PubMed Health⌕ Search

Biomedical subjects

L Pavia

Publications and source records attributed to L Pavia.

At least 19 recordsLinked to original sources

Recovery kinetics of oxygen uptake and heart rate in patients with coronary artery disease and heart failure.

BACKGROUND: Patients with congestive heart failure exhibit a prolonged period of recovery to baseline levels of oxygen consumption, but the decline of heart rate during recovery from exercise has been shown to be similar to that in healthy subjects, and the results of studies on the response of ventilation in recovery have been mixed. Patients with coronary artery disease have a reduced exercise capacity, but it is unknown whether the patterns of the decline in oxygen uptake (VO2), ventilation, or heart rate are similar to those in patients with heart failure. METHODS: We performed a cardiopulmonary exercise test with a ramping protocol in 18 healthy subjects, 18 patients with coronary artery disease, 19 patients with class A or B congestive heart failure, and 19 patients with class C congestive heart failure, according to the Weber classification. Peak oxygen uptake and the kinetics of oxygen uptake, ventilation, and heart rate were calculated and expressed as the slope of a single exponential relation between VO2 levels and time during the first 3 min of recovery as y(VO2) = y0Ae(-x/t). RESULTS: A difference in time of recovery of VO2 was found only between healthy subjects and patients with more severe heart failure (class C) (p < 0.05); no significant differences were observed among any of the groups in ventilation or heart rate recovery responses. CONCLUSION: VO2 recovery time is prolonged only in the presence of more severe heart failure. The presence and degree of heart disease has no effect on ventilation or heart rate recovery time.

Coronary Disease↗

Achieving business growth through minority equity partnerships.

Healthcare organizations can become more accessible to patients and managed care organizations and can expand their patient base by forming minority equity partnerships with physician practices. By investing in practices, healthcare organizations provide capital and guidance to help the practices grow. Such an arrangement fosters goodwill as the physicians retain ownership interests, which preserves their entrepreneurial spirit.

Capital Financing↗

The effect of beta-blockade therapy on the response to exercise training in postmyocardial infarction patients.

Cardiac rehabilitation after a myocardial infarction has been shown to improve exercise capacity. Beta blockade has been shown to be effective in treating angina and reducing mortality, but studies are controversial as to whether beta-blockade therapy attenuates the effects of training. We attempted to study the effects of beta blockade (metoprolol) on the response to training in patients enrolled in a cardiac rehabilitation program after an uncomplicated myocardial infarction. We studied 27 patients with a recent uncomplicated myocardial infarction who were subdivided in two groups: Group 1 (13 patients) not taking a beta blocker, and Group 2 (14 patients) taking metoprolol (mean 142 +/- 57 mg daily). All patients underwent a maximal cardiopulmonary exercise test before and after a 3-month training program. The training intensity was designed to approximate the ventilatory threshold. Results showed an increase in peak VO2 in both Group 1 (27%, p < 0.01) and Group 2 (33%, p < 0.001), and an increase in VO2 at the ventilatory threshold (39% in Group 1 and 28% in Group 2, p < 0.01). The mean changes in exercise capacity were not different between groups. It was concluded that metoprolol did not influence the beneficial effects of a cardiac rehabilitation program in postmyocardial infarction patients.

Adrenergic beta-Antagonists↗

[Efficacy of long-term treatment with enalapril in patients with congestive heart failure].

Effects of enalapril on congestive heart failure and survival until 12 months have been evaluated in 60 patients with congestive heart failure (II, III, IV NYHA class) versus 60 control patients. Enalapril has been administered with digitalis and diuretic for 12 months 5 mg twice a day; in 60 control patients only digitalis and diuretic have been administered. Patients have been controlled every month during 12 months evaluating: NYHA class, time of exercise at treadmill, ejection time of left ventricle, speed index of ejection, cardiac output, systolic output, ECG, blood pressure, creatinine, BUN and electrolytes. After 12 months a significant increase (p less than 0.001) of systolic and cardiac output in patients with enalapril has been recorded. Also the increase of exercise time was more evident in patients with enalapril (p less than 0.01). The results show that long term treatment with enalapril in patients with congestive heart failure, improving cardiac performance, gives an hemodynamic and symptomatic benefit.

Adult↗

Assessment of left ventricular filling in patients with systemic hypertension. A Doppler echocardiographic study.

To assess left ventricular (LV) diastolic function in patients with hypertension, a Doppler echocardiographic study of transmitral blood flow (TBF) was performed in 46 hypertensive patients (H), 18 without (H1) and 28 with (H2) left ventricular hypertrophy and in 25 age-matched normal subjects (N). All patients showed normal systolic function. The following indices of Doppler TBF were measured: peak flow velocity during early filling (Evel), atrial systole (Avel) and their ratio (E/Avel); area under early filling phase (Earea), area under atrial systole (Aarea), expressed as a percentage of total diastolic area and their ratio (E/Aarea); deceleration half-time (DHT) of early filling phase. When compared with N, H1 and H2 showed significant reductions in early filling indices and an increase in atrial contribution parameters. (Evel = 0.62 +/- 0.1(N), 0.52 +/- 0.1(H1) P less than 0.01, 0.44 +/- 0.1(H2) P less than 0.001; Earea = 56 +/- 5(N), 48 +/- 5(H1) P less than 0.001, 43 +/- 6(H2) P less than 0.001; Avel = 0.49 +/- 0.1(N), 0.59 +/- 0.1(H1) P less than 0.01, 0.69 +/- 0.14(H2) P less than 0.001; Aarea = 26 +/- 5(N), 41 +/- 4(H1) P less than 0.001, 47 +/- 7(H2) P less than 0.001). Also DHT was significantly prolonged, compared with N (80 +/- 12 msec), in H1 (90 +/- 12 msec, P less than 0.01) and H2 (105 +/- 20 msec, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗