ABSTRACT
Objetivos El objetivo es estudiar la relación entre los parámetros estructurales, de remodelado, de sincronía y de función sistólica del ventrículo izquierdo (VI) mediante gSPECT. Obtener los valores de corte del VI para el índice de la forma telediastólica (iFTD), el índice de la forma telesistólica (iFTS), el índice de excentricidad (iEX) y la velocidad máxima de vaciado (VMV). Desarrollar un nuevo índice para evaluar diferentes patrones de función sistólica del VI. Material y métodos Analizamos prospectivamente 238 pacientes (edad: 63,4±13 años) estudiados mediante gSPECT de esfuerzo-reposo (grupo-control, n=148; pacientes con infarto de miocardio [IM] previo, n=90). Estudio aprobado por el Comité de Ética del Hospital (PR[AG]168.2010). Resultados En el grupo-control, el índice del volumen telediastólico (iVTD) y el iEX influyeron en el iFTD (r2: 0,52, p<0,001). El iVTD, la VMV, ser varones y el iEX (r2: 0,44; p<0,001) influyeron en el iFTS. El iFTD, iFTS, la fracción de eyección VI (FEVI) y el volumen de eyección sistólica (r2: 0,62; p<0,001) influyeron en el iEX. La FEVI, la frecuencia cardíaca, el ancho de banda (AB) y la desviación estándar influyeron (r2: 0,76; p<0,001) en la VMV. Los valores de corte para iFTD, iFTS, iEX y VMV fueron 0,59, 0,42, 0,87 y −3,3 respectivamente. La VMV, el iFTS y el AB fueron los parámetros mejor relacionados con los pacientes con IM previo (AUC: 0,89), y sumados a la FEVI permitieron obtener distintos patrones de función sistólica (índice PERRS). Conclusiones Los parámetros de remodelado, sincronía y función sistólica del VI deben interpretarse simultáneamente, ya que esto permite obtener distintos patrones de función sistólica del VI (AU)
Introduction and objectives The aim of this study is to assess the relationship between structural, remodeling, synchrony, and systolic left ventricular (LV) function parameters using gated-SPECT myocardial-perfusion-images (gSPECT-MPI). In addition, obtaining the cut-off values for end-diastolic LV-shape-index (EDLVsi), end-systolic LV-shape-index (ESLVsi), ECC (eccentricity-index) and PER, and developing a new index to evaluate different patterns of the LV systolic function. Methods The study was approved by the Hospital's Ethical-Committee (PR[AG]168.2010), and all patients gave their informed consent. We analyzed prospectively 238 patients (age 63.4±13 years) who underwent stress-rest gSPECT-MPI (control-group, n=148; patients with previous myocardial infarction [MI], n=90). Results In the control group, with regard to remodeling parameters: the end-diastolic-volume-index (EDV) and the ECC were the parameters that influenced the EDLVsi (r2: 0.52, P<.001). EDV, PER, men, and the ECC were the parameters (r2: 0.44; P<.001) which influenced the ESLVsi. EDLVsi, ESLVsi, LVEF and the stroke-volume were the parameters (r2: 0.62; P<.001) which influenced the ECC. With regards to PER: LVEF, heart-rate, bandwidth, and the standard-deviation were the influencing parameters (r2: 0.76; P<.001). The cut-off values for EDLVsi, ESLVsi, ECC, and PER were 0.59, 0.42, 0.87, and 3.3, respectively. The PER, the ESLVsi and the bandwidth were the parameters related to patients with previous MI (AUC: 0.89); and they allow the assessment of different patterns of systolic function (PERRS-index: Peak-Emptying-Rate, left ventricular-Remodeling and Synchrony). Conclusions The remodeling, synchrony and the systolic function parameters of the LV should be interpreted together (PERRS-index). In this way, we obtain different patterns of LV systolic function (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Ventricular Function, Left/physiology , Ventricular Remodeling/physiology , Single Photon Emission Computed Tomography Computed Tomography , Case-Control Studies , Prospective StudiesABSTRACT
Pleuroperitoneal hernias are the most uncommon type of diaphragmatic hernias in dogs and cats. The treatment of choice is surgery and may involve the use of prosthetic implant through celiotomy. In the current report, laparoscopic repair of a congenital pleuroperitoneal hernia using polypropylene mesh in a dog is described. The surgery was feasible. Appropriate reduction of the hernia was carried out and no complications were noted.
Hérnias pleuroperitoneais são o tipo mais incomum de hérnias diafragmáticas em cães e gatos. O tratamento de escolha é cirúrgico e pode envolver o uso de implantes protéticos na abordagem via laparotomia. No presente relato, é descrito o reparo de uma hérnia pleuroperitoneal congênita através de laparoscopia com utilização de malha de polipropileno. A cirurgia foi viável. Houve redução apropriada da hérnia sem observação de complicações.