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Biomedical subjects

F Soria

Publications and source records attributed to F Soria.

At least 37 records · Page 2Linked to original sources
PubMed1993

Reduction of left ventricular hypertrophy: how beneficial?

Left ventricular hypertrophy (LVH) can no longer be considered a compensatory adaptation of the heart serving to normalize the increased wall stress in hypertension. Recent studies have indicated that LVH is a powerful pressure-independent risk factor for cardiovascular morbidity and mortality. The pathophysiologic sequelae of LVH are reduced ventricular filling and contractility, ventricular dysrhythmias, and diminished coronary reserve or myocardial ischemia. Left ventricular hypertrophy can be reduced by antihypertensive therapy, although not all drugs are equipotent in this regard. Recent studies have shown that such a reduction also improves the pathophysiologic sequelae of LVH, that is, ventricular filling, coronary reserve, and ventricular dysrhythmias, and maintains left ventricular pump function. Although the reversal of these pathophysiologic findings is encouraging, it remains unknown whether a reduction of LVH will ultimately reduce the excessive risk of sudden death, acute myocardial infarction, and congestive heart failure that has been associated with this disorder independent of arterial pressure.

Calcium Channel Blockers↗
PubMed1993

[Morphologic and functional heart changes in a group of healthy elderly individuals aged 70 years and over].

UNLABELLED: BACKGROUND. The increasing age of the population, makes necessary to have "normal values" in order to make diagnosis and treatment in this population group. The purpose of this study is to determine the morphological and functional changes in a group of healthy aged above 70 years. METHODS: We studied 125 subjects older than 70 years, mean of 74.9 and 50 healthy aged 9-45, with a mean of 25.8, who served as control group. Twenty-five were excluded by history, chest X-Ray, ECG and Echocardiogram because cardiac disease. An echocardiographic M and 2D and pulsed Doppler study, was done to obtained several morphological and systolic and diastolic function parameters. A good quality echo to measure morphologic and systolic function was obtained in 69 study group patients. In all study and control group, was obtained a good quality mitral flow signal to measure diastolic function.

Aged↗
PubMed1992

Hypertension, left ventricular hypertrophy, ventricular ectopy, and sudden death.

Left ventricular hypertrophy (LVH) is a common sequela of sustained arterial hypertension, although the correlation between spot blood pressure measurements and LV mass is not a close one. LVH has been shown to be a powerful blood pressure-independent risk factor for cardiovascular morbidity and mortality. LVH has been shown to trigger or to accelerate ventricular dysrhythmias, although the connection between ventricular dysrhythmias and sudden death is poorly documented. LVH can be reduced by specific antihypertensive therapy; however, not all drugs are equipotent in this regard. A reduction of LVH has been shown to be associated with a suppression of ventricular dysrythmias. Preliminary studies also indicate that the reduction of LVH may reduce its inherent excessive morbidity and mortality.

Antihypertensive Agents↗
PubMed1992

[Cardiac anatomical and functional changes in a group of young type I diabetics with microangiopathy].

BACKGROUND: There are conflicting data concerning the alteration of cardiac function in diabetics without another type of accompanying pathology. Therefore this study was designed with the aim to analyze the anatomical and functional changes and relate them with the time and control of diabetes. METHODS: Fifty-four type I diabetics with a mean age of 33.5 years and 25 healthy controls paired by age and sex were studied. The patients were rigourously selected excluding any disease or treatment other than insulin and the presence of demonstrated microangiopathy was required. M-mode and bidimensional echocardiographic studies were carried out in 46 patients to calculate thickness, cavity dimension and systolic function rates. Doppler-echo studies analyzing 9 parameters of diastolic function were performed in all the 54 patients studied. RESULTS: The results obtained demonstrated significant differences in the thickness of the posterior wall and the septum in the diabetics in comparison with the normal subjects. No differences were observed in the parameters of systolic function with the diastolic parameters being significant. Considered globally 41% of the patients demonstrated structural alterations, 4% systolic and 70% diastolic. The only significant correlation was established between the diastolic alteration and the time of evolution of the diabetes. The autonomic alteration which some patients presented did not vary the results obtained. CONCLUSIONS: In this group of selected diabetic structural and cardiac diastolic alterations appeared being attributed only to the diabetes itself in relation to the length of time of the same and possibly to the microangiopathy.

Adolescent↗
PubMed1992

Cardiac rhythm in healthy elderly subjects.

To study the normal cardiac rhythm in elderly subjects we performed 24-h Holter monitoring on 94 subjects aged over 70 years. We had previously discarded those with cardiac disease by using history, physical examination, electrocardiography (ECG), chest X-radiography and Doppler echocardiography. The maximum, average and minimum heart rates were 113, 79 and 62, respectively, during the day, and 90, 64 and 53 during the night. Supraventricular and ventricular arrhythmias were frequent (91% and 89.4%, respectively). Some 50% of the subjects had complex ventricular arrhythmias. Two subjects presented with sinus pauses of more than 2 s, and 4 had Wenckebach second-degree atrioventricular (AV) block. During a follow-up averaging 20.8 months, there were no deaths or symptoms of an arrhythmic origin.

Aged↗
PubMed1992

Anatomical and functional cardiac abnormalities in type I diabetes.

To analyse the anatomy and systolic and diastolic cardiac function in a group of type I diabetics with no other abnormality and to correlate it with the duration of the disease, the presence of complications, the control of the diabetes and the abnormalities in the autonomous nervous system, 125 type I diabetics and 50 age- and sex-matched healthy controls were studied. In 112 diabetics, an echocardiographic image which enabled us to calculate the thickness, cavity dimensions and systolic function rates was obtained. A Doppler echocardiograph was done in all patients to measure 9 parameters of diastolic function. The autonomic nervous system was evaluated by the response to 4 cardiovascular reflexes. Two control groups and 4 study groups were established, based on duration and on the presence and number of microangiopathic complications. The results showed a significant increase in the septal and posterior wall thickness, although without differences between the study groups. There were no differences in the analysis of systolic function. The abnormalities in diastolic function were significant in all the groups, but greater in the groups with microangiopathy. Overall, for groups 1-4, respectively, the incidence of anatomical abnormalities was 9.6%, 17%, 28% and 57% (average 22%); systolic 0%, 0%, 4% and 4.7% (average 2.2%); and diastolic 15%, 21%, 60% and 80% (average 44%). Only 13 diabetics from group 4 presented with cardiac autonomic neuropathy. No correlation between these alterations and the glycaemic control or the duration of the disease was found, although there was a correlation between the presence or absence of complications and the anatomic and diastolic abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Selection of antihypertensive therapy: cardiac and extracardiac considerations.

There are four possible pathophysiological mechanisms which may relate left ventricular hypertrophy (LVH) with cardiovascular morbidity and mortality: LVH diminishes left ventricular filling; LVH decreases coronary reserve and hampers myocardial oxygenation; LVH is commonly associated with ventricular arrhythmias, and with long-standing LVH, left ventricular contractility decreases. LVH can be reduced by a range of antihypertensive drugs, although not all drugs are equipotent in this regard. Two recent meta-analyses have indicated that ACE inhibitors are among the most powerful monotherapeutic modalities to reduce LVH. Calcium channel blockers are almost as effective, whereas beta-blockers and diuretics seem to have a lesser effect, despite equipotent antihypertensive properties. Reducing LVH with ACE inhibitors and calcium channel blockers has been shown to improve contractility and left ventricular filling, and diminish ventricular ectopy. A preliminary study also indicates that coronary reserve increases after reduction in LVH. Despite these promising pathophysiological signs, it remains unknown whether or not a reduction in LVH will reduce morbidity and mortality over and above the reduction achieved by a reduction in arterial pressure alone.

Antihypertensive Agents↗
PubMed1992

Does a reduction in left ventricular hypertrophy reduce cardiovascular morbidity and mortality?

Left ventricular hypertrophy is an important risk factor for sudden death and other cardiovascular morbidity and mortality irrespective of the level of arterial blood pressure. Left ventricular hypertrophy, i.e. an increase in wall thickness at the expense of left ventricular volume, is an adaptive mechanism observed in patients with long standing arterial hypertension. Severe left ventricular hypertrophy is associated with a reduction in left ventricular compliance, impaired coronary reserve, ventricular ectopy, and impaired contractile function. Left ventricular hypertrophy can be reduced by antihypertensive therapy; however, not all antihypertensive agents have the same effect on left ventricular hypertrophy despite their similar effects on arterial blood pressure. Angiotensin converting enzyme (ACE) inhibitors appear to be the most powerful agents for reducing left ventricular hypertrophy, followed by the nondihydropyridine calcium antagonists. In addition to reducing left ventricular mass and arterial blood pressure, certain calcium antagonists also improve left ventricular filling, suppress ventricular ectopy, and maintain or enhance contractile function. However, despite these beneficial effects, it is not known whether the risk of cardiovascular morbidity and mortality can be prevented or reduced by specific antihypertensive agents.

Cardiovascular Diseases↗
PubMed1992

[An analysis of the circadian rhythm of the heart rate and arrhythmias in healthy elderly subjects].

The incidence of asymptomatic arrhythmia detected by Holter monitor in the normal aged population is high. Nevertheless, there are few studies in the literature about the existence and characteristics of their circadian rhythm (CR). The aim of this study, is to determine the presence of CR of the heart rate (HR), supraventricular and ventricular extrasystoles (SVE, VE), atrial tachycardias (AT) and ventricular complex tachycardias (VCT) in the normal aged population. We studied 120 subjects, older than 70 years of age, belonging to a pensioner club, without apparent cardiovascular disease by history, physical, ECG, Chest X-Ray and echocardiography. All the patients had a 24 hours Holter monitor. 42 patients whose recording showed more than 50 SVE and/or more than 50 VE were included in the study. To study the CR the cosinor method was used. In the simple analysis, the HR had significant CR in 40 subjects (95.2%), the SVE in 18 out of 29 (62.1%) and the VE in 16 out of 26 (61.5%). The global analysis showed significant CR for the HR, with an acrophase at 15:47 hours (confidence limits at 95% between 14:45 and 15:42 hours) and for the VE, (acrophase: 15:35 hours, confidence limits between 11:53 and 19:05 hours). There was not significant CR for the SVE because the wide dispersion of the acrophases between the subjects. The AT had significant CR but no the VCT. We conclude that the majority of the aged normal subjects with frequent ectopy had significant CR for the HR and extrasystoles. The VE follow a CR similar to the frequency, suggesting a common modulation of the autonomic nervous system. The SVE variation follow a different CR.

Aged↗
PubMed1991

Comparison of the effectiveness of various antibiotics in the treatment of methicillin-susceptible Staphylococcus aureus experimental infective endocarditis.

The effectiveness of various antibiotics was tested in the eradication of a strain of methicillin-susceptible Staphylococcus aureus (MSSA) of cardiac vegetations, in an experimental model of endocarditis in rabbits. Twelve animals comprised the control group and 48 the treated ones. After inducing the experimental endocarditis, the animals were treated for three days; then mortality, blood cultures at 48 and 72 hours and the title of the colony forming units per gram of vegetation (CFU/g) were evaluated. Imipenem and the cloxacillin-gentamicin association were found to be as effective as cloxacillin in eradicating the microorganisms of the vegetation. Clindamycin in high doses was shown to be a valid alternative. Vancomycin, teicoplanin, rifampin and ciprofloxacin were less effective than cloxacillin. The experimental model seems to be an effective method for evaluating antimicrobial treatments in staphylococcal endocarditis.

Animals↗
PubMed1991

[The cardiac anatomical and functional changes in a group of young type-1 diabetics without microangiopathy].

We study 71 type I diabetics and 25 controls, trying to analyze the anatomical and functional changes due to diabetes. The diabetics, with a mean age of 18.4 +/- 8.2 years, were strictly selected excluding any disease and treatment besides insulin. In 66, and echocardiographic M mode and 2D study was done to calculate wall thickness, cavity dimensions and systolic function indexes; in all, Eco-Doppler analyzing 9 diastolic function indexes. The results showed an increase in septal thickness in diabetics (p less than 0.01 in diastole and less than 0.001 in systole). There was no difference in systolic function or posterior wall thickness, having the diabetics a significant increase of the T 1/2 (p less than 0.001), a decrease of the deceleration of E and the ratio E/A (p less than 0.001). As a group, 12.5% of the diabetics had anatomical abnormalities, and 18.3% diastolic abnormalities at least in two indexes. The only significant correlation was established between the evolution time and the T 1/2 (p less than 0.01). We conclude that in this group of selected diabetics, the anatomical and functional abnormalities found were only imputable to the diabetic abnormality.

Adolescent↗
PubMed1991

[Teicoplanin versus cloxacillin, cloxacillin-gentamycin and vancomycin in the treatment of experimental endocarditis caused by methicillin-sensitive Staphylococcus aureus].

Thirty-three rabbits, (12 in the control group and 21 treated, 5 with teicoplanin, vancomycin and cloxacillin-gentamycin and 6 with cloxacillin alone) with methicillin-sensitive Staphylococcus aureus (MSSA) experimentally induced endocarditis were studied to evaluate the efficacy of teicoplanin and its comparison with cloxacillin, vancomycin and cloxacillin-gentamycin. The rabbits were treated during three days. Mortality, blood cultures at 48 and 72 hours and the number of colonies forming units per gram of vegetation were then evaluated. There was statistically significantly differences between the control group and the 4 treated groups in respect of mortality (p less than 0.001), and blood culture's negativity at 48 and 72 hours (p less than 0.001), but not among the various groups of treatments. The CFU number of the vegetations were also significantly different between control and treatment groups (p less than 0.001). Cloxacillin and the combination cloxacillin-gentamycin lowered the CFU number more than teicoplanin and vancomycin (p less than 0.005). These results, allowed us to conclude than teicoplanin may be used as an alternative of standard treatments in infective endocarditis due to MSSA.

Animals↗
PubMed1991

[The spontaneous regression of a rhabdomyoma of the right ventricle].

Rhabdomyoma is the most common intracardiac tumor in the newborn. The diagnosis is made by the clinical history and the physical examination, the electrocardiogram, chest X-ray, and the echocardiographic data. It has a poor prognosis, 80% dying in the first year of life because congestive heart failure or sudden death. Rarely, spontaneous regression has been described. We present the case of a newborn diagnosed of tuberous sclerosis, with an echocardiographic image of a rhabdomyoma in the right ventricle with a spontaneous total regression of the tumor 2 years later.

Echocardiography↗
PubMed1990

[The development of a linear function for stratifying the risk of hospital mortality in acute myocardial infarct].

In spite of conventional treatment in a Coronary Unit, there is a group of patients with acute myocardial infarction who present a high mortality index. A more aggressive attitude (coronariography, angioplasty, and/or emergency coronary bypass) could improve the prognosis in some of these patients but can only be performed in a limited number of centers. In the present work, we have reviewed data obtained from the Emergency Room on 167 patients diagnosed of myocardial infarction. The variables that were correlated to mortality were: age, heart rate, blood pressure, presence of rales, radiologic heart failure cardiomegaly, ventricular extrasystoles in ECG and delay in arrival to hospital. We obtain a lineal function (z = 24.6 X1 - 0.4 X2 + 0.2 X3 + 11) which combining ventricular extrasystoles, diastolic arterial pressure, and heart rate permits to differentiate three risk groups: low, medium and high, associated to hospital mortality rates of 5.7, 36.4 and 83.3%. We suggest the use of a function of this type to select those patients who should be sent to a hospital with facilities for emergency coronary surgery.

Discriminant Analysis↗
PubMed1990

[The prevalence of arrhythmias and repolarization changes in patients with mild or moderate essential hypertension undergoing an exercise test. Their variations with different antihypertensive treatments].

42 mild and moderate hypertensive patients treated with Verapamil, Atenolol and Xipamide were studied. Exercise tests (ET) were performed at the onset and after a month of therapy, in order to detect arrhythmias and repolarization change prevalence of ventricular arrhythmias (VA) was 23.7% and 11.9% for supraventricular arrhythmias (SVA). 45.2% of the exercise tests were considered positive, with a significant correlation with maximum pressure peak. Patients with left ventricular hypertrophy (LVH) showed a significant increase in VA and +ET prevalence (42.1% and 63.2%). After treatment, the prevalence for VA registered a slight decrease and an increase for SVA; these differences not being considered significant. +ET showed a significant decrease in all patients, as well as in those with previous LVH (21.4%, 26.3%). Only atenolol produced a significant decrease in the +ET of patients with previous LVH (75% to 12.5%).

Adult↗
PubMed1990

[The electrocardiographic changes in constrictive pericarditis before and after pericardiectomy. The role of the myocardium in the genesis of preoperative electrocardiographic changes].

We studied 19 patients diagnosed of chronic pericarditis and treated surgically with pericardiectomy, to evaluate the role of the pericardium and myocardium on the preoperative electrocardiogram. Before surgery, there was atrial fibrillation in 17 cases, the P axis was between 0 and +70 and pseudomitral morphology was found in 10 of the 12 cases with normal sinus rhythm. The mean voltage in the QRS complex was (13.8 mm), and the R wave in V5 8.6 mm. The T wave was negative in 17 patients. After surgery there was only a case of atrial fibrillation that converted to normal sinus rhythm; the P wave axis moved to the right between +30 and +150 (p less than 0.002), the pseudomitral morphology of the P changed to normal in 3 cases, the voltage of the QRS increased to 16.7 mm (p less than 0.003) and that of the R wave in V5 to 9.4 mm (p less than 0.001). The T wave became positive in only 3 cases. Because of the persistence of some alterations, we concluded that both components, pericardium and myocardium are important in the changes of the electrocardiogram of constrictive pericarditis.

Adult↗