Subject(s)
Humans , Male , Female , Myocardial Reperfusion/methods , Myocardial Ischemia/diagnostic imaging , Radiopharmaceuticals/therapeutic use , Acute Coronary Syndrome/diagnostic imaging , Radionuclide Imaging/methods , Echocardiography, Stress/methods , Dipyridamole/adverse effects , Dobutamine/adverse effects , Exercise Test/drug effectsSubject(s)
Humans , Female , Middle Aged , Vasodilator Agents/adverse effects , Coronary Artery Disease/diagnostic imaging , Dipyridamole/adverse effects , ST Elevation Myocardial Infarction/chemically induced , Radionuclide Imaging/adverse effects , Electrocardiography , ST Elevation Myocardial Infarction/diagnostic imagingABSTRACT
Pacientes com resposta da frequência cardíaca (FC) diminuída apresentam mortalidade cardíaca aumentada embora o mecanismo para isso seja desconhecido...
Subject(s)
Humans , Male , Adolescent , Dipyridamole/administration & dosage , Dipyridamole/adverse effects , Heart Rate , Tomography, Emission-Computed, Single-Photon/adverse effectsABSTRACT
Fundamentos: Com o envelhecimento da população, no Brasil e no mundo, cresce o número de doenças crônicas, dentre elas a doença arterial coronariana. Faz-se, portanto, necessária a adoção de estratégias racionais na avaliação dessa população. Objetivos: Avaliar segurança, exequibilidade e resposta hemodinâmica do ecocardiograma de estresse com dipiridamol e atropina (Eco-Dip-Atro) num grupo de idoso (maior ou menor que 65 anos - Grupo I), comparando os achados com um grupo jovem (menor que 65 anos - Grupo II). Métodos: Um total de 203 pacientes consecutivos com suspeita ou com coronariopatia conhecida (Grupo I - n igual 69; Grupo II - n igual 134) realizaram o Eco-Dip-Atro seguindo o protocolo do estudo EPIC 2, ou seja, dipiridamol (até 0,84mg/kg em 10min) e atropina (até 1mg em 4 min).Resultados: O índice de exames conclusivos ou em que o protocolo pôde ser completado foi de 78,9 por cento no Grupo I e 92,5 por cento no Grupo II (p menor que 0,0001)...
Subject(s)
Humans , Aged , Coronary Disease , Stress, Physiological , Atropine , Dipyridamole/adverse effects , EchocardiographyABSTRACT
Objetivo: Avaliar a segurança do uso do dipiridamol (dipi) em dose máxima com a técnica combinada para a pesquisa de isquemia miocárdica(TCPI). Métodos: Foram avaliados, prospectivamente, 110 pacientes, encaminhados no período de junho 2006 a abril 2007, com indicação de pesquisa de isquemia miocárdica, associada ou não à pesquisa de viabilidade miocárdica, que não apresentassem alguma contra-indicação ao exame. Resultados: Todos os pacientes conseguiram realizar o exame completo, sem interrupção por sintomas. O tempo médio de aquisição das imagens durante os exames foi de 39,6min, com o tempo de estresse de 11,8min. Conclusão: É possível realizar o exame completo de TCPI pela RMC, com dose máxima do dipi, com boa tolerabilidade e segurança, e com tempo de aquisição de imagem em média inferior a 40 minutos.
Objective: To assess the safety of using a maximum dose of dipyridamole through the combined technique forinvestigating myocardial ischemia.Methods: A prospective assessment of 110 patients from June 2006 to April 2007, recommended for myocardialischemia investigation and associated or not with myocardial feasibility studies, presenting no counterindicationsfor this examination. Results: All the patients managed to complete the fullexamination with no interruptions caused by symptoms. The average time of image acquisition was 39.6 minutes,with a stress time of 11.8 minutes.Conclusion: It is possible to use the combined technique for investigating myocardial ischemia through magneticresonance imaging (MRI) with a maximum dose of dipyridamole, without causing hemodynamic effects orsymptoms that interrupt the examination. This procedure may be performed in less than forty minutes, providing important clinical information.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Dipyridamole/administration & dosage , Dipyridamole/adverse effects , Myocardial Ischemia/complications , Myocardial Ischemia/diagnosis , Ischemia/complications , Ischemia/diagnosisABSTRACT
An up-to-date overview of antithrombotic drugs, with their currently reported beneficial cutaneous effects and skin side effect, is presented. Attempts to balance traditional pharmacodynamic concepts with the newly described empiric benefits are made. A concise, current and useful reference for dermatologists with an interest in dermatopharmacology and the practicing physician in the field of wound care, vasculitides and skin involvement of internal diseases is tried to be achieved
Subject(s)
Humans , Fibrinolytic Agents/adverse effects , Dipyridamole/adverse effects , Pentoxifylline/adverse effects , Pentoxifylline/pharmacology , Ticlopidine/pharmacology , Ticlopidine/adverse effects , Aspirin/pharmacology , Dipyridamole/pharmacology , Aspirin/adverse effectsABSTRACT
PURPOSE--To analyze adverse reactions (AR), hemodynamic and electrocardiographic changes and thallium scintigraphy (TS) results, during pharmacological stress with dipyridamole (SD), correlating these data to the presence and extension of coronary artery disease (CAD). METHODS--We studied 126 patients, 66 had no evidence of cardiovascular disease (G1) and 60 had critical occlusive CAD > or = 70 per cent stenosis (G2). Most of them were male, mean age 56.5 +/- 10.9 years old. All patients were submitted to TS after receiving 0.56 mg/kg of dipyridamole intravenously (0.14 mg/min during 4 min) followed by 111MBq of thallium-chloride-201. Conventional ECG was recorded before and after SD; heart rate (HR) and arterial pressure (AP) were monitored during dipyridamole infusion. All signals and/or symptoms were observed. RESULTS--Cine-coronarography showed 22 patients (37 per cent ) with one vessel disease (VD) (G2a), 26 (46 per cent ) with two VD (G2b) and 12 (20 per cent ) with three VD (G2c). Of the 126 patients 63 per cent did not present symptoms. Flushing (25 per cent ) and sick-headache (12 per cent ) were most frequent AR. Typical angina was reported by one G1 patient (1.5 per cent ) and six G2 patients (10 per cent ) (p < 0.05). HR increased 18.09 +/- 12.27 per cent and 12.40 +/- 4.90 per cent , systolic blood pressure varied -5.2 +/- 7.5 per cent and -4.3 +/- 6.5 per cent in G1 and G2, respectively. These parameters are not correlated to CAD presence and extension. ST depression and ectopic beats occurred in 5 per cent and 11 per cent of G1 patients, in 15 per cent and 30 per cent of G2 patients, respectively (p < 0.05). Typical angina was more common in G2a and G2b; ST changes in G2b and G2c; and arrhythmia in G2c (not significant). Sensitivity of TS associated to SD was 84 per cent , comparable to stress exercise thallium test. CONCLUSION--TS associated to SD, a noninvasive, safe with low morbidity and few collateral effects method is an option to patients with limitations to physical exercise tests
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Coronary Disease , Heart , Coronary Disease/physiopathology , Dipyridamole/adverse effects , Dipyridamole , Electrocardiography , Heart , Heart/physiopathology , Heart Rate , Hemodynamics , Injections, Intravenous , Arterial PressureABSTRACT
La prueba de Talio con Dipiridamol constituye en la actualidad un método no invasivo de gran utilidad para evaluar a pacientes en quienes se sospecha o se ha confirmado una enfermedad coronaria. El Dipiridamol se puede administrar por vía endovenosa u oral, produce vasodilatación coronaria y puede poner en evidencia defectos de reperfusión miocárdica. Su administración puede asociarse a una incidencia variable de efectos colaterales. Comunicamos nuestra experiencia con la administración de Dipiridamol en 286 pacientes, 223 de ellos por vía endovenosa y 63 por vía oral. El 87% de los pacientes tenía evidencia previa de enfermedad coronaria. La administración de Dipiridamol se asoció a un aumento significativo de la frecuencia cardiaca y descenso también significativo de la presión arterial. Encontramos efectos colaterales en el 29,7% de los pacientes que recibieron Dipiridamol endovenoso y en el 32,3% de los que recibieron Dipiridamol oral. El síntoma colateral más frecuente, 15,4%, fue el dolor torácico, que se presentó de preferencia, 81,3%, en pacientes con enfermedad coronaria y cedió con la administración de Trinitina y/o Aminofilina. Otros síntomas colaterales fueron cefalea, náuseas y/o vómitos, pero con una incidencia menor. Concluimos en que los síntomas colaterales durante la prueba de Talio con Dipiridamol son frecuentes, la mayoría de ellos leves y no son diferentes según el tipo de administración oral o endovenosa de la droga. El síntoma colateral más severo, dolor torácico, revierte facilmente con la administración de Trinitina o Aminofilina