Insights into the actions of angiotensin-1 receptor (AT1R) inverse agonists: Perspectives and implications in COVID-19 treatment.

New coronavirus SARS-CoV-2 (COVID-19) has caused chaos in health care systems. Clinical manifestations of COVID-19 are variable, with a complex pathophysiology and as yet no specific treatment. It has been suggested that the renin-angiotensin-aldosterone system has a possible role in the severity of cases and the number of deaths.

Disparities in Access and Mortality of Patients With ST-Segment-Elevation Myocardial Infarction Using the Brazilian Public Healthcare System: VICTIM Register.

Background There is a scarcity of knowledge as to whether rates of myocardial reperfusion use and 30-day mortality for patients with ST-segment-elevation myocardial infarction are similar among patients using the Brazilian Public Health System (SUS) and those using the private healthcare system. Methods and Results A total of 707 patients were analyzed using the VICTIM (Via Crucis for the Treatment of Myocardial Infarction) register database; 589 patients from the SUS and 118 from the private network with ST-segment-elevation myocardial infarction, who attended hospitals with the capacity to perform primary percutaneous coronary intervention (PCI) were investigated. The timeline, rates of use of PCI, and the 30-day probability of death were investigated, comparing the SUS patients to those in the private system.

The Role of Acute Intermittent Hypoxia in Neutrophil-Generated Superoxide, Sympathovagal Balance, and Vascular Function in Healthy Subjects.

Recurrent hypoxia (HPX), a hallmark of the obstructive sleep apnea (OSA), impairs autonomic balance, and increases arterial blood pressure (BP). Oxidative stress is one of the mechanisms involved in these alterations. The cumulative effect of acute intermittent HPX and the chronicity may determine whether the response crosses the threshold from having protective value to pathology.

Severity of erectile dysfunction is highly correlated with the syntax score in patients undergoing coronariography.

Objective: To investigate the association between the severity of erectile dysfunction (ED) and coronary artery disease (CAD) in men undergoing coronary angiography for angina or acute myocardial infarct (AMI).

Material And Methods: We studied 132 males who underwent coronary angiography for first time between January and November 2010. ED severity was assessed by the international index of erectile function (IIEF-5) and CAD severity was assessed by the Syntax score.

Aging, heart rate variability and patterns of autonomic regulation of the heart.

Objectives: To evaluate the effects of aging, gender and body mass index on the heart rate variability (HRV), and to compare the patterns of global autonomic regulation (GAR) and parasympathetic outflow (PO) throughout the aging process.

Design, Setting And Participants: CROSS-SECTIONAL: Large sample of community-based adults and elderly people. Individuals aged from 40 to 100 years, functionally independent and with satisfactory cognitive function defined as the self-capacity to interact with an interviewer (N= 1743).

Level of Physical Activity and In-Hospital Course of Patients with Acute Coronary Syndrome.

Background: Acute coronary syndrome (ACS) is one of the main causes of morbidity and mortality in the modern world. A sedentary lifestyle, present in 85% of the Brazilian population, is considered a risk factor for the development of coronary artery disease. However, the correlation of a sedentary lifestyle with cardiovascular events (CVE) during hospitalization for ACS is not well established.

Trends in left ventricular assist device use and outcomes among Medicare beneficiaries, 2004-2011.

Objective: To characterise the trends in the left ventricular assist device (LVAD) implantation rates and outcomes between 2004 and 2011 in the Medicare population. Since the approval of the HeartMate II in 2008, the use of LVADs has steadily climbed. Given the increase in LVAD use, issues around discharge disposition, post-implant hospitalisations and costs require further understanding.

Left atrial volume index and prediction of events in acute coronary syndrome: Solar Registry.

Background: According to some international studies, patients with acute coronary syndrome (ACS) and increased left atrial volume index (LAVI) have worse long-term prognosis. However, national Brazilian studies confirming this prediction are still lacking.

Objective: To evaluate LAVI as a predictor of major cardiovascular events (MCE) in patients with ACS during a 365-day follow-up.

Increased visceral adiposity and cortisol to cortisone ratio in adults with congenital lifetime isolated GH deficiency.

Context: Adult-onset GH deficiency (GHD) increases visceral adiposity and the activity of the enzyme 11β-hydroxysteroid dehydrogenase, which converts cortisone (E) to cortisol (F), both linked to insulin resistance and increased cardiovascular risk. Conversely, we reported that adults with congenital isolated GHD (IGHD) have increased insulin sensitivity.

Objective: To assess the type of fat distribution and the amount of visceral and sc fat and to correlate them to the F/E ratio in adults with untreated IGHD due to a mutation in the GHRH receptor gene.

Resistant hypertension optimal treatment trial: a randomized controlled trial.

The prevalence of resistant hypertension (ReHy) is not well established. Furthermore, diuretics, angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers, and calcium channel blockers are largely used as the first 3-drug combinations for treating ReHy. However, the fourth drug to be added to the triple regimen is still controversial and guided by empirical choices.

Transfer rates from nonprocedure hospitals after initial admission and outcomes among elderly patients with acute myocardial infarction.

Importance: It is unknown whether hospital transfer rates for patients with acute myocardial infarction admitted to nonprocedure hospitals (facilities that do not provide catheterization) vary and whether these rates further influence revascularization rates, length of stay, and mortality.

Objectives: To examine hospital differences in transfer rates for elderly patients with acute myocardial infarction across nonprocedure hospitals and to determine whether these rates are associated with revascularization rates, length of stay, and mortality.

Design, Setting, And Participants: We used Medicare claims data from January 1, 2006, to December 31, 2008, to assess transfer rates in nonprocedure hospitals, stratified according to transfer rates as low (≤ 20%), mid-low (>20%-30%), mid-high (>30%-40%), or high (>40%).

Hospital readmission performance and patterns of readmission: retrospective cohort study of Medicare admissions.

Objectives: To determine whether high performing hospitals with low 30 day risk standardized readmission rates have a lower proportion of readmissions from specific diagnoses and time periods after admission or instead have a similar distribution of readmission diagnoses and timing to lower performing institutions.

Design: Retrospective cohort study.

Setting: Medicare beneficiaries in the United States.

Trends in aortic valve replacement for elderly patients in the United States, 1999-2011.

Importance: There is a need to describe contemporary outcomes of surgical aortic valve replacement (AVR) as the population ages and transcatheter options emerge.

Objective: To assess procedure rates and outcomes of surgical AVR over time.

Design, Setting, And Participants: A serial cross-sectional cohort study of 82,755,924 Medicare fee-for-service beneficiaries undergoing AVR in the United States between 1999 and 2011.

Statin restores cardiac autonomic response to acute hypoxia in hypercholesterolaemia.

Background: Hypercholesterolaemia may alter cardiovascular autonomic function. We investigated the autonomic cardiovascular regulation during normoxia and hypoxia in familial isolated HC patients with or without statin treatment.

Materials And Methods: Low (LF-RR) and high (HF-RR) components of spectral analysis of RR interval and systolic arterial pressure (LF-SAP) were obtained during 5 min of normoxia and isocapnic hypoxia (10% O(2) ) in 10 normotensive familial HC patients without medication, in seven HC patients after a 12-week treatment period with 40 mg of simvastatin (HC + SVT) and in eight matched normal volunteers (CO).

Does the aging process significantly modify the Mean Heart Rate?

Background: The Mean Heart Rate (MHR) tends to decrease with age. When adjusted for gender and diseases, the magnitude of this effect is unclear.

Objectives: To analyze the MHR in a stratified sample of active and functionally independent individuals.