[A low-level stress test, in the early phase of myocardial infarction and its correlation with coronary angiography]. / Prueba de esfuerzo de bajo nivel, en la fase temprana del infarto del miocardio y su correlación con la coronariografía.

In a prospective 24-month trial at the Instituto Nacional de Cardiologia, 56 patients were studied. All patients had acute myocardial infarction (AMI), diagnosed by clinical, electrocardiographic and enzymatic means. They were studied in two groups: Group A with single localized AMI (n = 30) and Group B with AMI at two locations (n = 26); a resting electrocardiogram (EKG) was analyzed in each case and a low level stress test was performed within the 2nd and 3rd postinfarction weeks; coronary angiography was done between the 8th and 9th postinfarction weeks. In Group A the low level stress test (LLST) was positive for ischemia at a distance from the infarction site in 21, and eighteen of them had multi-vessel injuries (MVI); in 9 the LLST was negative; of these 7 had single-vessel injury; only the remaining 2 had MVI (p less than 0.001) with 90% sensitivity and 78% specificity. In Group B there was no significant relationship between LLST and coronary angiography (64% sensitivity, and 62% specificity). Relating the ischemic change at a distance in the resting EKG with coronary angiography, we found 75% sensitivity and 55% specificity in Group A. In Group B, sensitivity and specificity were even lower. We conclude that LLST in the early postinfarction phase in Group A is a safe and reliable method to suspect MVI, allowing the early identification of patients with lesions that could be treated by surgical means.

[Exercise test with cold water intake. Preliminary results]. / Prueba de esfuerzo con ingestión de agua fría. Resultados preliminares.

Thirty healthy individuals with no history of cardiovascular disease were studied to determine the electrocardiographic effects of maximal exercise immediately followed by ingestion of ice water. The subjects were subgrouped according to their training into (A) high (N = 5), (B) moderate (N = 14) and (C) low (N = 11) levels. Electrocardiograms (ECGs) were taken at rest and at rest with ingestion of ice water followed by maximal stress tests. Maximal stress tests were repeated followed by ingestion of ice water at the beginning of and at 2, 3, 6 and 9 minutes of recuperation. The stress test combining maximal effort and ice water ingestion was positive in all members of Group A, in 4 from Group B and in 1 from Group C. A stress test associating maximal effort with ice water ingestion is a useful method of detecting subjects susceptible to changes in ECG which appear to be secondary to coronary spasm. It has a low cost it is simple to perform and represents minimal risk.

[Effects of aerobic physical conditioning on the profile of plasma lipoproteins in a group of healthy volunteers]. / Efectos del acondicionamiento físico aeróbico sobre el perfil de lipoproteinas plasmáticas en un grupo de voluntarios sanos.

To evaluate the effects of aerobic physical conditioning on plasma lipoproteins, we studied 26 previously untrained, apparently healthy, non obese volunteers. All participants underwent a treadmill test performed according to the protocol of Bruce with the direct measurement of maximal oxygen consumption (VO2max). A program of aerobic exercise was prescribed for each volunteer at 70% of their corresponding VO2max. At baseline and at the end of weeks 4, 8 and 12 of the exercise program, cholesterol and triglycerides were measured by enzymatic analysis in total plasma and in the lipoprotein fractions separated by preparative ultracentrifugation and precipitation methods. At the end of week 12, the VO2max measurement was repeated. At the end of the protocol, mean VO2max increased from the value of 39.9 observed at baseline to 94.4 ml/kg/min (p less than 0.01). There were no variations in mean body weight, diet or smoking status of the participants during the exercise program. Cholesterol associated with High-density lipoproteins (C-HDL) increased from 42.5 to 46.1 mg/dl (p less than 0.05). This effect was first noticeable at week 8. We didn't observe significant changes in Total Cholesterol nor the Cholesterol fraction associated with Low-density lipoproteins (C-LDL). Total triglycerides decreased at weeks 4 and 8 but returned to near baseline values at week 12. The C-LDL/C-HDL ratio considered as an index of a high coronary risk decreased from 2.32 at baseline to 2.02 (p less than 0.05) at week 12. Thirteen of the twenty six initial volunteers completed the physical conditioning program as planned, the rest were eliminated at different stages of the protocol due to incomplete adherence to their exercise schedules.(ABSTRACT TRUNCATED AT 250 WORDS)

[Response of normal children to the treadmill exercise test using the Bruce protocol]. / Respuesta de los niños sanos a la prueba de esfuerzo en banda sinfin con el protocolo de Bruce.

Fifty nine boys and 41 girls underwent exercise stress testing (ETT), utilizing the Bruce protocol. Their mean age was 10 years. They were grouped by sex, age and body surface area. Blood pressure (BP), heart rate (HR) at rest, during exercise and after were monitored as well as the duration of the test and the energy cost. The HR and-BP had a similar linear relationship in both groups during the different stages of the test. The duration of the test expressed in minutes was 11.8 +/- 1.2 in boys and 10.7 +/- 1.2 in girls (P = 0.001). The oxygen consumption (ML/kg/min) was 45.2 +/- 4.9 and 41.9 +/- 4.5 that is equivalent to 12.9 +/- 1.4 and 11.9 +/- 1.2 mets for each group respectively. The group of boys of 6 (9.8) and 14 years of age (13.6) (P = 0.002) and in the girls in the 7 (9.5) and 10 years age group (11.8) P = 0.05. We conclude that 1) The ETT can be done in children safely but was have to take in consideration their age, sex, and body surface area in evaluating the results. 2) This study gives a reference to evaluate children with an without heart disease.

[Congenital intrapericardial parietal aneurysm of the left atrium. The electrocardiogram and echocardiogram as methods of diagnostic value]. / Aneurisma congénito parietal intrapericárdico de la aurícula izquierda. El electrocardiograma y el ecocardiograma como métodos de valor diagnóstico.

A case of congenital intrapericardial aneurysm of the left atrium associated with functional mitral insufficiency is described; it was resected successfully. Clinical, radiographic, vecto-electrocardiographic, ecocardiographic and angiocardiographic findings are shown. Those are compared with those of other nine similar cases. The finding of qR or QS complexes in L-I and a VL in the electrocardiogram as a sign of left atrial enlargement and eco-fre space posterior to the left ventricular endocardium in the ecocardiogram is mentioned as useful data in the diagnosis of left atrial aneurysmal dilatation not previously reported. Considering that the surgical result is always good, it is concluded that the congenital intrapericardial aneurysm of the left atrium is a rare malformation which needs to be resected irregardless of the presence or absence of arrhythmias, embolisms or heart failure.

[Prevention of recurrence of rheumatic cardiopathy in 564 patients]. / Profilaxis secundaria en 564 pacientes con cardiopatía reumática.

In a group of 564 patients with rheumatic heart disease seen in the period from 1971 to 1975, who were under benzatinic prophylaxis, 23% were seen in the clinic and 77% at home. The object of this revision is to analyze the latter group in order to obtain the frequency of pharyngoamigdaline infections, and of relapses. 1. During the observation, those patients who did not present pharyngeal infections had no relapses. On the other hand, all relapses were observed in those patients who presented infections. 2. Those patients who carried out the prophylaxis incorrectly and who also presented pharyngeal infections, had almost twice the percentage of relapses as those who carried out the prophylaxis correctly. 3. In the group with effective prophylaxis, including those cases with or without pharyngeal infection, 5% had recurrences. In the group with ineffective prophylaxis, 16% had relapses. 4. Those patients with subsequent attacks doubled the percentage of relapses in comparison with those with initial attacks. 5. The plurivalvular patients have a higher frequency of recurrences than the univalvular patients. 6. During the first year of post-attack prophylaxis, the incidence of relapses is only 1.7%, in comparison with the following years in which there is a higher incidence of around 10%. 7. The total number of recurrences in 564 patients was 8%.