The Mediating Role of Physical Inactivity on the Relationship between Inflammation and Artery Thickness in Prepubertal Adolescents

Objective: To analyze the relationship between inflammatory markers and the lipid profile, blood flow, and artery structure in prepubertal adolescents stratified according to sports practice.Study design The sample was composed of 120 adolescents (57 boys and 63 girls) with a mean age of 11.7 +/- 0.7 years (ranging from 11 to 13 years). Intima-media thickness (IMT) and blood flow were measured with ultrasonography. The lipid profile and high-sensitivity C-reactive protein were measured after the subjects had fasted for 12 hours overnight. Trunk fatness was measured by dual-energy x-ray absorptiometry. Organized sports participation was analyzed as a categorical variable. Biological maturation was determined via the age at peak height velocity. Results: In the adjusted model, high-sensitivity C-reactive protein was significantly related to high-density lipoprotein-cholesterol (beta = -5.797 [-11.500 to -0.093]), femoral IMT (beta = 0.062 [0.008-0.116]), and the sum of femoral and carotid IMT (beta = 1.107 [0.223-1.919]), but only in the group without sports participation. Slopes of the crude linear regression were greater in the group without sports participation for femoral IMT (t = 2.621; P = .009) and the sum of femoral and carotid IMT (t = 2.876; P = .004) when compared with the group with sports participation. Conclusion: Independent of body fatness and biological maturation, inflammatory status was related to artery IMT and dyslipidemia in prepubertal adolescents, modulated by sport participation.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Sports practice is related to parasympathetic activity in adolescents

AbstractObjectiveTo analyze the relationship among sports practice, physical education class, habitual physical activity and cardiovascular risk in adolescents.MethodsCross-sectional study with 120 schoolchildren (mean: 11.7±0.7 years old), with no regular use of medicines. Sports practice and physical education classes were assessed through face-to-face interview, while habitual physical activity was assessed by pedometers. Bodyweight, height and height-cephalic trunk were used to estimate maturation. The following variables were measured: body fatness, blood pressure, resting heart rate, blood flow velocity, intima-media thickness (carotid and femoral) and heart rate variability (mean between consecutive heartbeats and statistical index in the time domain that show the autonomic parasympathetic nervous system activity root-mean by the square of differences between adjacent normal R-R intervals in a time interval). Statistical treatment used Spearman correlation adjusted by sex, ethnicity, age, body fatness and maturation.ResultsIndependently of potential confounders, sports practice was positively related to autonomic parasympathetic nervous system activity (β=0.039 [0.01; 0.76]). On the other hand, the relationship between sport practice and mean between consecutive heartbeats (β=0,031 [–0.01; 0.07]) was significantly mediated by biological maturation.ConclusionsSport practice was related to higher heart rate variability at rest

Myocardial strain analysis by cardiac magnetic resonance feature-tracking in patients treated with anthracyclines and kidney transplant recipients

Objetivos: Determinar se as taxas de deformação diastólica do ventrículo esquerdo (VE) medidas por ressonância magnética cardíaca feature-tracking (RMC-FT) estão reduzidas em adultos sobreviventes de linfoma não Hodgkin e analisar associações com a dose acumulada de antraciclinas, parâmetros de função sistólica e características do tecido miocárdico; analisar alterações da deformação global longitudinal (SGL) do VE medida por RMC-FT após o transplante renal e estudar associações entre o SGL, remodelamento reverso e características do tecido miocárdico. Métodos e Resultados: para testar cada um dos objetivos foram realizados estudos que resultaram em dois artigos científicos. O primeiro, “Characterization of subclinical diastolic dysfunction by cardiac magnetic resonance feature-tracking in adult survivors of non- Hodgkin lymphoma treated with anthracyclines”, foi publicado na revista BMC Cardiovascular Disorders em abril de 2021 e o segundo, “Feature-tracking cardiac magnetic resonance left ventricular global longitudinal strain improves 6 months after kidney transplantation associated with reverse remodeling, not myocardial tissue characteristics”, foi publicado na revista The International Journal of Cardiovascular Imaging em maio de 2021. Conclusões: A taxa de deformação diastólica inicial (SRGD-E) do VE medida por RMC-FT está reduzida tardiamente após a quimioterapia com antraciclinas em adultos sobreviventes de linfoma não Hodgkin. A redução do SRGD-E foi associada à maior dose acumulada de antraciclina e à redução de parâmetros da função sistólica. Não houve correlação entre o SRGD-E e as características do tecido miocárdico; o SGL do VE medido por RMC-FT aumenta 6 meses após o transplante renal, associado ao remodelamento reverso, não às características do tecido miocárdico.Objectives: To determine whether left ventricular (LV) diastolic strain rates measured by cardiac magnetic resonance feature tracking (CMR-FT) are impaired in long-term adult survivors of non-Hodgkin lymphoma (NHL) and to analyze associations with cumulative anthracycline dose, systolic function parameters and myocardial tissue characteristics; To analyze changes in LV global longitudinal strain (GLS) measured by CMR-FT after kidney transplantation and to study associations between LV GLS, reverse remodeling and myocardial tissue characteristics. Methods and Results: To test each of the objectives we conducted studies which resulted in two scientific articles. The first one, “Characterization of subclinical diastolic dysfunction by cardiac magnetic resonance feature-tracking in adult survivors of non-Hodgkin lymphoma treated with anthracyclines” published in BMC Cardiovascular Disorders in April 2021 and the second one, “Feature-tracking cardiac magnetic resonance left ventricular global longitudinal strain improves 6 months after kidney transplantation associated with reverse remodeling, not myocardial tissue characteristics” published in The International Journal of Cardiovascular Imaging in May 2021. Conclusions: LV early diastolic strain rates (GDSR-E) by CMR-FT are impaired late after anthracycline chemotherapy in adult survivors of NHL. Impaired GDSR-E were associated with cumulative anthracycline dose and systolic function parameters. There were no correlations be- tween GDSR-E and myocardial tissue characteristics; LV GLS measured by FT-CMR improves 6 months after KT in association with reverse remodeling, not myocardial tissue characteristics.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Sports participation improves metabolic profile in adolescents: ABCD growth study

To analyze the impact of participation in sports with different cardiorespiratory fitness (CRF) demands on changes in metabolic and cardiovascular markers in adolescents. Longitudinal study with 12 months of follow-up (Analysis of Behaviors of Children During Growth [ABCD Growth Study]). Overall, 184 adolescents (age 15.6 ± 2.1) were classified according to sports participation: non-sport (control), low CRF sports, and high CRF sports. Metabolic outcomes were total cholesterol (TC) and its fractions, triacylglycerol (TG), glucose, insulin levels, and the insulin resistance index. Cardiovascular outcomes were arterial thickness (carotid and femoral [ultrasound]), blood pressure, and resting heart rate. Adolescents engaged in sports classified as high CRF demand presented a significant increase in HDL-c (1.2 mg/dL [95%CI: −0.5 to 3.0]) when compared to the non-sport group (−2.4 mg/dL [95%CI: −4.4 to −0.5]). Regular engagement in high CRF sports was significantly related to changes in TC (β = −0.027 [95%CI: −0.048 to −0.005]), HDL-c (β = 0.009 [95%CI: 0.001 to 0.019]), LDL-c (β = −0.032 [95%CI: −0.049 to −0.016]), and glucose (β = −0.017 [95%CI: −0.025 to −0.008]), while engagement in low CRF sports was related to changes in TG (β = −0.065 [95%CI: −0.112 to −0.019]). No significant relationships for cardiovascular parameters were observed in the low CRF group, but one significant relationship was found between high CRF sports and changes in SBP (β = −0.063 [95%CI: −0.117 to −0.009]). In conclusion, engagement in sports seems to be beneficial for improvements in metabolic and cardiovascular parameters in adolescents, mainly sports with higher CRF demand

Doppler transcraniano convencional em voluntários assintomáticos: variabilidade e valores de referência para parâmetros de fluxo sanguíneo Reference values for measures of blood flow velocities and impedance indexes in healthy individuals through conventional transcranial Doppler

OBJETIVO: Estabelecer valores de referência para medidas de velocidade sanguínea e índices de impedância em indivíduos saudáveis por meio do Doppler transcraniano convencional (DTC) e observar suas variações em relação à idade e sexo. MÉTODO: Foram examinados 88 voluntários assintomáticos, sem antecedentes de doença cerebrovascular, cardíaca ou vascular periférica. Os exames de DTC foram realizados pelo mesmo examinador, sendo as artérias cerebrais médias, anteriores e posteriores estudadas por meio da janela temporal e as artérias vertebrais e basilar por meio da janela suboccipital. Foram arquivados os valores de velocidade média (VM), velocidade de pico sistólico (VPS), velocidade diastólica final (VDF) e índices de resistência (IR) e pulsatilidade (IP) de cada segmento arterial examinado. RESULTADOS: Os limites de referência encontrados por nós foram semelhantes aos descritos por outros autores para todos os parâmetros estudados. Houve tendência das velocidades de fluxo diminuírem e dos índices de impedância aumentarem com o avançar da idade. Os valores de velocidade nas mulheres foram superiores aos encontrados em homens. CONCLUSÃO: O DTC se mostrou útil na avaliação hemodinâmica cerebral de nossa população. Os nossos resultados são semelhantes aos de outros estudos, tanto nos valores de referência quanto na sua relação com a idade e o sexo.<br>OBJECTIVE: To establish reference values for measures of blood flow velocities and impedance indexes in healthy individuals through conventional transcranial Doppler (TCD) and to observe their variations in relation to the age and sex. METHOD: 88 asymptomatic volunteers were examined without antecedents of cardiac, peripheral or cerebrovascular diseases. The TCD were accomplished by the same examiner. The middle, anterior and posterior cerebral arteries were studied through the temporal acoustic window and the vertebral and basilar arteries through the suboccipital acoustic window. The values of mean velocity (MV), peak-systolic velocity (PSV), final diastolic velocity (FDV), resistance index (RI) and pulsatility index (PI) of each examined arterial segment were filed. RESULTS: The reference limits found by us were similar to the described by other authors for all of the studied parameters. There was tendency of the flow velocities decrease and of the impedance indexes increase with moving forward of the age. The values of velocities in the women were superior to the found in men. CONCLUSION: TCD was shown useful in the evaluation of hemodynamic cerebral for our population. Our results are similar to the other studies, so much in the reference values as in relationship with the age and the sex

Cardiovascular assessment of patients with Ullrich-Turner's Syndrome on Doppler echocardiography and magnetic resonance imaging

OBJECTIVE: To assess the cardiovascular features of Ullrich-Turner's syndrome using echocardiography and magnetic resonance imaging, and to correlate them with the phenotype and karyotype of the patients. The diagnostic concordance between the 2 methods was also assessed. METHODS: Fifteen patients with the syndrome were assessed by echocardiography and magnetic resonance imaging (cardiac chambers, valves, and aorta). Their ages ranged from 10 to 28 (mean of 16.7) years. The karyotype was analyzed in 11 or 25 metaphases of peripheral blood lymphocytes, or both. RESULTS: The most common phenotypic changes were short stature and spontaneous absence of puberal development (100%); 1 patient had a cardiac murmur. The karyotypes detected were as follows: 45,X (n=7), mosaics (n=5), and deletions (n=3). No echocardiographic changes were observed. In regard to magnetic resonance imaging, coarctation and dilation of the aorta were found in 1 patient, and isolated dilation of the aorta was found in 4 patients. CONCLUSION: The frequencies of coarctation and dilation of the aorta detected on magnetic resonance imaging were similar to those reported in the literature (5.5% to 20%, and 6.3% to 29%, respectively). This confirmed the adjuvant role of magnetic resonance imaging to Doppler echocardiography for diagnosing cardiovascular alterations in patients with Ullrich-Turner's syndrome

Kidney transplantation is associated with reduced myocardial fibrosis. A cardiovascular magnetic resonance study with native T1 mapping

Abstract Background The measurement of native T1 through cardiovascular magnetic resonance (CMR) is a noninvasive method of assessing myocardial fibrosis without gadolinium contrast. No studies so far have evaluated native T1 after renal transplantation. The primary aim of the current study is to assess changes in the myocardium native T1 6 months after renal transplantation. Methods We prospectively evaluated 44 renal transplant patients with 3 T CMR exams: baseline at the beginning of transplantation and at 6 months after transplantation. Results The native T1 time was measured in the midventricular septum and decreased significantly from 1331 ± 52 ms at the baseline to 1298 ± 42 ms 6 months after transplantation (p = 0.001). The patients were split into two groups through a two-step cluster algorithm: In cluster-1 (n = 30) the left ventricular (LV) mass index and the prevalence of diabetes were lower. In cluster-2 (n = 14) the LV mass index and diabetes prevalence were higher. Decrease in native T1 values was significant only in the patients in cluster-1 (p = 0.001). Conclusions The native myocardial T1 time decreased significantly 6 months after renal transplant, which may be associated with the regression of the reactive fibrosis. The patients with greater baseline LV mass index and the diabetic group did not reach a significant decrease in T1

Cardiovascular assessment of patients with Ullrich-Turner's Syndrome on Doppler echocardiography and magnetic resonance imaging

OBJECTIVE: To assess the cardiovascular features of Ullrich-Turner's syndrome using echocardiography and magnetic resonance imaging, and to correlate them with the phenotype and karyotype of the patients. The diagnostic concordance between the 2 methods was also assessed. METHODS: Fifteen patients with the syndrome were assessed by echocardiography and magnetic resonance imaging (cardiac chambers, valves, and aorta). Their ages ranged from 10 to 28 (mean of 16.7) years. The karyotype was analyzed in 11 or 25 metaphases of peripheral blood lymphocytes, or both. RESULTS: The most common phenotypic changes were short stature and spontaneous absence of puberal development (100%); 1 patient had a cardiac murmur. The karyotypes detected were as follows: 45,X (n=7), mosaics (n=5), and deletions (n=3). No echocardiographic changes were observed. In regard to magnetic resonance imaging, coarctation and dilation of the aorta were found in 1 patient, and isolated dilation of the aorta was found in 4 patients. CONCLUSION: The frequencies of coarctation and dilation of the aorta detected on magnetic resonance imaging were similar to those reported in the literature (5.5% to 20%, and 6.3% to 29%, respectively). This confirmed the adjuvant role of magnetic resonance imaging to Doppler echocardiography for diagnosing cardiovascular alterations in patients with Ullrich-Turner's syndrome