O fitoterápico CATUAMA, utilizado no Brasil há mais de 20 anos, e seu extrato isolado T catigua apresentam efeito de reversão e prevenção da fibrilação ventricular (FV). FV, em pacientes com disfunção cardíaca, representa uma importante causa de morte súbita no mundo ocidental. Neste contexto, os efeitos de CATUAMA sobre a função cardíaca e os parâmetros hemodinâmicos foram investigados em ratos normais. Várias concentrações (10 a 800 ?g/mL) de CATUAMA (uma mistura dos extratos das plantas Trichilia Catigua, Paullinia Cupana, Ptychopetalum Olacoide e Zingiber Officinale) e de cada um de seus constituintes foram infundidas em preparações de músculos papilares isolados. A tensão desenvolvida (TD), tensão de relaxamento (TR) e as velocidades de aumento e redução da tensão (dT/dtmax e dT/dtmin) foram analisadas. Uma única dose de 200 ?g/mL foi injetada na veia jugular direita in situ. Os índices (dP/dtmax e dP/dtmin) de função ventricular esquerda (VE), as pressões sistólica (PSVE) e diastólica final (PDFVE), de perfusão coronariana (PPC), arteriais sistólica (PAS), diastólica (PAD) e média (PAM) e a frequência cardíaca (FC) foram monitoradas por 10min via cateterização VE. CATUAMA afetou a contratilidade miocárdica na maior dose (dose tóxica), reduzindo 9% a TD e 16% a TR, aumentando 90% a dT/dtmin. CATUAMA também melhorou em até 16% as PAS, PAD, PAM e PPC. Seus extratos isolados apresentaram efeitos diferenciados. T catigua não interferiu nas variáveis. P cupana reduziu a contratilidade e a PDFVE e aumentou os parâmetros hemodinâmicos assim como CATUAMA. P olacoide reduziu a TD, a TR e a PDFVE. Z officinale também reduziu a TD e a TR. CATUAMA e T catigua não trazem prejuízo à função cardíaca. / The Brazilian herbal medicine CATUAMA and its extract T catigua have shown reversion and prevention action on ventricular fibrillation (VF). VF, in patients with cardiac dysfunction, is an important cause of sudden death in Western world. In this regard, CATUAMA effects on cardiac function and hemodynamic parameters in normal rats were investigated. Various concentrations (10 to 800?g/mL) of CATUAMA (a mixture of Trichilia Catigua, Paullinia Cupana, Ptychopetalum Olacoide and Zingiber Officinale) and each herbal extract were infused into isolated papillary muscle bath. Developed tension (DT), tension at rest (RT) and velocities of increase and decrease tension (dT/dtmax and dT/dtmin) were analyzed. A single 200?g/mL dose was injected into jugular vein in situ. Left ventricular (LV) function index (dP/dtmax and dP/dtmin), LV systolic and end-diastolic pressures (LVSP and LVEDP), coronary driving pressure (CDP), systolic, diastolic and mean blood pressures (SBP, DBP and MBP) and heart rate (HR) were monitored during 10min by LV catheterization. CATUAMA affected myocardium contractility in the higher and toxic dose, decreasing 9% DT and 16% TR and increasing 90% dT/dtmin. CATUAMA also improved 16% SBP, DBP, MBP and CDP. Its isolated extracts showed different actions. T catigua demonstrated no interference in the variables. P cupana decreased contractility and LVEDP. It improved hemodynamic parameters as CATUAMA. P olacoide decreased DT, TR and LVEDP. Z officinale also decreased DT and TR. CATUAMA and T catigua did not affect cardiac function. These are important results for development of a new drug to prevent and to reverse VF without heart function impairment.

O fitoterápico CATUAMA, utilizado no Brasil há mais de 20 anos, e seu extrato isolado T catigua apresentam efeito de reversão e prevenção da fibrilação ventricular (FV). FV, em pacientes com disfunção cardíaca, representa uma importante causa de morte súbita no mundo ocidental. Neste contexto, os efeitos de CATUAMA sobre a função cardíaca e os parâmetros hemodinâmicos foram investigados em ratos normais. Várias concentrações (10 a 800 ?g/mL) de CATUAMA (uma mistura dos extratos das plantas Trichilia Catigua, Paullinia Cupana, Ptychopetalum Olacoide e Zingiber Officinale) e de cada um de seus constituintes foram infundidas em preparações de músculos papilares isolados. A tensão desenvolvida (TD), tensão de relaxamento (TR) e as velocidades de aumento e redução da tensão (dT/dtmax e dT/dtmin) foram analisadas. Uma única dose de 200 ?g/mL foi injetada na veia jugular direita in situ. Os índices (dP/dtmax e dP/dtmin) de função ventricular esquerda (VE), as pressões sistólica (PSVE) e diastólica final (PDFVE), de perfusão coronariana (PPC), arteriais sistólica (PAS), diastólica (PAD) e média (PAM) e a frequência cardíaca (FC) foram monitoradas por 10min via cateterização VE. CATUAMA afetou a contratilidade miocárdica na maior dose (dose tóxica), reduzindo 9% a TD e 16% a TR, aumentando 90% a dT/dtmin. CATUAMA também melhorou em até 16% as PAS, PAD, PAM e PPC. Seus extratos isolados apresentaram efeitos diferenciados. T catigua não interferiu nas variáveis. P cupana reduziu a contratilidade e a PDFVE e aumentou os parâmetros hemodinâmicos assim como CATUAMA. P olacoide reduziu a TD, a TR e a PDFVE. Z officinale também reduziu a TD e a TR. CATUAMA e T catigua não trazem prejuízo à função cardíaca. / The Brazilian herbal medicine CATUAMA and its extract T catigua have shown reversion and prevention action on ventricular fibrillation (VF). VF, in patients with cardiac dysfunction, is an important cause of sudden death in Western world. In this regard, CATUAMA effects on cardiac function and hemodynamic parameters in normal rats were investigated. Various concentrations (10 to 800?g/mL) of CATUAMA (a mixture of Trichilia Catigua, Paullinia Cupana, Ptychopetalum Olacoide and Zingiber Officinale) and each herbal extract were infused into isolated papillary muscle bath. Developed tension (DT), tension at rest (RT) and velocities of increase and decrease tension (dT/dtmax and dT/dtmin) were analyzed. A single 200?g/mL dose was injected into jugular vein in situ. Left ventricular (LV) function index (dP/dtmax and dP/dtmin), LV systolic and end-diastolic pressures (LVSP and LVEDP), coronary driving pressure (CDP), systolic, diastolic and mean blood pressures (SBP, DBP and MBP) and heart rate (HR) were monitored during 10min by LV catheterization. CATUAMA affected myocardium contractility in the higher and toxic dose, decreasing 9% DT and 16% TR and increasing 90% dT/dtmin. CATUAMA also improved 16% SBP, DBP, MBP and CDP. Its isolated extracts showed different actions. T catigua demonstrated no interference in the variables. P cupana decreased contractility and LVEDP. It improved hemodynamic parameters as CATUAMA. P olacoide decreased DT, TR and LVEDP. Z officinale also decreased DT and TR. CATUAMA and T catigua did not affect cardiac function. These are important results for development of a new drug to prevent and to reverse VF without heart function impairment.

<p>UVOD: Vilisov poligon predstavlja najznačajniju rezervu kolateralnog protoka između ekstrakranijalnih arterija koje vaskularizuju mozak i ima sposobnost razvoja kolateranih puteva kod ekstrakranijalne karotidne bolesti. Ova anatomska struktura podložna je varijacijama koje uključuju i prekid kontinuiteta i nekompletnost kolateralizacije. CILJEVI: Cilj je bio da se utvrdi da li nekompletnost Vilisovog poligona utiče na če&scaron;će pojavljivanje neurolo&scaron;ke simptomatologije i ishemijske moždane lezije kod pacijenata sa ekstrakranijalnom karotidnom bolesti. Takođe cilj je bio i da se utvrdi da li cerebrovaskularna reaktivnost kod pacijenata sa asimptomatskom ekstrakranijalnom karotidnom bolesti zavisi od kompletosti Vilisovog poligona i na koji način hirur&scaron;ki tretman utiče na parametre cerebrovaskularne rezerve kod pacijenata sa kompletnim i nekompletnim Vilisovim poligonom. METOD: U retrospektivnoj studiji analiziran je nalaz MRA kod 211 pacijenata sa ekstrakranijalnom karotidnom bolesti i 102 pacijenta iz kontrolne grupe. U prospektivnoj studiji je kod 98 pacijenata sa asimptomatskom karotidnom bolesti pored MRA nalaza određivana cerebrovaskularna reaktivnost putem određivanja &bdquo;breath hold index&ldquo;-a (BHI) pre i nakon operativnog tretmana. REZULTATI: Nekompletan Vilisov poligon nađen je kod 25% asimptomatskih, 47,5% simptomatskih pacijenata sa karotidnom bolesti i kod 59% kontrolne grupe pacijenata, pri čemu su se razlike pokazale kao statistički značajne. Kod asimptomatskih pacijenata sa nekompletnim Vilisovim poligonom BHI preoperativno iznostio je 0,62 a postoperativno 1,01 na strani lezije. U slučaju nekompletnog Vilisovog poligona preoperativna vrednost BHI iznostila je 0,88 a postoperativna 1,09 na strani lezije. Razlike su se pokazale kao statistički značajne između grupa i pre i posle operativnog tretmana. Porast je bio statistički značajno izraženiji u grupi asimptomatskih pacijenata sa nekompletnim Vilisovim poligonom. Nisu zabeležene major operativne komplikacije (perioeprativni moždani udar,smrtni ishod) a na pojavu hiperperfuzionog sindroma najvi&scaron;e su uticali kompletnost Vilisovog poligona, vrednost BHI i preoperativni tretman hipertenzije. ZAKLJUČCI: Nekompletan Vilisov poligon predstavlja faktor rizika za pojavu neurolo&scaron;ke simptomatologije ili ishemijske moždane lezije kod pacijenata sa ekstrakranijalnom karotidnom bolesti. Kod asimptomatskih pacijenata nekompletan Vilisov pologon utiče na smanjenu cerebrovaskularnu reaktivnost i veći rizik od moždanog udara. Parametri cerebrovaskularne reaktivnosti signifikantno se pobolj&scaron;avaju nakon operativnog tretmana.</p> / <p>INTRODUCTION: Circle of Willis is the most important reserve of collateral flow between the extracranial arteries that supply the brain and has the ability to develop collateral pathways in extracranial carotid disease. This anatomical structure is subject to variations which include a disruption in the continuity and incompleteness of collateralisation. OBJECTIVES: was to determine whether the incompleteness of the Circle of Willis is more often associated with neurological symptoms and ishemic cerebral lesions in patients with extracranial carotid artery disease. Also, the objective was to determine whether cerebrovascular reactivity in patients with asymptomatic extracranial carotid artery disease depends on the completeness Circle of Willis and how surgical treatment affects the parameters of cerebrovascular reserve in patients with complete and incomplete Circle of Willis. METHODS: This study analyzed the findings of MRA in 211 patients with extracranial carotid artery disease and 102 patients in the control group. In prospective study in 98 patients with asymptomatic carotid artery disease in addition to the MRA findings cerebrovascular reactivity was determined by determining the &quot;breath hold index&quot; -a (BHI) before and after surgical treatment. RESULTS: Incomplete Circle of Willis was found in 25% of asymptomatic, 47.5% of symptomatic patients with carotid artery disease, and 59% of the control group patients, where the difference proved to be statistically significant. In asymptomatic patients with incomplete Circle of Willis BHI values were 0.62 preoperatively and 1.01 postoperatively on the side of the lesion. In the case of incomplete Circle of Willis preoperative BHI values were 0.88 preopertively and 1.09 postoperatively in asymptomatic patients. The differences are shown to be statistically significant between the groups before and after surgical treatment. The increase was significantly more pronounced in the group of asymptomatic patients with incomplete Circle of Willis. There were not recorded major operative complications (perioeprativni stroke, mortality) and the occurrence hyperperfusion syndrome was most affected by completeness of the Circle of Willis, a value BHI and preoperative treatment of hypertension. CONCLUSIONS: Incomplete Circle of Willis is a risk factor for the occurrence of neurological symptoms or ischemic brain lesions in patients with extracranial carotid artery disease. In asymptomatic patients incomplete Circle of Willis affects the reduced cerebrovascular reactivity and a higher risk of stroke. The parameters of cerebrovascular reactivity significantly improved after surgical treatment.</p>