RESUMEN
INTRODUCTION: We have studied the effects of captopril on myocardial ischaemia in normotensive and hypertensive patients with coronary artery disease and stable effort-induced angina. STUDY DESIGN: A maximal treadmill effort test (Bruce modified) was obtained before and after 60 min administration of 25 mg. p.o. of captopril. In a first open pilot essay, 12 patients were studied. In a double-blind randomized, placebo-controlled, without crossover, 20 patients with the same characteristics and methodology were divided in two groups (10 in placebo and 10 in captopril group) and compared in a maximal treadmill effort test. RESULTS: In the pilot essay, the second test don't showed increments in heart rate, systolic and diastolic blood pressure showed a significant reduction at rest (p < 0.01) and at 1 mV ST segment depression (p < 0.01). Captopril increased exercise duration at 1 mV ST segment depression, time to angina and total exercise time (p < 0.01). In double-blind essay, captopril group results were similar to the pilot essay. In comparing results between placebo and captopril groups the most relevant differences were: significant increment in the time to 0.1 mV ST segment depression (p < 0.01), to angor (p < 0.05) and total exercise duration (p < 0.01). Maximal work-load sustained increased significantly with captopril (7.43 +/- 2.1 to 10.34 +/- 1.8 METS) (p < 0.01). CONCLUSIONS: We conclude that captopril used in monotherapy in patients with chronic stable angina, seems to reduce clinical and electric ischemia and to ameliorate maximal exercise duration and work-load.
Asunto(s)
Angina de Pecho/tratamiento farmacológico , Captopril/uso terapéutico , Isquemia Miocárdica/tratamiento farmacológico , Función Ventricular Izquierda/efectos de los fármacos , Adulto , Anciano , Angina de Pecho/fisiopatología , Prueba de Esfuerzo/estadística & datos numéricos , Femenino , Hemodinámica/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/fisiopatología , Función Ventricular Izquierda/fisiologíaRESUMEN
Double-orifice mitral valve is an uncommon congenital heart defect. The isolated occurrence of this anomaly is exceptional and, more often, is encountered in association with other congenital cardiac abnormalities. Principal among these are the partial and complete forms of the atrioventricular canal. In this paper, we present two cases of double-orifice mitral valve. Our first case is associated with subaortic stenosis and coarctation of aorta. The second case is an isolated one resembling a severe mitral stenosis. As we know, the diagnosis of this rare anomaly by color-Doppler technique has not been previously reported. We believe this technique provides definite anatomical and functional information about double-orifice mitral valve.
Asunto(s)
Ecocardiografía Doppler , Ecocardiografía , Válvula Mitral/anomalías , Válvula Mitral/diagnóstico por imagen , Adolescente , Adulto , Coartación Aórtica/diagnóstico por imagen , Cardiomiopatía Hipertrófica/diagnóstico por imagen , Femenino , Humanos , Masculino , Estenosis de la Válvula Mitral/diagnóstico por imagenRESUMEN
We compared the acute electrophysiologic properties of prifuroline (P), a new aminopyrroline derivative, to those of amiodarone (A) in pentobarbital-anesthetized dogs using His bundle recordings and programmed stimulation. Ten dogs received in randomized order four cumulative doses of P (2.5-20 mg/kg) and of A (1.25-10 mg/kg) with a 14-day interval between drug administrations. In a control group of four dogs receiving the diluent of the drugs, no significant changes occurred in cardiac automaticity, conduction, and refractoriness except for the atrioventricular (AV) nodal functional refractory period (RP), which increased with time (p less than 0.05). P and A produced a significant dose-related decrease in heart rate and in sinus node recovery time, with A being 3.7-3.1 times more potent than P. While atrionodal conduction time increased with both drugs, only P resulted in a significant dose-related increase in the His-Purkinje system conduction time. Prifuroline was 2.9 times more potent than A in increasing the atrial effective refractory period, while A was 2.5 times more potent than P in increasing the ventricular effective refractory period. Both drugs increased the AV nodal refractoriness in a dose-dependent way. These results suggest that the new compound prifuroline possesses some properties similar to intravenous amiodarone on sinus automaticity, atrionodal conduction, and atrial and ventricular refractoriness. However, its effects on the His-Purkinje System are typical of those of a class I quinidine-like agent.