Estudo morfométrico do miocárdio em adultos com subnutrição protéico-energética

Abstract

Purpose - Estudo Morfométrico do Miocárdio em Adultos com Subnutrição Protéico-Energética Artigo OriginalA subnutrição protéico-energética (SPE) crônica, do tipo marasmo, decorre do aporte alimentar insuficiente para suprir as necessidades energéticas e protéicas do indiví-duo, processo que se acompanha de emagrecimento progressivo, com diminuição do peso corporal e das reservas de gordura e de massa muscular. Em adultos, a SPE do tipo kwashiorkor está associada com hipoalbuminemia e edema, geralmente com evolução mais rápida e muitas vezes desencadeada por infecção, trauma ou cirurgia 1 . Nos seres humanos, uma conseqüência da subnutrição é a progressiva perda das reservas corporais de musculatura e de tecido adiposo, com hipotrofia de diversos órgãos, incluindo rins, intestinos e órgãos linfóides 1 . O fígado (esteatose hepática) e os pulmões (maior susceptibilidade às infecções) também podem ser afetados 2 .

Heart Weight and Heart Weight/Body Weight Coefficient in Malnourished Adults

“…However, we also observed a positive and significant correlation between body weight and heart weight (r=0.65), and also between heart weight and body mass index (r=0.52), which indicates that the thinner the individual, the lower his heart weight is. Likewise, according to morphometric studies on myocardiocytes 5 , individuals with advanced malnutrition have greater degrees of heart hypotrophy 13 . This fact may have clinical repercussions, such as a prolonged QTc interval on the electrocardiogram 14 , a lower cardiac output 2 , and a higher risk of developing the refeeding syndrome, a condition in which cardiac decompensation would result from myocardial dysfunction associated with cardiac hypotrophy secondary to malnutrition 7 .…”

“…Experiments with animals 2 and autopsies of malnourished children show that the heart undergoes hypotrophy proportional to the degree of weight loss 3,4 . Even though studies on heart morphometry and function of malnourished adults are rare 5 , experiments with animals suggest that the myocardium undergoes a milder wasting than striated skeletal muscles do, possibly due to the relative increase in vascularization and oxygenation of the myocardiocytes 6 . However, patients quite frequently develop tachycardia, hydric retention, and cardiac decompensation during nutritional therapy, and this phenomenon has been attributed to myocardial dysfunction associated with cardiac hypotrophy secondary to malnutrition 7 .…”

Effects of Biodegradable Detergents in the Accumulation of Lipofuscin (Age Pigment) in Gill and Liver of Two Neotropical Fish Species

“…Reversibility of lipopigment accumulation is not yet fully understood or proven, but recent studies have shown that in fish, up to 45% of lipopigment accumulation can be reverted due to recovery of lysosomal stability, knowing that the more polluted the area, the more efficient tissue regeneration gets (Au et al). On the other hand, the possibility of oxidation and consumption of lipofuscin's lipid components and protein components cannot be discarded (Cunha et al, 1998).…”