RESUMO
BACKGROUND: Chilean aboriginal populations (Mapuche) predominantly live in the region of Araucanía, in the southern part of the country. Their cardiovascular risk factors have not been systematically assessed. AIM: To study the prevalence of cardiovascular risk factors in the Mapuche population. SUBJECTS AND METHODS: Blood pressure, weight, height, dietary habits, fasting serum total cholesterol, HDL cholesterol and triglycerides were measured in 1.948 adults living in 28 Mapuche communities. RESULTS: Thirteen percent of males and 16% of females had high blood pressure. Body mass index was 25.5 kg/m2 in males and 28.1 kg/m2 in females. Forty five percent of women and 24% of men were classified as obese. Mean serum total cholesterol was 186.7 +/- 9.6 mg/dl, HDL cholesterol was 58.7 +/- 30.7 mg/dl, total cholesterol/HDL cholesterol was 3.4 +/- 2 and triglycerides were 155.2 +/- 91.2 mg/dl. Twenty eight percent of males and 9.6% of females smoked. CONCLUSIONS: Mapuche individuals have higher levels of HDL cholesterol a better total cholesterol/HDL cholesterol ratio and lower frequency of smoking than non aboriginal Chileans subjects.
Assuntos
Pressão Sanguínea , Doenças Cardiovasculares/epidemiologia , Indígenas Sul-Americanos , Lipídeos/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Chile/epidemiologia , Colesterol/sangue , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Prevalência , Fatores de RiscoRESUMO
OBJECTIVE: To determine the prognosis in patients with diphtherial myocarditis and bradyarrhythmias and to assess the results of ventricular pacing in those with third degree atrioventricular block. DESIGN: Case series. SETTING: Referral department of cardiology in a teaching hospital. PATIENTS: Twenty four out of 46 patients admitted with diphtherial myocarditis over 10 years had bradyarrhythmias. Six had sinus bradycardia, 15 atrioventricular or intraventricular conduction disturbances, and three atrioventricular dissociation. MAIN OUTCOME MEASURE: Death rate. RESULTS: Eleven patients died (46%): all seven patients with third degree atrioventricular block, the patient with bifascicular block, and three of the six patients with bundle branch block. Seven died of cardiogenic shock and four of ventricular fibrillation. All nine patients with sinus bradycardia or atrioventricular dissociation survived. CONCLUSION: Conduction system disturbances in patients with diphtherial myocarditis are markers of severe myocardial damage and a poor prognosis. In addition, ventricular pacing does not improve survival.
Assuntos
Bradicardia/complicações , Estimulação Cardíaca Artificial , Difteria/complicações , Miocardite/complicações , Adolescente , Bradicardia/mortalidade , Bradicardia/terapia , Criança , Pré-Escolar , Difteria/mortalidade , Difteria/terapia , Feminino , Bloqueio Cardíaco/mortalidade , Bloqueio Cardíaco/terapia , Humanos , Masculino , Miocardite/mortalidade , Miocardite/terapia , PrognósticoRESUMO
Con el fin de evaluar la importancia de la contracción auricular en pacientes (pac.) con Marcapaso (MP) ventricular en pacientes con Insuficiencia Cardíaca (IC), se efectuó cateterismo cardíaco derecho y medición de Presión Arterial (PA) directa en 11 pac. con bloqueo a-v total y MP: 4 pac. sin IC y 7 con IC. Se efectuó medición de presiones y débito (DC): 1.- Basal (B); 2.- Con estimulación auricular secuencial (ES) con estimulador externo Medtronic 5325 y 3.- Con estimulación auricular intra QRS (EI). El DC. B. de 3.86 ñ 0.30 lt/min. aumentó a 4.53 ñ0.48 lt/min., con 17.3% de incremento en relación a DC.B (p< 0.0025). Con EI. el DC. bajó a 3.60 ñ 0.14 lt/min. que es 6.7% inferior a DC.B y 20.5% inferior a ES. (p.< 0.01). En los pacientes con IC. el aumento del DC con ES fue de 0.36 ñ 0.4 lt./min. (8% mayor que DC.B.), significativamente menor que el aumento de los pacientes sin IC.: 0.93 ñ 0.4 lt/min. que equivale a 23% (p <0.025). Al pasar de ES a EI la PA. descendió en promedio de 171/78 a 149/75 mm. de Hg. La PA. diferencial descendió 47% en los pac. sin IC y 15% en los pac. con IC., (diferencia significativa: p < 0.005). Hubo correlación lineal entre el cambio de presión y cambio de débito. Se concluye que la relación temporal P-QRS determina importantes cambios de DC y PA. Los pac. con IC tuvieron menor mejoría con ES, explicable en la IC avanzada en porción horizontal de curva de función ventricular. Ello y la amplia variación individual, justifican la metódica de estudio seguida antes de un implante de M.P. Secuencial