Índice de dissincronia ventricular: comparação com a fração de ejeção bidimensional e tridimensional

Vieira, Marcelo Luiz Campos; Cury, Alexandre Ferreira; Naccarato, Gustavo; Oliveira, Wercules; Monaco, Claudia; Cordovil, Adriana; Rodrigues, Ana Clara Tude; Filho, Edgar Bezerra Lira; Fischer, Cláudio Henrique; Morhy, Samira Saady

doi:10.1590/s0066-782x2008001500004

Cited by 12 publications

(8 citation statements)

References 13 publications

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“…However, production of PF involves not only filtration processes, but also active mechanisms resulting in the accumulation of several biologically important substances, which are produced by the myocardium. Such substances are endothelins (ETs) [ 5 ], adenine nucleosides [ 6 ], angiotensin [ 7 ]. It has also been revealed that these substances present in higher concentration in the PF compared to the plasma.…”

Section: Introductionmentioning

confidence: 99%

Elevated Levels of Asymmetric Dimethylarginine (ADMA) in the Pericardial Fluid of Cardiac Patients Correlate with Cardiac Hypertrophy

et al. 2015

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BackgroundPericardial fluid (PF) contains several biologically active substances, which may provide information regarding the cardiac conditions. Nitric oxide (NO) has been implicated in cardiac remodeling. We hypothesized that L-arginine (L-Arg) precursor of NO-synthase (NOS) and asymmetric dimethylarginine (ADMA), an inhibitor of NOS, are present in PF of cardiac patients and their altered levels may contribute to altered cardiac morphology.MethodsL-Arg and ADMA concentrations in plasma and PF, and echocardiographic parameters of patients undergoing coronary artery bypass graft (CABG, n = 28) or valve replacement (VR, n = 25) were determined.ResultsWe have found LV hypertrophy in 35.7% of CABG, and 80% of VR patients. In all groups, plasma and PF L-Arg levels were higher than that of ADMA. Plasma L-Arg level was higher in CABG than VR (75.7±4.6 μmol/L vs. 58.1±4.9 μmol/L, p = 0.011), whereas PF ADMA level was higher in VR than CABG (0.9±0.0 μmol/L vs. 0.7±0.0 μmol/L, p = 0.009). L-Arg/ADMA ratio was lower in the VR than CABG (VRplasma: 76.1±6.6 vs. CABGplasma: 125.4±10.7, p = 0.004; VRPF: 81.7±4.8 vs. CABGPF: 110.4±7.2, p = 0.009). There was a positive correlation between plasma L-Arg and ADMA in CABG (r = 0.539, p = 0.015); and plasma and PF L-Arg in CABG (r = 0.357, p = 0.031); and plasma and PF ADMA in VR (r = 0.529, p = 0.003); and PF L-Arg and ADMA in both CABG and VR (CABG: r = 0.468, p = 0.006; VR: r = 0.371, p = 0.034). The following echocardiographic parameters were higher in VR compared to CABG: interventricular septum (14.7±0.5 mm vs. 11.9±0.4 mm, p = 0.000); posterior wall thickness (12.6±0.3 mm vs. 11.5±0.2 mm, p = 0.000); left ventricular (LV) mass (318.6±23.5 g vs. 234.6±12.3 g, p = 0.007); right ventricular (RV) (33.9±0.9 cm2 vs. 29.7±0.7 cm2, p = 0.004); right atrial (18.6±1.0 cm2 vs. 15.4±0.6 cm2, p = 0.020); left atrial (19.8±1.0 cm2 vs. 16.9±0.6 cm2, p = 0.033) areas. There was a positive correlation between plasma ADMA and RV area (r = 0.453, p = 0.011); PF ADMA and end-diastolic (r = 0.434, p = 0.015) and systolic diameter of LV (r = 0.487, p = 0.007); and negative correlation between PF ADMA and LV ejection fraction (r = -0.445, p = 0.013) in VR.ConclusionWe suggest that elevated levels of ADMA in the PF of patients indicate upregulated RAS and reduced bioavailability of NO, which can contribute to the development of cardiac hypertrophy and remodeling.

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Section: Introductionmentioning

confidence: 99%

Elevated Levels of Asymmetric Dimethylarginine (ADMA) in the Pericardial Fluid of Cardiac Patients Correlate with Cardiac Hypertrophy

et al. 2015

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“…50% of the studies analysed use this technique to carry out postoperative control of patients (12-14). The use of the Holter as well as a longer follow-up period after injection of the anesthetic is thoroughly justified by the complexity of these patients and the risk of accident, even of a subclinical type (which we must detect) in the hours following the administration of the anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…The exclusion criteria ban from the studies those patients with temporary conditions which contraindicate the use of the treatment (acute myocardial infarction of less than three or six months of evolution (11,14) or those with severe varieties of the pathologies under study (severe hypertension, class IV heart failure (10,12). So far, there is no information available on the effects local anesthetics associated to vasoconstrictor agents may have on the cardiovascular system of these patients, therefore we must avoid their use, or be extremely cautious in case of administration.…”

Section: Discussionmentioning

confidence: 99%

Use of anesthetics associated to vasoconstrictors for dentistry in patients with cardiopathies. Review of the literature published in the last decade.

Serrera-Figallo¹,

Cayón²,

Lagares³

et al. 2012

J Clin Exp Dent

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Objective: The use of local anesthetics associated to vasoconstrictor agents in dentistry is thoroughly justified and is widely extended, but we cannot ignore the fact that anesthetic infiltration poses risk of complications throughout the dental treatment period. The objective of the present review is to document the reported effects the use of the local anesthetics most widely employed in dentistry, with or without association to vasoconstrictor agents may have in patients with any sort of cardiopathy. Study Design: We have searched for randomized clinical trials on the assessment of the cardiovascular effects of local anesthetics used in dentistry, without limits as regards age or sex, conducted in patients with any type of cardiopathy which were published during the last decade and were index-linked in Cochrane, Embase and Medline. Results: We have found six randomized clinical trials index-linked in Medline and Cochrane in the past ten years. These trials compare different types of anesthetics: lidocaine 2%, mepivacaine 2%, prilocaine 2% , associated or not to different vasoconstrictor concentrations such as adrenaline or felypressin. The cardiopathies affecting the patients included in the different trials range from hypertension, ischemic heart disease, arrythmias, chronic coronary disease to heart transplantation. Conclusions: The use of anesthetics associated to vasoconstrictor agents is justified in the case of patients with cardiopathies (once we get over the period in which any type of dental manipulation is contraindicated) and in controlled hypertensive patients. In any case, we must be very careful with the choice and execution of the anesthetic technique, being it possible to use a dose between 1.8 and 3.6 ml, on a general basis. Further studies are necessary to establish the effects of these drugs on severe hypertensive patients or in patients with other more advanced cardiopathies. Key words:Vasoconstrictor agents, epinephrine/adverse effects, local anesthetics, dental restoration, oral surgery, cardiovascular diseases, coronary arteriosclerosis, heart disease, hypertension, arrhythmias, coronariopathy.

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“…The sigma represents the standard deviation of the mean end-systolic contraction time of each segment compared to global end-systolic contraction (a lower index indicates lower dyssynchrony); a value of less than 8% is considered normal. The disadvantage of this method is the low number of frames [33][34][35] . New techniques have been developed to evaluate intraventricular dyssynchrony, such as the two-dimensional strain, in which a computer software analyzes the deformation suffered by the muscle in two dimensions and not only toward the Doppler [36][37][38] beam.…”

Section: Assessment Of Intraventricular Dyssynchronymentioning

confidence: 99%

O ecocardiograma na terapia de ressincronização cardíaca

Veiga¹,

Abensur²,

Rojas³

2009

Arq. Bras. Cardiol.

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Índice de dissincronia ventricular: comparação com a fração de ejeção bidimensional e tridimensional

Abstract: SummaryBackground: Left ventricular (LV) electromechanical coupling (synchrony) is important in the analysis of the systolic performance, especially for the indication of cardiac resynchronization therapy in patients with advanced CHF.

Cited by 12 publications

References 13 publications

Elevated Levels of Asymmetric Dimethylarginine (ADMA) in the Pericardial Fluid of Cardiac Patients Correlate with Cardiac Hypertrophy

Elevated Levels of Asymmetric Dimethylarginine (ADMA) in the Pericardial Fluid of Cardiac Patients Correlate with Cardiac Hypertrophy

Use of anesthetics associated to vasoconstrictors for dentistry in patients with cardiopathies. Review of the literature published in the last decade.

O ecocardiograma na terapia de ressincronização cardíaca

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