Membrana subaórtica evaluada con ecocardiografía tridimensional

Subaortic membrane represents a 9% of the left ventricle outfl owtract obstructions. We presented a 50 year-old woman who was referred to our laboratory with dyspnea and an aortic systolic murmur. Two-dimensional echocardiography demonstrated a sub-aortic stenosis due to a circumferential membrane. A signifi cant high gradient across the defect and a moderate aortic regurgitation were assessed. A detailed spatial assessment of this complex defect was performed by three-dimensional echocardiography.La membrana subaórtica representa aproximadamente el 9% de las obstrucciones fi jas al tracto de salida del ventrículo izquierdo. Se presenta el caso de una mujer de 50 años con disnea en clase funcional II y soplo sistólico en foco aórtico. Se realizó una ecocardiografía que evidenció la presencia de una membrana subaórtica de morfología circunferencial con elevados gradientes e insufi ciencia aórtica moderada. El análisis tridimensional aportó información más precisa en cuanto a las características morfológicas del defecto

Semana de prevención cardiovascular en un hospital universitario de la ciudad de buenos aires

Introduction: Despite pharmacological and non-pharmacological measures, the prevalence of cardiovascular risk factors (CRFs)continues to increase.Objective: The aim of this study was to evaluate the level of cardiovascular risk in the population usually consulting at the Divisionof Cardiology of Hospital de Clínicas José de San Martín, in order to carry out a sampling of reliable epidemiological data.Methods: This is a descriptive, comparative, cross-sectional study of consecutive individuals who spontaneously consultedduring the “Cardiovascular Prevention Week” in September 2015.Results: A total of 497 individuals were included in the study. There was high prevalence of CRFs, with poor achievement ofblood pressure, blood glucose and total cholesterol goals. Overweight revealed alarming rates. The prevalence of subclinicalatheromatosis was proportional to the individual cardiovascular risk.Conclusions: The data collected suggest the need for cardiology areas of primary cardiovascular prevention, with objectivesfocused on the estimation of cardiovascular risk and patient adherence through education.Se diseñó un estudio descriptivo y comparativo para evaluar el nivel de riesgo cardiovascular de la población que habitualmente concurre al Hospital de Clínicas José de San Martín, a fin de realizar un muestreo con datos epidemiológicos confiables. Se evaluaron 497 individuos. Los resultados mostraron una elevada prevalencia de factores de riesgo cardiovasculares, un pobre alcance de las metas de presión arterial, glucemia y colesterol total. El sobrepeso, expresado a través del índice de masa corporal, arrojó valores alarmantes. La prevalencia de ateromatosis subclínica fue proporcional al riesgo cardiovascular del individuo. Los datos recabados nos entregan un panorama del riesgo cardiovascular de nuestra población y sugieren la necesidad de un abordaje multidisciplinario e individualizado. El análisis de este trabajo enfatiza la necesidad de contar con áreas cardiológicas de prevención cardiovascular primaria, cuyos objetivos se centralicen en la estimación del riesgo cardiovascular y el bienestar del paciente, a través de su educación, adherencia a las medidas de tratamiento y atención individualizada; en estrecho contacto con las especialidades intervinientes en cada caso

Frailty is independently associated with 1-year mortality after hospitalization for acute heart failure

Introduction: Frailty is a complex condition that results from the loss of physiological reserve across multiple systems. Its presence should be considered in the aging heart failure population, since it is an important predictor of death and institutionalization in the elderly. Methods and results: In a prospective, observational and analytical single-center study of 100 elderly patients hospitalized for acute heart failure, we assessed the characteristics associated with an increased hospital and 1-year mortality. Frailty was evaluated with the Clinical Frailty Scale, and there was a significant association between its presence and 1-year mortality (RR = 2.03; 95% CI = 1.18–3.48; p = 0.014), although not with in-hospital mortality. After adjusting for probable confounders, it remained independently associated with 1-year mortality. Conclusion: Frailty can be assessed with a simple bed-side scale and provides significant prognostic information in acute heart failure patients. Keywords: Frailty, Heart failure, Acute heart failure, 1-year mortality, Elderly, CF

Dose dependency of the serum bio/immuno GH ratio in children during pharmacological secretion tests.

Dissociation between GH bioactivity (bio-GH) and GH immunoactivity (immuno-GH) is due to the heterogeneity of the molecule: the measurements do not always provide reliable information on the bio-GH. We studied the ratio of bio-GH and immuno-GH during pharmacological secretion tests in 211 sera to study the concentration-response curve of the assay (Cl), 16 samples of normally growing subjects with idiopathic short stature (C2), 13 samples from patients with GH deficiency (GHD1) and 6 samples of 3 patients with GHD and normal provocative tests (GHD2). GH bioactivity was determined by the Nb-2 cell proliferation assay (bio-GH) and immuno-GH by a time-resolved immunofluorometric assay (IFMA) (immuno-GH). A non-linear negative relationship between the serum bio-GH/immuno-GH ratio and serum immuno-GH was observed in C1. In log-log plotting representation, two cut-off lines were drawn: a vertical cut-off line separating above-below cut-off serum peak immuno-GH values in provocative tests, and a diagonal cut-off line separating normal-abnormal serum bio-GH/immuno-GH ratio; four areas were defined. GHD1 had normal ratios, but below cut-off peak immuno-GH responses. P2 and P3 of Group GHD2 had abnormal ratios in samples with low serum immuno-GH but only P2 had autosomal dominant mutation. P1 had the same autosomal dominant isolated GHD as P2 but a low normal ratio. Our data underline the importance of relatively low serum GH concentrations in mediating GH biological actions. An abnormal serum bio-GH/immuno-GH ratio might explain certain cases of GHD and might be useful in detecting abnormal circulating isoforms of GH in patients with growth failure