RESUMEN
A retrospective study was undertaken of the cases of patients admitted for congestive cardiac failure over a 4 year period, and investigated by radionuclide angiography to determine the prevalence of cardiac failure with normal left ventricular systolic function, to document the underlying mechanisms of this condition and to assess whether the clinical data could predict the presence or absence of left ventricular systolic dysfunction. After excluding patients with significant valvular disease, severe renal failure, or myocardial infarction in the previous 2 months, the study population comprised 152 patients divided into 2 groups: Group I (N = 112) with abnormal systolic function (radionuclide ejection fraction less than 45%) and Group II (N = 40) with normal systolic function (radionuclide ejection fraction greater than or equal to 45%). The clinical, echocardiographic and radionuclide angiographic data was analysed (global ejection fraction in both groups and peak filling rate in Group II). The patients in Group II (26% of the total study population) were older (66.5 +/- 12.4 vs 61.3 +/- 12.3 years, p less than or equal to 0.02), were more often female (35% vs 17.9%, p less than or equal to 0.02), had acute cardiac failure (75% vs 37%, p less than 0.00001), and were frequently hypertensive (65% vs 39%, p less than or equal to 0.005). Univariate analysis of clinical and radiological signs did not show any significant difference between the two groups except for increased jugular venous pressure and cardiomegaly which were more common in Group I (56% vs 25%, p less than 0.00001 and 93% vs 68%, p less than or equal to 0.00001, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Insuficiencia Cardíaca/fisiopatología , Sístole , Adulto , Anciano , Cardiomegalia/fisiopatología , Diástole , Ecocardiografía , Femenino , Insuficiencia Cardíaca/diagnóstico por imagen , Insuficiencia Cardíaca/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Angiografía por Radionúclidos , Estudios Retrospectivos , Volumen SistólicoRESUMEN
The effects of increasing the heart rate on left ventricular filling were studied by Doppler echocardiography in 12 mildly sedated normal subjects. The heart rate was increased by 10, 20 and 30 bpm with respect to the basal rhythm by transoesophageal pacing. Four stages were thereby defined: S0, S1, S2 and S3. The principal results were: absence of variation of the isovolumic relaxation period in absolute values (92 +/- 14, 86 +/- 16, 87 +/- 16, 78 +/- 11 ms); absence of variation of the duration of the rapid filling period (246 +/- 36 at 50 vs 220 +/- 28 ms at 53); no change in peak filling velocity (72 +/- 11 at 50 vs 61 +/- 11 ms at 53) or in the timing of peak velocity (77 +/- 12 at 50 vs 72 +/- 13 ms at 53); increased contribution of atrial systole during tachycardia (Vmax 43 +/- 7 at 50 vs 76 +/- 17 cm/s at 53). Therefore, of these Doppler echo parameters, only atrial systole changed during the range of tachycardia rates which were studied. Its increase compensated the loss of diastolic diastasis. These changes should be born in mind in Doppler echocardiographic studies of left ventricular diastolic function.
Asunto(s)
Ecocardiografía Doppler , Frecuencia Cardíaca , Función Ventricular Izquierda/fisiología , Adulto , Estimulación Cardíaca Artificial/métodos , Esófago , Femenino , Hemodinámica , Humanos , MasculinoRESUMEN
The authors investigated the corrosion mechanism of metallic implants inserted into the human body in contact with bone. It was shown that a significant degree of corrosion occurred after several months. The dissolution seems to be non-selective but can be different for each individual. The corrosion mechanism is complex, starting with an inter-granular process, but pitting also occurred . The oxidation of Fe2+ to Fe3+ favours the elimination of iron oxides and is followed by the destruction of the local alloy structure. An estimation of the quantity of each type of element released in the organism was also realized.