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ISSN (Print): 2359-4802 | ISSN (Online): 2359-5647

Edition: 24.1 - 11 Article(s)



Ricardo Mourilhe Rocha

Rev Bras Cardiol. 2011;24(1):8


Original Article

Evaluation of cardiovascular risk factors and pre-operative electrocardiogram alterations in the extreme elderly

Avaliação dos fatores de risco cardiovascular e alteração eletrocardiográfica pré-operatória no idoso longevo

José Augusto Sales; Carlos Alberto Bezerra Tomaz

Rev Bras Cardiol. 2011;24(1):9-17

Abstract PDF PORT

BACKGROUND: Cardiovascular risk factors (CRF) and electrocardiographic alterations (EA) in the extreme elderly (EE) offer important information for pre-operative evaluations.
OBJECTIVE: To determine the prevalence of cardiovascular risk factors such as arterial hypertension (AH), type 2 diabetes mellitus (DM), EA (atrial fibrillation - AF), ventricular extrasystole (VE) and left bundle branch block (LBBB) in EE referred for elective surgery.
METHODS: In a study of 100 EE men and women (54% women) more than 70 years old, fasting blood was collected in order to measure glucose and blood pressure, in addition to a twelve-lead electrocardiogram at rest.
RESULTS: Among these patients, 48% presented cardiovascular risk factors; EA: 25%; AH: 31%; DM: 5%; DM+AH: 12%%; AF: 9%; VE: 8%; and LBBB: 8%. All patients with LBBB presented histories of hypertension. These findings differ from those reported in the literature for young adults.
CONCLUSION: In this population, there was a higher prevalence of cardiovascular risk factors compared to EA, with LBBB appearing as an important characteristic for the extreme elderly with hypertension.

Keywords: Cardiovascular diseases; Risk factors; Aging; Aged; Preoperative care; Electrocardiography

Preparation of a scoring system for dietetic interventions in hyperlipidemic individuals

Elaboração de um sistema de pontos para intervenções dietéticas em indivíduos hiperlipidêmicos

Edeli Simioni de Abreu; Márcia Araújo Leite Nacif Pinheiro; Elizabeth Aparecida Ferraz da Silva Torres

Rev Bras Cardiol. 2011;24(1):18-25

Abstract PDF PORT

BACKGROUND: The existence of foods containing atherogenic substances that cause cardiovascular diseases is well known. An eating guide that is easy to handle and understand could thus help patients choose healthier foods.
OBJECTIVE: To prepare an eating guide as a tool for dietetic intervention in hyperlipidemic individuals.
METHODS: A food scoring system was drawn up, assigning points to foods using ordinary home measurements, considering the social and cultural characteristics of the population. A list of foods was prepared, assigning points based on the Cholesterol / Saturated Fat Index (CSI). This Index was calculated through a validated methodology based on the following formula: CSI=(1.01xg saturated fat) + (0.05xmg of cholesterol). A low score indicates good capacity for reducing hyperlipidemias. The individual fat and cholesterol requirements for calculating this Index are drawn from the American Heart Association recommendations.
RESULTS: A cholesterol score diet was designed and presented in a leaflet, together with explanatory materials, using the Healthy Food Guide Pyramid as this clearly demonstrates important food-related concepts, but reshaped into a heart in order to underscore its importance for preventing cardiovascular diseases.
CONCLUSION: A successful eating guide was prepared, using a points system to score cholesterol and fat in the blood. This tool can provide input for training professional health promoters, as well as offering guidance to patients and the population in general.

Keywords: Arteriosclerosis/etiology; Cholesterol/adverse effects; Fats,unsaturated; Diet; Hypercholesterolemia/etiology; Nutritional requirements; Coronary disease/prevention & control

Blood pressure behavior in hypertensive patients after walking and ballroom dancing sessions: preliminary study

Comportamento da pressão arterial em hipertensos após única sessão de caminhada e de dança de salão: estudo preliminar

Isabel de Castro Schenkel; Daiana Cristine Bündchen; Mirele Porto Quites; Rafaella Zulianello dos Santos; Márcio Borgonovo dos Santos; Tales de Carvalho

Rev Bras Cardiol. 2011;24(1):26-32

Abstract PDF PORT

BACKGROUND: There are few studies evaluating the acute effects of aerobic exercise on blood pressure, focused mainly on traditional exercises like walking. There is a gap on the effects of exercises such as ballroom dancing.
OBJECTIVE: To evaluate blood pressure behavior after a walk and a ballroom dancing session in hypertensive subjects.
METHODS: Eight sedentary people with high blood pressure taking anti-hypertensive medications were selected intentionally, with 75% being women with an average age of 56±11 years. They initially completed a pre-participatory ergospirometry evaluation test, for prescribing exercise intensity. Subsequently, they were evaluated through an ambulatory blood pressure monitoring during 22 hours on three occasions: a day without exercise, after a thirty-minute walk, and after a ballroom dancing session at 70%-75% of the peak heart-rate. The data were expressed as means and standard deviations, using the ANOVA one-way test for repeat measurements, considering p<0.05 as significant.
RESULTS: The mean values for the systolic (SBP) and diastolic blood pressure (DBP) during the total period (22 hours), awake and asleep for the three situations presented no statistical difference. During the 22 hours post-exercise, both types performed better than on the no-exercise day, being more evident during the hours after the ballroom dancing session, although with no statistical difference.
CONCLUSION: Blood pressure behavior was similar on the no-exercise day, after a walk and after a ballroom dancing session.

Keywords: Blood Pressure; Walking; Hypertension; Dancing

Intake of saturated fat and carbohydrates among adult and elderly patients with dyslipidemia in the Veranópolis project

Ingestão dietética de gordura saturada e carboidratos em adultos e idosos com dislipidemias oriundos do projeto Veranópolis

Celiana Bortoli; Simone Bonatto; Neide Maria Bruscato; Josiane Siviero

Rev Bras Cardiol. 2011;24(1):33-41

Abstract PDF PORT

BACKGROUND: Factors contributing to increased cardiovascular disease include dyslipidemia. As high consumption of saturated fats may step up the risk of cardiovascular diseases, this led to a recommendation on replacing fats by carbohydrates, resulting in the adoption of high carbohydrate diets that may result in more severe atherogenic dyslipidemia.
OBJECTIVE: To evaluate nutritional status and the consumption of saturated fats and carbohydrates among patients with dyslipidemia in the Veranópolis Project.
METHODS: This retrospective, descriptive and analytical observational study used the Veranópolis Project database, including all subjects with complete records of age, gender and lipid profile laboratory tests (total cholesterol, LDL-c, HDL-c and triglycerides), totaling 211 participants, and analyzing socio-economic, behavioral, anthropometric and nutritional variables.
RESULTS: Among the study participants, 75.8% were female, most aged >60 years, nonsmokers and sedentary. In terms of anthropometric variables, 40% of the sample was obese, with similar percentages for men and women. For the waist circumference, 60% were at far higher risk for cardiovascular disease. With respect to nutritional variables, carbohydrate consumption was higher than recommended for men and women, while the lipids percentage remained within recommended levels.
CONCLUSION: Most of the sample was overweight, with large waist circumferences, sedentary lifestyles, and diets featuring high carbohydrate intakes and low or adequate intakes of saturated fat.

Keywords: Atherosclerosis/prevention & control; Dietary carbohydrates/administration & dosage; Dietary fats/administration & dosage; Aged; Brazil

Review Article

Potassium ion channels associated with acquired long QT syndrome

Canais iônicos de potássio associados à síndrome do QT longo adquirido

Alex Souto Maior; Paulo Roberto Benchimol Barbosa; Octavio Barbosa Neto; Gustavo Ribeiro da Mota; Moacir Marocolo Júnior

Rev Bras Cardiol. 2011;24(1):42-51

Abstract PDF PORT

The QT interval is a parameter measured by a surface electrocardiogram that corresponds to the period from the onset of depolarization through to the end of ventricular repolarization. Due to its dependence on the instantaneous heart rate, the QT interval is corrected as QT by heart rate. The corrected QT interval is then used in clinical practice, for normal values. Values higher than those recommended in the literature reveal significant extension of the QT interval - the long QT syndrome - a myocardial electrical conduction disorder that alters repolarization and thus increases the likelihood of developing ventricular tachyarrhythmia, torsades de pointes and sudden death. This syndrome may be congenital or acquired, with changes in the potassium ion channel properties, in terms of the activation and deactivation of ionic current density kinetics or even its structure, resulting in the prolongation of ventricular repolarization. The objective is thus to review the literature with regard to potassium channel descriptions or electrophysiological characterizations under normal conditions and related to long QT syndrome.

Keywords: Potassium channels; Long QT syndrome; Arrhythmias, cardiac/diagnosis; Ventricular function/physiology; Heart ventricles/physiopathology

Cardiovascular Image

Constrictive pericarditis secondary to thoracic trauma occurring 20 years previously

Pericardite constritiva secundária a trauma torácico ocorrido há 20 anos

Carla Daniela Fank; Marcos Antônio Leão de Araújo; Marilu Cavalcante Gomes; Marlúcia do Nascimento Nobre

Rev Bras Cardiol. 2011;24(1):52-54

Abstract PDF PORT

Constrictive pericarditis results from a fibrous thickening of the pericardium secondary to chronic inflammation caused by a variety of diseases, leading to progressive signs and symptoms of right and left heart failure. This case study reports on thoracic trauma identified, after excluding common causes, as occurring twenty years prior to the symptoms of heart failure, drawing attention to this time lapse and also justifying the chest radiography image with visible calcification.

Keywords: Pericarditis, constrictive / etiology; Pericarditis, constrictive / physiopathology; Heart failure; Thoracic injuries

Point of View

Religiosity, spirituality and cardiovascular diseases

Religiosidade, espiritualidade e doenças cardiovasculares

Giancarlo Lucchetti; Alessandra Lamas Granero Lucchetti; Álvaro Avezum Jr.

Rev Bras Cardiol. 2011;24(1):55-57

Abstract PDF PORT

The relationship between religiosity / spirituality (R/S) and their interface with the health-disease process has long been under discussion. Epidemiological studies have shown a relationship between R/S and cardiovascular diseases, including less depression, longer survival times, lower blood pressure and fewer complications after surgery. However, few doctors address this aspect during consultations. With chronic diseases and frequently fatal outcomes, cardiac patients may benefit from a spiritual history, so that cardiologists can discover how patient beliefs might influence treatment, in addition to offering comfort or causing distress.

Keywords: Cardiovascular diseases/psychology; Religion and medicine; Spiritual therapies; Spirituality

Case Report

Non atherosclerotic left main coronary artery ostial lesion

Lesão não aterosclerótica do óstio do tronco da coronária esquerda

Andrea Rocha De Lorenzo; Valmir Barzan; Felipe José Monassa Pittella; Antônio Sérgio Cordeiro da Rocha

Rev Bras Cardiol. 2011;24(1):58-60

Abstract PDF PORT

This report addresses a case of ischemic heart disease whose initial clinical expression was Takayasu´s Arteritis (TA). Hospitalized for coronary artery bypass graft surgery (CABG) due to stable angina and isolated left main coronary artery lesion, the patient presented vascular anomalies during the physical examination that suggested a diagnosis of TA. This report prompts reflection on seeking etiologies other than atherosclerotic coronary artery disease, especially in young people or among those with few risk factors. Although infrequent compared to other vascular lesions found in this disease, involvement of the coronary artery in TA results in high morbidity and mortality rates.

Keywords: Takayasu arteritis; Coronary artery disease; Truncus arteriosus/injuries

Complex late coronary intervention after chemotherapy

Intervenção coronariana complexa e tardia pós-tratamento quimioterápico

Fernando José Soares Tavares; Fabio Vivian Ferreira; Murillo Kenji Furukawa; Anselmo Antonio Salgado

Rev Bras Cardiol. 2011;24(1):61-64

Abstract PDF PORT

Although associations between chemotherapy and acute coronary syndromes or even acute myocardial infarctions are rare, they may result in complications that might even be severe, surprising patients during treatments of diseases that are already debilitating. We present a case study of such an association, represented on the one hand by the use of paclitaxel (Taxol), with a complex coronary lesion (bifurcation) treated percutaneously on the other.

Keywords: Percutaneous transluminal coronary angioplasty; Coronary occlusion; Stents/utilization; Antineoplastic agents/therapeutic use

Dilated cardiomyopathy due to H1N1 virus

Cardiomiopatia dilatada por vírus H1N1

Hugo Filipe de Mendonça Arruda Gonçalves Café; Marco Filipe Gomes Serrão; Ana Paula Moreira Faria; José Jorge Rodrigues Araújo

Rev Bras Cardiol. 2011;24(1):65-67

Abstract PDF PORT

A 58-year-old woman with no relevant prior medical conditions presented a respiratory infection caused by the H1N1 virus, requiring admittance to an Intensive Care Unit. After discharge, the patient complained of progressive asthenia and dyspnea, being hospitalized nine months later with a diagnosis of pleural effusion and respiratory infection. Further evaluation by the Cardiology Unit revealed dilated cardiomyopathy with poor systolic function of the left ventrícle, compatible with myocarditis. A cardiac magnetic ressonance examination was compatible with myocarditis. Given her previous admittance and having ruled out toxic aspects and autoimmune disease, the disease was associated with the H1N1 virus. The prognosis is very positive, with almost complete recovery of the left ventricular function.

Keywords: Dilated cardiomyopathy; Myocarditis; Influenza A virus H1N1 subtype; Left ventricular dysfunction