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Evaluation of the diagnostic value of the renal resistive index as a marker of the subclinical development of cardiorenal syndrome in MMVD dogs. 肾阻力指数作为MMVD犬心肾综合征亚临床发展标志物的诊断价值评价
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2021-01-01 DOI: 10.1177/1470320321995082
Barbara Szczepankiewicz, Urszula Pasławska, Natalia Siwińska, Krzysztof Plens, Robert Pasławski

Introduction: Myxomatous mitral valve disease (MMVD) in dogs inevitably causes renal dysfunction. These interactions are known as the cardiorenal syndrome (CRS). The main aims of the study were to evaluate whether renal resistive index (RRI) may be useful as a non-invasive marker in subclinical stage of kidney injury in dogs with MMVD and to compare RRI with SDMA and Cyst C.

Methods: Forty-four dogs were divided into two groups: control-15 healthy dogs and the heart group-29 dogs with MMVD (ACVIM class Cc). Study protocol included: anamnesis, clinical examination, electrocardiography, echocardiography, chest radiography, abdominal ultrasonography with measurements of the renal resistive index (RRI), urine, and blood analysis.

Results: The RRI in the heart group was significantly higher 0.725 ± 0.035 versus control group 0.665 ± 0.028 (p < 0.00085). The RRI cut-off point in dogs with stable chronic heart failure (CHF) under 8 years is 0.775, in older 0.64. RRI was similar in MMVD dogs treated with ACE-I + furosemide and dogs treated ACE-I + torasemide + pimobendan + spironolactone. There was no correlation between RRI and SDMA or Cyst C.

Conclusion: RRI is more sensitive than creatinine, SDMA and Cyst C to reveal kidney injury in MMVD dogs class Cc younger than 8 years.

犬二尖瓣黏液瘤病(MMVD)不可避免地会导致肾功能不全。这些相互作用被称为心肾综合征(CRS)。本研究的主要目的是评估肾抵抗指数(RRI)是否可以作为MMVD犬亚临床阶段肾损伤的非侵入性标志物,并将RRI与SDMA和囊肿c进行比较。方法:44只狗分为两组:对照组15只健康狗和心脏组29只MMVD狗(ACVIM Cc级)。研究方案包括:记忆、临床检查、心电图、超声心动图、胸片、腹部超声检查及肾阻力指数(RRI)测量、尿液和血液分析。结果:心脏组RRI值(0.725±0.035)显著高于对照组(0.665±0.028)(p < 0.05)。结论:RRI值比肌酐、SDMA、囊肿C值对8岁以下Cc级MMVD犬肾损伤更敏感。
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引用次数: 7
Cardiovascular events and all-cause mortality in surgically or medically treated primary aldosteronism: A Meta-analysis. 手术或药物治疗原发性醛固酮增多症的心血管事件和全因死亡率:一项荟萃分析
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2021-01-01 DOI: 10.1177/14703203211003781
Ying Jing, Kangla Liao, Ruolin Li, Shumin Yang, Ying Song, Wenwen He, Kanran Wang, Jun Yang, Qifu Li, Jinbo Hu

Objectives: To compare the effect of surgical or medical treatment on the risk of cardiovascular diseases (CVD) and all-cause mortality in patients with established primary aldosteronism (PA).

Methods: We searched PUBMED, MEDLINE and Cochrane Library for the meta-analysis. We included patients who were diagnosed with PA following guideline-supported protocols and received surgery or mineralocorticoid receptor antagonist (MRA)-based medical treatment, and age-sex matched patients with treated essential hypertension (EH). Primary endpoints were CVD incidence and all-cause mortality.

Results: Compared with EH, patients with treated PA had a higher risk of CVD [odds ratio (OR) 1.79; 95% confidence interval (CI) 1.39-2.31]. This elevated risk was only observed in patients with medically treated PA [OR 2.11; 95%CI 1.88-2.38] but not in those with surgically treated PA. The risk of all-cause mortality was significantly lower in patients with treated PA [OR 0.86; 95% CI 0.77-0.95] compared to EH. The reduced risk was only observed in patients with surgically treated PA [OR 0.47; 95% CI 0.34-0.66], but not in those with medically treated PA.

Conclusions: Patients with medically treated PA have a higher risk of CVD compared to patients with EH. Surgical treatment of PA reduces the risk of CVD and all-cause mortality in patients with PA.

目的:比较手术或药物治疗对原发性醛固酮增多症(PA)患者心血管疾病(CVD)风险和全因死亡率的影响。方法:检索PUBMED、MEDLINE和Cochrane图书馆进行meta分析。我们纳入了遵循指南支持方案诊断为PA并接受手术或矿皮质激素受体拮抗剂(MRA)药物治疗的患者,以及年龄性别匹配的治疗过的原发性高血压(EH)患者。主要终点是心血管疾病发病率和全因死亡率。结果:与EH相比,经治疗的PA患者发生CVD的风险更高[优势比(OR) 1.79;95%置信区间(CI) 1.39-2.31]。这种升高的风险仅在接受药物治疗的PA患者中观察到[OR 2.11;95%CI 1.88-2.38],但手术治疗的PA患者无此症状。经治疗的PA患者全因死亡风险显著降低[OR 0.86;95% CI 0.77-0.95]。仅在手术治疗的PA患者中观察到风险降低[OR 0.47;95% CI 0.34-0.66],但在接受药物治疗的PA患者中没有。结论:与EH患者相比,经药物治疗的PA患者发生心血管疾病的风险更高。前列腺癌的手术治疗降低了心血管疾病和全因死亡率的风险。
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引用次数: 8
The controversy of using angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in COVID-19 patients. 在 COVID-19 患者中使用血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂的争议。
IF 2.1 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2021-01-01 DOI: 10.1177/1470320320987118
Amer Harky, Cheryl Yan Ting Chor, Henry Nixon, Milad Jeilani
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引用次数: 0
PM2.5 inducing myocardial fibrosis mediated by Ang II/ERK1/2/TGF-β1 signaling pathway in mice model. 在小鼠模型中,PM2.5 通过 Ang II/ERK1/2/TGF-β1 信号通路诱导心肌纤维化。
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2021-01-01 DOI: 10.1177/14703203211003786
Xiwen Zang, Jun Zhao, Chengzhi Lu

Objects: To discuss the influence of PM2.5 on myocardial fibrosis and related mechanism.

Methods: PM2.5 particles were prepared into different concentrations of solution to drip into the mice's trachea twice each week. The mice were divided into five groups, Blank control group (C group), NS control group (J group), high dose group (G group, 10 mg/kg), medium dose group (Z group, 5 mg/kg), and 1ow dose group (D group, 2.5 mg/kg). After 6 weeks, the myocardial fibrosis was observed by HE and Masson staining. The expression of Ang II, ERK1/2, and TGF-β1 was examined by Western Blotting (WB) and Real time PCR (RT-PCR).

Results: The higher dose PM2.5 was administrated, the worse the myocardial fibrosis was in PM2.5 groups. The expression of Ang II, ERK1/2, and TGF-β1 was increased in higher dose groups in protein and mRNA level.

Conclusion: 1. PM2.5 induced the cardiac fibrosis. 2. PM2.5 dripped into trachea in mice model activated the expression of Ang II, ERK1/2, and TGF-β1. The activation of renin-angiotensin system (RAS) was suggested to participate in the cardiac fibrosis induced by PM2.5.

目的:探讨PM2.5对心肌纤维化的影响及相关机制:探讨PM2.5对心肌纤维化的影响及相关机制:将PM2.5颗粒配制成不同浓度的溶液滴入小鼠气管,每周两次。小鼠分为五组,分别为空白对照组(C组)、NS对照组(J组)、高剂量组(G组,10 mg/kg)、中剂量组(Z组,5 mg/kg)和低剂量组(D组,2.5 mg/kg)。6周后,用HE和Masson染色法观察心肌纤维化。Western Blotting (WB)和Real time PCR (RT-PCR)检测了Ang II、ERK1/2和TGF-β1的表达:结果:PM2.5剂量越高,PM2.5组心肌纤维化越严重。结论:1.PM2.5诱导心肌纤维化。2.2. PM2.5滴入小鼠气管模型激活了Ang II、ERK1/2和TGF-β1的表达。肾素-血管紧张素系统(RAS)的激活被认为参与了PM2.5诱导的心脏纤维化。
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引用次数: 0
Angiotensin II Induces Differentiation of Human Neuroblastoma Cells by Increasing MAP2 and ROS Levels. 血管紧张素II通过增加MAP2和ROS水平诱导人神经母细胞瘤细胞分化
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2021-01-01 DOI: 10.1155/2021/6191417
Bryan Jael Collazo, Dariana Morales-Vázquez, Jaylene Álvarez-Del Valle, Javier E Sierra-Pagan, Juan Carlos Medina, Jarold Méndez-Álvarez, Yamil Gerena

Introduction: The roles of angiotensin II (Ang II) in the brain are still under investigation. In this study, we investigated if Ang II influences differentiation of human neuroblastoma cells with simultaneous activation of NADPH oxidase and reactive oxygen species (ROS). Moreover, we investigated the Ang II receptor type involved during differentiation.

Methods: Human neuroblastoma cells (SH-SY5Y; 5 × 105 cells) were exposed to Ang II (600 nM) for 24 h. Differentiation was monitored by measuring MAP2 and NF-H levels. Cell size and ROS were analyzed by flow cytometry, and NADPH oxidase activation was assayed using apocynin (500 μM). Ang II receptors (ATR) activation was assayed using ATR blockers or Ang II metabolism inhibitors (10-7 M).

Results: (1) Cell size decreased significantly in Ang II-treated cells; (2) MAP2 and ROS increased significantly in Ang II-treated cells with no changes in viability; (3) MAP2 and ROS decreased significantly in cells incubated with Ang II plus apocynin. (4) A significant decrease in MAP2 was observed in cells exposed to Ang II plus PD123.319 (AT2R blocker).

Conclusion: Our findings suggest that Ang II influences differentiation of SH-SY5Y by increasing MAP2 through the AT2R. The increase in MAP2 and ROS were also mediated through NADPH oxidase with no cell death.

血管紧张素II (Ang II)在大脑中的作用仍在研究中。在这项研究中,我们研究了Ang II是否通过同时激活NADPH氧化酶和活性氧(ROS)来影响人神经母细胞瘤细胞的分化。此外,我们还研究了在分化过程中参与的Ang II受体类型。方法:人神经母细胞瘤细胞(SH-SY5Y;5 × 105个细胞)暴露于Ang II (600 nM) 24h。通过测量MAP2和NF-H水平来监测分化。流式细胞术检测细胞大小和ROS, 500 μM夹竹桃碱检测NADPH氧化酶活性。使用ATR阻滞剂或Ang II代谢抑制剂(10-7 M)检测Ang II受体(ATR)的激活。结果:(1)Angⅱ处理后细胞大小明显减小;(2)在angii处理的细胞中,MAP2和ROS显著升高,但细胞活力没有变化;(3) angii + apocynin孵育的细胞中,MAP2和ROS显著降低。(4)暴露于Ang II + PD123.319 (AT2R阻滞剂)的细胞中,MAP2显著降低。结论:我们的研究结果表明Ang II通过AT2R增加MAP2影响SH-SY5Y的分化。MAP2和ROS的增加也通过NADPH氧化酶介导,无细胞死亡。
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引用次数: 1
Association between angiotensin converting enzyme gene polymorphism and essential hypertension: A systematic review and meta-analysis. 血管紧张素转换酶基因多态性与原发性高血压的关系:一项系统综述和荟萃分析。
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2021-01-01 DOI: 10.1177/1470320321995074
Mingyu Liu, Jian Yi, Wenwen Tang

Background: The current meta-analytic study explored the relation between ACE gene insertion/deletion (I/D), and the risk of EH by reviewing relevant trials so as to determine the association between Angiotensin Converting Enzyme (ACE) gene polymorphism and essential hypertension (EH) susceptibility.

Methods: Relevant studies published before May 2019 were collected from the PubMed, Cochrane, Embase, CNKI, VANFUN, and VIP databases.

Results: Fifty-seven studies involving a total of 32,862 patients were included. These studies found that ACE gene D allele was associated with higher EH susceptibility in allelic model, homozygote model, dominant model, and regressive model, and that Asian population with ACE gene D allele showed a higher EH susceptibility in all these models. Moreover, ACE gene D allele was found closely related to a higher EH susceptibility in the subgroups of HWE, NO HWE, Caucasian population, and Mixed population, with the majority being males in allelic model, homozygote model, and regressive model and the majority being females in allelic model.

Conclusion: ACE gene D allele is associated with an overall higher EH susceptibility, which is confirmed in the subgroup analysis of Asian population, HWE, NO HWE, Caucasian population, and Mixed population.

背景:本荟萃分析研究通过回顾相关试验,探讨ACE基因插入/缺失(I/D)与EH风险之间的关系,以确定ACE基因多态性与原发性高血压(EH)易感性之间的关系。方法:从PubMed、Cochrane、Embase、CNKI、VANFUN和VIP数据库中收集2019年5月前发表的相关研究。结果:57项研究共纳入32,862例患者。这些研究发现,ACE基因D等位基因在等位基因模型、纯合子模型、显性模型和回归模型中都与EH易感性相关,并且ACE基因D等位基因的亚洲人群在所有模型中都表现出更高的EH易感性。ACE基因D等位基因与高智商人群、非高智商人群、高加索人群和混血人群的EH易感性密切相关,在等位基因模型、纯合子模型和回归模型中以男性居多,在等位基因模型中以女性居多。结论:ACE基因D等位基因与EH总体高易感性相关,这在亚洲人群、高智商人群、非高智商人群、高加索人群和混血儿人群的亚组分析中得到证实。
{"title":"Association between angiotensin converting enzyme gene polymorphism and essential hypertension: A systematic review and meta-analysis.","authors":"Mingyu Liu,&nbsp;Jian Yi,&nbsp;Wenwen Tang","doi":"10.1177/1470320321995074","DOIUrl":"https://doi.org/10.1177/1470320321995074","url":null,"abstract":"<p><strong>Background: </strong>The current meta-analytic study explored the relation between ACE gene insertion/deletion (I/D), and the risk of EH by reviewing relevant trials so as to determine the association between Angiotensin Converting Enzyme (ACE) gene polymorphism and essential hypertension (EH) susceptibility.</p><p><strong>Methods: </strong>Relevant studies published before May 2019 were collected from the PubMed, Cochrane, Embase, CNKI, VANFUN, and VIP databases.</p><p><strong>Results: </strong>Fifty-seven studies involving a total of 32,862 patients were included. These studies found that ACE gene D allele was associated with higher EH susceptibility in allelic model, homozygote model, dominant model, and regressive model, and that Asian population with ACE gene D allele showed a higher EH susceptibility in all these models. Moreover, ACE gene D allele was found closely related to a higher EH susceptibility in the subgroups of HWE, NO HWE, Caucasian population, and Mixed population, with the majority being males in allelic model, homozygote model, and regressive model and the majority being females in allelic model.</p><p><strong>Conclusion: </strong>ACE gene D allele is associated with an overall higher EH susceptibility, which is confirmed in the subgroup analysis of Asian population, HWE, NO HWE, Caucasian population, and Mixed population.</p>","PeriodicalId":17330,"journal":{"name":"Journal of the Renin-Angiotensin-Aldosterone System","volume":"22 1","pages":"1470320321995074"},"PeriodicalIF":2.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1470320321995074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25485429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 14
The predictive value of brain natriuretic peptide or N-terminal pro-brain natriuretic peptide for weaning outcome in mechanical ventilation patients: Evidence from SROC. 脑钠肽或n端前脑钠肽对机械通气患者脱机结局的预测价值:来自SROC的证据。
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2021-01-01 DOI: 10.1177/1470320321999497
Jian Liu, Chuan-Jiang Wang, Jun-Huai Ran, Shi-Hui Lin, Dan Deng, Yu Ma, Fang Xu

Objective: Mechanical ventilation is an important treatment for critically ill patients. Physicians generally perform a spontaneous breathing trial (SBT) to determine whether the patients can be weaned from mechanical ventilation, but almost 17% of the patients who pass the SBT still require respiratory support. Cardiac dysfunction is an important cause of weaning failure. The use of brain natriuretic peptide or N-terminal pro-BNP is a simple method to assess cardiac function. We performed a systematic review of investigations of brain natriuretic peptide or N-terminal pro-BNP as predictors of weaning from mechanical ventilation.

Data sources: PubMed (1950 to December 2020), Cochrane, and Embase (1974 to December 2020), and some Chinese databases for additional articles (China Biology Medicine (CBM), China Science and Technology Journal Database (CSTJ), and Wanfang Data and China National Knowledge Infrastructure (CNKI)).

Study selection: We systematically searched observation studies investigating the predictive value of brain natriuretic peptide or N-terminal pro-brain natriuretic peptide in weaning outcome of patients with mechanical ventilation.

Data extraction: Two independent reviewers extracted data. The differences are resolved through consultation.

Data synthesis: We included 18 articles with 1416 patients and extracted six index tests with pooled sensitivity and specificity for each index test. For the BNP change rate predicting weaning success, the pooled sensitivity was 89% (83%-94%) and the pooled specificity was 82% (72%-89%) with the highest pooled AUC of 0.9511.

Conclusions: The brain natriuretic peptide change rate is a reliable predictor of weaning outcome from mechanical ventilation.

目的:机械通气是危重患者的重要治疗手段。医生通常会进行自发呼吸试验(SBT)来确定患者是否可以脱离机械通气,但几乎17%通过SBT的患者仍然需要呼吸支持。心功能障碍是导致脱机失败的重要原因。使用脑利钠肽或n端前bnp是评估心功能的一种简单方法。我们对脑利钠肽或n端前bnp作为机械通气脱机预测因子的研究进行了系统回顾。数据来源:PubMed(1950年至2020年12月)、Cochrane和Embase(1974年至2020年12月),以及一些中文数据库(中国生物医学(CBM)、中国科技期刊数据库(CSTJ)和万方数据和中国知网)。研究选择:我们系统地检索了研究脑钠肽或n端脑钠肽前体对机械通气患者脱机预后预测价值的观察性研究。数据提取:两个独立的审稿人提取数据。分歧是通过协商解决的。资料综合:我们纳入了18篇文献,1416例患者,提取了6个指标试验,每个指标试验的敏感性和特异性汇总。对于预测断奶成功率的BNP变化率,合并敏感性为89%(83%-94%),合并特异性为82%(72%-89%),合并AUC最高为0.9511。结论:脑利钠肽变化率是机械通气断奶结局的可靠预测指标。
{"title":"The predictive value of brain natriuretic peptide or N-terminal pro-brain natriuretic peptide for weaning outcome in mechanical ventilation patients: Evidence from SROC.","authors":"Jian Liu,&nbsp;Chuan-Jiang Wang,&nbsp;Jun-Huai Ran,&nbsp;Shi-Hui Lin,&nbsp;Dan Deng,&nbsp;Yu Ma,&nbsp;Fang Xu","doi":"10.1177/1470320321999497","DOIUrl":"https://doi.org/10.1177/1470320321999497","url":null,"abstract":"<p><strong>Objective: </strong>Mechanical ventilation is an important treatment for critically ill patients. Physicians generally perform a spontaneous breathing trial (SBT) to determine whether the patients can be weaned from mechanical ventilation, but almost 17% of the patients who pass the SBT still require respiratory support. Cardiac dysfunction is an important cause of weaning failure. The use of brain natriuretic peptide or N-terminal pro-BNP is a simple method to assess cardiac function. We performed a systematic review of investigations of brain natriuretic peptide or N-terminal pro-BNP as predictors of weaning from mechanical ventilation.</p><p><strong>Data sources: </strong>PubMed (1950 to December 2020), Cochrane, and Embase (1974 to December 2020), and some Chinese databases for additional articles (China Biology Medicine (CBM), China Science and Technology Journal Database (CSTJ), and Wanfang Data and China National Knowledge Infrastructure (CNKI)).</p><p><strong>Study selection: </strong>We systematically searched observation studies investigating the predictive value of brain natriuretic peptide or N-terminal pro-brain natriuretic peptide in weaning outcome of patients with mechanical ventilation.</p><p><strong>Data extraction: </strong>Two independent reviewers extracted data. The differences are resolved through consultation.</p><p><strong>Data synthesis: </strong>We included 18 articles with 1416 patients and extracted six index tests with pooled sensitivity and specificity for each index test. For the BNP change rate predicting weaning success, the pooled sensitivity was 89% (83%-94%) and the pooled specificity was 82% (72%-89%) with the highest pooled AUC of 0.9511.</p><p><strong>Conclusions: </strong>The brain natriuretic peptide change rate is a reliable predictor of weaning outcome from mechanical ventilation.</p>","PeriodicalId":17330,"journal":{"name":"Journal of the Renin-Angiotensin-Aldosterone System","volume":"22 1","pages":"1470320321999497"},"PeriodicalIF":2.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1470320321999497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25442928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
The role of renin-angiotensin system in patients with left ventricular assist devices. 肾素-血管紧张素系统在左心室辅助装置患者中的作用。
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-10-01 DOI: 10.1177/1470320320966445
Alexandros Briasoulis, Ernesto Ruiz Duque, Dimitrios Mouselimis, Anastasios Tsarouchas, Constantinos Bakogiannis, Paulino Alvarez

End-stage heart failure is a condition in which the up-regulation of the systemic and local renin-angiotensin-aldosterone system (RAAS) leads to end-organ damage and is largely irreversible despite optimal medication. Left ventricular assist devices (LVADs) can downregulate RAAS activation by unloading the left ventricle and increasing the cardiac output translating into a better end-organ perfusion improving survival. However, the absence of pulsatility brought about by continuous-flow devices may variably trigger RAAS activation depending on left ventricular (LV) intrinsic contractility, the design and speed of the pump device. Moreover, the concept of myocardial recovery is being tested in clinical trials and in this setting LVAD support combined with intense RAAS inhibition can promote recovery and ensure maintenance of LV function after explantation. Blood pressure control on LVAD recipients is key to avoiding complications as gastrointestinal bleeding, pump thrombosis and stroke. Furthermore, emerging data highlight the role of RAAS antagonists as prevention of arteriovenous malformations that lead to gastrointestinal bleeds. Future studies should focus on the role of angiotensin receptor inhibitors in preventing myocardial fibrosis in patients with LVADs and examine in greater details the target blood pressure for these patients.

终末期心力衰竭是全身和局部肾素-血管紧张素-醛固酮系统(RAAS)上调导致终末器官损伤的一种情况,尽管使用了最佳药物,但这种情况在很大程度上是不可逆的。左心室辅助装置(lvad)可以通过卸载左心室和增加心输出量来下调RAAS的激活,从而转化为更好的终末器官灌注,从而提高生存率。然而,连续血流装置带来的无脉动性可能会根据左心室固有收缩性、泵装置的设计和速度而不同地触发RAAS激活。此外,心肌恢复的概念正在临床试验中得到验证,在这种情况下,LVAD支持结合强烈的RAAS抑制可以促进移植后的心肌恢复并确保左心室功能的维持。LVAD受者的血压控制是避免胃肠道出血、泵血栓形成和中风等并发症的关键。此外,新出现的数据强调了RAAS拮抗剂在预防导致胃肠道出血的动静脉畸形方面的作用。未来的研究应关注血管紧张素受体抑制剂在预防lvad患者心肌纤维化中的作用,并更详细地检查这些患者的目标血压。
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引用次数: 4
Lifestyle and severe SARS-CoV-2 infections: Does the individual metabolic burden determines the outcome? 生活方式与严重的 SARS-CoV-2 感染:个人的代谢负担会决定结果吗?
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-10-01 DOI: 10.1177/1470320320963929
Birgit Markus, Julian Kreutz, Bernhard Schieffer
{"title":"Lifestyle and severe SARS-CoV-2 infections: Does the individual metabolic burden determines the outcome?","authors":"Birgit Markus, Julian Kreutz, Bernhard Schieffer","doi":"10.1177/1470320320963929","DOIUrl":"10.1177/1470320320963929","url":null,"abstract":"","PeriodicalId":17330,"journal":{"name":"Journal of the Renin-Angiotensin-Aldosterone System","volume":"21 4","pages":"1470320320963929"},"PeriodicalIF":2.9,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/f7/10.1177_1470320320963929.PMC7550949.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38577054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endothelial prostaglandin D2 opposes angiotensin II contractions in mouse isolated perfused intracerebral microarterioles. 内皮前列腺素D2在小鼠离体脑内微动脉灌注中对抗血管紧张素II收缩。
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-10-01 DOI: 10.1177/1470320320966177
L Li, E Y Lai, X Cao, W J Welch, C S Wilcox

Hypothesis: A lack of contraction of cerebral microarterioles to Ang II ("resilience") depends on cyclooxygenase (COX) and lipocalin type prostaglandin D sythase L-PGDS producing PGD2 that activates prostaglandin D type 1 receptors (DP1Rs) and nitric oxide synthase (NOS).

Materials & methods: Contractions were assessed in isolated, perfused vessels and NO by fluorescence microscopy.

Results: The mRNAs of penetrating intraparenchymal cerebral microarterioles versus renal afferent arterioles were >3000-fold greater for L-PGDS and DP1R and 5-fold for NOS III and COX 2. Larger cerebral arteries contracted with Ang II. However, cerebral microarterioles were entirely unresponsive but contracted with endothelin 1 and perfusion pressure. Ang II contractions were evoked in cerebral microarterioles from COX1 -/- mice or after blockade of COX2, L-PGDS or NOS and in deendothelialized vessels but effects of deendothelialization were lost during COX blockade. NO generation with Ang II depended on COX and also was increased by DP1R activation.

Conclusion: The resilience of cerebral arterioles to Ang II contractions is specific for intraparenchymal microarterioles and depends on endothelial COX1 and two products that are metabolized by L-PGDS to generate PGD2 that signals via DP1Rs and NO.

假设:脑微动脉缺乏对Ang II(“弹性”)的收缩取决于环加氧酶(COX)和脂钙素型前列腺素D合成酶L-PGDS产生的PGD2激活前列腺素D 1型受体(DP1Rs)和一氧化氮合成酶(NOS)。材料与方法:用荧光显微镜观察离体、灌注血管和NO的收缩情况。结果:L-PGDS和DP1R穿透性脑实质内微动脉mrna比肾传入小动脉mrna高3000倍以上,NOS III和COX 2 mrna高5倍以上。较大的脑动脉与Ang II收缩。然而,脑微动脉完全无反应,但随着内皮素1和灌注压而收缩。COX1 -/-小鼠或COX2、L-PGDS或NOS阻断后的脑微动脉和去内皮化血管均可引起angii收缩,但在COX阻断期间去内皮化的作用消失。Ang II的NO生成依赖于COX,也因DP1R激活而增加。结论:脑小动脉对Ang II收缩的恢复能力是脑实质内微动脉特有的,依赖于内皮COX1和L-PGDS代谢产生PGD2的两种产物,PGD2通过DP1Rs和NO发出信号。
{"title":"Endothelial prostaglandin D<sub>2</sub> opposes angiotensin II contractions in mouse isolated perfused intracerebral microarterioles.","authors":"L Li,&nbsp;E Y Lai,&nbsp;X Cao,&nbsp;W J Welch,&nbsp;C S Wilcox","doi":"10.1177/1470320320966177","DOIUrl":"https://doi.org/10.1177/1470320320966177","url":null,"abstract":"<p><strong>Hypothesis: </strong>A lack of contraction of cerebral microarterioles to Ang II (\"resilience\") depends on cyclooxygenase (COX) and lipocalin type prostaglandin D sythase L-PGDS producing PGD<sub>2</sub> that activates prostaglandin D type 1 receptors (DP1Rs) and nitric oxide synthase (NOS).</p><p><strong>Materials & methods: </strong>Contractions were assessed in isolated, perfused vessels and NO by fluorescence microscopy.</p><p><strong>Results: </strong>The mRNAs of penetrating intraparenchymal cerebral microarterioles versus renal afferent arterioles were >3000-fold greater for L-PGDS and DP1R and 5-fold for NOS III and COX 2. Larger cerebral arteries contracted with Ang II. However, cerebral microarterioles were entirely unresponsive but contracted with endothelin 1 and perfusion pressure. Ang II contractions were evoked in cerebral microarterioles from COX1 -/- mice or after blockade of COX2, L-PGDS or NOS and in deendothelialized vessels but effects of deendothelialization were lost during COX blockade. NO generation with Ang II depended on COX and also was increased by DP1R activation.</p><p><strong>Conclusion: </strong>The resilience of cerebral arterioles to Ang II contractions is specific for intraparenchymal microarterioles and depends on endothelial COX1 and two products that are metabolized by L-PGDS to generate PGD<sub>2</sub> that signals via DP1Rs and NO.</p>","PeriodicalId":17330,"journal":{"name":"Journal of the Renin-Angiotensin-Aldosterone System","volume":"21 4","pages":"1470320320966177"},"PeriodicalIF":2.9,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1470320320966177","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38527141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
期刊
Journal of the Renin-Angiotensin-Aldosterone System
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