Relações pressão-diâmetro e esforço-diâmetro do ventrículo esquerdo em seres humanos. Padronização e análise crítica do método.

PURPOSE--To provide a critical analysis of the fluid filled manometric system and M-mode echocardiography and, by their association, to standardize the determination of left ventricular (LV) pressure-diameter and stress-diameter relationships in humans. MATERIAL AND METHODS--The pressure curve and the LV M-mode image was obtained in 24 patients with cardiopathy. The dynamic characteristics of the fluid-filled system have been studied to define the amplitude, the resonance and the time gap of the pressure curve register. The delay of the pressure curve recording was determined in all cases by comparing pressure curve and echocardiographic aortic valve registers. The values of pressure, diameter, posterior wall thickness and LV meridional stress was calculated at every 0.02s. RESULTS--Preliminary analyses of the fluid-filled manometric system indicated that this system has variable dynamic characteristics. The pressure-diameter and stress-diameter loops obtained were similar to those of the literature. The values of end-systolic stress, percentage of fractional shortening, ejection fraction and circumferential fiber shortening rate of patients with dilated cardiomyopathy (n = 5) were significantly reduced when compared to the values of patients without left ventricular overload (n = 8) and patients with ventricular volume overload. It has been verified, also, that the retard of the pressure curve record introduced by the fluid-filled manometric system does not modify the values of these variables. CONCLUSION--The LV pressure-diameter and stress-diameter relationships obtained by the association of echocardiography and LV manometry showed functional characteristics of the ventricle that could not appear by the use of the echocardiography or by the LV manometry themselves.

O limiar de esforço percebido (LEP) corresponde à potência crítica e a um indicador de máximo estado estável de consumo de oxigěnio

The perceived exertion has been a target of several investigations, many times with association with objective physiological indicators in exercise. Recently, the identification of the perceived exertion threshold (PET) was proposed in the water running, which presented no difference in relation to the critical velocity. Theoretically, both parameters would be indicators of the maximum steady state of variables such as V̇O2 and blood lactate. The objective of this work was to verify the coincidence between PET, critical power (PCrit) and an indicator of maximum V̇O2 steady state (PCrit') in cycle ergometer. Eight male participants were submitted to progressive effort test in order to determine V̇O2peak (46.7 ± 8.5 ml/kg/min) and to four rectangular tests until exhaustion for the estimation of the critical power model parameters, PET and PCrit'. The hyperbolic relation between mechanical power and time spent for the V̇O2peak to be reached in each test was used for the PCrit' estimation, considered as the asymptote in the power axis, and the portion of the anaerobic work capacity (CTAnaer) depleted up to the establishment of the V̇O2peak (CTAnaer'). In order to identify PET, the straight lines angular coefficients of the perceived exertion in time (ordinate) and the powers used (abscissa) were adjusted to a linear function that provided a point in the power axis in which the perceived exertion would be kept indefinitely stable. The parameters PCrit and CTAnaer were estimated by means of the power-time non-linear equation. In order to compare the estimations of PET, PCrit and PCrit', the analysis of variance ANOVA for repeated measurements was employed, and the associations were established through the Pearson correlation. CTAnaer and CTAnaer' were compared through the t test. PET (180 W ± 61 W), PCrit (174 W ± 43 W) and PCrit' (176 W ± 48 W) were not significantly different and the correlations were of 0.92-0.98. CTAnaer' (14,080 ± 5,219 J) was lower than CTAnaer (22,093 ± 9,042 J). One concludes that the PET predicts the intensity of PCrit and PCrit' with accuracy.

Hacia una perspectiva crítica de la modernidad: las dimensiones culturales de la transformación productiva con equidad

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Políticas sociales y necesidades familiares en Colombia: una revisión crítica

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Revisión crítica del enfoque de cohesión social de la CEPAL y desafíos para su operacionalización

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