Biomedical subjects

José Fernando Guadalajara Boo

Publications and source records attributed to José Fernando Guadalajara Boo.

3 recordsLinked to original sources

PubMedDate not supplied

[Echocardiographic evaluation of heart failure].

The echocardiogram is an easily accessible procedure to study patients with heart disease. It is very useful specifically to establish a diagnosis of heart failure and to distinguish this condition from other diseases with similar clinical manifestations, which require different treatment and with distinct prognosis. Once the diagnosis has been established with certainty, other parameters must be obtained, such as ejection fraction, ventricular mass, mass/volume ratio, thickness/radius ratio (h/r), dP/dT of the left ventricle, and a recording of transmitral blood flow can be obtained by means of pulsed and continuous Doppler blood flow. All these measurements not only quantify the degree of heart failure but also have a powerful prognostic implications.

Heart Failure↗

PubMedDate not supplied

[Does diastolic heart failure exist?].

This paper reviews the concepts of systolic function, diastolic function, heart failure, diastolic dysfunction, and diastolic heart failure. We refer to the historic evolution of the concept of heart failure and the origin of the term diastolic heart failure. Based on the current concepts of the physiology of the heart and its pathophysiology, we discuss the inappropriateness of the term and to the confusion it has generated in clinical practice, treatment, and prognosis, as well as in numerous research papers (of which some examples are given) when terming as "heart failure" the diastolic dysfunction and using both terms indistinctively. We conclude that an increasing need has arisen, ever more imperative, to identify clearly the concepts of heart failure and diastolic dysfunction, emphasizing on their differences to recognize them as distinct clinical entities with their own personality and, hence, having different prognosis and treatment. This would be of great help to achieve more accuracy in the clinical guidelines, standards, and consensus, especially regarding treatment. Besides it would be useful to avoid, inconsistencies in the design of research, which appear in some of the publications just by the lack of a clear meaning of the terms. Finally, at present we have the necessary elements to conclude that the terms "diastolic heart failure" and "cardiac failure with preserved systolic function" are inexact, poorly gauged, and far away from the actual problem they try to define. Therefore, they should be substituted by the concept of Diastolic Dysfunction, which defines clearly the pathophysiology of the functional alteration, without having to state that "the heart is failing".

Biomedical Research↗

PubMedDate not supplied

[Estimate of the systolic parietal stress of the left ventricle by magnetic resonance imaging. A new approach to the study of the overload].

OBJECTIVE: To determine the systolic parietal stress of the left ventricle by image of magnetic resonance in healthy subjects. MATERIAL AND METHODS: 21 healthy subjects studied: 11 male and 10 female: the ages among 26 and 31 years (29.33). A magnetic resonance of heart was made using the short axis at the level of the papillary muscles, from where the epicardic and endocardic areas of the left ventricular cavity were obtained in diastolic as in systolic by means of the layout with an electronic pencil, later the radius of each drawn up area was calculated, with the value of the radius, the diastolic and systolic thickness was calculated; to obtain the relation between thickness/radio. Once the relation was obtained between thickness/radio in diastole as systole the degree of change between both values and the percentage of this change was calculated. Finally, the systolic parietal stress developed by the left ventricle was calculate with the following formula: S = PVI x A4/A3-A4 x 1.35.PVI: systolic pressure of the left ventricle (the average of 5 synchronized systolic arterial pressures, obtained by an esphingomanometer). A4: endocardic area in systole; A3: epicardial area in systole. The value obtained in this equation was multiplied per 1.35 to turn mmHg gm/cm2. RESULTS: The average of the arterial systolic pressure was of 103.24 +/- 10.27 mmHg; A3 (average 27.58 +/- 2.29); A4 (average 6.84 +/- 0.71); being the systolic stress of the left ventricle of 46.12 +/- 4.9 gm/cm2, not existing significant differences between sexes. CONCLUSIONS: With this new method it is possible to determine with greater exactitude in a noninvasive way, through the best definition of its epicardic and endocardic edges, the areas and the radio of the left ventricular cavity in systole as in diastole, to determine the thickness of the wall and its relation with the radius, for one better valuation of the ventricular function, specially in those subjects with overloads of volume or pressure that depress the ventricular function.

Adult↗