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M E Poyatos

Publications and source records attributed to M E Poyatos.

7 recordsLinked to original sources
PubMed2006

[Current concepts of pathophysiology, monitoring and resolution of pulmonary edema].

Pulmonary edema, both in its lesional as well as hydrostatic version, is a frequent cause of acute respiratory failure. From the pathophysiological point of view, the most important advance is undoubtedly the knowledge that the reabsorption process of pulmonary edema is an active process with energy consumption. This concept has revolutionized this field due to the possibility of finding substances or factors that stimulate or inhibit this reabsorption. Furthermore, in the monitoring field, significant advances have also been experimented due to the possibility of quantifying the edema in a simple and reliable way with transpulmonary thermodilution.

Acute Lung Injury↗
PubMed1997

Comparison of dobutamine electrocardiographic stress test and exercise test in two different groups of patients with unstable angina.

Exercise testing is a well known means of evaluating patients with unstable angina, but in recent years, alternative methods have been proposed. We prospectively compared standard exercise testing with dobutamine electrocardiographic stress testing for patients who were admitted with a diagnosis of unstable angina. A total of 43 patients were studied, divided into two different groups, according to the presence (group A n = 26) or absence (group B n = 17) of a previous history of coronary artery disease and/or electrocardiographic changes compatible with ischemia on admission. Dobutamine electrocardiographic stress testing was performed in a standard manner at 3 +/- 1 days after admission in group A and at 16 +/- 8 hours after admission in group B. Exercise testing was performed, on average 5 +/- 1 days following the event in group A and 2 days after admission in group B. Agreement between both tests was observed in 39 (91%) cases, Kappa value: 0.81. The dobutamine test predicted the result of the exercise test with a sensitivity of 79% (95% CI 54-90), and a specificity of 100% (95% CI 86-100), with a positive predictive value of 100% and a negative predictive value of 86%. It can be concluded that dobutamine electrocardiographic stress testing is an objective and reliable procedure that accurately predicts the results of standard exercise testing in patients with a diagnosis of unstable angina. If this result were confirmed with a greater number of patients, it would be a good option for definitive diagnosis and risk stratification, in addition to being inexpensive and easy to perform. It can also be particularly useful for patients who cannot perform exercise.

Adult↗
PubMed1986

Exercise testing and thallium-201 myocardial perfusion scintigraphy in the clinical evaluation of patients with Wolff Parkinson White syndrome.

In 58 patients with Wolff Parkinson White syndrome (WPW), we performed exercise stress testing in order to investigate the incidence of normalization of the auriculo-ventricular conduction and the ST-segment changes. For a more accurate evaluation of the latter, exercise and redistribution radionuclide images with Thallium-201 were obtained in 18 cases. Forty-nine had type A and nine had type B of WPW. Forty-eight had permanent, four had alternant and six had no pre-excitation (PE) when they started the test. Mean maximal functional capacity, mean maximal heart rate and mean maximal double product were not different when compared to an age-matched control group. Of the 48 patients who began the test with PE, in 23 (48%) it disappeared while PE persisted in 25 (52%). In 16 cases the disappearance of the PE was sudden and in seven it was progressive. Pre-excitation persisted in 39.5% of patients with type A and in 88.8% with type B (p less than 0.01). ST-segment depression was observed in 76.6% of patients with PE and in 28.6% of cases without PE (p less than 0.01). ST-segment depression occurred in 44.8% of patients with type A and in 100% of cases with type B (p less than 0.05). Transient abnormal Thallium-201 scans were observed in 62.5% of patients without PE and in 20% with PE. No patients showed exertional arrhythmias. This study suggests the possibility of measuring the duration of the refractory period of the accessory pathway in those patients in which the PE disappears suddenly, at a given heart rate.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Predictive value of changes in R-wave amplitude after exercise in coronary heart disease.

To assess the predictive value of coronary events reflected by changes in R-wave amplitude after exercise, 146 patients with angiographically documented coronary heart disease were studied. All patients were followed up for 6 years, during which time myocardial infarction and death of cardiovascular origin were considered endpoints. The incidence of events in patients in whom R-wave amplitude decreased (normal response) and in those in whom R-wave amplitude did not change or increase (abnormal response) were compared. The incidence of coronary events in patients with a normal response was 23% and in those with an abnormal response, 45.8% (p less than 0.01). Correlating the results with several noninvasive and angiographic variables, an abnormal R-wave response showed a significantly higher rate of events in the subsets of patients with prior myocardial infarction, absence of cardiomegaly, maximal functional capacity lower than 4 METs, maximal heart rate higher than 140 beats/min and abnormal left ventricular function. Thus, the changes in R-wave amplitude after exercise is a variable that should be taken into account when assessing the risk of future events in patients with coronary heart disease.

Adult↗