested, Combretumleprosum extract (1.5µg/mL) was able to cause relaxations, which were strictly endothelium-dependent. In rabbit or rat thoracic aorta rings, the relaxations were reversed by vitamin B12a or L-NG-nitroarginine. In porcine right coronary arteries and rabbit abdominal aorta, extract caused both L-NG-nitroarginine-sensitive and L-NG-nitroarginine-resistant relaxations. In rabbit thoracic aorta, the extract was relatively potent (EC50=0.20µg/mL) and caused relaxations; intriguingly the endothelium continued to produce relaxing factors for a long period after removing the extract. The magnitude of extract-induced relaxations was significantly reduced in the absence of extracellular Ca2+; in addition, the TRPs channels blocker ruthenium red (10µM) was able to revert extract-induced relaxations. Phytochemical analyses indicated that the extract was rich in polyphenol-like reacting substances. CONCLUSIONS: Combretum leprosum extract contains bioactive compounds capable of promoting Ca2+-dependent stimulation of endothelial cells which results in a prolonged production of relaxing factors.
Assuntos
Combretum/química , Fatores Relaxantes Dependentes do Endotélio/farmacologia , Relaxamento Muscular/efeitos dos fármacos , Óxido Nítrico/farmacologia , Acetilcolina/farmacologia , Animais , Aorta Abdominal/efeitos dos fármacos , Aorta Abdominal/fisiologia , Aorta Torácica/efeitos dos fármacos , Aorta Torácica/fisiologia , Artéria Carótida Primitiva/efeitos dos fármacos , Artéria Carótida Primitiva/fisiologia , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/fisiologia , Feminino , Cobaias , Masculino , Artéria Mesentérica Superior/efeitos dos fármacos , Artéria Mesentérica Superior/fisiologia , Camundongos , Relaxamento Muscular/fisiologia , Casca de Planta/química , Coelhos , Ratos Wistar , Suínos , Fatores de TempoRESUMO
Objective To describe and to characterize the relaxing effect of an extract of the bark of Combretum leprosum on isolated arterial rings from different animals.Methods Rings (3 to 4mm) from rabbit, rat, or porcine arteries rings were suspended in an organ bath (Krebs, 37°C, 95%O2/5%CO2) to record isometric contractions. After the stabilization period (2 to 3 hours) contractions were induced by the addition of phenylephrine (0.1 to 0.3µM) or U46619 (10 to 100nM), and Combretum leprosum extract was added on the plateau of the contractions. Experiments were performed to determine the potency, duration, reversibility, and to get insights on the potential mechanism involved in extract-induced relaxations.Results In all rings tested, Combretumleprosum extract (1.5μg/mL) was able to cause relaxations, which were strictly endothelium-dependent. In rabbit or rat thoracic aorta rings, the relaxations were reversed by vitamin B12a or L-NG-nitroarginine. In porcine right coronary arteries and rabbit abdominal aorta, extract caused both L-NG-nitroarginine-sensitive and L-NG-nitroarginine-resistant relaxations. In rabbit thoracic aorta, the extract was relatively potent (EC50=0.20µg/mL) and caused relaxations; intriguingly the endothelium continued to produce relaxing factors for a long period after removing the extract. The magnitude of extract-induced relaxations was significantly reduced in the absence of extracellular Ca2+; in addition, the TRPs channels blocker ruthenium red (10µM) was able to revert extract-induced relaxations. Phytochemical analyses indicated that the extract was rich in polyphenol-like reacting substances.ConclusionsCombretum leprosum extract contains bioactive compounds capable of promoting Ca2+-dependent stimulation of endothelial cells which results in a prolonged production of relaxing factors.
Objetivo Descrever e caracterizar os relaxamentos induzidos por um extrato das cascas de Combretum leprosum em anéis de artérias de diferentes espécies de animais.Métodos Anéis (3 a 4mm) de artérias de coelho, rato e porco foram montados em cubas para órgão isolado (Krebs, 37°C, 95%O2/5%CO2) para registro das contrações isométricas. Após um período de estabilização (2 a 3 horas), as contrações foram induzidas com fenilefrina (0,1 a 0,3µM) ou U46619 (10 a 100nM); no platô dessas contrações, adicionamos o extrato Combretum leprosum. Diferentes protocolos foram realizados para determinar potência, duração, reversibilidade e mecanismo dos relaxamentos induzidos pelo extrato.Resultados Em todas as preparações testadas, o extrato de Combretum leprosum (1,5µg/mL) provocou relaxamentos dependentes de endotélio. Em aorta torácica de coelho ou rato, os relaxamentos foram revertidos pela vitamina B12a ou L-NG-nitro-arginina. Em anéis de aorta abdominal de coelho e de artérias coronárias de porco, o extrato causou relaxamentos sensíveis e resistentes à L-NG-nitro-arginina. Em aorta torácica de coelho, o extrato foi relativamente muito potente (EC50=0,20μg/mL) e quando causou relaxamentos; intrigantemente o endotélio continuou a produzir fatores relaxantes por um longo período após remoção do extrato. A magnitude dos relaxamentos induzidos pelo extrato foi significativamente reduzida em ausência Ca2+ extracelular; ademais, o vermelho de rutênio (10μM), um bloqueador de canais TRPs, foi capaz de reverter os relaxamentos induzidos pelo extrato. Análises preliminares indicaram que o extrato continha compostos com reatividade química semelhante à polifenóis.Conclusão O extrato de Combretum leprosum contem compostos bioativos capazes de promover estimulação dependente de Ca2+ das células endoteliais a qual resulta numa produção prolongada de fatores relaxantes.
Assuntos
Animais , Feminino , Cobaias , Masculino , Camundongos , Coelhos , Combretum/química , Fatores Relaxantes Dependentes do Endotélio/farmacologia , Relaxamento Muscular/efeitos dos fármacos , Óxido Nítrico/farmacologia , Acetilcolina/farmacologia , Aorta Abdominal/efeitos dos fármacos , Aorta Abdominal/fisiologia , Aorta Torácica/efeitos dos fármacos , Aorta Torácica/fisiologia , Artéria Carótida Primitiva/efeitos dos fármacos , Artéria Carótida Primitiva/fisiologia , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/fisiologia , Artéria Mesentérica Superior/efeitos dos fármacos , Artéria Mesentérica Superior/fisiologia , Relaxamento Muscular/fisiologia , Casca de Planta/química , Ratos Wistar , Suínos , Fatores de TempoRESUMO
Many authors have found that diastolic retrograde arterial flow is associated with increased stiffness of the arterial wall. Most of the studies were based in femoral or brachial artery examination. As the abdominal aorta is a large vessel routinely explored in abdominal ultrasound scans, we decided to study whether it could be useful for early identification of abnormalities of the arterial wall. Sixteen young and 16 old, healthy patients matched for sex, weight and height were studied using pulsed Doppler at the level of the abdominal aortic bifurcation. Different hemodynamic factors were measured and compared to establish the systolic and diastolic function of this artery. Triphasic wave pattern was present in 14 of 16 patients in the younger group and only in 4 of 16 in the older group. In addition, diastolic retrograde arterial flow duration and retrograde components of diastolic phase were more prominent in the advanced age group. Increased retrograde flow and incapacity to impulse arterial flow forward during diastolic time are early markers of vascular wall deterioration that can be observed easily in the abdominal aorta during routine abdominal ultrasound scans.
Assuntos
Envelhecimento/fisiologia , Aorta Abdominal/diagnóstico por imagem , Aorta Abdominal/fisiologia , Ecocardiografia Doppler/métodos , Interpretação de Imagem Assistida por Computador/métodos , Modelos Cardiovasculares , Rigidez Vascular/fisiologia , Adulto , Idoso , Velocidade do Fluxo Sanguíneo/fisiologia , Simulação por Computador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Renal diseases are common in older cats. Decreased renal blood flow may be the first sign of dysfunction and can be evaluated by Doppler ultrasound. But previous studies suggest that the resistive index (RI) has a low sensitivity for detecting renal disease. Doppler waveforms of renal and intrarenal arteries demonstrate decreased blood flow before there are any changes in the RI. The purpose of this study was to evaluate the normal Doppler flowmetrics parameters of renal arteries (RAs), interlobar arteries (IAs) and abdominal aorta (AO) in adult healthy, Persian cats. Twenty-five Persian cats (13 females and 12 males with mean age of 30 months and an age range 12-60 months) with normal clinical examinations and biochemical tests and normal systemic blood pressure were given B-mode ultrasonographies in order to exclude all nephropathies, including polycystic kidney disease. All measurements were performed on both kidneys. Both kidneys (n=50) were examined by color mapping of the renal vasculature. Pulsed Doppler was used to examine both RAs, the IAs at cranial, middle and caudal sites, and the AO. The RI was calculated for all of the vessels. Early systolic acceleration (ESA) of RA and IA was obtained with Doppler spectral analysis. Furthermore, the ratio indices between RA/AO, and IA/RA velocities were calculated. The mean values of peak systolic velocity (PSV) and the diameter for AO were 53.17±13.46 cm/s and 0.38±0.08 cm, respectively. The mean RA diameter for all 50 kidneys was 0.15±0.02 cm. Considering the velocimetric values in both RAs, the mean PSV and RI that were obtained were 41.17±9.40 cm/s and 0.54±0.07. The RA had a mean ESA of 1.12±1.14 m/s(2) and the calculated upper limit of the reference value was 3.40 m/s(2). The mean renal-aortic ratio was 0.828±0.296. The IA showed PSV and RI values of 32.16±9.33 cm/s and 0.52±0.06, respectively. The mean ESA of all IAs was 0.73±0.61 m/s(2). The calculated upper limit of the reference value was 2.0m/s(2). The mean renal-interlobar artery ratio was 1.45±0.57. The RI values obtained in this study were similar to values reported in the literature. Some conditions that lead to a decrease in compliance and to an increase in vascular resistance can affect the Doppler spectral waveforms without changes in RI. To our knowledge, there are no studies that were directed toward to the normal ESA values of the renal vasculature in Persian cats. This study introduced a new ratio between the PSV of the RA and the IA. This index was developed based on the well-known effects of Doppler on the detection of stenosis, regardless of the cause. Further studies are necessary to verify the hemodynamic behavior of this index under pathological conditions in cats as well as the effect of aging, nephropathies and systemic pressure on Doppler velocimetric parameters.
Assuntos
Aorta Abdominal/fisiologia , Rim/irrigação sanguínea , Artéria Renal/fisiologia , Circulação Renal/fisiologia , Ultrassonografia Doppler em Cores/veterinária , Animais , Aorta Abdominal/diagnóstico por imagem , Velocidade do Fluxo Sanguíneo , Gatos , Feminino , Rim/diagnóstico por imagem , Masculino , Valores de Referência , Artéria Renal/diagnóstico por imagem , Resistência VascularRESUMO
BACKGROUND: The pathogenesis of abdominal aortic aneurysm is associated with changes of several components of arterial wall. Vascular glycosaminoglycans contribute to the non-thrombogenic activity of blood vessels. We investigated whether modifications of glycosaminoglycans in human abdominal aortic aneurysm affect their anticoagulant properties. METHODS: Glycosaminoglycans were extracted from abdominal aortic aneurysms (n=11) derived from reconstitution surgeries, human abdominal aortas (n=9) from normal organ transplant donors and from preserved (n=10) and atherosclerotic (n=17) segments obtained from autopsy of an old patient. Glycosaminoglycan composition, concentration and anticoagulant activity were determined. RESULTS: Glycosaminoglycans extracted from aneurysms have a more potent anticoagulant activity than those from normal arteries of young adults, mostly due to a relative enrichment of dermatan sulfate, which potentiates heparin cofactor II inhibition of thrombin. Arterial segments of aged patient with severe atherosclerosis showed a glycosaminoglycan composition similar to aneurysms samples. Glycosaminoglycans extracted from these regions showed also a more potent heparin cofactor II-dependent anticoagulant activity than lesion-free areas due to the relative enrichment of dermatan sulfate. CONCLUSION: The anticoagulant activity from abdominal aortic aneurysms is preserved. No modifications particular to the aneurysms were dissociated from those observed in atherosclerosis.
Assuntos
Aneurisma da Aorta Abdominal/metabolismo , Aterosclerose/metabolismo , Coagulação Sanguínea , Dermatan Sulfato/metabolismo , Heparitina Sulfato/metabolismo , Adolescente , Adulto , Idoso , Envelhecimento/metabolismo , Aorta Abdominal/metabolismo , Aorta Abdominal/fisiologia , Aorta Abdominal/fisiopatologia , Aneurisma da Aorta Abdominal/fisiopatologia , Aterosclerose/patologia , Aterosclerose/fisiopatologia , Humanos , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: Several studies have shown that the distribution of cardiac output to the intra-abdominal organs may vary during low-flow states. In this study, we developed an experimental model to selectively reduce the abdominal aortic blood flow in order to assess the initial impact of selective hepatosplanchnic hypoperfusion on regional blood flow redistribution. METHODS: Eight anesthetized and mechanically ventilated mongrel dogs were subjected to aortic blood flow reduction with an occluder in a stepwise manner by 50% and 100% for 45 min. After the ischemic period, the occluder was released, and animals were observed for an additional 45 min. Systemic hemodynamics were evaluated through a Swan-Ganz and arterial catheters, and gastrointestinal tract perfusion was evaluated by portal vein and hepatic arterial blood flows measurements (ultrasonic flowprobe). Intestinal O2-derived variables, intestinal mucosal (tonometric)-arterial and tonometric-(end-tidal-carbon-dioxide) gradients (Dt-apCO2 and Dt-EtpCO2) were also calculated. RESULTS: No significant changes in systemic and regional oxygen consumption were observed during the 50% reduction of aortic blood flow. On the other hand, both microregional pCO2 gradients (Dt-apCO2 e Dt-EtpCO2) showed a significant increase during this period. Aortic occlusion was associated with a marked reduction of systemic and regional oxygen delivery and consumption. During the reperfusion, no significant improvement in the tonometry-based pCO2 gradients was observed, in spite of the partial reestablishment of blood flow to the hepatosplanchnic territory. CONCLUSION: During selective intra-abdominal low-flow, a proportional reduction in the splanchnic and hepatic blood flows occurs. A selective reduction of approximately 50% in splanchnic oxygen delivery was not associated with significant changes in macroregional markers of hypoperfusion. In this situation, tonometry-based pCO2 gradients can be used for the assessment of hepatosplanchnic perfusion and histologic changes.
Assuntos
Aorta Abdominal/fisiologia , Hemodinâmica/fisiologia , Consumo de Oxigênio/fisiologia , Choque/metabolismo , Choque/fisiopatologia , Animais , Pressão Sanguínea/fisiologia , Soluções Tampão , Débito Cardíaco/fisiologia , Cães , Fígado/irrigação sanguínea , Fígado/metabolismo , Fígado/patologia , Circulação Hepática/fisiologia , Masculino , Manometria , Traumatismo por Reperfusão/metabolismo , Traumatismo por Reperfusão/patologia , Traumatismo por Reperfusão/fisiopatologia , Choque/patologia , Baço/irrigação sanguínea , Baço/metabolismo , Baço/patologiaRESUMO
INTRODUCTION: Orthotopic liver transplantation (OLT) is today the gold standard treatment of the end-stage liver disease. Different solutions are used for graft preservation. Our objective was to compare the results of cadaveric donor OLT, preserved with the University of Wisconsin (UW) or Celsior solutions in the portal vein and Euro-Collins in the aorta. METHODS: We evaluated retrospectively 72 OLT recipients, including 36 with UW solution (group UW) and 36 with Celsior (group CS). Donors were perfused in situ with 1000 mL UW or Celsior in the portal vein of and 3000 mL of Euro-Collins in the aortia and on the back table managed with 500 mL UW or Celsior in the portal vein, 250 mL in the hepatic artery, and 250 mL in the biliary duct. We evaluated the following variables: donor characteristics, recipient features, intraoperative details, reperfusion injury, and steatosis via a biopsy after reperfusion. We noted grafts with primary nonfunction (PNF), initial poor function (IPF), rejection episodes, biliary duct complications, hepatic artery complications, re-OLT, and recipient death in the first year after OLT. RESULTS: The average age was 33.6 years in the UW group versus 41 years in the CS group (P = .048). There was a longer duration of surgery in the UW group (P = .001). The other recipient characteristics, ischemia-reperfusion injury, steatosis, PNF, IPF, rejection, re-OLT, and recipient survival were not different. Stenosis of the biliary duct occured in 3 (8.3%) cases in the UW group and 8 (22.2%) in the CS (P = .19) with hepatic artery thrombosis in 4 (11.1%) CS versus none in the UW group (P = .11). CONCLUSION: Cadaveric donor OLT showed similar results with organs preserved with UW or Celsior in the portal vein and Euro-Collins in the aorta.
Assuntos
Aorta Abdominal/fisiologia , Soluções Hipertônicas/uso terapêutico , Falência Hepática/cirurgia , Transplante de Fígado/métodos , Soluções para Preservação de Órgãos/uso terapêutico , Veia Porta/fisiologia , Adenosina/uso terapêutico , Adolescente , Adulto , Idoso , Alopurinol/uso terapêutico , Aorta Abdominal/efeitos dos fármacos , Cadáver , Criança , Pré-Escolar , Dissacarídeos/uso terapêutico , Eletrólitos/uso terapêutico , Feminino , Glutamatos/uso terapêutico , Glutationa/uso terapêutico , Histidina/uso terapêutico , Humanos , Imunossupressores/uso terapêutico , Insulina/uso terapêutico , Transplante de Fígado/imunologia , Masculino , Manitol/uso terapêutico , Pessoa de Meia-Idade , Preservação de Órgãos/métodos , Veia Porta/efeitos dos fármacos , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Rafinose/uso terapêutico , Traumatismo por Reperfusão/epidemiologia , Estudos Retrospectivos , Doadores de TecidosRESUMO
Contexto: A arteriografia com contraste (AC) tem sido o exame tradicional de avaliação de pacientes com suspeita de doença oclusiva aorto-ilíaca (DOAI). Recentemente, métodos menos invasivos, como a eco-Doppler, têm sido usados com a mesma finalidade. Objetivo: Comparar prospectivamente a eco-Doppler com a AC e eventual manometria arterial direta (MAD) na avaliação pré-operatória de pacientes com suspeita de DOAI. Métodos: Foram submetidos a eco-Doppler e a AC 125 pacientes internados para tratamento de doença arterial oclusiva dos membros inferiores, avaliando comparativamente 552 segmentos da aorta infrarrenal e das artérias ilíacas comum e externa. As lesões encontradas foram classificadas em cinco categorias: 1) normal e estenose leve (0 a 19 por cento); 2) estenose moderada (20 a 49 por cento); 3) estenose significativa (50 a 79 por cento); 4) estenose crítica (80 a 99 por cento); e 5) oclusão total. A MAD foi usada em 19 segmentos de 15 pacientes para classificar lesões limítrofes entre duas categorias. Foram calculados índices de validade (sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo e acurácia) para distinguir lesões hemodinamicamente significativas de não-significativas e para distinguir estenoses críticas de oclusões. O padrão-ouro foi AC, complementado pela MAD. Foram também calculados coeficientes de correlação kappa entre arteriografias e eco-Doppler para o conjunto dos segmentos aorto-ilíacos. Resultados: Lesões clinicamente relevantes (estenoses de 50 a 99 por cento e oclusões totais) foram observadas na eco-Doppler em 163 segmentos (29,5 por cento) e na AC em 158 segmentos (28,6 por cento). A eco-Doppler mostrou altos índices de validade para distinguir lesões hemodinamicamente significativas de lesões não-significativas em todos os segmentos (acurácia = 92 por cento; kappa = 0,81) e para diferenciar estenoses críticas de oclusões (acurácia = 86 por cento; kappa = 0,73). Os índices ...
Background: Contrast arteriography (CA) has been the traditional method of evaluation of patients with suspected aortoiliac occlusive disease (AIOD). Recently, less invasive methods, such as Doppler ultrasonography, have been used for the same purpose. Objective: The present study prospectively compares Doppler ultrasonography with CA and direct arterial manometry (DAM) in the preoperative evaluation of patients with suspected AIOD. Methods: A total of 125 patients admitted for treatment of arterial occlusive disease of the lower extremities underwent Doppler ultrasonography and CA, comparatively evaluating 552 aortic, common iliac e external iliac segments. The lesions found were classified into five categories: 1) normal and mild stenosis (0-19 percent); 2) moderate stenosis (20-49 percent); 3) significant stenosis (50-79 percent); 4) critical stenosis (80-99 percent); and 5) total occlusion. DAM was used in 19 segments of 15 patients to classify borderline lesions. Validity indexes (sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy) were calculated to distinguish hemodynamically significant from non-significant stenosis and to discriminate critical stenosis from total occlusions. The gold standard was CA, supplemented by DAM. Correlation coefficients (kappa statistics) between arteriography and Doppler ultrasonography were also calculated for the whole sample of aortoiliac segments. Results: Clinically relevant lesions (stenoses between 50-99 percent and total occlusions) were observed on Doppler ultrasonography in 163 segments (29.5 percent) and on CA in 158 segments (28.6 percent). Doppler ultrasonography showed high validity indexes to distinguish hemodynamically significant from non-significant lesions (overall accuracy = 92 percent; kappa = 0.81) and an overall accuracy of 86 percent (kappa = 0.73) to distinguish critical stenosis from total occlusion. Optimal correlation coefficients ...
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Angiografia/métodos , Aorta Abdominal/fisiologia , Artéria Ilíaca/fisiologia , Aterosclerose/complicações , Aterosclerose/diagnóstico , Ecocardiografia Doppler/métodos , Ecocardiografia DopplerRESUMO
CONTEXTO: A realização de programas de triagem para o aneurisma da aorta abdominal de forma indiscriminada auxiliará uma pequena porcentagem de indivíduos, mas ao considerarmos grupos com fatores de risco relacionados à dilatação da aorta, aumentando a probabilidade da doença, este permitirá um direcionamento adequado dos recursos e um benefício maior à população. Programas direcionados pelas sociedades médicas, permitindo um diagnóstico precoce das doenças vasculares e conseqüentemente um melhor preparo do doente, promoveriam melhores taxas de sobrevida com menor morbidade. OBJETIVO: Avaliar a prevalência da dilatação da aorta abdominal em uma amostra de pacientes idosos com mais de 60 anos de idade, portadores de coronariopatia aterosclerótica diagnosticada por cineangiocoronariografia. MÉTODOS: Para a seleção dessa amostra, levou-se em consideração o fato de que a avaliação pré-operatória de cirurgia vascular não tenhasido a indicação do cateterismo. Procedeu-se então a avaliação, baseada na anamnese, exame físico e Doppler ultra-som da aorta abdominal. A análise estatística iniciou-se com o teste qui-quadrado, com a posterior análise de regressão logística multivariada e regressão logística univariada, considerando significativo um p < 0,05. RESULTADOS: Dos 180 pacientes, 57 (31,7 por cento) dos casos pertencem ao sexo feminino, e 123 (68,3 por cento) ao masculino. A faixa etária variou entre 60 e 80 anos, com idade média de 66,7 anos. Dos 16 indivíduos portadores de dilatação da aorta abdominal (10 aneurismas e 6 ectasias), apenas um era do sexo feminino. O risco para um indivíduo com 1 lesão aterosclerótica coronariana de apresentar dilatação da aorta abdominal foi de 0,4 por cento no grupo avaliado. Da mesma forma, nos portadores de 2 ou 3 lesões, o risco foi de 1,7 por cento, e naqueles com mais de 3 lesões, de 4,5 por cento. Quando associados ao tabagismo, estes valores alteraram-se respectivamente para 6,9, 11,8 e 27,1 por...
BACKGROUND: Indiscriminate screening programs for abdominal aortic aneurysm will help a small percentage of individuals. However, when considering groups with risk factors associated with aortic dilatation, which increases the probability of the disease, such programs will provide an adequate allocation of resources and a greater benefit to the population. Programs guided by medical societies, providing an early diagnosis of vascular diseases and consequently a better preparation of patients, would result in better survival rates with lower morbidity. OBJECTIVE: To evaluate the prevalence of abdominal aortic dilatation in patients aged 60 years or older with atherosclerotic coronary disease diagnosed by coronary angiography. METHODS: The sample selected for this study considered the fact that preoperative assessment of vascular surgery had not been indication for catheterization. Evaluation was then performed, based on anamnesis, physical examination and ultrasound Doppler of the abdominal aorta. Statistical analysis started with chi-square test, with further multivariate logistic regression analysis and univariate logistic regression, with p < 0.05 considered significant. RESULTS: Of 180 patients, 57 (31.7 percent) were female and 123 (68.3 percent) were male. Age varied from 60 to 80 years, with mean of 66.7 years. Among the 16 individuals with abdominal aortic dilatation (10 aneurysms and six dilatations), only one was female. The risk of an individual with one atherosclerotic coronary lesion presenting abdominal aortic dilatation was 0.4 percent. Similarly, in those with two or three lesions the risk was 1.7, and 4.5 percent in those with more than three lesions. When associated with smoking, these values were 6.9, 11.8 and 27.1 percent, respectively. CONCLUSION: The present study leads to the conclusion that prevalence of abdominal aortic dilatation was 8.9 percent (16 out of 180 patients) in this specific sample. It was more prevalent...
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Pessoa de Meia-Idade , Aneurisma Aórtico/complicações , Aneurisma Aórtico/diagnóstico , Aneurisma Aórtico/mortalidade , Aorta Abdominal/fisiologia , Doença das Coronárias/complicações , Doença das Coronárias/diagnóstico , Tabagismo/efeitos adversos , Tabagismo/mortalidadeRESUMO
Previous studies have shown that the vascular reactivity of the mouse aorta differs substantially from that of the rat aorta in response to several agonists such as angiotensin II, endothelin-1 and isoproterenol. However, no information is available about the agonists bradykinin (BK) and DesArg9BK (DBK). Our aim was to determine the potential expression of kinin B1 and B2 receptors in the abdominal mouse aorta isolated from C57BL/6 mice. Contraction and relaxation responses to BK and DBK were investigated using isometric recordings. The kinins were unable to induce relaxation but concentration-contraction response curves were obtained by applying increasing concentrations of the agonists BK and DBK. These effects were blocked by the antagonists Icatibant and R-715, respectively. The potency (pD2) calculated from the curves was 7.0 ± 0.1 for BK and 7.3 ± 0.2 for DBK. The efficacy was 51 ± 2 percent for BK and 30 ± 1 percent for DBK when compared to 1 æM norepinephrine. The concentration-dependent responses of BK and DBK were markedly inhibited by the arachidonic acid inhibitor indomethacin (1 æM), suggesting a mediation by the cyclooxygenase pathway. These contractile responses were not potentiated in the presence of the NOS inhibitor L-NAME (1 mM) or endothelium-denuded aorta, indicating that the NO pathway is not involved. We conclude that the mouse aorta constitutively contains B1 and B2 subtypes of kinin receptors and that stimulation with BK and DBK induces contractile effect mediated by endothelium-independent vasoconstrictor prostanoids.
Assuntos
Animais , Masculino , Camundongos , Aorta Abdominal/efeitos dos fármacos , Bradicinina/agonistas , Bradicinina/análogos & derivados , Músculo Liso Vascular/efeitos dos fármacos , Músculo Liso Vascular/fisiologia , Receptor B1 da Bradicinina/efeitos dos fármacos , /efeitos dos fármacos , Aorta Abdominal/fisiologia , Bradicinina/farmacologia , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/fisiologia , Indometacina/farmacologia , Contração Isométrica/efeitos dos fármacos , Contração Isométrica/fisiologia , Receptor B1 da Bradicinina/fisiologia , /fisiologia , Vasoconstrição/efeitos dos fármacos , Vasoconstrição/fisiologiaRESUMO
Previous studies have shown that the vascular reactivity of the mouse aorta differs substantially from that of the rat aorta in response to several agonists such as angiotensin II, endothelin-1 and isoproterenol. However, no information is available about the agonists bradykinin (BK) and DesArg(9)BK (DBK). Our aim was to determine the potential expression of kinin B(1) and B(2) receptors in the abdominal mouse aorta isolated from C57BL/6 mice. Contraction and relaxation responses to BK and DBK were investigated using isometric recordings. The kinins were unable to induce relaxation but concentration-contraction response curves were obtained by applying increasing concentrations of the agonists BK and DBK. These effects were blocked by the antagonists Icatibant and R-715, respectively. The potency (pD(2)) calculated from the curves was 7.0 +/- 0.1 for BK and 7.3 +/- 0.2 for DBK. The efficacy was 51 +/- 2% for BK and 30 +/- 1% for DBK when compared to 1 microM norepinephrine. The concentration-dependent responses of BK and DBK were markedly inhibited by the arachidonic acid inhibitor indomethacin (1 microM), suggesting a mediation by the cyclooxygenase pathway. These contractile responses were not potentiated in the presence of the NOS inhibitor L-NAME (1 mM) or endothelium-denuded aorta, indicating that the NO pathway is not involved. We conclude that the mouse aorta constitutively contains B(1) and B(2) subtypes of kinin receptors and that stimulation with BK and DBK induces contractile effect mediated by endothelium-independent vasoconstrictor prostanoids.
Assuntos
Aorta Abdominal/efeitos dos fármacos , Bradicinina/análogos & derivados , Bradicinina/agonistas , Músculo Liso Vascular/efeitos dos fármacos , Músculo Liso Vascular/fisiologia , Receptor B1 da Bradicinina/efeitos dos fármacos , Receptor B2 da Bradicinina/efeitos dos fármacos , Animais , Aorta Abdominal/fisiologia , Bradicinina/farmacologia , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/fisiologia , Indometacina/farmacologia , Contração Isométrica/efeitos dos fármacos , Contração Isométrica/fisiologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Receptor B1 da Bradicinina/fisiologia , Receptor B2 da Bradicinina/fisiologia , Vasoconstrição/efeitos dos fármacos , Vasoconstrição/fisiologiaRESUMO
Cardiovascular effects of Labd-8 (17)-en-15-oic acid (Labd-8), a labdenic diterpene isolated from methanolic extract of Moldenhawera nutans were investigated in normotensive rats. Additionally, this study examined the role of autonomic nervous system in the mediation of these cardiovascular effects. In pentobarbital-anesthetized rats, bolus intravenous (i.v.) injection of Labd-8 (1-10 mg/kg) induced dose-dependent hypotensive and tachycardiac responses. After cervical bivagotomy, hypotensive responses to Labd-8 were significantly enhanced whereas the tachycardia was completely abolished. In conscious rats, Labd-8 (1-10 mg/kg, i.v.) also decreased blood pressure and increased heart rate in a dose-dependent manner. Pretreatment with methylatropine (1 mg/kg, i.v.) or propranolol (2 mg/kg, i.v.) significantly reduced the tachycardia evoked by Labd-8 without affecting the hypotension. Blockade of ganglionic neurotransmission with hexamethonium (30 mg/kg, i.v.) reduced and abolished the hypotensive and tachycardic effects of Labd-8, respectively. However, hypotensive effects of Labd-8 were not reduced by pretreatment with N(w)-nitro-L-arginine methyl ester (L-NAME; 20 mg/kg, i.v.), a nitric oxide synthase inhibitor. In rat endothelium-containing aorta preparations, Labd-8 (1-1000 micro g/ml) induced a concentration-dependent reduction of potassium (60 mM)-induced contraction [IC(50) (geometric mean +/-95% confidence interval)=313.6 (191.4-513.8) micro g/ml], an effect that remained unaffected [IC(50)=440.8 (225.1-863.3) micro g/ml] by removal of vascular endothelium. These results show that i.v. treatment with Labd-8-induced dose-dependent hypotensive and tachycardiac effects in both conscious and anesthetized rats. The tachycardia is mediated reflexly through inhibition of vagal and activation of sympathetic drive to the heart. The hypotension is mainly due to withdrawal of sympathetic tone to the vasculature and also partly to an active vascular relaxation. Released nitric oxide from vascular endothelial cells is not involved in the mediation of Labd-8-induced hypotension.
Assuntos
Sistema Cardiovascular/efeitos dos fármacos , Diterpenos/farmacologia , Fabaceae/química , Vasodilatadores/farmacologia , Antagonistas Adrenérgicos beta/farmacologia , Animais , Aorta Abdominal/efeitos dos fármacos , Aorta Abdominal/fisiologia , Aorta Torácica/efeitos dos fármacos , Sistema Nervoso Autônomo/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Brasil , Sistema Cardiovascular/inervação , Diterpenos/isolamento & purificação , Relação Dose-Resposta a Droga , Bloqueadores Ganglionares/farmacologia , Coração/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Técnicas In Vitro , Masculino , Antagonistas Muscarínicos/farmacologia , Extratos Vegetais/farmacologia , Caules de Planta , Ratos , Ratos Wistar , Valores de Referência , Vasodilatação/efeitos dos fármacosRESUMO
Objetivos: Deteminar a prevalência de aneurisma da aorta abdominal na população da cidade de Vitória(ES) e associar com possíveis fatores de risco. Métodos: Estudo de prevalência realizado por amostragem aleatória estratificada por faixa etária e classe socioeconômica. Os exames foram realizados nos postos de saúde dos setores censitários do IBGE sorteados. A amostra foi recrutada pela equipe do Programa de Saúde da Família, após uma campanha de conscientização da importância do diagnóstico da doença. O exame foi ralizado por ecocardiografistas vasculares, utilizando os aparelhos de ultra-som HDI 5000-ATL e o portátil sonosite. Resultados: Foram examinados 834 pessoas no período de dezembro de 2002 a junho de 2003. Dessas, 21 eram portadoras de aneurisma da aorta abdominal (prevalência de 2,5 por cento). Dos casos, 15 (71,4 por cento) eam do sexo masculino, 14 (66,7 por cento) tinham idade entre 65 a 75 anos, 13 (61,9 por cento) eram brancas, 14 (66,7) eram fumantes ou ex-fumantes, 12 (57,1 por cento) tinham hipertensão arterial. Dos aneurismas encontrados, 20 (95,2 por cento) eram infra-renais, do tipo fusiforme e com diâmetro médio de 3,43 mais ou menos 0,57 cm. Quando comparamos os casos com os demais pacientes da amostra, encontramos associação estatisticamente significante com sexo...
Assuntos
Masculino , Feminino , Humanos , Aneurisma/complicações , Aneurisma/diagnóstico , Aorta Abdominal/fisiologia , Fatores de RiscoRESUMO
Blood flow in human arteries is dominated by time-dependent transport phenomena. In particular, in the abdominal segment of the aorta under a patient's average resting conditions, blood exhibits laminar flow patterns that are influenced by secondary flows induced by adjacent branches and in irregular vessel geometries. The flow dynamics becomes more complex when there is a pathological condition that causes changes in the normal structural composition of the vessel wall, for example, in the presence of an aneurysm. An aneurysm is an irreversible dilation of a blood vessel accompanied by weakening of the vessel wall. This work examines the importance of hemodynamics in the characterization of pulsatile blood flow patterns in individual Abdominal Aortic Aneurysm (AAA) models. These patient-specific computational models have been developed for the numerical simulation of the momentum transport equations utilizing the Finite Element Method (FEM) for the spatial and temporal discretization. We characterize pulsatile flow dynamics in AAAs for average resting conditions by means of identifying regions of disturbed flow and quantifying the disturbance by evaluating wall pressure and wall shear stresses at the aneurysm wall.
Assuntos
Aneurisma da Aorta Abdominal/fisiopatologia , Simulação por Computador , Modelos Anatômicos , Modelos Cardiovasculares , Fluxo Pulsátil , Aorta Abdominal/anatomia & histologia , Aorta Abdominal/fisiologia , Fenômenos Biomecânicos , Velocidade do Fluxo Sanguíneo , Pressão Sanguínea , Análise de Elementos Finitos , Hemodinâmica , HumanosRESUMO
The cyclooxygenase inhibitor, indomethacin, depresses adrenergic agonist constriction of endothelium-denuded rat abdominal, but not thoracic, aorta. In order to explain this finding, we explored the possibility of segmental differences in the population of alpha 1-adrenoceptor (AR) subtypes. In endothelium-denuded tissues, phenylephrine elicited concentration-dependent contractions in the thoracic and abdominal aortic rings with potencies and maximal effects that, respectively, did not differ significantly (P > .05). Indomethacin (1 x 10(-5) M) inhibited phenylephrine-induced contractions only in abdominal aorta. The subtype-selective alpha 1D-AR antagonist, BMY 7378, was found to antagonize contractions to phenylephrine competitively in abdominal (pA2 8.44) and thoracic (pA2 8.56) aortic rings. These data are consistent with published alpha 1D-AR functional potency and clonal alpha 1D-AR binding affinity. In addition, cumulative concentration-contraction curves for phenylephrine were competitively antagonized in the rat abdominal and thoracic aortae by prazosin, 5-methylurapidil and WB 4101, with pA2 values of 9.39 and 9.61, 7.64 and 7.85, and 9.43 and 9.58, respectively. These compounds with varying degrees of subtype selectivity inhibited contractions of the thoracic and abdominal aortae with affinities consistent with those determined at the alpha 1D-AR subtype. The results of this study suggest that the contraction to phenylephrine of the rat abdominal and thoracic aorta is mediated via the same alpha 1D-AR subtype.
Assuntos
Aorta Abdominal/fisiologia , Aorta Torácica/fisiologia , Músculo Liso Vascular/fisiologia , Receptores Adrenérgicos alfa 1/fisiologia , Agonistas alfa-Adrenérgicos/farmacologia , Antagonistas Adrenérgicos alfa/farmacologia , Análise de Variância , Animais , Aorta Abdominal/efeitos dos fármacos , Aorta Torácica/efeitos dos fármacos , Endotélio Vascular/fisiologia , Técnicas In Vitro , Indometacina/farmacologia , Contração Isométrica/efeitos dos fármacos , Masculino , Músculo Liso Vascular/efeitos dos fármacos , Fenilefrina/farmacologia , Ratos , Ratos Wistar , Receptores Adrenérgicos alfa 1/efeitos dos fármacos , Vasoconstritores/farmacologiaRESUMO
A central dopaminergic origin has been demonstrated for the bromocriptine-induced tachycardia in conscious, normotensive rats. The present study investigated the effect of bromocriptine on heart rate and the principal site of action of this agonist in conscious, deoxycorticosterone acetate-salt hypertensive rats, in which altered central dopaminergic activity has been previously reported. Intravenous administration of bromocriptine (150 microg/kg) increased heart rate (49+/-5 beats/min.) in uninephrectomized control rats, while it induced a significant bradycardia (50+/-6 beats/min.) in deoxycorticosterone acetate-salt hypertensive rats. In the latter animals, intravenous (500 microg/kg) or intrathecal (40 microg/rat at T9-T10) pretreatment with domperidone, a selective dopamine D2 receptor antagonist that does not cross the blood-brain barrier, reduced partially, but significantly, the bradycardiac responses to bromocriptine (reduction of about 44% and 48% of the maximal effect, respectively). In contrast, the bromocriptine-induced bradycardia was fully abolished by intravenous pretreatment with metoclopramide (300 microg/kg), a dopamine D2 receptor antagonist that crosses the blood-brain barrier, or by combined pretreatment with intravenous and intrathecal domperidone. These results indicate that, in deoxycorticosterone acetate-salt hypertensive rats, bromocriptine decreases rather than increases heart rate, an effect that is mediated partly through a peripheral D2 dopaminergic mechanism and partly through stimulation of spinal dopamine D2 receptors. They further support the concept that, in normotensive, conscious rats, the central tachycardia of bromocriptine appears to predominate and to mask the bradycardia of this agonist at both peripheral and spinal dopamine D2 receptors.