Browsing by Author "Corbalan, R"

Now showing 1 - 11 of 11
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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 diabetes mellitus and glycemic control strategies with clinical outcomes after acute coronary syndromes
    (MOSBY, INC, 2004) McGuire, DK; Newby, LK; Bhapkar, MV; Moliterno, DJ; Hochman, JS; Klein, WW; Weaver, WD; Pfisterer, M; Corbalan, R; Dellborg, M; Granger, CB; Van de Werf, F; Topol, EJ; Califf, RM; SYMPHONY and 2nd SYMPHONY Investigators
    Background Diabetes is associated with an increased risk for coronary artery disease (CAD) and its complications. The relative effect of glucose-lowering strategies of "insulin provision" versus "insulin sensitization" among patients with CAD remains unclear.
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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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    Effect of primary coronary angioplasty on left ventricular function and myocardial perfusion as determined by Tc-99m sestamibi scintigraphy
    (EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC, 2001) Castro, PF; Corbalan, R; Baeza, R; Nazzal, C; Greig, DP; Miranda, FP; Gonzalez, R; Marchant, E; Olea, E; Larrain, G
    Twenty-foul consecutive patients undergoing primary angioplasty were systematically studied with technetium-99m sestamibi myocardial scanning before intervention at 72 hours and at 3 months. Treatment with primary angioplasty was associated with a significant early decrease in the perfusion defect size, followed by a later improvement in left ventricular dimensions and ejection fraction.
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    Effects of carvedilol on oxidative stress and chronotropic response to exercise in patients with chronic heart failure
    (WILEY, 2005) Castro, P; Vukasovic, JL; Chiong, M; Diaz Araya, G; Alcaino, H; Copaja, M; Valenzuela, R; Greig, D; Perez, O; Corbalan, R; Lavandero, S
    Background: Our previous studies suggest that the increase in heart rate from rest to peak exercise is reduced in patients with chronic heart failure (CHF) and this is associated with increased oxidative stress, as determined by malondialdehyde (MDA) plasma levels.
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    Effects of Carvedilol upon intra- and interventricular synchrony in patients with chronic heart failure
    (EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC, 2005) Castro, PF; Mc Nab, P; Quintana, JC; Bittner, A; Greig, D; Vergara, I; Vukasovic, JL; Corbalan, R; Copaja, M; Diaz Araya, G; Chiong, M; Troncoso, R; Alcaino, H; Lavandero, S
    Radionuclide isotopic ventriculography with phase analysis was performed in 30 patients with stable heart failure (HF), determining left ventricular (LV) and interventricular contraction synchrony at baseline and after 6 months of treatment with maximal tolerated doses of carvedilol. Patients with HF had significant ventricular dyssynchrony compared with a normal population. The 50th percentile of patients with the greatest dyssynchrony at baseline showed significant improvement in ventricular synchrony after receiving carvedilol, and this was correlated positively with a reduction in end-diastolic LV volumes. (c) 2005 Elsevier Inc. All rights reserved.
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    Effects of early decrease in oxidative stress after medical therapy in patients with class IV congestive heart failure
    (EXCERPTA MEDICA INC, 2002) Castro, PF; Diaz Araya, G; Nettle, D; Corbalan, R; Perez, O; Nazzal, C; Larrain, G; Lavandero, S
    It has been reported that patients with congestive heart failure (CHF) have increased breath pentane content, conjugated diene levels, and plasma malondialdehyde (MDA) levels, an indirect marker of lipid peroxidation.(1-3) Ghatak et al(4) found that patients with chronic CHF had increased MDA and superoxide levels, which correlated with the severity of the CHF. Low glutathione levels and superoxide dismutase (SOD) activity have also been reported.(5,6) There have been no studies in human refractory CHF to evaluate the impact of acute intensive medical therapy on oxidative stress status and antioxidant enzyme activity. We determined the plasma levels of MDA, SOD, catalase (CAT), and glutathione peroxidase (GSH-Px) activities before and after therapeutic intervention in patients with chronic advanced CHF and refractory symptoms (New York Heart Association functional class IV).
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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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    Evaluation of eplerenone in the subgroup of EPHESUS patients with baseline left ventricular ejection fraction <= 30%
    (ELSEVIER SCIENCE BV, 2006) Pitt, B; Gheorghiade, M; Zannad, F; Anderson, JL; van Veldhuisen, DJ; Parkhomenko, A; Corbalan, R; Klug, EQ; Mukherjee, R; Solomon, H; EPHESUS Invest
    Aims: Because of the prognostic importance of LV dysfunction following an AMI and the increasing use of electrical and/or mechanical interventions in patients with LV systolic dysfunction, this retrospective analysis of EPHESUS patients with LVEF <= 30% at baseline was conducted to determine the value of eplerenone in this setting.
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    The TIMI risk score for unstable angina/non-ST elevation MI - A method for prognostication and therapeutic decision making
    (AMER MEDICAL ASSOC, 2000) Antman, EM; Cohen, M; Bernink, PJLM; McCabe, CH; Horacek, T; Papuchis, G; Mautner, B; Corbalan, R; Radley, D; Braunwald, E
    Context Patients with unstable angina/non-ST-segment elevation myocardial infarction (MI) (UA/NSTEMI) present with a wide spectrum of risk for death and cardiac ischemic events.