Browsing by Author "Acevedo, M"

Now showing 1 - 5 of 5
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    Administration of growth hormone to patients with advanced cardiac heart failure: effects upon left ventricular function, exercise capacity, and neurohormonal status
    (ELSEVIER IRELAND LTD, 2003) Acevedo, M; Corbalan, R; Chamorro, G; Jalil, J; Nazzal, C; Campusano, C; Castro, P
    Experimental and clinical studies have shown that the administration of recombinant human growth hormone can improve deteriorated left ventricular function and hemodynamics in patients with heart failure. Herein, we compared the effects of growth hormone versus placebo upon resting left ventricular ejection fraction, exercise capacity and neurohormonal status in patients with advanced heart failure. Nineteen patients with advanced cardiac heart failure (ejection fraction <30%) were studied at baseline and after 8 weeks of treatment with growth hormone (0.03 U/kg per day) or placebo. Primary end points were resting left ventricular ejection fraction, peak oxygen consumption and neurohormonal status, including plasma norepinephrine levels and insulin like growth factor-1 and its binding protein-3. Results are presented as median and interquartile ranges. Patients receiving growth hormone had a significant increase in insulin growth factor-1 plasma levels (median difference growth hormone=83 ng/ml [57-170] versus placebo=-6 ng/ml [-23-6], P<0.05) and its binding protein-3. However, no significant increase in left ventricular ejection fraction after growth hormone treatment (ejection fraction pre=16% [13-18] and post=17% [14-27]) was noticed when compared to placebo (ejection fraction pre=20% [15-24] and post=20% [15-26]). Also, no significant effect of growth hormone treatment was seen on peak oxygen consumption or norepinephrine plasma levels. Although the administration of growth hormone to patients with advanced cardiac heart failure was associated with a significant increase in insulin growth factor-1, there were no significant changes in ejection fraction, exercise capacity and/or neurohormonal status. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
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    Association of noninvasive markers of coronary artery reperfusion to assess microvascular obstruction in patients with acute myocardial infarction treated with primary angioplasty
    (EXCERPTA MEDICA INC, 2001) Corbalan, R; Larrain, G; Nazzal, C; Castro, PF; Acevedo, M; Dominguez, JM; Bellolio, F; Krucoff, MW
    Early restoration of coronary artery patency through primary angioplasty limits infarct size and improves survival. Increasing evidence, however, suggests that microvascular obstruction is often present despite coronary artery recanalization. This may limit the benefits of reperfusion therapy. We studied the use of noninvasive markers of coronary artery reperfusion as indicators of microvascular obstruction and determinants of prognosis in 98 patients with acute myocardial infarction (AW) who were successfully treated with primary angioplasty (Thrombolysis In Myocardial Infarction grade 3 flow and residual stenosis < 30%). Plasma creatine kinase (CK) levels and 12-lead electrocardiograms were performed on admission, at 90 minutes, and at 6, 12, and 24 hours after treatment. We defined: (1) reperfusion as resolution of ST-segment elevation > 50% at 90 minutes, with peak CK levels within 12 hours, and T-wave inversion within 24 hours; and (2) failed reperfusion, as the absence of these parameters. Of the 98 patients studied, 87 (88.8%) had reperfusion and 11 (11.2%) had failed reperfusion. Infarct location was anterior (versus inferior) in 9 patients in the failed reperfusion group (81.8%) compared with 41 patients in the reperfusion group (47.1%) (p < 0.01). Congestive heart failure > 24 hours after presentation or in-hospital death occurred in 11 patients (12.6%) in the reperfusion group versus 5 (45.5%) in the failed reperfusion group (p < 0.01). One-year survival was 96.1% for the reperfusion group and 60.6% for the failed reperfusion group (p < 0.0001). We conclude that the association of noninvasive markers of reperfusion better identifies patients with microvascular obstruction among those who had a "successful" primary angioplasty. Evidence of impaired microvascular reperfusion is associated with a poor in-hospital and 1-year outcome. (C) 2001 by Excerpta Medica, Inc.
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    C-reactive protein and atrial fibrillation: "Evidence for the presence of inflammation in the perpetuation of the arrhythmia"
    (ELSEVIER IRELAND LTD, 2006) Acevedo, M; Corbalan, R; Braun, S; Pereira, J; Navarrete, C; Gonzalez, I
    Background: Atrial fibrillation (AF) is associated to a high risk of systemic embolism. The mechanisms that contribute to thrombogenesis in these patients are still poorly understood. Systemic and/or local inflammation could be involved in the process of thrombogenesis and contribute to the perpetuation of the arrhythmia. The purpose of the study was to evaluate the role of inflammation and its relation to thrombogenesis and cardiac rhythm in AF.
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    Effects of glucose-insulin-potassium solution on myocardial salvage and left ventricular function after primary angioplasty
    (LIPPINCOTT WILLIAMS & WILKINS, 2003) Castro, PF; Larrain, G; Baeza, R; Corbalan, R; Nazzal, C; Greig, DP; Miranda, FP; Perez, O; Acevedo, M; Marchant, E; Olea, E; Gonzalez, R
    Objective. To evaluate the effects of glucose-insulin-potassium (GIK) therapy on infarct size and left ventricular function when used as an adjuvant therapy to primary angioplasty.
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    Radiofrequency catheter ablation of slow-pathway conduction. Experience in 30 cases
    (SOC MEDICA SANTIAGO, 1995) Vergara, I; Acevedo, M; Fajuri, A; Cambon, AM; Rosas, A; Gonzalez, R
    Atrioventricular nodal reentry tachycardia (AVNRT) is one of the most frequent mechanism of paroxysmal supraventricular tachycardia. In these patient tachycardia is maintained due to anterograde conduction through a slow pathway and retrograde conduction to the atrium via a fast pathway. We present herein our experience in ablation of the slow pathway. Since January 1993, 30 consecutive patients with AVNRT underwent attempted catheter ablation of the slow pathway. Mean age was 35 +/- 3.7 years. All patients has symptomatic tachycardia and six had history of syncope. Electrophysiologic studies revealed AVNRT in all patients, in addition, two patients had a left accessory pathway. Slow pathway ablation was performed with a Mansfield 7 F catheter, guided by both fluoroscopic positioning and endocardial signals. A mean of 13 bursts were applied. in the 30 patients conduction through the slow pathway was interrupted, and thus tachycardia was no longer inducible. Retrograde conduction post ablation was evaluated in 17 of the 30 patients, significant changes were observed in three of them. One patient developed second degree AV block and a permanent observed in three of them. One patient developed second degree AV block and a permanent pacemaker was implanted. Another patient had recurrence of tachycardia three months post ablation. After a second attempt she is arrhythmia free. Patients have been followed for a mean of 15.7 +/- 2.5 months and are asymptomatic in the absence of antiarrhythmic therapy.