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Biomedical subjects

J Barba

Publications and source records attributed to J Barba.

54 records · Page 3Linked to original sources
PubMedDate not supplied

[Cardiac magnetic resonance: clinical applications].

Cardiovascular disease is the most frequent cause of mortality in the developed countries and represents a serious social, economic and health problem. Although very diverse, useful techniques exist for diagnosing cardiac diseases, it is frequently necessary to ask for more than one test to reach a specific diagnosis. Magnetic resonance is a harmless, well tolerated and safe technique, which is currently available in the majority of hospitals. This technique makes it possible in a single exploration to study the anatomy of the heart and to make a qualitative, semi-quantitative and quantitative assessment of the parameters of cardiac function. It provides information of cardiac and vascular anatomy and function in complex congenital cardiopathies. Besides, with the administration of intravenous contrast, it enables knowledge to be gained of myocardial viability in ischaemic cardiopathy. Hence, cardiac magnetic resonance is emerging as one of the most promising techniques for the study of congenital and acquired cardiac pathology.

Heart Diseases↗
PubMedDate not supplied

[Imaging modalities in cardiology: the present answers to permanent questions].

Tremendous advances have been made in non-invasive cardiology, such as improved visualization of the anatomy and function of the heart and better understanding of heart disease. Echocardiography has improved in both simplicity and complexity, offering a range of modalities from small, hand-held devices that provide basic information simply and inexpensively to complex, dynamic three-dimensional imaging of regional myocardial function. Cardiovascular magnetic resonance imaging is the newest technique for non-invasive cardiology. It assesses cardiac function, mass and volume and can detect myocardial infarction, fibrosis, valvular and congenital heart disease. Computed tomography is used to detect and quantify coronary heart disease and coronary calcium, high scores being related to increased risk, but its use remains controversial. Myocardial perfusion scintigraphy single photon emission computed tomography (SPECT) is cost effective in investigating patients with suspected coronary disease and acute coronary syndrome. Also positron emission tomography (PET) is useful in the study of perfusion, metabolism, patients selection for revascularization, and in translational research in transgenic animal models.

Cardiology↗
PubMedDate not supplied

[Myocardial regeneration: future at reach].

The last few years have witnessed a growing interest in regenerative therapy of the failing heart by cell transplantation. Initial studies with skeletal myoblasts were conducted more than 10 years ago. However, the potential of bone marrow derived cells has more recently led to a flurry of experimental studies generating overall positive but occasionally conflicting results. The ethics of initiating clinical trials with stem cells in patients with heart failure has been questioned. Although laboratory research attempts to overcome a number of questions surrounding the usefulness and safety of cell therapy, the accumulated body of evidence warrants implementation of clinical trials. The earliest of these have now documented the feasibility of cell therapy. It is now appropriate to conduct safety and efficacy studies which, if carefully done, should allow assessment of the extent to which this concept of regenerative therapy can be made a clinical reality.

Clinical Trials as Topic↗
PubMedDate not supplied

[A comparative analysis of patients with coronary stenotic and ectatic lesions].

A total number of 177 patients with coronary lesions were studied. Sixty nine of them presented either a combination of stenotic and ectatic lesions (n = 18) or isolated ectatic lesions (n = 51) and 108 presented only stenotic lesions. Analyzing several clinical and epidemiological parameters we observed a significant difference with respect to the higher prevalence of hypertension among the group affected by ectatic lesions. We verified as well a higher prevalence of myocardial infarction in the group of ectasia associated to the stenotic lesions. Finally, a higher global mortality was observed in the group of ectasia associated to stenotic lesions after medical or surgical treatment.

Constriction, Pathologic↗
PubMedDate not supplied

[Echocardiographic study following corrective surgery for transposition of the great arteries using a baffle].

Sixteen patients undergoing corrective surgery of transposition of the great arteries following Arcas' technique were studied by echocardiography. Mean age was 8.7 years, ranging from 2 to 25 years. The echocardiographic studies were performed between 6 months and 10 years after surgery (X: 5.6 years). Paradoxical movement of the interventricular septum, right ventricle dilatation, diastolic fluttering of the mitral valve and tricuspid incompetence are commonly recorded. Tricuspid insufficiency does not necessarily mean right ventricular disfunction in these patients. Due to the particular baffle shape, bidimensional echocardiographic recognition of superior cava vein obstruction is easy. In addition, the waves of cava veins showed a characteristic pattern with predominant diastolic wave, which is an argument against its obstruction. In conclusion, echo and Doppler studies are reliable means for an adequate follow-up of these patients.

Adolescent↗
PubMedDate not supplied

[Acute myocardial infarction in patients over 65 years of age].

Three hundred and ten patients, 129 under sixty-five years (group A) and 181 over this age (group B), were studied to determine the clinical differences between young and elderly patients with acute myocardial infarction. Women were significantly more present in group A and heavy smokers in group B. Hypertension, although not significantly, was more frequent among the elderly. Serial ECG and enzyme determinations followed the same classic pattern in both groups. Age did not influence neither the localization of the infarction nor the incidence of subendocardial infarction. Young patients remained more often in functional class I, whereas class IV was twofold more frequent among the older. First and second degree A-V block were equally present in the two groups, while third degree A-V block was significantly more frequent in patients over 65. Finally, as expected, in-hospital mortality was significantly higher (34% vs 16% p less than 0.001) among the older patients.

Aged↗
PubMedDate not supplied

Intracardiac thrombi after orthotopic heart transplantation: clinical significance and etiologic factors.

The frequency and clinical significance of intracardiac thrombi after orthotopic heart transplantation are still not fully understood. The aim of this article is to present five patients with heart transplants with intracardiac thrombi and to subject the possible cause, methods of diagnosis, and treatment of this phenomenon to scrutiny. The frequency of intracardiac thrombi may well be higher than anticipated, with emboli occurring only in a small proportion of cases. Hematologic, anatomic, and hemodynamic factors seem to have a bearing on thrombogenesis. Further multicenter studies are required to gain a better understanding of this disorder.

Acenocoumarol↗
PubMedDate not supplied

[Non-invasive diagnosis of rejection in heart transplant: usefulness of Doppler echocardiography].

Cardiac transplantation is a valid therapeutic option for advanced chronic heart failure, with a one year survival of 60-80%. Although the introduction of cyclosporine has markedly improved survival in heart transplant recipients, early detection of cardiac allograft rejection remains the major problem to be solved. At present, the diagnosis of cardiac rejection has been based on the results of endomyocardial biopsy, which remains actually as the gold standard for rejection surveillance. However, ideally the detection of cardiac rejection should be noninvasive to allow frequent follow-up of the patients. Several attempts have been made to find a noninvasive alternative to replace endomyocardial biopsy, doppler-echocardiography being the most promising technique. A review of current noninvasive methods for graft rejection detection will be discussed emphasising the importance of doppler-echocardiography.

Echocardiography, Doppler↗