Biomedical subjects

Murilo Foppa

Publications and source records attributed to Murilo Foppa.

4 recordsLinked to original sources

PubMed2006

Diabetes, gender, and left ventricular structure in African-Americans: the atherosclerosis risk in communities study.

BACKGROUND: Cardiovascular risk associated with diabetes may be partially attributed to left ventricular structural abnormalities. However, the relations between left ventricular structure and diabetes have not been extensively studied in African-Americans. METHODS: We studied 514 male and 965 female African-Americans 51 to 70 years old, in whom echocardiographic left ventricular mass measurements were collected for the ARIC Study. In these, we investigated the independent association of diabetes with left ventricular structural abnormalities. RESULTS: Diabetes, hypertension and obesity prevalences were 22%, 57% and 45%, respectively. Unindexed left ventricular mass was higher with diabetes in both men (238.3 +/- 79.4 g vs. 213.7 +/- 58.6 g; p < 0.001) and women (206.4 +/- 61.5 g vs. 176.9 +/- 50.1 g; p < 0.001), respectively. Prevalence of height-indexed left ventricular hypertrophy was higher in women while increased relative wall thickness was similar in men and women. Those with diabetes had higher prevalences of height-indexed left ventricular hypertrophy (52% vs. 32%; p < 0.001), and of increased relative wall thickness (73% vs. 64%; p = 0.002). Gender-adjusted associations of diabetes with left ventricular hypertrophy (OR = 2.29 95% CI:1.79-2.94) were attenuated after multiple adjustments in logistic regression (OR = 1.50 95% CI:1.12-2.00). Diabetes was associated with higher left ventricle diameter (OR = 2.13 95% CI:1.28-3.53) only in men and with higher wall thickness (OR = 1.89 95% CI:1.34-2.66) only in women. Attenuations in diabetes associations were frequently seen after adjustment for obesity indices. CONCLUSION: In African-Americans, diabetes is associated with left ventricular hypertrophy and, with different patterns of left ventricular structural abnormalities between genders. Attenuation seen in adjusted associations suggests that the higher frequency of structural abnormalities seen in diabetes may be due to factors other than hyperglycemia.

Black or African American↗

PubMed2005

Echocardiography-based left ventricular mass estimation. How should we define hypertrophy?

Left ventricular hypertrophy is an important risk factor in cardiovascular disease and echocardiography has been widely used for diagnosis. Although an adequate methodologic standardization exists currently, differences in measurement and interpreting data is present in most of the older clinical studies. Variability in border limits criteria, left ventricular mass formulas, body size indexing and other adjustments affects the comparability among these studies and may influence both the clinical and epidemiologic use of echocardiography in the investigation of the left ventricular structure. We are going to review the most common measures that have been employed in left ventricular hypertrophy evaluation in the light of some recent population based echocardiographic studies, intending to show that echocardiography will remain a relatively inexpensive and accurate tool diagnostic tool.

Clinical Trials as Topic↗

PubMed2002

Red wine with the noon meal lowers post-meal blood pressure: a randomized trial in centrally obese, hypertensive patients.

OBJECTIVE: Despite being recognized as a cause of hypertension at higher doses, consumption of lesser amounts of alcohol appears to protect against cardiovascular disease and acutely reduces blood pressure. We tested the hypothesis that two glasses of red wine, taken together with the noon meal, would cause postprandial reduction in blood pressure in hypertensive individuals. METHOD: Thirteen (8 female) middle-aged, centrally obese, hypertensive and otherwise healthy participants received, in an open randomized crossover experiment, red wine (250 ml to approximately 23 g of ethanol) and a placebo equivalent, together with a standardized lunch. Blood pressure was measured with 24-hour ambulatory monitoring. RESULTS: Wine with the meal produced a mean (SD) reduction of 5.3 (7.66) mmHg in postprandial blood pressure (p = .03), which persisted for most of the remaining daytime interval. The maximal blood pressure reduction was 8.5 (11.84) mmHg, occurring 3 hours after intervention (p = .02). In addition, nocturnal dipping in systolic blood pressure was lessened during the wine intervention period (5.3 [10.19] vs 11.1 [8.08] mmHg; p = .03). CONCLUSIONS: Ingestion of 250 ml of red wine, together with the noon meal, resulted in reduction of the postprandial blood pressure of centrally obese, hypertensive subjects. The effect lasted throughout most of the remaining daytime interval and appeared to modify the usual blood pressure variation pattern.

Adult↗

PubMed2002

Implications of the hemodynamic optimization approach guided by right heart catheterization in patients with severe heart failure.

OBJECTIVE: To report the hemodynamic and functional responses obtained with clinical optimization guided by hemodynamic parameters in patients with severe and refractory heart failure. METHODS: Invasive hemodynamic monitoring using right heart catheterization aimed to reach low filling pressures and peripheral resistance. Frequent adjustments of intravenous diuretics and vasodilators were performed according to the hemodynamic measurements. RESULTS: We assessed 19 patients (age = 48+/-12 years and ejection fraction = 21+/-5%) with severe heart failure. The intravenous use of diuretics and vasodilators reduced by 12 mm Hg (relative reduction of 43%) pulmonary artery occlusion pressure (P<0.001), with a concomitant increment of 6 mL per beat in stroke volume (relative increment of 24%, P<0.001). We observed significant associations between pulmonary artery occlusion pressure and mean pulmonary artery pressure (r=0.76; P<0.001) and central venous pressure (r=0.63; P<0.001). After clinical optimization, improvement in functional class occurred (P< 0.001), with a tendency towards improvement in ejection fraction and no impairment to renal function. CONCLUSION: Optimization guided by hemodynamic parameters in patients with refractory heart failure provides a significant improvement in the hemodynamic profile with concomitant improvement in functional class. This study emphasizes that adjustments in blood volume result in immediate benefits for patients with severe heart failure.

Adult↗