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

Edition: 23.2 - 9 Article(s)



Ricardo Mourilhe Rocha

Rev Bras Cardiol. 2010;23(2):92


Original Article

Prevalence of metabolic syndrome in adults referred to a nutrition out-patient clinic in Rio de Janeiro, Brazil

Prevalência de síndrome metabólica em adultos referenciados para ambulatório de nutrição no Rio de Janeiro, Brasil

Leila Sicupira Carneiro de Souza Leão; Érica Guimarães Barros,1 Rosalina Jorge Koifman

Rev Bras Cardiol. 2010;23(2):93-100

Abstract PDF PORT

BACKGROUND: As an important cardiovascular risk factor, Metabolic Syndrome (MS) should be identified in population groups with different characteristics.
OBJECTIVES: Estimate the prevalence of MS and describe the associated risk factors among patients >18 years old at a specialized nutritional care unit at the UNIRIO University Hospital.
METHODS: The prevalence of MS was identified using NCEP-ATPIII and IDF in 414 patients, with the comparison made through kappa and concordance percentage. The Poisson univariate regression shows SM as the dependent variable while gender, age, nutritional status, schooling, income, marital status, alcoholism and smoking were the independent variables. The model was construed through the prevalence ratio with a significance level of 5%.
RESULTS: Prevalence by the IDF criterion was slightly higher than that for the NCEP (61.1% vs 55.6%), with 93% concordance and kappa=0.855 (p value X2=0.000). It was observed that SM increases with age, with no significant differences for gender or higher body mass index, with a significant effect-dose-response (linear p trend <0.001), suggesting a positive association between MS with age and body mass.
CONCLUSION: Despite the criteria used, the prevalence of MS is high among patients requiring nutritional care at a specialized healthcare unit. Age and excess body mass appeared as variables for predicting MS.

Keywords: Prevalence, Metabolic syndrome X, Outpatients

Assessment of the effects of cardiac rehabilitation in patients after myocardial infarctions

Avaliação dos efeitos da reabilitação cardíaca em pacientes pós-infarto do miocárdio

John Richard Silveira Berry; Ademir Batista da Cunha

Rev Bras Cardiol. 2010;23(2):101-110

Abstract PDF PORT

BACKGROUND: The basic principle of cardiac rehabilitation programs is to allow patients diagnosed with cardiopathies to return to a productive and active lives, despite the constraints imposed by their pathological processes.
OBJECTIVE: To evaluate the metabolic, hemodynamic and biochemical effects obtained through cardiac rehabilitation programs after myocardial infarctions.
METHODS: This prospective observational study encompasses 27 men and 10 women between 20 and 80 years old (mean age: 56 years), with clinical and hemodynamic stability, ejection fraction of >40% (Simpson method), making regular use of drugs and >75% attendance at cardiac rehabilitation sessions. The exercise prescriptions were individual, with each session lasting ninety minutes three times a week, measuring effort intensity by the ventilation threshold obtained through the cardio-respiratory test.
RESULTS: Among the 37 patients evaluated, there was a 14% increase in the V'O2 peak (p=0.0001) and 9.2% in the oxygen pulse (p=0.005), as well as the maximum heart rate of 6.2% (p=0.0001), the recovery rate of 2.4% (p=0.0005) and the maximum systolic blood pressure of 6%. There was a reduction in the serum total cholesterol (p=0.006), LDL-C (p=0.004), triglycerides (p=0.01), glucose (p=0.006), glycated hemoglobin, (p=0.02) and increased HDL-c (p=0.0001). There was no significant variation in the PCR-T.
CONCLUSION: Cardiac rehabilitation programs enhance functional capacity and cardio-respiratory system efficiency, as well as the biochemical profiles of patients after acute myocardial infarction.

Keywords: Myocardial infarction, Cardiac rehabilitation, Functional capacity, Cardio-respiratory exercise test

Hypotensive effect of strength training in elderly men

Efeito hipotensivo do treinamento de força em homens idosos

Luciana Campos Mutti; Roberto Simão; Ingrid Dias; Tiago Figueiredo; Belmiro Freitas de Salles

Rev Bras Cardiol. 2010;23(2):111-115

Abstract PDF PORT

BACKGROUND: The literature still offers only a few studies on blood pressure (BP) behavior among elderly men after a strength training (ST) session.
OBJECTIVE: To analyze the systolic BP (SBP) and diastolic BP (DBP) behavior in trained normotensive elderly men after an ST session.
METHODS: Twenty healthy men (age 67±2 years; height 172±6cm; body mass 76±8kg; BMI 25±2kg.m-2, SBP 122±4mmHg; DBP 81±4mmHg) experienced in strength training performed three sets of ten repetitions at 70% of 10 RM in a seven-exercise program with two-minute intervals between the sets and the exercises. The BP was measured at rest and at the end of the training session, taking measurements every ten minutes during a total period of sixty minutes.
RESULTS: Significant reductions were noted in the all SBP and DBP measurements after the ST session, compared to the at-rest measurements.
CONCLUSION: This study demonstrates reductions in the SBP and DBP among trained elderly men after a ST session. These findings show that there is a hypotensive response to ST for at least sixty minutes among trained elderly men. This information is important for healthcare practitioners, underscoring the importance of prescribing strength training for normotensive elderly men.

Keywords: Strength training, Blood pressure, Hypotension, Elderly men

Cardiovascular risk identification among patients treated at an outpatient nutrition clinic

Identificação de risco cardiovascular em pacientes atendidos em ambulatório de nutrição

Andrea Mariana Nunes da Costa Teixeira; Anita Sachs; Gianni Mara da Silva Santos; Leiko Asakura; Lucíola de Castro Coelho;Clarissa Viana Demézio da Silva

Rev Bras Cardiol. 2010;23(2):116-123

Abstract PDF PORT

BACKGROUND: Cardiovascular diseases are the main cause of deaths in Brazil. Some 80% of these cases could be avoided through modifications in lifestyles and diets.
OBJECTIVE: To describe diet and cardiovascular risk factors among outpatients.
METHODS: Cross-section study of 103 male and female patients with no history of cardiovascular events or myocardiopathies. Diet, anthropometric, biochemical lifestyle and health status data were used, as well as the Framingham algorithm.
RESULTS: The mean age was 51.91±13.25 years, predominantly female, with 61.17% of the population studied being obese (31.91±5.96kg/m2 adults; 30.09±4.87kg/m2 elderly), and 92.23% had increased waist circumference, both more prevalent among women. The diet evaluation indicated: hypoglycidic diet (48,89±9,01%VCT) with a high intake of saturated fatty acids (9.88±3.57%VET), cholesterol (222±151.04mg/dl), and high-sodium foods (61.17%), with insufficient intake of fruits, vegetables and greens (302.07±260.93g), and fiber (18.21±8.92g); 9.71% were smokers and 76.70% were sedentary, with 24.27% diabetics and 64.08% with hypertension. The fasting glucose (118.37±53.59mg/dl), triglycerides (160.21±84.22mg/dl) and LDL-c (116.49±30.03mg/dl) tests were impaired. Medium and high cardiovascular risks were identified to the same extent among the patients through the Framingham score.
CONCLUSION: The high prevalence of the cardiovascular risk factors under consideration suggest the need for preventive measures in order to alter diets and lifestyles.

Keywords: Cardiovascular diseases, Risk factors, Diet, Outpatient clinics, Hospital

Review Article

The role of vitamin D in heart failure

O papel da vitamina D na insuficiência cardíaca

Vanessa dos Santos Pereira Montera; Evandro Tinoco Mesquita

Rev Bras Cardiol. 2010;23(2):124-130

Abstract PDF PORT

Vitamin D, more specifically 1,25-dihydroxyvitaminD (1,25[OH]2D) or calcitriol, has been linked to cardiovascular disease, and seems to be closely associated with the pathophysiology of heart failure (HF) in this context. Many studies demonstrate that calcitriol deficiency and/or the alterations this causes in the parathyroid hormone (PTH) blood levels activate the renin-angiotensin-aldosterone system (RAAS), modulating the immune system, regulating protein kinase C causing myofibrillar hypertrophy and cardiomyocyte apoptosis, resulting in arrhythmias, mitochondrial dysfunction and oxidative stress. This paper thus reviews vitamin D, its metabolism and relationship to PTH, calcium and phosphorus as factors that intervene in this status, the influence of such deficiencies in HF and the possible benefits of their supplementation in HF.

Keywords: Deficiency, Calcitriol, Parathyroid hormone, Heart failure

Pharmacogenetic aspects associated with anti-platelet therapy resistance in patients with acute coronary syndrome

Aspectos farmacogenéticos associados à resistência terapêutica antiplaquetária em pacientes com síndrome coronariana aguda

Jamil da Silva Soares; Fernanda Carla Ferreira de Brito; Felipe Montes Pena; Evandro Tinoco Mesquita; Enrique Medina-Acosta

Rev Bras Cardiol. 2010;23(2):131-142

Abstract PDF PORT

The use of drugs that inhibit platelet function significantly reduces ischemic complications and the cardiovascular death rate among patients with acute coronary syndromes (SCA) and those undergoing percutaneous coronary intervention (PCI) with stent implantation. Despite well developed anti-platelet therapy, thrombotic events continue to occur and, although their causes have multiple determinants, the concept of antiplatelet therapy resistance is expanding, better understood as low or even no response to anti-platelet agents, which may reflect pharmacokinetic and pharmacological aspects of each drug. Anti-platelet therapy resistance may be classified as laboratorial or clinical. Laboratorial resistance is defined as the failure of the drug to inhibit platelet function ex vivo. Clinical resistance is defined as the failure of the drug in preventing the occurrence of cardiovascular adverse events in patients with ACS and patients undergoing PCI. Considerable interindividual variability is observed in responses evoked by different platelet function inhibitors. This variability is associated with high rates of cardiovascular adverse events. Part of this heterogeneity is explained by genetic polymorphisms in the receptors involved in platelet activation, or the metabolism of anti-platelet therapies, while part is also related to non-genetic factors. This review presents the main mechanisms involved in determining a lower response to platelet function inhibiting drugs.

Keywords: Anti-platelet, Percutaneous coronary intervention, Platelet function, Polymorphism, Acute coronary syndrome

Case Report

Fetal cardiac arrhythmia as an initial indication of rhabdomyoma in tuberous sclerosis

Arritmia cardíaca fetal como manifestação inicial de rabdomioma na esclerose tuberosa

Bruno Maia de Resende; Bernardo Lisboa Tambasco; Armando de Toledo Cabral; Nilson Maia

Rev Bras Cardiol. 2010;23(2):143-145

Abstract PDF PORT

This report presents a case of tuberous sclerosis (TS) diagnosed through fetal cardiac arrhythmia and multiple cardiac rhabdomyomas. A dominant autosomal multisystemic disease, TS has an incidence of 1:10000 births, characterized by multiple hamartomas in organs of mesodermal and ectodermal origin. Rhabdomyoma is the most frequent primary heart tumor in childhood, and is associated with TS in 50% of cases. Other manifestations include epilepsy, mental retardation, and compressive disorders in the affected organs. TS has serious physical and psychological manifestations, requiring multidisciplinary monitoring. The purpose is to foster a better understanding and recognition of this disease, integrating the practitioners involved in its management.

Keywords: Tuberous sclerosis, Cardiac arrhythmias, Rhabdomyoma, Subependimal node

Cardiovascular Image

Electrocardiographic abnormalitys after doxorubicin use

Alterações eletrocardiográficas com o uso de doxorrubicina

Antônio Celso Siqueira dos Santos; Evandro Tinoco Mesquita; Maria Eduarda Ferro Costa Menezes; Maurício Pimentel Costa; Mírian Cruz de Souza Santos

Rev Bras Cardiol. 2010;23(2):146-148

Abstract PDF PORT

The electrocardiogram (ECG) has proven useful in assessing patients using cardiotoxic chemotherapy. Although it is not an early marker, it is easy to perform, inexpensive and noninvasive. For best accuracy is important having a baseline ECG and if possible, one after each cycle of chemotherapy. If evolutionary changes in the electrocardiographic pattern are seen, more specific cardiac exams should be provided.

Keywords: Myocardial dysfunction, Doxorubicin, Electrocardiography