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Biomedical subjects

J Peteiro

Publications and source records attributed to J Peteiro.

34 records · Page 2Linked to original sources
PubMed1990

[Functional capacity and rhythm changes after atrial correction of transposition of great arteries].

A group of 12 patients, previously submitted to atrial correction of the transposition of the great vessels, were studied through stress test with direct metabolimetry and Holter to assess aerobic functional capacity and its relationship with conduction disturbances. The results were compared with those obtained with a control group of 23 non athletic healthy children. All the patients showed amputation of their heart rates on effort, though this parameter and the oxygen consumption were normal at low work load levels. The VO2 at anaerobic threshold, the maximum VO2, and the maximum work load were also decreased in most of the patients. Holter studies demonstrated sick sinus syndrome in nine of them. Aerobic functional capacity was reduced in most of the patients with atrial correction of the transposition of the great vessels. The amputation of the heart rate on effort is a common finding though its relationship with the decrease of the aerobic functional capacity in these patients is limited. Finally, the stress test is probably more sensible than Holter for the detection of slight degrees of sinus disfunction.

Adolescent↗
PubMed1990

[Postoperative left ventricle-right auricle fistula: a case report].

We present a case of a postoperative left ventricular--right atrial shunt in a 46 year-old patient operated for aortic valvulopathy. Through two-dimensional echocardiography and hemodynamic studies a communication between the left ventricle and the right atrium was observed. We review the literature about this rare anomaly.

Cardiomyopathies↗
PubMed1990

Utility and tolerance of stress testing in geriatric patients.

OBJECTIVES: To determine the sensitivity and specificity of stress testing in geriatric patients and to estimate the tolerance of these patients to exercise. DESIGN: A prospective study done in two populations with different ages. SETTING: Cardiologists and a stress testing laboratory. PATIENTS: Persons with ages above and under 65 years who were admitted in our center and submitted to stress testing and coronary angiography for suspicion of ischemic heart disease. PROCEDURES: All stress tests were performed on a Siemens Elama cicloergometer model 380-B adapted to a Hewlett Packard 1517 A ECG recorder. Our protocol started with an initial work load of 30 Watts with increments of other 30 Watts every three minutes. A 12 lead ECG was registered at rest, at maximum effort and in the recovery phase (approx. eight minutes after maximum effort). Three leads ECG's (V2, aVF, V5) were registered every three minutes. Stress finishing criteria were: symptom's limited, fatigue and maximum heart rate (220-age). Blood pressure was also controlled every three minutes during exercise and every two minutes during the recovery phase. Coronary angiographies were performed on a Siemens Cardoskop U (cine) using the Judkins technique. Left anterior oblique, right anterior oblique and postero anterior projections were used in all the procedures. RESULTS: Stress testing presents high sensitivity and low specificity in geriatric patients. A good tolerance to exercise was observed in this group of patients. CONCLUSIONS: A similar sensitivity was observed in the stress tests performed by patients with ages above and under 65 years. Sensitivity seems to be related to the severity of the coronary lesion. On the other hand stress testing presented a lower specificity in the geriatric patient. Finally, good tolerance to exercise was observed in patients older than 65 years.

Aged↗
PubMed1990

[Aneurysm of interauricular septum associated with mesosytolic click].

An echocardiographic study was performed to a patient with symptoms of cardiac failure and midsystolic click confirmed by phonocardiography. The echocardiograms suggested an incipient dilated myocardiopathy and also atrial septal aneurysm. We report the relationship between midsystolic click and atrial septal aneurysm.

Heart Aneurysm↗
PubMed1989

[Coronary ectasis: another form of atherosclerosis].

In a review of 3,693 coronary angiographies carried out in our department for suspected coronary artery disease we evaluated the 69 patients (1.86%) in whom lesions of coronary ectasia were found. Most of them (n = 51) had associated stenotic lesions and only 18 patients had isolated ectasia. The most common localization of the 96 ectasia lesions found in these patients was the right coronary artery, followed by the left anterior descending and, finally, the circumflex coronary artery. The ectasia lesions were classified according to the morphological classification proposed by Ducceschi in the following types: I) fusiform; II) saccular; III) spherical; IV) linear or diffuse, and V) mixed. Most lesions in our series were diffuse. Regarding clinical features, significant differences were found in the higher incidence of atypical angina presentation in those patients with isolated ectasia lesions.

Aged↗
PubMed1989

[Sensitivity and specificity of the exertion test in elderly patients].

One hundred and fifty four patients who presented at our Institution for suspected coronary artery disease were evaluated. They were divided in two groups: A) 77 patients older than 65 years (X = 68.35 +/- 2.99 years), and B) 77 patients younger than 65 years (X = 51.01 +/- 7.50 years). Diagnostic exercise test and coronary angiography were performed in all. Most tests in both groups were terminated due to physical exhaustion (71% and 74% in groups A and B, respectively). During the exercise test there was a higher incidence of ventricular premature beats and lower limb pain in the older group, while angina was more common in the younger group. The overall sensitivity of the test was similar in both groups (88%), with a high prevalence in both (86% in group A and 78% in group B). The sensitivity regarding the extension of coronary artery disease was higher for the detection of one-vessel disease in the younger group (76% vs 63%), while it was higher in the older group for the detection of two and three-vessel disease (86% and 91% vs 84% and 80% in the younger group).

Aged↗
PubMed1989

[Left ventricular diverticulum at the subaortic level].

We report a case of a left ventricular diverticulum located immediately under the aortic valve ring. The patient presented both aortic insufficiency and stenosis, and was submitted to valve replacement surgery and closure of the diverticulum. The peculiarity of this case relies on its non atherosclerotic etiology, its unusual location and also because of the calcification of the diverticulum's wall.

Aortic Valve Insufficiency↗
PubMed1989

[Echocardiographic diagnosis of a hydatid cyst localized at the intraventricular septum].

A patient with case of an hydatid cyst located in the interventricular septum is presented. The two-dimensional echocardiography clearly visualized the cystic configuration of the disease, demonstrating its great usefulness for detecting this type of cardiac pathology. The patient underwent surgery with extracorporeal circulation. In this article we also discuss the surgical indications of this pathology.

Adult↗
PubMedDate not supplied

[Changes in rhythm and conduction after atrial correction of transposition of great vessels].

Disorders of rhythm or conduction after correction by baffle of transposition of the great arteries (TGA) has been widely reported. In order to avoid them, transformations on Mustard original technique have been carried out. We analize here the incidence of arrhythmias during the follow up of 20 patients operated, following a modification of the Mustard technique, as well as the postoperative changes on the P wave. The 75% of the patients remained in sinus rhythm during the postoperative first year, but only 28% continued on it after 6 years. The rest of the patients presented nodal or low auricular rhythm, alternating with sinus rhythm. Seven patients fulfilled diagnostic criteria of sick sinus syndrome. Ninety five percent of the patients were asymptomatic. The 9 patients that performed a stress testing after operation presented sinus rhythm and heart rate acceleration, in spite of the rhythm was nodal at the beginning in 4 of them. The modifications of the Mustard technique apparently do not avoid the arrhythmias and disorders of conduction. Nevertheless, the exercise tolerance remain acceptable.

Adolescent↗
PubMedDate not supplied

[Echocardiographic study following corrective surgery for transposition of the great arteries using a baffle].

Sixteen patients undergoing corrective surgery of transposition of the great arteries following Arcas' technique were studied by echocardiography. Mean age was 8.7 years, ranging from 2 to 25 years. The echocardiographic studies were performed between 6 months and 10 years after surgery (X: 5.6 years). Paradoxical movement of the interventricular septum, right ventricle dilatation, diastolic fluttering of the mitral valve and tricuspid incompetence are commonly recorded. Tricuspid insufficiency does not necessarily mean right ventricular disfunction in these patients. Due to the particular baffle shape, bidimensional echocardiographic recognition of superior cava vein obstruction is easy. In addition, the waves of cava veins showed a characteristic pattern with predominant diastolic wave, which is an argument against its obstruction. In conclusion, echo and Doppler studies are reliable means for an adequate follow-up of these patients.

Adolescent↗
PubMedDate not supplied

Unreliability of echocardiographic and Doppler indexes in the diagnosis of heart transplant acute rejection.

OBJECTIVE: To investigate the value of Doppler echocardiography to diagnose heart transplant acute rejection in both patients submitted to the standard surgical technique (Group A), and to a new technique that preserves the size of the left atrium and leaves the right atrium intact (Group B). METHODS: 122 Doppler echocardiographic studies and endomyocardial biopsies were performed on 27 group A and 11 group B patients. Systolic measurements included left ventricular shortening fraction, left ventricular endsystolic stress and tricuspid ring systolic displacement. Diastolic indexes investigated were left and right ventricle filling and superior vena caval flow parameters. RESULTS: As expected, right atrium was smaller in group B(p < 0.01). In group A, peak early to late mitral flow velocity increased, as did the rejection grade; whereas in group B it decreased. Pericardial effusion was seen more frequently in group B rejectors (> or = 3) than non-rejectors (63% vs 27%, p < 0.01). Right heart pressures (right ventricular end-diastolic and right atrial mean) were slightly higher for group A and B rejector patients (p < 0.05 when comparing right ventricular end-diastolic pressure in rejector to non-rejector group B patients). Left ventricular isovolumic relaxation time was reduced during subsequent rejection episodes in the same patient, but sensitivity of 15% left ventricular isovolumetric relaxation time reduction for rejection > or = 3 diagnosis was only 22% with a specificity of 73%. No significant intrapatient changes were found in other Doppler-derived systolic or diastolic indexes. CONCLUSION: Doppler echocardiography does not diagnose heart transplant acute rejection with enough reliability to avoid endomyocardial biopsies.

Acute Disease↗