Alimentazione, fitness e salute

L’alimentazione, se associata all’attività fisica, ci consente di “plasmare” il nostro corpo, indirizzandolo verso la tonificazione, il dimagrimento, la massima efficienza e la salute. Con questa nuova edizione gli autori allargano ancora di più la visuale sulla scienza dell’alimentazione, offrendo un manuale ricco di informazioni utili sia a chi si avvicina all’argomento per la prima volta, sia allo sportivo amatoriale attento alle ultime novità in materia, sia al professionista in cerca di nuovi stimoli in questo affascinante mondo in continua evoluzione

704-3 Relation of Neurohormonal Activation to Functional Class in Patients with Primary or Precapillary Secondary Pulmonary Hypertension

Intense neurohormonal activation has been demonstrated in patients with primary or precapillary secondary pulmonary hypertension (PH) but the relation of neurohormons to functional impairment is not well known. Plasma levels of atrial natriuretic peptide (ANP), aldosterone (ALD), renin activity (PRA), epinephrine (PE), norepinephrine (PNE) and endothelin (ET) were assessed from the antecubital vein in 12 patients with primary PH, 7 patients with precapillary secondary PH (2 connective tissue disease, 2 chronic thromboembolic, 3 closed atrial septal defect) and 10 control subjects. Twelve patients were in NYHA functional class II (PH-II) and 7 in class III/IV (PH-III/IV). Mean PA pressure (PAP), cardiac index (CI), pulmonary vascular resistance (PVR) and right atrial pressure were assessed by heart catheterization:PAPCIPVRRAP(mmHg)(l/minlm2)(RU)(mmHg)PH-II53 ± 132.4 ± 0.412 ± 33 ± 2PH-III/IV61 ± 92.0 ± 0518 ± 611 ±5P0.170.070.0090.0001Neurohormons plasma levels in control subjects (C), PH-II and PH-III/IV patients were as follows:ANPALDPRAPEPNEET(pg/ml)(pg/ml)(ng/ml/h)(pg/ml)(pg/ml)(pg/ml)C58 ± 18110 ± 650.7 ± 0.433 ± 19220 ± 1011.7 ± 0.3PH-II167 ± 96*144 ± 10215 ± 2.0298 ± 263*420 ± 294*3.6 ± 1.4*PH-III/IV276 ± 153*†209 ± 2703.2 ± 3.9*462 ± 524*820 ± 693*†8.4 ± 3.9*°*p < 0.05 vs C° p < 0.001 vs PH-II †P < 0.09 vs PH-IIConclusionsNeurohormonal activation in primary or precapillary secondary PH is detectable also in patients without overt clinical and hemodynamic signs of right heart failure (PH-II). Neurohormonal activation seems to be progressive and is more severe in functional class III/IV patients. ET shows the best statistically significant relation with functional impairment