Browsing by Author "Braun, Sandra"

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    Biochemical predictors of cardiac rhythm at 1 year follow-up in patients with non-valvular atrial fibrillation
    (2012) Acevedo, Monica; Corbalan, Ramon; Braun, Sandra; Pereira, Jaime; Gonzalez, Ilse; Navarrete, Carlos
    C-reactive protein (CRP) is increased in patients with atrial fibrillation (AF) and it might predict the lack of sinus rhythm maintenance in the long term follow-up. Scarce data have been reported relating endothelial dysfunction and/or haemostatic or platelet markers to sinus rhythm maintenance in AF patients. We aimed to determine whether some biochemical markers including soluble thrombomodulin (sTM), soluble P-selectin, thrombin-antithrombin (TAT) complex and CRP levels could predict sinus rhythm maintenance at 1 year follow-up in non-valvular AF patients. 130 patients (70 males, mean age 67 +/- A 13 years) with newly diagnosed AF na < ve of antithrombotic or antiplatelet therapy were studied. Baseline CRP, P-selectin, sTM and TAT levels were compared to those of 20 matched-healthy subjects in sinus rhythm. AF patients had significantly higher plasma CRP (10.5 +/- A 2.2 vs 3.25 +/- A 0.3 mg/l, p = 0.001), P-selectin (219 +/- A 141 vs 126 ng/ml, p = 0.01), and TAT (54 +/- A 237 vs 2.7 +/- A 3.3 ng/l, p = 0.001) levels compared with controls. Soluble TM levels, although higher than controls, did not reach statistical significance. Multivariate regression analyses showed that elevated CRP (OR = 4.8, p = 0.02) and sTM (OR = 1.05, p = 0.04) were the only two predictors of lack of sinus rhythm at 1 year follow-up. An altered inflammatory, haemostatic, endothelial and platelet environment exists in newly diagnosed AF patients. CRP and sTM levels might be used as biochemical markers to predict the status of cardiac rhythm at 1 year follow-up in some AF patients.
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    Clinical characteristics, complications and mortality in 506 patients with infective endocarditis and determinants of survival rate at 10 years
    (SOC MEDICA SANTIAGO, 2012) Oyonarte, Miguel; Montagna, Rodrigo; Braun, Sandra; Rojo, Pamela; Jara, Jose L.; Cereceda, Mauricio; Morales, Marcelo; Nazala, Carolina; Alonso, Faustino
    Background: Rates of morbidity and mortality in Infective Endocarditis (IE) remain high and prognosis in this disease is still difficult and uncertain. Aim: To study IE in Chile in its active phase during inpatient hospital stay and long term survival rates. Material and Methods: Observational prospective national cohort study of 506 consecutive patients included between June 1, 1998 and July 31, 2008, from 37 Chilean hospitals (secondary and tertiary centers) nationwide. Results: The main findings were the presence of Rheumatic valve disease in 22.1% of patients, a history of intravenous drug abuse (IVDA) only in 0.7%, the presence of Staphylococcus aureus in 29.2% of blood cultures, negative blood cultures in 33.2%, heart failure in 51.7% and native valve involvement in 86% of patients. Echo cardiographic diagnosis was achieved in 94% of patients. Hospital mortality was 26.1% and its prognostics factors were persisting infection (Odds ratio (OR) 6.43, Confidence Interval (CI) 1.45-28.33%), failure of medical treatment and no surgical intervention (OR 48.8; CI 6.67-349.9). Five and 10 years survival rates were 75.6 and 48.6%, respectively. The significant prognostic factors for long term mortality, determined by multivariate analysis were the presence of diabetes, Staphylococcus aureus infection, sepsis, heart failure, renal failure and lack of surgical treatment during the IE episode. Conclusions: The microbiologic diagnosis of IE must be urgently improved in Chile. Mortality rates are still high (26.1%) partly because of a high incidence of negative blood cultures and the need for more surgical valve interventions during in-hospital period. Long term prognostic factors for mortality should be identified early to improve outcome. (Rev Med Chile 2012; 140: 1517-1528).
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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.