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

Edition: 23.3 - 9 Article(s)

Editorial

Editorial

Ricardo Mourilhe Rocha

Rev Bras Cardiol. 2010;23(3):156

PDF PORT


Original Article

Effect of prolonged strenuous exercise on endothelial function in non-elite runners

Efeito de exercício extenuante e prolongado sobre a função endotelial em corredores não elite

Robinson Ramírez-Vélez; Jorge Hernan Ramirez; Cecilia Aguilar

Rev Bras Cardiol. 2010;23(3):157-161

Abstract PDF ENGLISH

BACKGROUND: Prolonged exercise has been shown to result in an acute depression in endothelial function. However, little is known about the effect of this type of exercise in non-elite runners.
OBJECTIVE: To determine the impact of prolonged strenuous exercise on endothelial function in non-elite runners.
METHODS: Nine males participating as recreational runners (age: 49.5±5.1y) at the Santiago of Cali Half-marathon (21.097m) were studied. Endothelium dependent femoral artery flow-mediated dilatation (FA-FMD) was evaluated one day before the race and at 1h, 24h, 48h, and 6 days after finishing the half-marathon.
RESULTS: A decrease on FA-FMD was observed at 1h after the Half-marathon, followed by a non-significant recovery trend starting at 24h up to 6 days after the race. Increase in the posthyperemic diameter of the femoral artery was observed at 1h after race ending, with a trend to baseline values in subsequent measures.
CONCLUSION: Femoral artery diameter increased after prolonged running could explain the reduction of FA-FMD. More studies with larger sample size are needed to determine the effects of prolonged running on femoral artery endothelial function.


Keywords: Exercise, Marathon, Runners, Cardiovascular, Endothelial, Ultrasound

Food intake, blood pressure and metabolic control in elderly hypertensive diabetics

Consumo alimentar, pressão arterial e controle metabólico em idosos diabéticos hipertensos

Maria do Perpétuo Socorro Carvalho Martins; André Luiz Marques Gomes; Maria do Carmo de Carvalho e Martins; Marco Antonio de Mattos; Manoel Dias de Souza Filho; Danielli Braga de Mello; Estélio Henrique Martin Dantas

Rev Bras Cardiol. 2010;23(3):162-170

Abstract PDF PORT

BACKGROUND: Poor eating habits have been associated with rising obesity, type 2 diabetes, hypercholesterolemia, cardiovascular diseases and other non-transmissible chronic diseases.
OBJECTIVE: To evaluate the association between inadequate food intake and high blood pressure with high levels of seric lipids and glycemia among elderly hypertensive diabetics assisted through the Family Health Strategy at a government clinic in Teresina, Piaui State, Northeast Brazil.
METHODS: A cross-sectional study of a sample of 34 elderly people assisted in response to spontaneous demands at a government clinic in the Novo Horizonte district analyzed data on blood pressure, biochemical variables and diet. The associations among the variables were evaluated through the Fisher test for proportions and the linear regression test, establishing a significance level of p<0.05.
RESULTS: Among the investigated variables, associations were found between the proportion of individuals with altered blood pressure and inadequate intakes of fruits, vegetables, milk and dairy products for systolic and diastolic blood pressure. A positive association was noted between higher glycated hemoglobin and insufficient consumption of vegetables (F=4.42; p=0.04), as well as between high triglyceride levels and insufficient consumption of cereals (F=5.1; p=0.02).
CONCLUSION: Poor eating habits appear to be related to high blood pressure with higher glucose and seric lipid levels in this elderly group.


Keywords: Food consumption, Hypertension, Glycemia control, Triglycerides, Elderly

Prescription patterns of angiotensin converting enzyme inibhitors for Unified Health System users

Padrões de prescrição de inibidores da enzima conversora da angiotensina para usuários do Sistema Único de Saúde

Carolina Maria Xaubet Olivera; Evandro José Cesarino; Osvaldo de Freitas; Leonardo Régis Leira Pereira

Rev Bras Cardiol. 2010;23(3):171-177

Abstract PDF PORT

BACKGROUND: Angiotensin-converting enzyme inhibitors are often prescribed for the treatment of systemic arterial hypertension and congestive heart failure. The first two repesentatives of this class, enalapril and captopril, are in the National Essential Drugs List because of their clinical efficacy, proven safety and cost effectiveness.
OBJECTIVE: To analyze the prescription patterns of captopril and enalapril for Government Health System users in the West Public Health District of Ribeirão Preto, São Paulo State.
METHODS: A survey was conducted of the Ribeirão Preto Municipal Health Bureau database, in order to quantify Government Health System users receiving prescriptions for captopril and enalapril, with dispensing frequency and therapeutic schemes between 01/03/2006 and 28/02/2007. The data underwent variance analysis and Student t tests, with multiple mean comparisons.
RESULTS: 9,560 patients were identified as taking angiotensin-converting enzyme inhibitors, of whom 46.57% took captopril, 45.74% enalapril and 7.69% both medications, either simultaneously or not. The average patient age was 61 years and the use of these agents rose progressively with increasing age. The mean doses prescribed were 69.9 mg/day for captopril and 21.35 mg/day for enalapril, with 41.57% of patients at risk for potential drug-drug interactions.
CONCLUSION: Currently, there is a preference for prescribing ACE inhibitors at public health units in Ribeirao Preto due to their therapeutic relevance for the treatment of chronic diseases.


Keywords: Captopril, Enalapril, Government Health System

Review Article

Stress hyperglycemia in acute coronary syndrome: control and prognostic importance

Hiperglicemia de estresse na síndrome coronariana aguda: controle e importância prognóstica

Renata Faria Modenesi; Evandro Tinoco Mesquita; Felipe Montes Pena; Nelson Robson Mendes de Souza; Jamil da Silva Soares; Carlos Augusto Cardozo de Faria

Rev Bras Cardiol. 2010;23(3):178-184

Abstract PDF PORT

Heart failure is currently an important complication of acute coronary syndromes, with significantly poorer prognoses, both in and out of hospital. The presence of diabetes mellitus is classically a risk factor for the development of acute myocardial infarction and heart failure, constituting a highly prevalent problem that is expanding like an epidemic through the world's population. Stress hyperglycemia is present in 25% to 50% of patients admitted with acute coronary syndrome, associated with the risk of in-hospital complications for patients with and without diabetes mellitus, being a marker for poor prognosis in terms of death, heart failure and cardiogenic shock. The therapeutic approach to stress hyperglycemia in acute coronary syndrome is still controversial, with no consensus on the best glucose measurement method nor the best type of treatment. The purpose of this paper is to review the state of the art of the association between stress hyperglycemia and the incidence of heart failure after acute coronary syndrome.


Keywords: Acute coronary syndrome, Intensive care, Stress hyperglycemia

Quality in cardiac imaging: appropriateness criteria applied to echocardiography

Qualidade em cardioimagem: critérios de appropriateness aplicados à ecocardiografia

Flavia Candolo Pupo Barbosa; Evandro Tinoco Mesquita; Angelo Salgado; Cláudio Tinoco Mesquita

Rev Bras Cardiol. 2010;23(3):185-196

Abstract PDF PORT

Seeking to improve the clinical use of echocardiography examinations in healthcare, the American Society of Echocardiography / American College of Cardiology has established appropriateness criteria. The purpose of this paper is to describe the methodology and use of this tool, which can be useful for upgrading the quality of cardiovascular care.


Keywords: Echocardiography, Quality, Appropriateness

Cardiovascular Image

Electrocardiogram in Ebstein disease

Eletrocardiograma na doença de Ebstein

Roberto Luiz Menssing da Silva Sá; Dirson de Castro Abreu

Rev Bras Cardiol. 2010;23(3):197-199

Abstract PDF PORT

Ebstein's anomaly is a rare congenital heart disease occurring in ~1:200,000 live births and accounting for <1% of all causes of congenital heart disease. It is a malformation of the tricuspid valve and the right ventricle characterized mainly by the downward (apical) displacement of the tricuspid valve, dilation of the atrialized portion of the right ventricle with various degrees of wall thinning and hypertrophy, and dilation of the right atrioventricular junction (true tricuspid annulus) Two thirds of hearts with Ebstein's anomaly show dilated right ventricles. The ECG is abnormal in most patients with Ebstein's anomaly and may display tall broad P waves as a result of right atrial enlargement, as well as complete or incomplete right bundle branch blocks. The R waves in lead V1 and V2 are small. Bizarre morphologies of the terminal QRS pattern result from infra-Hisian conduction disturbances and abnormal activation of the atrialized right ventricle.


Keywords: Congenital heart disease, Ebstein's disease, Right atrial enlargement, Intraventricular conduction disturbance

Case Report

Precordial pain of unusual origin

Dor precordial de causa não usual

Polianna Lemos Moura Moreira Albuquerque; Larissa Bastos Costa; Breno Braga Bastos; Geraldo Bezerra da Silva Júnior

Rev Bras Cardiol. 2010;23(3):200-201

Abstract PDF PORT

This case study reports on an interesting case precordial pain of unusual origin. A 75-year-old man was admitted to the Emergency Room with precordial pain and malaise three days after eating a bread roll. The physical examination was normal. An electrocardiogram showed diffuse upward ST-segment. A chest radiography showed a foreign body in the topography of the esophagus. Esophagoscopy was performed and the pin was removed, with an improvement in the clinical status of the patient.


Keywords: Precordial pain, Electrocardiogram, Chest Radiography

Mitral valve replacement and papillary muscle relocation with PTFE neochordae: video-assisted surgery with periareolar approach

Troca valvar mitral e reposicionamento do músculo papilar com neocordas de PTFE: cirurgia videoassistida via periareolar

Olívio Souza Neto; William Camargo; Ailton Carvalho; Cláudio Sobrosa; Luiz Maurino Abreu

Rev Bras Cardiol. 2010;23(3):202-205

Abstract PDF PORT

The standard approach to mitral valve surgery in many centers is minimally invasive video-assisted surgery, with widespread discussions still under way over whether this technique offers more than merely cosmetic advances. This paper presents a case study of mitral replacement and papillary muscle relocation using a video-assisted periareolar approach. Through this technique, a smaller incision, using an area with a plastic advantage, offers great potential for reducing surgical trauma, with good cosmetic results and a shorter post-operative recovery time for the patient.


Keywords: Mitral valve, Minimally invasive surgical procedures, Video assisted thoracic surgery

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