[Chronotropic and pressoric response in myocardiopathy in patients with heart failure during ergometric test. Correlation of spirometry variables with effort]. / Resposta cronotrópica e pressórica nas miocardiopatias em portadores de insuficiência cardíaca durante prova ergométrica. Correlação das variáveis espirométricas ao esforço.

PURPOSE: To correlate the variables heart rate (HR), blood pressure (BP) and double product (DP) during the ergometric test with the variables oxygen consumption (VO2) and pulmonary ventilation (VE) of spiroergometry. METHODS: A study was carried out with 40 male patients suffering from cardiomyopathy with heart failure (functional class II-IV of NYHA)-of ischemic (IS), Chagas' disease (CH) and idiopathic (ID) etiology. These three groups were compared to a group of 10 normal individuals (N). The 4 groups were evaluated under 4 different conditions: rest (RES), anaerobic threshold (LA), power peak of exercise (P) and in the fourth minute recovery (REC). The investigation was carried out with the data obtained through spiroergometry (using a treadmill and spiroergometric equipment specific for the effort), as well as data related to HR, BP, DP, VO2 and VE. RESULTS: There were significant differences observed in the ergometric evaluate of the HR, BP and DP responses in the IS, CH and ID groups as compared with the N group. There were significant difference observed in the spirometric evaluation to the VO2 and VE efforts in the IS, CH and ID groups as compared with the N group. CONCLUSION: The HR, BP and DP variables studies, obtained by means of classic ergometry, unaided by direct methodology (spiroergometry) enabled them to infer valuable data for the control and evaluation of cardiomyopathies with IC, taking into consideration the low chronotropic and pressoric responses in the various phases of evaluation during this study, corresponding to the concomitant low performance of O2 consumption and pulmonary ventilation.

[Ergospirometry as a method for predicting the clinical course of ischemic, Chagas and idiopathic myocardiopathy]. / Ergoespirometria como método de predição do comportamento evolutivo da miocardiopatia isquêmica, chagásica e idiopática.

PURPOSE: To compare and evaluate the modifications variables obtained through spyroergometry in groups of patients with ischemic cardiomyopathy (IS), Chagas' disease (CH), and idiopathic cardiomyopathy (ID). To study tolerance to anaerobic conditions of patients from the above groups who died. METHODS: A study was carried with 50 male patients, 10 of which were found in normal conditions whereas 40 presented cardiomyopathy with compensated heart failure. We observed that from the 40 patients from the cardiomyopathy groups, nine died, subgroups OB--during the study period of 1.005 days. These were compared to subgroups NOB--the remaining 31 patients. These patients were evaluated under 4 conditions--Rest (Rep), anaerobic threshold (LA), power peak of the exercise (P) and in the fourth minute recovery (REC). The investigation was based on data collected by means of spyroergometry: oxygen consumption (MET), production of CO2-(VCO2), respiratory equivalent of oxygen (VE/VO2), oxygen pulse (VO2/FC) and the time elapsed between LA and P. RESULTS: There were significant differences when the three pathological groups (IS, CH, ID) were compared with the control groups (N). There were no significant differences when the three pathological groups compared among themselves. In relation to tolerance to anaerobic conditions significant differences were found among the patients of subgroup OB--1.33 min--who died when compared to subgroup NOB--3.26 min (time elapsed between LA and P). CONCLUSION: The authors conclude that the variables studied, obtained through spyroergometry may indicate important data towards the prognosis with heart failure.

[Effect of beta blockers with intrinsic sympathomimetic activity on blood pressure and blood lipids in patients with essential hypertension]. / Influência de betabloqueadores com atividade simpaticomimética intrínseca sobre pressão arterial e lípides sangüíneos em portadores de hipertensão arterial essencial.

The aim of this study was to compare the effects of a beta-blocker (mepindolol) with intrinsic sympathomimetic activity (ISA) to a beta-blocker (metoprolol duriles) without ISA. Hypertensive patients with more than 50 years of age were selected and randomly allocated to receive either 5 mg/day mepindolol (Group A, 10 patients), or 200 mg/day metoprolol duriles (Group B, 9 patients), or placebo (Group C, 10 patients). They were submitted to clinical exam, stress testing and plasma lipids dosage before and after four weeks of treatment. At rest, there were a significant reduction of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) in all groups. The mean values for SBP, DBP and HR at rest after treatment were respectively: 154.0, 95.5, 73.7 (Group A); 148.8, 94.4, 70.1 (Group B); 153.0, 96.0, 77.8; (Group C). During stress testing, there were a significant reduction of SBP, HR and double product (DP). The DBP remained unchanged. The mean values for SBP, DBP, HR and DP during stress testing after treatment were respectively; 198.0, 115.5, 124.3, 246.9 (Group A); 198.8, 114.4, 144.6, 283.2 (Group B); 202.2, 119.0, 143.5, 283.4 (Group C). Total cholesterol, HDL-cholesterol, and LDL-cholesterol, have not changed with both beta-blockers. There were a significant increase in plasma triglycerides and VLDL-cholesterol levels after treatment with beta-blockers. In conclusion, both mepindolol and metoprolol were similarly effective in reducing arterial blood pressure of hypertensive patients. There were not significant differences between the beta-blocker with or without ISA in regard to their effects on plasma lipids.