Nilda Espinola-Zavaleta - Academia.edu (original) (raw)
Papers by Nilda Espinola-Zavaleta
Archivos de cardiología de México, 2013
Revista Portuguesa De Pneumologia, Jan 6, 2008
Revista Portuguesa De Pneumologia, Jan 4, 2005
![Research paper thumbnail of [Uhl's anomaly. A case report with anatomoechocardiographic correlation]](https://attachments.academia-assets.com/120647051/thumbnails/1.jpg)
](PubMed, Dec 15, 2010
Uhl's anomaly is an uncommon malformation of the right ventricle, which is characterized by the a... more Uhl's anomaly is an uncommon malformation of the right ventricle, which is characterized by the absence of the myocardium in the right ventricular free wall, while the tricuspid and pulmonary valves are morphologically normal. The aim of this work was to present a clinical case of a patient with Uhl's anomaly, to describe the echocardiographic findings and to perform an anatomoechocardiographic correlation with a corresponding specimen. This is a case report of a 33 year old man with suspicion of atrial septal defect, who was in functional class II of the NYHA and presented signs of right ventricular failure. The echocardiogram showed dilation of the right cavities, the free wall of the right ventricle was thin and smooth, and the tricuspid and pulmonary valves were normal, which prompted the diagnosis of Uhl's anomaly. Also, an anatomoechocardiographic correlation was done with an equivalent specimen of the Embryology Department from the Instituto Nacional de Cardiologia Ignacio Chavez's collection. Conclusions: Uhl's anomaly is an extremely rare entity. The clinical findings and echocardiography are the main tools for its diagnosis. The anatomoechocardiographic correlation was precise and allowed a better understanding of this anomaly."
Revista española de cardiología, Mar 1, 2006
Archivos de cardiología de México
In hypoplastic right ventricle the dysplasia of the tricuspid valve (TV) has repercussions on the... more In hypoplastic right ventricle the dysplasia of the tricuspid valve (TV) has repercussions on the development of the right ventricle. This paper documents the results of an anatomopathologic and morphometric studies of the tricuspid valve and the right ventricle in 25 hearts with this cardiopathy, which were morphologically analyzed using the segmentary sequential system. The following measurements were made: the annulus of the tricuspid valve, the thickness of the walls of the right ventricle, the ventricular septum and the distances from the atrioventricular-apex (AV-A) and from the apex-pulmonary valve (A-PV). The values obtained were compared with those of normal hearts of equivalent ages; the morphologic features of the tricuspid valve and the right ventricle were described. The thickness of the anterior and posterior walls of righ ventricle was between 2 and 10 times greater than normal. The tickness of the ventricular septum was 1 to 3 times greater than normal and the anteri...
Clinics in oncology, Jan 9, 2019
Archivos de cardiología de México, Oct 1, 2016
Manejo conservador de seroma periaórtico en recoartación de aorta. Reporte de un caso y revisión ... more Manejo conservador de seroma periaórtico en recoartación de aorta. Reporte de un caso y revisión de la literatura Conservative management of periaortic seroma in recoarctation of the aorta. Case report and literature review Presentación del caso
Clinical Research and Trials, 2021
Background: Carotid atherosclerotic disease is a chronic inflammatory disorder that produces an i... more Background: Carotid atherosclerotic disease is a chronic inflammatory disorder that produces an intrinsic immune response and promotes the formation of plaque in the vascular endothelium, leading to clinical outcomes. Aim: To assess the presence of inflammation in patients with carotid atherosclerosis and calcified aortic valve disease (AVD) based on serum markers, endothelial function and carotid intima-media thickness (CIMT). Method: This is a cohort observational study. Patients with clinical suspicion of AVD were assessed by echocardiography and vascular ultrasound for measuring the endothelial function and carotid arteries plaque. Blood samples were taken for determination of inflammatory markers. A multivariate analysis was used to determine the most important variable for determine carotid artery disease (CAD) in patients with AVD. Results: Seventy-two patients with a mean age of 62 ± 11.94 years were included. Forty six percent were men. Forty percent of them had CAD. The patients with CAD were older (p=0.001), had more percentage of systemic hypertension (p=0.049) and coronary calcium score> 400 HU (p=0.045). Multivariate analysis showed that the strongest predictor of CAD in patients with calcified AVD was age greater than 65 years; Beta 3.57, p= 0.001. In this prediction, area under curve was 0.728 (CI95% 0.612-0.844), p=0.006. Conclusions: In patients with AVD the best predictive marker for CAD was the age over 65 years, which is associated with the appearance of carotid atherosclerotic plaques.
Journal of Cardiology & Cardiovascular Therapy, 2017
Archivos de cardiolog�a de M�xico (English ed. Internet)
International Journal of Cardiovascular Sciences
Coronary artery disease (CAD) and ischemic heart disease (IHD) are often indistinctly used terms.... more Coronary artery disease (CAD) and ischemic heart disease (IHD) are often indistinctly used terms. Both combined have generated, over the past years, concerns about sex disparities in their presentation. From an epidemiological perspective, females have several disadvantages regarding the prevention, diagnosis, and treatment of CAD. Most of the general cardiovascular risk factors affect women more frequently, or with a higher morbidity and mortality association. Besides, atypical manifestations of the disease and uncommon forms of CAD represent a diagnostic challenge for clinicians. Even if current treatments for CAD have no apparent sex bias, women representation in clinical trials and treatment patterns analyzed in clinical practice refuse this statement. Several disparities are caused by inevitable sex-particularities, but many of them are more social, cultural, and dogmatic beliefs that have to be addressed and overhaul. Epidemiology CAD affects around 1.72% of the population worldwide, meaning that almost 2 in 100 people will
Journal of Nuclear Cardiology, Apr 25, 2023
Asploro Journal of Biomedical and Clinical Case Reports
Kommerell diverticulums are an uncommon congenital vascular disease involving an aberrant origin ... more Kommerell diverticulums are an uncommon congenital vascular disease involving an aberrant origin of the right or left subclavian artery and a dilation of its root. Here, we present the case of a 44-year-old woman with a relapse of a surgically repaired aberrant subclavian artery with a Kommerell diverticulum.
Archivos de Cardiología de México
Journal of Nuclear Cardiology
Left atrium myxomas are the most frequent heart tumors. Assessment of this phenomenon is largely ... more Left atrium myxomas are the most frequent heart tumors. Assessment of this phenomenon is largely echocardiographic, since both TTE and TEE provide information on size, shape, and hemodynamic consequences of the tumor. In this publication, we bring forward the similarities between morphological assessment through transillumination echocardiography and pathologic anatomy, highlighting a possible study field for the future.
Arquivos Brasileiros de Cardiologia
World Journal of Cardiovascular Diseases
Journal of Nuclear Cardiology, 2021
64-year-old man with history of type 2 diabetes, dyslipidemia, smoking, chronic coronary syndrome... more 64-year-old man with history of type 2 diabetes, dyslipidemia, smoking, chronic coronary syndrome, and coronary artery bypass grafts came to our hospital. He has referred angina that been progressing over three months. The patient underwent dipyridamole stress and rest Tc-sestamibi myocardial perfusion imaging (MPI). Basal ECG showed q waves in the inferior and lateral leads due to prior myocardial infarction. His baseline blood pressure was 110/60 mmHg, so the dipyridamole was started at .56 lg/kg in 4, 7 minutes later he presented a paradoxical hypertensive response with an increase in blood pressure to 160/90 mmHg associated with an intense chest pain and downslope ST depression in 8 leads and ST elevation in aVR and V1, Figure 1. After intravenous aminophylline, oxygen with FiO2 at 24% and sublingual nitroglycerin, the ST-segment normalized and the chest pain disappeared. Stress MPI showed non-transmural infarction with severe ischemia in right coronary artery (RCA) territory, left ventricular transient ischemic dilatation, and fall of poststress ejection fraction more than 5%, Figure 2. The coronary angiogram showed a 60% obstruction of the left main coronary artery (LMCA). LAD artery had diffused non-obstructive atheromatosis and circumflex total proximal occlusion. The RCA had lesions in the proximal, middle, and distal thirds of 50%, 50%, and 70%, respectively. The grafts were patent. Percutaneous revascularization of RCA with 3 drug-eluting stents was performed (Figure 3), while revascularization of the proximal LMCA was deferred for a later intervention. Intravenous dipyridamole is widely used for pharmacological stress MPI. The expected response is an increase in heart rate and a decrease in blood pressure. Previous studies reported that a paradoxical hypertensive response is associated with more ischemia and worse outcomes, due to an increased myocardial oxygen demand associated with left ventricular afterload. Therefore, caution is recommended when using dipyridamole for stress MPI.
Archivos de cardiología de México, 2013
Revista Portuguesa De Pneumologia, Jan 6, 2008
Revista Portuguesa De Pneumologia, Jan 4, 2005
PubMed, Dec 15, 2010
Uhl's anomaly is an uncommon malformation of the right ventricle, which is characterized by the a... more Uhl's anomaly is an uncommon malformation of the right ventricle, which is characterized by the absence of the myocardium in the right ventricular free wall, while the tricuspid and pulmonary valves are morphologically normal. The aim of this work was to present a clinical case of a patient with Uhl's anomaly, to describe the echocardiographic findings and to perform an anatomoechocardiographic correlation with a corresponding specimen. This is a case report of a 33 year old man with suspicion of atrial septal defect, who was in functional class II of the NYHA and presented signs of right ventricular failure. The echocardiogram showed dilation of the right cavities, the free wall of the right ventricle was thin and smooth, and the tricuspid and pulmonary valves were normal, which prompted the diagnosis of Uhl's anomaly. Also, an anatomoechocardiographic correlation was done with an equivalent specimen of the Embryology Department from the Instituto Nacional de Cardiologia Ignacio Chavez's collection. Conclusions: Uhl's anomaly is an extremely rare entity. The clinical findings and echocardiography are the main tools for its diagnosis. The anatomoechocardiographic correlation was precise and allowed a better understanding of this anomaly."
Revista española de cardiología, Mar 1, 2006
Archivos de cardiología de México
In hypoplastic right ventricle the dysplasia of the tricuspid valve (TV) has repercussions on the... more In hypoplastic right ventricle the dysplasia of the tricuspid valve (TV) has repercussions on the development of the right ventricle. This paper documents the results of an anatomopathologic and morphometric studies of the tricuspid valve and the right ventricle in 25 hearts with this cardiopathy, which were morphologically analyzed using the segmentary sequential system. The following measurements were made: the annulus of the tricuspid valve, the thickness of the walls of the right ventricle, the ventricular septum and the distances from the atrioventricular-apex (AV-A) and from the apex-pulmonary valve (A-PV). The values obtained were compared with those of normal hearts of equivalent ages; the morphologic features of the tricuspid valve and the right ventricle were described. The thickness of the anterior and posterior walls of righ ventricle was between 2 and 10 times greater than normal. The tickness of the ventricular septum was 1 to 3 times greater than normal and the anteri...
Clinics in oncology, Jan 9, 2019
Archivos de cardiología de México, Oct 1, 2016
Manejo conservador de seroma periaórtico en recoartación de aorta. Reporte de un caso y revisión ... more Manejo conservador de seroma periaórtico en recoartación de aorta. Reporte de un caso y revisión de la literatura Conservative management of periaortic seroma in recoarctation of the aorta. Case report and literature review Presentación del caso
Clinical Research and Trials, 2021
Background: Carotid atherosclerotic disease is a chronic inflammatory disorder that produces an i... more Background: Carotid atherosclerotic disease is a chronic inflammatory disorder that produces an intrinsic immune response and promotes the formation of plaque in the vascular endothelium, leading to clinical outcomes. Aim: To assess the presence of inflammation in patients with carotid atherosclerosis and calcified aortic valve disease (AVD) based on serum markers, endothelial function and carotid intima-media thickness (CIMT). Method: This is a cohort observational study. Patients with clinical suspicion of AVD were assessed by echocardiography and vascular ultrasound for measuring the endothelial function and carotid arteries plaque. Blood samples were taken for determination of inflammatory markers. A multivariate analysis was used to determine the most important variable for determine carotid artery disease (CAD) in patients with AVD. Results: Seventy-two patients with a mean age of 62 ± 11.94 years were included. Forty six percent were men. Forty percent of them had CAD. The patients with CAD were older (p=0.001), had more percentage of systemic hypertension (p=0.049) and coronary calcium score> 400 HU (p=0.045). Multivariate analysis showed that the strongest predictor of CAD in patients with calcified AVD was age greater than 65 years; Beta 3.57, p= 0.001. In this prediction, area under curve was 0.728 (CI95% 0.612-0.844), p=0.006. Conclusions: In patients with AVD the best predictive marker for CAD was the age over 65 years, which is associated with the appearance of carotid atherosclerotic plaques.
Journal of Cardiology & Cardiovascular Therapy, 2017
Archivos de cardiolog�a de M�xico (English ed. Internet)
International Journal of Cardiovascular Sciences
Coronary artery disease (CAD) and ischemic heart disease (IHD) are often indistinctly used terms.... more Coronary artery disease (CAD) and ischemic heart disease (IHD) are often indistinctly used terms. Both combined have generated, over the past years, concerns about sex disparities in their presentation. From an epidemiological perspective, females have several disadvantages regarding the prevention, diagnosis, and treatment of CAD. Most of the general cardiovascular risk factors affect women more frequently, or with a higher morbidity and mortality association. Besides, atypical manifestations of the disease and uncommon forms of CAD represent a diagnostic challenge for clinicians. Even if current treatments for CAD have no apparent sex bias, women representation in clinical trials and treatment patterns analyzed in clinical practice refuse this statement. Several disparities are caused by inevitable sex-particularities, but many of them are more social, cultural, and dogmatic beliefs that have to be addressed and overhaul. Epidemiology CAD affects around 1.72% of the population worldwide, meaning that almost 2 in 100 people will
Journal of Nuclear Cardiology, Apr 25, 2023
Asploro Journal of Biomedical and Clinical Case Reports
Kommerell diverticulums are an uncommon congenital vascular disease involving an aberrant origin ... more Kommerell diverticulums are an uncommon congenital vascular disease involving an aberrant origin of the right or left subclavian artery and a dilation of its root. Here, we present the case of a 44-year-old woman with a relapse of a surgically repaired aberrant subclavian artery with a Kommerell diverticulum.
Archivos de Cardiología de México
Journal of Nuclear Cardiology
Left atrium myxomas are the most frequent heart tumors. Assessment of this phenomenon is largely ... more Left atrium myxomas are the most frequent heart tumors. Assessment of this phenomenon is largely echocardiographic, since both TTE and TEE provide information on size, shape, and hemodynamic consequences of the tumor. In this publication, we bring forward the similarities between morphological assessment through transillumination echocardiography and pathologic anatomy, highlighting a possible study field for the future.
Arquivos Brasileiros de Cardiologia
World Journal of Cardiovascular Diseases
Journal of Nuclear Cardiology, 2021
64-year-old man with history of type 2 diabetes, dyslipidemia, smoking, chronic coronary syndrome... more 64-year-old man with history of type 2 diabetes, dyslipidemia, smoking, chronic coronary syndrome, and coronary artery bypass grafts came to our hospital. He has referred angina that been progressing over three months. The patient underwent dipyridamole stress and rest Tc-sestamibi myocardial perfusion imaging (MPI). Basal ECG showed q waves in the inferior and lateral leads due to prior myocardial infarction. His baseline blood pressure was 110/60 mmHg, so the dipyridamole was started at .56 lg/kg in 4, 7 minutes later he presented a paradoxical hypertensive response with an increase in blood pressure to 160/90 mmHg associated with an intense chest pain and downslope ST depression in 8 leads and ST elevation in aVR and V1, Figure 1. After intravenous aminophylline, oxygen with FiO2 at 24% and sublingual nitroglycerin, the ST-segment normalized and the chest pain disappeared. Stress MPI showed non-transmural infarction with severe ischemia in right coronary artery (RCA) territory, left ventricular transient ischemic dilatation, and fall of poststress ejection fraction more than 5%, Figure 2. The coronary angiogram showed a 60% obstruction of the left main coronary artery (LMCA). LAD artery had diffused non-obstructive atheromatosis and circumflex total proximal occlusion. The RCA had lesions in the proximal, middle, and distal thirds of 50%, 50%, and 70%, respectively. The grafts were patent. Percutaneous revascularization of RCA with 3 drug-eluting stents was performed (Figure 3), while revascularization of the proximal LMCA was deferred for a later intervention. Intravenous dipyridamole is widely used for pharmacological stress MPI. The expected response is an increase in heart rate and a decrease in blood pressure. Previous studies reported that a paradoxical hypertensive response is associated with more ischemia and worse outcomes, due to an increased myocardial oxygen demand associated with left ventricular afterload. Therefore, caution is recommended when using dipyridamole for stress MPI.