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Introducrion: although the mortality rate among soccer players is low, it causes much impact on the entire community and is a fascinating conundrum. Objetive: to evaluate the cardiovascular risk of soccer referees, to describe the frequency of cardiovascular risk considering age groups younger and older than 35 years old and to relate the Framingham and PROCAM indices for the comparison of cardiovascular risk in soccer referees. Methods: We analyzed 50 referees of Paulista Soccer Federation subjected to clinical and laboratory based evaluations at the Center for Sports Health at the Faculty of Medicine of ABC, and were divided into two groups: lower and higher than 35 years of age. For analysis involving all variables of the study it was initially carried out as a descriptive evaluation of the entire group, and then the Framingham and PROCAM methods were applied in a two-dimensional way. Finally, the logistic regression analysis was applied. Anthropometric statistics, blood pressure, laboratory tests and ergospirometric values were within normal limits. Results: referees older than 35 years old presented significant increased values of waist circumference, body mass index, glucose blood levels, lower VO2max and higher cardiovascular risk according to Framingham and PROCAM. Conclusion: the risk for coronary heart disease was higher in referees older than 35 years old.
Introdução: embora a taxa de mortalidade entre os jogadores de futebol seja baixa, ela causa muito impacto em toda a comunidade e é um enigma fascinante.Objetivo: avaliar o risco cardiovascular de árbitros de futebol, descrever a frequência de risco cardiovascular considerando faixas etárias menores e maiores de 35 anos e relacionar os índices de Framingham e PROCAM para comparação de risco cardiovascular em árbitros de futebol.Métodos: foram analisados 50 árbitros da Federação Paulista de Futebol submetidos a avaliações clínicas e laboratoriais no Centro de Saúde Esportiva da Faculdade de Medicina do ABC, divididos em dois grupos: menores e maiores de 35 anos. Para a análise envolvendo todas as variáveis do estudo foi realizada inicialmente como uma avaliação descritiva de todo o grupo e, em seguida, foram aplicados os métodos de Framingham e PROCAM de forma bidimensional. Por fim, foi aplicada a análise de regressão logística. Estatísticas antropométricas, pressão arterial, exames laboratoriais e valores ergoespirométricos estavam dentro da normalidade.Resultados: os árbitros com mais de 35 anos apresentaram valores significantemente aumentados de circunferência da cintura, índice de massa corporal, glicemia, menor VO2máx e maior risco cardiovascular segundo Framingham e PROCAM.Conclusão: o risco de doença coronariana foi maior em árbitros com mais de 35 anos.
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One hundred patients underwent coronary artery bypass grafting and thirty patients underwent replacement of mitral valve were included in this study, and patients were randomized to two groups. Adenosine group (group I):6 mg adenosine was diluted with physiological saline and injected from the root of the ascending aorta after blocking it. The aorta was then perfused with high-potassium cold-blood cardioplegia. Control group (group II):the aorta was just perfused with high-potassium cold-blood cardioplegia. Adenosine was only added in first perfusion in adenosine group. Both groups were reperfused half-amount of cold-blood cardioplegia containing potassium every 30 minutes. Relevant clinical indexes and myocardial enzymological determination were compared between two groups. Results For patients who underwent CABG, the cardiac arrest induced time,ICU dwell and assisted ventilation time after surgery and dopamine usage were all less in adenosine group than those of control group (P 0.05). For patients who underwent MVR, the cardiac arrest induced time and dopamine usage were all less in adenosine group than those of control group (P0.05). For both operations, 4 hours after clamping aorta, creatine kinase isoenzyme (CK-MB) was less in adenosine group than that of control group (P<0.01 or P<0.05), and 4 hours and 24 hours after bypass, cardiac troponin I (cTnI) was significantly higher in control group than that of adenosine group (P < 0.05). Conclusion After aorta is clamped, immediate injection of adenosine diluent and cold-blood cardioplegia containing potassium from the root of the ascending aorta can lead to quick heart arrest, reduce the release of myocardial enzymes and dosage of vasoactive agents, and shorten ICU dwell and assisted ventilation time.
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Objective To investigate the effect of intralipid postconditioning on myocardial enzyme in patients receiving extracorporeal circulation of cardiac valve replacement. Methods Forty patients undergoing cardiac valve replacement were randomly divided into two groups. Patients in the experimental group were given intralipid (200 mL) immediately after aorta opening from the extracorporeal circulation machine, and those in the control group were given 200 mL normal saline in the same manner. The radial artery blood samples were collected at the beginning of the operation, 0. 5 h, 1 h, 2 h, 4 h, and 24 h after aorta opening. The serum lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), and cardiac troponin I (cTni) were observed and the blood gas analysis was performed. The hemodynamic parameters, time of cardiopulmonary bypass, time of aorta block, time of operation, recovery of heartbeat, the dosage of dopamine, assisted ventilation time, ICU detention time, 24 h urine amount, and 24 hour drainage amount after operation were all recorded in the two groups. Results There were no significant differences in hemodynamic parameters, dosage of dopamine used, spontaneous recovery of heartbeat, 24 h urine amount, or 24 hour drainage amount between the two groups CP>O. 05). The postoperative levels of serum LDH, CK, CK-MB, and cTni were significantly higher than those before operation in both groups CP
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Fructose-1,6-diphosphate (FDP) is a very important mesne product which links the glucose and hepatin with the oxidation in energy metabolism and keeps the glycolysis functional, which is made use of widely. In addition, FDP has the ability to stabilize the cell membrane, abate inflammatory response, and restrain the oxygen free radical and cell apoptosis, it can protect cell in both structure and function. Recent researches proved that FDP is effective on myocardium protection and cardiac function reviving. This article reviews these research progresses.
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Objective:Investigate whether adenosine disodium triphosphate for injection can reduce the systemic inflammatory response which induced by cardiopulmonary bypass.Methods:Forty-seven patients scheduled for cardiac surgery over 30 min following CPB were randomly divided into two groups. In treated group(n=23),adenosine disodium triphosphate for injection(2 mmol/L) was added into the prime during CPB, but in control group(n=24), no adenosine disodium triphosphate for injection was added. Blood samples were drawn from the radial artery at the following time points:(1)before CPB;(2)30 min after aortic clamping;(3)30 min after aortic declamping;(4) 12 h after aortic declamping;(5)24 h after aortic declamping.Enzyme-linked immunosorbent assays(ELISA) were used to measure the concentration of tumor necrosis factor-?(TNF-?), interleukin-6(IL-6), in plasma,CK-MB in plasma level were measured too.Results:The concentration of TNF-??IL-6?CK-MB levels in plasma level of two groups showed no difference before CPB. They all had increased by 30 min after aortic clamping(P
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Objective To summarize the experience of 11 orthotopic allogeneic heart transplantations for patients suffering from terminal heart disease, and to discuss how to improve the selection of donor and recipient, protection for the donated heart, postoperative treatment and immune surveillance suitable for our country. Methods 1.All the donated hearts were protected by perfusing cold modified St.Thomas cardioplegia and cold oxygenated blood. 2. Orthotopic heart transplantation was performed with the standard technique of medium low temperature extracorporeal circulation. 3. FK506, mycophenolate mofetil(MMF) and steroid were given to prevent rejection. 4. Troponin I, ? 1 and ? 2 microglobulin, C reactive protein (CRP), interleukins, lymphocyte subgroups and mixed lymphocyte reaction (MLR) were employed to monitor the immune rejection reactions. Furthermore, myocardial biopsy and coronary arteriography were conducted periodically. Results Three patients died of systemic failure and infection due to hepatic failure and mental disorder after operation. All the others survived with no complications. Conclusion Strictness in selection of the recipient, high quality of donor heart, correct early postoperative treatment and sound use of immunosurppressant are key to achieving successful cardiac transplantation.
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Objective To investigate the operation experience of reducing time of heart clamp in double valve replacement and tricuspidplasty in 66 patient. Methods From May 1999 to March 2003, 66 patients received mitral valve replacement(MVR), aortic valve replacement(AVR) and tricuspidplasty. Mitral valves were replaced by continuous suture. Aortic valves were replaced by continuous suture in 59 cases and interrupted suture in 7 cases. Results 132 artificial valves were grafted. The time of aortic clamp and pump was 34.5?4.3 minutes and 56.1?7.8 minutes respectively. There were no postoperative severe complications and death in all 66 cases in hospital. Conclusions Decreasing the time of aortic clamp and pump is good for myocardium protection and may reduce postoperative complications.