Biomedical subjects

M V Barros

Publications and source records attributed to M V Barros.

5 recordsLinked to original sources

PubMed2001

Doppler tissue imaging to evaluate early myocardium damage in patients with undetermined form of Chagas' disease and normal echocardiogram.

Chagas' disease can lead to severe and potentially lethal damage of cardiac function. Thus, the identification of contractile abnormalities in asymptomatic patients can be important for risk stratification in those patients. Doppler tissue imaging (DTI) is a new diagnostic modality for the study of regional and longitudinal contractility of the left ventricle. However, DTI has not been used for the assessment of Chagas' cardiopathy. The purpose of this study was to identify abnormalities related to longitudinal contractility by means of DTI in patients with an undetermined form of Chagas' disease and with normal echocardiogram and Doppler studies. Forty patients were studied, including 21 chagasic ones with normal electrocardiographic, radiologic, and echocardiographic studies, and 19 normal control individuals. All of the patients were submitted to DTI to evaluate longitudinal contractility in the various myocardial segments, including assessment of systolic and diastolic velocities and isovolumic contraction time (IVCT). Similar values were observed among the various systolic function rates in both groups, except for the IVCT along the septal wall, which was significantly higher in the chagasic group. DTI enabled the early detection of contractile abnormalities in patients with an undetermined form of Chagas' disease and with normal echocardiogram. Such abnormalities were particularly striking in the interventricular septum. The present study could be useful in risk stratification for those patients.

Adult↗

PubMed2001

Tissue Doppler imaging enables the identification of diastolic dysfunction of pseudonormal pattern in Chagas' disease.

The Doppler pseudonormal pattern of left ventricular (LV) diastolic function filling, characterized by apparent normal transmitral flow velocities, indicates advanced diastolic dysfunction with abnormal relaxation and compliance. Left ventricular diastolic dysfunction has been shown to occur in the early stages of the outcome of Chagas cardiopathy, and its identification may potentially contribute to the management of those patients. The aim of this study was to evaluate the usefulness of tissue Doppler imaging (TDI) in identifying LV diastolic dysfunction in patients with Chagas' disease with pseudonormal transmitral flow. For this purpose, 89 patients with Chagas' disease (48 men) who had no other pathology and showed normal (n = 79) or pseudonormal (n = 10) patterns of diastolic function by pulsed wave Doppler were submitted to TDI. A significant LV systolic impairment in terms of the dimensions (P = .00001), ejection fraction (P = .000001), and wall motion score (P = .000002) was observed in patients with diastolic dysfunction when compared with the group with normal LV diastolic function. Tissue Doppler imaging enabled the recognition of a pseudonormal type of transmitral flow velocity with high statistical significance through early (P = .000008) and late (P = .0003) expansion waves. The sensitivity and specificity in detecting LV diastolic dysfunction with TDI in the septal, anterior, inferior, posterior, and lateral walls were 90% and 87.3%, 87.3% and 90%, 87.3% and 90%, 84.8% and 90%, and 84.8 and 90%, respectively. In conclusion, TDI enabled the differentiation of patients with Chagas' disease with normal LV diastolic function and those with the pathologic LV pseudonormal pattern with high statistical significance. Moreover, this article shows the potential in demonstrating the occurrence of major alterations in the LV performance of patients with Chagas' disease with LV diastolic dysfunction, as well as the occurrence of signs of an increased LV filling pressure in those patients.

Chagas Cardiomyopathy↗

PubMed2001

[Health risk behaviors, health status self-assessment and stress perception among industrial workers].

OBJECTIVE: To identify the prevalence and association among health risk behaviors, stress perception, and health status self-assessment among industrial workers. METHODS: A cross-sectional study was performed using a questionnaire previously tested in a pilot study in the State of Santa Catarina, Brazil. Data on smoking, alcohol consumption, fruit and vegetables intake, physical activity, stress perception, and self-assessment of health status were available for 4,225 workers (67.5% males and 32.5% females). Subjects were selected using a 3-stage cluster sampling (5% error margin). Statistical analysis was performed using Chi-square, and logistic regression analysis (p<0.05). RESULTS: The mean age was 29.7 years old (SD=8.6). The prevalence of smokers was 20.6%, higher among males (23.1%) than females (15.6%). The proportion of heavy drinkers was high (57.2% among males and 18.8% among females). Almost half of the subjects (46.2%) reported no leisure-time physical activity (67% females and 34.8% males). Approximately 14% of subjects reported high levels of stress and difficulty to cope with daily tasks. About 15% of the workers perceived their health status as regular or poor. Gender, age, marital status, number of children, educational level and economic status were significantly associated with the prevalence of health risk behaviors. CONCLUSIONS: Despite the limitations of cross-sectional studies, based on self-report assessments, the study results suggest a high prevalence of alcohol consumption and physical inactivity during leisure time. The observed association between gender and health risk behavior suggests that both sexes engage in risk behaviors: for men these behaviors are direct or active (smoking, alcohol consumption) and for women, they are more indirect or passive (physical inactivity, stress).

Adult↗

PubMed2000

A narrow QRS does not predict a normal left ventricular function in Chagas' disease.

Left ventricular (LV) systolic dysfunction is a major prognostic determinant in Chagas' disease (ChD), a potentially fatal disorder which affects nearly 20 million individuals in Latin America. Therefore, reliable screening methods are needed to identify patients in need of a detailed evaluation of LV function. Since previous reports have suggested that a prolonged QRS duration may be an accurate predictor of LV dysfunction, the relationship between QRS duration and LV function was evaluated in ChD patients, in order to determine whether a narrow QRS on surface electrocardiogram (ECG) predicts a normal LV function. Ninety-eight patients with ChD and no other cardiac or systemic illness were underwent standard 12-lead ECG and Doppler echocardiogram (echo) examination. An investigator (blinded to the echo data) measured manually the QRS duration. LV dysfunction was defined by the presence of LV dilatation (LV diastolic dimension > 55 mm), depressed LV ejection fraction (LVEF < 0.50), segmental contractile abnormalities (SCA) or LV aneurysm. QRS duration was significantly correlated with LV diastolic dimension (r = 0.44, P = 0.000) and LVEF (r = 0.24, P = 0.016). A significant percentage of patients with QRS < 100 ms had abnormal systolic LV parameters, including LV dilatation (8.1%), reduced EF (10.2%), SCA (42.8%) and LV aneurysm (14.2%). A narrow QRS does not exclude the presence of significant global and segmental LV dysfunction in ChD patients. Since these abnormalities have prognostic and therapeutic implications, further evaluation of LV systolic performance is desirable in such patients.

Adult↗

PubMedDate not supplied

[The importance of clinical examination for the diagnosis of innocent heart murmur in adolescents].

PURPOSE: To determine the prevalence of innocent murmur among adolescents, and to evaluate the clinical features in comparison with echocardiogram (two-dimensional, M-mode, Doppler, and color-Doppler) in the assessment of heart murmurs. METHODS: The study was carried out from March to December, 1992, and involved high school students coming from families of the medium and low-medium social classes. Considering the total of 1400 students registered in a public school, 536 adolescents aging from 10 to 20 years were admitted in this study. Twenty seven students with heart murmur were submitted to Echocardiography in order to find any cardiac lesions. RESULTS: Among 536 adolescents, 171 (32%) had some kind of heart murmur. On the basis of the clinical diagnosis, 160 (29.9%) patients were classified as having innocent murmur and 11 (2.1%) as having "pathologic murmur". Out of 27 students submitted to echocardiography, 20 of them with clinical diagnosis of innocent murmur showed normal results. Among seven students with clinical diagnosis of "pathologic murmur", the echocardiography recognized cardiac lesions in two (small ventricular septal defect and rheumatic heart disease: combined mitral incompetence and stenosis, and aortic incompetence). CONCLUSION: From the data obtained, the prevalence of innocent murmur among adolescents was 29.9% on the basis of clinical diagnosis. It is suggested that careful clinical examination by physicians skilled in cardiac examination is the recommended method for the diagnosis of innocent murmur (sensitivity of 100% and specificity of 80%).

English Abstract↗