[Early physical conditioning of patients surgically treated for myocardial revascularization. Influence on the functional capacity].

Purpose: To evaluate the early physical conditioning (PC) effect [initiated 15 days after the myocardial revascularization surgery (MRS)] in the functional capacity.

Methods: Twenty-two male patients (mean-age of 52y-o), divided in two groups (A and B, 11 patients each), were studied. Group A started PC 3 months after MRS (phase III), with a training intensity of about 70% of the maximum heart rate reserve, during three months, three sessions per week with one hour duration.

[Exercise capacity evaluation in patients with mild to moderate left ventricular dysfunction. Influence of captopril].

Purpose: To analyse the captopril influence on physical activity on the six or nine minute walk test in patients with left ventricular dysfunction and mild or moderate failure.

Methods: Twenty one patients with functional class II or III heart failure and left ventricular diastolic diameter greater than 55 mm and with ejection fraction less than 45% were studied. Twelve were male, and the patients age range from 34 to 63 years old (mean 48 years).

[Pulmonary atresia with intact ventricular septum. Natural development of the right ventricle].

A case of pulmonary atresia with intact ventricular septum and a hypoplastic right ventricle, with three wall formed portions, that became naturally well developed until 2 years of age, is related. A Blalock-Taussig shunt had been performed early in life. Z value of tricuspid valve of 0.

[Mitral stenosis correction by double catheter-balloon valvuloplasty technique].

Purpose: To evaluate long-term efficacy of double balloon percutaneous mitral valvuloplasty technique (PMV2B).

Methods: Sixty-eight patients (76% female), mean-age 32 (15-69) years who had been submitted to PMV2B, that completed clinical and echodopplercardiographic one year follow-up (PO12M). Admission criteria were: exertional dyspnoea, no thromboembolism antecedent up to three months before the procedure, absence of other cardiac disease requiring correction, an admissible echodopplercardiographic score, absence of intracavitary thrombus and mitral regurgitation absent or minor.

[Acute atrial fibrillation in the emergency room. Which is the best drug for a rapid sinus rhythm conversion?].

Purpose: To evaluate differences between amiodarone, procainamide and quinidine in the time delay necessary to convert acute atrial fibrillation (AF) to sinus rhythm.

Methods: Sixty patients with acute AF were randomized in three groups (G) and treated with: quinidine (QG)-(21 patients) i.v.

[Comparative study between ibopamine and captopril in mild and moderate heart failure. A double-blind study].

Purpose: To evaluate the effect on symptoms, exercise capacity (stress test) and myocardial response (Echo, and Holter) of ibopamine or captopril in patients with congestive heart failure.

Methods: Double-blind, parallel randomized study of 18 patients, 9 in each group, studied during three months at the outpatient clinic. Twelve were male, 6 female, all in heart failure functional class II or III.

[Chronic rheumatic cardiopathy in a patient with of hemophilia successfully treated with surgery].

A 52 year-old man, with rheumatic cardiopathy and hemophilia was admitted to the hospital for aortic valve replacement and mitral valve commisurotomy. He had a history of allergic reaction to cryoprecipitate, and to undergo to the cardiac surgery, the ideal level of factor VIII was estimated to be 100%. To reach this level he first received 2,500UI of the factor VIII:C increasing the factor VIII:C level from 20 to 58%.

[Transesophageal echocardiography in the study of vascular anastomosis in a patient with right lung transplantation].

A 46 years-old man was submitted to right orthotopic lung transplantation due to pulmonary emphysema. The transesophageal echocardiography was important in the evaluation of functional and morphological aspects of pulmonary vessels after this proceeding.

[Study of myocardial viability by thallium-201 SPECT. Conventional redistribution versus reinjection].

Purpose: To verify if a third series of images acquired by reinjection thallium-201, 24h after conventional myocardial perfusion with the radioisotope, improves the identification of myocardial viability segments.

Methods: We studied 30 patients, mean age 57.7 +/- 9.

[Randomized, double-blind comparative study between pravastatin and lovastatin. Evaluation of efficacy and safety].

Purpose: To verify eventual difference observed in the efficacy and safety of lovastatin (L) when compared to pravastatin (P), considering increasing doses up to the maximum and recommended ones in clinical practice.

Methods: Forty-eight hypercholesterolemic patients (LDL-C > 160 mg/dl after a placebo seven-day period) were studied and randomly assigned to constitute groups of 24 patients (GL and GP groups). The patients from GL group received L 20 mg/day and those from GP group P 10 mg/day, in a double-blind fashion.

[Aneurysms of the left and non coronary sinus of Valsalva associated to mitral and aortic rheumatic valves and obstructive coronary disease].

A 30 years old, male, patient with rare multiple aneurysms of sinus of Valsalva associated to mitral and aortic regurgitation and total occlusion of circumflex artery had the clinical diagnosis made accidentally. The multiple aneurysms were detected by transesophageal echodopplercardiography and hemodynamic study. The diagnosis were confirmed at surgery and the patient underwent correction of the aneurysms through the use of pericardial patches and mitral and aortic valve replacement.

[Acquired ventricular septal defect during infective endocarditis].

We studied five patients with acquired ventricular septal defect during the course of an infective endocarditis. All patients were male and had a previous aortic valve disease associated with an aortic ring abscess. Clinical examination was useful for the diagnosis of 4 cases, emphasizing the following findings: systolic murmur and/or left paraesternal thrill and right-heart failure.

[Acute liver failure secondary to cardiogenic shock in patients with congestive heart failure].

Fulminant hepatic failure is a complication of severe cardiocirculatory failure, with high morbidity and mortality, and is frequently misdiagnosed as fulminant viral hepatitis. We report three cases of patients with chronic severe heart failure who developed cardiogenic shock complicated by elevation of aminotransferase levels above 1,000 soon after the most severe episode of hypotension. All the three patients presented regression of hepatic enzymes 72h after admission.

[Ischemic mitral valve insufficiency. Incidence, diagnosis and surgical treatment].

Purpose: To study the incidence of ischemic mitral regurgitation (MR) and the mortality.

Methods: One-hundred-five cases of acute myocardial infarction (AMI) with MR were reviewed. Patients were divided in two groups: group A-59 (56.

[Hypertension and complex ventricular arrhythmias. Evolution following a long-term blood pressure treatment].

Purpose: To evaluate the effects of long-term antihypertensive treatment in the frequency as well as in the complexity of ventricular arrhythmias in arterial hypertension.

Methods: Twenty three patients, 14 males and 11 whites, with mean age of 46 years, were submitted to 24 hours ambulatory electrocardiographic monitoring and echocardiographic studies before and 9 months after antihypertensive treatment.

Results: There was no significant serum potassium level alteration, but significant reductions of both systolic (from 192 +/- 29mmHg to 161 +/- 25mmHg) and diastolic (from 122 +/- 17mmHg to 99 +/- 16mmHg) blood pressure.

[Arrhythmias following orthotopic heart transplantation].

Purpose: To correlate the incidence of arrhythmias to the degree of allograft rejection on endomyocardial biopsy.

Methods: Seventeen patients who underwent orthotopic heart transplantation were submitted to ambulatory Holter monitoring 24h prior to endomyocardial biopsy. The biopsy results were compared to Holter monitoring results.

[Reproducibility of head-up tilt test in patients with neurocardiogenic syncope].

Purpose: In order to identify the reproducibility of head-up tilt test, a second test one week later in 22 patients with a positive first test, was performed.

Methods: The test was performed in a fasting state during the morning. The heart rate and blood pressure were monitored during 20 minutes in the supine position and then at 60 degrees for up to 40 minutes.

[Laser coronary angioplasty. Critical analysis of the first patients].

Purpose: To evaluate the success rate and complications, as well as the technical difficulties involved catheter laser coronary angioplasty, making evident the unsuccessful cases.

Methods: Twenty eight patients were treated with laser from August to November, 1993. The treatment was complemented with balloon angioplasty.

[Diagnostic value of the tilt test in the evaluation of syncope of unknown origin. Preliminary results].

Purpose: In order to identify neurally mediated syncope, head-up tilt testing was performed in patients with recurrent unexplained syncope.

Methods: The tests were performed in 125 patients in the fasting state, between 8:30 and 11:30 a.m.

[Intermittent ventricular pre-excitation in the presence of total atrioventricular block].

An 8 year old child suffering from asthenia and complete atrioventricular block, probably congenital. During the tread-mill test there was a sudden electrocardiogram change to a ventricular preexcitation pattern. Besides this rare association, we emphasize the importance of the autonomic balance over the accessory pathway's electrophysiological properties.