1999;72(6) – ABC CARDIOL

Brief Reports

Signal averaged electrocardiogram in top deficient athletes

Japy Angelini Oliveira Fº et al. Bráulio Luna Fº Silvia Helena Covre Edgar Lira Fº … Marcelo Regazzini José Greco Antônio Carlos Silva Dirceu Vieira Santos Fº Ângelo Amato Vincenzo de Paola

Brief report

Signal Averaged Electrocardiogram in Top Deficient Athletes

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Clinicoradiological Session

A 45 – year-old woman with hypertrophic cardiomyopathy and cardiogenic shock

Clinicopathologic Session

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Original Article

Difference in the in-hospital mortality of unstable angina pectoris between men and women

Luiz Carlos Santana Passos et al. Antonio Alberto Lopes Úrsula Costa Nelson Lobo Alvaro Rabelo Jr

PURPOSE: To assess differences in the in-hospital mortality (HM) rate between men and women with unstable angina pectoris (UA) according to age, depression of the ST segment, history of previous acute myocardial infarction (AMI), and risk factors for coronary heart disease. METHODS: From October 96 to March 98, 261 patients with UA were selected. Logistic regression models were developed to adjust the association between sex and HM for possible influence of covariables, such as hypertension, diabetes mellitus, dyslipidemia, sedentary lifestyle, smoking, and familial history of early coronary heart disease. RESULTS: HM due to UA was approximately three times higher in women (9.3%; 12/129) than in men (3.0%; 4/132) accounting for a relative risk of 3.07; 95% confidence interval (CI) =1.02-9.27. In logistic regression models, the association between sex and death was not significantly altered when the following parameters were considered: age, depression of the ST segment, history of previous AMI and risk factors for coronary heart disease. The nonadjusted and adjusted odds ratio (OR) for the distinct covariables were 3.28 (CI 95%=1.03-10.45) and 3.14 (CI = 95% = 0.88-11.20), respectively. CONCLUSION: Similarly to AMI, HM in UA is higher in women than in men. Age, risk factors for coronary heart disease, and depression of the ST segment in the electrocardiogram on patients’ admission to the hospital did not significantly influence the association between sex and death.

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Case Report

Hypoperfusion of the left ventricle in the absence of changes in segmental contractility as observed through echocardiography by using microbubbles during dobutamine infusion

Ana Lúcia Martins Arruda et al. Altamiro Ozório Eloisa Mattos José Lázaro de Andrade … Thomas Porter Wilson Mathias Jr

Case Report

Hypoperfusion of the Left Ventricle in the Absence of Changes in Segmental Contractility as Observed through Echocardiography by Using Microbubbles During Dobutamine Infusion

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Case Report

Catheter-induced 3:1 second degree atrioventricular nodal block during atrioventricular nodal reentrant tachycardia

Leandro Zimerman et al. Claudio Medeiros Gustavo Lima

Case Report

Catheter-Induced 3:1 Second Degree Atrioventricular Nodal Block During Atrioventricular Nodal Reentrant Tachycardia

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Original Article

Are apolipoproteins A and B better than lipoproteins for assessing risk of obstructive coronary heart disease?

Waldomiro Carlos Manfroi et al. Alcides José Zago Marcelo Campos Alexandre Alves … Maria Lúcia Brisolara Josiane de Souza Rafael Henriques Candiago Luciana Kirschnick Letícia Ribeiro Kárem Ordovás Cristiane Leitão Rosana Cruz

OBJECTIVE: To evaluate whether apolipoproteins A-I (Apo A-I) and B (Apo B) have, higher ensitivity (SN), specificity (SP) and positive predictive value (PPV) than lipoproteins (LP), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), and triglycerides (TGL) in assessing the risk of coronary heart disease (CHD). METHODS: This is a transversal case-control study of 241 patients, who were divided into two groups: 1) 145 patients with CHD, and 2) 96 patients without coronary disease. A model of logistic regression to evaluate the relation between the LPs and CHD was developed in which variables with a p-alpha <0.1 were included. RESULTS: Apo A-I levels were higher in the patients without CHD, (OR 2.08, CI 1.20-3.57). There were no statistical differences between the values of Apo A-I and the remaining lipid fractions (Apo A-I: 67%; Apo B: 100%; PPV: TC= 71%; TGC=71%; HDL=71%; LDL=71%). The costs of the tests in Reais were as follows: Apo A-I: R$ 56.60; Apo B-100: R$ 56.60; TC: R$ 9.94; HDL: R$ 21.30; LDL: R$ 28.40; TGL: R$ 14.20. CONCLUSION: Levels of Apo A-I and Apo B have no advantage over conventional lipoproteins in predicting the risk of CHD, despite the statistical association between Apo A-I and CHD; in addition, their costs are higher than those of the conventional lipoproteins.

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Brief Reports

Radiofrequency catheter ablation in patients with atrial fibrillation

Mauricio Scanavacca et al. Eduardo Sosa André D'Ávila Fernando Tondato … Francisco Darrieux Denise Hachul Antonio Bahia Paulo Cavalcanti Flávio Oliveira

Brief Report

Radiofrequency Catheter Ablation in Patients with Atrial Fibrillation

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Original Article

Myocardial perfusion by contrast echocardiography. Establishment of normal pattern of intracoronary injection and safety in humans

Fernando Morcerf et al. Armando Luiz Cantisano Flavia Salek Carlos Alberto Mendonça … Guilherme Paulino Flavio Cure Palheiro Antonio Carlos Nogueira Wanderley Quarte Pereira Álvaro Moraes

OBJECTIVE: To establish the normal pattern and safety of echocardiographic contrast in patients with no significant obstruction of epicardial coronary arteries. METHODS: 67 patients with normal coronary arteries or obstructions < 50% were selected from 277 patients who underwent coronary angiography (CA). Mean age was 56 ± 11years and 36 were males. At the end CA, echocardiographic contrast was selectively injected into each coronary artery. The parasternal short axis of the left ventricle (LV) was divided into six segments: anterior (A), antero-lateral (AL), postero-lateral (PL), posterior (P), infero-septal (IS) and antero-septal (AS). Anterolateral (ALPM) and posteromedial papillary muscles (PMPM) were also considered. The pattern and intensity of the appearance of the myocardial contrast was visually analyzed. RESULTS: The right coronary artery (RCA) was dominant in 60 patients. Contrast appearance was sudden and simultaneous in the 3 muscle layers. All segments could be contrasted after the injection in both coronary arteries. 100% of the AS, A and AL segments, 97% of the PL and 98% of the ALPM were perfused by the left coronary artery (LCA). P and IS segments were perfused by the RCA in 85% and 82%, respectively, and by a dominant LCA in 71% of the cases. The PMPM was perfused by a dominant RCA in 77% and by a dominant LCA in 86%. There were no symptoms. CONCLUSION: Intracoronary injection of the sonicated solution is a safe procedure that allows for an excellent opacification of the myocardium and can potentially be used during routine CA.

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Updated

Detection of functional changes of the fetal heart in the first trimester of gestation

Carlos Geraldo Viana Murta et al. Antônio Fernandes Moron Márcio Augusto Pinto de Ávila

The authors consider the possibility of using color Doppler of the ductus venosus and the measurement of nuchal translucency as a screening test for alterations in fetal cardiac functions in the first trimester of gestation. Review of the literature suggests that the combination of the ultrasonographic measurement of nuchal translucency and Doppler at 10 and 14 weeks of gestation can be effective in detecting certain cardiac abnormalities. This conclusion, however, is preliminary and needs to be further investigated.

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