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Biomedical subjects

J Pimenta

Publications and source records attributed to J Pimenta.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Risk factors for cardiovascular diseases in physicians. Preliminary data from the VIDAM Project of the Paulista Medical Association].

PURPOSE: To evaluate the frequency and other characteristics of some cardiovascular risk factors among physicians of São Paulo State, Brazil. METHODS: From a questionnaire, 1395 voluntary physicians answered questions about personal and familial cardiovascular disease and risk factors, and blood pressure, serum total cholesterol, glucose, height and weight were recorded. RESULTS: The frequency of familial history of ischemic heart disease was 24.4%; positive personal antecedent of hypercholesterolemia, 12.4%; serum total cholesterol > or = 240 mg/dl, 14.3%; positive personal antecedent of hypertension, 8.4%; systolic blood pressure > or = 140 mmHg or diastolic > or = 90 mmHg, 23.8%; current cigarette smokers, 17.4%; prior cigarette smokers, 19.1%; positive personal antecedent of diabetes, 0.8%; serum glucose > 120 mg%, 7.7%; sedentarism, 37%, and obesity, 17.2%. CONCLUSION: Cigarette smoking was the only risk factor that was taken in account with emphasis by the physicians of São Paulo State in order to prevent themselves from cardiovascular disease.

Adult↗
PubMed1993

[Acute electrophysiologic and echocardiographic changes induced by xamoterol in chronic chagasic patients with sinus node dysfunction].

PURPOSE: To evaluate xamoterol (Corwin)--a partial beta-adrenergic receptor agonist--in long-term chagasic patients with symptomatic sinus node dysfunction previously treated with permanent atrial pacemaker. METHODS: Ten patients with permanent AAI pacing were studied. Initially, in spontaneous rhythm (sinus rhythm due to inhibition of the pacemaker) and under atrial pacing with rate of 60, 80 and 100ppm with temporary external programming of the pulse generator were evaluated. Basic heart rate, maximal sinus node recovery time and the point at which Wenckebach AV block was achieved were recorded. After that, echocardiographic evaluation was performed to analyze the left ventricular performance with ejection fraction calculation and the percentage of the fractional shortening during spontaneous rhythm and under atrial pacing with rate of 60, 80 and 100ppm. This protocol was repeated after 5mg of intravenous xamoterol. RESULTS: Five men and 5 women (mean age of 46) were studied. Xamoterol increased the basic heart rate, the rate at which the Wenckebach AV block was achieved and shortened the maximal sinus node recovery time (statistically significant) suggesting a beta-adrenergic agonist action of the drug. Left ventricular performance showed significant improvement only when the values in sinus rhythm (during inhibition of the pulse generator) were compared. Under atrial pacing, left ventricular function was consistently improved in all patients but with no significance. CONCLUSION: Xamoterol showed to be a beta-adrenergic receptors agonist in long-term chagasic patients with sinus node dysfunction at rest, when the simpatic tone was low, with evident action on the electrophysiologic parameters.

Adult↗
PubMed1993

[Symptomatic mitral valve prolapse. Left ventricular dysfunction and beneficial effect of digitalis].

PURPOSE: To study the left ventricular function by M-mode echocardiography in symptomatic patients with primary mitral valve prolapse (MVP), without significant mitral regurgitation, during the phenylephrine test, before and after digitalization. METHODS: Thirty one patients with MVP and 10 normal subjects as a control group were studied by M mode echocardiography: Percentage of systolic shortening (DD), ejection fraction (EF) and mean velocity of circumferential fibers shortening (Vcf) were measured. The echocardiographic recordings were obtained at rest and during the continuous infusion of phenylephrine (40-60 micrograms/min) in order to allow an increase of 20-30 mmHg in systolic pressure. RESULTS: At rest, cardiac size and function were normal in both groups. During phenylephrine infusion in 27 patients a decrease in DD (from 37.7 +/- 4.6 to 31.0 +/- 4.0, p < 0.001); in EF (from 0.76 +/- 0.05 to 0.66 +/- 0.6, p < 0.001); in Vcf (from 1.05 +/- 0.77 to 0.76 +/- 0.13, p < 0.001) were observed. From this group 20 patients received digoxin. After the digitalization the phenylephrine test did not cause changes in DD (from 38.3 +/- 5.0 to 39.2 +/- 3.8, NS); in EF (from 0.77 +/- 0.06 to 0.77 +/- 0.04, NS); in Vcf (from 1.05 +/- 0.19 to 0.94 +/- 0.13, NS). These patients during the submaximal exercise test, showed significant increases at the total work load (from 617 +/- 248 to 982 +/- 244 watts, p < 0.001) and cardiac efficiency (from 25.0 +/- 11.5 to 37.2 +/- 10.4, p < 0.001). On the other hand the phenylephrine infusion in the control group did not result in changes in DD, EF and Vcf. CONCLUSION: Symptomatic patients with primary MVP showed total recovering of left ventricular dysfunction with digitalization during the phenylephrine test, with improvement of cardiac efficiency.

Adolescent↗
PubMed1993

[Regression of tachycardiomyopathy after implant of pacemaker with antitachycardial function].

A 27-year-old woman with systemic lupus erythematosus and Wolff-Parkinson-White syndrome complicated with refractory tachycardia and class III heart failure treated with pacemaker implantation was described. She had cardiomyopathy that could be due to lupus erythematosus or tachycardia-induced. Nonpharmacologic therapeutic alternative was used and a universal DDD pulse generator with selected programming was chosen. Twenty-four months follow-up showed tachycardia control and regression of symptoms of heart failure to class I as well as improvement of left ventricular function evaluated by echocardiographic method. Thus, pacemaker implant may be an useful alternative approach in patients with tachycardiomyopathy in whose other nonpharmacologic therapeutic options could not be performed.

Adult↗
PubMed1993

[Acute effects of propafenone in patients with ventricular pre-excitation].

PURPOSE: To evaluate the electrophysiological effects of intravenous propafenone in the anterograde and retrograde effective refractory period of the accessory pathways (AP), in patients with Wolff-Parkinson-White syndrome. METHODS: Forty symptomatic patients were studied. All patients were undergone to electrophysiologic study at baseline and after IV propafenone (2.0mg/kg). Drug effects were analysed according to the basal state of the anterograde and retrograde effective refractory periods of the AP > < 270ms. RESULTS: The mean anterograde and retrograde effective refractory periods of the AP were 275 +/- 76ms and 264 +/- 44ms at the control and 462 +/- 190ms and 438 +/- 184ms after drug respectively (p < 0.01 in both situations). The mean anterograde effective refractory period of the AV node was 236 +/- 40ms (control) and 276 +/- 57ms (post-drug)- p < 0.05. The mean atrial and right ventricular effective refractory period in the control were 210 +/- 23ms and 240 +/- 34ms passing to 215 +/- 24ms and 250 +/- 40 ms after drug respectively (p = ns). After drug, complete anterograde and retrograde block of the AP, occurred in 15 (42%) and 12 (35%) patients respectively. Out of 15 patients with complete anterograde block of the AP, 11 had anterograde effective refractory period of the AP > 270ms and 4, < 270ms (p < 0.02). Out of 12 patients with complete retrograde block of the AP after drug, 4 had retrograde effective refractory period > 270ms and 8, < 270ms (p: ns). CONCLUSION: Propafenone caused significant increase in the anterograde and retrograde effective refractory periods of the AP. There was a tendency of the drug to show better effectiveness in patients with anterograde effective refractory period of the AP > 270ms. This results were not seen in relation to the retrograde effective refractory period of the AP.

Adolescent↗
PubMed1991

[Uhl's anomaly in adults associated with coronary disease].

A 56-year-old male patient was submitted to coronary artery bypass graft surgery. Pericarditis and dilatation of the right ventricle with thinning of the walls of the right ventricle was observed. Intraoperative right ventricle biopsy revealed fibro-adipose tissue. The diagnosis of concomitant Uhl's syndrome was made.

Cardiomegaly↗
PubMed1990

Return ventricular rhythm: new mechanism for tachyarrhythmia.

A case study is presented in which the electrocardiographic patterns during tachycardia showed ventricular premature depolarizations with retrograde conduction to the atria probably using a left-sided anomalous pathway and reentry to the ventricles with normal ventricular activation and duplication of the heart rate. This type of tachycardia is being labeled "return ventricular rhythm" and, as far as it is known, this is the first description of its mechanism.

Aged↗
PubMed1990

[Clinical and angiographic characteristics of acute anteroseptal and upper lateral myocardial infarction: obliquous infarction; proposal of a new denomination for a specific type of infarction].

PURPOSE: Analysis of clinical and angiographic characteristics of oblique (anteroseptal and high lateral) myocardial infarction. MATERIAL AND METHODS: Forty-two patients, 33 men, aged 30 to 79 years (mean 57) with oblique myocardial infarction were clinically evaluated and through coronary arteriography between ten day and eight months (mean of two months) of the acute event. RESULTS: Twenty patients had severe proximal lesions of left anterior descending artery (LAD), being single in thirteen. Four cases showed severe lesions in two arteries and three cases in three arteries. Fourteen patients exhibited collateral circulation to LAD or recanalization. Ejection fraction values were between 0.12 and 0.65 (mean 0.38). Eight patients died, four of them due to myocardial failure and four due to noncardiac causes. During follow-up angina pectoris was present in five, stroke in three and pulmonary embolism in two patients. CONCLUSION: Oblique myocardial infarction is associated with single and proximal lesion of LAD in the majority of the patients who underwent coronary arteriography, with low incidence of cardiac failure and death.

Adult↗
PubMed1989

[Total A-V block due to tuberous sclerosis. A case report].

Tuberous sclerosis is a neurologic disease affecting various organs with a triade: sebaceum adenoma, mental retardation and seizures. This report presents a case of a patient with tuberous sclerosis and third degree A-V block with complete invasive and non-invasive evaluation. The patient had sincope and complete A-V block with QRS complexes showing right bundle branch block morphology. The echocardiogram showed dilated cardiomyopathy with diffuse left ventricular dysfunction and had normal coronary arteriography. The eletrophysiologic evaluation showed complete infra-hisian A-V block and QRS with left bundle branch block pattern with normal sinus nodal and A-V nodal function. It was not possible to induce ventricular tachtyarrhythmias up to two extrastimuli. Histologic study showed normal myocardium under light and electronic microscopy. After permanent VVI pacemaker implant, the patient in follow-up for 16 years. This case seems to be the first in the international medical literature of tuberous sclerosis with complete heart block.

Adult↗
PubMed1986

Effects of atenolol in patients with reciprocating supraventricular tachycardia.

We studied 12 patients with crisis of paroxysmal reciprocating supraventricular tachycardia before and after intravenous injection of 5 mg of atenolol. The patients were then followed for periods ranging from 6 to 50 months (median 34 months). During this time, they received oral atenolol therapy, at 200 mg for the first two weeks, and 100 mg daily thereafter. Tachycardia was due to reciprocation within the atrioventricular node in 9 patients, and to pre-excitation in 3 patients. Atenolol slowed the sinus rate, prolonged the atrioventricular conduction time, and increased the atrial cycle length at which atrioventricular nodal Wenckebach phenomenon occurred. During the tachycardia, atenolol increased the tachycardia During the tachycardia, atenolol increased the tachycardia cycle length, due to prolongation of the intranodal atrioventricular conduction time. Of the 11 patients who were observed for the full period, 7 had no further episodes of arrhythmia. One patient (with left-sided pre-excitation) failed to respond to any antiarrhythmic medication, one patient remained free of symptoms for two years, but received an atrial pacemaker for control of the tachycardia at the end of this period. Two patients (one with dual atrioventricular nodal pathways, and one with concealed left-sided pre-excitation) await other treatment for their tachycardia, after remaining free of symptoms for one and two years, respectively. These findings suggest that atenolol is an effective beta blocker for use in controlling arrhythmias in patients with reciprocating supraventricular tachycardia, for use in once daily dosage, and is a medication largely free of side effects.

Adult↗