Djair Brindeiro Filho

Endomyocardial fibrosis in children.

We describe 10 children with endomyocardial fibrosis who underwent surgical treatment between 1978 and 1999. Seven were male and 3 female, with an age range from 4 to 15 years, having a mean age of 11 years. All were in the final stage of heart failure. Three had biventricular disease, 6 had involvement of the right ventricle alone, and one had endomyocardial fibrosis confined to the left ventricle. There were 3 deaths (30%) in the postoperative period due to low cardiac output. The 7 survivors were followed up for a period ranging from 12 to 168 months, with a mean of 72 months. Two late deaths have occurred resulting from heart failure and infectious endocarditis. Five (50%) children are still alive. Two required 3 reoperations for dysfunction of the inserted valvar prosthesis. One patient is in functional Class IV, and 4 are in Class II to III, despite intensive medical treatment. It is concluded that surgery for endomyocardial fibrosis is an essentially palliative procedure and, especially in children, the results of surgical treatment leave much to be desired.

Phonomechanocardiographic Findings in Endomyocardial Fibrosis

Endomyocardial fibrosis (EMF) is a severe restrictive cardiomyopathy charac terized by the formation of fibrous tissue on the endocardium and to a lesser extent in the myocardium of one or both ventricles. The disease results in endocardial rigidity, atrioventricular valve dysfunction and progressive obliteration of the ventricular cavity. The clinical and pathological findings of EMF have been well established and definitive diagnosis can be made by selective cineangiocardiography.1-5 However, there are few reports concerning the phonomechanocardiographic (PMCG) patterns in this condition. In this paper we describe the PMCG findings in 12 patients with EMF which is now recognized with increasing frequency in the Northeast of Brazil.

Right Ventricular Evaluation with Speckle Tracking Echocardiography in COPD after a Pulmonary Rehabilitation Program

DOI: 10.5935/abc.20180183 Chronic obstructive pulmonary disease (COPD) is a serious public health problem, and is often related to smoking.1 In advanced stages of COPD, the presence of PAH is a common development. PAH progression rate in COPD is usually slow (an increase of < 1 mmHg per year). However, the presence of even moderate PAH is a strong predictor of mortality.2 During stable periods of the disease, the increase in mean pulmonary artery pressure is usually mild to moderate. However, severe PAH may occasionally occur in COPD patients COPD.3