DSpace Collection:https://hdl.handle.net/10171/177562024-03-29T08:50:35Z2024-03-29T08:50:35ZBurden and challenges of heart failure in patients with chronic kidney disease. A call to actionhttps://hdl.handle.net/10171/667532023-07-10T05:17:18Z2020-01-01T00:00:00ZTitle: Burden and challenges of heart failure in patients with chronic kidney disease. A call to action
Abstract: Patients with the dual burden of chronic kidney disease (CKD) and chronic congestive heart
failure (HF) experience unacceptably high rates of symptom load, hospitalization, and mortality. Currently, concerted efforts to identify, prevent and treat HF in CKD patients are
lacking at the institutional level, with emphasis still being placed on individual specialty
views on this topic. The authors of this review paper endorse the need for a dedicated
cardiorenal interdisciplinary team that includes nephrologists and renal nurses and jointly manages appropriate clinical interventions across the inpatient and outpatient settings.
There is a critical need for guidelines and best clinical practice models from major cardiology
and nephrology professional societies, as well as for research funding in both specialties to
focus on the needs of future therapies for HF in CKD patients. The implementation of crossspecialty educational programs across all levels in cardiology and nephrology will help train
future specialists and nurses who have the ability to diagnose, treat, and prevent HF in CKD
patients in a precise, clinically effective, and cost-favorable manner.; Los pacientes con enfermedad renal crónica (ERC) que desarrollan insuficiencia cardíaca (IC)
congestiva crónica presentan cifras inaceptablemente altas de síntomas, hospitalización y
mortalidad. Actualmente, se echan en falta iniciativas institucionales dirigidas a identificar,
prevenir y tratar la IC en los pacientes con ERC de manera multidisciplinar, prevaleciendo
las actuaciones de las especialidades individuales. Los autores de este artículo de revisión
respaldan la necesidad de crear equipos multidisciplinares cardiorrenales, en los que participen nefrólogos y enfermeras renales, que gestionen colaborativamente las intervenciones
clínicas apropiadas en los entornos de pacientes con ERC e IC hospitalizados y ambulatorios.
Es necesario y urgente que se elaboren guías y modelos de práctica clínica sobre la ERC con IC
por parte de las sociedades profesionales de cardiología y nefrología, así como financiación
para la investigación concertada entre ambas especialidades sobre la necesidad de futuros
tratamientos para la IC en pacientes con ERC. La implementación de programas educativos
cardiorrenales a todos los niveles en cardiología y nefrología ayudará a formar a los futuros
especialistas y enfermeras para que tengan la capacidad de diagnosticar, tratar y prevenir
la IC en pacientes con ERC de manera precisa, clínicamente efectiva y económicamente
favorable2020-01-01T00:00:00ZOxidative stress in cardiovascular disease and comorbiditieshttps://hdl.handle.net/10171/646542022-12-12T06:07:17Z2022-01-01T00:00:00ZTitle: Oxidative stress in cardiovascular disease and comorbidities2022-01-01T00:00:00ZThe activity of circulating dipeptidyl peptidase-4 is associated with subclinical left ventricular dysfunction in patients with type 2 diabetes mellitushttps://hdl.handle.net/10171/359872020-03-03T23:42:02Z2013-01-01T00:00:00ZTitle: The activity of circulating dipeptidyl peptidase-4 is associated with subclinical left ventricular dysfunction in patients with type 2 diabetes mellitus
Abstract: Background: Patients with type 2 diabetes mellitus (T2DM) present subclinical left ventricular systolic and/or
diastolic dysfunction (LVD). Dipeptidyl peptidase-4 (DPP4) inactivates peptides that possess cardioprotective actions.
Our aim was to analyze whether the activity of circulating DPP4 is associated with echocardiographically defined
LVD in asymptomatic patients with T2DM.
Methods: In this cross-sectional study, we examined 83 T2DM patients with no coronary or valve heart disease and
59 age and gender-matched non-diabetic subjects. Plasma DPP4 activity (DPP4a) was measured by enzymatic assay
and serum amino-terminal pro-brain natriuretic peptide (NT-proBNP) was measured by enzyme-linked
immunosorbent assay. LV function was assessed by two-dimensional echocardiographic imaging, targeted M-mode
recordings and Doppler ultrasound measurements. Differences in means were assessed by t-tests and one-way
ANOVA. Associations were assessed by adjusted multiple linear regression and logistic regression analyses.
Results: DPP4a was increased in T2DM patients as compared with non-diabetic subjects (5855 ± 1632 vs 5208 ± 957
pmol/min/mL, p < 0.05). Clinical characteristics and echocardiographic parameters assessing LV morphology were
similar across DPP4a tertiles in T2DM patients. However, prevalence of LVD progressively increased across
incremental DPP4a tertiles (13%, 39% and 71%, all p < 0.001). Multivariate regression analysis confirmed the
independent associations of DPP4a with LVD in T2DM patients (p < 0.05). Similarly, multiple logistic regression
analysis showed that an increase of 100 pmol/min/min plasma DPP4a was independently associated with an
increased frequency of LVD with an adjusted odds ratio of 1.10 (95% CI, 1.04 to 1.15, p = 0.001).
Conclusions: An excessive activity of circulating DPP4 is independently associated with subclinical LVD in T2DM
patients. Albeit descriptive, these findings suggest that DPP4 may be involved in the mechanisms of LVD in T2DM.2013-01-01T00:00:00ZBlockade of TGF-β 1 Signalling Inhibits Cardiac NADPH Oxidase Overactivity in Hypertensive Ratshttps://hdl.handle.net/10171/228222020-03-03T21:22:24Z2012-01-01T00:00:00ZTitle: Blockade of TGF-β 1 Signalling Inhibits Cardiac NADPH Oxidase Overactivity in Hypertensive Rats
Abstract: NADPH oxidases constitute a major source of superoxide anion (·O(2) (-)) in hypertension. Several studies suggest an important role of NADPH oxidases in different effects mediated by TGF-β 1. In this study we show that chronic administration of P144, a peptide synthesized from type III TGF-β 1 receptor, significantly reduced the cardiac NADPH oxidase expression and activity as well as in the nitrotyrosine levels observed in control spontaneously hypertensive rats (V-SHR) to levels similar to control normotensive Wistar Kyoto rats. In addition, P144 was also able to reduce the significant increases in the expression of collagen type I protein and mRNA observed in hearts from V-SHR. In addition, positive correlations between collagen expression, NADPH oxidase activity, and nitrotyrosine levels were found in all animals. Finally, TGF-β 1-stimulated Rat-2 exhibited significant increases in NADPH oxidase activity that was inhibited in the presence of P144. It could be concluded that the blockade of TGF-β 1 with P144 inhibited cardiac NADPH oxidase in SHR, thus adding new data to elucidate the involvement of this enzyme in the profibrotic actions of TGF-β 1.2012-01-01T00:00:00Z