Impacto do padrão geométrico ventricular na remodelação cardíaca após o infarto do miocárdio

BACKGROUND: The relevance of left ventricular (LV) geometric pattern after myocardial infarction is not known. OBJECTIVES: To analyze the presence of different LV geometric patterns and teir impact as a predictor of remodeling in patients with myocardial infarction. METHODS: Patients with anterior acute myocardial infarction (n = 80) were divided according to the geometric pattern: normal (normal left ventricular mass index [LVMI] and normal relative wall thickness [RWT]), concentric remodeling (normal LVMI and increased RWT), concentric hypertrophy (increased LVMI and RWT) and eccentric hypertrophy (increased LVMI and normal RWT). After six months, echocardiographic assessment was repeated. RESULTS: Four patients died. Of the survivors, 41 showed remodeling (R +), whereas 39 did not (R-). Considering the geometric pattern, the cases were distributed as follows: 24 patients with normal pattern, 13 with concentric remodeling, 29 with concentric hypertrophy and 14 with eccentric hypertrophy. Patients who showed remodeling had larger infarction sizes analyzed by peak CPK (R + = 4,610 (1,688-7,970), R- = 1,442 (775-4247), p <0.001) and CK-MB (R + = 441 (246 - 666), R- = 183 (101-465), p <0.001), trend towards higher prevalence of concentric remodeling (R+ = 10, R- = 3, p = 0.08) and lower prevalence of eccentric hypertrophy (R + = 2 R- = 12, p = 0.006). In the multivariate regression analysis, infarction size was a predictor (OR = 1.01, p = 0.020) and eccentric hypertrophy was a protective factor (OR = 0.189, p = 0.046) of ventricular remodeling after coronary occlusion. CONCLUSION: The LV geometric pattern of can have an impact on the remodeling process in patients with myocardial infarction.

Left ventricular sphericity index predicts systolic dysfunction in rats with experimental aortic regurgitation

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeito da aldosterona e da espironolactona na hipertrofia ventricular esquerda em pacientes com doença renal crônica em hemodiálise

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeito agudo de diferentes volumes de alongamento estático na contração voluntária máxima de idosas

Several studies have shown that different stretching routines can lead to decreases on acute neuromuscular system performance. Although the deficit in muscle strength mediated by different methods of stretching has been systematically observed, few studies have investigated the possible existence of a dose-response relationship between the amount of stretching and muscle strength deficit in older adults. In this context, the objective of this study was to investigate the acute effect of two different stretching volumes on isometric force-time curve (Cf-t) in elderly women. The study included 13 older women (64.08 ± 4.27 years, 69.98 ± 10.56 kg, 157.90 ± 8.66 cm, 28.25 ± 4.22 kg/m²). The participants visited the laboratory for five consecutive days, among which the first two were used for familiarization. During the other three days the participants underwent experimental conditions: control (C) stretch 30 seconds (AE30) and stretch 60 seconds (AE60). For the AE30 and AE60 conditions, three series of passive static stretching were performed, with duration of 30 and 60 seconds, respectively. The experimental conditions were performed with an interval of at least 24 hours between them and the order of execution was randomized. The recording of isometric Cf-t of the knee extensor muscles was performed in extensor chair connected to a force transducer. Measurements were recorded immediately after each experimental condition, for five seconds. For statistical analysis, descriptive procedures were used and ANOVA one way to check possible changes on the Maximal Voluntary Contraction (CVM) and Peak Rate of Force Development (TDFP) among the three conditions (p <0.05). The ANOVA showed no statistically significant difference for CVM and TDFP, between the three conditions. It can be concluded that different volumes of static stretching, three sets ...(Complete abstract click electronic access below)

Remodelação ventricular após infarto agudo do miocárdio. Conceitos, fisiopatologia e abordagem terapêutica

Após o infarto agudo do miocárdio (IAM), ocorrem alterações complexas na arquitetura ventricular, envolvendo tanto a região infartada como a não infartada. Nos últimos anos, estas adaptações, que podem ser identificadas na fase aguda do IAM, ou mais tardiamente, passaram a ser estudadas com o nome de remodelação ventricular (RV) pós-IAM 1 . O reconhecimento e entendimento deste processo é crítico, pois a RV pode estar associada a um pior prognóstico, pós-infarto, na dependência de diversos fatores. Outro aspecto relevante é que sua evolução pode ser modificada, por meio de diversas intervenções terapêuticas. Assim, abordaremos aspectos fisiopatológicos que envolvem a RV, bem como os efeitos das medicações comumente usadas no tratamento do infarto, nesse processo adaptativo.