Enhancing Magnetic Hyperthermia Nanoparticle Heating Efficiency with Non-Sinusoidal Alternating Magnetic Field Waveforms.

For decades now, conventional sinusoidal signals have been exclusively used in magnetic hyperthermia as the only alternating magnetic field waveform to excite magnetic nanoparticles. However, there are no theoretical nor experimental reasons that prevent the use of different waveforms. The only justifiable motive behind using the sinusoidal signal is its availability and the facility to produce it. Following the development of a configurable alternating magnetic field generator, we aim to study the effect of various waveforms on the heat production effectiveness of magnetic nanoparticles, seeking to prove that signals with more significant slope values, such as the trapezoidal and almost-square signals, allow the nanoparticles to reach higher efficiency in heat generation. Furthermore, we seek to point out that the nanoparticle power dissipation is dependent on the waveform's slope and not only the frequency, magnetic field intensity and the nanoparticle size. The experimental results showed a remarkably higher heat production performance of the nanoparticles when exposed to trapezoidal and almost-square signals than conventional sinusoidal signals. We conclude that the nanoparticles respond better to the trapezoidal and almost-square signals. On the other hand, the experimental results were used to calculate the normalized power dissipation value and prove its dependency on the slope. However, adjustments are necessary to the coil before proceeding with in vitro and in vivo studies to handle the magnetic fields required.

Inferring ontology graph structures using OWL reasoning.

BACKGROUND: Ontologies are representations of a conceptualization of a domain. Traditionally, ontologies in biology were represented as directed acyclic graphs (DAG) which represent the backbone taxonomy and additional relations between classes. These graphs are widely exploited for data analysis in the form of ontology enrichment or computation of semantic similarity. More recently, ontologies are developed in a formal language such as the Web Ontology Language (OWL) and consist of a set of axioms through which classes are defined or constrained. While the taxonomy of an ontology can be inferred directly from the axioms of an ontology as one of the standard OWL reasoning tasks, creating general graph structures from OWL ontologies that exploit the ontologies' semantic content remains a challenge. RESULTS: We developed a method to transform ontologies into graphs using an automated reasoner while taking into account all relations between classes. Searching for (existential) patterns in the deductive closure of ontologies, we can identify relations between classes that are implied but not asserted and generate graph structures that encode for a large part of the ontologies' semantic content. We demonstrate the advantages of our method by applying it to inference of protein-protein interactions through semantic similarity over the Gene Ontology and demonstrate that performance is increased when graph structures are inferred using deductive inference according to our method. Our software and experiment results are available at http://github.com/bio-ontology-research-group/Onto2Graph . CONCLUSIONS: Onto2Graph is a method to generate graph structures from OWL ontologies using automated reasoning. The resulting graphs can be used for improved ontology visualization and ontology-based data analysis.

Integrating phenotype ontologies with PhenomeNET.

BACKGROUND: Integration and analysis of phenotype data from humans and model organisms is a key challenge in building our understanding of normal biology and pathophysiology. However, the range of phenotypes and anatomical details being captured in clinical and model organism databases presents complex problems when attempting to match classes across species and across phenotypes as diverse as behaviour and neoplasia. We have previously developed PhenomeNET, a system for disease gene prioritization that includes as one of its components an ontology designed to integrate phenotype ontologies. While not applicable to matching arbitrary ontologies, PhenomeNET can be used to identify related phenotypes in different species, including human, mouse, zebrafish, nematode worm, fruit fly, and yeast. RESULTS: Here, we apply the PhenomeNET to identify related classes from two phenotype and two disease ontologies using automated reasoning. We demonstrate that we can identify a large number of mappings, some of which require automated reasoning and cannot easily be identified through lexical approaches alone. Combining automated reasoning with lexical matching further improves results in aligning ontologies. CONCLUSIONS: PhenomeNET can be used to align and integrate phenotype ontologies. The results can be utilized for biomedical analyses in which phenomena observed in model organisms are used to identify causative genes and mutations underlying human disease.

Resultado del cierre incompleto de defecto tipo Gerbode con coil Nit-Occlud Lê VSD: hemolisis grave que precisa reintervención / Effect of incomplete closure of a Gerbode defect with the Nit-Occlud Lê VSD Coil: severe hemolysis requiring a second procedure

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Sentiment Analysis on Tweets about Diabetes: An Aspect-Level Approach.

In recent years, some methods of sentiment analysis have been developed for the health domain; however, the diabetes domain has not been explored yet. In addition, there is a lack of approaches that analyze the positive or negative orientation of each aspect contained in a document (a review, a piece of news, and a tweet, among others). Based on this understanding, we propose an aspect-level sentiment analysis method based on ontologies in the diabetes domain. The sentiment of the aspects is calculated by considering the words around the aspect which are obtained through N-gram methods (N-gram after, N-gram before, and N-gram around). To evaluate the effectiveness of our method, we obtained a corpus from Twitter, which has been manually labelled at aspect level as positive, negative, or neutral. The experimental results show that the best result was obtained through the N-gram around method with a precision of 81.93%, a recall of 81.13%, and an F-measure of 81.24%.

Toma de decisiones por el equipo cardiaco: ¿democracia o dictadura? / Heart team decision-making: democracy or dictatorship?

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Calidad de vida en pacientes con insuficiencia cardiaca crónica / Quality of life in patients with chronic cardiac failure

OBJETIVO: evaluar la calidad de vida (CV) en pacientes con insuficiencia cardiaca crónica (ICC) pertenecientes a una unidad de insuficiencia cardiaca (UIC) y valorar la asociación con factores clínicos. MÉTODO: estudio descriptivo transversal en 87 enfermos con ICC pertenecientes la UIC del "Complejo Asistencial Universitario de León". Para medir la CV se utilizó el cuestionario 36-Item Short-Form Health Survey (SF-36). La comparación de variables se realizó con el testt-Student. Para evaluar la asociación independiente entre las diferentes dimensiones y las variables, se construyeron modelos de regresión lineal múltiple. RESULTADOS: la edad media de los sujetos estudiados fue de 71,3años, predominó el sexo masculino (70,6%), la etiología no-isquémica(57,6%), el grado funcional de la New York Heart Association (NYHA)III-IV (52,9%) y la IC sistólica (82,4%). La puntuación media de CV en el componente sumario físico (CSF) fue de 33,2 y en el componente sumariomental (CSM) de 48,9. En los análisis multivariantes: para el CSF, un grado funcional III-IV de la NYHA y una etiología no-isquémica, empeoraban la CV en su componente físico; el componente mental de la CV empeoraba en la IC diastólica y con etiología no-isquémica. CONCLUSIONES: la percepción de la CV en pacientes con ICC está considerablemente alterada en todas las dimensiones. Un peor grado funcional y la etiología no isquémica se asociaron independientemente con un mayor deterioro de la CV en las dimensiones físicas, y la IC diastólica y la etiología no isquémica con un mayor deterioro en las emocionales. La etiología es la variable con mayor impacto en todos los dominios

OBJECTIVE: critical patients tend to present hyperglycemia, a fact associated with an increase in morbimortality and infectious complications. According to the Spanish Society of Intensive and Critical Medicine and Coronary Units (SEMICYUC), a safe and good-quality care requires maintaining glycemic levels between80 and 150 mg/dl with insulin therapy. The objective is to obtain an estimation of the adequate maintenance of glycemic levels of patients, as well as to detect any potential for quality improvement, if necessary. METHOD: a descriptive observational study conducted in the Intensive Care Unit of the Hospital Virgen del Rocío during January, February and March, 2014. The sample size was estimated in 108 patients, recruited in 13 days randomly chosen, with all week days represented. The indicator was measured according to the following formula: (Number of patients with glycemia > 150 mg/dl and on insulin treatment / Number of patients with indication for glycemic control and glycemias> 150mg/d) X 100.RESULTS: the mean age of subjects was 64 years, with 73%male and 27% women. A 41% of the sample suffered Type 2diabetes, 1% suffered Type I diabetes, and 58% had no diabetes. A range of glycemias between 151 mg/dl and 323 mg/dl was obtained. The minimum level of the indicator required by the SEMICYUC (80%) was not reached in any of the three months measured, thus being in a sub-standard situation. CONCLUSIONS: there is no adequate maintenance of the glycemi levels in patients managed in our unit; therefore, a review of the current protocol for insulin therapy could improve the quality and safety in this aspect of care

Using data crawlers and semantic Web to build financial XBRL data generators: the SONAR extension approach.

Precise, reliable and real-time financial information is critical for added-value financial services after the economic turmoil from which markets are still struggling to recover. Since the Web has become the most significant data source, intelligent crawlers based on Semantic Technologies have become trailblazers in the search of knowledge combining natural language processing and ontology engineering techniques. In this paper, we present the SONAR extension approach, which will leverage the potential of knowledge representation by extracting, managing, and turning scarce and disperse financial information into well-classified, structured, and widely used XBRL format-oriented knowledge, strongly supported by a proof-of-concept implementation and a thorough evaluation of the benefits of the approach.

La calidad de vida en los enfermos con insuficiencia cardiaca: visión desde atención primaria de salud / Quality of life in patients with heart failure: the perspective of primary health care

Objetivo Medir e identificar las dimensiones y los determinantes de la calidad de vida relacionada con la salud (CVRS) en los enfermos con insuficiencia cardiaca crónica. Métodos Mediante un estudio transversal se midió la CVRS con los cuestionarios SF-36 y MLHFQ, en 544 enfermos con insuficiencia cardiaca crónica, clínicamente estables, de 97 médicos de atención primaria. Resultados La edad media de los enfermos es de 77,6 años (desviación estándar: 9,9), significativamente mayor en las mujeres. El 31,2% están en grado III-IV de la New York Heart Association (NYHA). El 88,6% tiene al menos otra enfermedad crónica. Las dimensiones físicas tienen peor puntuación que las emocionales en ambos cuestionarios. Tras ajustar por regresión múltiple, siete variables entran en alguno de los cinco modelos y explican entre un 22% y un 36% de la varianza. Conclusiones La CVRS en los pacientes con insuficiencia cardiaca crónica está alterada en todos los dominios. Ser mujer, estar en clase funcional de la NYHA III-IV, la presencia de otras afecciones tales como depresión o enfermedad osteoarticular, el ingreso hospitalario, el índice de masa corporal y la edad, se asocian con una peor percepción de la CVRS (AU)

Objective To measure and identify the dimensions and determinants of health-related quality of life (HRQoL) in patients with chronic heart failure. Methods We performed a cross-sectional study, in which HRQoL was measured with the short-form (SF)-36 and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) in 544 clinically-stable patients with chronic heart failure managed by 97 primary care physicians. Results The mean age of the patients was 77.6 years (SD: 9.9) and was significantly higher in women. A total of 31.2% were in New York Heart Association (NYHA) grade III-IV and 88.6% had at least one chronic condition. In both questionnaires, physical dimensions scored worse than emotional dimensions. After adjustment was made for multiple regression, seven variables entered into one of the five models and explained between 22% and 36% of the variance. Conclusions HRQoL in patients with chronic heart failure is impaired across all domains. Being female and being in NYHA functional class III-IV, as well as other factors such as depression, osteoarticular disease, hospital admission, body mass index and age, were associated with poorer self-perceived HRQoL (AU)

[Quality of life in patients with heart failure: the perspective of primary health care]. / La calidad de vida en los enfermos con insuficiencia cardiaca: visión desde atención primaria de salud.

OBJECTIVE: To measure and identify the dimensions and determinants of health-related quality of life (HRQoL) in patients with chronic heart failure. METHODS: We performed a cross-sectional study, in which HRQoL was measured with the short-form (SF)-36 and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) in 544 clinically-stable patients with chronic heart failure managed by 97 primary care physicians. RESULTS: The mean age of the patients was 77.6 years (SD: 9.9) and was significantly higher in women. A total of 31.2% were in New York Heart Association (NYHA) grade III-IV and 88.6% had at least one chronic condition. In both questionnaires, physical dimensions scored worse than emotional dimensions. After adjustment was made for multiple regression, seven variables entered into one of the five models and explained between 22% and 36% of the variance. CONCLUSIONS: HRQoL in patients with chronic heart failure is impaired across all domains. Being female and being in NYHA functional class III-IV, as well as other factors such as depression, osteoarticular disease, hospital admission, body mass index and age, were associated with poorer self-perceived HRQoL.

Validation of the Minnesota living with heart failure questionnaire in primary care.

INTRODUCTION AND OBJECTIVES: To evaluate the applicability, internal consistency and validity of the Minnesota Living with Heart Failure Questionnaire (MLHFQ) when used in primary care, compared with the Short Form-36 (SF-36) health survey. METHODS: The two questionnaires were administered to 589 patients with chronic heart failure who were registered with 97 primary care physicians. The applicability, internal consistency and validity of the MLHFQ were evaluated and comparisons were made with the SF-36. RESULTS: More than 90% of patients completed the questionnaires. The percentage of uncompleted items was low. Cronbach's alpha ranged from 0.79 to 0.94 for the various MLHFQ dimensions. Exploratory factorial analysis identified two factors that explained 65.8% of the variance. Moderate to good correlations were observed between similar dimensions of the MLHFQ and SF-36 (correlation coefficient -0.43 to -0.73). There were significant associations between scores on the MLHFQ and clinical measures of disease severity. CONCLUSIONS: When used in primary care, the MLHFQ had a high level of acceptability and good psychometric properties compared with the SF-36. Consequently, it would be useful for assessing health-related quality of life in patients with chronic heart failure.

Validación del Minnesota Living With Heart Failure Questionnaire en atención primaria / Validation of the Minnesota Living With Heart Failure Questionnaire in primary care

Introducción y objetivos. Evaluar la aplicabilidad, la consistencia interna y la validez del Minnesota Living with Heart Failure Questionnaire (MLHFQ) en atención primaria, comparándolo con el Short-Form Health Survey (SF-36). Métodos. Se aplicaron ambos cuestionarios a 589 pacientes con insuficiencia cardiaca crónica documentada atendidos por médicos de atención primaria. Analizamos la factibilidad, la consistencia interna y la validez del MLHFQ comparado con el SF-36. Resultados. Respondió los cuestionarios más del 90% de la muestra. El porcentaje de ítems no respondido es bajo. El coeficiente alfa de Cronbach oscila entre 0,79 y 0,94 para las dimensiones del MLHFQ. Del análisis factorial exploratorio, se extraen dos factores que explican una varianza total del 65,8%. Los coeficientes de correlación entre dimensiones similares del MLHFQ y el SF-36 fueron de moderados a altos (–0,43 a –0,73). Las puntuaciones del MLHFQ se asocian significativamente con variables clínicas de gravedad. Conclusiones. En atención primaria el MLHFQ, comparado con el SF-36, muestra buena aceptabilidad y buenas propiedades psicométricas que lo hacen útil para medir la calidad de vida relacionada con la salud en pacientes con insuficiencia cardiaca crónica (AU)

Introduction and objectives. To evaluate the applicability, internal consistency and validity of the Minnesota Living with Heart Failure Questionnaire (MLHFQ) when used in primary care, compared with the Short Form-36 (SF-36) health survey. Methods. The two questionnaires were administered to 589 patients with chronic heart failure who were registered with 97 primary care physicians. The applicability, internal consistency and validity of the MLHFQ were evaluated and comparisons were made with the SF-36. Results. More than 90% of patients completed the questionnaires. The percentage of uncompleted items was low. Cronbach’s alpha ranged from 0.79 to 0.94 for the various MLHFQ dimensions. Exploratory factorial analysis identified two factors that explained 65.8% of the variance. Moderate to good correlations were observed between similar dimensions of the MLHFQ and SF- 36 (correlation coefficient –0.43 to –0.73). There were significant associations between scores on the MLHFQ and clinical measures of disease severity. Conclusions. When used in primary care, the MLHFQ had a high level of acceptability and good psychometric properties compared with the SF-36. Consequently, it would be useful for assessing health-related quality of life in patients with chronic heart failure (AU)

Estimulación en la insuficiencia cardiaca congestiva. Situación actual y perspectivas / Cardiac pacing in congestive heart disease. Current status and future prospects

La resincronización cardiaca se ha consolidado en sus 10 años de vida como un tratamiento insustituible para determinados pacientes afectados de insuficiencia cardiaca refractaria. Este capítulo pretende transmitir algunos de los avances recientes y líneas de evolución que mantienen a este tipo de estimulación en permanente actualidad. Se revisan seguidamente los parámetros fisiopatológicos que justifican la mejora en la calidad de vida, disminución de las necesidades de tratamiento hospitalario y supervivencia logrados mediante la estimulación biventricular. También se aborda a los grupos de pacientes, fuera de las indicaciones establecidas en las guías de actuación internacionales, que son el centro de atención en importantes ensayos clínicos para ampliar la aplicación de esta terapia. Para optimizar la respuesta a la resincronización es preciso también una correcta planificación del implante incluida una cuidada estrategia de seguimiento y optimización en la programación del estimulador. Las indicaciones de resincronización se basan actualmente en determinados parámetros eléctricos y ecocardiográficos, se comentan también estos conceptos con especial énfasis en algunos datos de imagen que presumiblemente permitirán en un futuro próximo precisar la selección de pacientes y mejorar el porcentaje de respuestas al tratamiento de estimulación (AU)

In the ten years of its existence, cardiac resynchronization therapy has become established as an irreplaceable form of treatment in selected patients with refractory heart failure. This article presents a summary of recent advances and future trends which ensure that this type of pacing remains of continuing relevance. Thereafter, there is a review of the pathophysiologic factors that underlie the improvement in quality of life, the reduction in the need for hospitalization, and the increased survival brought about by biventricular pacing. There is also a discussion of the groups of patients who lie outside the indications listed in international guidelines and who are the focus of large clinical trials aimed at extending the applications of this type of therapy. To ensure an optimum response to resynchronization therapy, device implantation must be fully planned, there should be close follow-up, and device programming should be optimized. Currently, indications for resynchronization therapy are based on specific electrocardiographic and echocardiographic parameters. This article also contains a discussion of these parameters, with particular emphasis on imaging data that will enable more accurate patient selection in the near future, thereby increasing the response rate in cardiac pacing (AU)

Metaanálisis sobre la utilidad de la tomografía computarizada multicorte para la deteccion de lesiones coronarias estenóticas. Análisis coronario segmentario / Metaanalysis on the utility of multislice computed tomography to detect stenotic coronary lesions. Segmental coronary analysis

Objetivo: La tomografía computarizada multicorte (TCMC) permite la visualización de las arterias coronarias, y por tanto la detección de lesiones arterioscleróticas estenóticas. El objetivo del presente trabajo fue analizar la capacidad diagnóstica de la TCMC para la detección de lesiones estenóticas coronarias. Material y métodos: Se realizó un metaanálisis mediante búsqueda en las bases de datos MEDLINE y EMBASE de los trabajos que analizaran la sensibilidad y especificidad de la TCMC para el diagnóstico de enfermedad coronaria, mediante una división del árbol coronario por segmentos. Se incluyeron finalmente 10 estudios, con un total de 498 pacientes y 5.332 segmentos coronarios. Resultados: El porcentaje de segmentos correctamente visualizados osciló entre el 70 y el 96%. Tras la agrupación de la información proporcionada por los estudios individuales, la estimación global de la sensibilidad fue del 0,79 (intervalo de confianza [IC] del 95%, 0,77-0,81) y de la especificidad del 0,95 (IC del 95%, 0,94-0,96). Se demuestra la presencia de heterogeneidad significativa entre estudios y una curva ROC-resumen asimétrica, que corta a la diagonal para valores bajos de especificidad (8%). El área bajo la curva ROC-resumen oscila entre 0,82 y 0,89. Conclusiones: La TCMC es una prueba excelente para la detección de lesiones coronarias estenóticas en segmentos bien visualizados. Sin embargo, la curva ROC-resumen es asimétrica y existe significativa heterogeneidad entre estudios, por lo que es necesario profundizar más en la rentabilidad diagnóstica de la prueba antes de trasladar la información que proporciona a la práctica clínica diaria

Objective: The multislice computed tomography (MSCT) permits visualization of the coronary arteries and thus the detection of stenotic arteriosclerotic lesions. This present study aimed to analyze the diagnostic capacity of the MSCT to detect stenotic coronary lesions. Material and methods: A metaanalysis was conducted through the search in the MEDLINE and EMBASE data bases of the works that analyzed sensitivity and specificity of MSCT for the diagnosis of coronary disease, using a division of the coronary tree by segments. Finally 10 studies were included, with a total of 498 patients and 5322 coronary segments. Results: The percentage of the correctly visualized segments ranged from 70% to 96%. After grouping the information provided by the individual studies, global estimation of sensitivity was 0.79 (95% CI: 0.77-0.81) and specificity 0.95 (95% CI: 0.94-0.96). The presence of significant heterogeneity was demonstrated between studies and an asymmetric summary ROC curve, that cuts the diagonal line for low specificity values (8%). The area under the curve-summary ROC curve-ranges from 0.82 to 0.89. Conclusions: The MSCT is an excellent test to detect stenotic coronary lesions in well visualized segments. However, the summary ROC curve is asymmetric and there is significant heterogeneity between studies, so that it is necessary to study diagnostic profitability of the test in greater depth before transferring the information it provides to the daily clinical practice

Evaluación de la seguridad de la ecocardiografía de estrés en España y Portugal / Evaluation of Stress Echocardiography Safety in Spain and Portugal

Introducción. Los estudios que evalúan la seguridad de la ecocardiografía de estrés son escasos, con resultados discordantes y de series muy seleccionadas de centros con gran experiencia, difícilmente extrapolables. Objetivo. Conocer la seguridad de las diversas modalidades de ecocardiografía de estrés en nuestro medio. Método. Se analizaron retrospectivamente las complicaciones graves durante los ecocardiogramas de estrés practicadas en 29 hospitales de la península Ibérica, desde el inicio de su actividad hasta septiembre de 1999. En este período se habían realizado 22.105 ecocardiogramas, 10.975 de ejercicio, 2.969 con dobutamina a dosis bajas y 6.832 a dosis altas, 1.276 con dipiridamol, 41 con 'estimulación' y 12 con adenosina. Se consideró una complicación grave aquella que supuso riesgo vital o que precisó ingreso hospitalario. Resultados. Se registraron 26 complicaciones: una muerte, 3 fibrilaciones ventriculares, 10 taquicardias ventriculares sostenidas, 2 bloqueos auriculoventriculares completos, 6 infartos agudos de miocardio, 2 roturas de pared libre o tabique interventricular, un accidente isquémico transitorio y una hipotensión severa sintomática. Se presentó una complicación por cada 2.743 ecocardiografías de ejercicio, 1.231 de dipiridamol y 325 con dobutamina a dosis altas. No se presentó ninguna complicación con la dobutamina a dosis bajas. Se encontró relación entre la experiencia en ecocardiografía de estrés con dobutamina y la frecuencia de complicaciones. Tres complicaciones se presentaron después de haber terminado el test. Conclusiones. La ecocardiografía de estrés es una técnica segura, pero no inofensiva. La ecografía de estrés con ejercicio es la técnica más segura. Existe relación entre la experiencia y el número de complicaciones (AU)

Influencia de la angina preinfarto en la mortalidad a medio plazo tras infarto agudo de miocardio / Influence of pre-infarction angina on mid-term mortality after acute myocardial infarction

Introducción y objetivos. La angina preinfarto puede reducir el tamaño de la necrosis miocitaria y mejorar el pronóstico tras el infarto agudo de miocardio. El objetivo de este estudio es analizar la mortalidad total 6 meses después del infarto agudo de miocardio según la presencia o no de angina preinfarto. Métodos. Se incluyeron prospectivamente 175 pacientes consecutivos con infarto agudo de miocardio, 72 (41,1 por ciento) con angina preinfarto. Se realizó el seguimiento durante 6 meses. En el grupo sin angina preinfarto fallecieron en el seguimiento 16 pacientes (15,5 por ciento) frente a siete (9,7 por ciento) en el grupo con angina preinfarto (log-rank: 1,03; p = 0,311). Las funciones de riesgo de los dos grupos muestran un mayor riesgo de mortalidad a lo largo de todo el seguimiento en el grupo sin angina preinfarto. En el modelo de regresión logística múltiple, la presencia de angina preinfarto no contribuye significativamente a reducir la mortalidad (OR = 0,43; IC del 95 por ciento = 0,09-2,22; p = 0,303). Se detecta una interacción significativa entre el consumo de sulfonilureas previo al infarto y la angina preinfarto (p = 0,017).Conclusiones. En este estudio no hemos encontrado diferencias significativas en la mortalidad total tras 6 meses de seguimiento después de infarto agudo de miocardio según la presencia o no de angina preinfarto. El riesgo de muerte, sin embargo, parece estar incrementado en los pacientes sin angina preinfarto en todo el período de seguimiento. Existe una interacción significativa entre el consumo de sulfonilureas previo al infarto y la angina preinfarto (AU)

Doppler tisular del anillo mitral en pacientes con disfunción sistólica ventricular izquierda. Análisis de la función diastólica / Doppler tissue imaging of the mitral annulus in patients with left ventricular systolic dysfunction. Assessment of diastolic function

Introducción y objetivos. Evaluar el Doppler tisular del anillo mitral lateral en pacientes con disfunción sistólica ventricular izquierda. Esta técnica se ha propuesto para analizar la función diastólica ventricular puesto que los valores obtenidos son relativamente independientes de la precarga. Pacientes y métodos. Se estudiaron 46 pacientes con fracción de eyección < 40 por ciento, en ritmo sinusal y sin regurgitación mitral. Se analizó el Doppler pulsado del flujo transmitral (ondas E y A), el flujo en venas pulmonares (ondas S, D y Ar) y el Doppler tisular del anillo mitral lateral (ondas Ea y Aa).Resultados. Las correlaciones lineales de las medidas Doppler son en conjunto bajas. Cuando los pacientes se agruparon según el cociente E/A (E/A < 1 o grupo 1 y E/A 1 o grupo 2 con patrón seudonormalizado), el valor de Ea no difirió entre los dos grupos: 5,0 cm/s (4,2/6,0) frente a 6,2 cm/s (5,5/8,2); p = 0,129, ni tampoco el de E/Ea: 10,2 (8,2/14,5) frente a 12,9 (9,1/17,4); p = 0,160. El tamaño auricular izquierdo fue significativamente mayor en el grupo 2: 20,0 cm2 (18,0/22,0) frente a 25,0 cm2 (20,0/29,0); p < 0,001. El cociente Ea/Aa se seudonormalizó en el grupo 2: 0,65 (0,48/0,83) frente a 1,15 (0,75/1,71); p = 0,001.Conclusión. En pacientes con disfunción sistólica ventricular izquierda, el valor de Ea/Aa se seudonormaliza cuando la precarga aumenta. Esto no sucede en los valores de Ea, E/Ea ni en el tamaño de la aurícula izquierda. Por tanto, el Doppler tisular del anillo mitral es un método útil para evaluar la función diastólica ventricular izquierda al ser relativamente independiente de la precarga (AU)