Mecanismo da síncope em nadadoras de elite

Os atletas podem ter baixa tolerância ao ortostatismo. O mecanismo envolvido ainda nao é bem conhecido. Nossa hipótese se baseia em que as mulheres nadadoras de alta performance desmaiam facilmente durante o teste de inclinaçao, tilt test (TT), provavelmente devido a um pobre controle barorreflexo. A frequência cardíaca e as variabilidades da pressao arterial diastólica, a sensibilidade barorreflexa, a hemodinâmica cardíaca e a velocidade do fluxo cerebral foram analisadas durante o TT em um grupo de 8 mulheres recorde mundial de longa distância em águas abertas (travessia do Canal da Mancha). Cinco indivíduos (63%) tinham uma resposta positiva ao TT e três, negativa. A prova demonstrou ao início uma frequência cardíaca mais alta, componentes de baixa frequência na análise da variabilidade, uma relaçao baixa frequência/alta frequência (

Mecanismo da síncope em nadadoras de elite

Os atletas podem ter baixa tolerância ao ortostatismo. O mecanismo envolvido ainda nao é bem conhecido. Nossa hipótese se baseia em que as mulheres nadadoras de alta performance desmaiam facilmente durante o teste de inclinaçao, tilt test (TT), provavelmente devido a um pobre controle barorreflexo. A frequência cardíaca e as variabilidades da pressao arterial diastólica, a sensibilidade barorreflexa, a hemodinâmica cardíaca e a velocidade do fluxo cerebral foram analisadas durante o TT em um grupo de 8 mulheres recorde mundial de longa distância em águas abertas (travessia do Canal da Mancha). Cinco indivíduos (63%) tinham uma resposta positiva ao TT e três, negativa. A prova demonstrou ao início uma frequência cardíaca mais alta, componentes de baixa frequência na análise da variabilidade, uma relaçao baixa frequência/alta frequência (

Impact of the Pandemic on NonInfected Cardiometabolic Patients: A Survey in Countries of Latin America—Rationale and Design of the CorCOVID LATAM Study

Background: The first case of coronavirus 2019 (COVID-19) in Latin America was detected on February 26th, 2020, in Brazil. Later, in June, the World Health Organization announced that the focus of the outbreak had shifted to Latin America, where countries already had poor control of indicators of noncommunicable diseases (NCDs). Concerns about coronavirus infection led to a reduced number of visits and hospitalizations in patients with NCDs, such as cardiovascular disease, diabetes, and cancer. There is a need to determine the impact of the COVID-19 pandemic on patients who have cardiometabolic diseases but do not have clinical evidence of COVID-19 infection. Methods: The CorCOVID LATAM is a cross-sectional survey of ambulatory cardiometabolic patients with no history or evidence of COVID-19 infection. The study will be conducted by the Interamerican Society of Cardiology. An online survey composed of 38 questions using Google Forms will be distributed to patients of 13 Latin American Spanish-speaking countries from June 15th to July 15th, 2020. Data will be analyzed by country and regions. Seven clusters of questions will be analyzed: demographics, socioeconomic and educational level, cardiometabolic profile, lifestyle and habits, body-weight perception, medical follow-up and treatments, and psychological symptoms. Results: Final results will be available upon completion of the study. Conclusions: The present study will provide answers regarding the impact of the COVID-19 pandemic on noninfected cardiometabolic patients. Data on this topic are scarce, as it is an unprecedented threat, without short-term solutions.Fil: Lopez Santi, Ricardo. Hospital Italiano de La Plata; ArgentinaFil: Piskorz, Daniel Leonardo. No especifíca;Fil: Marquez, Manlio F.. Instituto Nacional de Cardiologia Ignacio Chavez; MéxicoFil: Ramirez Ramos, Cristhian. Centro de Medicina del Ejercicio y Rehabilitación Cardíaca; ColombiaFil: Renna, Nicolas Federico. Hospital Espanol de Mendoza; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: Ibarrola, Martin. No especifíca;Fil: Wyss, Fernando Stuardo. Servicios y Tecnología Cardiovascular de Guatemala; GuatemalaFil: Naranjo Dominguez, Adrián. Instituto de Cardiologia y Cirugia Cardiovascular; CubaFil: Perez, Gonzalo Emanuel. No especifíca;Fil: Farina, Juan María. No especifíca;Fil: Forte, Ezequiel. Centro Diagnóstico Cardiovascular; ArgentinaFil: Juarez Lloclla, Jorge Paul. Hospital de Apoyo II Santa Rosa; PerúFil: Flores de Espinal, Emma. Hospital Nacional San Juan De Dios; El SalvadorFil: Puente Barragan, Adriana. Instituto Mexicano del Seguro Social; MéxicoFil: Ruise, Mauro Gabriel. Clínica Yunes; ArgentinaFil: Delgado, Diego. University of Toronto; CanadáFil: Baranchuk, Adrian. Queens University; Canad

Sanger sequencing as a first-line approach for molecular diagnosis of Andersen-Tawil syndrome [version 1; referees: 2 approved]

In 1977, Frederick Sanger developed a new method for DNA sequencing based on the chain termination method, now known as the Sanger sequencing method (SSM).  Recently, massive parallel sequencing, better known as next-generation sequencing (NGS),  is replacing the SSM for detecting mutations in cardiovascular diseases with a genetic background. The present opinion article wants to remark that “targeted” SSM is still effective as a first-line approach for the molecular diagnosis of some specific conditions, as is the case for Andersen-Tawil syndrome (ATS). ATS is described as a rare multisystemic autosomal dominant channelopathy syndrome caused mainly by a heterozygous mutation in the KCNJ2 gene. KCJN2 has particular characteristics that make it attractive for “directed” SSM. KCNJ2 has a sequence of 17,510 base pairs (bp), and a short coding region with two exons (exon 1=166 bp and exon 2=5220 bp), half of the mutations are located in the C-terminal cytosolic domain, a mutational hotspot has been described in residue Arg218, and this gene explains the phenotype in 60% of ATS cases that fulfill all the clinical criteria of the disease. In order to increase the diagnosis of ATS we urge cardiologists to search for facial and muscular abnormalities in subjects with frequent ventricular arrhythmias (especially bigeminy) and prominent U waves on the electrocardiogram

Sleep Quality, Nutrient Intake, and Social Development Index Predict Metabolic Syndrome in the Tlalpan 2020 Cohort: A Machine Learning and Synthetic Data Study

This study investigated the relationship between Metabolic Syndrome (MetS), sleep disorders, the consumption of some nutrients, and social development factors, focusing on gender differences in an unbalanced dataset from a Mexico City cohort. We used data balancing techniques like SMOTE and ADASYN after employing machine learning models like random forest and RPART to predict MetS. Random forest excelled, achieving significant, balanced accuracy, indicating its robustness in predicting MetS and achieving a balanced accuracy of approximately 87%. Key predictors for men included body mass index and family history of gout, while waist circumference and glucose levels were most significant for women. In relation to diet, sleep quality, and social development, metabolic syndrome in men was associated with high lactose and carbohydrate intake, educational lag, living with a partner without marrying, and lack of durable goods, whereas in women, best predictors in these dimensions include protein, fructose, and cholesterol intake, copper metabolites, snoring, sobbing, drowsiness, sanitary adequacy, and anxiety. These findings underscore the need for personalized approaches in managing MetS and point to a promising direction for future research into the interplay between social factors, sleep disorders, and metabolic health, which mainly depend on nutrient consumption by region

Female gender as independent risk factor of torsadesde pointes during acquired atrioventricular block

WOS: 000396433000025PubMed ID: 27650425BACKGROUND: Female gender increases the risk of torsades de pointes (TdP) in the long QT syndrome, and this increased risk is assumed to be due to their longer QT interval. OBJECTIVE: The purpose of this study was to study the interplay between gender, duration of the QT interval, and risk of TdP during AV block. METHODS: We studied 250 patients (48% women) with AV block. QT interval was measured at the time of most severe bradycardia. We then constructed different receiver operating characteristic curves for the QTc of males and females for predicting TdP. RESULTS: As expected, patients with TdP had longer QTc intervals than did patients with uncomplicated AV block (564 +/- 81 ms vs 422 +/- 62 ms, P < .001). This correlation between longer QTc and higher risk of TdP was true for both genders. However, the QT of females with TdP was shorter than the respective value for males with TdP. Despite similar severity of bradycardia, the QT was shorter for females (QT 672 +/- 88 ms vs 727 +/- 57 ms for females with TdP vs males with TdP, P = .022). The QTc/TdP risk curve for females was shifted to the left in comparison to the pertinent graph for males. Female gender was an independent predictor of TdP. CONCLUSION: Women are at increased risk for developing TdP during AV block, but this increased risk is independent of their longer QT interval. Females develop TdP with QT intervals that are not necessarily arrhythmogenic for males

The Response of the QT Interval to the Brief Tachycardia Provoked by Standing A Bedside Test for Diagnosing Long QT Syndrome

Objectives This study was undertaken to determine whether the short-lived sinus tachycardia that occurs during standing will expose changes in the QT interval that are of diagnostic value. Background The QT interval shortens during heart rate acceleration, but this response is not instantaneous. We tested whether the transient, sudden sinus tachycardia that occurs during standing would expose abnormal QT interval prolongation in patients with long QT syndrome (LQTS). Methods Patients (68 with LQTS [LQT1 46%, LQT2 41%, LQT3 4%, not genotyped 9%] and 82 control subjects) underwent a baseline electrocardiogram (ECG) while resting in the supine position and were then asked to get up quickly and stand still during continuous ECG recording. The QT interval was studied at baseline and during maximal sinus tachycardia, maximal QT interval prolongation, and maximal QT interval stretching. Results In response to brisk standing, patients and control subjects responded with similar heart rate acceleration of 28 +/- 10 beats/min (p = 0.261). However, the response of the QT interval to this tachycardia differed: on average, the QT interval of controls shortened by 21 +/- 19 ms whereas the QT interval of LQTS patients increased by 4 +/- 34 ms (p <0.001). Since the RR interval shortened more than the QT interval, during maximal tachycardia the corrected QT interval increased by 50 +/- 30 ms in the control group and by 89 +/- 47 ms in the LQTS group (p <0.001). Receiver-operating characteristic curves showed that the test adds diagnostic value. The response of the QT interval to brisk standing was particularly impaired in patients with LQT2. Conclusions Evaluation of the response of the QT interval to the brisk tachycardia induced by standing provides important information that aids in the diagnosis of LQTS. (J Am Coll Cardiol 2010;55:1955-61) (C) 2010 by the American College of Cardiology Foundatio