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血管紧张素转换酶基因缺失多态性对心力衰竭患者症状发生和生存率的调节

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世界核心医学期刊文摘（心脏病学分册） 2005年第7期1卷 46-46页

作者： Cuoco m.A.R. Pereira A.C. de Freitas H.F.G. 高登峰 Heart Institute(InCor) Clinical Division Univ. of S. Paulo Medical School Av. Dr. Eneas Carvalho Aguiar 44 So Paulo 05403-000 Brazil

Background: Angiotensin-converting enzyme is involved in the pathophysiology of heart failure. We hypothesized that clinical characteristics as well as survival rate in patients with heart failure of different etiologies may be modulated by functional variants DD, ID and II of the angiotensin-converting enzyme gene. methods: We studied 333 patients with heart failure, aged 43.3±10.5 years, 262(78.7%) men and 71(21.3%) women. Heart failure was ascribed to idiopathic dilated cardiomyopathy in 125 patients. Heart failure was caused by ischemic heart disease in 63 patients, Chagas’disease in 58, hypertensive heart disease in 41, alcoholic cardiomyopathy in 24, and was due to other etiologies in 22 patients. Statistical analysis was performed with the χ2 test, Student’s t-test, analysis of variance, Kaplan-meier and Cox proportional hazards methods. Results: The DD genotype was associated with increased systolic left ventricular diameter(p=0.031). Earlier onset of symptoms was observed in patients with alcoholic cardiomyopathy and DD genotype(p=0.033, codominant D) and in patients with hypertensive cardiomyopathy and DD genotype(p=0.048, codominant D; p=0.024, recessive D). mortality was higher in patients older than 50 years with DD genotype(p=0.007, codominant D; p=0.002, recessive D). Variables independently associated with higher mortality in patients older than 50 years were age, diabetes mellitus, Chagas’disease etiology and DD genotype. Conclusions: These results add evidence for an association of the DD genotype of the angiotensin-converting enzyme gene with earlier onset of symptoms and decreased survival rate of selected patients with heart failure.

关键词：基因缺失酒精性心肌病多态性缺血性心脏病病理生理学显性基因左心室隐性基因试验研究统计学分析

Renal impairment and heart failure with preserved ejection fraction early post-myocardial infarction

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World Journal of Cardiology 2010年第1期2卷 13-18页

作者： Vinod Jorapur Gervasio A Lamas Zygmunt P Sadowski Harmony R Reynolds Antonio C carvalho Christopher E Buller James m Rankin Jean Renkin Philippe Gabriel Steg Harvey D White Carlos Vozzi Eduardo Balcells michael Ragosta C Edwin martin Vankeepuram S Srinivas William W Wharton III Staci Abramsky Ana C mon Shari S Kronsberg Judith S Hochman Columbia University Division of Cardiology Mount Sinai Medical Center II Ischemic Heart Disease department National Institute of Cardiology Leon Charney Division of Cardiology New York University School of Medicine Cardiology Division-Hospital Sao Paulo Federal University of Sao Paulo Division of Cardiology University of British Columbia department of Cardiovascular medicine Royal Perth Hospital department of Cardiology UCL St Luc University Hospital INSERm U-698 Department of CardiologyHopital Bichat Cardiology department Green Lane Cardiovascular ServiceAuckland City Hospital Interventional Cardiology Instituto de Intervenciones Cardiovasculares S.A. Cardiovascular Associates Wellmont Holston Valley Medical Center Cardiovascular Division University of Virginia department of medicine-Division of Cardiology York Hospital Division of Cardiology Montefiore Medical Center/Albert Einstein College of Medicine Research department Asheville Cardiology AssociatesP.A. maryland medical Research Institute

AIm:To study if impaired renal function is associated with increased risk of peri-infarct heart failure (HF) in patients with preserved ejection fraction (EF).mETHODS:Patients with occluded infarct-related arteries (IRAs) between 1 to 28 d after myocardial infarction (mI) were grouped into chronic kidney disease (CKD) stages based on estimated glomerular filtration rate (eGFR).Rates of early post-mI HF were compared among eGFR *** regression was used to explore independent predictors of ***:Reduced eGFR was present in 71.1% of 2160 patients,with significant renal impairment (eGFR mL/min every 1.73 m2) in 14.8%.The prevalence of HF was higher with worsening renal function:15.5%,17.8% and 29.4% in patients with CKD stages 1,2 and 3 or 4,respectively (P despite a small absolute difference in mean EF across eGFR groups:48.2 ± 10.0,47.9 ± 11.3 and 46.2 ± 12.1,respectively (P=0.02).The prevalence of HF was again higher with worsening renal function among patients with preserved EF:10.1%,13.6% and 23.6% (P mong patients with depressed EF:27.1%,26.2% and 37.9% (P= 0.071).moreover,eGFR was an independent correlate of HF in patients with preserved EF (P=0.003) but not in patients with depressed EF (P=0.181).CONCLUSION:A significant proportion of post-mI patients with occluded IRAs have impaired renal *** renal function was associated with an increased rate of early post-mI HF,the association being strongest in patients with preserved *** findings have implications for management of peri-infarct HF.

关键词： Heart failure myocardial infarction Kidney disease

肌细胞直径和胶原面积分数与特发性扩张型心肌病门诊患者的存活时间无关:一项基于右室心肌内膜活检的研究

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世界核心医学期刊文摘（心脏病学分册） 2007年第7期3卷 55-55页

作者： Benvenuti L.A. Freitas H.F.G. mansur A.J. Higuchi m.L. 马超 Laboratory of Pathology Heart Institute(InCor) University of So Paulo Medical School Av. Dr. Eneas de Carvalho Aguiar 44 05403-000So Paulo Brazil

来自心肌内膜活检分析的形态数据可能有助于评价扩张型心肌病患者的预后。作者检查了35例特发性扩张型心肌病门诊患者右室心肌内膜活检标本中的肌细胞直径、其变异系数以及胶原面积分数。研究中所有的组织学参数均与患者的存活时间无关... 详细信息

来自心肌内膜活检分析的形态数据可能有助于评价扩张型心肌病患者的预后。作者检查了35例特发性扩张型心肌病门诊患者右室心肌内膜活检标本中的肌细胞直径、其变异系数以及胶原面积分数。研究中所有的组织学参数均与患者的存活时间无关（极差2～5588d，中位时间706d）。不应使用右室心肌内膜活检来预测特发性扩张型心肌病患者的进展或致死性结局。

关键词：特发性扩张型心肌病内膜活检存活时间门诊患者细胞直径右室积分胶原

获得性局限性面部皮肤松弛症:病例报道和文献回顾

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世界核心医学期刊文摘（皮肤病学分册） 2005年第5期1卷 41-41页

作者： Perafán m.F. Franca L.F.S. an Riveros C.J. Bejarano Gavilét al. 张宪旗 Hosp.das Clin. da Faculdade de med. Universidade de S.ao Paulo Ave. Dr E neas de Carvalho Aguiar 255 05403-900 S.ao Paulo SP Brazil

Background. Cutis laxa is an uncommon entity characterized by laxity of the sk in, which hangs in loose folds, producing the appearance of premature aging. It can be subdivided into congenital and acquired. This latter variant is rare and the skin involvement varies from generalized to localized. We report a case of a localized acquired cutis laxa confined to the face, without preceding inflammat ory lesions or systemic compromise. Four similar cases have been reported to dat e. The etiology remains unknown and there is no definitive treatment. methods. A 27-year-old White woman came to our hospital with a wrinkled face, pendulous earlobes and drop eyelids. Changes began 5 years prior, and she appeared much ol der than her age. Results. Histological analysis and ultrastructural examination of skin biopsy revealed reduction and fragmentation of elastic fibers, confirmi ng the diagnosis of cutis laxa. No systemic involvement was diagnosed. The patie nt was submitted to plastic surgery for repair, with satisfactory results to dat e. Conclusions. Acquired localized cutis laxa confined to the face without prece ding inflammatory lesions is extremely rare. The etiology remains unknown. Clini cal features and histopathologic findings confirm the diagnosis. Surgical repair seems to be the only therapeutic choice, but the results are variable and tempo rary.

关键词：面部皮肤松弛症文献回顾面部皱纹弹力纤维眼睑松垂整形外科活检组织学早老症炎症变化特效治疗