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E Galve

Publications and source records attributed to E Galve.

29 records · Page 2Linked to original sources
PubMed1988

Prevalence, morphologic types, and evolution of cardiac valvular disease in systemic lupus erythematosus.

We performed echocardiography prospectively 4.9 +/- 0.7 years apart (mean +/- SD), in 74 patients with systemic lupus erythematosus. On the basis of the first study, the patients were distributed in four groups according to the type of valvular involvement: 7 patients had vegetations (Libman-Sacks endocarditis; group 1); 6 patients had rigid and thickened valves with stenosis, regurgitation, or both (group 2); 5 patients had miscellaneous forms of valvular involvement without valvular dysfunction (group 3), as did the 60 controls; and 56 patients had no valvular disease (group 4). The overall prevalence of clinically important valvular disease (groups 1 and 2) was 18 percent. Patients in group 1 were younger than those in group 2 (33.5 +/- 16.7 vs. 47.8 +/- 17.6 years; P less than 0.05), had a shorter mean duration of lupus (4.8 +/- 2.2 vs. 10.7 +/- 6.4 years; P less than 0.001), and had received a smaller cumulative dose of steroids (21.5 +/- 13.1 vs. 79.5 +/- 63.4 g of methylprednisolone or its equivalent; P less than 0.05). During the five-year follow-up, one patient in group 1 and five in group 2 required valve surgery, no patient in group 3 had valvular dysfunction, and five patients in group 4 had mild valvular lesions. We conclude that clinically important valvular involvement in systemic lupus is relatively frequent and sometimes requires surgery. Echocardiography can identify a subset of lesions (valvular thickening and dysfunction), other than verrucous (Libman-Sacks) endocarditis, that are prone to hemodynamic deterioration.

Adolescent↗
PubMed1988

[Function of the right ventricle in interauricular communication in adults].

This study was designed prospectively to analyze the influence of age and operation on right ventricular function in atrial septal defect; 17 patients were studied by means of radionuclide studies performed immediately before and approximately 6 months (5,8 +/- 2,3) after surgery. The pulmonary/systemic flow ratio (Qp/Qs) was determined by first pass technique, and right ventricular ejection fraction and peak filling rate were determined by equilibrium ventriculography. In addition, all patients had preoperative catheterization. According to age, patients were divided in group I (less than 35 years) and group II (greater than or equal to 35 years). Preoperatively, patients in group I, in comparison to group II, had better ejection fraction (48 +/- 8 vs 36 +/- 7; p less than 0.01), and better peak filling rate (3.7 +/- 0.9 vs 2.6 +/- 0.7; p less than 0.01), while Qp/Qs were not significantly different (2.5 +/- 0.8 vs 3.0 +/- 1.6) and pulmonary vascular resistances were less elevated (69 +/- 32 vs157 +/- 95 dynes/sec/cm-5; p less than 0.01). After surgery, right ventricular function did not significatively change in relation to preoperative data in both groups (ejection fraction: 44 +/- 13 and 34 +/- 5, respectively; peak filling rate: 3.3 +/- 1.4 and 2.1 +/- 0.6). We conclude that in atrial septal defect indexes of systolic and diastolic right ventricular function deteriorate with age, these changes being associated with a slight increase in pulmonary vascular resistance without changes of Qp/Qs; right ventricular dysfunction does not tend to improve postoperatively.

Adolescent↗
PubMed1986

Pericardial effusion in the course of myocardial infarction: incidence, natural history, and clinical relevance.

Incidence and significance of pericardial effusion in patients with acute myocardial infarction (AMI) have not been established. To evaluate these issues, we studied prospectively 138 consecutive patients with AMI. An echocardiogram was obtained in each 1, 3, and 10 days and 3 and 6 months after admission. Fifty four patients with unstable angina and 57 without heart disease were studied as controls. Echocardiographic diagnostic criteria of pericardial effusion were established from 33 additional patients undergoing surgery. Pericardial effusion was found in 28% of patients with AMI. Twenty-five percent of patients with AMI had pericardial effusion on the third day, vs 8% of patients with unstable angina (p less than .02) and 5% of patients without heart disease (p less than .01). At 1, 3, and 10 days and 3 and 6 months prevalence of pericardial effusion was 17%, 25%, 21%, 11%, and 8%, respectively. There was no case of tamponade. Pericardial effusion was more common in anterior AMI (p less than .02) and in patients with heart failure (p less than .05) but it was not significantly associated with early pericarditis, peak creatine kinase-MB, the level of anticoagulation, or mortality. Thus, pericardial effusion is a common event in patients with AMI (incidence of 28%), but does not result in specific complications. The reabsorption rate of pericardial effusion is slow and, in our experience, mild or moderate pericardial effusion does not preclude heparin therapy.

Adult↗
PubMed1984

Bidirectional shunt in uncomplicated atrial septal defect.

The presence of right to left shunts at atrial level in 40 patients with an uncomplicated atrial septal defect was determined by measuring the pulmonary vein to systemic artery oxygen stepdown . In six patients (group 1) a sizeable right to left shunt was found: left atrial oxygen stepdown was greater than or equal to 0.7 vol%, mean right to left shunt 0.67 1/min/m2 (range 0.36-1.0), and arterial oxygen saturation between 84% and 90.5%. The patients in group 1 did not show any differences from those with left to right shunts alone (group 2) as regards sex, cardiac rhythm, heart rate, "a" wave and mean right atrial pressure, end diastolic right ventricular pressure, morphology of diastolic right ventricular pressure curves, pulmonary to systemic vascular resistance ratio, size of the defect, and coexistence of anomalous pulmonary venous drainage. Patients with coexisting right to left shunts were, however, significantly older and had smaller left to right shunts. Thus an appreciable number of patients with uncomplicated atrial septal defects have major right to left shunts which are unrelated to pulmonary hypertension or right heart failure. These shunts may be detected by the usual oximetric techniques and apparently develop with age, which suggests that they result from changes associated with chronic right volume overload.

Adolescent↗
PubMed1983

Useless diagnostic value of exercise-induced R wave changes in coronary artery disease.

To investigate the usefulness of exercise-induced R wave changes in the diagnosis of coronary artery disease and detection of left ventricular contraction abnormalities, 105 patients were studied. Among 64 patients who had significant coronary artery disease (greater than or equal to 70% narrowing), 43 showed an increase or no change in the R wave amplitude and 55 showed ST segment depression (sensitivity 67 versus 86%). Among 41 patients without significant stenosis, 11 had decreased R wave amplitude and 36 had no change in ST segment (specificity 27 versus 88%). Twenty-five of 64 coronary disease patients had left ventricular contraction abnormalities, and the R wave amplitude changes gave a sensitivity of 80%, specificity of 41% and a predictive value of 47%. There were no differences in the variables of exercise intensity and ejection fraction between patients who had decreased R wave amplitude and those in whom it increased or did not change. We conclude that R wave amplitude change during exercise is not a useful variable for the diagnosis or evaluation of patients with coronary artery disease.

Adult↗
PubMed1980

[Clinical and bacteriological aspects of purulent pericarditis (author's transl)].

The clinical and bacteriological characteristics of eight cases with purulent pericarditis observed over the last five years are studied. The route of the infection and dissemination in the majority of the cases (75 percent) was through pleuropulmonary lesions in the form of pneumonia and/or empyema, attributing the remaining cases to a subhepatic abscess and a pericardial infection after a thoracic surgical operation. In seven patients the diagnosis of the disease was established while they were alive. The more orientative clinical data were the pericardial pain (50 percent), pericardial friction murmur (25 percent), and signs of cardiac tamponade (62.5 percent). The observation of the above mentioned clinical signs together with the presence of cardiomegaly and electrocardiographic alterations suggestive of pericarditis, obliged the practice of a pericardial puncture, which confirmed the diagnosis of a purulent pericarditis by the macro and microscopic characteristics of the fluid. Staphylococcus and pneumoncoccus were isolated in two cases, respectively; other Gram-negative bacillus (E. coli and Pseudomonas aeruginosa) were isolated in the remaining cases. All patients were treated with the appropriate antibiotic according to the isolated germ; surgical drainage was carried out in six cases, and a pericardiectomy in one. Two patients died, one as a consequence of a septic myocardiopathy and the other in which the diagnosis of purulent pericarditis was not clinically suspected. During the follow-up period one case presented a constrictive pericarditis, which was corrected by a pericardiectomy.

Adolescent↗