RESUMENObjetivo: Evaluar la factibilidad de realizar una estratificación hemodinámica en pacientes con infarto agudo de miocardio con segmento ST elevado, mediante el uso de ecocardiografía transtorácica. Materiales y métodos: Estudio descriptivo, prospectivo y transversal que incorporó a 30 pacientes en ritmo sinusal con diagnóstico de infarto agudo de miocardio con ST elevado, ingresados a la unidad coronaria del Hospital Edgardo Rebagliati Martins. Se estimó: gasto cardíaco, presión de llenado de ventrículo izquierdo, resistencia vascular sistémica y resistencia vascular pulmonar. Resultados: La edad promedio fue 67 ± 10.6 años, predominio masculino (86.7%). La estimación del gasto cardiaco y la presión de llenado del ventrículo izquierdo fue posible en el 100% de los individuos. La resistencia vascular sistémica y resistencia vascular pulmonar pudieron ser estimadas en 29 (96.6%) y 28 (93.3%) pacientes, respectivamente. La estratificación hemodinámica fue: estadio I (normal): 18 pacientes (60%), estadio II (congestivo): 6 pacientes (20%), estadio III (hipovolemia, compromiso de VD): 5 pacientes (16.7%) y estadio IV (Choque): 1 paciente (3.3%). Conclusiones: Se concluye que es factible realizar la estratificación hemodinámica ecocardiográfica transtorácica en la población estudiada.Palabras clave: Estratificación hemodinámica; ecocardiografía transtorácica; infarto de miocardio. Hemodynamic stratification using transthoracic echocardiography in patients with ST segment elevation acute myocardial infarction ABSTRACTObjective: To evaluate the feasibility of performing a hemodynamic stratification in patients with ST segment elevation acute myocardial infarction using transthoracic echocardiography. Materials and methods: A descriptive, prospective and cross-sectional study that included 30 patients in sinus rhythm with ST segment elevation acute myocardial infarction, admitted to the coronary care unit of Hospital Edgardo Rebagliati Martins. Cardiac output, left ventricle filling pressure, systemic vascular resistance and pulmonary vascular resistance were estimated. Results: The mean age was 67 ± 10.6 years old, with male predominance (86.7%). The estimation of cardiac output and left ventricle filling pressure was possible in 100% of the individuals. The systemic vascular resistance and pulmonary vascular resistance could be estimated in 29 (96.6%) and 28 (93.3%) patients, respectively. The hemodynamic stratification was as follows: stage I (normal): 18 patients (60%), stage II (congestive): 6 patients (20%), stage III (hypovolemia, RV infarction): 5 patients (16.7%) and stage IV (shock): 1 patient (3.3%). Conclusions: It is concluded that a transthoracic echocardiographic hemodynamic stratification may be performed in the studied population.
Objetivo: La paraoxonasa 1 (PON1), una esterasa asociada a las lipoproteínas de alta densidad (HDL), presenta diversos polimorfismos: el polimorfismo PON1 Q192R (región codificante) es el responsable de las variaciones de la actividad paraoxonasa de la enzima. El alelo PON1 192R es considerado un factor de riesgo para desarrollar trastornos cardiometabólicos en algunas poblaciones. El objetivo del presente estudio es determinar la distribución de los polimorfismos PON1 Q192R, y su asociación con el perfil lipidíco y APO A1 en una población andina. Materiales y métodos: Estudio descriptivo, transversal, en el que participaron 79 personas adultas (26 hombres y 53 mujeres), clínicamente sanas, residentes del distrito de Junín a 4105 msnm. Se empleó la técnica PCR/RFLP para el análisis del sitio polimórfico Q192R del gen PON1, y se determinaron los valores séricos del perfil lipídico y APO A1, y las actividades paraoxonasa y arilesterasa de la enzima. Resultados: La distribución de los genotipos para PON1192 fue: QQ 13,9%, QR 45,6% y RR 40,5%, y el alelo más frecuente fue 192R 63%. Las actividades paraoxonasa basal y estimulada fueron diferentes según sus genotipos, mientras que la actividad esterasa de la enzima no estuvo influenciada por el polimorfismo. Por otra parte, no se encontró asociación entre el polimorfismo PON1 Q192R y el perfil lipídico y APO A1. Conclusiones: La alta prevalencia del alelo PON1 192R en la población estudiada probablemente indique un papel importante en el desarrollo de enfermedades cardiometabólica. Palabras clave: Paraoxonasa; polimorfismo; factores de riesgo cardiovascular; altitud. Distribution of the Q192R polymorphism of the paraoxonase 1 gene in a population of the district of Junín (Junín region, Peru) ABSTRACT Objective: Paraoxonase 1 (PON1), an esterase associated with high-density lipoproteins (HDL), has several polymorphisms: the PON1 Q192R polymorphism (coding region) is responsible for variations in the paraoxonase activity of the enzyme. The PON1 192R allele is considered a risk factor for developing cardiometabolic disorders in some populations. The aim of the present study is to determine the distribution of the PON1 Q192R polymorphism and its association with the lipid profile and APO A1 in an Andean population. Materials and methods: A descriptive, cross-sectional study involving 79 healthy adults (26 males and 53 females), residents of the district of Junín at 4105 m.a.s.l. The PCR/RFLP technique was used for the analysis of the PON1 Q192R polymorphism. The serum values of the lipid profile and APO A1, and the paraoxonase and arylesterase activities of the enzyme were determined. Results: The distribution of the genotypes for PON1192 was QQ 13.9%, QR 45.6% and RR 40.5%, and the most frequent allele was 192R 63%. The baseline and stimulated paraoxonase activities were different based on their genotypes, while the esterase activity of the enzyme was not influenced by the polymorphism. On the other hand, no association was found between the PON1 Q192R polymorphism and th...
Background: Previous studies of Maytenus macrocarpa "Chuchuhuasi" and linked species have corroborated their biological effects related to cardiovascular, respiratory, and others systems. This research has focused on evaluating the effect in the corporeal temperature, respiratory rate, heart rate and electrocardiogram of concomitant administration of "Chuchuhuasi" and propranolol in escalating doses. Methods: Albino rats were divided randomly into four control groups and five experimental groups. Temperature was measured by a digital thermometer, respiratory rate by direct-counting and electrocardiogram and heart rate by a Grass Polygraph. Rhythmic and arrhythmic electrocardiographic patterns were identified by a mathematical modeling of autocorrelation. The outcomes were acquired in periods of time but were analyzed using the average of the whole of the experiment. The result was applied to the following statistical tests: one-way ANOVA, Tuckey, Shapiro-Wilk, Pearson Correlation and Chi square with Yate's correction test. Results: The comparison between control and experimental groups showed a profile of raise in the corporeal temperature, then, for the respiratory rate the bias was to increase, in contrast, it was showed trend to decrease of the heart rate and an increase of voltages of p and r wave, also, an increment of p-r interval and presences of arrhythmias. Conclusion: This study revealed effects of concomitant administration of propranolol and Maytenus macrocarpa on temperature, respiratory rate, heart rate and electrocardiogram. In addition, it showed abnormalities in the electrocardiogram which were associated with arrhythmia patterns Thus, the usage of propranolol and Maytenus macrocarpa may negatively impact several aspects of the health of users of these drugs.
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