RESUMO
OBJECTIVE: To study by doppler echocardiography the cardiac systolic and diastolic functions of health, uncomplicated obese subjects. METHODS: Fifty-nine obese women with an average body mass index (BMI) of 35 kg/m2 were evaluated and compared with 19 subjects with an average BMI of 23 kg/m2 (control group). RESULTS: In the obese group, a clear tendency was observed toward higher systolic pressure, increased wall thickness and, consequently, myocardial mass, elevation on the circumference stress of the left ventricular wall, and an indisputable presence of diastolic abnormalities. Filling abnormalities were observed with impaired relaxation, with prolonged isovolumic relaxation time (IVRT) and augmented atrium contribution representing early indexes of cardiac dysfunction when systolic performance is still normal. CONCLUSION: Obesity is generally a chronic condition, and doppler echocardiography can be used as a noninvasive instrument for early evaluation of left ventricular diastolic indexes.
Assuntos
Pressão Sanguínea/fisiologia , Ecocardiografia Doppler/métodos , Obesidade/fisiopatologia , Adulto , Índice de Massa Corporal , Superfície Corporal , Diástole/fisiologia , Feminino , Humanos , Sístole/fisiologia , Função Ventricular Esquerda/fisiologiaRESUMO
OBJETIVO - Estudo ecocardiográfico em recém-nascido (RN) de grupos de risco para cardiopatia congênita, a fim de se determinar a prevalência que justifique esse exame no período neonatal. MÉTODOS - Estudaram-se, de novembro/91 a abril/93, 156 RN do berçário anexo à Maternidade do HC-FMUSP, sendo RN de mães com cardiopatia congênita ou diabetes mellitus, crianças de muito baixo peso, com malformaçöes extracardíacas ou presença de sinais cardíacos, caracterizados por sopro, cianose, ou arritmia, todos submetidos ao ecocardiograma. RESULTADOS - A prevalência encontrada foi de 21,8 'por cento', superior ao da população geral (0,8 a 1,2 'por cento'), sendo que a maior entre os grupos, de 40,7 'por cento', ocorreu no grupo de malformaçöes extracardíacas. CONCLUSÄO - Nossos dados justificam a realização de ecocardiograma em RN pertencentes a um destes grupos de risco para cardiopatia congênita.
Assuntos
Humanos , Recém-Nascido , Pré-Escolar , Asfixia Neonatal , Cardiopatias Congênitas , Ecocardiografia , Epidemiologia Descritiva , Evolução Fatal , Mortalidade , Cuidados Pós-Operatórios , Prevalência , Grupos de RiscoRESUMO
PURPOSE: An echocardiographic study was performed in newborns from risk groups, with the aim of to determining prevalence and to evaluate the indications for this test in the neonatal period. METHODS: One hundred fifty six newborns were studied. They were admitted to the Newborn ward of the Department of Obstetric of the HC-FMUSP, in the period of November 91 to April 93, from mothers with congenital heart disease or diabetes, low birth weight newborns, with extracardiac malformations, cardiac signs and/or congenital infections. RESULTS: The observed prevalence was 21.8%, greater than that of the general population (0.8-1.2%). The group composed by 27 children with extracardiac abnormalities presented the largest prevalence when compared with the other groups (40.7%). These data justify the use of echocardiography in high risk newborns for the detection of congenital heart disease.
Assuntos
Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/epidemiologia , Feminino , Humanos , Recém-Nascido , Masculino , Prevalência , Estudos Prospectivos , Fatores de Risco , UltrassonografiaRESUMO
PURPOSE: To evaluate the cardiocirculatory abnormalities of hyperthyroidism in the elderly. PATIENTS AND METHODS: Twenty-four hyperthyroid patients, 18 women and six men, aged 60 to 87 (average 73.5) years were studied. Seventeen (70.9%) patients had associated cardiocirculatory diseases. The evaluation was made on clinical grounds complemented by electrocardiographic, radiologic, phonomechanocardiographic and echocardiographic examinations. RESULTS: Cardiocirculatory symptoms were observed in 17 (70.9%) patients and congestive heart failure in nine (37.5%) of them. The electrocardiogram was abnormal in 20 (83.3%) patients and the tachyarrhythmias were the commonest abnormality (62.5%). Eight (33.3%) patients had chronic atrial fibrillation and five (20.8%) had sinus tachycardia. There was no significant statistical difference on the electrocardiograms of patients with and without cardiocirculatory abnormalities. Cardiomegaly was significantly more prevalent in hyperthyroid patients, with (64.7%) or without (57.1%) cardiocirculatory abnormalities, than in normal elderly (23.9%). Left ventricular performance was studied in 14 patients through the systolic quotient and was found normal or high in 12 (85.7%). The percentage of fractional shortening (delta D%) was higher than 30 in all patients. None of the patients was found to have symmetric or asymmetric hypertrophic cardiomyopathy and mitral valve prolapse on echocardiogram. CONCLUSION: Hyperthyroidism in the elderly patient determines frequently cardiocirculatory abnormalities that may be misdiagnosed with those caused by the ageing process or by associated cardiopathies. This diagnosis should be suspected in all elderly patients having tachyarrhythmias and/or cardiac failure resistant to usual therapy, mainly in patients without clear cardiocirculatory pathology.
Assuntos
Cardiopatias/etiologia , Hipertireoidismo/complicações , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Pressão Sanguínea , Doença da Artéria Coronariana/etiologia , Feminino , Frequência Cardíaca , Humanos , Hipertensão/etiologia , Masculino , Pessoa de Meia-IdadeRESUMO
Besides the duration and severity of hypertension, several other factors have been shown to be related to left ventricular hypertrophy (LVH) in essential hypertension. The present study was conducted to examine the influence of salt sensitivity on LVH. Fifteen essential hypertensive ambulatory patients were submitted to a low-salt (30 mEq of Na/day for 7 days) and a high-salt (200 mEq of Na/day for 7 days) diet after 12 weeks on placebo. Daily urine collection was obtained during the whole study. After the placebo period, all patients were submitted to a complete clinical and laboratory investigation that included an echocardiogram (M-mode and two-dimensional). Five patients were salt-sensitive (mean blood pressure (BP) increase from the seventh day of the low- to the seventh day of the high-salt diet greater than 10%). No differences in weight, sex ratio, and duration of hypertension were obtained between salt-sensitive and -resistant patients. The initial BP was higher in the salt-sensitive patients. However, the difference was small and without statistical significance. The left ventricular weight was higher in the salt-sensitive than in salt-resistant patients (148 +/- 51 vs. 109 +/- 32 g/m2, p less than 0.05). The left ventricular end-diastolic diameter was also higher in the salt-sensitive patients (50 +/- 10 vs. 43 +/- 6 mm, p less than 0.05). The interventricular septum and posterior wall thicknesses were higher in salt-sensitive patients, although they did not reach statistical significance. In conclusion, salt-sensitive essential hypertensive patients are at a higher risk to develop LVH.
Assuntos
Cardiomegalia/induzido quimicamente , Hipertensão/complicações , Sódio na Dieta/efeitos adversos , Adulto , Pressão Sanguínea/efeitos dos fármacos , Cardiomegalia/etiologia , Ecocardiografia , Humanos , Pessoa de Meia-Idade , Sódio na Dieta/urinaRESUMO
PURPOSE: To detect in prenatal life fetal arrhythmia and congenital heart disease. We performed fetal echocardiography following classical indications according to the literature. PATIENTS AND METHODS: Two-dimensional echocardiography associated with M-mode and Doppler was performed in 200 patients according to the indications: maternal diabetes, fetal arrhythmia, maternal congenital heart disease, previous fetus with cardiac defect, intrauterine growth retardation, nonimmune fetal hydrops, rubeola, isoimmunization, fetal malformation by ultrasound, polyhydramnios, gemelarity, oligohydramnios, maternal ingestion of drugs, lupus and others. RESULTS: Structural abnormalities of the heart were found in 6 cases and associated with bradiarrhythmia in 5 cases (total of 5.5%). Fetal arrhythmias without cardiac malformation were found in 35 cases (17.5%) and premature atrial contractions were the most frequent. CONCLUSION: The findings in this study indicate that it is possible the accurate definition of the cardiac anatomy and function. We have emphasized the method trying to spread it, objecting to improve assistance to the fetus and newborn with arrhythmias and/or congenital heart disease.