RESUMEN
BACKGROUND: Few data are available on the behavior of myocardial ischemia during daily activities in patients with coronary artery disease receiving antianginal drug therapy. OBJECTIVE: To study the mechanism generating myocardial ischemia by evaluating blood pressure and heart rate changes in patients with stable atherosclerotic disease receiving drug therapy and with evidence of myocardial ischemia. METHODS: Fifty non-hospitalized patients (40 males) underwent 24-hour electrocardiographic monitoring synchronized with blood pressured monitoring. RESULTS: Thirty five episodes of myocardial ischemia were detected in 17 patients, with a total duration of 146.3 minutes; angina was reported in five cases. Twenty nine episodes (100.3 minutes) occurred during wakefulness, with 11 episodes (35.3 + 3.7 min) in the period from 11 a.m. to 3 p.m. Blood pressure and heart rate evaluation in the three ten-minute intervals following the ischemic episodes showed a statistically significant difference (p< 0.05), unlike that shown for the three intervals preceding the episodes. However, during the ischemic episode, a higher than 10-mmHg elevation in blood pressure and 5 beats per minute in heart rate were observed when compared with the time interval between 20 and 10 minutes before the episode. The mean heart rate at the onset of ischemia during the exercise test performed before the study was 118.2 + 14.0, and 81.1 + 20.8 beats per minute on the 24-hour electrocardiogram (p < 0.001). CONCLUSION: The incidence of silent myocardial ischemia is high in stable coronary artery disease and is related to alterations in blood pressure and heart rate, with different thresholds for ischemia for the same patient.
Asunto(s)
Antihipertensivos/uso terapéutico , Enfermedad de la Arteria Coronaria/tratamiento farmacológico , Hipolipemiantes/uso terapéutico , Isquemia Miocárdica/diagnóstico , Actividades Cotidianas , Adulto , Anciano , Anciano de 80 o más Años , Angina de Pecho/fisiopatología , Angina de Pecho/prevención & control , Determinación de la Presión Sanguínea , Enfermedad de la Arteria Coronaria/fisiopatología , Electrocardiografía Ambulatoria , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Hipertensión/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Infarto del Miocardio/prevención & control , Isquemia Miocárdica/fisiopatologíaRESUMEN
Treatment of large multinodular goiter (MNG) with radioiodine preceded by recombinant human thyrotropin (0.1 mg rhTSH) has been shown to be a safe alternative for patients with comorbidities that preclude surgery. However, the increase in serum thyroid hormones that follows both treatments may be harmful for some patients, particularly those with underlying cardiovascular disease. In this study, we evaluated cardiac parameters (clinical, ECG, 24-h Holter, Doppler echocardiogram, treadmill stress test) in 27 of 42 patients (ages 42-80 years) with large MNGs who were treated with rhTSH before receiving 30 mCi radioiodine therapy. At baseline, 18 patients had subclinical and six patients had overt iodine-induced hyperthyroidism. All patients had a transient surge in serum levels of free T4 and total T3 into the hyperthyroid range after therapy. However, repeated cardiac evaluation did not show significant changes as compared with baseline evaluation. In conclusion, rhTSH stimulated RAI treatment of MNG did not affect structural and functional parameters of the heart, despite transient high-serum levels of thyroid hormones.
Asunto(s)
Sistema Cardiovascular/fisiopatología , Bocio Nodular/tratamiento farmacológico , Bocio Nodular/radioterapia , Hipertiroidismo/tratamiento farmacológico , Hipertiroidismo/radioterapia , Radioisótopos de Yodo/uso terapéutico , Tirotropina/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Sistema Cardiovascular/efectos de los fármacos , Sistema Cardiovascular/efectos de la radiación , Terapia Combinada , Relación Dosis-Respuesta a Droga , Ecocardiografía Doppler , Electrocardiografía , Prueba de Esfuerzo , Femenino , Bocio Nodular/complicaciones , Humanos , Hipertiroidismo/etiología , Masculino , Persona de Mediana Edad , Proteínas Recombinantes/uso terapéutico , Hormonas Tiroideas/sangreRESUMEN
FUNDAMENTO: Existem poucos dados sobre comportamento da isquemia miocárdica às atividades habituais na vigência da medicação em pacientes com doença coronariana. OBJETIVO: Estudar mecanismo gerador da isquemia miocárdica avaliando-se o comportamento da pressão arterial e da freqüência cardíaca em pacientes com doença aterosclerótica estável, medicados e com evidência de isquemia. MÉTODOS: Cinqüenta pacientes (40 homens) realizaram ambulatorialmente por 24 horas a monitorização eletrocardiográfica sincronizada com a monitorização da pressão arterial. RESULTADOS: Em 17 pacientes detectaram-se 35 episódios de isquemia miocárdica, com duração total de 146,3 minutos, ocorrendo relato de angina em cinco casos. Houve 29 episódios (100,3 minutos) durante o período de vigília, com 11 episódios (35,3+3,7 min) no período das 11 às 15 horas. A avaliação da pressão arterial e freqüência cardíaca nos três intervalos de 10 minutos posteriores ao momento de isquemia mostrou diferença estatisticamente significante (p<0,05), o que não ocorreu nos três intervalos anteriores. Entretanto, durante o momento isquêmico, percebeu-se elevação maior que 10 mmHg da pressão arterial e de cinco batimentos por minuto da freqüência cardíaca quando comparado ao intervalo de tempo entre 20 e 10 minutos anterior. A freqüência cardíaca média no início da isquemia durante teste ergométrico prévio ao estudo foi de 118,2+14,0, e de 81,1+20,8 batimentos por minuto na eletrocardiografia de 24 horas (p<0,001). CONCLUSÃO: A incidência de isquemia silenciosa é freqüente na doença coronária estável, relacionando-se com alterações da pressão arterial e da freqüência cardíaca, com diferentes limiares de isquemia para o mesmo paciente.
BACKGROUND: Few data are available on the behavior of myocardial ischemia during daily activities in patients with coronary artery disease receiving antianginal drug therapy. OBJECTIVE: To study the mechanism generating myocardial ischemia by evaluating blood pressure and heart rate changes in patients with stable atherosclerotic disease receiving drug therapy and with evidence of myocardial ischemia. METHODS: Fifty non-hospitalized patients (40 males) underwent 24-hour electrocardiographic monitoring synchronized with blood pressured monitoring. RESULTS: Thirty five episodes of myocardial ischemia were detected in 17 patients, with a total duration of 146.3 minutes; angina was reported in five cases. Twenty nine episodes (100.3 minutes) occurred during wakefulness, with 11 episodes (35.3 + 3.7 min) in the period from 11 a.m. to 3 p.m. Blood pressure and heart rate evaluation in the three ten-minute intervals following the ischemic episodes showed a statistically significant difference (p< 0.05), unlike that shown for the three intervals preceding the episodes. However, during the ischemic episode, a higher than 10-mmHg elevation in blood pressure and 5 beats per minute in heart rate were observed when compared with the time interval between 20 and 10 minutes before the episode. The mean heart rate at the onset of ischemia during the exercise test performed before the study was 118.2 + 14.0, and 81.1 + 20.8 beats per minute on the 24-hour electrocardiogram (p < 0.001). CONCLUSION: The incidence of silent myocardial ischemia is high in stable coronary artery disease and is related to alterations in blood pressure and heart rate, with different thresholds for ischemia for the same patient.
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Antihipertensivos/uso terapéutico , Hipolipemiantes/uso terapéutico , Enfermedad de la Arteria Coronaria/tratamiento farmacológico , Isquemia Miocárdica/diagnóstico , Actividades Cotidianas , Angina de Pecho/fisiopatología , Angina de Pecho/prevención & control , Determinación de la Presión Sanguínea , Enfermedad de la Arteria Coronaria/fisiopatología , Electrocardiografía Ambulatoria , Frecuencia Cardíaca/fisiología , Hipertensión/tratamiento farmacológico , Infarto del Miocardio/prevención & control , Isquemia Miocárdica/fisiopatologíaRESUMEN
OBJECTIVES: To evaluate if radiofrequency catheter ablation is an effective procedure for the treatment of right ventricular outflow tract premature ventricular contractions (RVOT-PVC) and ascertain if it results in an improvement of symptoms. METHODS: A prospective study with 30 consecutive patients (mean age 40 +/- 13 years, 25 females), with no apparent structural cardiopathy, with very frequent (mean density of 1,263 +/- 593/h) RVOT-PVC, symptomatic for more than one year (mean = 74 months) and resistant to antiarrhythmic drugs (3 +/- 1.7, including beta-blockers), who underwent radiofrequency catheter ablation. RESULTS: After the first procedure, there were 23 initial successful cases (76.6%) and 7 initial failures (23.4%). Four patients experienced relapses, two of whom did not undergo the second procedure. The second procedure was carried out in 9 patients (7 initial failures and 2 relapses), and there was success in 5 additional patients, one of them by epicardial access. The final success rate was 80% (24/30), and there were no major complications. After a mean follow-up of 14 +/- 6 months, in the successful group there was a reduction greater than 90% in density of premature ventricular contractions (PVC) (24/24; p<0.0001) and a resulting absence of symptoms in the majority of patients (23/24; p<0.001). CONCLUSION: Radiofrequency catheter ablation is a safe and effective treatment for patients with persistent and symptomatic PVC with RVOT morphology.
Asunto(s)
Ablación por Catéter/normas , Obstrucción del Flujo Ventricular Externo/cirugía , Complejos Prematuros Ventriculares/cirugía , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Estudios Prospectivos , Recurrencia , Reoperación , Resultado del Tratamiento , Obstrucción del Flujo Ventricular Externo/complicaciones , Complejos Prematuros Ventriculares/complicacionesRESUMEN
OBJETIVOS: Avaliar se a ablação com radiofreqüência é um procedimento eficiente para o tratamento das extra-sístoles da via de saída do ventrículo direito (EVSVD), e se resulta em melhora dos sintomas. MÉTODOS: Estudo prospectivo, com 30 pacientes consecutivos (idade média de 40±13 anos, 25 do sexo feminino), sem cardiopatia estrutural aparente, com EVSVD, muito freqüentes (densidade média de 1.263±593/h), sintomáticos por mais de 1 ano (média =74 meses) e refratários aos fármacos antiarrítmicos (3±1,7, incluindo os beta-bloqueadores), que foram submetidos à ablação com radiofreqüência. RESULTADOS: Após o primeiro procedimento, houve 23 sucessos iniciais (76,6 por cento) e 7 iniciais insucessos (23,4 por cento). Quatro pacientes tiveram recorrências, sendo que dois desses não se submeteram ao segundo procedimento. O segundo procedimento foi realizado em 9 pacientes (7 insucessos iniciais e 2 recorrências), e o sucesso ocorreu em 5 pacientes adicionais, sendo 1 caso por acesso epicárdico. A taxa de sucesso final foi de 80 por cento (24/30), e nenhuma complicação maior ocorreu. Após um seguimento médio de 14±6 meses, no grupo de sucesso final houve uma redução de mais de 90 por cento na densidade das extra-sístoles(24/24; p<0,0001) e resultante ausência de sintomas na maioria dos pacientes (23/24; p<0,001). CONCLUSÃO: A ablação com radiofreqüência é um tratamento seguro e eficaz para os pacientes com extra-sístoles persistentes e sintomáticas com morfologia do trato de saída do ventrículo direito.
OBJECTIVES: To evaluate if radiofrequency catheter ablation is an effective procedure for the treatment of right ventricular outflow tract premature ventricular contractions (RVOT-PVC) and ascertain if it results in an improvement of symptoms. METHODS: A prospective study with 30 consecutive patients (mean age 40 ± 13 years, 25 females), with no apparent structural cardiopathy, with very frequent (mean density of 1,263 ± 593/h) RVOT-PVC, symptomatic for more than one year (mean = 74 months) and resistant to antiarrhythmic drugs (3 ± 1.7, including beta-blockers), who underwent radiofrequency catheter ablation. RESULTS: After the first procedure, there were 23 initial successful cases (76.6 percent) and 7 initial failures (23.4 percent). Four patients experienced relapses, two of whom did not undergo the second procedure. The second procedure was carried out in 9 patients (7 initial failures and 2 relapses), and there was success in 5 additional patients, one of them by epicardial access. The final success rate was 80 percent (24/30), and there were no major complications. After a mean follow-up of 14 ± 6 months, in the successful group there was a reduction greater than 90 percent in density of premature ventricular contractions (PVC) (24/24; p<0.0001) and a resulting absence of symptoms in the majority of patients (23/24; p<0.001). CONCLUSION: Radiofrequency catheter ablation is a safe and effective treatment for patients with persistent and symptomatic PVC with RVOT morphology.
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Ablación por Catéter/normas , Obstrucción del Flujo Ventricular Externo/cirugía , Complejos Prematuros Ventriculares/cirugía , Estudios de Seguimiento , Estudios Prospectivos , Recurrencia , Reoperación , Resultado del Tratamiento , Obstrucción del Flujo Ventricular Externo/complicaciones , Complejos Prematuros Ventriculares/complicacionesRESUMEN
OBJECTIVE: Antihypertensive therapy with thiazides decreases coronary events in elderly patients. However, the influence of diuretics on myocardial ischemia has not been fully investigated. The aim of this study was to compare the effect of chlorthalidone and diltiazem on myocardial ischemia. METHODS: Following a randomized, double-blind, crossover protocol, we studied 15 elderly hypertensive patients aged 73.6 + or - 4.6 years with myocardial ischemia. All patients had angiographically documented coronary artery disease. We measured patients using 48- hour ambulatory electrocardiogram monitoring and exercise testing. After a 2-week period using placebo, patients received chlorthalidone or diltiazem for 4 weeks. RESULTS: Both treatments lowered systolic and diastolic blood pressures...
Asunto(s)
Humanos , Masculino , Femenino , Anciano , Antihipertensivos/uso terapéutico , Clortalidona/uso terapéutico , Diltiazem/uso terapéutico , Diuréticos/uso terapéutico , Hipertensión/tratamiento farmacológico , Isquemia Miocárdica/tratamiento farmacológicoRESUMEN
A eletrocardiografia ambulatorial é um método näo-invasivo utilizado na prática clínica para detectar, documentar e caracterizar ocorrências de comportamento anormal da atividade elétrica cardíaca durante as atividades diárias rotineiras. Como tais anormalidades ocorrem raramente, o eletrocardiograma deve ser registrado por longos períodos de tempo. Desde a introduçäo em 1961 por Norman Holter, os sistemas de eletrocardiografia ambulatorial tem sido desenvolvlidos com uma ampla variedade de fidelidade de registro, peso e tamanho dos equipamentos, capacidades de análise e formatos de relatórios. Existem três tipos básicos de gravadores: gravadores contínuos, intermitentes (gravador de eventos) e gravadores de análise em tempo real. Gravadores contínuos possuem um gravador analógico para capturar o eletrocardiograma continuadamente e tipicamente registram na fita dois ou três canais do eletrocardiograma por 24 horas. Gravadores intermitentes registram somente um limitado número de curtos segmentos de dados; sua proposta é a de capturar o comportamento elétrico anormal quando o paciente apresenta o sintoma para o qual o estudo foi indicado. Os registros intermitentes podem ser transmitidos por telefone no momento da ocorrência do evento, ou os dados podem ser armazenados e transmitidos posteriormente. Os gravadores com análise em tempo real avaliam o eletrocardiograma continuamente. Os sinais eletrocardiográficos recebidos, ao invés de serem armazenados em uma fita analógica, säo digitalizados e armazenados em memória sólida. Utilizando-se do sistema Holter, podemos também investigar arritmias, efeito terapêutico de drogas ou procedimentos, marcapassos e desfibriladores, doença cardíaca isquêmica e variabilidade da frequência cardíaca. As indicaçöes gerais para a eletrocardiografia ambulatorial seguem as recomendaçöes da Força Tarefa ACP/ACC/AHA e säo discutidas neste artigo.
Asunto(s)
Humanos , Masculino , Femenino , Arritmias Cardíacas/diagnóstico , Electrocardiografía Ambulatoria , Electrocardiografía Ambulatoria/historia , Cardiopatías/diagnóstico , Frecuencia Cardíaca , Pronóstico , Factores de Riesgo , Tromboembolia , Factores de TiempoRESUMEN
PURPOSE--To evaluate the role of left ventricular hypertrophy (LVH), left ventricular systolic function an other clinical parameters on prevalence and complexity of ventricular arrhythmias in hypertension. METHODS--Ventricular arrhythmias were studied in 39 hypertensives by 24 hours ambulatory electrocardiographic monitoring. Frequency and complexity of ventricular arrhythmias were compared among 3 groups: A and B, respectively without and with LVH, both with normal left ventricular function; and C with LVH and systolic dysfunction. LVH and systolic dysfunction were established echocardiographically. Linear regression analysis was performed in order to identify an independent correlation between clinical parameters and presence of arrhythmias. RESULTS--Group C patients were older and had significantly higher systolic and diastolic blood pressures, greater mass index, diastolic posterior wall thickness and end-systolic stress and increased prevalence of electrocardiographic strain. Left ventricular diastolic diameter in C group patients was increased only when compared to A group. Frequencies of cases with more than 10 ectopic ventricular beats/hour, pairs and nonsustained ventricular tachycardia episodes were all significantly increased in C when compared to B and to A. However, only left ventricular mass index or diastolic posterior wall thickness identified independently patients with ventricular arrhythmias. CONCLUSION--Left ventricular hypertrophy is the main predictor of potential high risk rhythm disturbances in hypertension
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Arritmias Cardíacas/etiología , Hipertrofia Ventricular Izquierda/complicaciones , Función Ventricular Izquierda , Hipertensión/complicaciones , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/fisiopatología , Ecocardiografía , Electrocardiografía Ambulatoria , Hipertrofia Ventricular Izquierda/diagnóstico , Hipertrofia Ventricular Izquierda/fisiopatología , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Sístole , Ventrículos Cardíacos/fisiopatologíaRESUMEN
PURPOSE--To evaluate the effects of long-term antihypertensive treatment in the frequency as well as in the complexity of ventricular arrhythmias in arterial hypertension. METHODS--Twenty three patients, 14 males and 11 whites, with mean age of 46 years, were submitted to 24 hours ambulatory electrocardiographic monitoring and echocardiographic studies before and 9 months after antihypertensive treatment. RESULTS--There was no significant serum potassium level alteration, but significant reductions of both systolic (from 192 +/- 29mmHg to 161 +/- 25mmHg) and diastolic (from 122 +/- 17mmHg to 99 +/- 16mmHg) blood pressure. Left ventricular percent of fiber shortening significantly increased, even though only from 26 +/- 9 per cent to 30 +/- 9 per cent, and end-systolic wall stress did not change at all (before 258 +/- 94 10(3) dyn/cm2, after 255 +/- 101 10(3) dyn/cm2). Left ventricular mass index showed significant but also a discrete reduction from 211 +/- 75g/m2 to 196 +/- 70g/m2. Ambulatory electrocardiographic monitoring did not show any significant decrease in neither ventricular ectopic beats nor in couplets. Non-sustained ventricular tachycardia episodes remained unchanged too. Four out of 8 patients with more than 30 ventricular ectopic beats per hour reduced it by more than 70 per cent. On the other hand, the number of patients with couplets was reduced from 10 to 8 whilst those with non-sustained ventricular tachycardia increased from 5 to 7. Furthermore, in 7 patients reevaluated 24 months thereafter results were not expressively dissimilar. CONCLUSION--In hypertensive patients with either severe degree of left ventricular hypertrophy or myocardial dysfunction, long-term blood pressure treatment that produce no impressive changes in these abnormalities also do not modify complex ventricular arrhythmias, in spite of a great reduction in the increase blood pressure
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Arritmias Cardíacas/fisiopatología , Hipertensión/fisiopatología , Presión Arterial , Factores de Tiempo , Ecocardiografía/efectos de los fármacos , Electrocardiografía Ambulatoria/efectos de los fármacos , Antihipertensivos/uso terapéutico , Antihipertensivos/farmacología , Función Ventricular Izquierda , Hipertensión/tratamiento farmacológicoRESUMEN
A utiliazaçäo do método de Holter na doença de Chagas tem permitido melhor conhecimento das suas anormalidades elétricas e do comportamento das alteraçöes eletrocardiográficas transitórias, colaborando no estabelecimento do grau de risco e no controle de procedimentos terapêuticos. a introduçäo de nvoas tecnologias ao método, como a análise da variabilidade da frequência cardíaca com possibilidade de avaliar a atividade autonômica sobre o nó sinusal, poderá permitir avaliaçäo näo-invasiva desse aspecto täoimportante da doença. A possibilidade da aquisiçäo do eletrocardiograma de alta resoluçäo a partir de gravaçöes de Holter poderá ampliar a avaliaçào do risco desses pacientes.
Asunto(s)
Humanos , Enfermedad de Chagas , Electrocardiografía Ambulatoria , DiagnósticoRESUMEN
Objetivo - Verificar o efeito do enalapril na funçäo ventricular e na incidência de arritmia ventricular em portadores de doença de Chagas e insuficiência cardíaca congestiva (ICC). Métodos - Foram estudados 20 pacientes com doença de Chagas, com idades variando de 24 a 64 (media 44 anos, sendo 17 do sexo masculino. Todos tinham reaçöes sorológicas positivas para doença de Chagas, diâmetro ventricular diastólico final superior a 55mm e a fraçäo de ejeçäo menor que 0,60. Os pacientes foram divididos aleatoriamente em 2 grupos: grupo controle (GC) com 9 pacientes tratados com terapêutica convencional e grupo enalapril (GE) com 11 pacientes que além da terapêutica convencional receberam enalapril. O tratamento foi mantido por 2 meses e os pacientes foram avaliados no início e ao final sendo submetidos a exame clínico, ecodopplercardiograma, teste de esforço e Holter de 24h. No estudo ecocardiográfico avaliaram-se os diâmetros ventriculares e pela dopplercardiogrfia, a relaçäo E/A, o volume sistólico e o débito cardíaco. Ao teste de esforço e Holter avaliou-se a incidência de arritmia ventricular. Resultados - Quando comparadas as avaliaçöes inicial e final, houve melhora significativa (p = 0,04) da funçäo diastólica (relaçäo E/A) e tendência de melhora da funçäo sistólica (aumento de volume sistólico e débito cardíaco) no grupo enalapril. A incidência de taquicardia vantricular näo sustentada teve tendência em aumentar no GC e näo variou no GE. Conclusäo - Na miocardiopatia chagásica, enalapril melhora signficantemente a disfunçäo diastólica da ICC. Com dois meses de terapêutica observou-se tendência de melhora da funçäo sistólica e menor incidência da arritmia induzida pelo esforço
Purpose - To verify the effect of enalapril on ventricular function and on the incidence of ventricular arrhythmias in patients with Chagas' disease with congestive heart failare. Methods - We studied 20 patients with Chagas' disease, aged between 24 to 64 (mean 44) years. There were 17 male. All patients have positive serologic blood tests for Chagas' disease (immunofluorecence and Machado-Guerreiro test), leit ventricular diastolic diameter superior to 55mm and ejection fraction less than 0.60. The patients were divided aleatory in two groups: control group (CG) with 9 patients receiving conventional treatment (digital and diuretics) and enalapril group (EG), with 11 patients where enalapril was added to conventional treatment. The treatment was mantained during two months and the patients were evaluated at the beginning and at the end, when they were submitted to clinical examination, echodopplercardiogram, stress test and 24h Holter monitoring. At two dimensional echocardiographic study we evaluate left ventricular and leit atrial diameters, at doppler study the E/A relations, the systalic volume and cardiac index. At the stress test and Holter monitoring we evaluate the incidence of ventricular arrhythmias. Results - The comparison between initial and final evalu ations, showed that there was a significant improvement of diastolic function (p=0.04) and a trend to improvement of systolic function (great systolic volume and cardiac index) at EG. The incidence of non sustained ventricular tachycardia was the same in the two groups. Conclusion - In Chagas' disease enalapril improves significantly diastolic dysfunction in patients with heart failure. After two months of treatment we observed tendence to improvement of systolic dysfunction and the incidence of arrhythmias induced by stress test
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Enalapril/uso terapéutico , Enfermedad de Chagas/tratamiento farmacológico , Función Ventricular , Insuficiencia Cardíaca/tratamiento farmacológico , Arritmias Cardíacas , Ecocardiografía , Función Ventricular , Prueba de EsfuerzoRESUMEN
Objetivo - Verificar uma possível correlação entre freqüência cardíaca e isquemia silenciosa. Métodos - Quarenta e nove episódios isquêmicos registrados em seis pacientes durante um período total de 576 horas de gravação (monitorização eletrocardiográfica ambulatorial pelo sistema Holter). Esses doentes foram selecionados de um grupo de 40 indivíduos assintomáticos após o primeiro episódio de infarto do miocárdio não complicado; 11 (27,5%) apresentaram isquemia às atividades habituais ou ao esforco; os seis pacientes selecionados se mostraram isquêmicos à eletrocardiografia ambulatorial...
Purpose - To show a possible relation between heart rate and silent myocardial ischemia. Methods - Forty-nine ischemic episodes were registered in six patients during a total period of 576-hour Holter monitoring. Those patients were selected from a group of 40 asymptomatic individuals after a first uncomplicated myocardial infarction; 11 (27.5%) showed ischemia during daily activities or exercise, the six selected patients had myocardial ischemia on Holter monitoring...