Late Quaternary records of Najas spp. (Najadaceae) from the southwestern Baltic region.

Seeds of the submerged vascular plants Najas marina, Najas minor and Najas flexilis are reported from submarine Holocene deposits from the southwestern part of the Baltic Sea, and we also report on a find of Najas minor from an Eemian deposit in Jutland, which is the first record of this species from the Eemian of Denmark. The common and widespread occurrence of especially the southern extralimital N. minor is indicative of higher than present summer temperatures during the period from 10300 to 8000cal.yearsBP.

[Cardiac asystole during dobutamine stress echocardiography]. / Assistolia durante ecocardiograma de estresse com dobutamina.

We report a case of cardiac asystole during dobutamine stress echocardiography in a 59 year-old woman presenting with chest pain and a positive treadmill test for ischemia. Cardiac asystole was not associated with myocardial ischaemia and was probably related to a powerful cardioinhibitory reflex caused by dobutamine stimulation.

Sintomas, complicaçöes e alteraçöes hemodinâmicas associadas a ecocardiografia de estresse com dobutamina / Symptoms, complications and hemodynamic effects related to dobutamine stress echocardiography

OBJETIVO - Avaliar a segurança e efeitos hemodinâmicos da ecocardiografia de estresse com dobutamina. MÉTODOS - Estudo prospectivo de 735 pacientes consecutivos, submetidos a ecocardiografia de estresse com dobutamina, para avaliar doença coronária e ou miocardiopatia. Inicialmente, a dobutamina foi administrada via endovenosa com doses progressivas de 5, 10, 20, 30µg/ kg/min a intervalos de 3min. O protocolo foi modificado para atingir a dose máxima de 40µg/kg/min, e, finalmente, até o limite de 50µg/kg/min. RESULTADOS - A dobutamina aumentou significantemente a frequência cardíaca (FC) (de 72ñ12bpm para 117ñ23bpm, p<0,0005) a pressão sistólica (133ñ21pbm para 157ñ29mmHg, p<0,0005) e o duplo produto (de 9,635ñ2,100 para 18,400ñ4,050, p<0,0001) do estado basal para o pico de infusão, respectivamente. Observou-se aumento significativo (p<0,05) da FC em cada estágio de infusão de dobutamina até dose de 40µg/kg/min, além do qual se mantém inalterado. Não ocorreram morte, infarto do miocárdio ou episódios de taquicardia ventricular. Os efeitos colaterais mais comuns foram náusea, ansiedade, tremor, apreensão e cefaléia em 55 (7,4 por cento) pacientes. Angina de peito ocorreu em 10 (1,4 por cento). As arritmias mais comuns foram extra-sístoles ventriculares em 138 (18,7 por cento) pacientes e extra-sistolia supraventricular 36 (4,9 por cento). Houve 4 pacientes que apresentaram taquicardia ventricular não sustentada, sem repercussão hemodinâmica. CONCLUSÄO - Ecocardiografia de estresse com dobutamina é um método seguro e bem tolerado.Doses de infusão de dobutamina > 40µg/kg/min não provocam resposta cronotrópica adicional, o que torna questionável a validade do protocolo de ecocardiografia de estresse com doses de dobutamina > 40µg/kg/min.

[Symptoms, complications and hemodynamic changes related to dobutamine stress echocardiography]. / Sintomas, complicações e alterações hemodinâmicas associadas a ecocardiografia de estresse com dobutamina.

PURPOSE: This study focuses on the safety and hemodynamic effects of dobutamine stress echocardiography. METHODS: Seven hundred and thirty five consecutive patients underwent dobutamine stress echocardiography for the evaluation of coronary artery disease and or cardiomyopathy. Dobutamine was administered intravenously at incremental doses of 5, 10, 20, 30 micrograms/kg/min, at 3 min intervals. The maximal dose was 40 or 50 micrograms/kg/min. RESULTS: Dobutamine significantly (p < 0.0005) increased the heart rate (from 72 +/- 12 bpm to 117 +/- 23 bpm), systolic blood pressure (from 133 +/- 21 to 157 +/- 29 mmHg) and the rate-pressure product (from 9.635 +/- 2.100 to 18.400 +/- 4.050, p < 0.0001) from baseline to peak infusion rate, respectively. There was a significant increase in heart rate (p < 0.05) at each infusion step, except for the 50 micrograms/kg/min dose, when the heart became stable. There were no deaths myocardial infarctions, or episodes of sustained ventricular tachycardia. Common non cardiac side effects included nausea, anxiety, headache, tremors and urgency in 55 (7.4%) of the patients. Angina pectoris occurred in 10 (1.4%) of the patients. The most common arrhythmias were usually mild. CONCLUSION: Dobutamine stress echocardiography is safe, and well tolerated. In this study complications such as myocardial infarction, death, ventricular tachycardia or fibrillation did not occur. There was no additional increase in heart rate with doses greater than 40 micrograms/kg/min. The advantage of stress echocardiography protocol with peak doses of 50 micrograms/kg/min is questionable.