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M Cerqueira-Gomes

Publications and source records attributed to M Cerqueira-Gomes.

10 recordsLinked to original sources
PubMed1992

[Variability of heart rate: a perspective].

The present work is an attempt to provide a general overview on the current methods and applications of heart rate variability (HRV), starting from the underlying mechanisms of cardiac rhythmic automaticity and the influence on heart rate of biological modulators, namely autonomous nervous system. Different evaluation methods for HRV are compared in what concerns the duration of the records under analysis and the mathematical approach (spectral/non-spectral). Finally, clinical applications of HRV are mentioned, some of them the Department is particularly interested in, namely coronary heart disease, heart failure and diabetic neuropathy. The authors conclude, minding some aspects susceptible of discussion in the future of this technique.

Autonomic Nervous System↗
PubMed1991

[Diagnostic exercise tests in adult men with no symptoms or with non-angina complaints].

STUDY OBJECTIVE: to investigate clinical and ECG stress test differences in middle aged males either asymptomatic or with non-anginal symptoms and no previous myocardial infarction. DESIGN: retrospective stress data file analysis. SETTING: Outpatients at the stress test laboratory. PATIENTS: 296 consecutive patients referred to diagnostic treadmill testing from January-1988 to June-1989. RESULTS: no differences were found between symptomatic or asymptomatic individuals in the 17 variables analysed. CONCLUSIONS: despite the fact that patients with chest symptoms even if obviously non-anginal have an increased coronary disease prevalence when compared with age-matched asymptomatics, this difference seems to insufficient to be demonstrated by the ECG stress test results, making questionable the practical relevance of this symptomatic classification.

Adult↗
PubMed1989

[Neuro-hormonal mechanisms in heart insufficiency--from physiopathology to treatment].

This review updates some recent advances of a new and exciting developments in basic and clinical cardiology: a) the role, in the congestive heart failure (CHF), of the neurohormonal systems (NHS) which act to maintain circulatory homeostatic equilibrium, and b) the therapeutic implications of such a role. Six NHS, acting in CHF, have presently been identified: three of them induce vasoconstriction and sodium retention (sympathetic nervous systems, renin-angiotensin-aldosterone system and arginine-vasopressine system); the remaining three offset or balance the former ones, acting, therefore as "counterregulators" (prostaglandins--PGE2 and PGI2--, dopaminergic system and atrial natriuretic factor). Each one of these NHS influences the "compensatory" mechanisms of heart failure, acting on the target-organs both by direct effects and by interaction with other NHS; consequently, in heart failure, all the NHS are stimulated with the respective increase in the plasma levels of their agents. In asymptomatic stages of ventricular dysfunction the stimulation of the vasodilator-and-natriuretic systems appears to be predominant and able to maintain circulatory equilibrium. However, as the heart dysfunction increases and becomes symptomatic, the vasoconstrictor and sodium-retaining forces appear to predominate; this phenomenon becomes increasingly apparent as the functional class becomes more advanced. The hyperstimulation of these last systems has an extremely important role in the pathophysiology and clinical manifestations of congestive heart failure, as well as in its prognosis. Therefore, the attempts to correct these neurohormonal imbalance in patients with heart failure has a sound rational basis, not only to improve the symptoms and the exercise capacity but also to increase the survival of these patients. At the present time, amongst the potential pharmacological interventions acting on NHS in CHF, the blockade of the SRA system with ACE-inhibitors is generally accepted as the most feasible, the safer and the most effective therapeutic tool. In fact, its application has broadened from an earlier use in severe CHF to other symptomatic stages of cardiac failure, including the milder forms. In addition, preliminary data strongly suggest its unique usefulness in asymptomatic phases of ventricular dysfunction. Looking back at the medical therapy of heart failure, it can be concluded that we are starting a new era. Throughout 200 years (since the introduction of digitalis) the therapeutic goal in CHF has been the improvement of symptoms. With the developments of the present decade, a new and exciting goal is being offered to these patients, called by Packer "the second frontier", that is, the prolongation of their lives.

Angiotensin-Converting Enzyme Inhibitors↗