RESUMEN
I-Rationale of thrombolytic therapy in acute myocardial infarction (AMI). II-Thrombolytic drugs. III-Effects of thrombolytic therapy on mortality. IV-Studies comparing the effects of various thrombolytic agents on mortality.
Asunto(s)
Fibrinolíticos/uso terapéutico , Infarto del Miocardio/tratamiento farmacológico , Terapia Trombolítica , Ensayos Clínicos como Asunto , Humanos , Infarto del Miocardio/mortalidad , Estreptoquinasa/uso terapéutico , Activador de Tejido Plasminógeno/uso terapéuticoRESUMEN
V-Effects of thrombolytic therapy on coronary reperfusion and left ventricular function VI-Noninvasive markers of reperfusion. VII-Timing of thrombolysis. VIII-Side effects and adverse outcomes.
Asunto(s)
Fibrinolíticos/farmacología , Infarto del Miocardio/tratamiento farmacológico , Terapia Trombolítica , Función Ventricular Izquierda/efectos de los fármacos , Ensayos Clínicos como Asunto , Hipersensibilidad a las Drogas/etiología , Fibrinolíticos/efectos adversos , Hemorragia/inducido químicamente , Humanos , Reperfusión Miocárdica , Recurrencia , Terapia Trombolítica/efectos adversosAsunto(s)
Infarto del Miocardio/terapia , Antagonistas Adrenérgicos beta/uso terapéutico , Angioplastia Coronaria con Balón , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Aspirina/uso terapéutico , Fibrinolíticos/uso terapéutico , Heparina/uso terapéutico , Humanos , Terapia TrombolíticaRESUMEN
OBJECTIVE: To evaluate the influence of age (I) on the left ventricle (VE) systolic time intervals, the S2O interval, the pulse transmission time (TTP) and the relative amplitude of the a wave (Aa%) of the apexcardiogram (ACG) of normal individuals. METHODS: 202 subjects considered as normal by clinical and electrocardiographic examinations were studied. Their age (I) was 38 +/- 13 years (average +/- 1 SD), being 125 male and 77 female. The electrocardiogram (ECG), phonocardiogram, ACG and carotid arterial pulse tracing (PC) were simultaneously recorded. The following intervals were determined: Electromechanical (IEM)--from the onset of QRS complex of the ECG to the ascending branch of the great wave of the ACG (A point); mechanical systole (SM)--from the A point of the ACG to the beginning of first high frequency vibration of the aortic component of the second heart sound (S2); ejection period (FE)--from the beginning of the anacrotic branch of the PC to the nadir of its dicrotic notch (ID); isovolumic contraction time (FIS)--subtracting FE duration to the SM duration; S2O interval--since S2 to the O point (nadir) of the ACG; Aa%--relation percentage expressed between a wave amplitude and total amplitude of the ACG; pulse transmission time--since S2 to ID. Statistically significant correlations (p less than 0.05) between I (years expressed) and the previously mentioned variables were investigated. RESULTS: It was possible to verify: a) the IEM and FIS intervals were not significantly correlated with I; b) the FE had a linear, positive and significant correlation with I (r = 0.222); c) the correlations between FE and heart rate (FC) were not significantly different between the considered age groups (14-34, 35-49, 50-69 years); d) the S2O interval had a linear, negative and significant correlation with FC (r = -0.196), and a linear, positive and significant correlation with I (r = 0.392); e) multiple regression equation between S2O, I and FC was: S2O = 70 - 0.36 x FC + 0.55 x I; f) the Aa% had a linear, positive and significant correlation with I (r = 0.252); g) TTP has a linear, negative and significant correlation with I (r = -0.793). CONCLUSIONS: a) The FE increases with I related probably to the afterload increasing that follows aging process; b) the S2O interval increases with I reflecting the elongation of the relaxing time that is associated to the senescence; c) the Aa% increases with I, expressing the reduction of the compliance of the VE associated to the aging; d) the TTP decreases with I related to the increasing of velocity of the pulse wave that follows senescence and is attributed to the increasing of the aortic stiffness.