Background and Aim: The relationship between inspiratory muscle weakness and exercise intolerance in patients with heart failure has not been established, especially in elderly patients. The aim of this study was to investigate the relationship between inspiratory muscle strength and exercise tolerance according to age in elderly patients with heart failure. Methods: A total of 25 hospitalized patients were allocated to younger group (age<75) or older group (age>75). Medical records were reviewed with regard to echocardiograms (EF, LVDd/Ds), laboratory data (BNP), chest X-ray (CTR). We assessed inspiratory muscle strength (PImax), knee extensor muscle strength (KEMS), six-minute walk distance (6MWD) and normal / maximal gate speed. The correlation between 6MWD and other values was tested by Pearson's product-moment correlation coefficient in each group. Differences between 2 groups were compared with using stu-dent's t-test. A P-value of <.05 was considered to be statistically significant. Results: 6MWD was significantly correlated with PImax (r=0.74), KEMS (r=0.81), normal gate speed (r=0.71), maximal gate speed (r=0.68) in younger group. On the other hand, 6MWD was significantly correlated with only KEMS (r=0.57) and maximal gate speed (r=0.63) in older group. The value of 6MWD was shorter and the value of gate speed was slower in older group compared with those values in younger group (p<.05). Conclusion: These results suggested that inspiratory muscle weakness might be associated with exercise intolerance in younger patients with heart failure. Meanwhile, muscle strength and gate speed might be important as a determining factor of exercise tolerance in elderly patients with heart failure. Background: Although Chinese pulmonary function testing (PFT)

In CHF patients with IMW, IMT results in a significant increase in OUES.

Objectives: In the treatment of acute myocardial infarction (MI), the time delay to achieve reperfusion of the infarction-related artery has been linked to survival rates. Primary or direct angioplasty has been found to be an excellent means of achieving reperfusion in acute ST-elevation MI compared to thrombolytic therapy in randomized trials. However, no mortality benefit of primary angioplasty over thrombolysis was observed in several registries, in which delays in performing primary angioplasty were longer. Our objectives were to evaluate the door-to-balloon time (DBT) in our institution and investigate its relationship with clinical and prognostic variables. Methods:We studied, retrospectively, 67 patients submitted to primary angioplasty, from January 1999 to November 2000. We divided our patient population into two groups. Group A (GA) included patients with DBT less than 120 min and group B (GB) patients with DBT greater or equal to 120 min. We evaluated several clinical variables, such as left ventricular ejection fraction (LVEF) on their first echocardiogram during hospitalization, admission Killip classification, in-hospital length of stay (LOS) and major cardiovascular events (MACE) during hospitalization and up to 6-month follow-up (in 23 patients). Results:The median DBT was 132 min and the mean was 165 min, with a standard deviation of 137 min for all the cases. We had 32 patients in the GA and 35 patients (52%) in the GB. We observed four in-hospital deaths, all in GB. The mean LVEF was 53.1 ± 9% in GA and 46.1 ± 13% in GB (P = 0.059). Admission Killip class greater than 1 was noted in three patients of each group. The in-hospital LOS was similar for both groups (GA = 8.35 ± 4 and GB = 8.33 ± 4 days; NS). In-hospital events occurred in eight patients of GA (25%) and seven patients of GB (20%; NS). Only five follow-up events occurred during the first 6 months, three events in GA patients and two in GB patients (NS). Conclusion:DBT greater than or equal to 2 h are common and in our population it occurred in more than half of the primary angioplasties. Greater than 2 h DBTs were associated with a trend to larger left ventricular dysfunction early after MI. Monitoring and measures to reduce DBT are crucial for the potential prognosis improvement offered by primary angioplasty and for the broadening of its use in the management of acute MI. P2Primary angioplasty versus streptokinase in elderly patients with acute myocardial infarction PF Leite, M Park, VS Kawabata, MS Barduco, S Timerman, LF Cardoso, JAF Ramires Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil Because only a few studies about acute myocardial infarction (AMI) include elderly patients, we compared outcomes of patients aged 70 years or older with AMI who underwent thrombolysis or primary angioplasty treatment. Methods:From April 1995 to June 1999, 64 patients within 12 h of symptom onset and no contraindications for thrombolytic therapy were randomized in two groups. Group I (32 patients, 20 men) sub...

Objectives: In the treatment of acute myocardial infarction (MI), the time delay to achieve reperfusion of the infarction-related artery has been linked to survival rates. Primary or direct angioplasty has been found to be an excellent means of achieving reperfusion in acute ST-elevation MI compared to thrombolytic therapy in randomized trials. However, no mortality benefit of primary angioplasty over thrombolysis was observed in several registries, in which delays in performing primary angioplasty were longer. Our objectives were to evaluate the door-to-balloon time (DBT) in our institution and investigate its relationship with clinical and prognostic variables.