[The value of isotopic ventriculography in the prognosis and follow-up of patients undergoing dynamic myocardioplasty]. / Valor de la ventriculografía isotópica en el pronóstico y seguimiento de los pacientes sometidos a miocardioplastia dinámica.

Dynamic cardiomyoplasty was performed in twenty patients with dilated cardiomyopathy. The electrical stimulation was produced by a double chambered pacemaker. Patients were studied by nuclear ventriculography one week before surgery, in the immediate postoperative phase and 8 or 12 months later. Five patients died (four of them were operative deaths). In this group the left ventricular ejection fraction (LVEF) was lower than in survivors (22 +/- 8% vs 28 +/- 4%; p less than 0.001). The end-diastolic volume and the mitral regurgitation index were greater (200 +/- 76 ml/m2 vs 153 +/- 34 ml/m2; p less than 0.001 and 2.12 +/- 0.75 vs 1.68 +/- 0.54; p less than 0.001, respectively). The immediate effect of cardiomyoplasty was the significative reduction in the contractility. However, at 8 or 12 months of follow-up, the LVEF increased in the 72% of the survivors. The end-diastolic volume and the regurgitation index decreased significantly. The clinical status improved in the 81% of the survivors. The best results were obtained in those patients in which a pulse train stimulation was employed in the training phase. Nevertheless, the changes in LVEF are not consistent with the improvement in the clinical status. The improve in the cardiac performance should be also due to the reduction in the left ventricular diameters and in the mitral functional regurgitation.

[Serologic study of the diagnosis of Chagas disease in Nicaraguan students in the Juventud island]. / Estudio serológico para el diagnóstico de la enfermedad de Chagas en estudiantes nicaragüenses de la Isla de la Juventud.

The results obtained during the serologic study for the diagnosis of Chagas' disease in 868 Nicaraguan students in the Isle of Youth are reported. Qualitative hemagglutination and indirect immunofluorescence were used. It was found that 8.5% of these students showed antibodies specific to Trypanosoma cruzi by means of this diagnostic test.

Oral amiodarone in high-risk ventricular arrhythmias.

Oral amiodarone was evaluated in 24 patients with complex forms of ventricular premature depolarizations (VPD) by means of ECG monitoring and measurement of systolic time intervals. The patients received 800 mg daily for 3 days, 600 mg daily for 7 days and 400 mg daily thereafter. Follow-up lasted from 6 to 17 months. Advanced forms of VPD were abolished and the VPD rate was reduced in 98% of patients. After 10 days repetitive VPD were absent in more than 80% and after 4 months more than 70% were completely free from arrhythmia. ECG changes revealed heart rate reduction and prolongation of PR, QRS and QTc intervals. Left ventricular performance was not influenced. After 6 months of treatment, 10 randomly selected patients received placebo instead of amiodarone in a single blind fashion until arrhythmia reappeared; the latter was again abolished by reinstituting amiodarone, The most frequent side effect were corneal microdeposits which were reversible and did not impair vision. It is concluded that amiodarone is effective and well tolerated in patients with high-risk VPD.

Terapéutica de las arritmias cardiacas por el método electroimpulsivo (MEI) / Therapy of cardiac arrythmias by the electroimpulsive method (MEI)

Se presenta un trabajo en el que se plantean el desarrollo histórico, los aspectos científicos, teóricos y prácticos, y la forma correcta de aplicación del método electroimpulsivo (MEI) en la terapéutica de las arritmias cardíacas que, tanto congénitas como adquiridas, tienden agravar la evolución de las cardiopatías y constituyen la causa directa de muerte en muchos casos(AU)