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Background: Atherosclerotic intima-media thickening (IMT) of carotid or subclavian artery may be associated with alterations in the sensitivity of carotid and subclavian baroreceptors. This is why we aimed at investigating if IMT is associated with alterations in the autonomic modulation of heart rate variability (HRV). Methods: This was a cross-sectional study with 30 subjects. The atherosclerotic artery IMT was determined by B-mode and duplex ultrasonography. HRV was evaluated through linear (low frequency [LF, ms2], high frequency [HF, ms2], standard deviation (SD) of normal R-R wave intervals [SDNN], square root of the mean of the sum of the squares of differences between adjacent normal R wave intervals [RMSSD]) and nonlinear Poincaré analysis (SD of the points perpendicular to the line-of-identity [SD1, ms]; SD along the line-of-identity [SD2, ms]). Results: A significant negative linear correlation was identified between the IMT of common carotid artery and the HRV indexes that reflects baroreflex and the fluctuations of autonomic tone: LF, Spearman's r = -0.52, 95% CI: -0.75 to -0.19, P = 0.003; SDNN, Spearman's r = -0.57, 95% CI: -0.78 to -0.25, P = 0.001; SD2, Spearman's r = -0.59, 95% CI: -0.79 to -0.28, P = 0.0006. Similar strong negative correlations were found for subclavian IMT. In contrast, there was no relationship between IMT and the HRV indexes related to autonomic tone (HF, LF/HF, RMSSD, SD1, SD1/SD2). The receiver operating characteristic (ROC) sensitivities/specificities/area under curve of SD2 for predicting carotid and subclavian artery IMT were 0.75/0.83/0.81 and 0.70/0.69/0.70, respectively (cutoff values: <32.8 and <42.5, respectively). Identification of atherosclerotic plaque in subclavian artery (IMT > 1.5 mm) was associated with a drastic reduction of SD2 (25.9 [24.3-40.5] vs. 50.2 [38.1-68.7]; data are median and interquartile range values, p = 0.0009), LF (65% lower, p = 0.005) and SDNN (43% lower, p = 0.001). Conclusions: Our data demonstrate that the atherosclerotic carotid and subclavian IMT are associated with an impairment of cardiac autonomic control. The SD2 index of Poincaré plot may be a functional biomarker for subjects at risk for carotid disease and an indicator for ultrasound evaluation.

Background: The atherosclerotic carotid disease is characterized by thickening of the intima-media of the vascular wall (IMT), which is considered as a reliable predictor of cardiovascular events. The aim of this study was to investigate a relationship between IMT and nonatherosclerotic cardiac and vascular risk factors in postmenopausal women. Methods: Left and right carotid IMT, plaque score and resistive index (common, external and internal carotid RI), left ventricular (LV) wall thickness and ascending aorta diameter were determined by echography. Results: Women’s and men’s age was normally distributed with mean(SD) of 71(11) and 68(11), respectively. Left and right carotid IMTs were strongly correlated to each other (Spearman's r = 0.71 in women and 0.89 in men, p < 0.001). Only the right IMT was correlated with the plaque score at both sexes (Spearman's r = 0.36 in women and 0.37 in men, p = 0.01). The carotid resistive indexes had no significant relationship with the C-IMTs. The LV wall thickness and the ascending aorta diameter had a significantly positive correlation with the right IMT in women (Spearman's r = 0.31 and 0.31, p < 0.05) but not in men. The carotid RIs had a significantly positive association with age in both sexes (Spearman's r ranging between 0.30 and 0.56, p < 0.05). However, right IMT, LV thickness and aortic diameter were positively correlated with age only in women (Spearman's r = 0.33, 0.40 and 0.26 respectively, p < 0.05). Conclusion: These data demonstrate that nonatherosclerotic risk factors are associated with higher IMT in women but not in men. The synergic action of these factors may contribute to a worse carotid deterioration in postmenopausal women.

Caro(a) Leitor(a), O II Congresso Médico de Fernandópolis (II COMFER) da Universidade Brasil - Campus Fernandópolis, realizado nos dias 28 a 30 de outubro de 2021, mostrou-se um sucesso. Contamos com a participação de 9 profissionais médicos, que transmitiram através de palestras, um conhecimento de alta qualidade para os participantes. Neste ano, com o intuito de continuar levando conhecimento técnico e científico para acadêmicos e profissionais de diversas áreas da saúde, o evento propôs uma experiência diferente, de forma online, prezando a segurança de todos devido a pandemia da COVID19. Contamos com palestrantes egressos do Curso de Medicina de Fernandópolis, convidados de várias especialidades médicas, oriundos de outras instituições tais como: Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP); Universidade Camilo Castelo Branco (UNICASTELO); Faculdade de Medicina de São José do Rio Preto (FAMERP); Faculdade de Medicina da Universidade de São Paulo (FMUSP); Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP); Pontifícia Universidade Católica de Goiás (PUC-GO); Universidade Federal de São Paulo – Escola Paulista de Medicina (UNIFESP-EPM) e Faculdade de Medicina de Catanduva (FAMECA). O evento contou com a presença de 240 congressistas, entre eles, alunos do Curso de Medicina da Universidade Brasil em Fernandópolis e outras instituições de ensino do Brasil; médicos residentes na cidade de Fernandópolis e médicos residentes na região. Com inovação e tecnologia, neste ano abrimos a oportunidade à vários profissionais da saúde do Brasil e de outras áreas como o Direito Médico, a fim de acompanhar o congresso e submeter trabalhos científicos que tivessem uma temática em consonância à medicina. Contamos com 65 painéis submetidos nas modalidades: Pesquisa Científica, Caso Clínico, Revisão de Literatura e Projeto de Extensão Universitária. Dentre as submissões, foram escolhidos os 10 melhores para apresentação oral, realizada no dia 30 de outubro. Diante do sucesso alcançado, gostaríamos de agradecer a todos os envolvidos na realização deste evento. Nossos sinceros agradecimentos aos 18 membros da Comissão Organizadora, dentre discentes e docentes que com muito empenho puderam realizar este evento que só tende a abrilhantar o Curso de Medicina da Universidade Brasil (UB), sempre com o intuito de levar conhecimento e vivência na área da saúde. Muito obrigado a UB e a IFMSA BRAZIL – UB pelo apoio para realização do II COMFER. Em 2022 estaremos de volta! Vinicius Paiva Gontijo / Presidente Discente do II COMFER - II Congresso Médico de Fernandópolis - 2021 Curso de Medicina da Universidade Brasil – Campus Fernandópolis