Institute Cardiologia do Rio Grande do Sul FUC IC FUC

Porto Alegre, Brazil

Institute Cardiologia do Rio Grande do Sul FUC IC FUC

Porto Alegre, Brazil
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Bubols G.B.,Federal University of Rio Grande do Sul | Zielinsky P.,Institute Cardiologia do Rio Grande do Sul FUC IC FUC | Piccoli A.L.,Institute Cardiologia do Rio Grande do Sul FUC IC FUC | Nicoloso L.H.,Institute Cardiologia do Rio Grande do Sul FUC IC FUC | And 12 more authors.
Prenatal Diagnosis | Year: 2014

What's already known about this topic?Polyphenol-rich foods have been associated to premature ductal constriction when consumed in the third trimester of pregnancy. What does this study add?Polyphenols revealed to induce vasoconstriction of the ductus arteriosus by inhibiting nitric oxide vasodilatation. Consumption of polyphenol-rich foods in late pregnancy showed partial antioxidant effect by contributing to reduce lipid peroxidation. In contrast, NO-mediated ductal vasoconstriction could also be associated to oxidative damage to proteins. Objective: Because we have previously demonstrated the relation between polyphenol-rich foods (PRF) consumption and ductus arteriosus constriction, in this work, pregnant sheep were submitted to oral PRF intake for 14days to understand how this process occurs. Fetal Doppler echocardiography, oxidative and inflammatory biomarkers and total polyphenol excretion were evaluated. Results: The high polyphenol intake induced ductus arteriosus constriction by 71.6% increase in systolic (P=0.001) and 57.8% in diastolic velocities (P=0.002), and 18.9% decrease in pulsatility index (P=0.033), along with 1.7-fold increase in total polyphenol excretion, 2.3-fold decrease in inflammatory mediator nitric oxide and following redox status changes (mean±standard deviation): higher protein carbonyls (1.09±0.09 and 1.49±0.31), catalase (0.69±0.39 and 1.44±0.33) and glutathione peroxidase (37.23±11.19 and 62.96±15.03) in addition to lower lipid damage (17.22±2.05 and 12.53±2.11) and nonprotein thiols (0.11±0.04 and 0.04±0.01) found before and after treatment, respectively. Ductal parameters correlated to NOx, catalase, glutathione peroxidase and protein carbonyl. Conclusion: Our results highlight the need to reduce maternal PRF intake in late pregnancy to prevent fetal duct constriction through NO-mediated vasoconstrictive action of polyphenols. © 2014 John Wiley & Sons, Ltd.


Pivatto Jr. F.,Institute Cardiologia do Rio Grande do Sul FUC IC FUC | Pivatto Jr. F.,Federal University of Health Sciences, Porto Alegre | Kalil R.A.K.,Institute Cardiologia do Rio Grande do Sul FUC IC FUC | Kalil R.A.K.,Federal University of Health Sciences, Porto Alegre | And 14 more authors.
Arquivos Brasileiros de Cardiologia | Year: 2010

Background: Given the progressive increase in longevity and the need of an increasingly elderly population to undergo myocardial revascularization surgery (MRS), it becomes necessary to know its risks and benefits. Objective: To evaluate the in-hospital morbimortality of patients aged 80 and older submitted to MRS and identify its predictor variables. Methods: A total of 140 consecutive cases were studied between January 2002 and December 2007. The patients' mean age was 82.5 ± 2.2 years (range: 80-89) and 55.7% were males. In the sample,72.9% had arterial hypertension, 26.4% had diabetes, 65.7% presented severe lesion in three or more vessels and 28.6% presented a severe lesion in the left coronary trunk. An associated surgery was present in 35.7% of the cases, with aortic valve in 26.4% and mitral valve in 5.6%. Results: The mortality rate was 14.3% (isolated MRS 10.0% vs 22.0% with associated procedure; p = 0.091) and the morbidity was 37.9% (isolated MRS 34.4% vs 44.0% with associated procedure; p = 0.35). The most frequent complications were low cardiac output (27.9%), renal dysfunction (10.0%) and prolonged ventilatory support (9.6%). At the bivariate analysis, the most important mortality predictors were sepsis (RR 10.2; 95%CI: 6.10-17.7), previous MRS (RR 8.06; 95%CI: 5.16-12.6), postoperative low cardiac output (RR 7.77; 95%CI: 3.03-19.9) and postoperative renal dysfunction (RR 7.36; 95%CI: 3.71-14.6). The morbidity predictors were extracorporeal circulation time ≥ 120 min. (RR: 2.34; 95%CI: 1.62-3.38) and time of ischemia ≥ 90 min. (RR: 2.29 95%CI: 1.56-3.37). Conclusion: The MRS in octogenarians is associated with a higher morbimortality when compared to younger patients, which, however, does not prevent the procedure if the indication is justified by clinical condition.


PubMed | Institute Cardiologia do Rio Grande do Sul FUC IC FUC
Type: Clinical Trial | Journal: Journal of perinatology : official journal of the California Perinatal Association | Year: 2012

To test the hypothesis that maternal restriction of polyphenol-rich foods (PRF), which, like non-steroidal anti-inflammatory drugs (NSAID), inhibit prostaglandin synthesis in the third trimester, reverse fetal ductal constriction (DC).An open clinical trial of 51 third trimester fetuses with DC with no history of NSAID intake was designed. All mothers were submitted to a food frequency questionnaire and were oriented to withdrawl PRF, being reassessed after 3 weeks. Doppler parameters were assessed before and after discontinuation of these substances. A control group of 26 third trimester normal fetuses, with no ductus arteriosus (DA) constriction, in which no dietary intervention was offered, was reviewed after 3 weeks. Students t-test and Wilcoxons test were used.Mean gestational age was 323 weeks (28 to 37 weeks). After discontinuation of PRF (3 weeks), 48/51 fetuses (96%) showed complete reversal of DC, with decrease in mean ductal systolic velocity (1.740.20ms(-1) to 1.310.34ms(-1), P<0.001), mean diastolic velocity (0.330.09 ms(-1) to 0.210.07ms(-1), P<0.001) and mean right to left ventricular dimension ratio (1.370.26 to 1.120.17, P<0.001) and increase in mean ductal pulsatility index (PI) (1.980.36 to 2.460.23, P<0.001). Median daily maternal consumption of PRF was 286mg per day and decreased after orientation to 0mg per day, P<0.001. In the control group, with GA of 324w (29-37w), there was no significant differences in median daily maternal consumption of PRF, mean ductal systolic velocitiy, diastolic velocity, PI and right ventricular to left ventricular diameter ratio (RV/LV) ratio.Reduction of maternal PRF intake during pregnancy, especially in the third trimester, is followed by complete reversal of DC (wide open DA), which may influence maternal dietary habits in late pregnancy.


de Souza P.A.L.,Institute Cardiologia do Rio Grande do Sul FUC IC FUC | Fayh A.P.T.,Institute Cardiologia do Rio Grande do Sul FUC IC FUC | Portal V.L.,Institute Cardiologia do Rio Grande do Sul FUC IC FUC
Arquivos Brasileiros de Cardiologia | Year: 2011

Background: Abdominal circumference (AC) is the measure that correlates most closely with the risk factors and death from cardiovascular disease. However, the impact of obesity on the prognosis of patients with cardiovascular disease remains controversial and requires further clarification. Objective: To evaluate AC as a predictor of 30-day outcome in patients who were hospitalized with acute coronary syndrome (ACS), in a referral hospital for the treatment of cardiovascular diseases. Methods: Contemporary cohort 267 patients who were hospitalized for ACS and who were followed for 30 days after discharge, taking into account the major cardiovascular events - MACE - (death, reinfarction, rehospitalization for coronary artery bypass grafting procedures). In the first 24 hours of admission, patients answered a questionnaire and were subsequently measured for AC. The statistical analysis was performed with SPSS 17.0, using the chi-square test for categorical variables and Student t test for numerical variables, with significance level of p ≤ 0.05. The variables that had p < 0.10 in the bivariate analysis were included in a logistic regression model to evaluate the AC role as an independent predictor of MACE. Results: After multivariate analysis, only the female gender (OR = 8.86; 95% CI: 4.55-17. 10, p < 0.00), hypertension (OR = 2.06; 95% CI: 1.10-3.87; p = 0.02) and family history of ischemic heart disease (OR = 2.10; 95% CI: 1.17-3.74; p = 0.01) remained associated with the MACE. Conclusion: In our study, the modified AC was not associated with increased incidence of MACE over the 30 days of follow-up.


Zielinsky P.,Institute Cardiologia do Rio Grande do Sul FUC IC FUC | Manica J.L.L.,Institute Cardiologia do Rio Grande do Sul FUC IC FUC | Piccoli A.L.,Institute Cardiologia do Rio Grande do Sul FUC IC FUC | Nicoloso L.H.S.,Institute Cardiologia do Rio Grande do Sul FUC IC FUC | And 10 more authors.
Prenatal Diagnosis | Year: 2012

Objectives: The aim of this study was to test the hypothesis that experimental maternal intake of green tea in late pregnancy causes fetal ductus arteriosus constriction, probably because of prostaglandin inhibition. Methods and Results: Twelve fetal lambs (pregnancy>120days) were assessed before and after maternal administration of green tea (n=8) or water (n=4; controls) as the only source of liquid. After 1week, echocardiography showed signs of constriction of the ductus arteriosus in all fetuses from mothers ingesting green tea, with increase in mean systolic velocity(from 0.70±0.19m/s to 0.92±0.15m/s, 31.4%, p=0.001) and mean diastolic velocity (0.19±0.05m/s to 0.31±0.01m/s, 63.1%, p<0.001), decrease of pulsatility index (2.2±0.4 to 1.8±0.3, 22.2%, p=0.003) and increase of mean right ventricular/left ventricular diameter ratio (0.89±0.14 to 1.43±0.23, 60.6%, p<0.001). In the four control fetuses, there were no significant changes. All lambs exposed to green tea also showed at autopsy dilated and hypertrophic right ventricles, which was not present in control fetuses. Histological analysis showed a significantly larger mean thickness of the medial avascular zone of the ductus arteriosus in fetuses exposed to green tea than in controls (747.6±214.6μm vs 255.3±97.9μm, p<0.001). Conclusions: This study in fetal lambs shows a cause and effect relationship between experimental maternal exposure of green tea and fetal ductus arteriosus constriction in late pregnancy. © 2012 John Wiley & Sons, Ltd.


PubMed | Institute Cardiologia do Rio Grande do Sul FUC IC FUC
Type: Journal Article | Journal: Prenatal diagnosis | Year: 2012

The aim of this study was to test the hypothesis that experimental maternal intake of green tea in late pregnancy causes fetal ductus arteriosus constriction, probably because of prostaglandin inhibition.Twelve fetal lambs (pregnancy > 120 days) were assessed before and after maternal administration of green tea (n = 8) or water (n = 4; controls) as the only source of liquid. After 1 week, echocardiography showed signs of constriction of the ductus arteriosus in all fetuses from mothers ingesting green tea, with increase in mean systolic velocity(from 0.70 0.19 m/s to 0.92 0.15 m/s, 31.4%, p = 0.001) and mean diastolic velocity (0.19 0.05 m/s to 0.31 0.01 m/s, 63.1%, p < 0.001), decrease of pulsatility index (2.2 0.4 to 1.8 0.3, 22.2%, p = 0.003) and increase of mean right ventricular/left ventricular diameter ratio (0.89 0.14 to 1.43 0.23, 60.6%, p < 0.001). In the four control fetuses, there were no significant changes. All lambs exposed to green tea also showed at autopsy dilated and hypertrophic right ventricles, which was not present in control fetuses. Histological analysis showed a significantly larger mean thickness of the medial avascular zone of the ductus arteriosus in fetuses exposed to green tea than in controls (747.6 214.6 m vs 255.3 97.9 m, p < 0.001).This study in fetal lambs shows a cause and effect relationship between experimental maternal exposure of green tea and fetal ductus arteriosus constriction in late pregnancy.

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