ABSTRACT
BACKGROUND: Interatrial block (IAB) is due to disruption in the Bachmann region (BR). According to whether interatrial electrical conduction is delayed or completely blocked through the BR, it can be classified as IAB of first, second or third degree. On the surface electrocardiogram, a P wave ≥ 120 ms (partial IAB) is observed or associated to the prolongation of the P wave with a biphasic (positive / negative) morphology in the inferior leads (advanced IAB). Bayes syndrome is defined as an advanced IAB associated with atrial arrhythmia, more specifically atrial fibrillation. Objective and Conclusion: The purpose of this review is to describe the latest evidence about an entity considered an anatomical and electrical substrate with its own name, which may be a predictor of supraventricular arrhythmia and cardioembolic cerebrovascular accidents, as well as the role of new imaging techniques, such as echocardiographic strain and cardiac magnetic resonance imaging, in characterizing atrial alterations associated with this syndrome and generally in the study of anatomy and atrial function.
Subject(s)
Atrial Function/physiology , Echocardiography , Electrocardiography , Heart Atria/diagnostic imaging , Interatrial Block/diagnosis , Magnetic Resonance Imaging, Cine/methods , Multimodal Imaging , Heart Atria/physiopathology , HumansABSTRACT
OBJECTIVE: A rise in plasma levels of the amino acid homocysteine (HCY) is a possible risk factor in cardiovascular disease. The mechanisms proposed to explain how HCY can increase the risk of vascular disease include its direct effect on the vascular endothelium and its role in increasing the risk of thrombosis. The present work has been designed to determine HCY levels in patients with coronary artery disease (CAD) residents in the Canary Islands and to establish whether hyperhomocysteinemia can be considered as an risk factor. METHODS: The sample studied consisted of 132 patients with, angiographically demonstrated, CAD and 18 controls with normal coronary arteries. Biochemical parameters determined included: HCY, vitamin B12, vitamin B6, folic acid, creatinine, cholesterol and its fractions, triglycerides, glucose and fibrinogen. RESULTS: Mean levels of HCY were not significantly different between the cases and controls (p = 0.37). In the distribution of HCY levels into quintiles there was no significant association between the quintiles and the occurrence of CAD (p = 0.57). Multiple logistic regression analysis in which the risk factors were compared with quintiles 2, 3, 4 and 5 of HCY did not reveal a significant relation between HCY levels and risk of CAD. CONCLUSIONS: This study questions the previously accepted consideration that hyperhomocysteinemia is a risk factor of CAD. Controlled intervention trials are, therefore, necessary to clarify the possible association between total HCY levels and cardiovascular disease.
Subject(s)
Coronary Disease/blood , Homocysteine/blood , Female , Humans , Male , Middle Aged , Risk Factors , SpainABSTRACT
Objetivo: El aumento de las concentraciones séricas del aminoácido homocisteína (HCY) es un posible factor de riesgo de enfermedades cardiovasculares. Los mecanismos propuestos para explicar porqué la HCY puede hacer aumentar el riesgo de enfermedades vasculares son un efecto directo sobre el endotelio vascular y su intervención en el aumento del riesgo de trombosis. El presente estudio ha sido diseñado para conocer la homocisteinemia de pacientes residentes en las Islas Canarias con enfermedad arterial coronaria (EAC), y comprobar si la hiperhomocisteinemia es un factor de riesgo. Métodos: Se incluyeron 132 pacientes afectos de EAC demostrada angiográficamente y 18 controles con arterias coronarias normales. Se determinaron los valores de HCY, vitamina B12, vitamina B6 , ácido fólico, creatinina, colesterol con sus diferentes fracciones, triglicéridos, glucosa y fibrinógeno. Resultados: Las concentraciones medias de HCY no difirieron significativamente (p= 0,37) entre los casos y los sujetos de control. La distribución de los niveles de HCY por quintiles no parece estar asociada sobre la producción de EAC (p= 0,57). El análisis de regresión logística múltiple de los factores de riesgos comparado con los quintiles 2, 3, 4 y 5 de HCY no demostró evidencia significativa entre la concentración de HCY y el riesgo de EAC. Conclusiones: Este estudio añade incertidumbre de que la hiperhomocisteinemia sea factor de riesgo para EAC. Es necesario realizar estudios controlados de intervención clínica, algunos de los cuales están en marcha, para intentar aclarar las interrelaciones entre la HCY total y las enfermedades cardiovasculares (AU)
Subject(s)
Middle Aged , Male , Female , Humans , Spain , Risk Factors , Coronary Disease , HomocysteineABSTRACT
Arrhythmogenic right ventricular cardiomyopathy is a entity of unknown etiology, that is pathologically characterized by right ventricular myocardial atrophy and fibroadipous tissue replacement. We present the case of a 65-year-old male patient with the diagnosis of chronic liver disease, whose study lead a diagnosis of Arrhythmogenic right ventricular cardiomyopathy.
Subject(s)
Arrhythmogenic Right Ventricular Dysplasia/diagnosis , Aged , Diagnosis, Differential , Echocardiography , Electrocardiography , Humans , Magnetic Resonance Imaging , Male , Tachycardia, Ventricular/diagnosisABSTRACT
La miocardiopatía arritmogénica ventricular derecha es una entidad de etiopatogenia desconocida, que patológicamente se caracteriza por atrofia miocárdica ventricular derecha y sustitución por tejido fibroadiposo. Presentamos un paciente de 65 años de edad diagnosticado de hepatopatía crónica, cuyo estudio llevó al diagnóstico de miocardiopatía arritmogénica ventricular derecha. (AU)
Subject(s)
Aged , Male , Humans , Arrhythmogenic Right Ventricular Dysplasia , Tachycardia, Ventricular , Echocardiography , Diagnosis, Differential , Magnetic Resonance Imaging , ElectrocardiographyABSTRACT
We present the case of a male patient with aortic and mitral valve bioprostheses who developed infectious endocarditis due to Staphylococcus capitis, which has recently been described as an agent producing infectious endocarditis in native and prosthetic cardiac valves. The patient's course evolved unfavorably, despite specific antibiotic treatment, leading to the surgical replacement of the valve, which completely resolved the problem. This case points out that, although rare, in infectious endocarditis due to Staphylococcus capitis its pathogenicity is significant.
Subject(s)
Bioprosthesis/adverse effects , Endocarditis, Bacterial/etiology , Heart Valve Prosthesis/adverse effects , Prosthesis-Related Infections/etiology , Staphylococcal Infections/etiology , Aortic Valve , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/surgery , Humans , Male , Middle Aged , Mitral Valve , Prosthesis-Related Infections/diagnosis , Prosthesis-Related Infections/surgery , Reoperation , Staphylococcal Infections/diagnosis , Staphylococcal Infections/surgeryABSTRACT
Left ventricular hypertrophy associated with systemic hypertension differs from left ventricular hypertrophy initiated by other pressure overload diseases. Its development depends not only of hemodynamics aspects but of biochemical factors. Many studies have demonstrated a close link between left ventricular hypertrophy and cardiovascular morbidity and mortality. For that reason the idea of reversal of left ventricular hypertrophy has been a goal of the antihypertensive treatment. From the literature review has been established that the most classes of antihypertensive medications reduce the left ventricular mass, though there is a variation in required duration of treatment. At this point the angiotensin converting enzyme inhibitors, probably because a double effect: hypotensive and blockers of the trophic stimulus of angiotensin II, seemed to be the most potent for reducing the left ventricular mass. Still we don't know if reversal of left ventricular hypertrophy, by the antihypertensive treatment, reduce independently the cardiovascular risk.
Subject(s)
Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Hypertension/complications , Hypertrophy, Left Ventricular/etiology , Angiotensin II , Antihypertensive Agents/therapeutic use , Hemodynamics/drug effects , Humans , Hypertension/drug therapy , Hypertension/therapy , Hypertrophy, Left Ventricular/mortality , Hypertrophy, Left Ventricular/prevention & controlSubject(s)
Long QT Syndrome/chemically induced , Terfenadine/adverse effects , Adult , Female , HumansABSTRACT
Thrombolytic therapy has shown to be effective in acute myocardial infarction, and its benefits on left ventricular function and later survival are well known. However it is not a therapy free of complications and side effects. Allergic reactions, anafilaxia, hypotension, and several kinds of hemorrhages have been reported. Adult respiratory distress syndrome after streptokinase administration has been also described, and one case, recently communicated, after APSAC therapy. We present the case of a male with acute myocardial infarction who developed adult respiratory distress syndrome after APSAC therapy, with different outcome than the first case published in the literature. Finally, we discussed the mechanisms by means these drugs can produce such a complication.
