RESUMO
To value stress tolerance and stress myocardial perfusion before and after a week of oral therapy with gallopamil 150 mg daily, we studied 10 patients suffering from stable effort angina. We performed bicycle exercise stress testing and thallium scintigraphy (Tl) with planar technique in 3 projections (anterior-posterior and oblique left anterior at 45 and 70 degrees) according to the current standards. We valued systolic and diastolic blood pressure (SBP-DBP), heart rate (HR) and HR-SBP product at rest, at symptoms stress-induced and at the end of the procedure. Moreover we valued work threshold of chest discomfort and ischemia, the maximal work capacity and the perfusion defects according to a Tl score obtained dividing the 3 projections in 5 segments and fixing a value according to the observed perfusion from 0 = normal perfusion to 3 absent perfusion. We observed a significant reduction of basal HR (77 vs 71, p = 0.05), SBP (147 +/- 15 vs 131 +/- 15 mmHg, p = 0.001), DBP (91 +/- 6 vs 83 +/- 6 mmHg, p = 0.002). Work threshold of chest discomfort and ischemia significantly arose (8 +/- 3 vs 11 +/- 4 min., p = 0.002; 6 +/- 3 vs 10 +/- 4 min., p = 0.001). The HR-SBP product at the maximal work capacity and the Tl score significant decreased (31650 +/- 6239 vs 29406 +/- 5418, p = 0.003; 8 +/- 2 vs 5 +/- 1, p = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Angina Pectoris/tratamento farmacológico , Circulação Coronária/efeitos dos fármacos , Galopamil/farmacologia , Esforço Físico/efeitos dos fármacos , Adulto , Idoso , Angina Pectoris/diagnóstico por imagem , Angina Pectoris/fisiopatologia , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Circulação Coronária/fisiologia , Avaliação de Medicamentos , Teste de Esforço , Feminino , Galopamil/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Esforço Físico/fisiologia , Cintilografia , Radioisótopos de TálioRESUMO
In twenty-four patients admitted of the Coronary Care Unit for myocardial infarction, without signs of previous necrosis and uncomplicated course, amplitude of infarct size was estimated by 201-Thallium perfusion scintigraphy. The obtained results were compared with residual ventricular function (i.e. angiographic ejection fraction) and with other methods of fibrotic area evaluation such as electrocardiographic score and CPK and CK-MB dismission curve. Concordance was observed among: scintigraphy and ejection fraction, scintigraphy and electrocardiographic score, scintigraphy and CPK peak.