1997;69(4) – ABC CARDIOL

Relato de Caso

Nuclear magnetic resonance imaging in the diagnosis of left ventricular pseudoaneurysm. An old problem, a new option

Glaura S. Alvarenga et al. Liliane Kopel Luís Alberto Oliveira Dallan Luiz Francisco Avila … Maristela C. Monachini Silvia G. Lage

We describe the case of a 61 year-old female patient admitted to the hospital with acute lateral myocardial infarction, in pulmonary edema, who evolved to cardiogenic shock in the first hours. Transesophageal echodopplercardiogram and nuclear magnetic resonance imaging showed the diagnosis of a left ventricular pseudoaneurysm. Surgical repair was successfully undertaken.

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The evaluation of short term effects of awareness programs and pravastatin therapy on subjects from private clinics at high risk for cardiovascular disease

Raul D. Santos et al. Luiz O. do Nascimento Raul C. Maranhão

PURPOSE: To evaluate short-term efficacy of awareness programs (AP) in reducing coronary heart disease risk factors (CHDRF). METHODS: High risk hypercholesterolemic patients were divided in 2 groups during 16 weeks. Group A (n=417, 54.3±10.0 years, 55% males) received verbal and written orientation on CHDRF control, and group B (n=180, 54.4±10.9 years, 45% males) received only verbal orientation. All participants received pravastatin 10mg q.d. for 12 weeks. The evolution of body weight, arterial pressure, lipid profile, Castelli’s I and II indexes (TC/HDL and LDL/HDL), and Framingham scores were evaluated. RESULTS: At baseline, A had a lower HDL-C (40.0±11.0 vs 43.0±11.0mg/dl, p=0.013) and a higher index I (8.2±3.0 vs 7.6±2.3, p=0.008) than B. After 16 weeks, A had greater change than B in TC (-28.0 vs -25.0, p<0.05), LDL-C (-29.0 vs -27.6, p<0.05), HDL-C levels (+13.7 vs +10.8, p<0.05) and in the Castelli's Index (-39.0 vs -33.0; p<0.05). In both groups pravastatin use potentialized the effects of diet on the lipid profile. CONCLUSION: The AP seemed to be more effective than verbal orientation alone in CHDRF reduction at short-term.

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Risk factors of atherosclerosis in children. An epidemiologic study

Zoffi Roberto S. Gerber et al. Paulo Zielinsky

PURPOSE: To obtain a profile of risk factors for coronary atherosclerosis in a pediatric population from Bento Gonçalves, Rio Grande do Sul, from May 1990 to June 1991. METHODS: One thousand five hundred and one children with ages from 6 to 15 years were studied to assess serum cholesterol levels and their association with other risk factors, such as arterial hypertension, obesity and family history of cardiovascular disease. RESULTS: Four hundred and twenty (27.98%) children showed cholesterol levels over 180mg%; 75 (5%) had systolic hypertension and 48 (3.20%) diastolic hypertension. The family history was important to search for risk factors such as hypercholesterolemia, but did not exclude risk factors when negative. One hundred and thirty six (9.06%) children showed hipetriglyceridemia; 155 (10.33%) presented LDL-cholesterol above 130mg% and showed a strong association with hypercholesterolemia. Obesity was present in 111 children, but none showed a major prevalence of hypercholesterolemia. CONCLUSION: Risk factors for atherosclerosis are present in children and their search should be performed, independent of family income, family history, age and sex. The pediatrician must have a significant role in this setting.

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Mesoscopic study of the mitral valve and its fibrous ring

Jennecy Sales Cavalcanti et al. Eveline de Lucena Oliveira Emanuelle Tenório A. M. Godoi Laura Patrícia Ferreira Santos … Viviane Xavier de Lima e Silva Micheline de Lucena Oliveira

PURPOSE: To study the spatial arrangement of the fibrous elements that form the leaflets of the mitral valve and its fibrous ring. METHODS: The study of 20 human adult hearts, of both sexes, fixed in 10% formaldehyde solution was made. The mitral valves with their fibrous rings and small parts of the adjacent atrial and ventricular muscles were removed. Part of this material was embedded in paraffin and cut serially at a thickness of 40µm and stained by Azan’s trichrome and by resorcin-fuccin and another was dissected under stereoscope in order to verify the arrangement of the myocardial bundles at the level of the fibrous ring. RESULTS: It was observed that the fibrous ring is consisted of collagenous fibers which involved in an incomplete form the atrioventricular ostium, as they were absent in the anteromedial region of the ostium. The leaflets were made of collagenous fibers disposed parallel to the long axis of the valve. This collagenous fibers were covered by atrial and ventricular endocardium. The collagenous fibers of the leaflets were continuous, by their base, into the fibrous ring. It was observed, in a few cases, the presence of atrial muscle fibers into the anterior leaflet of the mitral, mainly in its central area. CONCLUSION: The leaflets of the mitral valve and its fibrous ring have a structural continuity suggesting that elements would act synchronously in the closure of the atrioventricular ostium during ventricular systole. The contraction of the myocardial bundles fixed in the fibrous ring contributes to decrease the diameter of the mitral ring.

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Maximal functional capacity and diastolic function in patients with cardiomyopathy due to Chagas' disease without congestive heart failure

Charles Mady et al. Barbara M. Ianni Edmundo Arteaga Vera Maria Cury Salemi … Paulo R. Santos Silva Rita Helena A. Cardoso Dalia Ballas

PURPOSE: To identify early cardiac dysfunctions in asymptomatic patients with Chagas’ cardiomyopathy. METHODS: We studied 38 male individuals: control group consisting of 20 sedentary normal individuals and Chagas’ group, of 18 asymptomatic patients with Chagas’ disease, with suggestive electrocardiographic alterations and normal fractional shortening (FS) on echocardiogram. Both groups were submitted to evaluation of the maximal functional capacity, with measurements of maximal O2 consumption (VO2max), O2-pulse rate (PO2max), maximal ventilation (VEmax), maximal heart rate (HRmax), and anaerobic threshold of the VO2max(VO2-AT). Left ventricular diastolic function was evaluated by conventional echocardiography (E wave, A wave and E/A ratio). RESULTS: No significant differences occurred between the two groups with regard to FS (p=0.212) and age means (p=0.060). The 2 groups were significantly different (p<0.001) regarding the parameters VO2max, PO2max, VEmax, HRmax and VO2-AT, E wave and E/A ratio. There was no difference (p=0.520) in A wave. CONCLUSION: Impaired ventricular function may account for the above mentioned differences, a consequence of both systolic and diastolic dysfunctions.

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Nuclear magnetic resonance imaging in the diagnosis of left ventricular pseudoaneurysm. An old problem, a new option

The evaluation of short term effects of awareness programs and pravastatin therapy on subjects from private clinics at high risk for cardiovascular disease

Risk factors of atherosclerosis in children. An epidemiologic study

Mesoscopic study of the mitral valve and its fibrous ring

Maximal functional capacity and diastolic function in patients with cardiomyopathy due to Chagas' disease without congestive heart failure

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