Prevalence and predictors of ventricular remodeling after anterior myocardial infarction in the era of modern medical therapy

Background: The consequences of aggressive therapy following a myocardial infarction (MI) on ventricular remodeling are not well established. Thus, the objective of this study was to analyze the prevalence, clinical characteristics, and predictors of left ventricular remodeling in the era of modern medical therapy.Material/Methods: Clinical characteristics and echocardiographic data were analyzed in 66 consecutive patients with anterior infarction at admission and at 6-month follow-up. Ventricular remodeling was defined as an increase of 10% in ventricular end-systolic or end-diastolic diameter.Results: In our study, 58% of patients presented with ventricular remodeling. Patients with remodeling possessed higher total plasma creatine kinase (CPK), MB-fraction (CPK-MB), heart rate, heart failure, shortness of breath, and reperfusion therapy than patients without remodeling. In contrast, patients with remodeling had a smaller ejection fraction, E-Wave deceleration time (EDT), and early (E' Wave) and late (A' Wave) diastolic mitral annulus velocity (average of septal and lateral walls), but a higher E/E' than patients without remodeling. Patients with remodeling used more diuretics, digoxin, oral anticoagulants and aldosterone antagonists than patients without remodeling. In the multivariate analyses, only E' Wave was an independent predictor of ventricular remodeling. Each 1 unit increase in the E' Wave was associated with a 59% increased odds of ventricular remodeling.Conclusions: In patients with anterior MI, despite contemporary treatment, ventricular remodeling is still a common event. In addition, diastolic function can have an important role as a predictor of remodeling in this scenario.

Drivers of change in animal protein production systems: changes from 'traditional' to 'modern' beef cattle production systems in Brazil

Until 1990, beef cattle production in Brazil was recognized as an enterprise of low investment, low cost of production, as well as an extensive production system that used large land areas to be economically feasible. The situation changed for the Brazilian beef market when the economy stabilized in 1994 and all sectors involved in the beef supply chain were able to predict their associated costs and profits. During the same period, purchasing power of the Brazilian population grew, and as a consequence, consumers began to demand higher quality beef products. This new scenario in the late 1990s and early 2000s has led to more intensive beef production systems in Brazil as well as the need for a greater understanding of how technologies might be applied. As consequence of this evolution, in the last five years, a necessity to increase beef production has occurred. The quality of Brazilian beef has improved compared with beef produced 15 years ago, but continued improvements are needed to achieve excellence in terms of large-scale production of high quality beef, be sustainable over a long period of time, and increase our contribution to global food security.