[Morphometric study of the influence of hypo and hyperthyroidism on papillar myocytes at left ventricle of rats]

Thyroid gland affects many physiologic and metabolic activities .Thyroxine [T4] and its effective form [T3] regulate metabolism of tissues. These hormones affect the heart work with direct or indirect mechanisms. In the present study we investigated the effect of hypo and hyperthyroidism on rat heart. We used female Wistar rats [250-300 gr] in 3 groups [each consisted of 6]: Hyperthyroid rats were treated with thyroxine [1 mg/lit water for 20 days] hypothyroid rats were treated with propylthyoacil [PTU] [0.5 gr/lit water] and Control. Finally, histopathological and stereometric evidences were investigated in heart slides. Results showed that in papillar muscle of hyperthyroid rats, there were clear evidences of hypertrophy and increased capillary density. In hypohtyroid rats, however, changes were in opposite to hyperthyroid rats. Results revealed that during changes of hypo and hyperthyroidism, the metabolic changes are in accordance with cardiac hyperthrophy during hyperthyroidism and in opposite direction in hypothyroid rats

Myocyte renewal and ventricular remodelling

Remaining young at heart is a desirable but elusive goal. Unbeknown to us, however, myocyte regeneration may accomplish just that. Continuous cell renewal in the adult myocardium was thought to be impossible, but multipotent cardiac stem cells may be able to renew the myocardium and, under certain circumstances, can be coaxed to repair the broken heart after infarction

Doppler-derived myocardial performance index: a new predictor for subclinical dysfunction in hypertensive patients

This study included 40 hypertensive patients and 20 normal subjects as a control group. They were subjected to complete clinical examination, ECG and complete echo-Doppler study with the calculation of Doppler-derived interval index [ICT + IRT]. The index was significantly higher in hypertensive patients as compared with the control, it was also significantly higher in hypertensive patient with eccentric LVH as compared with those with concentric LVH. The index was higher in patients with decreased EF and FS. The Doppler-derived index of combined systolic and diastolic function was higher in hypertensive than normotensive and it may be considered a simple accurate parameter for the detection of subclinical dysfunction and follow up studies of cardiac patients

Infarctus du myocarde sur pont myocardique [a propos d'une observation]

The authors report the case of a 44 year old patient who sustained an acute myocardial infarction. Coronary arteriography revealed no atherosclerotic lesion but a myocardial bridge over the left anterior descending artery. This report is exceptional because the myocardial bridge is rare and it's complicated of myocardial infarction in a few cases without associated coronary atherosclerosis. The incidence, predisposing factors gravity, prognosis and different therapeutic approaches of this affect are reviewed

Myocardial adaptation to physical training in hypertension

Thirty patients with age range from 25 to 50 years participated in this study and were divided into two groups. The study group included 15 hypertensive patients receiving nifedipine and physical training program. The control group included 15 hypertensive patients receiving nifedipine only. At the beginning of the study, the following parameters were measured before any intervention for both groups: Heart rate, systolic, diastolic blood pressure [by sphygmomanometer] and end systolic, end diastolic dimensions, volumes, interventricular septal thickness,% fractional shortening and early filling/atrial contractility ratio [by echocardiography]. Each patient of the study group performed ergometric exercise program for eight weeks three times per week. At the end of 8th week, another measurement of the previous parameters was done. The analysis of data revealed that physical training intervention caused a significant decrease in systolic and diastolic blood pressure, insignificant decrease in heart rate, insignificant difference in E/A ratio, insignificant difference in end systolic dimension and volume, insignificant difference in end diastolic dimension and a significant difference in interventricular septum,% fractional shortening and end diastolic volume in the study group; while the patients of the control group showed a decrease in the level of elevated blood pressure only

new approach to revascularize the ischemic myocardium

There are an increased number of treatment alternatives available today, as compared to as little as ten ears ago, for those with ischemic heart disease. Surgical procedures are more sophisticated, a wide array of medications are available, and numerous catheter techniques have evolved to treat patients with coronary artery disease. These technical advanced, combined with life style modifications, have contributed to a decline in age adjusted death rates. Despite these advances there remains a significant number of patients with myocardial ischemia who are not candidates for conventional therapies or who do not respond to regimes of treatment Transmyocardial Laser Revascularization, investigated by us in our laboratory and clinically for more than two decades, may be a viable adjunctive or alternative therapy. A high power carbon dioxide laser is used to create channels from the epicardial surface of the heart through the left ventricular wall, and penetrating the endocardium. Perfusion occurs from the blood supply in the left ventricular chamber which fills the channels in retrograde fashion. Blood from the channels seeps into the system of myocardial sinusoids and provides nourishment for the ischemic tissue. The channels remain patent Other methods utilized to perfuse myocardial tissue from the ventricular chamber provided immediate protection but quickly closed due to tissue reaction and scarring. The laser vaporizes tissue within milliseconds, there is little pyknosis or scarring, damage to adjacent cells is minimal The background for a clinical study utilizing the laser as sole therapy was preceded by extensive experimental investigation and early clinical experience which combined laser revascularization with coronary artery bypass. Patient evaluation, follow-up and preliminary results in a group of 24 patients in the sole therapy group will be discussed. The follow-up time ranges from three to 15 months. Evaluation includes nuclear, studies, stress testing, echocardiography, and cardiac catheterization, Early results suggest that a group of patients may benefit from this technique

Diastolic function abnormalities in young symptomatic diabetic patients assessed by pulsed doppler echocardiography

The objective of this study was to evaluate left ventricular [LV] diastolic function in young asymptomatic insulin-dependent diabetic patients. Thirty young asymptomatic patients [<35 years] and 15 control subjects were included. Patients were not received medications except insulin. Autonomic function tests, fundus examination were used to evaluate diabetic complications. Blood glucose and lipid profile were measured in all patients. M-mode, two-dimensional and Doppler echocardiography were used to study LV systolic and diastolic functions. Peripheral neuropathy was present in all patients and autonomic neuropathy in 23 [73.3%], resting tachycardia in 12 patients [40%], proteinuria in 14 [46.7%], retinopathy in 7 patients [23.3%]. Eight patients [26.7%] had LV diastolic dysfunction represented by decreased E filling and increased A with reversed PE/PA and increase atrial contribution of diastolic filling as compared to other diabetics. There was significant correlation between diastolic dysfunction, diabetic complications [r=0.51, P <0.05] and blood glucose [r=0.49, P <0.05], but not correlated with duration of diabetes or insulin dose. It was concluded that subclinical LV diastolic dysfunction is present in diabetic and is related to microvascular complications and hyperglycemia, but not related to the duration of the disease or insulin dose

Clinical significance of plasma fibrinogen level in acute myocardial infarction

Plasma fibrinogen and serum cardiac enzymes have been evaluated in patients with acute myocardial infarction. Our results showed that plasma fibrinogen and cardiac enzymes were significantly higher in patients with Q-wave myocardial infarction in comparison with non Q-wave infarction. Furthermore, plasma fibrinogen tended to be significantly higher in patients with complicated Q-wave infarction, and it showed a multimodal pattern in its values during the course of illness. We conclude that plasma fibrinogen can serve as a good diagnostic and prognostic parameter for Q-wave myocardial infarction

Myocardial performance in patients with chronic renal failure

The present work has been designated to re-assess the left ventricular morphofunctional changes by echocardiography in a group of non- dialyzed uremic as well as continuous ambulatory peritoneal dialysis [CAPD] and hemodialysis [HD] cases, together with clinical and laboratory assessment with a special attention to serum Ca, Mg, Zn, Cu, Fe, and Co. Myocardial suppression by uremic toxins was suggested but no such specific uremic toxins were isolated, yet trace metals were suggested to play an important role. The study involved 20 cases on conservative treatment, 20 cases on CAPD and 20 cases on HD, in addition to 20 control subjects. Patients with valvular heart disease, pericardial effusion, diabetes, manifested heart failure or any acute illness were excluded. The results of this work reflected the basal left ventricular function and represent a high prevalence of subclinical myocardial dysfunction, as well as significant morphological alterations. On the other hand, the studied biochemical parameters [serum creatinine, Ca, Mg, Zn, Cu and Fe] were not correlated to the studied left ventricular morphofunctional parameters

Avaliaçäo da funçäo renal e miocárdica na hipertensäo malígna / Evaluation of renal and myocardial functions in malignant hypertension

Foram avaliadas a funçäo renal e miocárdica em 13 pacientes com hipertensäo maligna (HM). Todos apresentavam hipertrofia miocárdica. A cintilografia renal revelou déficit de funçäo renal nos pacientes com creatininemia maior que 1,5mg%. A arteriografia mostrou lesäo severa em um caso, e lesöes de até 50% em quatro. Concluiu-se que a HM acomete órgäos-alvo de modo importante; existe correlaçäo entre cintilografia e creatininemia; a arteriografia está indicada pela alta prevalência de doença nevo-vascular e que o tratamento da HM parece deter a piora das lesöes em órgäos-alvo