Asociación entre el polimorfismo de la AQP-5 -1364A/C con la disfunción cardiovascular en pacientes con sepsis

“Estudio anidado al proyecto de investigación “Valor pronóstico de los polimorfismos de la Metaloproteinasa de Matriz extracelular-9 (MMP-9: SNP-1562C/T), su inhibidor tisular endógeno (TIMP-1: SNP-372T/C), MMP-2 (– 1575 A/G) y de la Acuaporina 5 (AQP5: SNP-1364A/C) en pacientes sépticos.” Introducc...

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Autores:
Correa Gómez, David Fernando
Tipo de recurso:
Fecha de publicación:
2020
Institución:
Universidad Autónoma de Bucaramanga - UNAB
Repositorio:
Repositorio UNAB
Idioma:
spa
OAI Identifier:
oai:repository.unab.edu.co:20.500.12749/7193
Acceso en línea:
http://hdl.handle.net/20.500.12749/7193
Palabra clave:
Internal medicine
Medicine
Medical sciences
Health sciences
Sepsis
Troponin I
Mortality
Heart failure systolic
Heart failure diastolic
Ventricular dysfunction
Septic shock
Aquaporin 5
Infections
Hematology
Heart
Medicina interna
Medicina
Ciencias médicas
Infecciones
Hematología
Corazón
Ciencias de la salud
Sepsis
Troponina I
NT pro BNP
Mortalidad
Insuficiencia cardíaca sistólica
Insuficiencia cardiaca diastólica
Disfunción ventricular
Choque séptico
Acuaporina 5
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openAccess
License
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
id UNAB2_64cc66008bb3af4040a941d53fdee1b3
oai_identifier_str oai:repository.unab.edu.co:20.500.12749/7193
network_acronym_str UNAB2
network_name_str Repositorio UNAB
repository_id_str
dc.title.spa.fl_str_mv Asociación entre el polimorfismo de la AQP-5 -1364A/C con la disfunción cardiovascular en pacientes con sepsis
dc.title.translated.eng.fl_str_mv Association between AQP-5 -1364A / C polymorphism with cardiovascular dysfunction in patients with sepsis
title Asociación entre el polimorfismo de la AQP-5 -1364A/C con la disfunción cardiovascular en pacientes con sepsis
spellingShingle Asociación entre el polimorfismo de la AQP-5 -1364A/C con la disfunción cardiovascular en pacientes con sepsis
Internal medicine
Medicine
Medical sciences
Health sciences
Sepsis
Troponin I
Mortality
Heart failure systolic
Heart failure diastolic
Ventricular dysfunction
Septic shock
Aquaporin 5
Infections
Hematology
Heart
Medicina interna
Medicina
Ciencias médicas
Infecciones
Hematología
Corazón
Ciencias de la salud
Sepsis
Troponina I
NT pro BNP
Mortalidad
Insuficiencia cardíaca sistólica
Insuficiencia cardiaca diastólica
Disfunción ventricular
Choque séptico
Acuaporina 5
title_short Asociación entre el polimorfismo de la AQP-5 -1364A/C con la disfunción cardiovascular en pacientes con sepsis
title_full Asociación entre el polimorfismo de la AQP-5 -1364A/C con la disfunción cardiovascular en pacientes con sepsis
title_fullStr Asociación entre el polimorfismo de la AQP-5 -1364A/C con la disfunción cardiovascular en pacientes con sepsis
title_full_unstemmed Asociación entre el polimorfismo de la AQP-5 -1364A/C con la disfunción cardiovascular en pacientes con sepsis
title_sort Asociación entre el polimorfismo de la AQP-5 -1364A/C con la disfunción cardiovascular en pacientes con sepsis
dc.creator.fl_str_mv Correa Gómez, David Fernando
dc.contributor.advisor.spa.fl_str_mv Torres Dueñas, Diego
Higuera Cobos, Juan Diego
Ochoa Vera, Miguel Enrique
dc.contributor.author.spa.fl_str_mv Correa Gómez, David Fernando
dc.contributor.cvlac.*.fl_str_mv https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000066885
https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001692834
https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000898465
dc.contributor.orcid.*.fl_str_mv https://orcid.org/0000-0002-8006-7461
https://orcid.org/0000-0003-2622-9412
https://orcid.org/0000-0002-4552-3388
dc.contributor.scopus.*.fl_str_mv https://www.scopus.com/authid/detail.uri?authorId=24282065800
https://www.scopus.com/authid/detail.uri?authorId=36987156500
dc.contributor.researchgate.*.fl_str_mv https://www.researchgate.net/scientific-contributions/29124133_David_Fernando_Correa_Gomez
https://www.researchgate.net/profile/Miguel_Ochoa7
dc.subject.keywords.eng.fl_str_mv Internal medicine
Medicine
Medical sciences
Health sciences
Sepsis
Troponin I
Mortality
Heart failure systolic
Heart failure diastolic
Ventricular dysfunction
Septic shock
Aquaporin 5
Infections
Hematology
Heart
topic Internal medicine
Medicine
Medical sciences
Health sciences
Sepsis
Troponin I
Mortality
Heart failure systolic
Heart failure diastolic
Ventricular dysfunction
Septic shock
Aquaporin 5
Infections
Hematology
Heart
Medicina interna
Medicina
Ciencias médicas
Infecciones
Hematología
Corazón
Ciencias de la salud
Sepsis
Troponina I
NT pro BNP
Mortalidad
Insuficiencia cardíaca sistólica
Insuficiencia cardiaca diastólica
Disfunción ventricular
Choque séptico
Acuaporina 5
dc.subject.lemb.spa.fl_str_mv Medicina interna
Medicina
Ciencias médicas
Infecciones
Hematología
Corazón
dc.subject.proposal.spa.fl_str_mv Ciencias de la salud
Sepsis
Troponina I
NT pro BNP
Mortalidad
Insuficiencia cardíaca sistólica
Insuficiencia cardiaca diastólica
Disfunción ventricular
Choque séptico
Acuaporina 5
description “Estudio anidado al proyecto de investigación “Valor pronóstico de los polimorfismos de la Metaloproteinasa de Matriz extracelular-9 (MMP-9: SNP-1562C/T), su inhibidor tisular endógeno (TIMP-1: SNP-372T/C), MMP-2 (– 1575 A/G) y de la Acuaporina 5 (AQP5: SNP-1364A/C) en pacientes sépticos.” Introducción: La disfunción cardiovascular asociada a la sepsis tiene un papel fundamental a nivel diagnóstico y pronóstico. Varios biomarcadores se han estudiado para objetivar la disfunción cardiovascular en la sepsis tales como la troponina, péptidos natriuréticos y parámetros ecocardiográficos. Se han encontrado moléculas como las acuaporinas y su polimorfismo AQP-5 SNP- 1364A/C que se han asociado a la fisiopatología de la sepsis y que impactan en la mortalidad. Objetivo: Determinar la asociación entre polimorfismo de la AQP-5 SNP-1364A/C con la disfunción cardiovascular en pacientes adultos con sepsis. Materiales y Métodos: Estudio analítico de corte transversal anidado a la cohorte del estudio “Valor pronóstico de los polimorfismos de la Metaloproteinasa de Matriz extracelular-9 (MMP-9: SNP-1562C/T), su inhibidor tisular endógeno (TIMP-1: SNP- 372T/C), MMP-2 (– 1575 A/G) y de la Acuaporina 5 (AQP5: SNP-1364 A/C) en pacientes sépticos.” Se calculó la asociación del NT pro BNP, troponina I disfunción sistólica /diastólicas medidas por variables ecocardiográficas con el polimorfismo AQP-5 -SNP1364A/C en pacientes con sepsis. Resultados: Se analizó 540 registros. La mediana de edad de los pacientes fue de 59 años con un rango de edad entre 45-74 años. La mediana de NT-pro BNP fue 762 (RIQ: 215.5-3284), de la troponina I 0.1 (RIQ: 0.1- 0.1). El origen más frecuente de la sepsis fue tracto urinario (34.4%). El 14.63% de los pacientes fallecieron. La disfunción sistólica estuvo presente en 29.64 %, la disfunción diastólica 66.1%. El 76.67% fueron manejados en unidad de cuidados intensivo, 22.04% presentaron choque séptico. La asociación entre el polimorfismo de la AQP-5 -SNP1364A/C con la disfunción sistólica (RP:0.94; IC 95%= 0.64- 1.3 Valor P: 0.4503), disfunción diastólica, (RP: 0.93; IC 95%= 0 .75- 1.14 Valor P: 0.2909) Troponina I (RP: 1.2; IC 95%= 0 .75- 2.1 Valor P: 0.2006 ) y NT-proBNP (RP: 1.0; IC 95%= 0 .90- 1.15 Valor P: 0.4169). Conclusiones: No se encontró una asociación estadísticamente significativa entre el polimorfismo AQP-5 -SNP1364A/C con los biomarcadores de lesión miocárdica y variables ecocardiográficas en pacientes con sepsis. A partir de los hallazgos, la metodología de análisis y la evidencia es necesario reorientar las estrategias de investigación alrededor, de la relacion polimorfismo de la AQP-5 -SNP1364A/C con la disfunción cardiovascular incluyendo más pacientes para evaluar su asociación.
publishDate 2020
dc.date.accessioned.none.fl_str_mv 2020-08-22T01:28:30Z
dc.date.available.none.fl_str_mv 2020-08-22T01:28:30Z
dc.date.issued.none.fl_str_mv 2020
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.local.spa.fl_str_mv Tesis
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/TM
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/20.500.12749/7193
dc.identifier.instname.spa.fl_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional UNAB
dc.identifier.repourl.spa.fl_str_mv repourl:https://repository.unab.edu.co
url http://hdl.handle.net/20.500.12749/7193
identifier_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
reponame:Repositorio Institucional UNAB
repourl:https://repository.unab.edu.co
dc.language.iso.spa.fl_str_mv spa
language spa
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spelling Torres Dueñas, Diego04828f3d-baa3-44d8-94b0-40406fe0bfa0-1Higuera Cobos, Juan Diego186d9eee-08a0-49b0-aa1d-20f6d2234f70-1Ochoa Vera, Miguel Enriquebf83ca83-93c9-401e-91d3-b424889e868f-1Correa Gómez, David Fernando10d292c8-a1d1-4a83-b677-bb235301c609-1https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000066885https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001692834https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000898465https://orcid.org/0000-0002-8006-7461https://orcid.org/0000-0003-2622-9412https://orcid.org/0000-0002-4552-3388https://www.scopus.com/authid/detail.uri?authorId=24282065800https://www.scopus.com/authid/detail.uri?authorId=36987156500https://www.researchgate.net/scientific-contributions/29124133_David_Fernando_Correa_Gomezhttps://www.researchgate.net/profile/Miguel_Ochoa7Floridablanca (Santander, Colombia)2020-08-22T01:28:30Z2020-08-22T01:28:30Z2020http://hdl.handle.net/20.500.12749/7193instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.co“Estudio anidado al proyecto de investigación “Valor pronóstico de los polimorfismos de la Metaloproteinasa de Matriz extracelular-9 (MMP-9: SNP-1562C/T), su inhibidor tisular endógeno (TIMP-1: SNP-372T/C), MMP-2 (– 1575 A/G) y de la Acuaporina 5 (AQP5: SNP-1364A/C) en pacientes sépticos.” Introducción: La disfunción cardiovascular asociada a la sepsis tiene un papel fundamental a nivel diagnóstico y pronóstico. Varios biomarcadores se han estudiado para objetivar la disfunción cardiovascular en la sepsis tales como la troponina, péptidos natriuréticos y parámetros ecocardiográficos. Se han encontrado moléculas como las acuaporinas y su polimorfismo AQP-5 SNP- 1364A/C que se han asociado a la fisiopatología de la sepsis y que impactan en la mortalidad. Objetivo: Determinar la asociación entre polimorfismo de la AQP-5 SNP-1364A/C con la disfunción cardiovascular en pacientes adultos con sepsis. Materiales y Métodos: Estudio analítico de corte transversal anidado a la cohorte del estudio “Valor pronóstico de los polimorfismos de la Metaloproteinasa de Matriz extracelular-9 (MMP-9: SNP-1562C/T), su inhibidor tisular endógeno (TIMP-1: SNP- 372T/C), MMP-2 (– 1575 A/G) y de la Acuaporina 5 (AQP5: SNP-1364 A/C) en pacientes sépticos.” Se calculó la asociación del NT pro BNP, troponina I disfunción sistólica /diastólicas medidas por variables ecocardiográficas con el polimorfismo AQP-5 -SNP1364A/C en pacientes con sepsis. Resultados: Se analizó 540 registros. La mediana de edad de los pacientes fue de 59 años con un rango de edad entre 45-74 años. La mediana de NT-pro BNP fue 762 (RIQ: 215.5-3284), de la troponina I 0.1 (RIQ: 0.1- 0.1). El origen más frecuente de la sepsis fue tracto urinario (34.4%). El 14.63% de los pacientes fallecieron. La disfunción sistólica estuvo presente en 29.64 %, la disfunción diastólica 66.1%. El 76.67% fueron manejados en unidad de cuidados intensivo, 22.04% presentaron choque séptico. La asociación entre el polimorfismo de la AQP-5 -SNP1364A/C con la disfunción sistólica (RP:0.94; IC 95%= 0.64- 1.3 Valor P: 0.4503), disfunción diastólica, (RP: 0.93; IC 95%= 0 .75- 1.14 Valor P: 0.2909) Troponina I (RP: 1.2; IC 95%= 0 .75- 2.1 Valor P: 0.2006 ) y NT-proBNP (RP: 1.0; IC 95%= 0 .90- 1.15 Valor P: 0.4169). Conclusiones: No se encontró una asociación estadísticamente significativa entre el polimorfismo AQP-5 -SNP1364A/C con los biomarcadores de lesión miocárdica y variables ecocardiográficas en pacientes con sepsis. A partir de los hallazgos, la metodología de análisis y la evidencia es necesario reorientar las estrategias de investigación alrededor, de la relacion polimorfismo de la AQP-5 -SNP1364A/C con la disfunción cardiovascular incluyendo más pacientes para evaluar su asociación.RESUMEN 9 SUMMARY 11 INTRODUCCIÓN 12 PLANTEAMIENTO DEL PROBLEMA Y JUSTIFICACIÓN 15 MARCO TEÓRICO Y ESTADO DEL ARTE 18 Definición y epidemiologia de la Sepsis 18 Fisiopatología de la sepsis: 22 Disfunción cardiaca asociada a la sepsis 29 Disfunción cardiaca asociada a la sepsis, fisiopatología: 31 Alteraciones hemodinámicas en miocardiopatía séptica 34 Definición de cardiomiopatía séptica 35 Métodos diagnósticos de cardiomiopatía séptica: 37 Biomarcadores de origen cardiogénico 38 Manifestaciones ecocardiográficas 40 Acuaporinas conceptos generales 42 Acuaporinas de origen cardiaco: 43 Acuaporinas cardiacas asociada a la sepsis: 45 OBJETIVOS 47 Objetivos específicos 47 METODOLOGÍA PROPUESTA 48 Tipo de estudio: 48 Población 48 Muestra 49 Recolección de la información 50 Procesamiento y control de calidad 52 Procesamiento y análisis estadístico 52 CONSIDERACIONES ÉTICAS 54 RESULTADOS 56 Características de base 56 Desenlaces primarios 57 Asociación entre el polimorfismo de la AQP-5 -SNP1364A/C con la disfunción sistólica medida por ecocardiograma. 57 Asociación entre el polimorfismo de la AQP-5 -SNP1364A/C con la disfunción diastólica medida por ecocardiograma. 57 Asociación entre el polimorfismo de la AQP-5 -SNP1364A/C con la troponina I.................................................................................................................................................. 58 Asociación entre el polimorfismo de la AQP-5 -SNP1364A/C con el NT- pro BNP. .................................................................................................................................................. 58 DISCUSIÓN 59 CONCLUSIONES 66 BIBLIOGRAFÍA 67 TABLAS 78 FIGURAS 82 ANEXOS 83 CRONOGRAMA 85 CARTAS AUTORIZACIÓN 86EspecializaciónBackground: Cardiovascular dysfunction associated with sepsis plays a fundamental role at a diagnostic and prognostic level. Various cardiac biomarkers have been studied to identify the cardiovascular dysfunction in sepsis such as troponin, natriuretic peptides and echocardiographic parameters. Molecules have been found such as aquaporins and its polymorphism AQP-5 SNP-136A/C that have been associated to the pathophysiology of sepsis that impact mortality. Objective: An association was determined between polymorphism of the AQP-5 SNP-1364A/C molecule with cardiovascular dysfunction in adult patients with sepsis Methods: Analytic study in a transversal cut added to the cohort of study “Prognostic value of polymorphisms of Extracellular Matrix Metalloproteinase-9 (MMP-9: SNP- 1562C / T), its endogenous tissue inhibitor (TIMP-1: SNP-372T / C), MMP-2 (- 1575 A / G ) and Aquaporin 5 (AQP5: SNP-1364 A / C) in septic patients.” An association was calculated of the NT pro BNP, troponin I dysfunction systolic/diastolic measurements through echocardiographic variables with the polymorphism AQP-5-SNP1364A/C in patients with sepsis. Results: 540 charts were reviewed. The average age of the patients was 59 years with a range of age between 45-74 years. The average NT-pro BNP was 762 (RIQ: 215.5-3284), and the average of troponin I was 0.1 (RIQ: 0.1- 0.1). The most frequent origin of sepsis was via the urinary tract (34.4%). 14.63% of patients expired. Systolic dysfunction was present in 29.64% and diastolic dysfunction was 66.1%. 76.67% were managed in the intensive care unit, 22.04% presented with septic shock. The association between polymorphism of AQP-5 SNP-1364A/C with systolic dysfunction (RP:0.94; IC 95%= 0.64- 1.3; P Value: 0.4503), diastolic dysfunction, (RP: 0.93; IC 95%= 0 .75- 1.14; P value: 0.2909), Troponin I (RP: 1.2; IC 95%= 0 .75- 2.1; P Value: 0.2006) and NT-proBNP (RP: 1.0; IC 95%= 0 .90- 1.15;P Value: 0.4169). Conclusions: There was not a stadistically significant association found between polymorphism AQP-5 SNP-136A/C with the biomarkers of myocardial injury and echocardiographic variables in patients with sepsis. As a result of these findings, the methodology of analysis and evidence is necessary to reorient the strategies of research surrounding the relation between AQP-5 -SNP1364A/C with cardiovascular dysfunction including more patients to assess their association.application/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Atribución-NoComercial-SinDerivadas 2.5 ColombiaAsociación entre el polimorfismo de la AQP-5 -1364A/C con la disfunción cardiovascular en pacientes con sepsisAssociation between AQP-5 -1364A / C polymorphism with cardiovascular dysfunction in patients with sepsisEspecialista en Medicina InternaUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludEspecialización en Medicina Internainfo:eu-repo/semantics/masterThesisTesishttp://purl.org/redcol/resource_type/TMInternal medicineMedicineMedical sciencesHealth sciencesSepsisTroponin IMortalityHeart failure systolicHeart failure diastolicVentricular dysfunctionSeptic shockAquaporin 5InfectionsHematologyHeartMedicina internaMedicinaCiencias médicasInfeccionesHematologíaCorazónCiencias de la saludSepsisTroponina INT pro BNPMortalidadInsuficiencia cardíaca sistólicaInsuficiencia cardiaca diastólicaDisfunción ventricularChoque sépticoAcuaporina 51. 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