Browsing by Author "Castro, Pablo"

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    AMBIENT FINE PARTICULATE MATTER IS ASSOCIATED WITH RISK OF HOSPITALIZATION FOR ACUTE DECOMPENSATED HEART FAILURE AMONG PATIENTS WITH DEPRESSED LEFT VENTRICULAR EJECTION FRACTION
    (ELSEVIER SCIENCE INC, 2011) Castro, Pablo; Verdejo, Hugo; Vera, Jeantte; Cifuentes, Luis; Concepcion, Roberto; Seplveda, Luis; Vukasovic, Jose Luis; Wellenius, Gregory
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    Cambios en el pronóstico a largo plazo de la hipertensión arterial pulmonar
    (SOC MEDICA SANTIAGO, 2011) Enriquez, Andres; Castro, Pablo; Sepulveda, Pablo; Verdejo, Hugo; Greig, Douglas; Gabrielli, Luigi; Ferrada, Marcela; Lapostol, Carolina
    Background: Pulmonary artery hypertension (PAR) is a progressive disease with high mortality. Major advances had been made in the treatment of this condition during the last decade. Aim: To characterize the clinical evolution and mortality of a cohort of Chilean patients. Material and Methods: Seventeen patients with PAH diagnosed in the last 10 years in two Chilean hospitals were enrolled. Measurements at diagnosis included hemodynamic variables and 6-minute walk test. The patients were followed clinically for 3 years and the observed mortality was compared with that predicted by the prognostic equation proposed by the historic registry of the National Institutes of Health (NIH). Results: The mean age of patients was 45 years and 80% had an idiopathic PAH. The mean median pulmonary artery pressure was 57 +/- 15 mmHg, the cardiac index was 2.4 +/- 0.7 l/min/m(2) and the right atrial pressure was 12 +/- 8 mmHg. The 6-minute walk distance was 348 +/- 98 m. All patients received anticoagulants. Eighty two percent received ambrisentan, 12% received bosentan, 29% received iloprost and 24% sildenafil. At the end of follow-up only 3 patients had died, with an observed survival rate of 88, 82 and 82% at 1, 2 and 3 years, respectively. In contrast, the survival calculated according to the predictive formula of the NIH was 67, 56 and 45%, respectively. Among surviving patients, an improvement in exercise capacity was observed after one year (p < 0.05). Conclusions: The observed survival rate was significantly better than that estimated according to historical data. Furthermore, therapy was associated with an improvement in functional capacity after one year. This prognostic improvement is consistent with data of other contemporary registries published after the NIH Registry. (Rev Med Chile 2011; 139: 327-333).
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    Cardiac dyssynchrony correlates with left ventricular remodeling after myocardial infarction
    (SOC MEDICA SANTIAGO, 2009) McNab, Paul; Castro, Pablo; Gabrielli, Luigi; Verdejo, Hugo; Carlos Quintana, Juan; Rodriguez, Jose A.; Corbalan, Ramon
    Background: Cardiac dyssynchrony is common in advanced heart failure (HF), but the changes in cardiac synchrony after myocardial infarction (MI) have not been adequately described. Aim: To study the relationship between cardiac synchrony and left ventricular remodeling after acute myocardial infarction. Material and methods: Forty nine patients aged 59+/-10 years (77% men) with a first episode of a ST segment elevation MI were studied. Scintigraphic left ventricular function and synchrony analyses were performed at baseline and after a six months follow-up. Determinations were compared with 33 healthy subjects. Results: At baseline, patients with MI had a decreased left ventricular ejection fraction (LVEF) and significant dyssynchrony, when compared with controls. LVEF was 36.4%+/-10%, left ventricular end-diastolic volume (LVEDV) 127+/-38 mL, interventricular delay (IEV) 29+/-35 milliseconds (ms), and intraventricular delay (IAV), 234+/-89 ms. After 6 months, LVEF significantly improved (38%+/-10%, p = 0.042) without significant changes in LVEDV (129+/-32 mL, p = 0.97), IEV (24+/-17, p = 0.96) or IAV (231 +/- 97, p = 0.34). At baseline there were significant correlations between IAV and LVEF, and between IAV and LVEDV (r = -0.48, p = 0.001 and r = -0.41, p = 0.004, respectively). These correlations remained significant after 6 months. There was a positive correlation between IAV and LVEDV changes at six months (r = 0.403, p = 0.04). Conclusions: The development of cardiac dyssynchrony correlates with adverse left ventricular remodeling after MI (Rev Med Chile 2009; 137: 1457-62).
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    Effects of atorvastatin therapy in heart failure: Oxidative stress, inflammation, endothelial dysfunction and exercise capacity
    (ELSEVIER SCIENCE INC, 2007) Miranda, Rodrigo; Castro, Pablo; Verdejo, Hugo; Greig, Douglas; Alcaino, Hernan; Bustos, Carlos; Vukasovic, Jose Luis; Godoy, Ivan; Diaz Araya, Guillermo; Lavandero, Sergio
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    Enalapril attenuates downregulation of angiotensin-converting enzyme 2 in the late phase of ventricular dysfunction in myocardial infarcted rat
    (LIPPINCOTT WILLIAMS & WILKINS, 2006) Ocaranza, Maria Paz; Godoy, Ivan; Jalil, Jorge E.; Varas, Manuel; Collantes, Patricia; Pinto, Melissa; Roman, Maritza; Ramirez, Cristian; Copaja, Miguel; Diaz Araya, Guillermo; Castro, Pablo; Lavandero, Sergio
    The early and long-term effects of coronary artery ligation on the plasma and left ventricular angiotensin-converting enzyme (ACE and ACE2) activities, ACE and ACE2 mRNA levels, circulating angiotensin (Ang) levels [Ang I, Ang-(1-7), Ang-(1-9), and Ang II], and cardiac function were evaluated 1 and 8 weeks after experimental myocardial infarction in adult Sprague Dawley rats. Sham-operated rats were used as controls. Coronary artery ligation caused myocardial infarction, hypertrophy, and dysfunction 8 weeks after surgery. At week 1, circulating Ang II and Ang-(1-9) levels as well as left ventricular and plasma ACE and ACE2 activities increased in myocardial-infarcted rats as compared with controls. At 8 weeks post-myocardial infarction, circulating ACE activity, ACE mRNA levels, and Ang II levels remained higher, but plasma and left ventricular ACE2 activities and mRNA levels and circulating levels of Ang-(1-9) were lower than in controls. No changes in plasma Ang-(1-7) levels were observed at any time. Enalapril prevented cardiac hypertrophy and dysfunction as well as the changes in left ventricular ACE, left ventricular and plasmatic ACE2, and circulating levels of Ang II and Ang-(1-9) after 8 weeks postinfafction. Thus, the decrease in ACE2 expression and activity and circulating Ang-(1-9) levels in late ventricular dysfunction post-myocardial infarction were prevented with enalapril. These findings suggest that in this second arm of the renin-angiotensin system, ACE2 may act through Ang-(1-9), rather than Ang-(1-7), as a counterregulator of the first arm, where ACE catalyzes the formation of Ang II.
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    Expression of Herpud1 during osteoclast and osteoblast differentiation
    (FEDERATION AMER SOC EXP BIOL, 2016) Quiroga, Clara; Da Silva, Luan Americo; Mansilla, Georthan; Oyarzun, Ingrid; Bustamante, Mario; Castro, Pablo; Verdejo, Hugo
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    Fine Particulate Air Pollution (PM2.5) Increases Emergency Hospital Admissions due to Decompensate Heart Failure
    (LIPPINCOTT WILLIAMS & WILKINS, 2009) Vera, Jeanette; Castro, Pablo; Cifuentes, Luis; Wellenius, Gregory; Verdejo, Hugo; Luis Vukasovic, Jose
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    Galectin-3 levels in patients hospitalized for decompensated heart failure
    (SOC MEDICA SANTIAGO, 2017) Rossel, Victor; Diaz Toro, Felipe; Verdejo, Hugo; Concepcion, Roberto; Sepulveda, Luis; Castro, Pablo; Luis Vukasovic, Jose; Bernales, Angie; Representacion Departmento Insufic
    Galectin-3 (Gal-3) is a mediator of myocardial fibrosis involved in cardiac remodeling and a potential new prognosis marker in heart failure (HF). Aim: To measure Gal-3 at the moment of discharge in patients hospitalized for HF and its association with different variables. Material and Methods: Patients hospitalized for decompensated HF from four hospitals between August 2014 and March 2015, were included. Demographic, clinical and laboratory variables were recorded at the time of admission. At discharge, a blood sample was withdrawn to measure Gal-3 and brain natriuretic propeptide (Pro-BNP). Patients were separated in two groups, according to the level of Gal-3 (using a cutoff value of 17.8 ng/mL), comparing clinical and laboratory values between groups. Results: We included 52 patients with HF aged 70 17 years (42% females). Functional capacity was III-IV in 46% of patients and the ejection fraction was 34.9 13.4%. Pro-BNP values at discharge were 5,323 8,665 pg/mL. Gal-3 values were 23.8 16.6 ng/mL. Sixty percent of patients had values over 17.8 ng/mL. Those with elevated Gal-3 levels were older (75 16 and 62 15 years, respectively, p = 0.025) and were hypertensive in a higher proportion (90.5% and 57.1% respectively, p = 0.021). Conclusions: In patients hospitalized for HF, Gal-3 levels are higher in older and hypertensive subjects.
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    Galectin-3 Promotes Pro-Hypertrophic Communication Between Fibroblasts and Cardiomyocytes
    (LIPPINCOTT WILLIAMS & WILKINS, 2017) Bustamante, Mario; Oyarzun, Ingrid; Mancilla, Georthan; Quiroga, Clara; Verdejo, Hugo E.; Castro, Pablo
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    Markedly increased Rho-kinase activity in circulating leukocytes in patients with chronic heart failure
    (MOSBY-ELSEVIER, 2011) Paz Ocaranza, Maria; Gabrielli, Luigi; Mora, Italo; Garcia, Lorena; McNab, Paul; Godoy, Ivan; Braun, Sandra; Cordova, Samuel; Castro, Pablo; Novoa, Ulises; Chiong, Mario; Lavandero, Sergio; Jalil, Jorge E.
    Background The small guanosine triphosphatase Rho and its target Rho-kinase have significant roles in experimental remodeling and ventricular dysfunction, but no data are available on Rho-kinase activation in patients with heart failure (HF). We hypothesized that, in patients with chronic HF, Rho-kinase in circulating leukocytes is activated and related to left ventricular (LV) remodeling and dysfunction.
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    Myocardial lipids and creatine measured by magnetic resonance spectroscopy among patients with heart failure
    (SOC MEDICA SANTIAGO, 2010) Luis Winter, Jose; Castro, Pablo; Meneses, Luis; Chalhub, Monica; Verdejo, Hugo; Greig, Douglas; Gabrielli, Luigi; Chiong, Mario; Concepcion, Roberto; Mellado, Rosemarie; Hernandez, Claudia; Uribe, Sergio; Lavander, Sergio
    Background: Heart failure (HF) is characterized, among other features, by the development of alterations in myocardial energy metabolism, involving a decrease in glucose utilization and increased free fatty acid uptake by cardiomyocytes, associated with decreased deposits of high-energy phosphates (creatine phosphate/ creatine transporter). Magnetic resonance (MR) imaging allows a direct and noninvasive assessment of myocardial metabolites. Aim: To measure myocardial creatine and lipids by MR spectroscopy among patients with HE Material and Methods: Cardiac MR spectroscopy (1.5 Tesla) with Hydrogen antenna and single voxel acquisition was performed in five patients with non-ischemic heart failure, aged 58 +/- 9.7 years, (60% males) and 5 healthy volunteers matched for age and sex. We analyzed the signals of creatine (Cr), lipids (L) and water (W) in the interventricular septum, establishing the water/lipid (W/L) and water/creatine (W/Cr) index to normalize the values obtained. Results: Among patients, left ventricular ejection fraction was 32 +/- 6.9%, 60% were in functional capacity II, 60% had hypertension and one was diabetic. Spectroscopic curves showed a depletion of total Cr, evidenced by the W/Cr index, among patients with heart failure, when compared with healthy controls (1.46 +/- 1.21 and 5.96 +/- 2.25 respectively, p < 0,05). Differences in myocardial lipid content, measured as the W/L index, were not significant (5.06 +/- 2.66 and 1.80 +/- 1.62 respectively, p = 0.08). Conclusions: Among patients with heart failure of non-ischemic etiology, there is a depletion of creatine levels measured by MR spectroscopy. (Rev Med Chile 2010; 138: 1475-1479).
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    Radiofrequency based wireless pressure sensor is a reliable method for hemodynamic assessment in ambulatory chronic heart failure patients: Comparison to swan-ganz catheter and echocardiography.
    (ELSEVIER SCIENCE INC, 2007) Castro, Pablo; Verdejo, Hugo; Bourge, Robert; Concepcion, Roberto; Ferrada, Marcela; Martinez, Alejandro; Alcaino, Milton; Alfaro, Mario; Godoy, Ivan; Perrone, Sergio
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    Relationship between mechanical and metabolic dyssynchrony with left bundle branch block: Evaluation by 18-fluorodeoxyglucose positron emission tomography in patients with non-ischemic heart failure
    (ELSEVIER SCIENCE INC, 2012) Castro, Pablo; Luis Winter, Jose; Verdejo, Hugo; Orellana, Pilar; Carlos Quintana, Juan; Greig, Douglas; Enriquez, Andres; Sepulveda, Luis; Concepcion, Roberto; Sepulveda, Pablo; Rossel, Victor; Chiong, Mario; Garcia, Lorena; Lavandero, Sergio
    BACKGROUND: Ventricular dyssynchrony is a common finding in patients with heart failure (HF), especially in the presence of conduction delays. The loss of ventricular synchrony leads to progressive impairment of contractile function, which may be explained in part by segmental abnormalities of myocardial metabolism. However, the association of these metabolic disarrangements with parameters of ventricular dyssynchrony and electrocardiography (ECG) findings has not yet been studied.