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Biomedical subjects

Miguel A Arias

Publications and source records attributed to Miguel A Arias.

At least 19 recordsLinked to original sources
PubMed2006

Statins and diastolic heart failure.

Although nearly 50% of patients with heart failure have normal ejection fraction, there are only few studies for guiding the treatment of this patient population. We emphasize the possible clinical benefit of statins therapy in these patients.

Diastole↗
PubMed2006

Pulmonary hypertension in obstructive sleep apnoea: effects of continuous positive airway pressure: a randomized, controlled cross-over study.

AIMS: We tested the hypothesis that: (i) obstructive sleep apnoea (OSA) by itself originates pulmonary hypertension (PH); and (ii) the application of continuous positive airway pressure (CPAP) can reduce pulmonary pressure. METHODS AND RESULTS: In this randomized and cross-over trial, 23 middle-aged OSA (apnoea-hypopnoea index, 44.1 +/- 29.3 h(-1)) and otherwise healthy patients and 10 control subjects were included. OSA patients randomly received either sham or effective CPAP for 12 weeks. Echocardiographic parameters, blood pressure recordings, and urinary catecholamine levels were obtained at baseline and after both treatment modalities. At baseline, OSA patients had higher pulmonary artery systolic pressure than control subjects (29.8 +/- 8.8 vs. 23.4 +/- 4.1 mmHg, respectively, P = 0.036). Ten out of 23 patients [43%, (95% CI: 23-64%)] and none of the control subjects had PH at baseline (P = 0.012). Two patients were removed from the study because of inadequate CPAP compliance. Effective CPAP induced a significant reduction in the values for pulmonary systolic pressure (from 28.9 +/- 8.6 to 24.0 +/- 5.8 mmHg, P < 0.0001). The reduction was greatest in patients with either PH or left ventricular diastolic dysfunction at baseline. CONCLUSION: Severe OSA is independently associated with PH in direct relationship with disease severity and presence of diastolic dysfunction. Application of CPAP reduces pulmonary systolic pressure levels.

Blood Pressure↗
PubMed2006

Incessant ventricular tachycardia acutely controlled with intracoronary injection of radiographic contrast media.

Management of patients with incessant monomorphic ventricular tachycardia is challenging. We report on 2 patients who had incessant ventricular tachycardia despite emergency treatment with antiarrhythmic drugs and repeated electrical cardioversions. In both cases, the arrhythmia was acutely terminated with intracoronary administration of radiographic contrast media, allowing hemodynamic stabilization. No tachycardia recurrences occurred.

Aged↗
PubMed2006

Better ventricular synchronization via an accessory pathway.

We report of a patient in whom the presence of a left ventricular accessory pathway plus enhanced AV nodal conduction led to a more physiological ventricular activation sequence than that observed after ablation of the accessory pathway in a patient with baseline left bundle branch block and concealed intra-QRS pre-excitation.

Accessory Nerve↗
PubMed2006

Repetitive intermittent left bundle branch block.

A 32-year-old woman with no structural heart disease was referred for evaluation due to daily occasional palpitations and documented left bundle branch block (LBBB) on surface electrocardiogram (EKG). Continuous 24-hour Holter monitoring revealed a broad range of repetitive intermittent LBBB grades with a rate-dependent pattern that was also associated with circadian variations.

Adult↗
PubMed2005

Obstructive sleep apnea in atrial fibrillation patients.

A high prevalence of obstructive sleep apnea has been demonstrated in patients with atrial fibrillation. Our comments want to emphasize the importance of identifying and treating a large proportion of patients with atrial fibrillation who have undiagnosed obstructive sleep apnea as an additional preventive strategy for atrial fibrillation patients.

Atrial Fibrillation↗
PubMed2005

Obstructive sleep apnoea-hypoapnoea syndrome reversibly depresses cardiac response to exercise.

AIMS: To evaluate cardiac response to exercise in middle-aged normotensive obstructive sleep apnoea-hypoapnoea syndrome (OSAHS) adults with normal resting left ventricular systolic function and to test the hypothesis that nasal continuous positive airway pressure (CPAP) therapy might improve cardiac performance during exercise. METHODS AND RESULTS: We performed a prospective, randomized, double-blind, placebo-controlled, cross-over clinical trial including 31 consecutive newly diagnosed OSAHS patients and 15 healthy subjects. Cardiopulmonary exercise testing with cardiac output measurement, blood pressure (BP) recordings, and urinary excretion of catecholamine levels were obtained at baseline and after 3 months on both effective and sham CPAP. OSAHS subjects had higher systolic and mean nocturnal BP and higher nocturnal levels of catecholamines. In contrast, they had lower increments in cardiac output (Qt) and in stroke volume (SV) in response to exercise than control subjects. CPAP therapy was associated with highly significant improvements in all the indices of left ventricular systolic performance response during exercise, whereas with sham CPAP, all of them remained unchanged. CONCLUSION: OSAHS patients with normal resting left ventricular systolic function and no hypertension had a worse cardiac response to exercise than healthy subjects. In these patients, 3 months of CPAP improved both Qt and SV responses to exercise.

Analysis of Variance↗