RESUMO
BACKGROUND: Type-D personality has been identified as a risk factor for general and cardiac mortality in patients with coronary artery disease (CAD). Dobutamine-atropine stress echocardiography (DASE) is an established method for non-invasive evaluation of myocardial ischemia in patients with CAD. The objective of this study was to evaluate the prevalence of type-D personality and its association with the occurrence of myocardial ischemia as assessed by DASE. METHODS: This case-control study enrolled 306 patients (61 ± 9.6 years, 57.8% female) who were referred by physicians to assessment of myocardial ischemia. Before undergoing DASE, the patients answered the type-D scale, which identifies type-D personality. RESULTS: Type-D personality was identified in 106 patients (34.6%). DASE was positive for myocardial ischemia in 32.4% (99) of 306 participants there was no significant association between type-D personality and ischemic changes on DASE (P = 0.941; odds ratio: 0.98; confidence interval 95%: 0.57-1.69). Chest pain was the only clinical variable with statistically significant prevalence in type-D personality patients (77.4% vs. 57.0%; P < 0.001). CONCLUSIONS: Type-D personality was not a significant risk factor for the presence of ischemic changes on DASE. Patients with type-D personality tended to complain more frequently of chest pain than non-type-D patients.
RESUMO
We studied 12 consecutive patients with chronic ischemic myocardiopathy treated with bone marrow adult stem cell (ASC) transplantation and coronary artery bypass grafting (CABG). The aim of the study was to evaluate functional class (New York Heart Association), wall motion score index (WMSI), and ejection fraction by echocardiography and to evaluate myocardial perfusion by single-photon emission computed tomography (SPECT). Follow-up evaluations were performed at 3, 6, and 12 months. The results revealed functional class improvement until 12 months, a progressive increase in the ejection fraction of 15% to 20% in the first 6 months, and a progressive increase in the WMSI by 35% to 45% in 12 months. Evaluation of the WMSI in the stem cell and CABG areas separately revealed a similar improvement in the first 3 months and a better progression in the CABG area. SPECT images revealed perfusion improvements in ischemic areas and no difference in fibrous tissue areas. These preliminary results show the safety of the method and its reproducibility. When performed concomitantly with CABG, bone marrow ASC transplantation may improve functional class, ejection fraction, WMSI, and myocardial perfusion. This study will be completed with all patients followed up for 12 months and compared with a control group.
