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Abstract(s)
Introdução: A Hipertensão Arterial constitui um problema grave de Saúde Pública por ter elevada prevalência no Mundo e ser um dos principais fatores de risco modificáveis para o desenvolvimento de doenças cardiovasculares (DCVs). A exposição crónica ao aumento da pressão arterial leva a um conjunto de alterações estruturais e funcionais em vários tecidos, nomeadamente no coração, resultando em Doença Cardíaca Hipertensiva. Esta entidade tem como principal característica, a Hipertrofia Ventricular Esquerda (HVE) que se define por um aumento da massa do ventrículo esquerdo. Numa primeira fase, esta surge como mecanismo compensatório de forma a manter o débito cardíaco, apesar do aumento da pós-carga imposta pela Hipertensão Arterial. No entanto, numa fase mais avançada, poderá evoluir para disfunção ventricular esquerda e consequente Insuficiência Cardíaca, entre outras complicações. Deste modo, A Hipertrofia Ventricular Esquerda constitui, por si só, um fator de risco cardiovascular independente. É, tradicionalmente, avaliada por eletrocardiograma, ecocardiograma ou ressonância magnética cardíaca, embora estes tenham algumas limitações como a eficácia dependente da experiência de quem executa, custos elevados, entre outras. Objetivos: Nesta revisão bibliográfica pretende-se: 1. Estudar possíveis biomarcadores capazes de identificar, precocemente, a Hipertrofia Ventricular Esquerda em doentes com Hipertensão Arterial; 2. Avaliar a capacidade desses biomarcadores poderem monitorizar a regressão de HVE. Métodos: Na elaboração desta revisão, efetuou-se uma pesquisa bibliográfica nas bases de dados Pubmed e Google Scholar, com enfoque para artigos científicos publicados a partir de 2012. Resultados: Os biomarcadores selecionados foram Cardiotrofina-1 (CT-1), NT-proBNP, ST-2, FDG-15, Galectina-3, Troponina de alta sensibilidade e Micro-RNAs. Conclusão: Estes biomarcadores selecionados, embora ainda estejam em estudo, poderão ser promissores na identificação precoce da HVE associada a hipertensão arterial, podendo ser alternativas ou complementares aos métodos convencionais de diagnóstico e/ou para estratificação do risco. Poderão, ainda, vir a ser úteis em monitorizar o efeito do tratamento anti-hipertensor na reversão da HVE e/ou funcionar como novos alvos-terapêuticos. Deste modo, os biomarcadores ajudariam a identificar a hipertrofia ventricular esquerda de forma precoce, acompanhar a sua evolução e prevenir futuras complicações da mesma.
Introduction: Hypertension is a serious public health problem because it has a high prevalence in the world and is one of the main modifiable risk factors for the development of cardiovascular diseases (CVDs). Chronic exposure to increased blood pressure leads to a set of structural and functional changes in various tissues, notably the heart, resulting in hypertensive heart disease. This entity has, as its main characteristic, Left Ventricular Hypertrophy (LVH) defined by an increase in left ventricular mass. In the first phase, this appears as a compensatory mechanism in order to maintain cardiac output, despite the increase in post-load imposed by arterial hypertension. However, at a later stage, it may progress to left ventricular dysfunction, heart failure and other complications. Thus, Left Ventricular Hypertrophy alone is an independent cardiovascular risk factor. It is traditionally evaluated by electrocardiogram, echocardiogram or cardiac magnetic resonance imaging, although these have some limitations such as efficacy dependent on the experience of the performer, high costs, among others. Objectives: In this literature review we intend to: 1. Study possible biomarkers capable of identifying early Left Ventricular Hypertrophy in patients with Arterial Hypertension; 2. Evaluate the ability of these biomarkers to monitor LVH regression. Methods: In the preparation of this review, a bibliographic search was carried out in the Pubmed and Google Scholar databases, with a focus on published scientific articles from 2012. Results: The selected biomarkers were Cardiotrophin-1, NT-proBNP, ST-2, Galectin-3, FDG-15, high-sensitivity cardiac Troponin T and Micro-RNAs). Conclusion: These biomarkers selected, although still under study, may be promising in the early identification of LVH associated with arterial hypertension, and may be alternative or complementary to conventional diagnostic methods and / or for risk stratification. They may also be useful in monitoring the effect of antihypertensive treatment on the reversal of LVH and / or to function as novel therapeutic targets. Thus, biomarkers would help to identify left ventricular hypertrophy early, monitor its evolution and prevent future complications of it.
Introduction: Hypertension is a serious public health problem because it has a high prevalence in the world and is one of the main modifiable risk factors for the development of cardiovascular diseases (CVDs). Chronic exposure to increased blood pressure leads to a set of structural and functional changes in various tissues, notably the heart, resulting in hypertensive heart disease. This entity has, as its main characteristic, Left Ventricular Hypertrophy (LVH) defined by an increase in left ventricular mass. In the first phase, this appears as a compensatory mechanism in order to maintain cardiac output, despite the increase in post-load imposed by arterial hypertension. However, at a later stage, it may progress to left ventricular dysfunction, heart failure and other complications. Thus, Left Ventricular Hypertrophy alone is an independent cardiovascular risk factor. It is traditionally evaluated by electrocardiogram, echocardiogram or cardiac magnetic resonance imaging, although these have some limitations such as efficacy dependent on the experience of the performer, high costs, among others. Objectives: In this literature review we intend to: 1. Study possible biomarkers capable of identifying early Left Ventricular Hypertrophy in patients with Arterial Hypertension; 2. Evaluate the ability of these biomarkers to monitor LVH regression. Methods: In the preparation of this review, a bibliographic search was carried out in the Pubmed and Google Scholar databases, with a focus on published scientific articles from 2012. Results: The selected biomarkers were Cardiotrophin-1, NT-proBNP, ST-2, Galectin-3, FDG-15, high-sensitivity cardiac Troponin T and Micro-RNAs). Conclusion: These biomarkers selected, although still under study, may be promising in the early identification of LVH associated with arterial hypertension, and may be alternative or complementary to conventional diagnostic methods and / or for risk stratification. They may also be useful in monitoring the effect of antihypertensive treatment on the reversal of LVH and / or to function as novel therapeutic targets. Thus, biomarkers would help to identify left ventricular hypertrophy early, monitor its evolution and prevent future complications of it.
Description
Keywords
Biomarcadores Cardiotrofina1 Fdg-15 Galectina-3 Hipertensão Arterial Hipertrofia Ventricular Esquerda Hs-Ctnt Micro-Rnas Nt-Probnp St-2