Navegando por Palavras-chave "Endothelial Function"

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    Avaliação da vasodilatação mediada por fluxo artéria braquial e dos fatores de risco cardiovascular em crianças e adolescentes com doença renal crônica
    (Universidade Federal de São Paulo (UNIFESP), 2019-04-04) Bocaletti, Ana Paula [UNIFESP]; Ajzen, Sergio Aron [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Cardiovascular morbidity and mortality are the leading causes of death in children and young adults with advanced chronic kidney disease (CKD) diagnosed in childhood. Individuals with impairment of endothelial function and carotid intima-media thickness have an increased cardiovascular risk in the future. High resolution ultrasonography is a useful noninvasive method to investigate subclinical atherosclerosis by measuring the intima-media thickness of carotid artery and evaluating the brachial flow-mediated vasodilation (FMD). Objectives: Estimate the prevalence of FMD reduction in pediatric patients with advanced chronic kidney disease and verify the association between FMD reduction, clinical, anthropometric, laboratory parameters and intima-media thickness. Methods: In this cross-sectional study 55 patients (60% male), age 6.2-17.4 years, 43 with non-dialysis CKD and 12 on chronic dialysis were included in the analysis. FMD was evaluated 60 seconds after cuff release and was reduced when less or equal to 5%, compared with the baseline parameters. Intima-media thickness of carotid artery complex was performed on the posterior wall, on the longitudinal axis. Results: The prevalence of FMD reduction (≤ 5%) at 60 seconds was 41.8% (95% CI). Systemic arterial pressure (p = 0.041) and hemodialysis treatment (p<0,001) was significant correlated was with FMD reduction, as the glomerular filtration rate (p = 0.001) in patients on conservative treatment. The correlation between FMD reduction and carotid ECMI were not statistically significant. No statistical significance was observed between reduction of vasodilatation with sex, age, etiology of renal disease, time of diagnosis of renal disease, conservative or dialytic treatment, use of medications and changes in the serum biochemical levels studied. Conclusions: The prevalence of endothelial disfunction due to brachial FMD reduction was 41.8% in pediatric patients with chronic kidney disease. There was significant correlation between FMD reduction and glomerular filtration rate, blood pressure (BP) and hemodialysis. BP and hemodialysis were independently associated with FMD reduction. There was no significant correlation between carotid ECMI (morphological parameter) and FMD reduction (functional parameter). No statistical significance was observed between FMD reduction and renal disease etiology, time of diagnosis of renal disease, conservative or dialytic treatment, use of drugs and serum biochemical levels studied.
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    Efeito do frutooligossacarídeo na função endotelial de pacientes na fase não dialítica da doença renal crônica
    (Universidade Federal de São Paulo (UNIFESP), 2019-08-29) Linger, Rachel Gatti Armani [UNIFESP]; Canziani, Maria Eugenia Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Microbiota-derived uremic toxins, p-cresyl sulfate (PCS), indoxyl sulfate (IS) and trimethylamine N-oxide (TMAO), have been associated with increased cardiovascular risk in chronic kidney disease (CKD). This has encouraged the investigation of alternative approaches to modulate gut environment with consequent attenuation of toxin production, inflammation and endothelial dysfunction. Aim: To evaluate the effect of the prebiotic fructooligosaccharide (FOS) on endothelial function markers in non-dialysis CKD patients. Methods: This is a 3-month double-blind randomized controlled trial that included 46 non-diabetic CKD patients [52% men; 57.6±14.4 years; eGFR: 21.3±7.3 mL/min/1.73m²]. Intervention and placebo consisted in 12g/day of FOS or maltodextrin, respectively. PCS, and IS were determined by high performance liquid chromatography, and urinary TMAO by mass spectrometer. C-reactive protein (CRP) and Interleukin 6 (IL6) were evaluated by ELISA essay. Endothelial function was assessed through stroma derived factor 1 alfa (SDF1α), serum nitric oxide (NO) and flow-mediated dilatation (FMD). Results: Aside for the intervention group being older (53.4±16.0 vs 61.9±11.4; p=0.04) the groups were homogeneous. During the study, the renal function and electrolytes remained stable in both groups. Regarding inflammation, IL6 decreased in the treated group (p=0.04). A downward trend in PCS serum levels (p=0.07) was observed in that group. There was no difference in endothelial dysfunction markers as NO, SDF1α levels and FMD. In an exploratory analysis, including only patients with less damaged endothelium at baseline (median FMD ≥ 2.2 %) we observed a significant higher value of FMD in the treated group after 3 months (group effect p=0.135; time effect p=0.012; interaction p=0.002). Conclusions: There was no effect of the prebiotic FOS on the endothelial function in the studied population. Nonetheless, in patients with less damaged endothelium we could observe a preservation of brachial FMD in the treated group, which could suggest a potential therapeutic impact of FOS in endothelial dysfunction.
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    As Implicações Da Restrição De Crescimento In Utero Sobre A Reatividade Vascular E As Células Progenitoras Endoteliais Em Ratos Wistar: O Papel Do Treinamento Aeróbio
    (Universidade Federal de São Paulo (UNIFESP), 2017-06-30) Oliveira, Vanessa Aparecida De [UNIFESP]; Franco, Maria Do Carmo Pinho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Intrauterine growth restriction (IUGR) can induce deleterious changes in the modulatory ability of the vascular endothelium, contributing to an increased risk of developing cardiovascular diseases in the long term. However, the mechanisms by which IUGR promotes these changes are not elucidated. Considering the functional properties of endothelial progenitor cells (EPCs) in promoting endothelial repair our first hypothesis is that negative adaptations in EPCs may be involved in endothelial dysfunction induced by IUGR. Therefore, our goals were to investigate the effects of IUGR on vascular reactivity in aortic artery, number, functional properties and senescence process of in vitro CPEs in adult male offspring. For this, pregnant Wistar rats received ad libitum diet or 50% of diet ad libitum during the gestational period. Our results showed that offspring submitted to IUGR had a significant reduction of acetylcholine (ACh) -mediated vasodilation in the thoracic aorta rings, which may be, in part, to the lower concentration of nitric oxide (NO) observed in this vascular bed. The number of circulating and bone marrow EPCs was similar between the experimental groups. However, in vitro functional capacity of circulating CPEs and bone marrow was reduced in the restricted group compared to controls. Additionally, we observed that the restricted animals presented a significant increase in the number of senescent EPCs in the bone marrow vs control group. Therefore, this set of data demonstrates that IUGR can induce endothelial dysfunction in male offspring, which may be due in part to the reduction in NO concentration as well as the lower EPCs repair capacity. Based on these findings, and considering that aerobic training (AT) can induce beneficial effects on vascular function and on the functional capacity of CPEs, our second hypothesis is that the TA could reverse the deleterious adaptations in vascular function and in EPCs in IUGR rats. Therefore, we evaluated the effects of AT on vascular reactivity in aortic artery, number, functional properties and senescence process of in vitro EPCs in adult male offspring submitted to IUGR. Adult male offspring were divided into groups: sedentary control, trained control, restricted sedentary and restricted training. After AT protocol (60 minutes / day, 5 times / weeks, 10 weeks, intensity 50-60% of maximum speed). We observed that AT was effective in restoring ACh-induced vasodilatation in the thoracic aorta of restricted animals, this improvement was associated with normalization of NO concentration. The number of EPCs in bone marrow was reduced in trained control group compared to sedentary. The AT restored the functional capacity in vitro of circulating and bone marrow-derived EPCs in restricted group, which may be associated to the normalization of the number of senescent EPCs in bone marrow in these animals. Therefore, beneficial TA-induced adaptations in restricted animals in utero provide evidence that AT may be a non-pharmacological approach to reverse the negative adaptations in IUGR-induced vasculature and CPEs.