Arquivos brasileiros de cardiologia最新文献

Background: Sustained pathological cardiac hypertrophy (CH) is an independent risk factor for increased incidence and mortality of cardiovascular events.

Objectives: This research was designed to unravel the role of long non-coding RNA (LncRNA) CCAT2 in CH progression.

Methods: Transverse aortic constriction (TAC) procedures were conducted to construct a pressure overload-induced in vivo CH model. Angiotensin II (Ang II) treatment was utilized to induce hypertrophic rat cardiomyocyte H9c2 cells.

Results: In vivo results showed that silencing of CCAT2 reduced cardiomyocyte surface area, alleviated cardiac fibrosis, and decreased β-MHC, ANP, and BNP levels in CH mouse models. In vitro results revealed that CCAT2 knockdown reduced cell surface area and attenuated β-MHC, ANP, and BNP levels in hypertrophic H9c2 cells. Besides, CCAT2 silencing decreased the levels of active β-catenin, phosphorylated-GSK-3β, and Wnt target genes (c-Myc, cyclinD1, and c-Jun) in CH mice and hypertrophic H9c2 cells. Importantly, treatment with the Wnt/β-catenin pathway activator LiCl reversed the suppression of CCAT2 knockdown on H9c2 cell surface area and MHC, ANP, and BNP levels.

Conclusions: Collectively, CCAT2 silencing plays a protective role against CH through inactivating the Wnt/β-catenin signaling, which suggests that CCAT2 might become a promising therapeutic target for CH.

To assess the intrarater reliability and agreement of blood pressure (BP), arterial stiffness, and heart rate variability (HRV) assessments in patients with Parkinson`s disease (PD). Twenty patients with PD visited the laboratory three times, during which brachial and central BP (auscultatory and applanation tonometry, respectively), arterial stiffness (carotid-femoral pulse wave velocity and augmentation index), and HRV assessments were performed at rest. Brachial and central systolic BP presented greater values on visit 1 when compared to visits 2 and 3 (122±13 vs. 116±16 vs. 120±15, p=0.029). There were no significant differences (p>0.05) among the experimental visits for other parameters. Brachial and central BP showed an intraclass correlation coefficient (ICC) above 0.842 and a standard error of measurement (SEM) lower than 5.0%. Bland-Altman plots indicated low agreement between visits 1 and 2 and good agreement between visits 2 and 3. Arterial stiffness indices exhibited ICC values between 0.781 and 0.886, and SEM ranged from 7.3% to 25.2%. Bland-Altman plots indicated moderate to good agreement among visits for arterial stiffness parameters. HRV indices presented ICC values ranging from 0.558 to 0.854 and SEM values ranging from 5.1% to 76.0%. Bland-Altman plots indicated moderate agreement among visits for HRV parameters. In PD patients, brachial and central BP present low intrarater reliability and agreement between visits 1 and 2 and good intrarater reliability and agreement between visits 2 and 3. In general, arterial stiffness and HRV assessments present acceptable intrarater reliability and agreement among visits, except for cardiac sympathovagal balance.

Background: The reduction of pulmonary congestion is an essential clinical target in the management of chronic heart failure. The remote dielectric sensing (ReDS) system is a recently introduced non-invasive technology used to easily estimate the degree of lung fluid volume without any expert techniques.

Objective: To conduct a comparative assessment of pulmonary congestion according to ultrasound and ReDS technology in patients hospitalized with decompensation of chronic heart failure (CHF).

Methods: The pilot single-center study included patients hospitalized with CHF decompensation. On admission and upon discharge, lung ultrasound and ReDS technology were simultaneously performed. Ultrasound of the lungs was performed according to the protocol with an assessment of 8 zones and calculation of the sum of B-lines. Pulmonary congestion was confirmed with a sum of B-lines ≥5, ReDS congestion if >35%. A p<0.05 was considered statistically significant.

Results: 35 patients were included in the study; 40% (n=14) were men, the average age was 71 (65.5; 78.5) years. Pulmonary congestion, according to ultrasound, was 57.1% (n=20), and according to ReDS, 62,9% (n=22). A moderate correlation was found between ReDS (%) and lung ultrasound (sum of B-lines) upon admission (Spearman correlation coefficient = 0.402; p=0.017). There was no correlation between the two methods at discharge (p=0.613).

Conclusion: There was a moderate correlation between ReDS and lung ultrasound in relation to the detection of pulmonary congestion at admission.

Background: Atrial fibrillation (AF) is the most common sustained arrythmia, but still underdiagnosed especially among asymptomatic patients.

Objectives: To evaluate a simple strategy to optimize the identification of AF.

Methods: Asymptomatic patients aged 65 years or older, with hypertension or heart failure (HF), were included. Data were inserted into the REDCap software platform. Patients were assessed for the risk for AF using the Stroke Risk Analysis (SRA) mathematical algorithm, which was applied on a one-hour electrocardiogram (ECG). All patients at high risk for AF were instructed to follow a home ECG protocol for seven days using a portable Kardia 6 (OMRON, AliveCor®). The Kolmogorov-test was used to test the normality of quantitative variables; those with normal distribution were expressed as mean and standard deviation. A p<0.05 was set as statistically significant.

Results: A total of 423 patients were assessed; 15 were excluded due to absence of SRA, yielding a sample of 408 patients. In 13 (3.2%), AF was identified, 120 (29.4%) were considered at high risk and 275 (67.4%) without increased risk for AF. Of the 120 high-risk patients, 111 successfully completed the seven-day protocol with Kardia; at least one episode of AF was identified in 43 patients.

Conclusion: The strategy adopted in the RITMO study was shown to be effective in identifying AF in asymptomatic elderly patients with hypertension or HF, with an incidence of 13.7% (56/408).