ABSTRACT
ABSTRACT Conducting a clinical study is a complex and challenging task, so using technology to facilitate the process is necessary for the medical and scientific community. Data digitization is needed to store and process it. Digitization speeds up data visualization techniques so scientists can analyze it most effectively depending on their goals. In this project, we developed two digital tools related to the cardiopulmonary exercise test (CPET) data, one for digitizing PDF reports and the other for generating databases. The latter was a web-based database visualization dashboard. Users can select parameters of interest and check for differences among subgroups. Basic statistical tests are performed for each variable under analysis, and its results are presented in numerical and graphical formats. The initial statistical tests and the derived recommendation will guide the research team in deeper statistical analysis and robust analysis supporting more decisive conclusions. We ended up with the first version for both tools and validated it using patients' CPET data from the Dante Pazzanese Institute of Cardiology. We conducted a pilot study to verify if the tools served their purpose and observed that both programs worked as planned. The tools can be further tailored to be clinically or research-oriented. On the analysis of CPET's results, the conclusions for our example study were in line with what is presented in the bibliography for cardiorespiratory physiology.
Subject(s)
Primary Health Care , Residence CharacteristicsABSTRACT
INTRODUÇÃO: A cardiomiopatia hipertrófica (CMHP) é uma doença cardíaca genética comum, com frequência aproximada de 1:500 na população geral e com expressões fenotípicas diversas. A forma obstrutiva caracteriza-se pela presença de gradiente pressórico intraventricular dinâmico, com manifestações mais graves e de difícil controle, sendo a realização de esforço físico contra indicada até recentemente, considerando-se a susceptilidade a arritmias ventriculares graves. Das variáveis do teste ergométrico a pressão arterial sistólica (PAS) é considerada fator determinante para morte súbita. OBJETIVO: avaliar a segurança do TCPE em pacientes com CMPH obstrutiva, bem como avaliar adicionalmente o comportamento de suas variáveis no auxílio à estratificação do risco cardiovascular. MÉTODOS: Foram incluídos pacientes com CMPH obstrutiva que realizaram TCPE entre o ano de 2013 e 2018. RESULTADOS: avaliados 18 pacientes com média de idade de 51 anos (DP 17.1) e 12 (67%) mulheres. Para caracterização anatômica foi empregada a ecodopplercardiografia que evidenciou: gradiente máximo da via de saída do ventrículo esquerdo: de 80 mmHg (DP 32.5); espessura septal (diástole) de 20 mm (DP 6.72); fração de ejeção do ventrículo esquerdo (FEVE) de 69.5 (DP 10.9). Todos em vigência de medicação específica, ressaltando-se os betabloqueadores em 16 pacientes (89%). Das variáveis obtidas durante o esforço, destacam-se as médias de tempo de exercício: 9,1 (DP 2.9) minutos ; frequência cardíaca pico = 111 (DP 19,4) bpm ou 65% do máxima; variação da PAS = 24.5 mmHg (DP 19.4), com curva deprimida em 75% dos pacientes; consumo de oxigênio pico de 18,25 ml.kg-1.min-1(DP 6.4), correspondendo a 62% do valor predito; VE / VCO2 slope = 30,2 (DP 7,60), Razão de trocas respiratórias ou RER = 1,02 (DP 0.13). Não houve arritmias ventriculares sustentadas, parada cardiorrespiratória, ou outra complicação que necessitasse de internação. CONCLUSÃO: Na amostra de pacientes avaliados o TCPE mostrou-se seguro durante sua realização em ambiente hospitalar, com variáveis hemodinâmicas e ventilatórias que podem auxiliar na caracterização prognóstica e no processo de decisão médica. (AU)
Subject(s)
Humans , Cardiomyopathy, Hypertrophic , Cardiovascular Diseases , RiskABSTRACT
A reabilitaçäo cardíaca é o processo de desenvolvimento e manutençäo de nível desejável de atividade física, social e psicológica após o início da doença coronária sintomática. Trata-se de terapêutica multidisciplinar para patologia multifatorial. Os maiores objetivos säo: melhora da capacidade funcional e da qualidade de vida, mudança de hábitos após evento coronário, com modificaçäo dos fatores de risco e reduçäo dos índices de mortalidade. Säo discutidos os vários efeitos do treinamento físico, clusive sobre a qualidade de vida de homens e mulheres, os tipos de exercício apropriados, conforme o tipo de doença cardiovascular, bem como a estratificaçäo quanto ao risco para atividade física após evento coronário. finalmente, säo apresentadas as indicaçöes e contra-indicaçöes atuais da reabilitaçäo cardíaca.
Subject(s)
Cardiovascular Diseases/rehabilitation , Rehabilitation , Exercise Therapy , Quality of LifeABSTRACT
Eighteen male patients with ages varying from 42 to 72 years (average 60.6), with coronary heart disease confirmed by angiography, on regular rehabilitation program and on regular use of dipyridamole were submitted to three exercise stress tests: a control test (TE1) and forty minutes after oral administration of macerated dipyridamole in doses of 150 mg (TE2) and 300 mg (TE3), respectively. The comparison between the data of TE2 and TE1 demonstrated that in TE2 the ST depression was more accentuated in the smallest maximal load attained and in the effort peak as well. The comparison between the data of TE3 and TE1 showed that in TE3: 1) the ST depression was more evident in the effort peak and in the smallest attained load; 2) the heart rate and the product heart rate x blood pressure were smaller in the effort peak; 3) the total time of angina and the time for its relief after effort, were longer. The other exercise stress test parameters did not show any significant changes. These data, suggest that the physical effort overload, after dipyridamole administration, produced a more marked myocardial ischemia, whose degree was proportional to the dose.
Subject(s)
Dipyridamole/pharmacology , Exercise Test/drug effects , Administration, Oral , Adult , Aged , Coronary Artery Disease/physiopathology , Dipyridamole/administration & dosage , Heart Rate/drug effects , Humans , Male , Middle AgedABSTRACT
Three hearts studied at autopsy with transposition of the great arteries and posterior aorta with isolated or predominantly subaortic conus are described. In all cases the aorta was posterior and to the right of the pulmonary trunk. In two cases it was significantly distant from the pulmonary trunk and in one it was very close. The caliber of the pulmonary trunk was larger than that of the aorta: greater than 2:1 in two cases and less than 2:1 in one case. A well developed subaortic conus was seen in all cases and a small subpulmonary conus in one case. In the other two cases, the pulmonary valve was in fibrous continuity with the mitral valve. In all cases the aortic valve was higher than the pulmonary valve, the relative heights above the ventricles being 25/20, 25/30 and 40/60 mm, respectively. The left coronary artery ran posteriorly and to the left of the pulmonary trunk in all the cases. The length of the main stem of the left coronary artery was 11, 11 and 30 mm, respectively. We discuss the significance of this type of transposition of the great arteries for techniques currently used for surgical correction.