QRS duration and dispersion for predicting ventricular arrhythmias in early stage of acute myocardial infraction. / Duración y dispersión del QRS para predecir arritmias ventriculares en las fases iniciales del infarto agudo de miocardio.

OBJECTIVE: To determine the relationship between QRS duration and dispersion and the occurrence of ventricular arrhythmias in early stages of acute myocardial infarction (AMI). DESIGN: A retrospective, longitudinal descriptive study was carried out. SETTING: Hospital General Universitario "Camilo Cienfuegos", Sancti Spíritus, Cuba. Secondary health care. PATIENTS OR PARTICIPANTS: A total of 209 patients diagnosed with ST-segment elevation AMI from January 2012 to June 2014. MAIN VARIABLES OF INTEREST: The duration and dispersion of the QT interval, corrected QT interval, and QRS complex were measured in the first electrocardiogram performed at the hospital. The presence of ventricular tachycardia/fibrillation was assessed during follow-up (length of hospital stay). RESULTS: Arrhythmias were found in 46 patients (22%); in 25 of them (15.9%), arrhythmias originated in ventricles, and were more common in those subjects with extensive anterior wall AMI, which was responsible for 81.8% of the ventricular fibrillations and more than half (57.1%) of the ventricular tachycardias. The widest QRS complexes (77.3±13.3 vs. 71.5±6.4ms; P=.029) and their greatest dispersion (24.1±16.2 vs. 16.5±4.8ms; P=.019) were found on those leads that explore the regions affected by ischemia. The highest values of all measurements were found in extensive anterior wall AMI, with significant differences: QRS 92.3±18.8ms, QRS dispersion 37.9±23.9ms, corrected QT 518.5±72.2ms, and corrected QT interval dispersion 94.9±26.8ms. Patients with higher QRS dispersion values were more likely to have ventricular arrhythmias, with cutoff points at 23.5ms and 24.5ms for tachycardia and ventricular fibrillation, respectively. CONCLUSIONS: Increased QRS duration and dispersion implied a greater likelihood of ventricular arrhythmias in early stages of AMI than increased duration and dispersion of the corrected QT interval.

Obesidad: aspectos patogénicos, alteraciones cardiovasculares asociadas y estrategias terapéuticas / Obesity: pathogenic issues, associated cardiovascular illness, and therapeutic approach

La obesidad es la alteración metabólica más frecuente delos seres humanos. Esta enfermedad aparece debido al excesode tejido adiposo que se produce por la acumulación progresivade grasa en sus reservorios debido a un desequilibrio dela homeostasis calórica donde la ingestión excede el gastoenergético. Afecta aproximadamente al 33% de los adultos ycada año se invierten en alimentos especiales y programas parareducir el peso corporal cerca de 30 millones de dólares; sinembargo, los tratamientos empleados han sido ineficaces y casiel 90% de las personas que bajan de peso, aumentan nuevamenteel peso perdido. En este artículo presentamos una revisiónsobre la obesidad, haciendo especial énfasis en ladefinición y su epidemiología, su patogenia, la relación conenfermedades cardiovasculares y el tratamiento actualizado

Obesity is the most frequent metabolic disturbance thataffects human beings. This disease appears due to the excessof fatty tissue which is produced because of progressive accumulationof fat on its reservoirs, as a response to misbalanceon caloric homeostasis where food intake exceedsenergetic needs. Obesity affects around 33% of adult population,and near 30 million dollars is inverted each year onspecial foods, and programs to reduce body weight; however,treatments applied have been unsuccessful, and almost90% of people who loose weight, gain the lost weight again.This article shows a review about obesity where we mainlyemphasis in concept and epidemiology, pathophysiology, itsrelation with cardiovascular diseases, and current treatment

[Giant atherosclerotic aneurysm. A case report]. / Aneurisma aterosclerótico gigante. Presentación de un caso.

INTRODUCTION: Intracraneal aneurysms are frequent in medical practice, most of them never produce symptoms, that is why occasionally, they are not diagnosed before death. Sacular is the most frequent aneurysm, and atherosclerotic aneurysm is rare. CASE REPORT: In this article we present the case of a 75 year old woman who has been suffering from high blood pressure and coronary artery disease since more than 20 years and in the last four months she had been complaining of dysphagia and dysartria. She was taken to the hospital because 24 hours ago mild headache started accompanied by vertigo, nausea and vomiting. On neurological exam we found sleepiness, dysartria, and right braguio crural hemiparesis, therefore we decided admitt her, but after 48 hours left braquio crural hemiparesis was added and later respiratory sepsis appeared. The patient died due to an acute respiratory failure. CONCLUSION: Necropsy revealed a huge atherosclerotic intracraneal aneurysm (31 mm) located on basilar artery. The case has been discussed and images were shown.