Metabolomic studies have demonstrated the existence of biological signatures in blood of patients with arterial hypertension, but no study has hitherto reported the sexual dimorphism of these signatures. We compared the plasma metabolomic profiles of 28 individuals (13 women and 15 men) with essential arterial hypertension with those of a healthy control group (18 women and 18 men), using targeted metabolomics. Among the 188 metabolites explored, 152 were accurately measured. Supervised OPLS-DA (orthogonal partial least squares-discriminant analysis) showed good predictive performance for hypertension in both sexes (Q 2 cum = 0.59 in women and 0.60 in men) with low risk of overfitting (pvalue-CV ANOVA = 0.004 in women and men). Seventy-five and 65 discriminant metabolites with a VIP (variable importance for the projection) greater than 1 were evidenced in women and men, respectively. Both sexes showed a considerable increase in phosphatidylcholines, a decrease in C16:0 with an increase in C28:1 lysophosphatidylcholines, an increase in sphingomyelins, as well as an increase of symmetric dimethylarginine (SDMA), acetyl-ornithine and hydroxyproline. Twenty-nine metabolites, involved in phospholipidic and cardiac remodeling, arginine/nitric oxide pathway and antihypertensive and insulin resistance mechanisms, discriminated the metabolic sexual dimorphism of hypertension. Our results highlight the importance of sexual dimorphism in arterial hypertension.
Pulmonary embolism is a major cause of death worldwide. Recurrences are mainly observed in patients with coagulation disorders or cancers. We describe the case of a brain tumor (Glioblastoma) revealed by behavioral disorder in a young patient admitted for a recurrent pulmonary embolism
Introduction: Pulmonary embolism and aortic dissection are two formidable cardiovascular emergencies. Their exceptional association has a poor prognosis with very high mortality. The aim of our study was to report the case of a 31-year-old patient with pulmonary embolism associated with De Bakey's type I aortic dissection, admitted to the cardiology department of Kati University Hospital. Case Presentation: We report the case of a young patient of 31 with no known cardiovascular history, on estrogen-progestogen contraception for 10 years, who consults for a left basal thoracic pain of increasing intensity, a whitish productive cough, hemoptysis and dyspnea stage III. She was admitted to the cardiology department, transthoracic cardiac ultrasound objectified aortic insufficiency, dissection of the aorta, the presence of the intimal flap, the false and the true channel, dilation of the right cavities with HTAP. The chest CT scan revealed bilateral lobar and segmental pulmonary embolism, De Bakey's type I aortic dissection. Medical treatment was instituted for hemodynamic stabilization at the end of sending her to a center specializing in cardiovascular surgery for better management; unfortunately she succumbed before the preparations for her evacuation were finished. Conclusion: The pulmonary embolism associated with aortic dissection constitutes a medical emergence of rare incidence in a cardiological environment; if the diagnosis was quickly made in our patient, the lack of technical platform made management difficult.
Objective: The purpose of this work was to determine the epidemiological, clinical and evolutionary aspects of the pulmonary embolism of the young person in the cardiology department of the University Hospital Center (CHU) Point G in Bamako-Mali. Methodology: This was an analytical study from January 01, 2018 to December 31, 2018 in the CHU Point G cardiology department, including all patients hospitalized during this period. Results: Of 1379 hospitalized patients, 19 patients were concerned by pulmonary embolism of the young person. The prevalence of pulmonary embolism of the young person was 1.37%. The most affected age group was 21-30 (47.4%) of patients. The predominance was female (89.47%) with a gender ratio of 0.11 in favour of women. The average age in the series was 29.79 years with extremes of 16 years and 40 years. Factors predisposing to pulmonary embolism were dominated by peri partum, cardiomyopathy and obesity with 47.3%, 31.57% and 21.1%, respectively. The dominant signs were chest pain and dyspnea in 94.7% and 89.5% of cases respectively. Pulmonary embolism was unlikely in 60.52% according to the Geneva and Wells score simplified. At the thoracic angioscanner, the embolism was bilateral in 52.6% of cases and distal in 36.8% of patients; in 10 patients who performed cardiac ultrasound, pulmonary arterial hypertension (70%), dilation of the right ventricle (20%) and left ventricular dilation (40%). Hyper leucocytosis (47.4%), anemia and low prothrombin rate (TP) (22.2%) were the most found biological abnormalities.
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