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1.
Front Cardiovasc Med ; 10: 1275194, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38155984

RESUMO

The aim was to characterize the electrovectorcardiographic pattern of ventricular aneurysms in ischemic cardiopathy by analyzing the cardiac ventricular repolarization. The medical records of 2,670 individuals were analyzed in this cross-sectional study. A test phase included 33 patients who underwent transthoracic echocardiogram with ultrasonic enhancing agent, electrocardiogram, and vectorcardiogram (aneurysm group - n = 22, and akinesia group - n = 11). In the validation phase, cardiac magnetic resonance imaging established the left ventricle segmental contractility in 16 patients who underwent electrocardiographic and vectorcardiographic tests (aneurysm group, n = 8, and akinesia group, n = 8). The variables studied were the presence of the T-wave plus-minus pattern and the T-wave loop anterior-posterior pattern in V2-V4. The diagnostic indices used were sensitivity, specificity, and predictive values, with their respective 95% confidence intervals. During the test and validation phases, the analysis of the presence of the T-wave plus-minus pattern identified the aneurysm group with a sensitivity of 91% vs. 87% and specificity of 91% vs. 87% (p < 0.0001 vs. p = 0.01), respectively. Meanwhile, the T-wave loop anterior-posterior pattern evidenced sensitivity of 95% vs. 77% and specificity of 91% vs. 87% (p < 0.0001 vs. p = 0.04), respectively. The electrovectorcardiographic parameters showed high accuracy for recognizing left ventricular aneurysms in ischemic heart disease.

2.
World J Hepatol ; 13(11): 1791-1801, 2021 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-34904046

RESUMO

BACKGROUND: Patients with cirrhosis are at risk of cirrhotic cardiomyopathy, with resulting cardiac dysfunction and exercise limitations. Six minute walking test (6MWT) assesses functional status and predicts morbidity and mortality in cardiopulmonary diseases. AIM: To determine if it associates with mortality by analyzing 6MWT performance in patients with liver cirrhosis. METHODS: A cohort of 106 cirrhotic patients was evaluated in the outpatient setting with echocardiogram and 6MWT and follow up for one year to document hepatic decompensation and mortality. The distance in meters was recorded at the end of 6 min (6MWD). RESULTS: This cohort had a mean age of 51 years and 56% male; patients were staged as Child A in 21.7%, B 66% and C 12.3%. Walk distance inversely correlated with Child scores, and was significantly reduced as Child stages progresses. Patients who died (10.4%) showed shorter mean 6MWD (P = 0.006). Low 6MWD was an independent predictor of mortality (P = 0.01). CONCLUSION: 6MWT is a noninvasive inexpensive test whose result is related to Child scores and mortality. It is useful to identify patients with liver cirrhosis at high risk of mortality for closer monitoring and potential early intervention.

3.
Nicolau, José Carlos; Filho, Gilson Soares Feitosa; Petriz, João Luiz; Furtado, Remo Holanda de Mendonça; Précoma, Dalton Bertolim; Lemke, Walmor; Lopes, Renato Delascio; Timerman, Ari; Marin-Neto, José A; Neto, Luiz Bezerra; Gomes, Bruno Ferraz de Oliveira; Santos, Eduardo Cavalcanti Lapa; Piegas, Leopoldo Soares; Soeiro, Alexandre de Matos; Negri, Alexandre Jorge de Andrade; Franci, Andre; Filho, Brivaldo Markman; Baccaro, Bruno Mendonça; Montenegro, Carlos Eduardo Lucena; Rochitte, Carlos Eduardo; Barbosa, Carlos José Dornas Gonçalves; Virgens, Cláudio Marcelo Bittencourt das; Stefanini, Edson; Manenti, Euler Roberto Fernandes; Lima, Felipe Gallego; Monteiro Jr, Francisco das Chagas; Filho, Harry Correa; Pena, Henrique Patrus Mundim; Pinto, Ibraim Masciarelli Francisco; Falcão, João Luiz de Alencar Araripe; Sena, Joberto Pinheiro; Peixoto, José Maria; Souza, Juliana Ascenção de; Silva, Leonardo Sara da; Maia, Lilia Nigro; Ohe, Louis Nakayama; Baracioli, Luciano Moreira; Dallan, Luís Alberto de Oliveira; Dallan, Luis Augusto Palma; Mattos, Luiz Alberto Piva e; Bodanese, Luiz Carlos; Ritt, Luiz Eduardo Fonteles; Canesin, Manoel Fernandes; Rivas, Marcelo Bueno da Silva; Franken, Marcelo; Magalhães, Marcos José Gomes; Júnior, Múcio Tavares de Oliveira; Filho, Nivaldo Menezes Filgueiras; Dutra, Oscar Pereira; Coelho, Otávio Rizzi; Leães, Paulo Ernesto; Rossi, Paulo Roberto Ferreira; Soares, Paulo Rogério; Neto, Pedro Alves Lemos; Farsky, Pedro Silvio; Cavalcanti, Rafael Rebêlo C; Alves, Renato Jorge; Kalil, Renato Abdala Karam; Esporcatte, Roberto; Marino, Roberto Luiz; Giraldez, Roberto Rocha Corrêa Veiga; Meneghelo, Romeu Sérgio; Lima, Ronaldo de Souza Leão; Ramos, Rui Fernando; Falcão, Sandra Nivea dos Reis Saraiva; Dalçóquio, Talia Falcão; Lemke, Viviana de Mello Guzzo; Chalela, William Azem; Júnior, Wilson Mathias.
Arq. bras. cardiol ; Arq. bras. cardiol;117(1): 181-264, July. 2021. graf, ilus, tab
Artigo em Português | CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1283725
4.
Echocardiography ; 30(1): 45-54, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23006451

RESUMO

BACKGROUND: Recently, multimodality imaging has been demonstrated to improve the sensitivity of dobutamine stress for the diagnosis of coronary artery disease (CAD). OBJECTIVE: We sought to determine the additional value of myocardial perfusion (MP) over wall-motion (WM) analysis for detecting CAD, using real time myocardial contrast echocardiography (RTMCE) and cardiovascular magnetic resonance (CMR), in the same group of patients. METHODS: We studied 42 patients who underwent RTMCE and CMR during high-dose dobutamine stress with early injection of atropine. RESULTS: No difference was observed in the diagnostic accuracy of RTMCE and CMR for detecting angiographically significant CAD when considering WM analysis alone (73% [95% CI, 65-81] and 78% [95% CI, 70-84], respectively; P = NS) or combined analysis of WM and MP (80% [95% CI, 73-97] and 83% [95% CI, 77-90], respectively; P = NS). Combined analysis of WM and MP had higher sensitivity than the analysis of WM alone by RTMCE (88% [95% CI, 75-100] vs. 72% [95% CI, 54-90]) and by CMR (92% [95% CI, 81-100] vs. 80% [95% CI, 64-96]) with no differences in specificity. The association of abnormal WM and MP abnormalities during high-dose dobutamine-atropine stress had additional value for detecting CAD over the analysis of WM alone, both by RTMCE (χ(2) = 16.16-24.13; P = 0.005) and CMR (χ(2) = 12.73-27.41; P = 0.001). CONCLUSION: RTMCE and CMR using the same dobutamine-atropine stress protocol had comparable diagnostic accuracies for the detection of angiographically significant CAD. MP imaging had additional value over WM analysis for the diagnosis of CAD, both at RTMCE and CMR.


Assuntos
Atropina , Doença da Artéria Coronariana/diagnóstico , Dobutamina , Ecocardiografia/métodos , Angiografia por Ressonância Magnética/métodos , Técnica de Subtração , Cardiotônicos , Meios de Contraste , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Imagem de Perfusão do Miocárdio , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
5.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 14(3): 429-440, Maio-Jun. 2004. ilus
Artigo em Português | LILACS | ID: lil-407461

RESUMO

A identificação ecocardiográfica de cardiopatias em indivíduos com alterações genéticas e em familiares pode representar um avanço muito grande no manuseio dessas anomalias. Apresentamos de maneira resumida, as mais importantes doenças genéticas associadas a alterações cardiovasculares morfológicas e/ou funcionais, e suas correspondentes alterações ecocardiográficas. Em seguida discutimos sobre o valor do método no rastreamento de familiares com doenças genéticas


Assuntos
Humanos , Cardiomiopatia Hipertrófica , Ecocardiografia/instrumentação , Ecocardiografia/tendências , Ecocardiografia , Doenças Genéticas Inatas/fisiopatologia , Doenças Genéticas Inatas/genética , Doenças Genéticas Inatas/patologia
6.
Echocardiography ; 21(2): 113-8, 2004 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-14961788

RESUMO

BACKGROUND: Dobutamine-atropine stress echocardiography (DASE) is a safe and accurate method to diagnose coronary artery disease (CAD), and can identify individuals at high risk for cardiac events such as myocardial infarction and cardiac-related death. The literature is limited regarding the prognostic value of DASE in women. OBJECTIVE: The objective was to determine the prognostic value of DASE in 300 women with known or suspected CAD. RESULTS: The 300 women underwent DASE and were followed up for 65 months (mean: 27 months). Ninety-five women had positive tests and 205 had negative tests. We demonstrated that women with negative tests had a 94% hard-event-free survival rate at follow-up (myocardial infarction and death), and in those with positive tests the event-free survival rate was 27% (P = 0.0003). The difference between women with positive and negative tests was also significant when minor events and total events were considered. Women with positive tests had 16.7 times more chance of having events than women with negative tests. Furthermore, women with positive tests but without cardiac events at follow-up (mean of peak WMSI - rest WMSI = 0.24 +/- 0.16) had less ischemic myocardium than women with positive tests and cardiac events at follow-up (mean of peak WMSI - rest WMSI = 0.34 +/- 0.26)(P < 0.04). CONCLUSION: Dobutamine-atropine stress echocardiography has good prognostic value for cardiac events in women. Women with negative tests have low probability for follow-up infarction or death. Women with positive tests and higher severity of induced ischemia have the highest incidence of cardiac events.


Assuntos
Atropina , Doença da Artéria Coronariana/diagnóstico por imagem , Dobutamina , Ecocardiografia sob Estresse/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Angina Pectoris/etiologia , Broncodilatadores , Cardiotônicos , Distribuição de Qui-Quadrado , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Análise de Regressão , Medição de Risco , Fatores de Risco , Taxa de Sobrevida
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