S1409-414220040003 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422004000300001 Revista Costarricense de Cardiología: Celebración del 5 °aniversario Araya Gómez Vivien ,Asociación Costarricense de Cardiología 09 2004 2004 6 03 03
S1409-414220040003 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422004000300002 Reducción Global del Riesgo Cardiovascular: una Tarea Mundial J. Chilton Robert ,Laboratorio de Cateterismo Cardíaco del Centro de Ciencias Médicas 09 2004 2004 6 4 6 Murray CJL Lopez AD The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020 The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020 1996 Boston Harvard School of Public Health Yusuf S Reddy S Ôunpuu S Anand S Global burden of cardiovascular diseases, part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization Circulation 2001 104 H Hennekens Charles Increasing Burden of Cardiovascular Disease: Current Knowledge and Future Directions for Research on Risk Factors Circulation 1998 97 Yusuf Salim Hawken Steven Ôunpuu Stephanie Dans Tony Avezum Alvaro Lanas Fernando McQueen Matthew Budaj Andrzej Pais Prem Varigos John Lisheng Liu on behalf of the INTERHEART Study Investigators Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study Lancet 2004 364 Fonarow Gregg C Gawlinski Anna Moughrabi Samira H. Tillisch Jan Improved Treatment of Coronary Heart Disease by Implementation of a Cardiac Hospitalization Atherosclerosis Management Program (CHAMP) Am J Cardiol 2001 87 Gæde Peter Vedel Pernille Larsen Nicolai V.H. Jensen Gunnar Parving Hans-Henrik Pedersen Oluf Multifactorial Intervention and Cardiovascular Disease in Patients with Type 2 Diabetes N Engl J Med 2003 348
S1409-414220040003 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422004000300003 Prevalencia de terapias inadecuadas con cardiodesfibriladores en la Clínica de Arritmias del Hospital México Gutiérrez Sotelo Oswaldo ,Caja Costarricense de Seguro Social Hospital México San José Costa Rica 09 2004 2004 6 7 12

Introducción: Los cardiodesfibriladores implantables están indicados en los pacientes que han tenido paro cardiorrespiratorio y/o taquicardia ventricular/fibrilación ventricular. Las terapias que administran son estimulación antitaquicardia, cardioversión y desfibrilación y existen diversos métodos matemáticos mediante los cuales estos dispositivos pueden discriminar si una taquiarritmia es ventricular o supraventricular. Cuando hay errores en la discriminación, administran terapias en forma inadecuada con consecuencias negativas en la calidad de vida y la vida útil de la batería. Metodología: El objetivo de este estudio es conocer la prevalencia de terapias inadecuadas en los pacientes portadores de cardiodesfibriladores implantables que se han controlado en la clínica de arritmias de nuestro centro en el período junio-2002 a julio-2004. Se interrogó por telemetría a todos los pacientes y se estableció si la terapia administrada por el dispositivo era adecuada en base a los electrogramas almacenados. Resultados: Se registraron 99 eventos almacenados en 16 pacientes. El número total de visitas a la clínica de marcapasos fue 33 (2.05 visitas/paciente). De los 99 eventos registrados, se consideró 22 como inadecuados (22.22%); si se excluye del análisis a un paciente con displasia arritmogénica del ventrículo derecho que tuvo 64 eventos adecuados el mismo día y otro con 17 cardioversiones el mismo día debidas a fibrilación atrial aguda, se obtiene una prevalencia de terapias inadecuadas del 45.45%. Conclusión: La prevalencia de terapias inadecuadas es relativamente frecuente y la más común en esta serie fue la fibrilación atrial interpretada como fibrilación ventricular debidas a errores en la discriminación.

Introduction: Implantable cardiodesfibrillators are indicated in patients with history of cardiorespiratory arrest and/or ventricular tachycardia/ventricular fibrillation. Therapies delivered by these devices includes antitachycardia pacing, cardioversion and defibrillation and there are mathematical algorithms to discriminate if an arrhythmia diagnosed is of ventricular or supraventricular origin. Because of mistakes during interpretation these devices can deliver inadequate therapies with negative consequences in quality of life and battery’s lifespan. Methods: The main objective of this study is to evaluate prevalence of inadequate therapies in patients with implanted defibrillators who were follow-up in the arrhythmia department of our hospital since june-2002 to july-2004. All devices were interrogated by telemetry and arrhythmic events were evaluated by mean of stored electrograms, assessing if delivered therapy was adequate or not. Results: There were 99 arrhythmic events stored in 16 patients. The total number of visits to the arrhythmia department were 33 (2.05 visits/patient). From 99 stored events, 22 were considered as inadequate (22.22%); excluding one patient with arrhythmogenic right ventricular dysplasia who had 64 adequately treated episodes on the same day and another one with 17 cardioversions the same day due to acute atrial fibrillation, prevalence of inadequate therapies was 45.45%. Conclusion: Prevalence of inadequate therapies is relatively frequent and the most common in this serie is atrial fibrillation interpreted as ventricular fibrillation due to misdiagnosis.

 Cardiodesfibriladores Terapias Inadecuadas Cardiodesfibrillators Inadecuate Therapies Gregoratos G Abrams J Epstein AE ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committee to update the 1998 practice guidelines) Circulation 2002 106 The Antiarrhythmic Versus Implantable Defibrilllator (AVID)investigators: A comparision of Antiarrhythmic-drug Therapy with Implantable Defibrillators in patients Resuscitated from Near-fatal Ventricular Arrhythmias N Engl J Med 1997 337 Kuck KH Cappato R Siebels J Randomized comparision of antiarrhythmic drug therapy with implantable defibrillators in patients resucitated from cardiac arrest: The cardiac arrest study Hamburg (CASH) Circulation 2000 102 Moss AJ Hall WJ Cannomm DS Improved survival with an implanted defibrillator in patients with coronary disease at high risk of ventricular arrhythmia (for the multicenter automatic defibrillator implantation trial investigators) N Engl J Med 1996 335 Buxton AE Lee KL Fisher JD A randomized study of the prevention of sudden death in patients with coronary artery disease: Multicenter unsustained tachycardia trial N Engl J Med 1999 341 Moss AJ Zareba W Hall WJ Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction N Engl J Med 2002 346 Brenan FJ Ethical Issues with Implantable defibrillators (editorial) Pacing and Clin Electrophys 2004 27 Esquivel L Gutiérrez O Terapia eléctrica de las arritmias cardiacas Acta Médica costarricense 2004 1 Gutiérrez O Araya V Manual de arritmias cardiacas: Guía diagnóstica y terapéutica Manual de arritmias cardiacas: Guía diagnóstica y terapéutica 2002 San José Editorial de la Universidad de Costa Rica Aliot E Nitzsche R Ripart A Arrhythmia detection by dual-chamber implantable cardioverter defibrillators: A review of current algorithms Europace 2004 6 Grimm W Flores BF Marchlinski FE Electrocardiographically documented unnecessary, spontaneous shocks in 241 patients with implantable cardioverter defibrillators Pacing Clin Electrophysiol 1992 15 Goldberger JJ Horvath G Challapalli R Kadish AH Inappropriate implantable cardioverter-defibrillator therapy due to the detection of premature ventricular complexes Pacing Clin Electrophysiol 1999 22 Weber M Block M Brunn J Bansch D Bocker D Hammel D Gietzen F Breithardt G Inadequate therapies with implantable cardioverter- defibrillators: incidence, etiology, predictive factors and preventive strategies Z Kardiol 1996 85 Nanthakumar K Dorian P Paquette M Greene M Edwards J Heng D Noble J Newman D Is inappropriate implantable defibrillator shock therapy predictable? Interv Card Electrophysiol 2003 8 Gradaus R Block M Brachmann J Breithardt G Huber HG Jung W Kranig W Mletzko RU Schoels W Seidl K Senges J Siebels J Steinbeck G Stellbrink C Andersen D German EURID Registry. Mortality, morbidity, and complications in 3344 patients with implantable cardioverter defibrillators: results from the German ICD Registry EURID Pacing Clin Electrophysiol 2003 26 Karanam S John RM Inappropriate sensing of pectoral myopotentials by an implantable cardioverter defibrillator system Pacing Clin Electrophysiol 2004 27 Washizuka T Chinushi M Kasai H Watanabe H Tagawa M Hosaka Y Abe A Aizawa Y Inappropriate discharges from an intravenous implantable cardioverter defibrillator due to T-wave oversensing Jpn Circ J 2001 65 Tiroke A Ganeeva ON Syrkin AL Unmotivated malfunction of implanted cardioverter-defibrillator and ways of its correction Klin Med (Mosk) 2003 81 Zaim S Sunthorn H Adatte JJ Kursteiner K Burgener D Huehn C Inappropriate high-rate ventricular pacing in a patient with a defibrillator Europace 2002 4 Healy E Ngarmukos T Rosenthal L A case of bad timing: inappropriate implantable cardioverter defibrillator therapy due to a critically placed premature ventricular contraction Pacing Clin Electrophysiol 2002 25 Goldberger JJ Horvath G Challapalli R Kadish AH Inappropriate implantable cardioverter-defibrillator therapy due to the detection of premature ventricular complexes Pacing Clin Electrophysiol 1999 22 Mela T Ngarmukos T Rosenthal L Mittleman R Inappropriate ICD therapy due to lead-related noise in an active fixation ICD lead J Invasive Cardiol 2001 13 Srivathsan K Bazzell JL Lee RW Biventricular implantable cardioverter defibrillator and inappropriate shocks J Cardiovasc Electrophysiol 2003 14 Boriani G Biffi M Frabetti L Parlapiano M Galli R Branzi A Magnani B Cardioverter-defibrillator oversensing due to double counting of ventricular tachycardia electrograms Int J Cardiol 1998 66 Kuhlkamp V Dornberger V Mermi J Mewis C Seipel L Shock-induced, but not terminated ventricular tachycardia in a patient with implantable defibrillator Z Kardiol 1996 85 Hunn RH Ashbaugh TJ Calderini M Anderson KP Multiple inappropriate shocks precipitated by interrogation of an implantable cardioverter defibrillator Pacing Clin Electrophysiol 1998 21 de Meester A Gilles PH ICD malfunction caused by excessive defibrillation charge time Pacing Clin Electrophysiol 2001 24 Coppess MA Miller JM Zipes DP Groh WJ Software error resulting in malfunction of an implantable cardioverter defibrillator J Cardiovasc Electrophysiol 1999 10 Healy E Goyal S Browning C Robotis D Ramaswamy K Rofino-Nadoworny K Rosenthal L Inappropriate ICD therapy due to proarrhythmic ICD shocks and hyperpolarization Pacing Clin Electrophysiol 2004 27 Schmitt C Montero M Melichercik J Significance of supraventricular tachyarrhythmias in patients with implanted pacing cardioverter defibrillators Pacing Clin Electrophysiol 1994 17 Brugada J Is inappropriate therapy a resolved issue with current implantable cardioverter defibrillators? Am J Cardiol 1999 83 Nanthakumar K Paquette M Newman D Deno DC Malden L Gunderson B Gilkerson J Greene M Heng D Dorian P Inappropriate therapy from atrial fibrillation and sinus tachycardia in automated implantable cardioverter defibrillators Am Heart J 2000 139 Stein KM Euler DE Mehra R Seidl K Slotwiner DJ Mittal S Markowitz SM Lerman BB Jewel AF Worldwide Investigators: Do atrial tachyarrhythmias beget ventricular tachyarrhythmias in defibrillator recipients? J Am Coll Cardiol 2002 40
S1409-414220040003 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422004000300004 Diagnóstico de la hipertrofia ventricular izquierda por electrocardiografía: Utilidad de los nuevos criterios Barrios Alonso Vivencio Calderón Montero Alberto ,Hospital Ramón y Cajal 09 2004 2004 6 13 19 The Seventh Report of Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure: The JNC 7 report JAMA 2003 289 Verdecchia P Schillacci G Borgioni C Ciucci A Gattobigio R Zampi I Prognostic significance of serial changes in left ventricular mass in essential hypertension Circulation 1998 97 Germain P Roul G Kastler B Mossard JM Bareiss P Sacrez A Inter-study variability in left ventricular mass measurement: Comparision between M-mode echography and MRI Eur Heart J 1992 13 Bottini PB Carr AA Prisant LM Flickinger FW Allison JD Gottdiener JS Magnetic resonance imaging compared to echocardiography to asses left ventricular mass in the hypertensive patient Am J Hypertens 1995 8 Okin PM Devereux RB Nieminen MS Jern S Oikarinen L Viitasalo M Electrocardiographic strain pattern and prediction of cardiovascular morbidity and mortality in hypertensive patients Hipertensión 2004 44 Koren MJ Devereaux RB Casale PN Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension Ann Intern Med 1991 114 Gardin JM McClelland R Kitzman D Lima JA Bommer W Klopfenstein HS M-mode echocardiography predictors of six-to-seven year incidence of coronary heart disease, stroke, congestive heart failure an mortality in an elderly cohort (the Cardiovascular Health Study) Am J Cardiol 2001 87 Di Tullio MR Zwas DR Secco RL Sciacca RR Homma S Left ventricular mass and geometry and the risk of ischemic stroke Stroke 2003 34 Verdecchia P Schillacci G Borgioni C Ciucci A Gattobigio R Zampi I Prognostic value of left ventricular mass and geometry in systemic hypertension with left ventricular hypertrophy Am J Cardiol 1996 78 Franklin SS Khan SA Wong ND Larson MG Levy D Is pulse pressure useful in predicting risk for coronary heart disease?: The Framingham Heart Study Circulation 1999 100 Barrios V Campuzano R Utilidad de los antagonistas de los receptores de angotensina II en la insuficiencia cardiaca Rev Clin Esp 2003 203 Ciaroni S Cuenoud L Bloch A Clinical study to investigate the predictive parameters for the onset of atrial fibrillation in patients with essential hypertension Am Heart J 2000 139 Haider AW Larson MG Benjamin EJ Levy D Increased left ventricular mass and hypertrophy are associated with increased risk for sudden death J Am Coll Cardiol 1998 32 Saadeh AM Evans SJ James MA Jones JV QTs dispersion and complex ventricular arrhythmias in untreated newly presenting hypertensive patients J Hum Hypertens 1999 13 Sokolow M Lyon TP The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads Am Heart J 1949 37 Casale PN Devereaux RB Alonso DR Campo E Kliegfield P Improved sex-specific criteria of left ventricular hypertrophy for clinical and computer interpretation of electrocardiograms: validation with autopsy findings Circulation 1987 75 Koiti H Spodick DH Accuracy of the R6: R5 voltage ratio for increased left ventricular mass Am J Cardiol 1988 62 Rodríguez Radial L Navarro A Sanchez J R6: R5 voltage ratio in systemic hypertension Am J Cardiol 1990 66 Verdecchia P Schillacci G Borgioni C Prognostic value of a new electrocardiographic method for diagnosis left ventricular hypertrophy in essential hypertension Am J Cardiol 1998 31 Wolf HK Burgraff GW Cuddy E Prediction of left ventricular mass from the electrocardiogram J Electrocardiol 1991 24 De Vries SO Essen WF Beltman FW Prediction of left ventricular mass from the electrocardiogram in systemic hypertension Am J Cardiol 1996 77 Romhilt DW Estes EH A point-score system for the ECG diagnosis of left ventricular hypertrophy Am Heart J 1968 75 Norman JE Levy D Adjustament of ECG left ventricular hypertrophy criteria for body mass index and age improves classification accuracy J of Electrocardiol 1991 29 Okin PM Roman MJ Devereaux RB ECG identification of left ventricular hypertrophy: Relationship of test performance to body habitus J of Electrocardiol 1996 29 ^ssuppl Levy D Labib SB Anderson KM Determinants of sensivity and specificity of electrocardiographic criteria for left ventricular hypertrophy Circulation 1990 81 Molloy TJ Okin PM Devereaux RB Kligfield P Electrocardiographic detection of left ventricular hypertrophy by the simple QRS voltage-duration product J Am Coll Cardiol 1992 20 Okin PM Roman MJ Devereaux RB Kligfield P Electrocardiographic identification of increased left ventricular mass by simple voltage-duration products J Am Coll Cardiol 1995 25 Dahlof B Devereaux RB Julius J Kjeldsen SE Beevers G de Fraire U Characteristics of 9194 patients with left ventricular hypertrophy: The LIFE Study Hypertension 1998 32 European Society of Hypertensión-European Society of Cardiology guidelines for the management of arterial hypertension J Hypertens 2003 20 03 21 Calderón A Barrios V The optimization of voltage-duration product criteria may improve the electrocardiographic diagnosis of left ventricular hypertrophy in hypertension J Hypertens 2004 22 ^s2 Calderón A Barrios V Detección de hipertrofia ventricular izquierda por ECG mediante el producto duración por voltaje: Validación por eco cardiografía Hipertensión 2003 20 Dahlof B Devereaux RB Julius J Kjeldsen SE Beepers G de Fraire U Cardiovascular morbidity and mortality in the Losartan Intervention for Endpoint reduction in hypertensión study (LIFE): a randomised trial against atenolol Lancet 2002 359 Okin PM Devereaux RB Julius J Kjeldsen SE Beepers G de Fraire U Regression of electrocardiographic left ventricular hypertrophy by losartan versus atenolol Circulation 2003 108 Okin PM Devereaux RB Julius J Kjeldsen SE Beepers G de Fraire U Regressión of electrocardiographic left ventricular hypertrophy during antihypertensive treatment and the prediction of mayor cardiovascular events Tervahauta M Pekkanen J Punsar S Nissinen A Resting electrocardiographic abnormalities as predictor of coronary events and total mortality among elderly men Am J Cardiol 1996 100 Larsen CT Dahlin J Blackburn H Scharling H Appleyard M Sigurd B Prevalence and prognosis of electrocardiographic left ventricular hypertrophy, ST segment depressión and negative T-wave: The Copenhagen City Heart Study Eur Heart J 2002 23 Schillacci G Pirro M Pasqualini L Vaudo G Ronti T Gemelli F Prognostic significance of isolated, non-specific left ventricular repolaritation abnormalities in hypertension J Hypertens 2004 22
S1409-414220040003 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422004000300005 El Laboratorio Vascular Periférico: requisitos y Conceptos Básicos Ciancaglini Carlos ,Instituto Modelo de Cardiología, Córdoba Córdoba Argentina 09 2004 2004 6 21 30 Hatle L Angelsen B Doppler Ultrasound in Cardiology Doppler Ultrasound in Cardiology 1985 Segunda Philadelphia Lea and Febiger Zwiebel W Introduction to Vascular Ultrasonography Introduction to Vascular Ultrasonography 2000 Fourth Philadelphia Saunders Company Bernstein E Noninvasive Diagnostic Techniques in Vascular Disease Noninvasive Diagnostic Techniques in Vascular Disease 1990 Missouri The C.V. Mosby Co. , St. Louis Polak J Peripheral Vascular Sonography Peripheral Vascular Sonography 1991 Philadelphia Williams and Wilkins
S1409-414220040003 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422004000300006 Síndromes Coronarios Agudos Evaluación del Riesgo Oculto Iglesias Ricardo José Lescano Adrián ,FACC ,Departamento Cardiovascular Argentina 09 2004 2004 6 31 36 Long-term low-molecular-mass heparin in unstable coronary-artery disease: FRISC II prospective randomised multicentre study Lancet 1999 354 Chierchia S Conferencia especial del XXXVI congrerso nacional de la sociedad española de cardiología Rev Esp Cardiol 2001 54 Malek AM Alper SL Izunmo S Hemodynamic shear stress and its role in atherosclerosis JAMA 1999 282 Stefanadis C Toutouzas K Tsiamis E Stratos C Vavuranakis M Kallikazaros I Plaque temperature after percutaneous intervention JACC 2001 37 Chesebro JH Fuster V Plaque disrupt and thrombosis in unstable angina pectoris Am J Cardiol 1991 68 Kaartinen M Van der Wal A Mast cell infiltration in acute coronary syndrome: implications for plaque rupture J Am Coll Cardiol 1998 32 Antman EM Cohen M Bernink PJL McCabe CH Braunwald E The TIMI Risk score for unstable angina/Non-ST elevation MI JAMA 2000 284 guideline update for the management of patients wtih unstable angina and non-ST-segment elevation myocardial infarction Circulation 2002 20 02 Lindahl B Toss H Siegbahn A Venge P Wallentin L Markes of myocardial damage and inflammation in relation to long-term mortality in unstable coronary artery disease N Engl J Med 2000 343 Galvani M Ottani F Ferrini D Ladenson J Destro A Jaffe A Prognostic influence of elevated values of cardiac troponin I in patients with unstable angina Circulation 1997 95 Castillo JA Florenciano R Molina E Egea S Prueba de esfuerzo de bajo riesgo en pacientes con angina inestable: ¿Implica un pronóstico favorable? Rev Esp Cardiol 2000 53 Braunwald E Jones RH Brown J Cheitlin MD Diagnosis and managing unstable angina Circulation 1994 90 Florenciano-Sánchez R Castillo-Moreno JA Molina-Laborda E Jiménez-Pascual J García-Urriticoechea P Egea-Beneyto S The exercise test that indicates a low risk of events J Am Coll Cardiol 2001 38 Saltzman AJ Waxman S Angioscopy and ischemic heart disease Curr Opin Cardiol 2002 17 Rioufol G Finet G Ginon I Multiple atherosclerotic plaque rupture in acute coronary syndrome: a three-vessel intravascular ultrasound study Circulation 2002 106 Stone PH A multifaceted search for the presence of high-risk, vulnerable plaque Current Opinion in Cardiology 2002 17 Toss H Lindahl B Siegbahn A Wallentin L for the FRISC Study Group. Prognostic influence of increased fibrinogen and C-Reactive protein levels in unstable coronary artery disease Circulation 1997 96 Thomson S Kienast J Pyke S Haverkate F Van de Loo J Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris N Engl J Med 1995 332 Liuzzo G Biasucci LM Gallimore JR Grillo RL Rebuzzi AG Pepys MB Maseri A The prognostic value of C-reactive protein and serum amyloid A protein in severe unstable angina N Engl J Med 1994 331 Libby P Ridker PM Maseri A Inflammation and atherosclerosis Circulation 2002 105 Koening W Sund M Doring A C reactive protein, a sensitive marker of inflammation, predicts future risk of coronary disease in initially healthy middle-aged men: results from the MONICA, 1984-1992 Circulation 1999 99 Ridker PM Buring JE Prospective study of C-reactive protein and the risk of future cardiovascular events among apparently healthy women Circulation 1998 97 Koenig W Lowel H Baumert J Meisinger C C-reactive Protein modulates risk prediction based on the Framingham Score: implications for future risk assessment Circulation 2004 109 Pearson TA Mensah GA Cannon RO III Markers of inflammation and cardiovascular disease: application to clinical and public health practice: AHA/CDC Circulation 2003 107 Iluso G Biasucci LM Gallimore JR Enhacend inflammatory response in patients with pre-infarction unstable angina J Am Coll Cardiol 1999 34 Ferreirós ER Boissonnet CP Pizarro R García Merletti PF Cagide A Bazzino O Independent prognostic value of elevated C-reactive protein in unstable angina Circulation 1999 100 Bertil Lindahl Henrik T Agneta S Per Venge M Wallentin Lars for the FRISC Study Group. Markers of myocardial damage and inflammation in relation to long-term mortality in unstable coronary artery disease N Engl J Med 2000 343 Morrow DA Rifai N Animan EM Cannon CP C-reactive Protein is a potent predictor of mortality independently: TIMI 11 A substudy J Am Coll Cardiol 1998 31 Sanchos J Boda V Insa Relación de los valores de PCR con los hallazgos angiográficos y los marcadores de necrosis en el síndrome coronario agudo sin elevación del segmento ST Rev Esp Cardiol 2004 57 Danesh J Whincup P Walker M Lennon L Thomson A Appleby P Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses BMJ 2000 321 Biasucci LM Liuzzo G Bufón Elevated levels of C-Reactive Proteina discharge in patients with unstable angina predict recurrent instabity Circulation 1999 99 Angiolillo DJ Biasucci LM Liuzo G Crea F La inflamación en los síndromes coronarios agudos: mecanismos e implicaciones clínicas Rev Esp Cardiol 2004 57 5 Libby P Molecular bases of tha acute coronary syndrome Circulation 1995 91 Seta Y Kanda T Tanaka T Interleukin 18 in acute myocardial infarction Heart 2000 84 Blankenberg S Tiret L Bickel C Peetz D Cambien F Meyer J Rupprecht HJ for the AtheroGene Investigators. Interleukin-18 is a strong predictor of cardiovascular death in stable and unstable angina Circulation 2002 106 Ridker PM Hennekens CH Allen J Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men Circulation 2000 101 Ridker PM Hennekens CH Roitman-Johnson B Stampfer MJ Allen J Plasma concentration of soluble intercellular adhesion molecule 1 and risks of future myocardial inferction in apparently healthy men Lancet 1998 351 Aukrust P Müller F Ueland T Berget T Aaser E Brunsvig A Enhanced levels of soluble and menbrane-bound CD 40 ligand in patients with unstable angina Circulation 1999100 Heeschen C Dimmeler S for the CAPTURE Study Investigators: Soluble CD40 Ligand in Acute Coronary Syndromes N Engl Med 2003 348 Barnes PJ Karin M Nuclear factor-6B-A pivotal transcription factor in chronic inflammatory diseases N Eng J Med 1997 336 García-Moll X Coccolo F Cole D Kaski JC Serum neopterin and complex stenosis morphology in patients with unstable angina J Am Coll Cardiol 2000 35 Kovanen PT Manttari M Palosuo T Prediction of myocardial infarction in dyslipidemic men by elevated leveles of immunoglobulin classes A, E and G, but no M Arch Intern Med 1998 158 Laguens RP Vigliano CA Macchia A Argel MI Chambó JG Gurfinkel EP Buenos Aires, Argentina Am Heart J 2001 141 Stein BC Levin RI Natriuretic peptides: Physiology, therapeutic potential and risk stratification in ischemic heart disease Am heart J 1998 135 Kikuta K Yasue H Yoshimura M Incresead plasma levels of B-type natriuretic peptide in patients with unstable angina Am Heart J 1996 132 Morrow DA Cannon CP Braunwald E Evaluation of B-type natriuretic peptide for risk assessment in instable angina/non-ST-elevation myocardial infarction (TACTICS-TIMI 18) J Am Coll Cardiol 2003 41 De Lemos JA Morrow DA Bentley JH Omland T Sabatine MS Braunwald The prognostic value of B-type natriuretic peptide in patients with acute coronary syndromes N Engl J Med 2001 345 Ridker PM Rifai N Pfeffer MA Sacks F Braunwald E Long-term effects of pravastatin on plasma concentration of C- reactive protein: The Cholesterol And Recurrent Events (CARE) investigators Circulation 1999 100 Cannon CP Braunwald E Skenen AM Comparison of intensive and moderate lipid lowering with statins after acute coronary syndrome (PROVET IT-TIMI 22) N Engl Med 2004 The Clopidogrel in Unstable Angina to prevent Recurrent Events trial investigador: Effects of clopidogrel in addition aspirin in patients with acute coronary syndromes without ST- Segment elevation N Engl J Med 2001 345 Cohen M Demers C Gurfinkel E A comparison of low molecular weight heparin with unfractioned heparin for unstable coronary artery disease: For the efficacy and safety of subcutaneus enoxaparin in Non-Q-wave coronary events study group N Engl J Med 1997 337 Effecto of glycoprotein IIb/IIIa receptor blocker abciximab on outcome in patients with acute coronary syndromes without early coronary revascularization; the GUSTO IV-ACS randomised trial Lancet 2001 357 Piegas LS Yusuf S for the OASIS registry investigators: The organization to assess strategies for ischemic syndrome. Registry in patients with unstable angina Am J Cardiol 1999 84 Inhibition of the platelet glycoprotein IIb/IIIa receptor with tirofiban in unstable angina and non-Q-wave myocardial infarction N Engl J Med 1998 338 Fox KA Poole-Wilson PA Pocock for the randomizend intervention trial of unstable angina (RITA) investigators: Interventional versus conservative treatment for patients with unstable angina or non ST-elevation myocardial infarction Lancet 2002 360 Cannon CP Frey MI Braunwald E the TACTIS- thrombolysis in myocardial infarction 18 investigators: Comparison of early invasive and conservative strategies in patients with the glycoprotein IIb/IIIa inhibitor tirofiban N Engl J Med 2001 1344 Animan EM McCabe CH Braunwald E Enoxaparin prevent death and cardiac ischemic events in instable angina/non-Q-wave myocardial infarction: Results of the thrombolysis in myocardial infarction (TIMI) 11B trial Circulation 1999 100 Boden W O ´Rourke R Crawford M for the VANQWISH trial investigators: Outcomes in patients with acute non-Q-wave myocardial infarction randomly assigned to and invasive as compared with as conservative management strategy for the VANQWISH trial investigators: Outcomes in patients with acute non-Q-wave myocardial infarction randomly assigned to and invasive as compared with as conservative management strategy
S1409-414220040003 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422004000300007 Protocolo de manejo cardiovascular en el Síndrome de Marfán Mas Romero Carlos Iturrino Monge Roberto ,C.C.S.S. Hospital Nacional de Niños Dr. Carlos Sáenz Herrera ,C.C.S.S. Hospital Nacional de Niños Dr. Carlos Sáenz Herrera San José 09 2004 2004 6 39 42 Health Supervision for Children with Marfan Syndrome Pediatrics 1996 5 Dean JC Management of Marfan Syndrome Heart 2002 88 Webb GD David TE Marfan Syndrome: A cardiovascular perspective Marfan Syndrome: A cardiovascular perspective 2003 Shores J Berger KR Murphy EA Pyeritz RE Progression of aortic dilatation and the benefit of long term beta adrenergic blockade in Marfan ’s Syndrome N Engl J Med 1994 330 Rossi-Foulkes R Roman MJ Rosen SE Phenotypic Features and Impact of Beta Blocker or Calcium Antagonist Therapy on Aortic Lumen Size in the Marfan Syndrome Am J Cardiol 1999 83 Ríos AS Silber EN Bavishi N Effect of Long Term Beta Blockade on Aortic Root Compliance in Patients With Marfan Syndrome Am Heart J 1999 137 Kornbluth M Schnittger I Eyngorina I Clinical Outcome in the Marfan Syndrome With Ascending Aortic Dilatation Followed Anually by Echocardiography Am J Cardiol 1999 84 Roman MJ Rosen SE Kramer-Fox R Devereux RB Prognostic significance of the pattern of aortic root dilatation in the Marfan syndrome J Am Coll Cardiol 1993 22 Yetman AT Bornemeir RA McCrindle BW Long Term Outcome in Patients with Marfan Syndrome: Is Aortic Dissection the Only Cause of Sudden Death? J Am Coll Cardiol 2003 41
S1409-414220040003 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422004000300008 Trauma Cardíaco: Una revisión práctica. I parte: Traumatismo No Penetrante Méndez J Edgar A Zamora L José F. Zeledón S Fernando Zamora R Fernando ,C.C.S.S. Hospital México San José Cosa Rica ,C.C.S.S. Hospital México ,C.C.S.S. Hospital México San José Cosa Rica ,C.C.S.S. Hospital México San José Cosa Rica 09 2004 2004 6 43 48 Pretre R Chilcott M Blunt trauma to the heart and great vessels N. Engl. J. Med 1997 336 Feghali NT Prisant LM Blunt miocardial injury Chest 1995 108 Parmley L. F Non penetrating traumatic injury of the Heat Circulation 1958 18 Moore EE Malangoni MA Organ injury scaling J. Trauma 1994 36 Lancey RA Monahan TS Correlation of clinical characteristics and outcomes with injury scoring in blunt cardiac trauma J Trauma 2003 54 Moore EE Cogbill TH Organ injury scaling Surg Clin North Am 75 Glock Y Cardiac damage in non penetrating chest injuries J. Cardiovascular surg 1989 30 Rothstein RJ Miocardial contusion J.A.M.A 1983 205 Snow N Richardson JD Miocardial contusion: implications for pacients with múltiple traumatic injuries Surgery 1982 92 Tenzer ML The spectrum of miocardial contusion: a review J. Trauma 1985 25 Baxter BT Moore EE Graded experimental miocardial contusion: impact on cardiac rhythm, coronary artery flow, ventricular function, and miocardial oxigen consumption J. Trauma 1998 28 Liedtke AJ DeMuth WE Non penetrating cardiac injuries: a collective review Am. Heart J 1973 86 DiMarco RF Layton TR Blunt traumatic rupture of the rigth atrium and teh rigth superior pulmonary vein J Trauma 1983 23 Marek A Rey JL Myocardial infarction caused by closed thoracic injury: pathogenic and angiocoronarographic aspects Ann Cardiol Angiol 1991 40 Biffl WL Moore FA Cardiac encimes and irrelevant in the patient with suspected miocardial contusion Am. J. Surg 1994 168 Malangoni MA McHenry CR Outcome of serious blunt cardiac injury Surgery 1994 116 Évora P Ribeiro P Late surgical repair of ventricular septal defect due to nonpenetrating chest trauma: review and report of two contrasting cases J Trauma 1985 25 Clements RH Fisher PJ Blunt injury of the intrapericardial great vessels J. Trauma 2001 50 Zakynthinos EG Vassilakopoulos T Early and late onset atrioventricular valve rupture after blunt chest trauma: the usefulness of transesophageal echocardiography J Trauma 2002 52 Lindstaedt M Germing A Acute and long term clinical significace of miocardial contusion following blunt thoracic trauma: results of a prospective study 2002 52 Pretre R Bendarkiewicz M Blunt cardiac injury: in achieving a practical diagnostic classification J. Trauma 1994 36 Collins JN Cole FJ The usefulness of serum troponin levels in evaluating cardiac injury The American Surgeon 2001 67821-5 Velmahos GC Karaiskakis M Normal electrocardiography and serum troponin I levels preclude the presence of clinically significant blunt cardiac injury J Trauma 2003 54 Sybrandy KC Cramer MJM Diagnosing cardiac contusion: old wisdom and new insights Heart 2003 89 van Wijngaarden MH Karmy-Jones R Blunt cardiac injury: a 10 year institutional review Injury 1997 28 Pontillo D Capezzuto A Bifasicular block complicating blunt cardiac injury: a case report an review of the literature Angiology 1994 45 Tenzer ML The spectrum of miocardial contusion: a review J. Trauma 1985 25 Braunwald E Heart Disease Heart Disease 1988 3th Philadelphia W. B. Saunders Timberlake GA McSwain NE Thromboembolism as a complication of miocardial contusion: a new capricious síndrome J. Trauma 1988 28 Shyu M.Y Lee AY Right atrial and ventricular thrombi after blunt chest trauma J. Trauma 2002 52 Link MS Ginsburg SH. Commotio cordis: cardivascular manifestations of a rare survivor Chest 1998 114 Arajavi E Santavirta S Chest injuries sustained in severe traffic accidents by seatbelt wearers J. Trauma 1989 29 Carrillo EH Schirmer TP Blunt hemopericardium detected by surgeon performed sonography J. Trauma 2000 48 Brown J Grover FL Trauma to the heart Chest Surg Clin North Am 1997 7 Mangram A Kozar RA Blunt cardiac injuries that require intervention: an unsuspected injury J. Trauma 2003 54 Baumgartel ED Cardiac rupture from blunt trauma with atrial septal defect Arch Surg 1992 127 May AK Patterson MA Combined blunt cardiac and pericardial rupture: review of the literature and report of a new diagnosis algorithm Am Surg 1999 65 Perchinsky MJ Ling WB Blunt cardiac rupture: the Emanuel Trauma Center experience Arch Surg 1995 130 Pevec WC Udekwu AO Blunt rupture of the miocardio Ann Thorac Surg 1989 48 Hendel PN Grant AF Blunt traumatic rupture of the heart: a successful repair of simultaneous rupture of the right atrium and left ventricule J Thorac Cardiovasc Surg 1981 81 Mattox KL Moore EE Trauma Trauma 2000 4th Texas McGraw -Gill Pretre R Faidutti B Surgical management of aortic valve injury after nonpenetranting trauma Ann Thorac Surg 1993 56 Mazzucco A Rizzoli G Acute mitral regurgitation after blunt chest trauma Arch Intern Med 1983 143 Cuadros CL Hutchinson JE Laceration of a mitral papillary review of the literature J Thorac Cardiovasc Surg 1984 88 Kirklin JW Barratt-Boyes BG Cardiac Surgery Cardiac Surgery 1992 Second New York Churchill Livingstone Aris A Delgado LJ Múltiple intracardiac lesions after blunt chest trauma Ann Thorac Surg 2000 70 Girardi L Isom OW Repair of traumatic aortic valve disruption and descending aortic transection Ann Thorac Surg 2000 69 Pretre R Kursteiner K Traumatic occlusion of the left anterior descending artery and rupture of the aortic isthmus J Trauma 1995 39 Ginzburg E Dygert J Coronary artery stenting for occlusive dissection after blunt chest trauma J Trauma Lowe JE Adams DH The natural history and recommend management of patients with traumatic coronary artery fistulas Ann Thorac Surg 1983 36 Rezulli A Wren C Coronary artery -left ventricular fistula and múltiple ventricular septal defect due to blunt chest trauma Thorax 1989 44 Fulda G Blunt traumatic rupture of the heart and pericardium: A ten year experience J. Trauma 1991 31 Janson JT Harris DG Pericardial rupture and cardiac herniation after blunt chest trauma Ann Thorac Surg 2003 75 Borrie J Lichter I Pericardial rupture from blunt chest trauma Thorax 1974 29 Mattila S Silvola H Traumatic rupture of the pericardium with luxation of the heart: case report and review of the literature J Thorac Cardiovasc Surg 1975 70 Lee J Miren A Blunt pericardial rupture with cardiac heniation: Unusual radiographics findings J Trauma 2004 56 Thomas P Saux P Diagnosis by video assisted thoracoscopy of traumatic pericardial rupture with delayed luxation of the heat: case report J Trauma 1995 38 Watkins BM Buckley DC Delayed presentation of pericardial rupture with luxation of the heart following blunt trauma: a case report J Trauma 1995 38 Eungle M.A.J Cardiovascular Med 1984 4
S1409-414220040003 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422004000300009 Angiosarcoma de arteria pulmonar con infiltración del tracto de salida del ventrículo derecho Toledo Ignacio Sprok José Solís Agustín Cai Daniel ,Medicina Interna ,Caja Costarricense de Seguro Social Hospital San Juan de Dios San José Costa Rica ,Caja Costarricense de Seguro Social Hospital Max Peralta Cartago Costa Rica 09 2004 2004 6 49 53

Se presenta el caso clínico de un paciente joven admitido por disnea, dolor torácico y dilatación de cámaras derechas e insuficiencia tricuspídea en el ecocardiograma transtorácico. Se documenta mediante ecocardiografía transesofágica masa en tracto de salida del ventrículo derecho.

We present a clinical case about a young patient admitted with dysnea, chest pain and tricuspid regurgitation with right ventricle pressure over 70 mmHg and secondary right chambers enlargement in a transtoracic echocardiogram. An obstructive right ventricle outflow tract mass in the transoesophageal echocardiogram was documented.

 tumores cardíacos masas cardíacas sarcomas cardíacos cardiac tumors cardiac masses cardiac sarcomas El libro de medicina cardiovascular, Eugene Braunwald; Douglas Zipes and Meter Libby. Capitulo 49: Tumores primarios del corazón El libro de medicina cardiovascular, Eugene Braunwald; Douglas Zipes and Meter Libby. Capitulo 49: Tumores primarios del corazón 2004 Editorial Marban Vargas Segura Jorge Radiología simple de silueta cardiovascular: Capítulo 6. Semiótica radiológica de la silueta cardiovascular Radiología simple de silueta cardiovascular: Capítulo 6. Semiótica radiológica de la silueta cardiovascular 2002 EDNASSS Carlos A Cubides S Salazar Gabriel Muñoz Alfonso Pedraza Jairo Hernández Edgar Martínez Jorge Tumores Cardíacos primarios Revista Colombiana de Cardiología 2003 20 03 10 8 Cipriano A Tumores cardíacos (I) Rev Esp Cardiol 1998 51 Cipriano A Tumores cardíacos (II) Rev Esp Cardiol 1998 51 Marelli Roberto Drago Adolfo Basso Gabriel Bravo Florencia Torrijos Roberto Gerones Carlos Tumores cardíacos primarios: aspectos clínicos y tratamiento Rev Fed Arg Cardiol 2002 31 Induni Eduardo Pucci Juan Soto Longino Tumores Intracardíacos Aspectos Generales y Experiencia Quirúrgica en el Hospital México Rev. Costarric. Cardiol 2002 4 1 Arrizaga N Tumores cardiacos y pericárdicos en el niño: Revisión de 16 años Rev Chil Ultrasonog 2003 6
S1409-414220040003 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422004000300010 Electrocardiograma del mes Araya Gómez Vivien ,Centro Cardiológico Integral 09 2004 2004 6 55 55