The carotid-radial PWV analysis, evaluated using robust and simple available techniques, could be used in the clinical practice to study the vascular response to transient ischaemia and the endothelial function.

Background:The characterization of the dynamic process of veins walls is essential to understand venous functioning under normal and pathological conditions. However, little work has been done on dynamic venous properties. Aim: To characterize vein compliance (C), viscosity (η), peak-strain (W St ) and dissipated (W D ) energy, damping (ξ), and their regional differences in order to evaluate their role in venous functioning during volume-pressure overloads. Methods: In a mock circulation, pressure (P) and diameter (D) of different veins (anterior cava, jugular and femoral; from 7 sheep), were registered during cyclical volume-pressure pulses. From the P-D relationship, C, W St and ξ (at low and high P-D levels), η and W D were calculated. Results: For each vein there were P-dependent differences in biomechanical, energetics, and damping capability. There were regional-differences in C, η, W St and W D (p<0.05), but not in ξ. Conclusion: The regional-dependent differences in dynamics and energetics, and regional-similitude in damping could be important to ensure venous functioning during acute overloads. The lower C and higher W St and W D found in back-limb veins (femoral), commonly submitted to high volume-pressure loads (i.e. during walking), could be considered relevant to ensure adequate venous system functionality and venous wall protection simultaneously.

Análise da Incidência e Preditores Clínicos e Ecocardiográficos do Refluxo Paraprotético Aórtico após o Implante de Prótese Aórtica Transcateter Introdução: A incidência de refluxo paraprotético (RPP) parece maior entre os pacientes submetidos a implante de prótese aórtica transcateter e sua potencial associação com aumento da mortalidade tardia tem suscitado preocupação na comunidade científica. Nosso objetivo foi avaliar a incidência e o impacto clínico e estabelecer preditores do RPP em nossa casuística. Métodos: Entre julho de 2009 e fevereiro de 2013, 112 pacientes foram submetidos a implante de prótese aórtica transcateter. O grau do RPP pós-procedimento foi avaliado segundo os critérios do VARC 2. Dividiu-se a população em grupo RPP ausente/RPP discreto e grupo RPP moderado/RPP grave.

The model was adequate to characterize the circadian pattern of AS. We provide the first evidence that AS in humans follows an asymmetric circadian pattern and that this differs between NG and HG. In both NG and HG, AS had a circadian profile, with the highest levels in the night. HG showed larger levels of AS, larger BP variations and rate of change and minor changes in AS during transitional periods.

BackgroundTranscatheter aortic valve implantation is an effective alternative to surgical treatment of severe aortic stenosis in patients who are inoperable or at high surgical risk.ObjectivesTo report the immediate and follow-up clinical and echocardiographic results of the initial experience of transcatheter aortic valve implantation.MethodsFrom 2009 June to 2013 February, 112 patients underwent transcatheter aortic valve implantation.ResultsMean age was 82.5 ± 6.5 years, and the logistic EuroSCORE was 23.6 ± 13.5. Procedural success was 84%. After the intervention, a reduction in the mean systolic gradient was observed (pre: 54.7 ± 15.3 vs. post: 11.7 ± 4.0 mmHg; p < 0.01). Cerebrovascular accidents occurred in 3.6%, vascular complications in 19% and permanent pacemaker was required by 13% of the patients. Thirty-day mortality and at follow-up of 16 ± 11 months was 14% and 8.9% respectively. The presence of chronic obstructive pulmonary disease was the only predictor of mortality at 30 days and at follow-up. During follow up, aortic valve area and mean systolic gradient did not change significantly.ConclusionsTranscatheter aortic valve implantation is an effective and safe procedure for the treatment of aortic stenosis in high-surgical risk or inoperable patients. The presence of chronic obstructive pulmonary disease was the only independent predictor of mortality identified both in the first month post-intervention and at follow-up.

While the situation of tissue donation and transplantation differs between Latin American and European countries, a common problem is tissue deficiency. Hence, at present, there is a pressing need to generate alternatives so as to increase the possibilities of obtaining the requested materials. Consequently, it would be of significant interest to establish an intercontinental network for tissue exchange, to improve international cooperation, and to help patients that need tissue transplantation, and to evaluate the feasibility of using an intercontinental network for the exchange of cryopreserved arteries (cryografts), preserving the arterial distensibility and ensuring a reduced native artery-cryograft biomechanical mismatch. Distensibility was studied in ovine arteries divided into three groups: intact (in vivo tests, conscious animals), fresh control (in vitro tests immediately after the artery excision, Uruguay), and cryografts (in vitro tests of cryopreserved-transported-defrosted arteries, Spain). Histological studies were performed so as to analyze changes in the endothelial layer and elastic components. The comparison between fresh control and cryografts showed that neither the cryopreservation nor the exchange network impaired the distensibility, despite the expected histological changes found in the cryografts. The comparison between intact and cryografts showed that the cryografts would be capable of ensuring a reduced biomechanical mismatch. The cryopreservation and the intercontinental network designed for artery exchange preserved the arterial distensibility. It could be possible to transfer cryografts between Latin America and Europe to be used in cardiovascular surgeries and/or for tissue banking reprocessing, with basic biomechanical properties similar to those of the fresh and/or native arteries.

Background: Percutaneous balloon mitral valvotomy is safe and effective in patients with severe symptomatic mitral stenosis with immediate and long-term results comparable to those of surgical intervention. This study was aimed at reporting the very late follow-up results of the first percutaneous balloon mitral valvotomies performed at our institution and at identifying predictive factors of restenosis. Methods: From 1987 to 1991, 200 consecutive patients were submitted to percutaneous balloon mitral valvotomy. Clinical and echocardiographic evaluations were performed prior to the procedure, 48 hours after the procedure and annually thereafter. results: Mean age was 32 ± 12 years; 86.5% were female and 80.5% were in New York Heart Association functional class III or IV. Mean Wilkins score was 7.6 ± 1.2 and procedure success was observed in 87.5% (175/200) of the patients. During follow-up, 129 patients (74%) were followed up for 140 ± 79 months. Restenosis was observed after the first procedure in 46.5% (60/129) patients and a second percutaneous balloon mitral valvotomy was performed in 25 patients, a third one in 4 patients and a fourth one in 1 patient. The probability of being restenosis-free was 85% at 5 years, 60% at 10 years and 36% at 20 years. Left atrial diameter (P = 0.034), and preoperative (P = 0.013) and postoperative (P = 0.038) transvalvar gradient were predictors of restenosis. conclusions: In a very late clinical follow-up, percutaneous balloon mitral valvotomy provided long-lasting results in over one-third of the patients and showed that repeated procedures may be performed safely in selected patients. The

The EST resulted in an early increase in the arterial stiffness, evidenced by regional and local parameters. There were quali-quantitative differences among the arterial local stiffness response to EST, when analyzing conjunctly the different postEST recovery stages. The biomechanical changes could not be explained only by blood pressure variations.