National Institute of Cardiology INC

Rio de Janeiro, Brazil

National Institute of Cardiology INC

Rio de Janeiro, Brazil

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Souza E.G.,National Institute of Cardiology INC | Souza E.G.,Federal University of Rio de Janeiro | De Lorenzo A.,National Institute of Cardiology INC | De Lorenzo A.,Federal University of Rio de Janeiro | And 5 more authors.
Coronary Artery Disease | Year: 2014

OBJECTIVES: The assessment of systemic microvascular reactivity is currently considered to be critical in the stratification of cardiovascular risk. In the present study, we compared skin microvascular function in individuals with early-onset (premature) coronary artery disease (EOCAD, n=30) with that of age-matched and sex-matched healthy individuals (n=30). MATERIALS AND METHODS: Using laser speckle contrast imaging, cutaneous blood flow was assessed in the forearm at rest and during reactivity tests, including postocclusive reactive hyperemia and the iontophoresis of acetylcholine or sodium nitroprusside with increasing currents of 30, 60, 90, 120, 150, and 180 μA for 10-s intervals spaced 1 min apart. Carotid intima-media thickness was evaluated using an ultrasound system and a 7.5 MHz ultrasound transducer. RESULTS: The endothelium-dependent skin microvascular vasodilator responses that were induced by both acetylcholine and postocclusive reactive hyperemia were significantly reduced in patients with EOCAD compared with healthy individuals. The vasodilator responses that were induced by sodium nitroprusside were also significantly reduced in individuals with EOCAD. These systemic microvascular alterations were concurrent with increased carotid intima-media thickness in these patients. CONCLUSION: Laser speckle contrast imaging identifies endothelial-dependent and endothelial-independent microvascular dysfunction in individuals presenting with EOCAD, and thus could be valuable as an early peripheral marker of atherothrombotic disease. © 2013 Wolters Kluwer Health.


Cordovil I.,National Institute of Cardiology INC | Huguenin G.,Federal University of Rio de Janeiro | Rosa G.,Federal University of Rio de Janeiro | Bello A.,National Institute of Cardiology INC | And 5 more authors.
Microvascular Research | Year: 2012

Objective: The aim of this study was to compare cutaneous microvascular function in young healthy subjects (n = 50) with that of cardiometabolic diseased patients (n = 50) using laser speckle contrast imaging (LSCI) coupled with transdermal iontophoretic delivery of acetylcholine (ACh) and post-occlusive reactive hyperemia (PORH). Methods: Cutaneous blood flow was assessed in the forearm using LSCI at rest, during PORH and during iontophoresis of ACh with increasing anodal currents of 30, 60, 90, 120, 150 and 180 μA during 10-second intervals spaced 1. min apart. Results: Endothelium-dependent skin microvascular vasodilator responses induced by both ACh and PORH were significantly reduced in cardiometabolic diseased patients compared to healthy subjects. Vasodilator responses induced by ACh were significantly higher in young women than in young men. Iontophoresis charges up to 1.5. mC do not induce nonspecific effects on skin microvascular flux. Conclusion: LSCI appears to be a promising noninvasive technique for evaluating systemic microvascular endothelial function. © 2012 Elsevier Inc.


Tibirica E.,National Institute of Cardiology INC | Tibirica E.,Oswaldo Cruz Institute | Souza E.G.,National Institute of Cardiology INC | Souza E.G.,Federal University of Rio de Janeiro | And 3 more authors.
Microvascular Research | Year: 2015

Objective: This study sought to test whether patients with early-onset coronary artery disease (EOCAD, n= 30) showed systemic microvascular rarefaction and endothelial dysfunction in comparison to age- and sex-matched healthy controls (CTL, n= 30), as evaluated by skin video-capillaroscopy. Methods: Functional capillary density (FCD) was defined as the number of spontaneously perfused capillaries per square millimeter of skin area and assessed by high-resolution intra-vital color microscopy in the dorsum of the middle phalanx. Capillary recruitment (capillary reserve) was evaluated using post-occlusive reactive hyperemia (PORH) after arm ischemia for 3. min. Results: The mean capillary density at rest was significantly reduced in patients with EOCAD compared to controls (CTL 95±20 and EOCAD 80±18capillaries/mm2, P=0.0040). During PORH, capillary density was also markedly reduced in EOCAD patients (CTL 96±18 and EOCAD 71±20capillaries/mm2, P<0.0001). Moreover, the capillary density in EOCAD patients was significantly reduced during PORH (EOCAD at rest 80±19 and EOCAD during PORH 71±20capillaries/mm2, P=0.0073). Conclusions: Patients with EOCAD presented systemic capillary rarefaction and impaired microvascular endothelial function. Thus, the early detection of these microvascular alterations in young adults at an increased risk of coronary artery disease could be useful as a surrogate marker of subclinical atherosclerosis. © 2014 Elsevier Inc.


Zuanazzi D.,Federal University of Rio de Janeiro | Souto R.,Federal University of Rio de Janeiro | Mattos M.B.A.,Federal University of Rio de Janeiro | Zuanazzi M.R.,Federal University of Rio de Janeiro | And 3 more authors.
Archives of Oral Biology | Year: 2010

Objective: To assess the prevalence of oral colonisation by bacterial respiratory pathogens in hospitalised patients. Methods: Thirty patients undergoing myocardium revascularisation surgery were evaluated. At baseline (pre-operative phase), full-mouth clinical periodontal assessment was performed. Saliva and biofilm samples were obtained from subjects at baseline and at the post-operative phase, after orotracheal extubation. DNA was extracted from samples and species of Acinetobacter, Pseudomonas, Staphylococcus aureus and Dialister pneumosintes were detected by PCR or culture (for staphylococci isolates). Results: Most of the subjects were males, with history of hypertension and smoking. Thirteen were edentulous (ED) and 17 were dentate (DE), with moderate chronic periodontitis. The most prevalent bacteria in saliva were Staphylococcus spp. (85.7%), Pseudomonas spp. (83.8%), and Acinetobacter spp. (53.3%). There was a trend for D. pneumosintes to be more frequently detected in DE (43.7%) than ED (11.5%) patients. In plaque samples, DE with >14 teeth showed a higher prevalence of Pseudomonas spp. (100%) than individuals with ≤14 teeth (69.1%; p = 0.048). Conversely, P. aeruginosa was more prevalent in subjects with fewer teeth (35.5%) than with >14 teeth (5.7%; p = 0.037). All staphylococci isolates were coagulase-negative, and about 11% were positive for the mecA gene. These mecA-positive isolates showed a tendency to increase in all samples, whereas P. aeruginosa reduced after surgery. A strong correlation between the presence of Acinetobacter spp. and Pseudomonas spp. was observed (rho = 0.886, p < 0.05). Conclusions: The oral cavity of hospitalised patients harbours high frequencies of bacterial respiratory pathogens, supporting its potential role as a reservoir for these species. © 2009 Elsevier Ltd. All rights reserved.


Huguenin G.V.B.,Federal University of Rio de Janeiro | Oliveira G.M.M.,Federal University of Rio de Janeiro | Moreira A.S.B.,National Institute of Cardiology INC | Saint'Pierre T.D.,Pontifical Catholic University of Rio de Janeiro | And 6 more authors.
Nutrition Journal | Year: 2015

Objectives: To investigate the effect of partially defatted Granulated Brazil nut (GBN) on biomarkers of oxidative stress and antioxidant status of hypertensive and dyslipidemic patients on nutrition and drug approaches. Methods: Ninety one hypertensive and dyslipidemic subjects of both genders (51.6 % men), mean age 62.1∈±∈9.3 years, performed a randomized crossover trial, double-blind, placebo controlled. Subjects received a diet and partially defatted GBN 13 g per day (≈227.5 μg/day of selenium) or placebo for twelve weeks with four-week washout interval. Anthropometric, laboratory and clinic characteristics were investigated at baseline. Plasma selenium (Se), plasma glutathione peroxidase (GPx3) activity, total antioxidant capacity (TAC), 8-epi PGF and oxidized LDL were evaluated at the beginning and in the end of each intervention. Results: GBN intake significantly increased plasma Se from 87.0∈±∈16.8 to 180.6∈±∈67.1 μg/L, increased GPx3 activity in 24,8 % (from 112.66∈±∈40.09 to 128.32∈±∈38.31 nmol/min/mL, p∈<∈0,05), and reduced 3.25 % of oxidized-LDL levels (from 66.31∈±∈23.59 to 60.68∈±∈20.88 U/L, p∈<∈0.05). An inverse association between GPx3 and oxidized LDL levels was observed after supplementation with GBN by simple model (β -0.232, p∈=∈0.032) and after adjustment for gender, age, diabetes and BMI (β -0.298, p∈=∈0.008). There wasn't association between GPx3 and 8-epi PGF (β -0.209, p∈=∈0.052) by simple model. Conclusion: The partially defatted GBN intake has a potential benefit to increase plasma selenium, increase enzymatic antioxidant activity of GPx3 and to reduction oxidation in LDL in hypertensive and dyslipidemic patients. Trial registration: ClinicalTrials.gov Identifier NCT01990391; November 20, 2013. © 2015 Huguenin et al.


Huguenin G.V.B.,Federal University of Rio de Janeiro | Moreira A.S.B.,National Institute of Cardiology INC | Siant'Pierre T.D.,Pontifical Catholic University of Rio de Janeiro | Goncalves R.A.,Pontifical Catholic University of Rio de Janeiro | And 5 more authors.
Microcirculation | Year: 2015

Objective: To investigate the effects of dietary supplementation with GBNs on microvascular endothelial function in hypertensive and dyslipidemic patients. Methods: Ninety-one patients of both sexes aged 62.1 ± 9.3 years received 13 g/day of GBNs or a placebo for three months with a washout period of one month between treatments. Microvascular endothelial function was assessed using LSCI coupled with iontophoresis of ACh and PORH. We also used skin video capillaroscopy to measure capillary density and recruitment at rest and during PORH. Plasma concentrations of NOx were also measured as a marker of nitric oxide bioavailability. Results: Supplementation with GBNs significantly increased the plasma levels of Se (p < 0.05) and NOx (p < 0.05). However, we did not observe any effects of GBN consumption on microvascular vasodilator responses to ACh or PORH (p > 0.05), and GBNs did not improve capillary density at baseline or recruitment during PORH (p > 0.05). Conclusions: Supplementation with GBNs induced significant increases in the plasma Se concentration and systemic bioavailability of nitric oxide. Nevertheless, GBN supplementation did not lead to any improvement in systemic microvascular reactivity or density in patients with arterial hypertension and dyslipidemia who were undergoing multiple drug therapies. © 2015 John Wiley & Sons Ltd.


Tibirica E.,National Institute of Cardiology INC
Nutrition journal | Year: 2014

BACKGROUND: Dietary creatine supplementation (CrS) is a practice commonly adopted by physically active individuals. However, the effects of CrS on systemic microvascular reactivity and density have never been reported. Additionally, CrS is able to influence blood levels of homocysteine, resulting in presumed effects on vascular endothelial function. Thus, we investigated the effects of CrS on the systemic microcirculation and on homocysteine levels in healthy young individuals.METHODS: This open-label study was performed on a group of 40 healthy male, moderately physically active subjects aged 27.7 ± 13.4 years who received one week of CrS at a dose of 20 g/day of commercially available micronized creatine monohydrate. Laser speckle contrast imaging was used in the evaluation of cutaneous microvascular reactivity, and intra-vital video microscopy was used to evaluate skin capillary density and reactivity, before and after CrS.RESULTS: CrS did not alter plasma levels of homocysteine, although CrS increased creatinine (p = 0.0001) and decreased uric acid (p = 0.0004) plasma levels. Significant changes in total cholesterol (p = 0.0486) and LDL-cholesterol (p = 0.0027) were also observed along with a reduction in plasma levels of T3 (p = 0.0074) and an increase in T4 levels (p = 0.0003). Skin functional capillary density (p = 0.0496) and capillary recruitment during post-occlusive reactive hyperemia (p = 0.0043) increased after CrS. Increases in cutaneous microvascular vasodilation induced by post-occlusive reactive hyperemia (p = 0.0078) were also observed.CONCLUSIONS: Oral supplementation with creatine in healthy, moderately physically active young adults improves systemic endothelial-dependent microvascular reactivity and increases skin capillary density and recruitment. These effects are not concurrent with changes in plasma homocysteine levels.


PubMed | National Institute of Cardiology INC, Federal University of Rio de Janeiro and Pontifical Catholic University of Rio de Janeiro
Type: Journal Article | Journal: Microcirculation (New York, N.Y. : 1994) | Year: 2016

To investigate the effects of dietary supplementation with GBNs on microvascular endothelial function in hypertensive and dyslipidemic patients.Ninety-one patients of both sexes aged 62.1 9.3 years received 13 g/day of GBNs or a placebo for three months with a washout period of one month between treatments. Microvascular endothelial function was assessed using LSCI coupled with iontophoresis of ACh and PORH. We also used skin video capillaroscopy to measure capillary density and recruitment at rest and during PORH. Plasma concentrations of NOx were also measured as a marker of nitric oxide bioavailability.Supplementation with GBNs significantly increased the plasma levels of Se (p < 0.05) and NOx (p < 0.05). However, we did not observe any effects of GBN consumption on microvascular vasodilator responses to ACh or PORH (p > 0.05), and GBNs did not improve capillary density at baseline or recruitment during PORH (p > 0.05).Supplementation with GBNs induced significant increases in the plasma Se concentration and systemic bioavailability of nitric oxide. Nevertheless, GBN supplementation did not lead to any improvement in systemic microvascular reactivity or density in patients with arterial hypertension and dyslipidemia who were undergoing multiple drug therapies.


PubMed | National Institute of Cardiology INC, Federal University of Rio de Janeiro and Pontifical Catholic University of Rio de Janeiro
Type: | Journal: Nutrition journal | Year: 2015

To investigate the effect of partially defatted Granulated Brazil nut (GBN) on biomarkers of oxidative stress and antioxidant status of hypertensive and dyslipidemic patients on nutrition and drug approaches.Ninety one hypertensive and dyslipidemic subjects of both genders (51.6 % men), mean age 62.19.3 years, performed a randomized crossover trial, double-blind, placebo controlled. Subjects received a diet and partially defatted GBN 13 g per day (227.5 g/day of selenium) or placebo for twelve weeks with four-week washout interval. Anthropometric, laboratory and clinic characteristics were investigated at baseline. Plasma selenium (Se), plasma glutathione peroxidase (GPx3) activity, total antioxidant capacity (TAC), 8-epi PGF2 and oxidized LDL were evaluated at the beginning and in the end of each intervention.GBN intake significantly increased plasma Se from 87.016.8 to 180.667.1 g/L, increased GPx3 activity in 24,8% (from 112.6640.09 to 128.3238.31 nmol/min/mL, p<0,05), and reduced 3.25% of oxidized-LDL levels (from 66.3123.59 to 60.6820.88 U/L, p<0.05). An inverse association between GPx3 and oxidized LDL levels was observed after supplementation with GBN by simple model ( -0.232, p=0.032) and after adjustment for gender, age, diabetes and BMI ( -0.298, p=0.008). There wasnt association between GPx3 and 8-epi PGF2 ( -0.209, p=0.052) by simple model.The partially defatted GBN intake has a potential benefit to increase plasma selenium, increase enzymatic antioxidant activity of GPx3 and to reduction oxidation in LDL in hypertensive and dyslipidemic patients.ClinicalTrials.gov Identifier NCT01990391; November 20, 2013.


PubMed | National Institute of Cardiology INC
Type: Journal Article | Journal: Nutrition journal | Year: 2014

Dietary creatine supplementation (CrS) is a practice commonly adopted by physically active individuals. However, the effects of CrS on systemic microvascular reactivity and density have never been reported. Additionally, CrS is able to influence blood levels of homocysteine, resulting in presumed effects on vascular endothelial function. Thus, we investigated the effects of CrS on the systemic microcirculation and on homocysteine levels in healthy young individuals.This open-label study was performed on a group of 40 healthy male, moderately physically active subjects aged 27.713.4 years who received one week of CrS at a dose of 20 g/day of commercially available micronized creatine monohydrate. Laser speckle contrast imaging was used in the evaluation of cutaneous microvascular reactivity, and intra-vital video microscopy was used to evaluate skin capillary density and reactivity, before and after CrS.CrS did not alter plasma levels of homocysteine, although CrS increased creatinine (p=0.0001) and decreased uric acid (p=0.0004) plasma levels. Significant changes in total cholesterol (p=0.0486) and LDL-cholesterol (p=0.0027) were also observed along with a reduction in plasma levels of T3 (p=0.0074) and an increase in T4 levels (p=0.0003). Skin functional capillary density (p=0.0496) and capillary recruitment during post-occlusive reactive hyperemia (p=0.0043) increased after CrS. Increases in cutaneous microvascular vasodilation induced by post-occlusive reactive hyperemia (p=0.0078) were also observed.Oral supplementation with creatine in healthy, moderately physically active young adults improves systemic endothelial-dependent microvascular reactivity and increases skin capillary density and recruitment. These effects are not concurrent with changes in plasma homocysteine levels.

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