Papel de los péptidos natriuréticos en la reversibilidad del daño miocárdico en el Síndrome de Takotsubo: una perspectiva fisiológica

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dc.contributor.advisorMockus Sivickas, Ismena Vilte Onaspa
dc.contributor.authorPaternina Álvarez, Mariel Ceciliaspa
dc.date.accessioned2024-05-27T21:14:31Z
dc.date.available2024-05-27T21:14:31Z
dc.date.issued2023-11-21
dc.descriptionilustraciones, diagramasspa
dc.description.abstractEl Síndrome de Takotsubo (ST) es un síndrome de falla cardíaca aguda con características similares al síndrome coronario agudo, salvo la mayor elevación de péptidos natriuréticos (NP) en sangre en la fase aguda y la recuperación completa de la función miocárdica en días posteriores al evento inicial. Su aparición se asocia con efectos directos e indirectos de las catecolaminas sobre las células miocárdicas, desencadenando aturdimiento miocárdico transitorio. Dada las características diferenciales, especialmente el aumento tres veces mayor de los péptidos natriuréticos, el objetivo de esta revisión narrativa es determinar a través de la revisión de información actual si los péptidos natriuréticos podrían estar implicados en la reversibilidad del daño miocárdico en pacientes adultos con Síndrome de Takotsubo y dilucidar las posibles vías moleculares implicadas en su acción cardioprotectora. Los péptidos natriuréticos, especialmente ANP y BNP, ejercen funciones cardioprotectoras sobre el miocardio en respuesta a cambios hemodinámicos cardíacos, presencia de hipoxia, isquemia y exceso de catecolaminas. De hecho, los péptidos natriuréticos no solamente disminuyen la cantidad de catecolaminas liberadas en respuesta a la activación simpática, sino que su uso como agente farmacológico bloquea la aparición de aturdimiento miocárdico, disfunción miocárdica parecida a ST y arritmias ventriculares en respuesta a un estímulo estresante o presencia de agonistas adrenérgicos; además, disminuyen el tamaño del infarto en SCA, y bloquean la inducción de isquemia irreversible durante la reperfusión. Los estudios sugieren a la vía de ANP-BNP/NPR-A/cGMP/PKG como la principal implicada en los efectos protectores de los péptidos natriuréticos sobre el miocardio. (Texto tomado de la fuente).spa
dc.description.abstractThe Takotsubo Syndrome (TS) is a syndrome of acute heart failure with characteristics similar to acute coronary syndrome, except for the higher elevation of natriuretic peptides (NP) in the blood during the acute phase and the complete recovery of myocardial function in the days following the initial event. Its onset is associated with direct and indirect effects of catecholamines on myocardial cells, triggering transient myocardial stunning. Given the differential characteristics, especially the threefold increase in natriuretic peptides, the aim of this narrative review is to determine through the examination of current information whether natriuretic peptides could be involved in the reversibility of myocardial damage in adult patients with Takotsubo Syndrome and to elucidate the possible molecular pathways involved in their cardioprotective action. Natriuretic peptides, especially ANP and BNP, exert cardioprotective functions on the myocardium in response to cardiac hemodynamic changes, hypoxia, ischemia, and excess catecholamines. In fact, natriuretic peptides not only reduce the amount of catecholamines released in response to sympathetic activation but also, when used as a pharmacological agent, block the occurrence of myocardial stunning, myocardial dysfunction similar to TS, and ventricular arrhythmias in response to a stressful stimulus or the presence of adrenergic agonists. Additionally, they reduce the infarct size in ACS and block the induction of irreversible ischemia during reperfusion. Studies suggest the ANP-BNP/NPR-A/cGMP/PKG pathway as the main player in the protective effects of natriuretic peptides on the myocardium.eng
dc.description.degreelevelMaestríaspa
dc.description.degreenameMagíster en Fisiologíaspa
dc.description.researchareaLínea de profundizaciónspa
dc.format.extentx, 134 páginasspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.instnameUniversidad Nacional de Colombiaspa
dc.identifier.reponameRepositorio Institucional Universidad Nacional de Colombiaspa
dc.identifier.repourlhttps://repositorio.unal.edu.co/spa
dc.identifier.urihttps://repositorio.unal.edu.co/handle/unal/86167
dc.language.isospaspa
dc.publisherUniversidad Nacional de Colombiaspa
dc.publisher.branchUniversidad Nacional de Colombia - Sede Bogotáspa
dc.publisher.facultyFacultad de Medicinaspa
dc.publisher.placeBogotá, Colombiaspa
dc.publisher.programBogotá - Medicina - Maestría en Fisiologíaspa
dc.relation.indexedBiremespa
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dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.licenseAtribución-NoComercial 4.0 Internacionalspa
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/spa
dc.subject.ddc610 - Medicina y salud::612 - Fisiología humanaspa
dc.subject.decsCardiomiopatía de Takotsubospa
dc.subject.decsTakotsubo Cardiomyopathyeng
dc.subject.decsPéptidos Natriuréticos/uso terapéuticospa
dc.subject.decsNatriuretic Peptides/therapeutic useeng
dc.subject.decsAturdimiento Miocárdico/tratamiento farmacológicospa
dc.subject.decsMyocardial Stunning/drug therapyeng
dc.subject.proposalSíndrome de Takotsubospa
dc.subject.proposalcGMPspa
dc.subject.proposalTakotsubo Syndromeeng
dc.subject.proposalcGMPeng
dc.subject.proposalmyocardial stunningeng
dc.subject.proposalAturdimiento miocárdicospa
dc.subject.proposalPéptidos natriuréticosspa
dc.subject.proposalNatriuretic peptideseng
dc.titlePapel de los péptidos natriuréticos en la reversibilidad del daño miocárdico en el Síndrome de Takotsubo: una perspectiva fisiológicaspa
dc.title.translatedRole of natriuretic peptides in the reversibility of myocardial damage in Takotsubo Syndrome: a physiological perspectiveeng
dc.typeTrabajo de grado - Maestríaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_bdccspa
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aaspa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/masterThesisspa
dc.type.redcolhttp://purl.org/redcol/resource_type/TMspa
dc.type.versioninfo:eu-repo/semantics/acceptedVersionspa
dcterms.audience.professionaldevelopmentInvestigadoresspa
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2spa
oaire.fundernameUniversidad Nacional de Colombiaspa

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