Browsing by Author "Puentes, Angel"

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    Balloon pulmonary angioplasty for the treatment of chronic thromboembolic pulmonary hypertension
    (SOC MEDICA SANTIAGO, 2019) Sepúlveda Varela, Pablo Andrés; Ortega, Juan; Armijo, German; Torres, Jose; Ramirez, Pablo; Backhouse, Christian; Vargas, Cesar; Lopez, Leonel; Gonzalez, Felipe; Puentes, Angel; Donoso, Hernan; Bellet, Augusto; Godoy, Diego; Araya, Mario; Luz Andrade, Carmen; Pablo Molina, Juan; Nazzal, Carolina
    Background: Balloon pulmonary angioplasty (BPA) is a therapeutic alternative for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Aim: To report the initial experience with the "refined BPA technique" with the use of intravascular images. Patients and Methods: Between June 2015 and June 2016 we selected fourteen patients with CTEPH who were considered candidates for BPA. Lesions targeted for treatment were further analyzed using intravascular imaging with optical frequency domain imaging (OFDI). We report the immediate hemodynamic results and four weeks of follow-up of the first eight patients of this series. Results: We performed 16 BPA in eight patients aged 61 +/- 14 years (88% women). Mean pulmonary artery pressure (PAPm) was 48.6 +/- 5.8 mmHg. Success was achieved in seven patients (88%). A mean of 2.3 segments per patient were intervened in 11 sessions (1.6 sessions/patient). Only one patient developed lung reperfusion injury. No mortality was associated with the procedure. After the last BPA session, PAPm decreased to 37.4 +/- 8.6 mmHg (p=0.02). Pulmonary vascular resistance (RVP) decreased from 858,6 +/- 377,0 at baseline to 516,6 +/- 323,3 Dynes/sec/cm(-5) (p<0.01) and the cardiac index increased from 2.4 +/- 0.6 at baseline to 2.8 +/- 0.3 L/min/m(2) (p=0.01). At 4 weeks after the last BPA, WHO functional class improved from 3.3 +/- 0.5 to 2.5 +/- 0.5 (p<0,01) and six minutes walking distance from 331 +/- 92 to 451 +/- 149 m (p=0.01). Conclusions: BPA guided by OFDI for the treatment of inoperable CTEPH patients is a safe alternative with excellent immediate hemodynamic and clinical results.
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    Safety and Pharmacokinetics of a Combined Antioxidant Therapy against Myocardial Reperfusion Injury: A Phase I Randomized Clinical Trial in Healthy Humans
    (2024) Gajardo Cortez, Abraham I. J.; Lillo-Moya, Jose; San-Martin-Martinez, Daniel; Pozo-Martinez, Josue; Morales, Pablo; Prieto, Juan C.; Aguayo, Ruben; Puentes, Angel; Ramos, Cristobal; Silva, Solange; Catalan, Mabel; Ramos, Karla; Olea-Azar, Claudio; Rodrigo, Ramon
    Myocardial reperfusion injury (MRI) accounts for up to 50% of the final size in acute myocardial infarction and other conditions associated with ischemia-reperfusion. Currently, there is still no therapy to prevent MRI, but it is well known that oxidative stress has a key role in its mechanism. We previously reduced MRI in rats through a combined antioxidant therapy (CAT) of ascorbic acid, N-acetylcysteine, and deferoxamine. This study determines the safety and pharmacokinetics of CAT in a Phase I clinical trial. Healthy subjects (n = 18) were randomized 2:1 to CAT or placebo (NaCl 0.9% i.v.). Two different doses/infusion rates of CATs were tested in a single 90-minute intravenous infusion. Blood samples were collected at specific times for 180 minutes to measure plasma drug concentrations (ascorbic acid, N-acetylcysteine, and deferoxamine) and oxidative stress biomarkers. Adverse events were registered during infusion and followed for 30 days. Both CAT1 and CAT2 significantly increased the CAT drug concentrations compared to placebo (P < .05). Most of the pharmacokinetic parameters were similar between CAT1 and CAT2. In total, 6 adverse events were reported, all nonserious and observed in CAT1. The ferric-reducing ability of plasma (an antioxidant biomarker) increased in both CAT groups compared to placebo (P < .001). The CAT is safe in humans and a potential treatment for patients with acute myocardial infarction undergoing reperfusion therapy.