RESUMO
The incidence of ventricular extrasystoles (VES) was documented in 50 patients with recent uncomplicated myocardial infarction, with a 72-h two-channel ambulatory electrocardiogram. All patients were free of symptoms of arrhythmias; unstable angina pectoris and heart failure were absent. A total of 82% of the patients had VES: 23/50 patients had multiform or complex VES, 8/50 patients had ventricular tachycardia. VES were independent of heart rate and stable angina pectoris. Thus, frequent and complex VES are common in asymptomatic patients with uncomplicated recent myocardial infarction. Even in the absence of symptoms, ambulatory electrocardiography is useful. The prognostic significance of asymptomatic complex VES in these patients remains unsettled.
Assuntos
Arritmias Cardíacas/epidemiologia , Infarto do Miocárdio/fisiopatologia , Idoso , Assistência Ambulatorial , Arritmias Cardíacas/diagnóstico , Eletrocardiografia , Feminino , Ventrículos do Coração/efeitos dos fármacos , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Fatores de TempoAssuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Antagonistas Adrenérgicos alfa/uso terapêutico , Antagonistas Adrenérgicos beta/uso terapêutico , Adulto , Fatores Etários , Idoso , Anti-Hipertensivos/administração & dosagem , Bloqueadores dos Canais de Cálcio/uso terapêutico , Diuréticos/uso terapêutico , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Complicações Cardiovasculares na Gravidez/tratamento farmacológico , Vasodilatadores/uso terapêuticoRESUMO
18 patients (14 men, 4 women) with a mean age of 64.3 years (range 41-75) and with chronic cardiac failure, NYHA functional class 1-2 (12 cases) or 2-3 (6 cases), insufficiently responsive to digitalis and diuretics, were treated for 4 weeks with Ro 12-4713, a minoxidil-like drug. The effects were assessed at rest and during maximal exercise, each patient was his own control. All patients completed the study. The treatment did not affect the body weight, the heart rate or the blood pressure, but it should be stressed that all patients were normotensive. The ejection fraction (by 99mTc pertechnetate scintigraphy) increased from 42.0 +/- 10.0 (resting means +/- SD) to 48.9 +/- 8.7%, and from 44.7 +/- 10.1 to 57.9 +/- 8.7% (end-exercise values), both changes being significant (p less than 0.0001). The ejection rate increased in a similar manner. The resting stroke volume increase from 53.5 +/- 13.6 to 60.2 +/- 16.5 ml (p less than 0.005), but the exercise stroke volume did not increase significantly. The cardiac output increased both at rest and during exercise, but the changes did not reach statistical significance. The end-diastolic volume decreased from 132.6 +/- 126.9 +/- 47.0 to 126.9 +/- 42.3 ml (resting values), and from 151.5 +/- 44.4 to 120.6 +/- 36.6 ml (exercise), the changes being significant (p less than 0.005). The physical work capacity increased, i.e. the duration of exercise increased from 7.8 +/- 3.2 to 9.9 +/- 1.9 min (p less than 0.05) and the 'quality of life' (symptoms related to heart failure) improved (fewer symptoms) in 14/18 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Insuficiência Cardíaca/tratamento farmacológico , Pirimidinas/uso terapêutico , Vasodilatadores/uso terapêutico , Adulto , Idoso , Pressão Sanguínea/efeitos dos fármacos , Débito Cardíaco/efeitos dos fármacos , Digoxina/uso terapêutico , Quimioterapia Combinada , Feminino , Furosemida/uso terapêutico , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Volume Sistólico/efeitos dos fármacosRESUMO
Twelve normotensive patients with coronary artery disease and stable effort-induced angina pectoris were selected: the antiischemic effect of captopril was studied. A maximal cycloergometer effort test was obtained before (base) and after administration of placebo or captopril (50 mg p.o.). The following parameters were measured: heart rate (HR), blood pressure (BP), maximal rate/pressure product (MRPP), maximal workload sustained, (MWS), maximal working time (MWT), and S-T depression at MRPP. The base and placebo were similar. Compared to them captopril augmented the MWT, increased the MWS, reduced S-T depression at MRPP, and decreased the number of patients with effort-induced angina pectoris. The antiischemic effect of captopril seems related both to its effect on HR and BP, and to a local enhancement of coronary blood flow.