No abstract

No abstract

No abstract

O estudo da função diastólica na ecocardiografia tem como tarefas primordiais: 1) Reconhecimento/Categorização da disfunção diastólica e 2) Identificação de sinais do aumento das pressões de enchimento do ventrículo esquerdo. O guideline ASE 2016 de avaliação da função diastólica do ventrículo esquerdo abre possibilidades para o emprego de novas tecnologias que auxiliam no processo diagnóstico. Realiza-se revisão da literatura sobre as evidências clínicas e sobre o aplicabilidade de parâmetros da ecocardiografia com strain na avaliação da função diastólica em pacientes com fração de ejeção preservada.

Smoking has been associated with renal disease progression in ADPKD but the underlying deleterious mechanisms and whether it specifically worsens the cardiac phenotype remain unknown. To investigate these matters, Pkd1-deficient cystic mice and noncystic littermates were exposed to smoking from conception to 18 weeks of age and, along with nonexposed controls, were analyzed at 13–18 weeks. Renal cystic index and cyst-lining cell proliferation were higher in cystic mice exposed to smoking than nonexposed cystic animals. Smoking increased serum urea nitrogen in cystic and noncystic mice and independently enhanced tubular cell proliferation and apoptosis. Smoking also increased renal fibrosis, however this effect was much higher in cystic than in noncystic animals. Pkd1 deficiency and smoking showed independent and additive effects on reducing renal levels of glutathione. Systolic function and several cardiac structural parameters were also negatively affected by smoking and the Pkd1-deficient status, following independent and additive patterns. Smoking did not increase, however, cardiac apoptosis or fibrosis in cystic and noncystic mice. Notably, smoking promoted a much higher reduction in body weight in Pkd1-deficient than in noncystic animals. Our findings show that smoking aggravated the renal and cardiac phenotypes of Pkd1-deficient cystic mice, suggesting that similar effects may occur in human ADPKD.