Biomedical subjects

Mário Cerqueira-Gomes

Publications and source records attributed to Mário Cerqueira-Gomes.

5 recordsLinked to original sources

PubMed2005

Heart failure and health related quality of life.

Quality of life is a major goal in the context of preventive and therapeutic cardiology. It is important, both as an outcome measure in clinical trials of congestive heart failure (CHF) and as a consideration in individual physicians' therapeutic decisions. In this article, quality of life concepts are reviewed, methods of measurement are explored and clinically significant changes on prognosis are discussed. There is a need for more research which is based on carefully selected measures of quality of life chosen as being of particular importance to patients and to the hypotheses being tested.

Journal Article↗

PubMed2004

The effect of dietary sodium restriction on neurohumoral activity and renal dopaminergic response in patients with heart failure.

BACKGROUND: This work evaluates the effect of a low-sodium diet on clinical and neurohumoral parameters and on renal dopaminergic system activity in heart failure (HF) patients. METHODS: We included 24 patients with mild-to-moderate stable HF with left ventricle ejection fraction <40%. Twelve patients were studied before and after a 15-day low-sodium diet; 12 maintained their usual diet. Serum sodium and creatinine, plasma l-DOPA, dopamine, its metabolites, BNP and aldosterone, and 24-h urinary sodium, creatinine, l-DOPA, dopamine and metabolites were measured. RESULTS: The two groups were matched respecting to demographic and clinical parameters. Low-sodium diet caused significant reductions in weight, 24-h urinary volume and sodium and sodium fractional excretion. Renal delivery of l-DOPA and urinary excretion of l-DOPA significantly decreased while dopamine and metabolites were not affected. Urinary dopamine/l-DOPA and urinary dopamine/renal delivery of l-DOPA ratios increased, plasma l-DOPA decreased and plasma dopamine increased. Plasma aldosterone slightly rose, BNP decreased and noradrenaline and adrenaline increased. NYHA functional class was not affected by sodium restriction. Controls showed no differences. CONCLUSIONS: These results suggest that sodium restriction leads to activation of antinatriuretic antidiuretic systems in HF patients. However, renal ability to synthesize dopamine is increased in this condition, probably as a counter-regulatory mechanism.

Aged↗

PubMed2004

[Heart failure].

Explore the source record for details and available documents.

Heart Failure↗

PubMed2002

Effect of a heart failure clinic on survival and hospital readmission in patients discharged from acute hospital care.

Ambulatory care by physicians especially devoted to the management of heart failure (HF) has been reported to have beneficial effects. The aim of this work was to assess the effect of outpatient management at a HF clinic, as compared with care by the usual assistant physician, on prognosis of HF patients. In this non-randomised study, we prospectively followed 339 patients after a hospitalisation index for HF, in order to compare prognosis between two groups of HF patients according to the ambulatory assistance setting: either a specific outpatient clinic (n=157) or the usual assistant physician (n=182). The outcomes assessed were all-cause death or cardiac-cause rehospitalisation during the first month after discharge and survival over the longer term. The risk of dying or being readmitted during the first month after discharge was significantly lower in patients followed at the HF clinic (adjusted odds ratio 0.23; 95% CI 0.12-0.46). Patients followed in the HF clinic also had an independent significantly lower hazard of dying during a longer-term follow up of average length 373 days (adjusted hazard ratio 0.52; 95% CI 0.34-0.81). The results support the fact that a multidisciplinary and permanently available medical staff might be of relevance in improving outcomes in HF patients.

Aged↗

PubMed2002

The renal dopaminergic system, neurohumoral activation, and sodium handling in heart failure.

BACKGROUND: Dopamine of renal origin exerts natriuretic and diuretic actions by activating specific receptors located in the renal proximal tubular epithelial cells. Heart failure (HF) is accompanied by activation of several neurohumoral systems. The interaction of these systems with the renal dopaminergic system and its effect on sodium handling in HF are not clarified. METHODS AND RESULTS: We studied 13 patients with decompensated New York Heart Association class III/IV HF and 17 sex- and age-matched patients with mild to moderate stable class I/II HF. We measured plasma catecholamines, aldosterone, type B natriuretic peptide (BNP), sodium, creatinine (UCr), and 24-hour urinary excretion of sodium, UCr, levo-3,4-dihydroxyphenylalanine (L-DOPA), 3-o -methyldopa, dopamine and its metabolites, 3,4-dihydroxyphenylacetic acid and homovallinic acid, and norepinephrine. All patients had HF of ischemic etiology. No statistically significant differences were found between the groups with respect to urine volume (1.79 +/- 0.23 L x d(-1) vs 2.20 +/- 0.18 L x d(-1), P =.18) and urinary sodium (161.3 +/- 27.5 mmol x d(-1) vs 232.9 +/- 28.8 mmol x d(-1), P =.12). Urinary L-DOPA was significantly lower in patients with decompensated class III/IV HF than in the other group (79.0 +/- 13.8 nmol x g UCr(-1) vs 108.4 +/- 10.3 nmol x g UCr(-1), P =.04). Urinary dopamine showed a nonstatistically significant trend to be slightly higher (1294.3 +/- 188.5 nmol x g UCr(-1) vs 953.2 +/- 107.4 nmol x g UCr(-1), P =.14). Consequently, urinary dopamine/L-DOPA ratios were markedly higher in patients with decompensated class III/IV HF than in the other patients (20.6 +/- 3.4 vs 9.0 +/- 0.9, P <.001). Plasma L-DOPA (38.1 +/- 4.4 pmol x mL(-1) vs 40.0 +/- 3.0 pmol x mL(-1), P =.48), dopamine (37.0 +/- 6.3 pmol x mL(-1) vs 41.1 +/- 2.6 pmol x mL(-1), P =.53), 3,4-dihydroxyphenylacetic acid (51.7 +/- 11.7 pmol x mL(-1) vs 56.5 +/- 5.4 pmol x mL(-1), P =.09), and norepinephrine (9.5 +/- 2.4 pmol x mL(-1) vs 5.6 +/- 1.0 pmol x mL(-1), P =.12) did not differ between groups. Plasma aldosterone (180.2 +/- 28.0 pg x mL(-1) vs 69.9 +/- 13.3 pg x mL(-1), P <.001) and BNP (677.5 +/- 133.9 pg x mL(-1) vs 389.4 +/- 88.4 pg x mL(-1), P <.04) levels were higher in the decompensated class III/IV HF group than in the other group, whereas serum sodium was lower (137.3 +/- 1.2 mmol x L(-1) vs 143.2 +/- 1.0 mmol x L(-1), P =.001). CONCLUSIONS: These results suggest that, in patients with HF, the increased renal utilization of L-DOPA may constitute a compensatory mechanism, activated in response to stimuli leading to sodium reabsorption.

3,4-Dihydroxyphenylacetic Acid↗