1
|
Abstract
OBJECTIVE To determine the prevalence of coronary risk factors in Paralympic athletes and evaluate their risk of coronary events. METHOD An observational prospective cross sectional study of 79 consecutive Brazilian Paralympic athletes (mean (SD) age 27.8 (6.7) years (median 26 years)). There were 56 men and 23 women, 67 with physical and 12 with visual disabilities. The occurrence of systemic hypertension, hypercholesterolaemia, diabetes mellitus, smoking, familial antecedents, obesity, and hypertriglyceridaemia was investigated. The risk of coronary events was calculated using the American Heart Association Coronary risk handbook, and also the 10 year probability of a coronary event using the Framingham risk score. RESULTS The prevalence of risk factors was: systemic hypertension, 11%; familial antecedents, 10%; smoking, 9%; hypertriglyceridaemia, 6%; hypercholesterolaemia, 1.3%; obesity, 4%; diabetes, 0%. They occurred in 51% of the Paralympic athletes: one factor (41%), two factors (4%), and three factors (6%). The risk of coronary events was absent in 80%, slight in 17%, and moderate in 3%. This could only be evaluated in 81% of the athletes, as 8% had amputations, 9% were young, and 2% had unknown familial antecedents. The Framingham risk score ranged from -14 to +6, predicting a 10 year probability of a coronary event of 3.3 (3.8)%. CONCLUSION This study shows a reasonably high prevalence of coronary risk factors (51%), despite a low probability of coronary events in Paralympic athletes. The lipid and blood pressure profiles were similar in ambulatory and wheelchair athletes.
Collapse
Affiliation(s)
- J A O Filho
- Department of Cardiology, São Paulo Federal University, São Paulo, Brazil.
| | | | | | | | | |
Collapse
|
2
|
Sella EMC, Sato EI, Leite WA, Oliveira Filho JA, Barbieri A. Myocardial perfusion scintigraphy and coronary disease risk factors in systemic lupus erythematosus. Ann Rheum Dis 2003; 62:1066-70. [PMID: 14583569 PMCID: PMC1754361 DOI: 10.1136/ard.62.11.1066] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [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: 11/03/2022]
Abstract
OBJECTIVE To evaluate the prevalence of myocardial perfusion abnormalities and the possible association between myocardial perfusion defects and traditional coronary artery disease (CAD) risk factors as well as systemic lupus erythematosus (SLE) related risk factors. PATIENTS AND METHODS Female patients with SLE, disease duration >5 years, age 18-55 years, who had used steroids for at least one year were enrolled. Traditional CAD risk factors evaluated were arterial hypertension, diabetes mellitus, dyslipidaemia, postmenopausal status, smoking, obesity, and premature family CAD profile. Myocardial perfusion scintigraphy was evaluated by single photon emission computed tomography with technetium 99m-sestamibi at rest and after dipyridamole induced stress. RESULTS Eight two female patients with SLE without angina pectoris with mean (SD) age 37 (10) years, disease duration 127 (57) months, SLE Disease Activity Index (SLEDAI) score 6 (5), and SLICC/ACR-DI score 2 (2) were evaluated. Myocardial perfusion abnormalities were found in 23 patients (28%). The mean (SD) number of CAD risk factors was 2.2 (1.6). There was a significant positive correlation between age and number of CAD risk factors. Lower high density lipoprotein (HDL) cholesterol level showed a significant association with abnormal scintigraphy. Logistic regression analysis showed that lower HDL cholesterol level and diabetes mellitus were associated with myocardial perfusion abnormalities. Current vasculitis was also associated with abnormal scintigraphy. CONCLUSIONS Lower HDL cholesterol level and diabetes mellitus have a significant influence on abnormal myocardial perfusion results found in asymptomatic patients with SLE. Current vasculitis was associated with abnormal myocardial scintigraphy. These data suggest that abnormal myocardial scintigraphy may be related to subclinical atherosclerosis.
Collapse
Affiliation(s)
- E M C Sella
- Rheumatology Division, Universidade Federal de São Paulo, Escola Paulista de Medicina, Brazil
| | | | | | | | | |
Collapse
|
3
|
Oliveira Filho JA, Luna Filho B, Covre SH, Lira Filho E, Regazzini M, Greco J, Silva AC, Santos Filho DV, de Paola AA. Signal averaged electrocardiogram in top deficient athletes. Arq Bras Cardiol 1999; 72:687-92. [PMID: 10752175 DOI: 10.1590/s0066-782x1999000600004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
4
|
Oliveira Filho JA, Luna Filho B, Salles T, Brito R, Palma L, Barbieri A, Herrmann JL, Martinez Filho E. [Exercise test: abnormal ST segments restricted to recovery phase]. Rev Assoc Med Bras (1992) 1999; 45:137-41. [PMID: 10413916] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
PURPOSE To determine the incidence of atherosclerotic coronary artery disease (CAD) and or myocardial ischemia in patients (pt) with abnormal ST segments restrict to recovery phase (RRAST) of exercise testing (ET). MATERIAL AND METHOD Retrospective study in 19 non consecutive pt with RRAST, related to coronary arteriography or exercise planar scyntillography (18 men, 58 +/- 9 years, 18 asymptomatic). RESULTS RRAST corresponded to ST segment depression from 1 to 4 mm, with T inversion during early recovery (2 pt); late (14 pt) or both (4 pt). It was documented CAD (14 pt and 9) with artery-by-pass surgery); hypertensive myocardiopathy with normal coronary (3 pt), and mitral prolapse valve (1 pt). In 13 pt with coronary arteriography or exercise scyntillography, within the first 6 months from exercise testing, myocardial ischemia was confirmed in 8 pt in 3 pt, successive exercise testing showed RRAST reproductive in 2 cases. CONCLUSION The authors report the high incidence of CAD and or transitory hypoperfusion during myocardial scyntillography in symptomatic men with middle age with RRAST during exercise testing.
Collapse
Affiliation(s)
- J A Oliveira Filho
- Setor de Ergometria e Reabilitação da Escola Paulista de Medicina, São Paulo
| | | | | | | | | | | | | | | |
Collapse
|
5
|
Oliveira Filho JA, Regazzini M, Campos Filho O, Salles AF, Barros Neto TL, Novo NF, Bocanegra J, Martinez Filho E, Santos Filho DV. [Early and late physiological effects of balloon mitral valvuloplasty]. Arq Bras Cardiol 1998; 70:81-6. [PMID: 9659713] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To evaluate the early and late cardiorespiratory responses after balloon mitral valvuloplasty. METHODS Nine female patients aged 35 +/- 9 years with mitral stenosis, in class II or III (NYHA) underwent up-right ergoespirometric test, resting electrocardiogram and echocardiogram before, 3 to 5 days (early evaluation) and 8 to 12 months (late evaluation) after mitral valvuloplasty. All patients were treated with digitalis and diuretics. RESULTS During late evaluation, 44% patients were in class II and 56% were in class I (NYHA). The resting heart rate decreased (87 +/- 11 bpm vs 85 +/- 7 bpm vs 75 +/- 9 bpm) and the number of steps increased (4 +/- 1 steps vs 5 +/- 2 steps vs 6 +/- 1 steps); the peak oxygen uptake improved only in the late evaluation (16 +/- 3 mL/kg/min vs 18 +/- 4 mL/kg/min vs 22 +/- 7 mL/kg/min). The anaerobic threshold, minute ventilation (VE) and ventilatory equivalent for oxygen showed no change. The heart rate (1st step: 124 +/- 18 bpm vs 112 +/- 13 bpm vs 87 +/- 15 bpm), O2 uptake (1st step: 10 +/- 2 mL/ kg/min vs 8 +/- 2 mL/kg/min vs 8 +/- 2 mL/kg/min) and VE decreased during submaximal exercise in early and late phases. The mitral valve area decreased in the late evaluation (0.94 cm2 vs 1.66 cm2 vs 1.20 cm2). CONCLUSION Although partial restenosis tended to occur in these patients, they improved the functional class and cardiorespiratory performance and cardiocirculatory load during submaximal exercise.
Collapse
|
6
|
Salles AF, Oliveira Filho JA, de Barros Neto TL, de Almeida DR, Carvalho AC, Juliano Y, Buffolo E, Martinez Filho EE. [Cardiorespiratory response during exercise in heart transplant recipients. Comparative ergoespirometric analysis with normal health subjects]. Arq Bras Cardiol 1998; 70:15-8. [PMID: 9629682 DOI: 10.1590/s0066-782x1998000100004] [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] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To evaluate the cardiorespiratory response of heart transplant (HT) recipients. METHODS Nine HT recipients (GI) underwent ergospirometric tests and were compared to 9 apparently healthy, sedentary subjects with similar sex, age, weight and height (GII). All were male patients aging 48 +/- 12 years, in functional class I (NYHA) an average of 23 +/- 21 months after HT. They were receiving cyclosporin, azathioprine, prednisone, dipyridamole and antihypertensive drugs. The tests were symptom-limited and they were interrupted due to exhaustion. RESULTS During peak exercise, GI had a significantly lower physical performance related to lower VO2, VE, VEO2, HR, endurance time and work load. At the anaerobic threshold, VO2, endurance time and work load levels were also significantly lower in GI. The physical performance was similar between the groups in the 40W load. CONCLUSION The cardiorespiratory performance in GI was significantly lower at peak exercise and similar to GII in the 40W load, showing the HT benefits cardiac patients during usual activities.
Collapse
|
7
|
Oliveira Filho JA, Silva AC, Lira Filho E, Luna Filho B, Covre SH, Lauro FA, Danucalov MA, Leite WA, Tuffik S, Andrade JL, de Paola AA, Martinez Filho E. [Athlete's heart in elite disabled athletes]. Arq Bras Cardiol 1997; 69:385-8. [PMID: 9609009] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To assess the prevalence of the athlete's, heart syndrome in elite disabled Brazilians athletes. METHODS Seventy-five athletes, age 27.8 +/- 6.7 years, 56 men, with various disabilities (47 physical, 12 visual and 16 cerebral paralysis) underwent clinical, electrocardiographic, vectorcardiographic, ergometric and echocardiographic evaluations. RESULTS Athlete's heart signs occurred in 33% of the clinical evaluations, in 55% of the electrocardiograms, in 15% of the vectorcardiograms, and in 5% of the echocardiograms. At least one of these signs was presented in 51% of the athletes. There were 2 or more abnormalities in 46% of the athletes and 4 or more signs in 12%. Exercise test was considered not ischemic in 77% of the subjects. There was right bundle branch block in 23% of the tests. CONCLUSION There were two or more athlete's heart syndrome signs in 46% of Brazilian disabled athletes.
Collapse
|
8
|
Vidalon M, Tosta C, Oliveira Filho JA, Pimenta J. [Symptomatic mitral valve prolapse. Left ventricular dysfunction and beneficial effect of digitalis]. Arq Bras Cardiol 1993; 60:19-24. [PMID: 8240036] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
PURPOSE To study the left ventricular function by M-mode echocardiography in symptomatic patients with primary mitral valve prolapse (MVP), without significant mitral regurgitation, during the phenylephrine test, before and after digitalization. METHODS Thirty one patients with MVP and 10 normal subjects as a control group were studied by M mode echocardiography: Percentage of systolic shortening (DD), ejection fraction (EF) and mean velocity of circumferential fibers shortening (Vcf) were measured. The echocardiographic recordings were obtained at rest and during the continuous infusion of phenylephrine (40-60 micrograms/min) in order to allow an increase of 20-30 mmHg in systolic pressure. RESULTS At rest, cardiac size and function were normal in both groups. During phenylephrine infusion in 27 patients a decrease in DD (from 37.7 +/- 4.6 to 31.0 +/- 4.0, p < 0.001); in EF (from 0.76 +/- 0.05 to 0.66 +/- 0.6, p < 0.001); in Vcf (from 1.05 +/- 0.77 to 0.76 +/- 0.13, p < 0.001) were observed. From this group 20 patients received digoxin. After the digitalization the phenylephrine test did not cause changes in DD (from 38.3 +/- 5.0 to 39.2 +/- 3.8, NS); in EF (from 0.77 +/- 0.06 to 0.77 +/- 0.04, NS); in Vcf (from 1.05 +/- 0.19 to 0.94 +/- 0.13, NS). These patients during the submaximal exercise test, showed significant increases at the total work load (from 617 +/- 248 to 982 +/- 244 watts, p < 0.001) and cardiac efficiency (from 25.0 +/- 11.5 to 37.2 +/- 10.4, p < 0.001). On the other hand the phenylephrine infusion in the control group did not result in changes in DD, EF and Vcf. CONCLUSION Symptomatic patients with primary MVP showed total recovering of left ventricular dysfunction with digitalization during the phenylephrine test, with improvement of cardiac efficiency.
Collapse
Affiliation(s)
- M Vidalon
- Hospital do Servidor Público Estadual, São Paulo
| | | | | | | |
Collapse
|
9
|
de Andrade CH, Santos Filho DV, Nacarato E, Oliveira Filho JA, Cirenza C, Lorena YG, Barcellini A. [Identification of arterial hypertension in aortic insufficiency. I. Relation between pressure levels before and after valve implantation]. Arq Bras Cardiol 1985; 44:383-8. [PMID: 4096662] [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: 01/08/2023] Open
|
10
|
de Andrade CH, Santos Filho DV, Nacarato E, Cirenza C, Oliveira Filho JA, Paiva ER, Barcellini A. [Aortic valve implant and arterial hypertension]. Arq Bras Cardiol 1985; 44:327-31. [PMID: 4091729] [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: 01/08/2023] Open
|
11
|
Faria SL, Alvarenga M, Prando A, Télis CM, Oliveira Filho JA, Chiminazzo Júnior H. [Non-Hodgkin's lymphoma in adults. Critical review of the patients treated at the Campinas Oncology Center]. AMB Rev Assoc Med Bras 1984; 30:85-90. [PMID: 6332348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
12
|
Oliveira Filho JA, Santos Filho DV, Godoy M, Severino CA, Pfeferman A, Arroyo JB, Paiva ER, Feher J, Barcellini A. [Disagreement in the interpretation of ergometric tests]. Arq Bras Cardiol 1983; 41:349-55. [PMID: 6675628] [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: 01/21/2023] Open
|
13
|
Oliveira Filho JA, Arroyo JB, Pfeferman A, Paiva ER, dos Santos Filho DV, Barcellini A. [Analysis of the ergometric test in symptomatic patients in the detection of coronary disease. New criteria]. Arq Bras Cardiol 1983; 41:27-32. [PMID: 6667157] [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: 01/21/2023] Open
|
14
|
Oliveira Filho JA, Pfeferman A, Arroyo JB, dos Santos Filho DV, Barcellini A. [The ergometric test]. Arq Bras Cardiol 1983; 40:341-51. [PMID: 6651569] [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: 01/21/2023] Open
|
15
|
Oliveira Filho JA, Santos Filho DV, Martinez TL, Delboni Filho H, Pfeferman A, Godoy M, Severino CA, Herman JL, Paiva ER, Arroyo JB. [Behavior of creatine kinase and its MB fraction in serum after an ergometric test]. Arq Bras Cardiol 1983; 40:239-46. [PMID: 6661082] [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: 01/21/2023] Open
|
16
|
Faria SL, Chiminazzo Júnior H, Schlupp WR, Leite MT, Oliveira Filho JA. [Breast cancer: conservative treatment]. Rev Paul Med 1983; 101:34. [PMID: 6879032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
17
|
Pereira Filho RA, Souza SA, Oliveira Filho JA. Primary neurilemmal tumour of the liver: case report. Arq Gastroenterol 1978; 15:136-8. [PMID: 749850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A probably unique case of primary benign neurilemmoma of the liver is presented in which no evidence of visceral neurofibromatosis was observed. The histological characteristic of the tumour are discussed.
Collapse
|