[Long-term course and complications of arterial hypertension after heart transplantation].

Purpose: To evaluate the progression of arterial hypertension (AH) and its consequences, in patients submitted to cardiac transplantation (CT) in use of cyclosporine (CY).

Methods: In 65 patients submitted to orthotopic CT, we evaluated blood pressure, serum creatinine and blood levels of CY before, 15 and 30 days, and 6, 12, 24, 48 and 60 months after CT; in 20 patients we analyzed cardiac index and systemic vascular resistance pre-CT, 15 and 30 days, 6 and 12 months after CT; in 33 patients, we studied anatomic and functional modifications by echocardiography, 24 +/- 13 months after CT.

Results: Thirty days after CT, AH was present in 58.

[Cardiac amyloidosis. A disease with many faces and different prognosis].

Purpose: To identify the principal forms of cardiac amiloydosis presentation in a terciary hospital.

Methods: Eight cases with cardiac amyloidosis were identified. Five were women, their ages ranged from 23 to 83 years (mean 62).

[Clinical profile of aged patients with severe aortic stenosis].

Purpose: To evaluate clinical symptoms and echocardiographic findings in elderly patients with severe aortic stenosis and possible gender differences.

Methods: We studied 54 patients, 24 (44.5%) males and 30 (55.

[Minimally invasive myocardial bypass surgery using video-assisted thoracoscopy].

Purpose: In order to associate the major benefits of the coronary artery bypass graft (CABG) with a less aggressive procedure minimally invasive coronary artery bypass graft (MICABG) has been utilized. The aim of the work is to report our initial experience with this technical approach, using video assisted thoracic surgery (VATS) to facilitate the operation.

Methods: Twenty-six patients, 19 males with ages from 44 to 83 years old, and having isolated lesion of the anterior descending artery were operated upon.

[Persistence of palpitations after successful radiofrequency catheter ablation].

Purpose: The aim of this study was to determine prevalence and the underlying mechanism of persistent palpitations after successful radiofrequency ablation of reentrant nodal tachycardia and atrioventricular tachycardia.

Methods: One hundred twenty consecutive patients (mean age of 36 +/- 16 years) who underwent radiofrequency catheter ablation of atrioventricular or reentrant nodal tachycardia constituted the analyzed group. Prevalence of palpitations was investigated during out-clinic visits and telephone interviews.

[Effects of partial ventriculectomy on left ventricular mechanical properties, shape, and geometry in patients with dilated cardiomyopathy].

Purpose: To investigate the short-term effects of the partial ventriculectomy (resection of lateral wall associated to mitral annuloplasty) on cardiac mechanics, contractility, shape and geometry of the left ventricle (LV).

Methods: Eleven male patients with severe congestive heart failure due to dilated cardiomyopathy were studied. The mean age was 51 +/- 7 years and the functional class was III (five patients) or IV (six patients) before the surgery.

[Coronary transluminal angioplasty in octogenarians].

Purpose: To evaluate the immediate and long term results of percutaneous transluminal coronary balloon angioplasty (PTCA) in patients over 80 years old.

Methods: From 1/1/89 to 6/31/95, 97 patients with 80 years of age or older were submitted to PTCA and were divided into three groups: group A (GrA)-30 patients with stable angina, mean age of 82.5 years, 24 (80%) men; group B(GrB)-40 patients with unstable angina, mean age 81.

[Clinico-pathological correlation in the indeterminate form of experimental Chagas' disease in dogs].

Purpose: To study the functional cardiac component of the indeterminate form of experimental Chagas' disease in dogs.

Methods: Four dogs chronically infected with Trypanosoma cruzi and eight normal controls were used. They were submitted to several invasive procedures, either in the presence of complete autonomic block or not, to test for disturbances in the origin and conduction of electric stimuli and the function of cardiac muscle.

[Results of aortic stenosis surgery in patients with severe ventricular dysfunction].

Purpose: To study the short and long term clinical course of patients with severe aortic stenosis after surgical treatment of the valvular lesion.

Methods: Thirty survivors among 31 consecutive patients with severe left ventricular dysfunction (LVD) due to aortic stenosis (AS) were submitted to clinical and echocardiographic follow-up during a mean of 30 months after surgical treatment of the valvular lesion. Twenty five (83.

[Mitral subvalvular aneurysm of the left ventricle].

A 21-year-old white man presented with cardiogenic shock and refractory pulmonary congestion. At the transthoracic echocardiogram a subvalvar left ventricular aneurysm of the inferior wall with severe mitral regurgitation was observed. The outcome was favorable after surgical correction of the mitral regurgitation and of the subvalvar aneurysm.

[When should we stop cardiopulmonary resuscitation in patients brought to the emergency room in cardiac arrest without pre-hospital care?].

Purpose: The decision of stopping cardiopulmonary resuscitation (CPR) in patients brought to emergency room in arrest remains a challenge. Such decision is even more difficult when someone is brought by bystanders, after an acute loss of consciousness without any out-of-hospital care. To evaluate the probability of survival of these patients we reviewed retrospectively charts in our institution, during a period of five years.

[Endomyocardial fibrosis with massive biventricular endocardial calcification].

Endomyocardial fibrosis is an endemic cardiac disease, characterized by the presence of fibrous tissue in the endocardium, eventually extending to the myocardium. Massive endocardial calcification of the left ventricle is a rare finding, with only a few cases reported in the literature. We reported a first case of biventricular massive endocardial calcification associated with endomyocardial fibrosis in a 22 year old woman.

[Intensive Care Unit stay. Variables that affect emotional reactions].

Purpose: To evaluate the anxiety and depression levels during five days of stay in a Clinical Cardiological Intensive Care Unit (ICU) and verify the relation to different variables.

Methods: Forty seven patients were submitted to IDATE scale for anxiety and an avaliation for depression. The scores were compared to medical diagnoses, age, local of stay before the ICU, number of hospitalizations.

[Risk factors in elderly patients selected by primary care physicians for hypolipemic treatment].

Purpose: To evaluate the influence of age on response to pravastatin treatment in patients treated by community physicians.

Methods: According to age, 873 patients were divided in three groups: group A with ages ranging from 45 to 59 years (n = 55), group B with ages from 60 to 64 years (n = 182) and group C with ages from 65 to 70 years (n = 143). After four weeks only with diet orientation, patients received 10 mg/day of pravastatin for 12 weeks.

[Acute effects of ibopamine on left ventricular mechanics and contractility in patients with idiopathic dilated cardiomyopathy].

Purpose: The effects of ibopamine (IBO) on left ventricular (LV) mechanics and contractility have not been described. The aim of this study was to test the hypothesis that IBO has a contractile effect at a dose of 200 mg.

Methods: Ten male patients (43 +/- 7 years) with refractory heart failure due to idiopathic dilated cardiomyopathy were studied.

[When does the treatment with captopril show a better improvement in physical performance in patients with heart failure?].

Purpose: Considering that heart failure reduces exercise capacity and that converting enzyme inhibitor increases this capacity, using the 6 min walk test we try to demonstrate when the treatment with captopril shows a better improvement in exercise capacity in patients with heart failure.

Methods: Twenty one patients with functional class II or III heart failure (NYHA), left ventricular diastolic diameter greater than 55 mm and with ejection fraction less than 45% were studied. Twelve were male, and the patients mean age was 48 years.

[Effects of rejection on the contractile reserve of the graft after heart transplantation].

Purpose: To test the hypothesis that rejection could affect the contractility and contractile reserve of left ventricle after heart transplantation.

Methods: Echocardiographic parameters and noninvasive blood pressure end-systolic pressure (ESP), heart rate (HR), end diastolic (EDV) and end-systolic (ESV) volumes, ejection fraction (EF), end-systolic stress (ESS) and the end-systolic relation (ESS/ESV) were recorded in 68 studies in 11 patients, seven days-12 months after heart transplantation. Accordingly with the endomyocardial biopsies results were divided into two groups: group A-with no rejection (53 studies), and group B-with rejection (15 studies).

[Normal maximal functional capacity in patients with congestive heart failure due to Chagas' cardiomyopathy].

Purpose: To compare patients with heart failure due to Chagas' cardiomyopathy and maximal oxygen consumption greater than 20mL/kg-1/min-1 to normal individuals.

Methods: We studied 104 male patients with heart failure due to Chagas' cardiomyopathy, functional classe II-IV, age 18 to 65 years (40.3 +/- 9.

[Coronary artery perforation with rotational coronary atherectomy].

The authors describe a rare case of circumflex coronary artery perforation during rotational coronary atherectomy complicated with cardiac tamponade and good outcome. The possible causes of perforation are discussed and the burr oversize (burr/artery ratio was 0.58) was refused.

[Precision and accuracy of blood lipid analyses by a portable device (Cholestech-LDX)].

Purpose: To verify whether precision and accuracy of lipids analyses by a new portable device, Cholestech-lipid desktop analyzer (LDX), were in agreement with the guidelines of the National Cholesterol Education Program (NCEP).

Methods: Serum samples from 45 outpatients were collected for the determination of total Cholesterol (TC), HDL-cholesterol (HDL-C) and triglycerides (TG). These samples were analysed simultaneously by the Cholestech-LDX, and by the automatic enzymatic methods routinely used at the Heart Institute's laboratory.

Rupture of posteromedial papillary muscle as a mechanism of death in dilated cardiomyopathy.

The pathogenesis of mitral regurgitation in dilated cardiomyopathy is ascribed to several mechanisms. The authors describe the case of an adult male with idiopathic dilated cardiomyopathy who developed myocardial infarction in the absence of coronary atherosclerosis and died from acute lung edema following rupture of a papillary muscle of the left ventricle. The possibility of coronary embolism could not be ruled out.

[Total anomalous pulmonary venous connection. Experience with 70 cases].

Purpose: To evaluate the clinical and surgical experience with consecutive patients with isolated total anomalous pulmonary venous connection admitted to the Heart Institute, São Paulo, Brasil.

Methods: Hospital records of 70 consecutive patients (January 1985 to December 1993) were retrospectively reviewed. There were 28 girls and 42 boys whose ages ranged from two days to four years (mean 20.

[Contraceptive use in women with heart disease].

Purpose: To analyse efficacy, tolerance and adverse events of reversible contraceptives in women with cardiac disease.

Methods: We studied prospectively during 24-39 (mean = 29) months, 89 women with heart disease with a mean age of 25.6 (16-42) years.