[Unnoticed hypothyroidism and myopathy due to lipid-lowering drugs].
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Biomedical subjects
Publications and source records attributed to G Gascón Ramón.
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INTRODUCTION AND AIMS: To analyze the influence of variations in the length of cardiac cycle length of calculating mitral valve area by means of the pressure half time in patients with mitral valve stenosis and atrial fibrillation. METHODS: Fifty-nine patients with pure mitral valve stenosis and atrial fibrillation were subjected to transmitral flow measurements by continuous Doppler monitoring from the apical window. In each patient the pressure half time was quantified, corresponding to a minimum of 30 consecutive cycles. RESULTS: Considering all the measurements made in each patient, the correlation between pressure half time and cardiac cycle was significant in 20 cases (34%). The pressure half time variation coefficients were significantly greater when including the values corresponding to the shortest cycles. Thus, for cycle duration of > or = 800, 700, 600, 500 and 400 ms, the mean values were 0.096 +/- 0.041, 0.106 +/- 0.042 (NS), 0.128 +/- 0.032 (p < 0.05), 0.167 +/- 0.048 (p < 0.001) and 0.231 +/- 0.057 (p < 0.0001), respectively. Upon analyzing the relation between pressure half time and cardiac cycle with progressive exclusion of the longer cycles > or = 800, 700 and 600 ms the number of patients with significant correlation coefficients increased to 19/37 (51%), 12/23 (52%) and 4/6 (67%) on respectively excluding. CONCLUSIONS: Patients with mitral valve stenosis and atrial fibrillation show a variation in pressure half time that may complicate calculation of the mitral valve area. Variability is inherent to the measurement method, and is furthermore dependent upon cardiac cycle duration. This may be resolved by limiting determinations to cycles longer than 800 ms.
The aim of this work is to review the role of the main risks factors in relation to cardiovascular diseases, and to evaluate the relative effectiveness of different preventive strategies. In the first part of the paper we summarize the historical background that allows us to understand the magnitude of this problem and its evolution. Secondly, we evaluate the significance of these strategies in the primary prevention of stroke and myocardial infarction, and how an intervention in one risk factor can have a greater significance for one of these events. But in any case, we must consider the whole benefit in each patient's health in our final evaluation of this intervention. Finally, we describe the strategies for hypertension and diabetes in order to reduce the incidence of end renal disease.
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