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Biomedical subjects

A Aleixo

Publications and source records attributed to A Aleixo.

8 recordsLinked to original sources
PubMed1998

[Myocardial viability. Concept, physiopathology. Methods and diagnostic value].

The purpose of this study is to describe the concept and physiopathology of myocardial viability to provide rational use of diagnostic methodologies and their value. Great relevance has been given to the diagnosis of myocardial viability since it was published in 1982, because of the consequences of therapeutic decisions and prognostic evaluation on the patient's quality of life. The cost/benefit values of these methodologies must be adequate in clinical terms and carefully assessed.

Echocardiography↗
PubMed1989

Detection of rejection after heart transplantation. A computerized precordial mapping experience.

A low-cost modular compact personal computer-based system for surface precordial mapping (SPM) developed by the authors was used to detect rejection periods, documented by endomyocardial biopsy (EB), in heart transplant patients on cyclosporine A therapy. Data were collected with a matrix of 35 Ag-AgCl electrodes positioned over the precordio with anatomical references within 12 hours of EB. For each acquisition the authors computed the root mean square waveform from all signals collected to assess the accuracy of the maximum value of the RMS waveform (mRMS) parameter to detect rejection episodes. A mRMS variation of 20% in consecutive mapping acquisitions was the decision criterion. In EB, only presence or absence of acute rejection was considered. Eleven heart transplant patients were studied and 46 acquisitions were done. The mRMS obtained with SPM showed a sensitivity of 69% and a specificity of 91%, with a positive predictive value of 75% and negative value of 88%. The results indicate that surface precordial mapping may be promising for monitoring rejection.

Adolescent↗
PubMed1989

[Diagnostic value of the submaximal treadmill exercise test in the subacute phase of myocardial infarct].

OBJECTIVES: To assess the diagnostic value of treadmill submaximal exercise testing (TSET), early after myocardial infarction (MI) under medical treatment, evaluating the ST changes predominantly. MATERIALS AND METHODS: 65 patients, 62 males and 3 females, mean age 52 years with demonstrated MI under clinical, electrocardiographic and enzymatic criteria were evaluated with TSET before hospital discharge. Thrombolytic therapy in acute phase of MI was done in 45 of the patients. All patients underwent angiographic studies with left ventriculography and selective coronariography. RESULTS: Of all TSET variables considered (Treadmill time, ST segment, presence of chest pain, systolic pressure, double product and presence of ventricular arrythmias) the single most important predictor for high-risk groups like left main disease and three vessels disease, was ST changes alone or associated with exercise precordial pain, with a sensitivity of 100% to left main and 83% to three vessels disease. In the thrombolytic group we did not find any differences related with reperfusion. IN CONCLUSION: TSET is a useful, noninvasive, and safe method for risk stratification after MI mainly when ST segment changes are considered alone or with stress precordial pain, predicting high risk groups, namely left main or three vessels disease patients.

Adult↗
PubMed1987

Evaluation of 2 intravenous thrombolytic agents (anisoylated plasminogen streptokinase activator complex versus streptokinase) in patients with acute myocardial infarction.

Ten patients with symptoms of acute myocardial infarction of less than 6 hours duration were randomised to receive either anisoylated plasminogen streptokinase activator complex [APSAC] (30U) or streptokinase (1,500,000U) intravenously. The aims of the study were to compare the angiographic patency of the infarct-related coronary arteries and to monitor drug safety and tolerance for up to 24 hours. The left anterior descending artery was occluded in 3, the left circumflex in 3 and right coronary artery in 4 patients. Time between onset of pain and treatment ranged from 150 to 330 minutes. At 90 minutes, 8 patients, 3 of 5 (60%) of the APSAC group and all of the streptokinase group, had patent arteries. No significant differences were found in measurements of coagulation. There were no haemorrhagic complications. One patient of the APSAC group had reinfarction 6 hours after treatment and died in cardiogenic shock. APSAC seems safe and is easier to use than streptokinase, and both agents result in patency in the majority of patients, although too few patients were included to allow a valid comparison. However, thrombolysis should be considered only a temporary solution in acute myocardial infarction, associated mainly with 3-vessel disease.

Aged↗
PubMedDate not supplied

[The diagnostic and prognostic value of the 12-lead electrocardiogram in assessing the severity of coronary disease in the acute phase of an acute myocardial infarct].

UNLABELLED: The conventional twelve-lead electrocardiogram (ECG) still is the cheapest, most used and absolutely essential diagnostic method for the acute phase of myocardial infarction (MI) allowing risk stratification and coronary prognostic evaluation in this phase mainly by the localization of the ST segment depression and/or T wave inversion (ST/T changes) not related to the infarct area in Q-Wave MI or at any localization in case of non-Q wave MI. The etiology and pathophysiology of these ST/T changes in the setting of MI has been controversial. With the objective of determining ECG prognostic and diagnostic value, 70 patients (Pts) (59 men and 11 women, mean age 58 + 13) admitted in the acute phase of MI were studied with revision of acute phase ECG ST/T changes. All patients underwent coronary angiography and ventriculography at the moment of hospital discharge. Patients were divided into two classifications: A) MI localization: A1--Q-wave MI (anterior--20 pts, inferior--29 pts, lateral--1 pt); A2--non-Q wave--20 pts. B) Evidence of ST/T changes outside the infarct area in Q wave MI or at any localization in non-Q wave MI (group B1--with ST/T changes, group B2--without ST/T changes). We correlated the angiographically documented coronary artery disease in groups with ST/T changes and their localization. RESULTS: A1) Anterior MI group: in the 6 pts (30%) with "opposite" (inferior) ST/T changes, right coronary artery (RCA) disease was documented in 5 and in the other 14 patients the RCA did not show significant lesions. Inferior MI group: in the 24 Pts (83%) with "opposite" (precordial) ST/T changes. 23 of them had angiographic correlation (left anterior descending (LAD) and/or circumflex (CX) artery disease). Lateral MI group: one Pt with anterior wall ST/T changes and LAD and CX disease. A2) Non-Q wave group: in 13 pts (87%) the diseased vessels were correlated with the site of ST/T changes. B1) Q-Wave AMI: left main and 3-vessel disease in 2 pts, 3-vessel disease in 17 pts, 2-vessel disease in 9 pts, 1-vessel disease in 2 pts and non-significant disease in one pt. Non-Q wave MI: left main and 3-vessel disease in 1 pt, 3-vessel disease in 7 patients, 2-vessel disease in 3 pts and 1-vessel disease in 4 pts. B2) non-Q Wave MI: 3-vessel disease in 5 pts, 2-vessel disease in 7 pts, 1-vessel disease in 6 pts and non-significant disease in 1 pt. Non-Q wave MI: 2-vessel disease in 2 pts and non-significant disease in 1 pt. IN CONCLUSION: When pts were divided according to MI localization, a correlation was found between the ST/T changes outside the infarct area with CAD in 91% of Pts in the Q-Wave infarction group, with more significance in inferior and lateral MI. In the non-Q wave group, we found correlation between the a coronary lesions and the localization of ST/T changes in 87% of the pts. The pt group with ST/T changes presented, when compared with the pt group without these changes, evidence of more severe coronary artery disease (CAD): 3 vessels or left main with 3 vessel disease. However, only in the Q-Wave infarction group was a statistically significant difference found between the group with ST/T changes compared to the group without these changes, concerning to the existence of more severe coronary disease.

Acute Disease↗