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Biomedical subjects

A M Alonso Gómez

Publications and source records attributed to A M Alonso Gómez.

15 recordsLinked to original sources
PubMed1999

[Giant-cell myocarditis simulating an apical myocardial infarct].

We present a case of a 57-year-old man with a giant-cell myocarditis that made its debut as a sustained ventricular polymorphic tachycardia interpreted in the context of old apical myocardium infarct, with a posterior evolution towards refractory heart failure, which finally needed urgent cardiac transplantation. We explain the characteristics of this unusual myocarditis, which has a poor prognosis, and also the results of the laboratory techniques that led to an equivocal diagnosis in this patient.

Diagnosis, Differential↗
PubMed1997

[II. Role of Doppler echocardiography in the management of chronic ischemic cardiopathy].

Doppler echocardiography is a simple, fast and non-invasive method to identify abnormal regional and global left ventricular function. One could consider this method the best application for this end within the techniques of imaging. This chapter reviews the role of Doppler echocardiography in the management of chronic coronary artery disease, as well as for studying the global and regional function at rest, as in the applications derived from their use during stress testing. Frequent techniques of stress echocardiography for the diagnosis of ischemic heart disease, their utility in the study of myocardial viability, and the establishment of recommendations for their use in clinical practice are analyzed.

Cardiotonic Agents↗
PubMed1997

[Usefulness of exercise Doppler in the diagnosis of severe mitral stenosis].

BACKGROUND: Exercise in mitral stenosis produces an increase in cardiac output and heart rate which determines the increment in the transmitral gradient. However, it has not yet been established what level is reached by the gradients on exercise in severe mitral stenosis nor whether the rise in the gradient during such exercise is different to that occurring in non-severe stenosis. OBJECTIVE: To evaluate the effect of exercise in patients with severe mitral stenosis on the mitral valve gradients in absolute values and on the increment with respect to base values. METHODS: Forty-eight mitral stenosis patients (mean age: 48.8 +/- 11 years) underwent 50 exercise Doppler echocardiographic studies using supine bicycle ergometry in two stages with increases of 25 W every 3 minutes; from each of these we obtained the peak and mean mitral gradient using a non-imaging continuous-wave Doppler probe. We also conducted this procedure on 14 patients with a mean age of 50 +/- 6 who had Bjork mitral prostheses which were functioning normally. RESULTS: We defined a hemodynamic profile of severity based on the data from 18 patients whose basal mitral valve areas was < 1.2 cm2 (group I), and compared them with the data from the 32 studies of mitral stenosis patients with an area > 1.1 cm2 (group II) and with the patients with mitral prostheses (group III). The mean mitral gradient (mmHg) in group I was greater than in group II at rest (9.3 +/- 3.2 and 6.6 +/- 2.7; p < 0.001), at 25 W (20.6 +/- 4.8 and 14.1 +/- 5; p < 0.001) and at 50 W (25.9 +/- 5.4 and 17.3 +/- 5.8; p < 0.001). The increase in mean mitral gradient from the baseline to 50 watts was 16.7 +/- 4.5 mmHg in group I, which was greater than in group II and III (11.1 +/- 4.1 and 6.8 +/- 2.6 mmHg; p < 0.001). CONCLUSIONS: Exercise Doppler echocardiography enabled us to define a differential hemodynamic profile in patients with severe mitral stenosis which can be used in isolation as an indicator of severity in this condition.

Adult↗
PubMed1993

[The prescription of physical exercise in the individual with aortic prostheses. The role of Doppler exercise study].

BACKGROUND AND OBJECTIVES: Exercise Doppler echocardiography allows measure valvular gradient during exercise, that could be useful in the prescription of physical activity in patients with a prosthetic aortic valve. METHODS: Exercise Doppler echocardiography was performed in 50 patients (mean age 53 +/- 12 years) with normally-functioning aortic prosthesis. Maximal exercise was performed by supine bicycle ergometry in 35 and modified Bruce protocol in 15. Continuous wave Doppler examinations were obtained at rest, during and at maximal exercise with a nonimaging transducer. RESULTS: The mean value of workload was 6.9 +/- 2 METS and there were no complications. Gradients at peak exercise were available in 43/50 patients. Exercise induced a statistic significant increase in the heart rate (76 +/- 14 to 136 +/- 26), systolic blood pressure (128 +/- 19 to 182 +/- 19 mmHg), peak gradient (29 +/- 9 to 61 +/- 17 mmHg) and mean gradient (16 +/- 5 to 32 +/- 9 mmHg). The gradient was greater than 59 mmHg in 18/43 patients, greater than 69 mmHg in 12/43 and greater than 79 mmHg in 5/43. CONCLUSIONS: Prescription of exercise in patients with aortic prosthesis requires perform an exercise Doppler echocardiography to measure the increase of valvular gradient with the exercise in each patient, since the stress testing could be normal, it can advise a rate of physical activity that determine very high prosthetic gradients.

Adult↗
PubMed1993

[The role of Doppler of effort in the indications for percutaneous valvuloplasty and/or mitral surgery in patients with a preserved functional class].

We have evaluated in this study the role of exercise Doppler echocardiography to establish the clinical indication of invasive procedures in patients with mitral stenosis and preserved functional class. Thirty-tree patients, mean age 45 +/- 9 years, underwent 35 exercise Doppler studies by supine bicycle ergometry with a 2 MHz nonimaging continuous wave Doppler probe. Sixteen patients were in N.Y.H.A. class I and 19 in class II. Peak and mean mitral gradient were obtained at rest, during, at maximal exercise and at recovery period, averaging at least 5 cardiac cycles. The data of 16 patients with mitral area at rest < 1.2 cm2 (group I) were compared with the data of 19 patients with mitral area at rest > 1.1 cm2 (group II). The mean gradient (mmHg) in the group I compared with respect group II was significantly higher at rest (9.5 +/- 3 vs 6 +/- 3, p < 0.01), step 1 (21 +/- 5 vs 14 +/- 6, p < 0.001), step 2 (26.4 +/- 5 vs 17.9 +/- 6, p < 0.001), step 3 (26.5 +/- 4 vs 20.7 +/- 6, p < 0.01), step 4 (29.8 +/- 5 vs 23.8 +/- 4, p < 0.05) and peak exercise (31.4 +/- 4 vs 21.9 +/- 6, p < 0.001). The functional capacity in mets was similar in both groups (6.7 +/- 1 vs 7.2 +/- 2, p = NS). Three patients of group I (15.7%) showed the same increase of gradient as group I. We conclude that exercise Doppler echocardiography allow identification of the haemodynamic severity of patients with mitral stenosis and preserved functional class. This technique could be a good tool in clinical indication of invasive procedures in these patients.

Adult↗
PubMed1990

[Calculation of the mitral valve area using Hatle's method. Effect of the preload change induced by nitrates].

The aim of the present study was to assess the effect of changes in preload induced by nitrates on calculated mitral valve area by Doppler pressure half-time. Forty patients (mean age 51 +/- 10 years), 23 with mitral stenosis, ten with mechanical prosthesis and seven with bioprosthesis were studied by Doppler echocardiography. Twelve were in sinus rhythm and 28 had atrial fibrillation. Mitral valve area by Doppler pressure half-time, peak and mean mitral gradient and pulmonary artery systolic pressure were measured before and after isosorbide dinitrate (5 mg) or nitroglycerin (0.4 mg). The nitrates produced a significant reduction of pre-load in total group (p less than 0.001) but did not change the mitral valve area (1.9 +/- 0.8 to 1.9 +/- 0.8). The subsets of patients with size valvular area (greater than 2 cm2, less than 2 cm2, less than 1.5 cm2, mechanical prosthesis, bioprosthesis, sinus rhythm and atrial fibrillation) had an insignificant change in mitral valve area after administration of nitrates. We conclude that the mitral valve area by Doppler pressure half-time method do not modify in different conditions of preload. These findings remain in patients with prosthesis, different sizes of mitral valve area and atrial fibrillation.

Adult↗