Browsing by Author "Larrain, G"

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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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    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 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.