Navegando por Palavras-chave "Carotid intima-media thickness"

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    Avaliação da espessura do complexo médio-intimal da carótida em pacientes com ataxia telangiectasia: associação com biomarcadores relacionados ao metabolismo lipídico e da glicose
    (Universidade Federal de São Paulo (UNIFESP), 2015-06-26) Paulino, Talita Lemos [UNIFESP]; Sarni, Roseli Oselka Saccardo [UNIFESP]; Costa-Carvalho, Beatriz Tavares [UNIFESP]; http://lattes.cnpq.br/1072990929102111; http://lattes.cnpq.br/1760819469047929; Universidade Federal de São Paulo (UNIFESP)
    Introdução: A ataxia telangiectasia (A-T) é uma doença neurodegenerativa, que cursa com imunodeficiência em graus variáveis, disfunção mitocondrial e estresse oxidativo. Descobertas recentes incluem como fenótipo estendido da doença outras alterações como a resistência à insulina e o risco para o desenvolvimento de diabetes e doenças ateroscleróticas. Objetivo: Avaliar a espessura médio-intimal da carótida e correlacioná-la com biomarcadores do metabolismo lipídico e da glicose em pacientes com A-T. Métodos: Estudo transversal prospectivo e controlado que avaliou 18 pacientes e 17 controles, pareados por sexo, idade e estadiamento puberal, quanto ao estado nutricional, perfil lipídico, apolipoproteínas A-I e B (Apo A-I e Apo B), glicemia e insulinemia basais e após sobrecarga oral de glicose e aferiu a medida da espessura do complexo médio-intimal (CMI) da carótida. Resultados: A mediana de idade do grupo A-T foi de 13,1 anos; 6/18 (33%) eram desnutridos, 3/13 (23,1%) apresentavam baixa estatura para idade e 10/18 (55,5%) comprometimento da massa muscular. Foi observado dislipidemia em 10/18 (55,5%) dos pacientes, no entanto, apenas para o HDL-c foi constatada diferença significante entre os dois grupos (p=0,020). No grupo A-T 1/18 (5,5%) era diabético, 2/11 (18,2%) apresentavam intolerância à glicose e 5/11 (41,2%) resistência à insulina. Na análise bivariada o índice de massa corporal (IMC) e as concentrações de glicemia de jejum foram menores, e as de Apo B e da relação Apo B/ApoA-I foram maiores no grupo A-T. No entanto, na análise multivariada somente o IMC e a relação Apo B/Apo A-I permaneceram no modelo. A mediana da espessura do CMI da carótida apresentou correlação com as relações Apo B/Apo A-I, LDL-c/HDL-c e com a Apo B. A ingestão de energia, macronutrientes e colesterol não diferiu entre os grupos. Conclusão: Pacientes com A-T apresentam risco de aterosclerose e de diabetes que aliado ao comprometimento do estado nutricional pode complicar a evolução da doença.
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    Avaliação da espessura médio-intimal da carótida e fatores associados à doença cardiovascular em crianças e adolescentes com doença renal crônica
    (Universidade Federal de São Paulo (UNIFESP), 2017-12-08) Lopes, Renata [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Andrade, Maria Cristina de [UNIFESP]; Oliveira, Fernanda Luisa Ceragioli [UNIFESP]; Maria Cristina Andrade : http://lattes.cnpq.br/0214601557718892; Fernanda Luisa Ceragioli Oliveira : http://lattes.cnpq.br/1217784724548967; http://lattes.cnpq.br/5056114729141952; http://lattes.cnpq.br/4444045245169523; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Cardiovascular complications are the leading cause of death in patients with chronic kidney disease (CKD). The measurement of carotid intima-media thickness (IMT) is a noninvasive tool for the early detection of arterial injury in these patients. The aim of the present study was to evaluate the carotid intima-media thickness and factors associated with cardiovascular disease in children and adolescents with CKD. Material and Methods: Observational cross-sectional study of 55 patients (60% male), with median age 11.9 years (I25-I75: 9.2 - 14.8 years). Out of the 55 patients, 43 were on conservative treatment and 12 were on dialysis. Serum laboratory parameters (creatinine, uric acid, C-reactive protein, total cholesterol and fractions and triglycerides), nutritional status (z-score of body mass index, height / age z score), body fat and abdominal circumference) and blood pressure were evaluated. The carotid IMT measure was evaluated by single ultrasonographer and compared to percentiles established according to gender and height. Data collection was performed between May 2015 and March 2016. Results: 74.5% (95% CI: 61.0; 85.3) of children and adolescents with CKD presented an increase (above the 95th percentile) of the carotid IMT. In patients with stage I and II hypertension, 90.9% presented increased of the carotid IMT. The nutritional status and body fat were not associated with increased of the carotid IMT. Regarding laboratory tests, C-reactive protein and uric acid were elevated in 54.5% and 45.5% of patients with CKD, respectively, both of which were no association with the increase of the carotid IMT. After multivariate adjustment, only the puberty (RP = 1.30, p = 0.037) and arterial hypertension stages I and II (RR = 1.42, p = 0.011) were independently associated to the change in the carotid IMT. Conclusion: The prevalence of increased carotid thickness was high in children and adolescents with CKD. The puberty and arterial hypertension were independently associated to the increased of the carotid IMT. The other factors related to cardiovascular disease in patients with CKD were not associated with carotid artery alteration in the ultrasound evaluation. The risk factors studied play an important role in CVD associated morbidity and mortality in children with CKD. Early and routine assessment of these factors, along with appropriate intervention are important in preventing CVD progression and mortality in these patients.
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    Avaliação do risco cardiovascular de pais de pacientes com ataxia telangiectasia
    (Universidade Federal de São Paulo (UNIFESP), 2016-11-28) Kotchetkoff, Elaine Cristina de Almeida [UNIFESP]; Sarni, Roseli Oselka Saccardo [UNIFESP]; http://lattes.cnpq.br/1760819469047929; http://lattes.cnpq.br/6291344918359532; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Ataxia telangiectasia (A-T) is a rare neurodegenerative disease, which attends with immunodeficiency in several levels, with mitochondrial dysfunction and oxidative stress. As it is a recessive autosomal disease, patient?s parentes with A-T are carriers of its mutation. Researches suggest that A-T heterozygotes individuals presente higher risk to develop illness. Objective: Objective of the present study was to evaluate the carotid intima-media thickness (IMT) and lipid metabolism biomarkers associated to the cardiovascular in patient?s parentes and verify association to its gender. Methods: A cross-sectional and controlled study involving 29 A-T patients? parentes and 14 healthy controls, paired by gender and age. It was evaluated: lipid profile, apolipoproteins AI and B (Apo AI and Apo B), paraoxonase 1 (PON1), Interleukin 6 (IL-6), glycemia, C-reactive protein ultrasensitive (hs-CRP) and IMT through ultrasound. Results: The average of IMT measure in A-T patient?s parent´s group was 0.72 ± 0.01 mm (minimum: 0.5 mm and maximum: 1.0 mm). Noticed high percentage of amounts above 75 percentile compared to the population referential [16 (76.2%)], without any significant statistics diferences between feminine and masculine gender [11/15 (73.3%) vs 5/6 (83.3%); P = 0.550]. Comparison between the A-T patients? parents and controls, stratified by gender, showed that in the group of A-T patients?s parentes, women had higher HDL-c levels compared to men, and higher hs-CRP related to women control group. In the group of A-T patients? parents, stratified according to gender, correlation between HDL-c and hs-CRP was inversely proportional and stronger among women, with tendency to statistical significance. Conclusion: heterozygotes ATM did not differ from controls in relation to biomarkers studied associated with cardiovascular risk, however, most of them presented na increase in IMT, independente predictor of death and risk for myocardial infarction and stroke compared to the reference for the same age group. This finding suggests a cardiovascular risk in the heterozigous ATM and points to the need to monitor IMT and nutricional orientations and stimulate the practice of physical activity.
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    Prevalence of subclinical atherosclerosis and cardiovascular risk reclassification by measure of carotid intima-media thickness in ambulatory hypertensive patients
    (Elsevier B.V., 2013-12-01) Monteiro Junior, Francisco das Chagas [UNIFESP]; Cunha Junior, Cacionor Pereira da; Muniz Ferreira, Pedro Antonio; Teixeira Nunes, Jose Aldemir; Brito, Ronald Lopes; Barbosa, Jose Bonifacio; Mandarino, Natalia Ribeiro; Lages, Joyce Santos; Salgado Filho, Natalino; Lima, Valter Correia de [UNIFESP]; Univ Fed Maranhao; Universidade Federal de São Paulo (UNIFESP)
    Introduction and Objectives: Although carotid intima-media thickness (CIMT) is considered a surrogate marker of subclinical atherosclerosis, with known value in risk stratification, its routine use in hypertensive patients is not recommended. the aim of this study was to determine the prevalence of subclinical atherosclerosis through measurement of CIMT and its impact on reclassification of risk in hypertensive patients.Methods: This was a cross-sectional study of 94 middle-aged (56.99 +/- 11.89 years) hypertensive outpatients without overt cardiovascular disease, 68.1% female. All participants underwent clinical examination, biochemical tests, echocardiogram and measurement of CIMT by high-resolution ultrasound.Results: Although the majority of patients were stratified as low (63.5%) or intermediate risk (23%) according to their Framingham score, a high prevalence (75.3%) of increased CIMT was observed in the overall sample, including in the low (61%) and intermediate risk groups (93.8%). CIMT measurement resulted in risk reclassification of 70.31% of the patients, 61% of those at low risk being reclassified as intermediate risk and 93.8% of those at intermediate risk being reclassified as high risk.Conclusion: in these hypertensive outpatients, predominantly middle-aged and female, CIMT measurement revealed a high prevalence of subclinical atherosclerosis and resulted in risk reclassification in the majority of cases. (C) 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L. All rights reserved.
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    Relationship between cardiovascular risk factors and the echogenicity and pattern of the carotid intima-media complex in men
    (Associação Paulista de Medicina - APM, 2014-01-01) Sarmento, Priscilla Lopes da Fonseca Abrantes [UNIFESP]; Plavnik, Frida Liane; Scaciota, Andrea; Lima, Joab Oliveira; Miranda, Robson Barbosa; Ajzen, Sergio Aron [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Paraíba Department of Statistics; Faculdade de Medicina do ABC Department of Surgery
    CONTEXT AND OBJECTIVE:The thickness of the carotid intima-media complex (C-IMC) is considered to be a marker of early atherosclerosis, but visual and echogenic changes to the C-IMC can also be noted. The objective here was to evaluate the relationship between cardiovascular risk factors and the echogenicity of the C-IMC and identify those most associated with an abnormal C-IMC.DESIGN AND SETTING:Cross-sectional study in the ultrasound sector of the Department of Diagnostic Imaging, Universidade Federal de São Paulo.METHODS:Eighty men were evaluated. Measurements of arterial blood pressure, waist circumference (WC), lipid profile, fasting glucose, uric acid and high-sensitivity C-reactive protein were obtained. The thickness of the C-IMC was measured by means of B-mode ultrasound, and the intima-media gray-scale mean (IM-GSM) and standard deviation (IM-SD) were calculated.RESULTS:The following were discriminating variables: fasting glucose (r2 = 0.036; P = 0.013), uric acid (r2 = 0.08; P = 0.03), IM-SD (r2 = 0.43; P < 0.001), IM-GSM (r2 = 0.35; P < 0.001) and thickness of the C-IMC (r2 = 0.29; P < 0.001). IM-GSM showed significant correlations with WC (r = -0.22; P = 0.005), fasting glucose (r = -0.24; P = 0.002) and high-density lipoprotein cholesterol (HDL-C) (r = 0.27; P = 0.0007).CONCLUSION:IM-GSM showed correlations with WC, fasting glucose and HDL-C. However, uric acid and IM-SD presented the greatest discriminating impact. These results suggest that visual changes in C-IMC may help identify patients with potential cardiovascular risk, independently of the thickness of the C-IMC.