[Percutaneous myocardial revascularization procedures in Brazil in 1996-1997 compared to the 1992-1993 period. A report of the National Registry--National Center for Cardiovascular Interventions (CENIC)]. / Intervenções percutâneas para revascularização do miocárdio no Brasil em 1996 e 1997 comparadas as do biênio 1992 e 1993. Relatório do registro CENIC (Central Nacional de Intervenoes Cardiovasculares).

PURPOSE: To report the results of percutaneous coronary interventions, in Brazil, in the years 1996-97, comparing them to those of 1992-93. METHODS: Data were collected in a standard form and the 1996-97 results were compared to those of 1992-93. RESULTS: The current Registry received data from 79% effective members of the SBHCI in 127 hospitals, including 22,025 patients, 60.67% of whom underwent PTCA, 36.57% stent implantation, 2.3% PTRA, 0.06% DCA and 0.4% laser angioplasty. Balloon angioplasty was the most frequent procedure in 1996-97, but its overall rate fell from 6.75% to 55.8% (p = 0.0001) concomitantly, there was a 35% relative increase in the use of stents from 1992-93 to 1996-97. The success rate of the later period was higher (89.7% vs 92.8%, p = 0.000001), with lower residual stenosis (22% vs 19%, p = 0.001). Besides, there were lower major complications rates: acute myocardial infarction (2.5% vs 1.2%, p = 0.002) and death (1.8% vs 1.4%, p = 0.0003). CONCLUSION: The procedures most often carried out in both periods were balloon angioplasty (60.67%) and implantation of stents (36.57%); the success rate high, abrupt closure rate was low (1.5%). These favorable results corroborate the high standards of the Brazilian Interventional Cardiology.

Systolic and diastolic time intervals in the critically ill patient.

OBJECTIVE: The waveform of the first derivative of thoracic electrical bioimpedance was used to calculate systolic time intervals of the cardiac cycle, preejection period/left ventricular ejection time ratio, and diastolic time intervals, isovolumic relaxation period/filling time ratio. DESIGN: Prospective clinical study. Waveforms were examined from 913 normal and abnormal tracings from a thoracic electrical bioimpedance monitor. This monitor was coupled to a two-channel strip-chart recorder that identified preejection period/LV ejection time and isovolumic relaxation period/filling time in 86% of the tracings. SETTING: Two university-affiliated hospitals and one community hospital. PATIENTS: We assessed 100 subjects (ranging in age from 17 to 93 yrs) under various conditions. MEASUREMENTS AND MAIN RESULTS: Data from 15 normal subjects were used as a reference series to define normative values. Preejection period/left ventricular ejection time ratio was 0.35 +/- 0.1 (SD) and was consistent with data from systolic time intervals derived from simultaneous study of the ECG recording, carotid artery tracing, and phonocardiography. The diastolic time ratio (isovolumic relaxation period/filling time) was 0.4 +/- 0.2, in agreement with normal values derived by echocardiography and angiography. In a subgroup of 17 critically ill patients, a correlative study of simultaneously measured thoracic electrical bioimpedance, nuclear stethoscope, and radionuclide ventriculography was conducted. Systolic functions were compared by the ejection fraction derived by preejection period/left ventricular ejection time ratio displayed on the thoracic electrical bioimpedance monitor and by the radionuclide technique, and were found to be 57 +/- 13.8% and 58 +/- 8.6%, respectively (r2 = .49; y = 4.06x + 0.94; p less than .02; n = 17). Increased diastolic time ratios with normal or near-normal systolic time intervals were documented in nine (53%) of 17 critically ill patients with low systolic index. CONCLUSION: Both systolic and diastolic time intervals can be investigated noninvasively at the bedside by the thoracic electrical bioimpedance technique to provide a better understanding of left heart function.