RESUMO
OBJECTIVE: To assess the effects of carvedilol in patients with idiopathic dilated cardiomyopathy. METHODS: In a double-blind randomized placebo-controlled study, 30 patients (7 women) with functional class II and III heart failure were assessed. Their ages ranged from 28 to 66 years (mean of 43 +/- 9 years), and their left ventricular ejection fraction varied from 8% to 35%. Carvedilol was added to the usual therapy of 20 patients; placebo was added to the usual therapy of 10 patients. The initial dose of carvedilol was 12.5 mg, which was increased weekly until it reached 75 mg/day, according to the patient's tolerance. Clinical assessment, electrocardiogram, echocardiogram, and radionuclide ventriculography were performed in the pretreatment phase, being repeated after 2 and 6 months of medication use. RESULTS: A reduction in heart rate (p = 0.016) as well as an increase in left ventricular shortening fraction (p = 0.02) and in left ventricular ejection fraction (p = 0.017) occurred in the group using carvedilol as compared with that using placebo. CONCLUSION: Carvedilol added to the usual therapy for heart failure resulted in better heart function.
Assuntos
Antagonistas Adrenérgicos beta/uso terapêutico , Carbazóis/uso terapêutico , Baixo Débito Cardíaco/tratamento farmacológico , Cardiomiopatia Dilatada/complicações , Frequência Cardíaca/efeitos dos fármacos , Propanolaminas/uso terapêutico , Volume Sistólico/efeitos dos fármacos , Adulto , Idoso , Baixo Débito Cardíaco/etiologia , Carvedilol , Método Duplo-Cego , Feminino , Ventrículos do Coração/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
This is a case of a 5-month-old girl with massive rectal bleeding caused by a gastric duplication. Cyst heterotopic pancreas and pancreatic duplication, an association not previously reported were present. The peculiar clinical presentation was due to cyst perforation that had subsequently eroded the transverse colon. Coexistent gastric containing heterotopic pancreas and pancreatic duplications were probably produced as traction diverticular by an embryonic entoectodermal adhesions.