[Relation of left ventricular mass, volume and systolic function in three-dimensional transesophageal echocardiography. Multifactorial linear regression analysis].
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Adult↗
Biomedical subjects
V Araújo
Publications and source records attributed to V Araújo.
[A pulsed Doppler study of left atrial and ventricular inflow in 2 populations of normotensive and hypertensive subjects].
OBJECTIVE: Comparative analysis of left atrial and left ventricle Doppler inflow patterns in patients with essential systemic mild to moderate hypertension and normal global left ventricular systolic function. PATIENTS: A group of out patients with the diagnosis of hypertension referred to the Echocardiographic Laboratory of Egas Moniz Hospital in Lisbon. SETTING: Echocardiographic Doppler prospective study. MATERIAL AND METHODS: We studied a group of 50 patients with the diagnosis of mild to moderate arterial hypertension (Group H), which was compared with a population of 50 normal subjects (Group N). In each case we analysed the pulsed Doppler flow of the right upper pulmonary vein and the diastolic inflow of the left ventricular cavity. We calculated the peak velocities and time velocity integrals of the systolic, diastolic and atrial contraction waves of the pulmonary venous flow and also the systo-diastolic velocity and time velocity integral ratios. In the transmitral Doppler flow analysis we evaluated the peak velocities and time velocity integrals of the early (E wave) and late (A wave) waves, and their time velocity and velocity ratio. We assessed also the isovolumic relaxation time and left ventricular mass index. RESULTS: In groups N and H the peak velocity of the pulmonary venous flow systolic wave was 0.53 +/- 0.15 cm/sec and 0.75 +/- 0.10 cm/sec (p = 0.01), diastolic wave was 0.50 +/- 0.10 cm/sec and 0.41 +/- 0.09 cm/sec (p = 0.03) and atrial contraction wave was 0.18 +/- 0.03 cm/sec and 0.35 +/- 0.08 (p = 0.001), with a systo-diastolic ratio of 1.06 +/- 0.10 and 1.83 +/- 0.10 (p < 0.001), respectively. In these two groups the time velocity integral of the pulmonary venous flow systolic wave was 14.4 +/- 2.6 cm and 17.8 +/- 1.8 cm (p = 0.001), the diastolic wave was 12.5 +/- 3.2 cm and 9.3 +/- 1.3 cm (p = 0.05) and the atrial contraction wave was 4.4 +/- 0.07 cm (p = 0.001), with a systo-diastolic ratio of 1.1 +/- 0.16 and 1.9 +/- 0.12 (p < 0.001), respectively. For the group H and considering the three subgroups, hypertensive patients without anatomical or functional alterations, with isolated diastolic dysfunction and with left ventricular hypertrophy associated to diastolic dysfunction, the velocity systo-diastolic ratio was 1.08 +/- 0.12, 1.57 +/- 0.08 (p < 0.01) and 2.4 +/- 0.08 (p < 0.01) and 2.4 +/- 0.08 (p < 0.001), the systo-diastolic time velocity integral ratio was 1.22 +/- 0.17, 1.72 +/- 0.13 (p < 0.01) and 2.4 +/- 0.15 (p < 0.001), the peak velocity of the atrial contraction wave was 0.28 +/- 0.07, 0.3 +/- 0.08 (p < 0.01) and 0.43 +/- 0.07 (p < 0.001) and its time velocity integral was 4.6 +/- 0.06 cm, 5.6 +/- 0.07 cm (p < 0.01) and 7.0 +/- 0.08 cm (p < 0.001). CONCLUSIONS: Pulsed Doppler study of pulmonary venous flow is significantly abnormal in patients with arterial hypertension. This abnormal pulmonary venous flow pattern has a close relationship with structural and functional alterations of the left ventricle. Combined analysis of the pulsed Doppler inflow at these two cardiac anatomical levels is fundamental to understand the pathophysiology of hypertensive heart disease.
Adult↗
[Paroxysmal atrial fibrillation and flutter and "occult" arterial hypertension. The importance of the ambulatory monitoring of the blood pressure. Apropos 2 cases].
The authors describe two hypertensive patients with paroxysmal auricular flutter or fibrillation. The arterial hypertension was suspected because of a hypertensive response in a treadmill stress test, confirmed by a 24-hour blood pressure ambulatory monitoring and there was no damage in target organs. They focus that auricular flutter/fibrillation may be related to "occult hypertension".
Atenolol↗
[Surgery for infectious endocarditis].
OBJECTIVE: to assess the experience of both departments in the surgical therapy of infective endocarditis--indications and results. DESIGN: retrospective analysis on clinical data, surgery and follow up. SETTING: patients (pts) studied in the Cardiology Department and Cardiothoracic Surgery Department of the Santa Marta Hospital in Lisbon. PATIENTS AND INTERVENTIONS: sequential sample of 28 patients (11 females, 17 males, mean age 39 years) submitted to surgery between 1978 and 1987 for infective endocarditis. MEASUREMENTS AND RESULTS: the indications for surgery were: heart failure (15 pts), "resistant" infection (8 pts), emboli (4 pts) and "large" vegetations shown by echocardiography (2 pts). Surgical mortality -27.5%. Four patients developed periprosthetic leaks. There was an improvement in functional class of the survivals. CONCLUSION: the indications for surgery were heart failure, "resistant" infection, emboli and "large" vegetations. There was a high surgical mortality, namely in the patients with resistant infection, severe heart failure and periprosthetic leaks. In the follow up there was a net improvement of functional class. The morbidity is due to the periprosthetic leaks, which induced most of the reoperations.
Adolescent↗
[Cardiac insufficiency. New physiopathological approaches and therapeutic implications].
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Heart Failure↗
[Complete auriculo-ventricular block during therapy with carbamazepine].
The authors describe the case of a complete AV block probably induced by carbamazepine. They also review cases described in the literature and suggest some preventive measures before beginning therapy with carbamazepine, mainly in patients over sixty-five years of age, with or without known cardiovascular pathology.
Aged↗
[The indices of pressure variability by noninvasive ambulatory monitoring of the arterial pressure. A study in 2 normotensive and hypertensive populations].
OBJECTIVE: Analysis of different indices of blood pressure (BP) variability using the ambulatory blood pressure monitoring (ABPM) method in two populations of hypertensive patients (HTA Group) and normotensive volunteers (NOR Group). SETTING: Noninvasive prospective ambulatory study to assess the alterations of the circadian blood pressure profile through ABPM indices of blood pressure variability. PATIENTS: Patients with the diagnosis of essential arterial hypertension referred for clinical investigation to the Cardiology Department of Egas Moniz Hospital in Lisbon. MATERIAL AND METHODS: 40 hypertensive patients (HTA Group) and 30 normal subjects (NOR Group) were included in this study. We calculated the short and long term variability indices. The short term variability indices were the casual and mean immediate BP deviation, percentage of BP peaks and BP peak relative deviation and maximal range variation. Some clinical and general factors considered were namely age, gender, height, weight, body area and index, mean and casual systolic-diastolic blood pressure. RESULTS: Concerning systolic blood pressure in hypertension Vs normal groups respectively, the casual BP deviation was 15 +/- 4 mmHg and 7 +/- 4 mmHg (p 0.003), the mean immediate BP deviation was 18.5 +/- 4 mmHg and 7.5 +/- 3 mmHg (p 0.002), the percentage of BP peaks was 27 +/- 6% (p < 0.001), the percentage of BP peak area was 29 +/- 7% and 6 +/- 3% (p 0.001) and the percentage of relative deviation was 14 +/- 4% and 8 +/- 3% (p 0.03). For diastolic blood pressure all differences were not statistically significant between the two groups and the same happened for systolic blood pressure in relation to standard deviation and maximal range variation. Among these parameters and general and clinical characteristics, the systolic mean and casual blood pressure level showed an acceptable correlation with mean immediate deviation (R = 0.54/0.49), percentage of BP peaks (R = 0.56/0.49) and percentage of BP peak area (R = 0.60/0.53). CONCLUSIONS: Blood pressure variability can be adequately evaluated through the method of ambulatory blood pressure monitoring. Some variability indices can be extracted from the 24 hour curves of ambulatory blood pressure monitoring. Long-term variability indices are not related to the level of blood pressure. In the hypertension group we found a greater variability concerning short term indices, namely immediate deviation, percentage and are of peak curve.
Adult↗
[A double ambulatory product (blood pressure and heart rate), mild arterial hypertension and left ventricular hypertrophy].
OBJECTIVE: Analysis of the different ambulatory blood pressure monitoring derived parameters in terms of cardiac structural repercussion, in patients with isolated systolic and mild systolic-diastolic hypertension. SETTING: Prospective study involving simultaneously the two-dimensional echocardiographic technique and the ambulatory blood pressure monitoring method. PATIENTS: Out patients regularly observed in the Cardiology Department of Egas Moniz Hospital in Lisbon, were included in our study. MATERIAL AND METHODS: We studied 50 hypertensive patients who fulfilled the inclusion criteria of our study (Group H) and 20 subjects who were the normal aged matched population (Group N). through ambulatory blood pressure monitoring, in each individual of these two groups, we considered the mean values of daily systolic blood and diastolic blood pressure, heart rate and ambulatory heart rate blood pressure product. Through two-dimensional echocardiography we calculated the left ventricular mass and the correspondent index corrected for the body surface. RESULTS: In the H group an comparing to the N group, the mean value of the daily systolic blood pressure was 112 +/- 6 mmHg and 159 +/- 8 mmHg (p < 0.001) respectively, diastolic blood pressure was 60 +/- 5 mmHg and 75 +/- 7 mmHg respectively (p < 0.001), heart rate blood pressure product was 6720 +/- 580 and 12561 +/- 678 (p < 0.0001) and of the left ventricular mass index was 109 +/- 10 gm2 and 145 +/- 7 g/m2 (p < 0.001). The correlation coefficient between the left ventricular mass index and mean systolic, diastolic blood pressures and ambulatory heart rate blood pressure product was 0.60 (p < 0.01), 0.45 (p = NS) and 0.73 (p < 0.001) respectively. CONCLUSIONS: In the evaluation of the increase in left ventricular mass, ambulatory heart rate blood pressure product is a more accurate parameter compared to the mean daily blood pressure values. Ambulatory blood pressure monitoring is a method with a great potential and clinical application, when studying patients with hypertension diagnosis.
Adult↗