Pesquisa | SciELO

OBJECTIVE: Using magnetic resonance imaging, we aimed to assess the presence of silent brain vascular lesions in a sample of apparently healthy elderly individuals who were recruited from an economically disadvantaged urban region (São Paulo, Brazil). We also wished to investigate whether the findings were associated with worse cognitive performance. METHODS: A sample of 250 elderly subjects (66-75 years) without dementia or neuropsychiatric disorders were recruited from predefined census sectors of an economically disadvantaged area of Sao Paulo and received structural magnetic resonance imaging scans and cognitive testing. A high proportion of individuals had very low levels of education (4 years or less, n=185; 21 with no formal education). RESULTS: The prevalence of at least one silent vascular-related cortical or subcortical lesion was 22.8% (95% confidence interval, 17.7-28.5), and the basal ganglia was the most frequently affected site (63.14% of cases). The subgroup with brain infarcts presented significantly lower levels of education than the subgroup with no brain lesions as well as significantly worse current performance in cognitive test domains, including memory and attention (p<0.002). CONCLUSIONS: Silent brain infarcts were present at a substantially high frequency in our elderly sample from an economically disadvantaged urban region and were significantly more prevalent in subjects with lower levels of education. Covert cerebrovascular disease significantly contributes to cognitive deficits, and in the absence of magnetic resonance imaging data, this cognitive impairment may be considered simply related to ageing. Emphatic attention should be paid to potentially deleterious effects of vascular brain lesions in poorly educated elderly individuals from economically disadvantaged environments.

https://doi.org/10.6061/clinics/2017(08)04 719 downloads

Acute management of unstable angina and non-ST segment elevation myocardial infarction
Facebook Twitter

Outras redes sociais
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Outras redes

Métricas
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Silva, Fernando Morita Fernandes

; Pesaro, Antonio Eduardo Pereira

; Franken, Marcelo

; Wajngarten, Mauricio

einstein (São Paulo)

Métricas do periódico
- Sobre o periódico
- SciELO Analytics

Set 2015, Volume 13 Nº 3 Páginas 454 - 461

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

A síndrome coronária sem supradesnivelamento do ST geralmente resulta da instabilização de uma placa aterosclerótica, com subsequente ativação plaquetária e de diversos fatores de coagulação. O tratamento visa aliviar a dor isquêmica, limitar o dano miocárdico e diminuir a mortalidade. Diversos agentes antiagregantes e anticoagulantes provaram sua utilidade, e novas drogas passaram a compor o arsenal terapêutico, buscando maior eficácia anti-isquêmica e menores índices de sangramento. Apesar dos avanços, as taxas de mortalidade, infarto e reinternação ainda permanecem elevadas.

Non-ST segment elevation coronary syndrome usually results from instability of an atherosclerotic plaque, with subsequent activation of platelets and several coagulation factors. Its treatment aims to reduce the ischemic pain, limiting myocardial damage and decreasing mortality. Several antiplatelet and anticoagulation agents have been proven useful, and new drugs have been added to the therapeutic armamentarium in the search for higher anti-ischemic efficacy and lower bleeding rates. Despite the advances, the mortality, infarction and readmission rates remain high.

https://doi.org/10.1590/S1679-45082015RW3172 42366 downloads

Depression as a Clinical Determinant of Dependence and Low Quality of Life in Elderly Patients with Cardiovascular Disease
Facebook Twitter

Outras redes sociais
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Outras redes

Métricas
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Rodrigues, Giselle Helena de Paula

; Gebara, Otavio Celso Eluf

; Gerbi, Catia Cilene da Silva

; Pierri, Humberto

; Wajngarten, Mauricio

Arquivos Brasileiros de Cardiologia

Métricas do periódico
- Sobre o periódico
- SciELO Analytics

Jun 2015, Volume 104 Nº 6 Páginas 443 - 449

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Fundamento:Com o envelhecimento, a prevalência de doenças crônico-degenerativas sofreu aumento progressivo. A repercussão dessas doenças sobre a capacidade funcional foi reconhecida. Outro parâmetro de saúde é a “qualidade de vida relacionada à saúde”. Na população idosa, as doenças cardiovasculares destacam-se pelo impacto epidemiológico e clínico. Elas, geralmente, vêm associadas a outras afecções. Esse conjunto de problemas pode comprometer a independência e a qualidade de vida do idoso que busca tratamento cardiológico.Objetivo:Avaliar, em uma população de idosos cardiopatas, quais são os determinantes clínicos mais relevantes de dependência e de qualidade de vida.Métodos:O grupo foi selecionado aleatória e consecutivamente, sendo aplicados quatro questionários: HAQ, SF-36, PRIME‑MD e Mini Exame do Estado Mental.Resultados:Incluiu-se 1020 idosos, 63,3% mulheres. O grupo tinha em média 75,56 ± 6,62 anos. 61,4% mostrou-se independente ou com dependência leve. O escore de qualidade de vida foi elevado (HAQ: 88,66 ± 2,68). 87,8% dos pacientes apresentou escore total do SF-36 ≥ 66. À análise multivariada, a associação entre os diagnósticos e graus elevados de dependência foi significante apenas para acidente vascular cerebral prévio (p = 0,014), obesidade (p < 0,001), sedentarismo (p = 0,016), osteoartrite (p < 0,001), déficit cognitivo (p < 0,001), e depressão maior (p < 0,001). Ao analisarmos a qualidade de vida, a depressão maior e a depressão por doença física associou-se significativamente com todos os domínios do SF-36.Conclusão:Em uma população de idosos cardiopatas, os determinantes clínicos mais relevantes de prejuízos para dependência e qualidade de vida foram as comorbidades não cardiovasculares, particularmente a depressão.

Background:The aging process promotes a progressive increase in chronic-degenerative diseases. The effect of these diseases on the functional capacity has been well recognized. Another health parameter concerns “quality of life related to health”. Among the elderly population, cardiovascular diseases stand out due to the epidemiological and clinical impact. Usually, these diseases have been associated with others. This set of problems may compromise both independence and quality of life in elderly patients who seek cardiologic treatment. These health parameters have not been well contemplated by cardiologists.Objective:Evaluating, among the elderly population with cardiovascular disease, which are the most relevant clinical determinants regarding dependence and quality of life.Methods:This group was randomly and consecutively selected and four questionnaires were applied: HAQ, SF-36, PRIME-MD e Mini Mental State.Results:The study included 1,020 elderly patients, 63.3% women. The group had been between 60 and 97 years-old (mean: 75.56 ± 6.62 years-old). 61.4% were independent or mild dependence. The quality of life total score was high (HAQ: 88.66 ± 2.68). 87.8% of patients had a SF-36 total score > 66. In the multivariate analysis, the association between diagnoses and high degrees of dependence was significant only for previous stroke (p = 0.014), obesity (p < 0.001), lack of physical activity (p = 0.016), osteoarthritis (p < 0.001), cognitive impairment (p < 0.001), and major depression (p < 0.001). Analyzing the quality of life, major depression and physical illness for depression was significantly associated with all domains of the SF-36.Conclusion:Among an elderly outpatient cardiology population, dependence and quality of life clinical determinants are not cardiovascular comorbidities, especially the depression.

https://doi.org/10.5935/abc.20150034 4408 downloads

Behavioral Cardiology: Cardiology’s New Frontier of Action
Facebook Twitter

Outras redes sociais
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Outras redes

Métricas
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Katz, Marcelo

; Wajngarten, Mauricio

Arquivos Brasileiros de Cardiologia

Métricas do periódico
- Sobre o periódico
- SciELO Analytics

Jan 2015, Volume 104 Nº 1 Páginas 3 - 4

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.5935/abc.20150002 1904 downloads

Predictors of the risk of falls among elderly with chronic atrial fibrillation
Facebook Twitter

Outras redes sociais
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Outras redes

Métricas
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Santos, Angela Cristina Silva dos

; Nobre, Moacyr Roberto Cucê

; Nussbacher, Amit

; Rodrigues, Giselle Helena de Paula

; Gebara, Otavio Celso Eluf

; Serro Azul, João Batista Carvalho

; Wajngarten, Mauricio

Clinics

Métricas do periódico
- Sobre o periódico
- SciELO Analytics

2012, Volume 67 Nº 4 Páginas 305 - 311

Resumo: En | Texto: En | PDF: En

OBJECTIVES: Though elderly persons with chronic atrial fibrillation have more comorbidities that could limit indications for the chronic use of anticoagulants, few studies have focused on the risk of falls within this particular group. To evaluate the predictors of the risk of falls among elderly with chronic atrial fibrillation, a cross-sectional, observational study was performed. METHODS: From 295 consecutive patients aged 60 years or older with a history of atrial fibrillation who were enrolled within the last 2 years in the cardiogeriatrics outpatient clinic of the Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 107 took part in this study. Their age was 77.9±6.4 years, and 62 were female. They were divided into two groups: a) no history of falls in the previous year and b) a history of one or more falls in the previous year. Data regarding the history of falls and social, demographic, anthropometric, and clinical information were collected. Multidimensional assessment instruments and questionnaires were applied. RESULTS: At least one fall was reported in 55 patients (51.4%). Among them, 27 (49.1%) presented recurrent falls, with body lesions in 90.4% and fractures in 9.1% of the cases. Multivariate logistic regression showed that selfreported difficulty maintaining balance, use of amiodarone, and diabetes were independent variables associated with the risk of falls, with a sensitivity of 92.9% and a specificity of 44.9%. CONCLUSION: In a group of elderly patients with chronic atrial fibrillation who were relatively independent and able to attend an outpatient clinic, the occurrence of falls with recurrence and clinical consequences was high. Difficulty maintaining balance, the use of amiodarone and a diagnosis of diabetes mellitus were independent predictors of the risk for falls. Thus, simple clinical data predicted falls better than objective functional tests.

https://doi.org/10.6061/clinics/2012(04)02 2862 downloads

Intervenção coronária percutânea em idosos
Facebook Twitter

Outras redes sociais
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Outras redes

Métricas
- SciELO Analytics

Gebara, Otavio C. E.

; Wajngarten, Mauricio

Revista Brasileira de Cardiologia Invasiva

Métricas do periódico
- Sobre o periódico
- SciELO Analytics

2010, Volume 18 Nº 1 Páginas 13 - 14

Resumo: Pt | Texto: Pt | PDF: Pt

696 downloads

The prevalence of thyroid dysfunction in elderly cardiology patients with mild excessive iodine intake in the urban area of São Paulo
Facebook Twitter

Outras redes sociais
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Outras redes

Métricas
- SciELO Analytics

Duarte, Glaucia C.

; Tomimori, Eduardo K.

; Camargo, Rosalinda Y. A.

; Rubio, Ileana G.S.

; Wajngarten, Mauricio

; Rodrigues, Amanda G.

; Knobel, Meyer

; Medeiros-Neto, Geraldo

Clinics

Métricas do periódico
- Sobre o periódico
- SciELO Analytics

Fev 2009, Volume 64 Nº 2 Páginas 135 - 142

Resumo: En | Texto: En | PDF: En

OBJECTIVES: To evaluate the prevalence of thyroid dysfunction in elderly cardiac patients in an outpatient setting. SUBJECTS AND METHODS: A total of 399 consecutive patients (268 women, age range 60-92 years) who were followed at Heart Institute were evaluated for thyroid dysfunction with serum free T4, TSH, anti-Peroxidase antibodies, urinary iodine excretion measurements and thyroid ultrasound. RESULTS: Hyperthyroidism (overt and subclinical) was present in 29 patients (6.5%), whereas hypothyroidism (overt and subclinical) was found in 32 individuals (8.1%). Cysts were detected in 11 patients (2.8%), single nodules were detected in 102 (25.6%), and multinodular goiters were detected in 34 (8.5%). Hashimoto's thyroiditis was present in 16.8% patients, most of whom were women (83.6%). The serum TSH increased with age and was significantly higher (p= <0.01) in patients, compared to the normal control group. No significant differences in serum TSH and free T4 values were observed when patients with atrial fibrillation (AF) where compared with those without arrhythmia. The median urinary iodine levels were 210 µg/L (40-856 µg/L), and iodine levels were higher in men than in women (p<0.01). Excessive iodine intake (urinary iodine >300 µg/L) was observed in one-third of patients (30.8%). CONCLUSIONS: Elderly patients have a higher prevalence of both hypo- and hyperthyroidism as well as thyroid nodules when compared with the general population. About one-third of the older patients had elevated urinary secretion of iodine and a higher prevalence of chronic Hashimoto's thyroiditis. It is recommended that ultrasonographic studies, tests for thyroid function and autoimmunity should be evaluated in elderly patients.

3324 downloads

10.

Depressão e infarto agudo do miocárdio
Facebook Twitter

Outras redes sociais
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Outras redes

Métricas
- SciELO Analytics

Alves, Tânia Correa de Toledo Ferraz

; Fráguas, Renério

; Wajngarten, Mauricio

Archives of Clinical Psychiatry (São Paulo)

Métricas do periódico
- Sobre o periódico
- SciELO Analytics

2009, Volume 36 Supl. 3 Páginas 88 - 92

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

A associação entre transtorno depressivo maior e doenças cardiovasculares, em particular infarto agudo do miocárdio, é frequente, levando a pior prognóstico tanto da depressão como da doença cardiovascular, com maiores taxas de reinfarto e maior morbidade e mortalidade. Os autores discutem as evidências na literatura que demonstram essa associação entre infarto agudo do miocárdio e quadros depressivos, com enfoque nos avanços em fisiopatologia e terapêutica psiquiátrica. Vários estudos têm mostrado que o tratamento da depressão associada a quadros cardíacos é eficaz, melhora a qualidade de vida e pode ser feito com segurança. Embora o tratamento da depressão tenha sido associado à melhora de alguns parâmetros cardiovasculares, ainda não existem, entretanto, evidências de associação entre tratamento da depressão e melhora da morbidade e mortalidade cardiovascular.

The association between major depressive disorder and cardiovascular diseases, particularly myocardial infarction, is frequently observed, leading to worse prognosis both on the depressive disorder as well as cardiovascular disease, with increased rates of re-infarction and both morbidity and mortality. The authors review and discuss the evidence in the literature that supports the relationship between depressive disorder and cardiovascular disease, with focus on the advances on the physiopathology and the psychiatric management. Various studies have shown that treatment of depression is efficacious, improves quality of life and can be safely conducted. Although, treatment of depression has been associated with improvement on some cardiovascular parameters, there is no evidence so far that treatment of depression is associated with decrease of cardiovascular morbidity and mortality.

16551 downloads

11.

Depressão maior em pacientes com dor torácica não cardíaca: Quem vai tratar?
Facebook Twitter

Outras redes sociais
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Outras redes

Métricas
- SciELO Analytics

Fráguas, Renério

; Nobre, Moacyr Roberto Cuce

; Wajngarten, Mauricio

; Cardeal, Marcus Vinicius

; Figueiró, João Augusto Bertuol

; Iosifescu, Dan V.

; Teixeira, Manoel Jacobsen

Archives of Clinical Psychiatry (São Paulo)

Métricas do periódico
- Sobre o periódico
- SciELO Analytics

2009, Volume 36 Supl. 3 Páginas 83 - 87

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

OBJETIVO: Investigar a presença de transtornos psiquiátricos em pacientes com dor torácica de origem não cardíaca que não respondem aos tratamentos regulares. MÉTODO: Dezoito pacientes com dor torácica sem origem cardíaca e considerados por seus clínicos como não respondentes aos tratamentos regulares instituídos foram avaliados por um psiquiatra treinado. As entrevistas foram realizadas com base no Present State Examination e os diagnósticos psiquiá-tricos, de acordo com os critérios do Manual de Diagnóstico e Estatística da Associação Psiquiátrica Americana, 3ª Edição Revisada (DSM-III-R). RESULTADOS: Depressão maior no momento da avaliação foi diagnosticada em 6 (30%) pacientes, somatização em 1 (6%) e transtorno do pânico em 1 (6%) paciente. Sete pacientes estavam recebendo antidepressivos tricíclicos com doses < 75 mg/dia. CONCLUSÕES: A baixa dose de ADTs usadas para o tratamento da dor nesses pacientes pode ter melhorado parcialmente os sintomas depressivos, tornando mais difíceis o diagnóstico e o tratamento apropriado(s) da depressão e, assim, contribuindo para a persistência da dor e outras queixas. As futuras pesquisas deverão focalizar a eficácia do tratamento da depressão nesses pacientes e o impacto deste no alívio da dor torácica não cardíaca.

OBJECTIVE: To investigate the presence of psychiatric disorders in patients with chest pain not responsive to treatment. METHOD: We evaluated 18 patients judged by their physicians to have a chest pain not responsive to usual treatment, which included anti-pain medicines and investigation and treatment of possible etiological causes such as coronary artery disease, and gastroesophageal reflux disease. A psychiatrist interviewed the patients using the Present State Examination and made the diagnosis based on the DSM-III-R criteria. Current major depression was diagnosed in 6 (30%) patients, somatization in 1 (6%) and panic disorder in 1 (6%) patient. Seven patients were receiving tricyclics antidepressant with doses > 75 mg/day. DISCUSSION: Patients were receiving doses of tricyclics antidepressants efficacious for pain but not for major depression. It is possible that the low dose of antidepressants used to treat pain may partially ameliorate depressive symptoms, making the appropriate diagnosis and treatment of major depression even more difficult, consequently contributing to the persistence of pain and other complains. Considering the wide alternatives to effectively treat depression, a focus on detection and treatment of major depression in patients with chest pain is warranted by clinicians and researchers.

5890 downloads Citado 1 vez em SciELO

12.

Cardiogeriatria: uma subespecialidade ou uma necessidade?
Facebook Twitter

Outras redes sociais
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Outras redes

Métricas
- SciELO Analytics

Wajngarten, Mauricio

Arquivos Brasileiros de Cardiologia

Métricas do periódico
- Sobre o periódico
- SciELO Analytics

Set 2006, Volume 87 Nº 3 Páginas e8 - e9

Resumo: Pt | Texto: Pt | PDF: Pt

3667 downloads

13.

Teste ergométrico: valor prognóstico em pacientes idosos com doença aterosclerótica coronariana estável
Facebook Twitter

Outras redes sociais
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Outras redes

Métricas
- SciELO Analytics

Ochiai, Marcelo Eidi

; Gebara, Otávio C. E.

; Serro-Azul, João Batista

; Pinto, Lígia B.

; Nussbacher, Amit

; Pierri, Humberto

; Wajngarten, Mauricio

Arquivos Brasileiros de Cardiologia

Métricas do periódico
- Sobre o periódico
- SciELO Analytics

Mai 2006, Volume 86 Nº 5 Páginas 346 - 352

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

OBJETIVO: Estudar o valor prognóstico das variáveis do teste ergométrico em pacientes idosos com doença aterosclerótica coronariana e isquemia induzida pelo esforço. MÉTODOS: Foram estudados 64 pacientes idosos (61 homens, idade de 73 ± 5 anos) com doença aterosclerótica coronariana, comprovada por coronariografia, clinicamente estável, fração de ejeção de ventrículo esquerdo maior ou igual a 0,40 e isquemia miocárdica durante o teste ergométrico. A cada seis meses, os pacientes foram avaliados para eventos cardíacos (morte, infarto do miocárdio, angina instável, angioplastia e revascularização do miocárdio). RESULTADOS: Após seguimento médio de 48 meses, 23 (36%) pacientes sofreram eventos cardíacos. Não houve diferença clínica e angiográfica entre os pacientes que sofreram o evento e os que não o sofreram. Pela análise multivariada, a presença de dor precordial durante o teste ergométrico (risco relativo de 2,668 e p = 0,031) e a freqüência cardíaca no início da isquemia (risco relativo de 0,966 e p = 0,009) foram associadas a eventos cardíacos. CONCLUSÃO: Nessa população idosa, a presença de dor precordial durante o teste ergométrico e a freqüência cardíaca no início da isquemia foram associadas a eventos cardíacos. Essas variáveis podem ser úteis para avaliação do risco de pacientes com doença aterosclerótica coronariana estável.

OBJECTIVE: To study the prognostic value of exercise stress test variables in elderly patients with coronary atherosclerosis and exercise-induced ischemia. METHODS: Sixty-four elderly patients (61 men, 73 ± 5 years old) with coronary atherosclerosis, verified by cardiac catheterization, that were clinically stable, had a left ventricle ejection fraction greater than or equal to 0.40 and developed myocardial ischemia during the exercise stress test were studied. The patients were evaluated every six months for cardiac events (death, myocardial infarction, unstable angina, angioplasty and myocardial revascularization). RESULTS: After a mean follow-up period of 48 months, 23 (36%) patients suffered cardiac events. There was no clinical or angiographical differences among the patients that suffered cardiac events and those that did not. Using multivariate analysis, the presence of chest pain during the exercise stress test (relative risk 2.668, p = 0.031) and the heart rate at the onset of ischemia (relative risk 0.966, p = 0.009) were associated with cardiac events. CONCLUSION: In this elderly population, the presence of chest pain during the exercise stress test and the heart rate at the onset of ischemia were associated with cardiac events. These variables could be useful for risk evaluation in patients with stable coronary atherosclerosis.

6745 downloads

14.

Efficacy, safety and tolerability of sildenafil in Brazilian hypertensive patients on multiple antihypertensive drugs
Facebook Twitter

Outras redes sociais
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Outras redes

Métricas
- SciELO Analytics

Albuquerque, Denilson C.

; Miziara, Lineu J.

; Saraiva, Jose F. K.

; Rodrigues, Ulisses S.

; Ribeiro, Artur B.

; Wajngarten, Mauricio

International braz j urol

Métricas do periódico
- Sobre o periódico
- SciELO Analytics

Ago 2005, Volume 31 Nº 4 Páginas 342 - 355

Resumo: En | Texto: En | PDF: En

OBJECTIVE: To evaluate the efficacy, safety and tolerability of sildenafil among Brazilian patients with hypertension treated with combinations of anti-hypertensive drugs. MATERIALS AND METHODS: One hundred twenty hypertensive men aged 30 to 81 years old under treatment with 2 or more anti-hypertensive drugs and with erectile dysfunction (ED) lasting for at least 6 months were enrolled at 7 research centers in Brazil. Patients were randomized to receive treatment with either sildenafil or placebo taken 1 hour before sexual intercourse (initial dose of 50 mg, adjusted to 25 mg or 100 mg according to efficacy and toxicity). During the following 8 weeks, patients were evaluated regarding vital signs, adverse events, therapeutic efficacy, satisfaction with treatment and use of concurrent medications. RESULTS: The primary evaluation of efficacy, which was based on responses to questions 3 and 4 of the International Index of Erectile Function, showed significant differences regarding treatment with sildenafil (p = 0.0002 and p < 0.0001, respectively). In the assessment of global efficacy, 87% of the patients treated with sildenafil reported improved erections, as compared with 37% of patients given placebos (p < 0.0001). The other secondary evaluations supported the results favoring sildenafil. The most frequent adverse events among patients treated with sildenafil were headaches (11.4%), vasodilation (11.4%) and dyspepsia (6.5%). There were no significant changes in blood pressure measurements in both groups. CONCLUSION: Sildenafil is efficacious and safe for the treatment of hypertensive patients with ED who receive concurrent combinations of anti-hypertensive drugs.

3666 downloads

15.

Fatores de risco cardiovascular, declínio cognitivo e alterações cerebrais detectadas através de técnicas de neuroimagem
Facebook Twitter

Outras redes sociais
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Outras redes

Métricas
- SciELO Analytics

Alves, Tânia Corrêa de Toledo Ferraz

; Wajngarten, Mauricio

; Busatto Filho, Geraldo

Archives of Clinical Psychiatry (São Paulo)

Métricas do periódico
- Sobre o periódico
- SciELO Analytics

Jun 2005, Volume 32 Nº 3 Páginas 160 - 169

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Diversos estudos têm demonstrado associação entre fatores de risco cardiovascular e desenvolvimento de declínio cognitivo. Também há evidências do aumento das taxas de morbimortalidade em pacientes com doenças cardiovasculares e déficit cognitivo. Dentre os fatores de risco cardiovascular, hipertensão arterial e insuficiência cardíaca apresentaram forte associação com a presença de déficit cognitivo, entretanto os mecanismos cerebrais subjacentes não foram totalmente esclarecidos. Nos pacientes cardiopatas, o prejuízo cognitivo se dá principalmente nos aspectos de memória (fixação e aprendizado) e processamento das informações. Nesse artigo, revisa-se os achados de neuroimagem observados em amostras de pacientes com fatores de risco cardiovascular com declínio cognitivo, incluindo achados regionais de anormalidades volumétricas, hiperintensidade de substância branca, acidentes vasculares silenciosos, infartos lacunares e déficits funcionais na perfusão cerebral global (associada à redução do débito cardíaco) e perfusão cerebral regional. Discute-se, também, as implicações destes achados para a fisiopatologia do declínio cognitivo e suas aplicações clínicas. Finalmente, aborda-se o potencial de utilização de novas técnicas de imagem em estudos futuros na avaliação das alterações estruturais e funcionais associadas a fatores de riscos vasculares em amostras de base populacional.

Several research studies have shown associations between cardiovascular risk factors and the development of cognitive decline. There is also evidence of an increased rate of morbidity and mortality in subjects with cardiovascular diseases with concomitant cognitive decline. Congestive heart failure and hypertension, among all cardiovascular risk factors, have shown a strong relationship with the presence of cognitive deficits, but the brain mechanisms underlying such association have not yet been clarified. The cognitive decline associated with cardiac diseases is characterized mainly by impairments of memory (learning and fixation), attention and information processing. In this article, we review neuroimaging abnormalities that may be found in samples of subjects presenting with cardiovascular risk factors and cognitive decline, including regional brain volumetric changes, white matter hyperintensities, silent brain infarcts, lacunars infarcts, and functional deficits in global blood flow (associated to reduced cardiac output) or regional cerebral blood flow. We discuss the implications of these findings to the knowledge about the pathophysiology of cognitive deficits associated with cardiovascular risk factors, as well as their potential clinical applications. Finally, we discuss the potential use of novel imaging technologies in future studies evaluating abnormalities in brain structure and function related to cardiovascular risk factors, in large samples of elderly patients.

4742 downloads

Exibindo

itens por página

Página de 2 Próxima

Selecione um ou mais resultados

Todos Ordem alfabética

Resultados

Gráfico comparativo Download CSV

Visualizar estatísticas de

Enviar resultado

E-mail do(s) destinatários*

Utilize ; (ponto e vírgula) para mais de um e-mail.

Enviar por e-mail

Esta página

Registros selecionados

Todos os registros (max. 300)

Alterar remetente, assunto e comentários

Seu email

Assunto

Comentários

Alterar remetente, assunto e comentários

Exportar resultados

Formato de exportação:

RIS (para EndNote, ProCite, Reference Manager, RefWorks, Citavi, etc.)

BibTeX

Citação

CSV (para Excel, etc)

Exportar:

Esta página

Itens selecionados

Todos os registros (max. 2000)

Mostrar mais

Sem resultados

Não foram encontrados documentos para sua pesquisa

Glossário e ajuda para busca

Você pode enriquecer sua busca de uma forma muito simples. Use os índices de pesquisa combinados com os conectores (AND ou OR) e especifique cada vez mais sua busca.

Por exemplo, se você deseja buscar artigos sobre
casos de dengue no Brasil em 2015, use:
ti:dengue and publication_year:2015 and aff_country:Brasil

Veja abaixo a lista completa de índices de pesquisa que podem ser usados:

Cód. do Índice	Elemento
ti	título do artigo
au	autor
kw	palavras-chave do artigo
subject	assunto (palavras do título, resumo e palavras-chave)
ab	resumo
ta	título abreviado da revista (ex. Cad. Saúde Pública)
journal_title	título completo da revista (ex. Cadernos de Saúde Pública)
la	código do idioma da publicação (ex. pt - Português, es - Espanhol)
type	tipo do documento
pid	identificador da publicação
publication_year	ano de publicação do artigo
sponsor	financiador
aff_country	código do país de afiliação do autor
aff_institution	instituição de afiliação do autor
volume	volume do artigo
issue	número do artigo
elocation	elocation
doi	número DOI
issn	ISSN da revista
in	código da coleção SciELO (ex. scl - Brasil, col - Colômbia)
use_license	código da licença de uso do artigo

SciELO - Scientific Electronic Library Online
Rua Dr. Diogo de Faria, 1087 – 9º andar – Vila Clementino 04037-003 São Paulo/SP - Brasil
Email: scielo@scielo.org

Todo o conteúdo de www.scielo.org, exceto onde está identificado, está licenciado sob uma Licença Creative Commons.
saiba mais »