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Bignoto TC, Moreira DAR, Habib RG, de Barros Correia E, Amarante RC, Jatene T, Nunes MBG, Senra T, Mastrocolla LE. Electrocardiography scar quantification correlates with scar size of hypertrophic cardiomyopathy seen by multidetector computed tomography. Clin Cardiol 2018; 41:837-842. [PMID: 29671882 DOI: 10.1002/clc.22966] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/05/2018] [Accepted: 04/16/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Hypertrophic cardiomyopathy (HCM), a genetically transmitted disease, is the most common genetic cardiovascular disease. Current strategies to stratify risk are expensive and concentrated in wealthy centers. Twelve-lead electrocardiography (ECG) is inexpensive, universally available, and can be readily used for Selvester QRS scoring, which estimates scar size. This study aimed to establish the relation between ECG scar quantification and myocardial fibrosis (extent of myocardial delayed enhancement) in multidetector computed tomography (MDCT). HYPOTHESIS There is a significant association between ECG scar quantification and the extent of myocardial delayed enhancement in MDCT. METHODS Seventy-five patients with HCM underwent a routine clinical evaluation and echocardiography, 12-lead ECG, and MDCT study. Patients with and without an implantable cardioverter-defibrillator were included. RESULTS The estimated Selvester QRS score of myocardial fibrosis was correlated significantly (R = 0.70; P < 0.01) with the quantified MDCT fibrosis. Compared with MDCT, the QRS score had 84.8% sensitivity and 88.8% specificity. Myocardial fibrosis was present in 88% of these patients with HCM (fibrotic mass, 9.87 ±10.8 g) comprising 5.66% ±6.16% of the total myocardial mass seen on the MDCT images. The Selvester QRS score reliably predicted the fibrotic mass in 76% of patients, which estimated 8.44% ±7.39% of the total myocardial mass. CONCLUSIONS The Selvester QRS score provides reliable quantification of myocardial fibrosis and was well correlated with MDCT in patients with HCM.
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Affiliation(s)
| | | | | | | | | | - Tannas Jatene
- Institute of Cardiology Dante Pazzanese, São Paulo, Brazil
| | | | - Tiago Senra
- Institute of Cardiology Dante Pazzanese, São Paulo, Brazil
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Garcia MK, Rizzo L, Yazbek-Júnior P, Yutiyama D, da Silva FJ, Matheus D, Mastrocolla LE, Massad E. Cardiorespiratory performance of coronary artery disease patients on land versus underwater treadmill tests: a comparative study. Clinics (Sao Paulo) 2017; 72:667-674. [PMID: 29236912 PMCID: PMC5706058 DOI: 10.6061/clinics/2017(11)04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 07/21/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To compare responses to a cardiopulmonary exercise test on land versus on an underwater treadmill, to assess the cardiorespiratory performance of coronary artery disease patients while immersed in warm water and to compare with the performance of healthy individuals. METHODS The sample population consisted of 40 subjects, which included 20 coronary artery disease patients aged 63.7±8.89 years old, functional class I and II, according to the New York Hearth Association, and 20 healthy subjects aged 64.7±7.09 years old. The statistical significances were calculated through an ANOVA test with a (1 - β) power of 0.861. ClinicalTrials.gov: NCT00989248 (22). RESULTS Significant differences were uncovered in coronary artery disease group regarding the variables heart beats (HB), (p>0.01), oxygen consumption (VO2), (p>0.01) and carbon dioxide production (VCO2) (p<0.01). Also, for the same group, in relation to the environment, water versus on land for HB, VO2, VCO2 and oxygen for each heart beat (VO2/HB) all of than (p<0.01). The stages for data collected featured the subject's performance throughout the experiment, and within the given context, variables rating of perceived exertion (RPE), HB, VO2, VCO2 and VO2/HB (p<0.01) showed significant interactions between test stages and environment. Additionally, there was a significant interaction between the etiology and the test stages for the variables HB, VO2 and VCO2 (p<0.01). Electrocardiographic changes compatible with myocardial ischemia or arrhythmia were not observed. The subjects exhibited lower scores on Borg's perceived exertion scale in the water than at every one of the test stages on land (p<0.01). CONCLUSION This study show that a cardiopulmonary exercise test can be safely conducted in subjects in immersion and that the procedures, resources and equipment used yielded replicable and reliable data. Significant differences observed in water versus on land allow us to conclude that coronary artery disease patients are able to do physical exercise in water and that the physiological effects of immersion do not present any risk for such patients, as exercise was well tolerated by all subjects.
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Affiliation(s)
- Mauricio Koprowski Garcia
- Instituto de Medicina e Reabilitacao, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | - Limanara Rizzo
- Departamento de Medicina Legal e Etica Medica, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Paulo Yazbek-Júnior
- Instituto de Medicina e Reabilitacao, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Daniela Yutiyama
- Instituto de Medicina e Reabilitacao, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Fabiola Jomar da Silva
- Instituto de Medicina e Reabilitacao, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Denise Matheus
- Instituto de Medicina e Reabilitacao, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | | | - Eduardo Massad
- Departamento de Medicina Legal e Etica Medica, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
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Fuchs ARCN, Meneghelo RS, Stefanini E, De Paola AV, Smanio PEP, Mastrocolla LE, Ferraz AS, Buglia S, Piegas LS, Carvalho AAC. Exercise may cause myocardial ischemia at the anaerobic threshold in cardiac rehabilitation programs. Braz J Med Biol Res 2009; 42:272-8. [PMID: 19287906 DOI: 10.1590/s0100-879x2009000300008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2008] [Accepted: 01/28/2009] [Indexed: 11/22/2022] Open
Abstract
Myocardial ischemia may occur during an exercise session in cardiac rehabilitation programs. However, it has not been established whether it is elicited when exercise prescription is based on heart rate corresponding to the anaerobic threshold as measured by cardiopulmonary exercise testing. Our objective was to determine the incidence of myocardial ischemia in cardiac rehabilitation programs according to myocardial perfusion SPECT in exercise programs based on the anaerobic threshold. Thirty-nine patients (35 men and 4 women) diagnosed with coronary artery disease by coronary angiography and stress technetium-99m-sestamibi gated SPECT associated with a baseline cardiopulmonary exercise test were assessed. Ages ranged from 45 to 75 years. A second cardiopulmonary exercise test determined training intensity at the anaerobic threshold. Repeat gated-SPECT was obtained after a third cardiopulmonary exercise test at the prescribed workload and heart rate. Myocardial perfusion images were analyzed using a score system of 6.4 at rest, 13.9 at peak stress, and 10.7 during the prescribed exercise (P < 0.05). The presence of myocardial ischemia during exercise was defined as a difference > or = 2 between the summed stress score and summed rest score. Accordingly, 25 (64%) patients were classified as ischemic and 14 (36%) as nonischemic. MIBI-SPECT showed myocardial ischemia during exercise within the anaerobic threshold. The 64% prevalence of ischemia observed in the study should not be looked on as representative of the whole population of patients undergoing exercise programs. Changes in patient care and exercise programs were implemented as a result of our finding of ischemia during the prescribed exercise.
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Affiliation(s)
- A R C N Fuchs
- Serviço de Reabilitação Cardiovascular, Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
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Oliveira MACD, Duarte PS, Gonzalez MMC, Moises VA, Alonso G, Lima EV, Smanio PE, Martins LRF, Oliveira CAR, Mastrocolla LE. Biological factors and overestimation of left ventricular ejection fraction by gated SPECT. Arq Bras Cardiol 2008; 90:305-10. [PMID: 18516399 DOI: 10.1590/s0066-782x2008000500005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2007] [Accepted: 11/19/2007] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Some patients present an overestimated left ventricular ejection fraction (LVEF) on electrocardiogram-gated myocardial scintigraphy (gated SPECT). OBJECTIVE To establish the relationship between biological factors and overestimated LVEF. METHODS We selected 3838 patients who underwent gated SPECT between May 20, 2000 and September 16, 2005 with normal perfusion images and LVEF > or =50%. The following variables were analyzed: gender (29.4% females and 70.6% males), age (from 20 to 94 years - mean: 56 years), weight (from 33.5 to 150 kg - mean: 79.6 kg), height (from 138 to 220 cm - mean: 171 cm) and BMI (from 13.9 to 54 - mean: 27.2). In a subgroup of 1002 patients who underwent echocardiogram, the diastolic diameter (from 36 to 68 mm - mean 47.5 mm) and systolic diameter (from 22 to 41 mm - mean 29.8 mm) variables were included. The patients were divided into two groups: normal LVEF (< or =80%) and overestimated LVEF (>80%). The odds ratio (OR) for presenting an overestimated LVEF was calculated for each variable using logistic regression. RESULTS The following odds ratios were found (p < 0.005): female gender OR = 3.585 (95%CI: 2.745 to 4.683), age in years OR = 1.020 (95%CI: 1.011 to 1.029) and height in cm OR = 0.893 (95%CI: 0.829 to 0.962). Weight and BMI were not significantly associated with LVEF (p>0.2). In the subgroup of 1002 patients, a statistically significant influence was found in overestimated LVEF values for the systolic diameter, gender and height variables. CONCLUSION Although systolic diameter influences the overestimation of LVEF, the gender and height variables have an independent influence on LVEF overestimation by gated SPECT.
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Duarte PS, Mastrocolla LE, Alonso G, Lima EV, Smanio PE, Oliveira MACD, Martins LRF, Pereira JCR. Associação entre fatores de risco para doença arterial coronariana e coronariopatia em pacientes submetidos a cintilografia de perfusão do miocárdio. Arq Bras Cardiol 2007; 88:304-13. [PMID: 17533472 DOI: 10.1590/s0066-782x2007000300009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2006] [Accepted: 07/23/2006] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To establish the degree of association between cardiovascular risk factors and the presence of coronary artery disease (CAD) in a group of patients undergoing myocardial perfusion scintigraphy (MPS). METHODS The study included 7183 patients who had undergone MPS. Using logistic regression analysis the odds ratios for the following risk factors were evaluated: age, gender, family history, body mass index, smoking, dyslipidemia, diabetes mellitus (DM) and systemic hypertension. Indicators for the presence of CAD were defined as: myocardial infarction, revascularization, angioplasty or an altered MPS. Analysis was based on the whole the group as well as on male and female subgroups. The impact of the risk factors in relation to age was also analyzed. RESULTS A statistically significant association was observed between patient age and gender and the presence of CAD. For females, it was demonstrated that DM is the main modifiable risk factor for CAD. For males various modifiable risk factors were associated with the presence of CAD, particularly DM and dyslipidemia. In the analysis by age groups some risk factors showed a more expressive association. CONCLUSION The main risk factors for CAD were aging and male gender. In relation to modifiable risk factors and the presence of CAD, the greatest associations for males were DM and dyslipidemia and for females DM. The most relevant factors for specific age groups were smoking for young men and DM and smoking for women between the ages of 40 and 50.
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Affiliation(s)
- Paulo Schiavom Duarte
- Centro de Medicina Diagnóstica Fleury e Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil.
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Duarte PS, Mastrocolla LE, Sampaio CREPS, Rossi JM, Smanio PE, Martins LRF, Pereira JCR. Indicação de cintilografia de perfusão do miocárdio para a detecção de doença arterial coronariana, baseada em evidências ergométricas e clínico-epidemiológicas. Arq Bras Cardiol 2006; 87:415-22. [PMID: 17128309 DOI: 10.1590/s0066-782x2006001700004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2005] [Accepted: 08/22/2005] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To establish when the myocardial perfusion scintigraphy (MPS) should be performed based on well-defined information obtained from treadmill test results and clinical-epidemiological parameters for coronary artery disease (CAD). METHODS 2,100 patients who underwent MPS were classified according to the results of scintigraphy, the Duke score and a clinical-epidemiological score based on Framingham study. The patients with positive results on MPS were followed to define whether the results were true positives. Receiver operating characteristic (ROC) curves were used to establish the efficiency and the best Duke and clinical-epidemiological scores to define patients that should be submitted to scintigraphy. RESULTS It was observed that the MPS use restriction in patients with Duke score below 7.5 and/or clinical-epidemiological score above 4 could decrease the utilization of this method by 50% without exposing the patients to a significant misdiagnosis risk. CONCLUSION The utilization of the Duke score and a clinical-epidemiological score to classify the patients expressively decreased the number of unnecessarily requested scintigraphies.
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Mastrocolla LE, Sousa AGMR, Smanio PEP, Staico R, Pinto IFM, Meneghelo RS, Abizaid AC, Graebin R, Vaz VD, Paes A, Martins DS, Sousa JEMR. [Adenosine myocardial perfusion SPECT with Tc-99m-MIBI in patients with obstructive coronary artery disease: correlation between quantitative coronary angiography and intravascular ultrasound measurements]. Arq Bras Cardiol 2006; 86:3-13. [PMID: 16491203 DOI: 10.1590/s0066-782x2006000100002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To correlate myocardial perfusion scintigraphy (MPS) with Tc-99m-MIBI and adenosine infusion using quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS). METHODS Seventy patients with coronary artery disease (CAD) referred for myocardial perfusion scintigraphy (MPS) with MIBI and adenosine were studied. Clinical, electrocardiographic (ECG), and scintigraphic findings were correlated with variables of visual and quantitative angiographic analysis, as well as to those of IVUS. RESULTS The mean age of patients was 60.6 years, and 39 were male. Coronary angiography showed percentage of diameter stenosis (% DS) of 49.94% in 105 arteries, 83 of which were re-evaluated by QCA (79%), mean of 44.20%, p<0.05. ST-segment depression during adenosine infusion was associated with higher degrees of % DS (55.0% vs. 47.8%), p<0.05). Scintigraphic ischemia was correlated with greater cross-sectional area of lumen obstruction by IVUS (% CSA). Clinical, ECG, and IVUS findings were considered together and expressed as global ischemic versus non-ischemic responses. Ischemia was associated with lower values of minimal lumen diameter (MLD) and minimal lumen area (MLA) determined by QCA and IVUS. CONCLUSION Tc-99m-MIBI and adenosine myocardial SPECT is correlated with % CSA on IVUS, perfusion images considered. Global results assessment showed association between lumen diameter and area at obstructed sites as determined by QCA and IVUS.
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Duarte PS, Mastrocolla LE, Farsky PS, Sampaio CREPS, Tonelli PA, Barros LC, Ortega NR, Pereira JCR. Selection of patients for myocardial perfusion scintigraphy based on fuzzy sets theory applied to clinical-epidemiological data and treadmill test results. Braz J Med Biol Res 2005; 39:9-18. [PMID: 16400460 DOI: 10.1590/s0100-879x2006000100002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Coronary artery disease (CAD) is a worldwide leading cause of death. The standard method for evaluating critical partial occlusions is coronary arteriography, a catheterization technique which is invasive, time consuming, and costly. There are noninvasive approaches for the early detection of CAD. The basis for the noninvasive diagnosis of CAD has been laid in a sequential analysis of the risk factors, and the results of the treadmill test and myocardial perfusion scintigraphy (MPS). Many investigators have demonstrated that the diagnostic applications of MPS are appropriate for patients who have an intermediate likelihood of disease. Although this information is useful, it is only partially utilized in clinical practice due to the difficulty to properly classify the patients. Since the seminal work of Lotfi Zadeh, fuzzy logic has been applied in numerous areas. In the present study, we proposed and tested a model to select patients for MPS based on fuzzy sets theory. A group of 1053 patients was used to develop the model and another group of 1045 patients was used to test it. Receiver operating characteristic curves were used to compare the performance of the fuzzy model against expert physician opinions, and showed that the performance of the fuzzy model was equal or superior to that of the physicians. Therefore, we conclude that the fuzzy model could be a useful tool to assist the general practitioner in the selection of patients for MPS.
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Affiliation(s)
- P S Duarte
- Seção de Medicina Nuclear, Centro de Medicina Diagnóstica, São Paulo, SP, Brazil.
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Carvalho TD, Cortez AA, Ferraz A, Nóbrega ACLD, Brunetto AF, Herdy AH, Hossri CAC, Neder CA, Negrão CE, Araújo CGS, Brito FSD, Drummond FA, Roselino F, Nogueira GÂ, Umeda IIK, Oliveira Filho JA, Teixeira JAC, Lazzoli JK, Mastrocolla LE, Benetti M, Leitão MB, Zager M, Alves MJNN, Grinberg M, Godoy M, Silva OBE, Stein R, Costa RV, Meneghelo RS, Moraes RS, Serra SM, Ramos S. Reabilitação cardiopulmonar e metabólica: aspectos práticos e responsabilidades. REV BRAS MED ESPORTE 2005. [DOI: 10.1590/s1517-86922005000600002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Duarte PS, Smanio PE, Oliveira CA, Martins LR, Mastrocolla LE, Pereira JC. Clinical significance of transient left ventricular dilation assessed during myocardial Tc-99m sestamibi scintigraphy. Arq Bras Cardiol 2003; 81:474-82. [PMID: 14666268 DOI: 10.1590/s0066-782x2003001300004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess the clinical significance of transient ischemic dilation of the left ventricle during myocardial perfusion scintigraphy with stress/rest sestamibi. METHODS The study retrospectively analyzed 378 patients who underwent myocardial perfusion scintigraphy with stress/rest sestamibi, 340 of whom had a low probability of having ischemia and 38 had significant transient defects. Transient ischemic dilation was automatically calculated using Autoquant software. Sensitivity, specificity, and the positive and negative predictive values were established for each value of transient ischemic dilation. RESULTS The values of transient ischemic dilation for the groups of low probability and significant transient defects were, respectively, 1.01 0.13 and 1.18 0.17. The values of transient ischemic dilation for the group with significant transient defects were significantly greater than those obtained for the group with a low probability (P<0.001). The greatest positive predictive values, around 50%, were obtained for the values of transient ischemic dilation above 1.25. CONCLUSION The results suggest that transient ischemic dilation assessed using the stress/rest sestamibi protocol may be useful to separate patients with extensive myocardial ischemia from those without ischemia.
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Affiliation(s)
- Paulo Schiavom Duarte
- Nuclear Medicine and Cardiology Unit, Fleury - Centro de Medicina Diagnóstica and Faculdade de Saúde Pública of USP - São Paulo, SP - Brazil.
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Feitosa GS, Nicolau JC, Chalela WA, Meneghetti JC, Ximenes AAB, Almeida CAD, Vítola JV, Mastrocolla LE, Barroso AA, Précoma DB, Salis F, Marin-Neto JA, Buchpieguel CA, Salis F, Meneghelo RS, Brito FSD. I Diretriz da Sociedade Brasileira de Cardiologia Sobre Cardiologia Nuclear. Arq Bras Cardiol 2002. [DOI: 10.1590/s0066-782x2002000900001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Mastrocolla LE, Meneghelo RS, Barretto AC. [Use of the ergometric test at supporting clinical decision]. Arq Bras Cardiol 1996; 67:69-75. [PMID: 9035471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Buchler RD, Meneghelo RS, Arakaki H, Mastrocolla LE, Batlouni M, Fehér J. [Evaluation of the effects of macerated oral dipyridamole on the ergometric test]. Arq Bras Cardiol 1989; 52:193-6. [PMID: 2604565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Eighteen male patients with ages varying from 42 to 72 years (average 60.6), with coronary heart disease confirmed by angiography, on regular rehabilitation program and on regular use of dipyridamole were submitted to three exercise stress tests: a control test (TE1) and forty minutes after oral administration of macerated dipyridamole in doses of 150 mg (TE2) and 300 mg (TE3), respectively. The comparison between the data of TE2 and TE1 demonstrated that in TE2 the ST depression was more accentuated in the smallest maximal load attained and in the effort peak as well. The comparison between the data of TE3 and TE1 showed that in TE3: 1) the ST depression was more evident in the effort peak and in the smallest attained load; 2) the heart rate and the product heart rate x blood pressure were smaller in the effort peak; 3) the total time of angina and the time for its relief after effort, were longer. The other exercise stress test parameters did not show any significant changes. These data, suggest that the physical effort overload, after dipyridamole administration, produced a more marked myocardial ischemia, whose degree was proportional to the dose.
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Borges Neto S, Blömer E, de Moraes AG, Pimentel Filho WA, Tom AF, Mastrocolla LE, Sousa JE. [Computed tomography with thallium-201 and oral dipyridamole in the diagnosis of coronary artery disease]. Arq Bras Cardiol 1988; 50:19-22. [PMID: 3265321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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