[Correlation between ventricular arrhythmia and geometric remodeling of the left ventricle in arterial hypertension]. / Correlação entre arritmia ventricular e remodelamento geométrico do ventrículo esquerdo na hipertensão arterial.

PURPOSE: To study the presence and type of ventricular arrhythmias in patients with different geometric patterns of the left ventricle (LV). METHODS: Seventy-two patients with essential hypertension were divided in 4 groups, by the echocardiographic patterns: group I with concentric remodeling of the LV (normal LV mass with increased relative wall thickening); group II with concentric hypertrophy (both LV mass and relative wall thickening increased); group III with normal geometry of the LV (both LV mass and relative wall thickening normal); group IV, with eccentric hypertrophy (increased LV mass with normal relative wall thickening). The groups were compared by the quantity and quality of ventricular arrhythmia, measured by the number of ventricular ectopic beats (VEB) and episodes of ventricular tachycardia (VT) on Holter monitoring, and the presence of late potentials (LP) on signal-averaged electrocardiogram. RESULTS: Group I showed fewer VEB than group II (16.2 +/- 12.85 x 996.4 +/- 518.8, p < 0.05), and a statistic tendency to this result when compared with group IV (16.2 +/- 12.85 x 1634.2 +/- 1001.33, p = 0.063). When compared with group III, no statistical difference was found (16.2 +/- 12.85 x 19.8 +/- 14.81, p = NS). Episodes of VT and the presence of LP were noted only in groups II and IV. CONCLUSION: The group with concentric remodeling of the LV had fewer ventricular arrhythmias than hypertrophic groups, with characteristics closer to the patients with normal LV geometry.

[Myocardial infarction as a consequence of infective endocarditis in valvar bioprosthesis]. / Infarto do miocárdio conseqüente à endocardite infecciosa em bioprótese valvar.

A sixteen year-old male, followed in the Unicamp Cardiology Clinic with a previous record of rheumatic heart disease and a biological mitral prosthesis, presented with infective endocarditis. In spite of a good initial response to antibiotic therapy, the patient died in two weeks. Autopsy disclosed endocarditis of the prosthetic valve and embolic occlusion of the circumflex branch of left coronary artery.

[The heart and diabetes. An anatomo-clinical study]. / Coração e diabetes. Estudo anátomo-clínico.

We performed a retrospective study in 72 autopsies of diabetic patients (DMP) selected out of 2,239 adult autopsies, comprehending the period between 1966 to 1982. In order to analyse the possible Diabetic Cardiomyopathy, the DMP were divided into 8 groups according to the presence or the absence of Myocardial Fibrosis (MF) and Congestive Heart Failure (CHF). The Diabetes Mellitus (DM) incidence according to the race, sex, age and the presence of Kimmestiel-Wilson (KW) were in agreement with the literature data. The majority of the deaths occurred after the sixth-decade and we did not find any DMP with Malignant Hypertension. Hypertension and Coronary Artery Disease (CAD) increased the frequency of anatomical cardiac alterations, as follows: 1. MF was more associated with CAD, 2. Hypertension was more frequent in DMP with KW in the nodular form; 3. Hypertension increased the frequency of left ventricular hypertrophy; 4. Myocardial Infarction occurred in the absence of occlusive vascular phenomena. The Myocardial Fibrosis (MF) observed in DMP without ACD and without hypertension may be final anatomic demonstration of a gradual metabolic-functional process, and not the basic mechanism of the CHF in the possible Diabetic Cardiomyopathy.

"Torsades de pointes" induzida por antiarrítmicos. Relato de dois casos / Torsade de pointes induced by anti-arrhythmia agents.Report of 2 cases

Em dois casos, o uso de amiodarona e de procainamida foi o fator desencadeante de um tipo peculiar de arritmia: "torsades de pointes". Tecem comentarios sobre os aspectos eletrocardiograficos, fatores que favorecem o aparecimento de tal arritmia, criterios para o diagnostico e a respectiva conduta

Observacoes sobre o valor do eletroencefalograma rotineiro na deteccao de disturbios neuro-sensoriais predisponentes a acidentes do trabalho, em empregados de uma empresa distribuidora de energia eletrica. / Observations on the value of routine electroencephalographies in detection of neurosensorial disorders as a preventive measure against occupational accidents in workers of an electric power company

Os autores estudam o valor de eletroencefalograma, feito rotineiramente, como metodo preventivo contra acidentes do trabalho, em empregados de uma empresa distribuidora de energia eletrica. Apos analise de quatro grupos de empregados, a saber: empregados que sofreram acidentes do trabalho; - empregados em funcoes de alto risco; empregados com problemas neurologicos; e empregados sem problemas neurologicos e que nao sofreram acidentes do trabalho, - concluem que o eletroencefalograma rotineiro nao e um metodo adequado para a selecao de empregados com predisposicao a acidentes e nem para a deteccao de problemas neuro-sensoriais inaparentes

Uma complicação pouco comum das próteses valvares cardíacas. Relato de um caso / An unusual complication of cardiac valve prosthesis. Report of a case

Relata-se um caso de embolia da arteria coronaria esquerda com origem em trombo formado na protese valvar tipo StarrEdwards, colocada em posicao aortica. Esta verificacao se deu durante o exame necroscopico

Taquicardia ventricular pelo uso de amiodarona. Relato de um caso. / Ventricular tachycardia by the use of amiodarone.Report of a case

O autores apresentam o caso de paciente que, durante esforco fisico, desenvolveu taquicardia ventricular, na vigencia de altas doses de amiodarona