Avaliação ecocardiográfica dos diferentes padrões geométricos do ventrículo esquerdo em pacientes hipertensos / Echocardiographic assessment of the different left ventricular geometric patterns in hypertensive patients

OBJECTIVE: To identiy left ventricular geometric patterns in hypertensive patients on echocardiography, and to correlate those patterns with casual blood pressure measurements and with the parameters obtained on a 24-hour ambulatory blood pressure monitoring. METHODS: We studied sixty hypertensive patients, grouped according to the Joint National Committee stages of hypertension.. Using the single- and two-dimensional Doppler Echocardiography, we analyzed the left ventricular mass and the geometric patterns through the correlation of left ventricular mass index and relative wall thickness. On ambulatory blood pressure monitoring we assessed the means and pressure loads in the different geometric patterns detected on echocardiography RESULTS: We identified three left ventricular geometric patterns: 1) concentric hypertrophy, in 25 percent of the patients; 2) concentric remodeling, in 25 percent; and 3) normal geometry, in 50 percent. Casual systolic blood pressure was higher in the group with concentric hypertrophy than in the other groups (p=0.001). Mean systolic pressure in the 24h, daytime and nighttime periods was also higher in patients with concentric hypertrophy, as compared to the other groups (p=0.003, p=0.004 and p=0.007). Daytime systolic load and nighttime diastolic load were higher in patients with concentric hypertrophy ( p=0.004 and p=0.01, respectively). CONCLUSIONS: Left ventricular geometric patterns show significant correlation with casual systolic blood pressure, and with means and pressure loads on ambulatory blood pressure monitoring

Terapêutica antitrombótica nas doenças cardiovasculares: Parte II / Antithrombotics treatment in cardiovascular: Part II

Neste artigo os autores fazem consideraçöes sobre os principais aspectos clínicos no uso de anticoagulantes. Assim, chamam a atençäo para o uso destas drogas na prevençäo primária, na doença cérebro-vascular, fibrilaçäo atrial, tromboembolismo venoso, próteses mecânicas e biológicas e nas crianças. Os autores simplificam o assunto que já é uma especialidade dentro da cardiologia.