1,721,147 research outputs found
Norepinephrine, plasma renin activity and cardiovascular mortality in systolic heart failure
No full textObjective: We analysed the circulating levels and prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP), norepinephrine (NE), epinephrine (E), plasma renin activity (PRA) and aldosterone in patients with systolic heart failure (HF) receiving therapies that target the sympathetic system and the renin-angiotensin-aldosterone axis. Methods: We retrieved data from consecutive HF outpatients with left ventricular ejection fraction (LVEF) <50% and available neurohormones, evaluated at a tertiary referral centre for HF from 1999 to 2016. Results: Patients (n=1477) were aged 66±13 years, 75% were men, median LVEF was 32% (IQR 25-38), 77% had LVEF <40% and 44% ischaemic HF. At the time of sampling, 69% were on beta-blockers, 75% on ACE inhibitors/angiotensin receptor blockers and 48% on mineralocorticoid receptor antagonists vs 88%, 87% and 66%, respectively, after therapy optimisation. Median NT-proBNP, NE, E, PRA and aldosterone were 1441 ng/L, 494 ng/L, 30 ng/L, 1.2 ng/mL/hour and 130 ng/dL, respectively. Over a 4.8-year follow-up (2.4-8.2), 376 patients died from cardiovascular causes (26%). NT-proBNP and PRA predicted cardiovascular mortality after adjusting for all other univariable predictors. The risk of cardiovascular death increased by 8% or 7% per each doubling of PRA in 2 models considering therapies at the time of sampling or after therapy optimisation. PRA improved metrics of reclassification and discrimination, and independently predicted outcome even in the LVEF <40% subgroup. Conclusions: In patients with HF with LVEF <50% or <40%, PRA shows independent prognostic significance from a model that includes NT-proBNP, and might represent an additive tool for risk stratification
Clinical implications of a recent adjustment to the high-sensitivity cardiac troponin T assay: some results.
No full textAldosterone elevation during the luteal phase of the menstrual cycle may suggest primary aldosteronism in hypertensive women
No full textALDOSTERONE ELEVATION DURING LUTEAL PHASE OF THE MENSTRUAL CYCLE MAY SUGGEST PRIMARY ALDOSTERONISM IN HYPERTENSIVE WOMEN
Objective. Primary aldosteronism is a low-renin hypertensive condition which has being increasingly diagnosed in the last years. It is known that plasma aldosterone (ALDO) concentration may increase during the luteal phase of the menstrual cycle in normal women, particularly in the premenstrual syndrome. We here report some observations on the spontaneous changes of plasma ALDO during the menstrual cycle in hypertensive women.
Design and Method. Eleven reproductive-age essential hypertensive women (mean age 41, range 33-53 yrs) with known low renin values ( PRA<1 ng/ml/hr) under no antihypertensive treatment were studied four times during one menstrual cycle (at days 7, 14, 21, 28). Plasma samples were taken at 08:30 hr in the morning and assayed for LDH, FSH, 17 beta-estradiol, progesterone, aldosterone (ALDO) and PRA.
Results. The hormonal profile of each menstrual cycle was normal except for one patient who showed a non-ovulatory pattern. At day 7 normal ALDO and low PRA values were observed except for one patient with 1.2 ng/ml/hr PRA. During the luteal phase a significant increase in ALDO levels was observed (p<0.005, ANOVA test) with a resultant increase in ALDO/PRA ratio, as showed in the table. In particular, five patients showed ALDO levels above the normal range in the presence of low PRA values. A direct correlation was observed between ALDO and progesterone levels (p<0.02).
Table: PRA, ALDO and ALDO/PRA ratio (mean values and ranges).
Day 7 Day 14 Day 21 Day 28
PRA (ng/ml/hr) 0.34 (0.2-1.2) 0.68 (0.2-3.3) 0.59 (0.2-1.8) 0.46 (0.2-1.5)
ALDO (ng/dl) 8.8 (6.1-14.6) 13.1 (7.5-22.7) 17.9 (5.5-33.6) 16.4 (7.3-28.9)
ALDO/PRA 36 (5-63) 36 (2-66) 41 (7-92) 45 (16-70)
Conclusions. Our observations confirm that ALDO levels may change during the menstrual cycle; abnormally high ALDO and low PRA values may be observed during the luteal phase. These facts should be taken into account when screening for primary aldosteronism in hypertensive women of reproductive age
Rilevanza clinica e interpretazione dei marcatori biochimici nello scompenso cardiaco
No full textClinical relevance and interpretation of biochemical markers in heart failure. Heart failure (HF) is a global
problem with an estimated prevalence of 38 million patients worldwide. Both prevalence and incidence of HF increase
progressively with population ageing (prevalence ≥10% in people >75 years), especially in the high-income countries.
HF is considered as the fatal event of all cardiovascular disorders. Despite some progress in diagnosis and treatment,
its prognosis is worse than that of most cancers. The disease is heterogeneous in its clinical presentation and the
diagnosis is not based on a single test, but on a combination of the history, physical examination and appropriate
investigations, including some laboratory tests. As a consequence, the accuracy of diagnosis by clinical signs alone
is often inadequate, especially in the early asymptomatic stage of HF. For these reasons, there is an increasing
interest in the development of new biomarkers useful for the diagnosis, prognosis and follow-up of patients with HF.
The aim of this paper is to provide an overview of biomarkers recommended by international guidelines for HF,
discussing their clinical impact and the interpretation of results. Furthermore, a possible strategy for the development
and evaluation of novel prognostic biomarkers for HF will be suggested
An electrochemical study of natural and chemically controlled eumelanin
No full textEumelanin is the most common form of the pigment melanin in the human body, with functions including antioxidant behavior, metal chelation, and free radical scavenging. This biopigment is of interest for biologically derived batteries and supercapacitors. In this work, we characterized the voltammetric properties of chemically controlled eumelanins produced from 5,6-dihydroxyindole (DHI) and 5,6-dihydroxyindole-2-carboxylic acid (DHICA) building blocks, namely, DHI-melanin, DHICA-melanin, and natural eumelanin, extracted from the ink sac of cuttlefish, Sepia melanin. Eumelanin electrodes were studied for their cyclic voltammetric properties in acidic buffers including Na+, K+, NH4+, and Cu2+ ions. (C) 2017 Author(s)
Aldosterone in the ovarian cycle of low renin hypertensive women.
No full textAldosterone in the Ovarian Cycle of Low Renin Hypertensive Women.
E. Fommei, S. Maffei, S. Ghione, A. Iervasi, C. Prontera.
Institute of Clinical Physiology, C.N.R., Pisa, Italy
"ish2006ab"
Abstract Registration [11693]
Objective. We previously reported an increase in plasma aldosterone levels during the luteal phase of the menstrual cycle in low renin hypertensive women. Recent in vitro observations indicate a stimulating effect of LH in aldosterone secreting adenomas (Amigh,2006). We here extend our observations and compare aldosterone changes with those of other hormonal parameters.
Design and Method. In fourteen low renin hypertensive women (range 33-53 yrs) plasma was taken at 08:30 hr a.m. and assayed for LH, FSH, 17beta-estradiol, progesterone, aldosterone (ALDO), PRA, cortisol (CORT) and BNP during one menstrual cycle (at days 7, 14, 21, 28).
Results. ALDO levels increased in the luteal phase (ANOVA p<0.005), clearly above the normal range in seven patients in the presence of low PRA. ALDO was related positively to PRA (<0.05), CORT(<0.05) and progesterone (<0.03) but negatively to estrogen (p<0.05) and BNP (p<0.005), the last two being directly related to each other (p<0.01).
Conclusions. Our results 1) confirm our previous observations that ALDO may abnormally increase during the menstrual cycle in low renin women; 2) support a possibile role of LH in ALDO stimulation, as recently suggested; 3) suggest that ALDO may increase in response to the natriuretic effect of progesterone whereas estrogen may be opposed by natriuretic peptide.
These findings should be considered when examining endocrine cardiovascular profile in women, particularly when screening for primary aldosteronism; in many hypertensive women the occurrence of hyperaldosteronism in the luteal phase could induce or aggravate pre-menstrual syndrome that might be relieved by aldosterone antagonist therapy
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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