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A J Zago

Publications and source records attributed to A J Zago.

At least 19 recordsLinked to original sources
PubMed1999

Does serum ferritin correlate with coronary angiography findings?

BACKGROUND: A number of epidemiological studies have described a positive relationship between serum ferritin levels and coronary heart disease. In this prospective study, we evaluated the association between serum ferritin levels and the angiographic extent of coronary atherosclerosis. METHOD: We studied 307 consecutive patients (60.9% male, age 60.1+/-11.0 years) referred for diagnostic coronary angiography. Risk factors for coronary artery disease, lipids and ferritin levels, as well clinical characteristics were recorded from all patients. Two experienced cardiologists blinded for clinical and laboratory data reviewed the cinefilms. Angiographic significant coronary artery disease (CAD) was defined as any more than a 50% diameter stenosis. RESULTS: From the 307 patients, 196 (63.8%) were found to have angiographic significant CAD. The presence of significant CAD was associated with ferritin levels (P=0.015) as well as patient age (P<0.001), male sex (P<0.001), smoking (P<0.002), and cholesterol levels (P=0.028). By multivariate analysis, however, ferritin level was not an independent risk factor for CAD (P=0.27), while the association with all the other factors remained significant. CONCLUSION: In patients referred for coronary angiography no independent relationship was found between angiographic significant coronary artery disease and serum ferritin levels.

Analysis of Variance↗
PubMed1999

Are apolipoproteins A and B better than lipoproteins for assessing risk of obstructive coronary heart disease?

OBJECTIVE: To evaluate whether apolipoproteins A-I (Apo A-I) and B (Apo B) have, higher ensitivity (SN), specificity (SP) and positive predictive value (PPV) than lipoproteins (LP), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), and triglycerides (TGL) in assessing the risk of coronary heart disease (CHD). METHODS: This is a transversal case-control study of 241 patients, who were divided into two groups: 1) 145 patients with CHD, and 2) 96 patients without coronary disease. A model of logistic regression to evaluate the relation between the LPs and CHD was developed in which variables with a p-alpha < 0.1 were included. RESULTS: Apo A-I levels were higher in the patients without CHD, (OR 2.08, CI 1.20-3.57). There were no statistical differences between the values of Apo A-I and the remaining lipid fractions (Apo A-I: 67%; Apo B: 100%; PPV: TC = 71%; TGC = 71%; HDL = 71%; LDL = 71%). The costs of the tests in Reais were as follows: Apo A-I: R$ 56.60; Apo B-100: R$ 56.60; TC: R$ 9.94; HDL: R$ 21.30; LDL: R$ 28.40; TGL: R$ 14.20. CONCLUSION: Levels of Apo A-I and Apo B have no advantage over conventional lipoproteins in predicting the risk of CHD, despite the statistical association between Apo A-I and CHD; in addition, their costs are higher than those of the conventional lipoproteins.

Aged↗
PubMed1999

Lack of a relationship between serum ferritin levels and coronary atherosclerosis evaluated by coronary arteriography.

Many clinical and epidemiological studies have demonstrated the relationship between serum ferritin and ischemic heart disease. In the present study we evaluated the relationship between coronary heart disease (CHD) and serum ferritin levels in patients submitted to coronary arteriography. We evaluated 307 patients (210 (68.7%) males; median age: 60 years) who were submitted to coronary angiography, measurement of serum ferritin and identification of clinical events of ischemic heart disease. Serum ferritin is reported as quartiles. Ninety-six patients (31.27%) had normal coronary angiography (group 1) and 211 (68.73%) had coronary heart disease (group 2). Of the patients with CHD, 61 (28.9%) had serum ferritin levels higher than 194 ng/ml (4th quartile), as opposed to only 14 (14.58%) of those without CHD (P = 0.0067). In the 2nd quartile, 39 patients (18.48%) had CHD, while 35 patients (36.46%) had normal coronary arteries (P = 0.00064). Multivariate analysis of the data showed that the difference between groups was not statistically significant (P = 0.33). We conclude that there is no independent relationship between coronary heart disease and increased levels of serum ferritin.

Coronary Angiography↗
PubMed1998

Left ventricular function and endomyocardial biopsy in early and advanced dilated cardiomyopathy.

We evaluated left ventricular function and endomyocardial biopsy in 20 patients with early and advanced dilated cardiomyopathy, with the purpose of assessing the correlation between histologic variables and systolic and diastolic filling indexes. Group 1 included 10 patients with no clinical history of heart failure and left ventricular ejection fraction > or = 45% and group 2, 10 patients with a clinical history of heart failure and left ventricular ejection fraction <45%. Group 1 showed lower left ventricular end-systolic and end-diastolic volumes indexes (49+/-14 versus 86+/-23 ml/m2, P<0.001; 98+/-25 versus 127+/-35 ml/m2, P=0.049), higher left ventricular ejection fraction (50+/-4 versus 32+/-4%, P<0.001) and lower coefficient of variation of percentage shortening of left ventricular transverse hemiaxes (0.3+/-0.1 versus 0.5+/-0.1, P=0.001) compared with group 2. Group 1 had higher A wave peak velocity (78+/-18 versus 60+/-20 cm/s, P=0.048), lower E/A ratio (0.9+/-0.3 versus 1.5+/-0.6, P=0.02) and slower E wave deceleration time (204+/-51 versus 155+/-50 ms, P=0.047) compared with group 2. Semiquantitative histologic scores did not differ significantly between groups. There was no significant correlation between histologic variables and left ventricular systolic and diastolic indexes. Thus, dilated cardiomyopathy shows borderline to severe left ventricular systolic impairment and distinct left ventricular diastolic filling abnormalities, according to the clinical stage. This study suggests a marked dissociation between histologic findings and functional abnormalities in early and advanced dilated cardiomyopathy.

Adult↗
PubMed1998

[Comparison of coronary arteriosclerosis in patients with myocardial infarction and angina pectoris].

PURPOSE: To compare the severity of the coronary heart disease and the presence of coronary risk factors between angina and myocardial infarction (MI) patients. METHODS: We studied 62 patients with MI and 129 with angina through coronary angiography to evaluate occlusion (lesion of 99% or 100%), extent (with a score of 0-5 derived by the number of vessels affected) and severity (3 groups of different stenosis degrees). Two experiment observers blindly interpreted the angiograms. RESULTS: Patients with MI had more occlusions (50% vs 13.2% [p < 0.01]), more severity (79% vs 54.3% with > 90% stenosis [p < 0.02]) and more extent (2.0 vs 0.87; [p < 0.001]), even when controlled for current coronary risk factors and disease duration. Smoking was the only independent risk factor related to MI (p < 0.001). CONCLUSION: Among the studied patients, coronary heart disease extent and severity was greater in the MI group, as well as the prevalence smoking.

Adult↗
PubMed1997

Postangioplasty restenosis: a practical model in the porcine carotid artery.

Transluminal coronary angioplasty is a routine therapeutic intervention in coronary heart disease. Despite the high rate of primary success, restenosis continues to be its major limitation. Porcine models have been considered to be the most adequate experimental models for studying restenosis. One limitation of porcine models is the need for radiological guidance and the expenses involved. The objective of the present study was to adapt an experimental model of angioplasty in the porcine carotid artery that does not require radiological equipment. Eight animals were used to develop the technique of balloon injury to the common carotid artery by dissection without radiological guidance. This technique was then employed in six other animals. Under anesthesia, the left common carotid artery was dissected and incised at the carotid sinus for insertion of an over-the-wire angioplasty balloon towards the aorta. Overstretch injury of the carotid artery was performed under direct visualization. After 30 days, the arteries were excised and pressure-fixated. Uninjured carotid arteries from 3 additional animals were used as controls. A decreased luminal area associated with intimal hyperplasia and medial reaction was observed in all injured arteries. Immunohistochemistry identified the intimal hyperplastic cells as smooth muscle cells. Computerized morphometry of the ballooned segments revealed the following mean areas: lumen 2.12 mm2 (+/- 1.09), intima 0.22 mm2 (+/- 0.08), media 3.47 mm2 (+/- 0.67), and adventitia 1.11 mm2 (+/- 0.34). Our experimental model of porcine carotid angioplasty without radiological guidance induced a vascular wall reaction and permitted the quantification of this response. This porcine model may facilitate the study of vascular injury and its response to pharmacological interventions.

Angioplasty↗
PubMed1997

[Thrombolytic therapy in deep venous thrombosis. Initial clinical experience].

Four cases of proximal deep venous thrombosis treated with streptokinase and tissue plasminogen activator are reported. Therapy monitorization was performed by ultrasonography with color Doppler and thrombolytic agents were used by venous infusion. There was complete lysis in two cases, and the mean rate of venous recanalization was 88%. Reversible hemorrhagic complications were observed in two patients, and late ultrasonographic control (after six months) demonstrated venous insufficiency in one case.

Adolescent↗
PubMed1995

[Acute effects of isosorbide mononitrate on blood circulation and myocardial ischemia in patients with coronary atherosclerosis].

PURPOSE: To evaluate the acute effects of isosorbide mononitrate on circulation, cardiac function and left ventricular segmental motility in patients with isquemic heart disease due to coronary artery disease. METHODS: Twenty-four patients with ischemic heart disease, 10 women, with mean age of 58 years, were studied during cardiac catheterization, at baseline condition and 5min after intravenous infusion of 0.3mg/kg of isosorbide mononitrate. RESULTS: After infusion of isosorbide mononitrate there were significant reduction in mean right atrial pressure no mean pulmonary artery pressure (< 0.0001), left ventricular and diastolic pressure (p < 0.004), left ventricular systolic pressure (p < 0.002), maximum (p < 0.002) and mean (p < 0.008) aortic pressure, and left ventricular systolic volume (p < 0.004), as well as significant increase in the left ventricular ejection fraction (p < 0.001) and mean velocity of circunferential fibers shortening (p < 0.001). There was no significant modification of minimum aortic pressure, heart rate, cardiac output nor of left ventricular and diastolic volume. With respect of segmental motility of the left ventricle after medication, 38 kypokinetic segments normalized their motility, 4 akinetic segments remained intact, and of the 21 dyskinetic segments, 6 normalized, 8 became hypokinetic and 7 remained dyskinetic. CONCLUSION: Isosorbide mononitrate, when used as intravenous infusion, have a rapid and direct effect on systemic and pulmonary circulation, and improving segmental motility and left ventricular performance in patients with impaired left ventricular motility caused by ischemic heart disease.

Adult↗
PubMed1994

[Percutaneous balloon aortic valvuloplasty in the newborn].

Two cases of aortic valvar stenosis are presented, each of them submitted to balloon valvoplasty in the newborn period, with instant relief of the obstruction and clinical improvement. Studies about the aortic balloon valvuloplasty are being accomplished, showing results similar to the surgical approach, but with lower risks.

Angioplasty, Balloon↗
PubMed1993

Atrioventricular junctional and orthodromic atrioventricular reentrant tachycardia in Wolff-Parkinson-White syndrome.

The existence of two or more types of reentrant tachycardias in the same patient with Wolff-Parkinson-White syndrome has been emphasized, and the occurrence of orthodromic atrioventricular (AV) reentrant tachycardia and AV junctional reentrant tachycardia have been well documented. This report describes a patient with Wolff-Parkinson-White syndrome in whom the phenomena of spontaneous transition from AV reentry to AV junctional reentry and adenosine-induced conversion from AV junctional reentry to AV reentry were observed.

Adult↗
PubMed1993

[Refractory heart failure and sepsis in a patient with hypertrophic cardiomyopathy].

A twenty one years old man with obstructive hypertrophic cardiomyopathy with resting gradient and which develops subacute infectious endocarditis and acute mitral regurgitation by valvular apparatus destruction. During the course occurs refractory heart failure and sepsis. The association between these diseases and difficulties in management are analyzed, and literature is reviewed. It is emphasized the high mortality of this condition and indication for surgical referral, as well the necessity for infectious endocarditis prophylaxis in patients with obstruction at rest.

Acute Disease↗
PubMed1991

[Percutaneous coronary atherectomy by the Simpson's technique].

The directional coronary atherectomy (DCA) is a percutaneous procedure which can be performed to cut and retrieve the plaque of coronary arteries. This procedure was performed by Simpson's technique at Hospital de Clínicas de Porto Alegre with success in three patients with restenosis of percutaneous transluminal coronary angioplasty (PTCA) in the anterior descending coronary. The criteria of successfully treated lesions are: tissue yield of the plaque, residual stenosis less than 30%, smoothness borders of the lesions in the end of procedure and absence of complications. Our initial experience with the method is satisfactory and DCA is an alternative to PTCA for selected cases of coronary artery disease.

Aged↗