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Biomedical subjects

J Verdejo

Publications and source records attributed to J Verdejo.

At least 37 records · Page 2Linked to original sources
PubMed1985

Hemodynamic effect of hydralazine in interstitial lung disease patients with cor pulmonale. Immediate and short-term evaluation at rest and during exercise.

Hydralazine was administered short-term to 13 patients who had stable interstitial lung disease (ILD), pulmonary arterial hypertension (PAH); mean pulmonary arterial pressure ( [PAP]=26 +/- 9 mm Hg), and cor pulmonale (CP). All patients were studied at rest and during exercise. After intravenous hydralazine at rest, there were statistically significant increases in cardiac index (CI) (p less than 0.001), arterial oxygen saturation (SaO2) (p less than 0.01), and mixed venous saturation (S-vO2) (p less than 0.01). Pulmonary vascular resistance (Rp) (p less than 0.005) and systemic resistance (Rs) decreased (p less than 0.001), and PAP did not change. During exercise, PAP did not change; however, CI (p less than 0.01), PaO2 (p less than 0.001), and S-vO2 (p less than 0.01) increased further. The increase in Rp was significantly reduced (p less than 0.01). After continuation of oral hydralazine therapy in 12 patients for 7 days, PAP at rest was not statistically different from control; Rp and Rs remained decreased (p less than 0.001). The same results were found for CI, PaO2, S-vO2, and Rs during exercise. Although PAP did not change from control values, the drug significantly reduced the increase in Rp (p less than 0.005). Vasodilator therapy with hydralazine could be useful in patients with stable ILD who have inflammation with minimal to moderate fibrosis and PAH and might be used as an adjunct to conventional therapy for ILD and CP.

Administration, Oral↗
PubMed1984

Hemodynamic effect of hydralazine in advanced, stable chronic obstructive pulmonary disease with cor pulmonale. Immediate and short-term evaluation at rest and during exercise.

Hydralazine was administered to eight patients (mean age, 69 +/- 2 years) who had stable, advanced chronic obstructive pulmonary disease (COPD), pulmonary arterial hypertension (mean pulmonary arterial pressure, 31 +/- 3 mm Hg), and cor pulmonale. All of the patients were studied at rest and during exercise. After intravenous administration of hydralazine at rest, there were statistically significant increases in pulmonary arterial pressure (p less than 0.05), cardiac index (p less than 0.005), arterial oxygen saturation (p less than 0.01), and mixed venous saturation (SvO2) (p less than 0.005). Pulmonary vascular resistance did not change, and systemic resistance decreased (p less than 0.005). During exercise, pulmonary arterial pressure increased in all patients, and this increase was not blunted by hydralazine; however, cardiac index (p less than 0.005), arterial oxygen pressure (p less than 0.005), and SvO2 (p less than 0.001) increased further during exercise. The increase in pulmonary vascular resistance was significantly blunted by hydralazine (p less than 0.005). Therapy with the drug was continued orally in seven patients because one patient showed a deleterious response in pulmonary hemodynamics. After seven days of oral hydralazine, pulmonary arterial pressure and pulmonary vascular resistance were not statistically different from control. There were statistically significant increases in cardiac index (p less than 0.005) and SvO2 (p less than 0.05), systemic resistance decreased (p less than 0.01). The same condition was found during exercise; however, only two patients showed pulmonary gas exchange and pulmonary hemodynamic benefit at rest and during exercise with hydralazine therapy. Our results suggest that it is unlikely that vasodilator therapy with hydralazine will be useful in patients with advanced stable COPD and cor pulmonale who seem to have fixed pulmonary vascular disease.

Aged↗
PubMedDate not supplied

[Hyperhomocysteinemia as risk factor in a Mexican population].

Hyperhomocysteinemia is considered one of the emerging risk factors for the development of coronary artery disease (CAD). In order to know the prevalence of this metabolic disorder in a Mexican population with early CAD (< 50 years), we studied a group of these patients and compared the levels of homocysteine with a group of patients, paired by age and gender, without angiographic evidence of coronary atherosclerosis. Preliminary results show that the population with early CAD has more traditional risk factors, specially diabetes mellitus, and higher levels of homocysteine in plasma. Moreover there is a genetic factor with higher incidence of a TT homozygotic mutation of the MTHFR that increases homocysteine because of an altered folate metabolism.

Adult↗
PubMedDate not supplied

[Rupture of the interventricular septum in acute myocardial infarct].

Ventricular septal rupture in patients with acute myocardial infarction is not a common complication. It was found in 20 patients of 4298 admitted to the coronary care unit of the Instituto Nacional de Cardiología Ignacio Chávez from January 1980 to March 1991. The diagnosis was made by right heart catheterization if 85%, by echocardiography in 35% and by postmortem study in 15% of the patients. Mortality was 70%. In all patients the functional class worsened after the rupture, from class I to III or IV. There were not significant differences in mortality in relation to risk factors, or hemodynamic findings. Mortality was higher in older patients, females and patients with anterior myocardial infarction. Angiographic studies did not increase mortality and are necessary to establish an early surgical treatment.

Age Factors↗
PubMedDate not supplied

[Premature atherosclerosis in a 17-year-old male with diabetes mellitus and familial dyslipoproteinemia].

A 17-year-old male was admitted with an acute myocardial infarction. A coronarography showed 90% occlusion in of the descendent anterior artery. A coronary angioplasty was done with excellent response. As coronary risk factors he had diabetes mellitus for 5 years and dyslipidemia with a phenotype IIb and hypo-alpha-lipoproteinemia. The case is discussed in regard to the possible etiopathogenic causes for his premature atherosclerosis.

Adolescent↗
PubMedDate not supplied

[The recurrence of a right atrial myxoma. Apropos a case].

Cardiac myxomas are the most frequent cardiac tumor and they have the capability for growing again years after resection. We have recently reviewed such cases at the Instituto Nacional de Cardiología "Ignacio Chávez" and no cases of recurrence of these tumors was detected. In this paper we inform a case that had recurrence of the tumoral mass 4 years after successful resection of the primary one. There were two masses in the right atrium of different sizes. To our knowledge this is the first case with this characteristic.

Adult↗
PubMedDate not supplied

[Clinical development of the in-hospital phase of acute myocardial infarction in patients treated with intravenous streptokinase].

In order to determine the clinical in-hospital course of patients with acute myocardial infarction treated with intravenous Streptokinase (SK), 132 patients were studied divided as follows: Group I: 44 patients who arrived to the hospital within 6 hours from the onset of symptoms and received fibrinolytic therapy. Group II: 44 patients who arrived more than 6 hours delay and did not receive SK. Group III: 44 patients who arrived less than 6 hours delay but they did not receive SK. The overall hospital mortality was 2.2% in the SK recipients versus 4.4% in the group II (Odd ratio 0.95, p = NS) and 13.6% in group III (Odd ratio 0.79, p greater than 0.05). The incidence of hemorrhagic episodes was not increased in SK recipients. In-hospital period differences between groups were explained by protocol studies and postoperative complications in patients that needed further revascularization procedures.

Aged↗
PubMedDate not supplied

[Effects of nifedipine in patients with unstable chronic obstructive pulmonary disease].

The hemodynamic and gas exchange effects of 20 mg of nifedipine (NFD), at rest and exercise were evaluated in seven patients with unstable COPD and pulmonary hypertension. The cause of instability was pulmonary infection (n = 6) and pulmonary emboli (n = 1). At rest, pulmonary hypertension (Pp = 40 +/- 3 mmHg), severe hypoxemia (PaO2 +/- 2 mmHg) and elevated pulmonary vascular resistance (Rp) = 9 +/- .6 u.sq.m, were found. At exercise, Pp raised to 52 +/- 5 mmHg with no change in cardiac index (CI), Rp or gas exchange. After NFD at rest, significant (p less than 0.05) increases in CI, oxygen transport and venous admixture occurred. Also, Rp and systemic arterial pressure and resistance decreased significantly. Pp and blood gas exchange did not vary. Rp and systemic resistance were lower at exercise after NFD than without the drug with no change in blood gas exchange. The pulmonary flow pressure relationship showed a right shift after NFD in both, rest and exercise conditions. We conclude that NFD can be of value for the management of pulmonary hypertension that aggravates COPD.

Adult↗
PubMedDate not supplied

[Pulmonary blood volume in patients with interstitial pneumopathy and pulmonary heart disease. Its study at rest and during exercise].

Pulmonary blood volume (PBV) measurements have been reported in chronic lung disease that do not include diffuse interstitial lung disease (ILD) and cor pulmonale (CP). In this study, PBV was measured using the double injection single sampling method, at rest and at exercise in ten patients with ILD due to extrinsic allergic alveolitis (n = 6) or usual interstitial pneumonia (n = 4). Lung biopsies were obtained in 8 patients, and in none of them the stage of fibrosis was predominant over inflammation. The degree of vascular lesions was in four patients grade I and in four grade II (Heath-Edwards classification). At rest, most of the patients had elevated mean pulmonary artery pressure (PAP) and vascular resistance (PVR), (mean PAP 30 +/- 4 mmHg and 336 +/- 171 d.s. cm.-5, respectively), hypoxemia (paO2 = 48 +/- 2 mmHg) and a severely reduced PBV (53.6 +/- 11 ml.s.qm.). At exercise, pulmonary arterial hypertension worsened and, although PBV value increased significantly (rest = 53.6 +/- 11.6 ml.m2, s.qm. exercise 132 +/- 28 ml.s.qm.p less than 0.01) it remained abnormally low with respect to normal value. Comparison of the mean intravascular pressure-PBV measurements relationship in different lung diseases showed that ILD patients with CP have the greatest abnormality. Possible explanations for the severe reduction in PBV include restriction of extra-alveolar vessels as a consequence of lung volume loss, restriction of intra-alveolar vessels due to structural and functional changes imposed by the inflammation-fibrosis process and vascular restriction due to vasoactive factors (alveolar hipoxia).

Adult↗
PubMedDate not supplied

[Continuous electrocardiographic recording during a first parachute jump].

The behavior of the cardiac rhythm under intense stress was studied with continuous electrocardiographic recording during the first jump with an automatic parachute in 13 members of the Universidad Nacional Autónoma de México sky diving club. There were 12 male (92.3%) and one female (7.68) with an average age of 22.8 years. A complete clinical history, 12 lead electrocardiogram and a treadmill stress test were performed two weeks before jumping. A two-channel Holter recording system was hooked up 30 min. before boarding the airplane and was turned off one hour later. The heart rate values were compared two weeks prior (64.5 beats/min), before (112.8 beats/min), during (170 beats/min) and after the jump (122.8 beats/min). The mean difference between each phase was statistically significant with p less than 0.001 values. The observed cardiac rhythm was sinus tachycardia in each case. In six cases (43.6%) 22 episodes of sudden decrease of the heart rate were seen and there were no major rhythm or conduction disturbances. The urinary catecholamines were similar in nine cases (69.2%) after the jump (x 51.2 micrograms/100 ml) and two weeks later in four control cases (x 10.3 micrograms/100 ml). We concluded there were no significant rhythm disturbances in the presence of an intense but brief stress condition in young healthy people. This study was classified as longitudinally, descriptive, experimental and projective.

Adult↗