Abstract:
Background::In the Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial (SHIFT), heart rate (HR) reduction with ivabradine was associated with improved survival and reduced hospitalizations in patients with heart failure (HF). The mechanisms by which elevated HR increases mortality are not fully understood. Objective::To assess the relationship of baseline HR with clinical, neurohormonal and cardiac sympathetic activity in patients with chronic HF and elevated HR. Method::Patients with chronic HF who were in sinus rhythm and had resting HR>70 bpm despite optimal medical treatment were included in a randomized, double-blind study comparing ivabradine versus pyridostigmine. This report refers to the baseline data of 16 initial patients. Baseline HR (before randomization to one of the drugs) was assessed, and patients were classified into two groups, with HR below or above mean values. Cardiac sympathetic activity was assessed by 123-iodine-metaiodobenzylguanidine myocardial scintigraphy. Results::Mean HR was 83.5±11.5 bpm (range 72 to 104), and seven (43.7%) patients had HR above the mean. These patients had lower 6-min walk distance (292.3±93 vs 465.2±97.1 m, p=0.0029), higher values of N-Terminal-proBNP (median 708.4 vs 76.1, p=0.035) and lower late heart/mediastinum rate, indicating cardiac denervation (1.48±0.12 vs 1.74±0.09, p<0.001). Conclusion::Elevated resting HR in patients with HF under optimal medical treatment was associated with cardiac denervation, worse functional capacity, and neurohormonal activation. Fundamento::No SHIFT (Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial, ou Estudo do Tratamento da Insuficiência Cardíaca Sistólica com o Inibidor de If Ivabradina), a redução da frequência cardíaca (FC) com ivabradina associou-se com melhor sobrevida e redução das hospitalizações em pacientes com insuficiência cardíaca (IC). Os mecanismos pelos quais a FC elevada aumenta a mortalidade não são totalmente compreendidos. Objetivo::Avaliar a relação da FC basal com atividade clínica, neuro-hormonal e simpática cardíaca em pacientes com IC crônica e FC elevada. Método::Pacientes com IC crônica em ritmo sinusal e FC≥70 apesar de tratamento adequado foram incluídos em um estudo duplo-cego, randomizado, que comparou ivabradina com piridostigmina. Este artigo refere-se a dados basais dos primeiros 16 pacientes. A FC basal (antes da randomização para um dos medicamentos) foi avaliada, e os pacientes classificados em dois grupos, com FC abaixo ou acima dos valores médios. A atividade simpática cardíaca foi avaliada por cintilografia com metaiodobenzilguanidina marcada com iodo 123. Resultados::A FC média foi 83,5±11,5 bpm (intervalo 72 a 104), e sete pacientes (43.7%) tinham FC acima da média. Esses pacientes apresentaram menor distância percorrida no teste de caminhada de 6 minutos (292,3±93 vs 465,2±97,1 m, p=0,0029), valores mais altos de N-terminal do pró-BNP (mediana 708,4 vs 76,1, p=0,035) e menor relação coração/mediastino tardia, indicando desnervação cardíaca (1,48±0,12 vs 1,74±0,09, p<0,001). Conclusão::A FC de repouso elevada em pacientes com IC em tratamento médico adequado associou-se com desnervação cardíaca, pior capacidade funcional e ativação neuro-hormonal.
journal_name
Arq Bras Cardioljournal_title
Arquivos brasileiros de cardiologiaauthors
Villacorta AS,Villacorta H Junior,Souza JS,Teixeira JA,Muradas MC,Alves CR,Precht BC,Porto P,Ubaldo L,Mesquita CT,Nóbrega ACdoi
10.5935/abc.20160166subject
Has Abstractpub_date
2016-11-01 00:00:00pages
455-459issue
5eissn
0066-782Xissn
1678-4170pii
S0066-782X2016004400455journal_volume
107pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Birth weight (BW) is a medium- and long-term risk determinant of cardiovascular risk factors. OBJECTIVE:To assess the association between BW and cardiovascular risk factors in adolescents of the city of Salvador, Bahia state. METHODS:Cross-sectional study with comparison of BW groups. Sample comprising 250...
journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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abstract::Growth hormone (GH), the main regulator for post-natal growth, has important metabolic actions on different tissues, similar or opposite to insulin like growth factor I (IGF-I), mainly produced by the liver after the binding of GH to its receptor. Experiments with animal models indicate an important role of GH on insu...
journal_title:Arquivos brasileiros de cardiologia
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abstract::A 79-year-old woman developed myocardial infarction associated with acute pulmonary edema. The electrocardiogram recorded QRS complex of QS type in V1 with upper ST extending from V3R to V6R. The polarity of the P wave in bipolar leads was positive, so compatible with dextrorotation complicated by myocardial infarctio...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章,评审
doi:
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abstract:BACKGROUND:The determination of the prevalence of electrocardiographic alterations in the older age strata of the Brazilian population represents important information with clinical and epidemiological purpose. OBJECTIVE:To verify the prevalence rates of atrial fibrillation, enlarged Q/QS waves (Minnesota code 1.1-1.2...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2009001200015
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abstract:PURPOSE:To study the predischarge exercise testing importance in determining prognosis after acute myocardial infarction (AMI). PATIENTS AND METHODS:Treadmill exercise testing was performed in 50 stable and without complications patients with AMI, just before hospital discharge; there were 43 men and 7 women, mean age...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00
abstract::There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS b...
journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
pub_type: 临床试验,杂志文章,随机对照试验
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abstract::A 39-year-old female patient with refractory heart failure has been studied. On February, 1982 she was submitted to right lobar thyroidectomy for remotion of the left thyroid lobe. Following the surgery, she had signs of hypocalcemia and the diagnosis of secondary hypoparathyroidism and heart failure had been made. Se...
journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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更新日期:1995-06-01 00:00:00
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journal_title:Arquivos brasileiros de cardiologia
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2005001400005
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journal_title:Arquivos brasileiros de cardiologia
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