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Biomedical subjects

Francisco Manes Albanesi Filho

Publications and source records attributed to Francisco Manes Albanesi Filho.

10 recordsLinked to original sources
PubMed2006

[Assessing autonomic function in hypertrophic cardiomyopathy].

OBJECTIVE: Assess the autonomic function in hypertrophic cardiomyopathy (HCM) through heart rate variability (HRV) and to correlate it to echocardiographic data. METHODS: Two groups were studied, and compared for gender, age and HR: A) Ten (10) patients reporting septal HCM (70% non-obstructive); B) Ten (10) healthy volunteers. HRV was analyzed along four successive stages: at rest, under controlled breathing, while bending, and controlled breathing associated to bending. Variables means were compared between groups and intra-groups in the different stages; in Group A, variables means were correlated to echocardiographic measurements (interventricular septum and left atrial diameter). RESULTS: No HRV difference was reported among groups in the first 3 stages. In the fourth stage vagal activity was shown to be higher in Group A [quadratic mean log between RR intervals (RMSSD) - 1.35+/-0.14 vs 1.17+/-0.16; p=0.019; high frequency component logarithm (LogHF)- 4.89+/-0.22 vs 4.62+/-0.26; p=0.032]. Along the stages, vagal measurements [rate of pairs of consecutive RR intervals whose difference is > or =50 ms (pNN50) and LogHF] also showed lower reduction in the third stage in Group A, while LogHF showed some increase in last stage (p=0.027), thus indicating marked parasympathetic activity in that group. Group A HRV analysis showed no difference among patients reporting larger hypertrophy or atrial diameter. CONCLUSION: 1) Parasympathetic prevalence was shown during autonomic stimulation in HCM patients; 2) No correlation was found between HRV and echocardiographic measurements under analysis.

Adult↗
PubMed2006

[Myocardial viability in a single-vessel disease: the role of a dobutamine stress echocardiography].

OBJECTIVE: To investigate a group of patients that have a significant lesion in a single-vessel and to demonstrate whether or not the sensitivity and specificity of a dobutamine stress echocardiography (DSE) was valuable in the evaluation of myocardial viability for these patients. METHODS: Twenty patients who had undergone percutaneous transluminal coronary angioplasty (PTCA) were studied. This group was evaluated 2 to 7 days (3.65 +/- 1.69) before the procedure and 2 to 5 days (4 +/- 0.80) after the procedure with a DSE. Myocardial viability was assessed three months after the procedure using a two dimensional echocardiogram. Twelve patients underwent PTCA on the left anterior descending artery (LAD), 7 on the right coronary artery (RC) and 1 on the circumflex artery (CX). Only one right coronary artery procedure was not 100% successful. RESULTS: From the 340 segments that were studied, 99 (29.18%) demonstrated contractile alterations of which 63 were hypokinetic (63.4%), 28 akinetic (28.28%) and 8 dyskinetic (8.08%). In reference to the segments involved, we obtained a sensitivity of 92.59%, specificity of 84.45%, and accuracy of 88.88% for the DSE. The solitary case of PTCA for the circumflex artery demonstrated 100% sensitivity. The LAD demonstrated a sensitivity of 88.58%, specificity of 95% and accuracy of 90.91%. For the RC segments, sensitivity was 91.30%, specificity 83.33% and accuracy 88.71%. All dyskinetic segments were unviable. The DSE predicted a 91.48% recovery rate for the 63 hypokinetic segments. CONCLUSION: The DSE is an effective test for evaluating myocardial viability in patients with a significant single-vessel disease.

Adult↗
PubMed2005

[Therapy of advanced heart failure adapted to hemodynamic objectives acquired by invasive hemodynamic monitoring].

OBJECTIVE: To assess advanced heart failure (HF) treatment in relation to reduction of ventricular filling pressures, with the use of greater doses of vasodilators, through invasive hemodynamic monitoring. METHODS: Nineteen advanced HF patients were studied, in whom Swan-Ganz catheter was inserted to direct administration of diuretic intravenously (IV) and sodium nitroprusside, with the aim of significantly reduce ventricular filling pressures. After achieving such objective or 48 hours, oral drugs were introduced until venous medicines were removed, keeping hemodynamic benefit. RESULTS: From 19 patients studied, 16 (84%) were of male sex. The average age was 66 +/- 11.4 years old; average ejection fraction was 26 +/- 6.3%; 2 patients (10.5%) showed functional class (FC) III and 17 (89.5%), FC IV. There was a decrease of pulmonary artery occlusion pressure from 23 +/- 11.50 mmHg to 16 +/- 4.05 mmHg (p = 0.008), of systemic vascular resistance index from 3,023 +/- 1,153.71 dynes/s/cm-5/m(2) to 1,834 +/- 719.34 dynes/s/cm-5/m(2) (p = 0.0001) and an increase of cardiac index from 2.1 +/- 0.56 l/min/m(2) to 2.8 +/- 0.73 l/min/m(2) (p = 0.0003). A subgroup with hypovolemia was identified. CONCLUSION: It was possible to reduce ventricular filling pressures to significantly lower values, obtaining a significant improvement of cardiac index, systemic vascular resistance index and pulmonary artery mean pressure, by using significantly higher doses of vasodilators.

Blood Pressure↗
PubMed2004

How can the echocardiogram be useful for predicting death in children with idiopathic dilated cardiomyopathy?

OBJECTIVE: To determine the echocardiographic predicting factors of death in children with idiopathic dilated cardiomyopathy. METHODS: A retrospective study of 148 children with idiopathic dilated cardiomyopathy diagnosed between September 1979 and March 2003 was carried out. The inclusion criteria were as follows: heart failure and a reduction in contractility on the echocardiogram in the absence of congenital or secondary heart disease. Four hundred and seventy examinations during a period of 244.8 months of evolution were analyzed. The following parameters were assessed: left atrial dimension (LAD); left atrium/aorta ratio (LAD/Ao); left ventricular systolic (LVSD) and diastolic (LVDD) dimensions; left ventricular mass (LVmass); right ventricular dimension (RVD); left ventricular ejection fraction (LVEF); left ventricular shortening fraction (% SH); severity of the insufficiency of the atrioventricular and pulmonary valves; and right ventricular systolic (RVSP) and diastolic (RVDP) pressures. The significance level adopted was alpha < 0.05. RESULTS: The mean age was 2.37 years, and 35 patients died (23.7%--95 CI = 17.1% to 31.2%). The analysis of variance showed the following: LAD (p<0.0001); LAD/Ao (p<0.0001); LVSD (p=0.0061); LVDD (p=0.0086); LVmass (p<0.0001); LVEF (p=0.0074); %SH (p=0.0072); and RVD (p<0.0001). Worsening of mitral (MI) (p=0.0113) and tricuspid (TI) insufficiencies (p=0.0044) were markers of death, and the presence of MI, TI, and moderate/severe pulmonary insufficiency were deleterious to survival. The Cox proportional hazards regression model showed the following independent predictors of death: LAD/Ao (p=0.0487); LVEF (<0.0001); and the presence of moderate/severe MI (p=0.0419). CONCLUSION: Patients with a progressive increase in LAD/Ao, a reduction in LVEF, and progressive worsening of MI, regardless of the clinical treatment, should be considered for early heart transplantation.

Adolescent↗
PubMed2003

Noninvasive cardiac assessment in children of women with systemic lupus erythematosus.

OBJECTIVE: Noninvasive cardiac assessment of newborns and infants of women with systemic lupus erythematosus. The children had no congenital total atrioventricular block and were compared with the children of healthy women. METHODS: We prospectively assessed 13 newborns and infants aged 1 to 60 days, children of women with systemic lupus erythematosus and without congenital total atrioventricular block. These children were compared with 30 children of women who had no lupus or anti-Ro/SSA antibodies, and no risk factors for congenital heart disease either. Their age groups matched. The following examinations were performed: cardiological physical examination, electrocardiography, echocardiography, and signal-averaged electrocardiography. RESULTS: The statistical analysis showed no significant difference in ventricular function or in the cardiac conduction system between the groups. CONCLUSION: In regard to the conduction system and ventricular function in the absence of total atrioventricular block, no statistically significant difference was observed between the children of women with systemic lupus erythematosus and children of healthy women.

Antibodies, Antinuclear↗
PubMed2003

Serum sample levels of selenium and copper in healthy volunteers living in Rio de Janeiro city.

The objective of this study was to analyze the serum sample levels of selenium and copper in healthy volunteers living in the city Rio de Janeiro. Thirty individuals were submitted for nutritional assessment, electrocardiogram, echocardiogram, and serum selenium and copper analysis through hydride generation and flame atomic absorption spectrometry, respectively. The accuracy and precision of these methods were evaluated using certified reference materials. None of the studied individuals was undernourished; 53% were overweight and 13.3% were slightly obese. The mean serum selenium level was 73.18+/-9.9 microg/l (56.50-94.50 microg/l). Among women it was 76.28+/-8.7 microg/l and in men 72.23+/-10.24 microg/l (P=0.35). Among non-white individuals the mean was 73.12+/-12.57 microg/l and in the white individuals it was 73.20+/-9.11 microg/l (P=0.98). The mean serum level of copper was 1.09+/-0.39 mg/l (0.56-1.80 mg/l). The mean found in women was 0.99+/-0.22 mg/l and in the men 1.13+/-0.43 mg/l (P=0.42). In non-white individuals it was 1.36+/-0.48 mg/l and in white individuals was 1.00+/-0.31 mg/l (P=0.02). The authors concluded that selenium and copper serum levels observed in this study were similar to those found in other cities.

Adult↗
PubMed2003

Effects of carvedilol therapy on QT-interval dispersion in congestive heart failure: is there a difference in the elderly?

In cases of chronic congestive heart failure, QT-interval dispersion is a strong predictor of death. Carvedilol therapy appears to decrease QT-interval dispersion. We investigated whether carvedilol reduces QT-interval dispersion in congestive heart failure and whether this pharmaceutical agent has additional effects on elderly patients. Seventy-seven ambulatory patients who had chronic congestive heart failure were evaluated for hypertension, diabetes mellitus, smoking, alcohol abuse, concomitant medications, and QT-interval dispersion. Carvedilol therapy was then initiated. Six months later, we re-evaluated the same variables, as well as morbidity and mortality rates, and number of hospitalizations. The patients were divided into 2 groups: Group I, aged < 65 years (n = 42); and Group II, aged > or = 65 years (n = 35). Statistics were analyzed with the Student's t-test chi2 test, and Cox regression model. At 6 months, both groups showed significantly decreased QT-interval dispersion values compared with baseline values (76.9 +/- 29.3 vs 104.3 +/- 41.5 ms, respectively; P < 0.0001). An elevated QT-interval dispersion value at baseline increased morbidity (P = 0.041) but not hospitalization (P > 0.05). Group II had a smaller reduction in QT-interval dispersion than did Group I (24.41 +/- 29.36 and 30.98 +/- 32.70 ms, respectively), but this difference was not significant. We conclude that in ambulatory patients with chronic congestive heart failure, long-term carvedilol therapy significantly decreases QT-interval dispersion, and this effect is uniformly distributed between patients aged < 65 years and those aged 265 years.

Adrenergic beta-Antagonists↗
PubMed2002

Thiamin, selenium, and copper levels in patients with idiopathic dilated cardiomyopathy taking diuretics.

OBJECTIVE: To analyze the association of thiamin, selenium, and copper serum levels with cardiac function in patients with idiopathic dilated cardiomyopathy using diuretics, and also to compare them with levels in control patients with no evidence of disease. METHODS: The study comprised 30 patients with heart disease and 30 healthy control individuals. Thiamin was analyzed by measuring the activity of erythrocytic transketolase and the effect of thiamin pyrophosphate. Selenium and copper serum levels were measured by hydride generation and flame atomic absorption spectrophotometry, respectively. RESULTS: Thiamin deficiency was observed in 10% of the control individuals and in 33% of the patients with heart disease (p=0.02). The mean selenium and copper serum levels in control individuals and patients with heart disease were, respectively, 73.2+/-9.9 microg/L (56.5 to 94.5 microg/L) and 72.3+/-14.3 microg/L (35.5 to 94 microg/L) (p=0.77); 1.1+/-0.4 mg/L (0.6 to 1.8 mg/L) and 1.2+/- 0.4 mg/L (0.6 to 2.2 mg/L) (p=0.27). No association between the levels of these nutrients and cardiac function was observed. CONCLUSION: Thiamin deficiency was significantly more frequent in patients with heart disease. No significant difference was observed between the mean selenium and copper serum levels in control individuals and in patients with heart disease. The results suggest possible benefits with thiamin replacement in patients taking diuretics.

Adult↗