Revista Argentina de Cardiologia最新文献

{"title":"Pulmonary Valve Implant Infective Endocarditis. Surgical Resolution with Homograft","authors":"Guillermo Gutierrez, Manuel Clusa, Mariana López Daneri, S. Baratta, E. Martino, J. Bilbao","doi":"10.7775/racv.91.i3.20639","DOIUrl":"https://doi.org/10.7775/racv.91.i3.20639","url":null,"abstract":"","PeriodicalId":34966,"journal":{"name":"Revista Argentina de Cardiologia","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81053455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recap","authors":"Claudio R. Majul","doi":"10.7775/rac.v91.i3.20642","DOIUrl":"https://doi.org/10.7775/rac.v91.i3.20642","url":null,"abstract":"","PeriodicalId":34966,"journal":{"name":"Revista Argentina de Cardiologia","volume":"289 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79428998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Anatomy the New Paradigm in the Chronic Coronary Syndromes?","authors":"C. Caroli","doi":"10.7775/rac.v91.i3.20635","DOIUrl":"https://doi.org/10.7775/rac.v91.i3.20635","url":null,"abstract":"Address for reprints: chrcaroli@gmail.com The condition widely known as chronic stable angina used to be considered as uncomplicated and generally easy to solve by percutaneous revascularization. However, this is no longer the case. Understanding of its true significance has evolved towards characterizing different pathophysiological forms currently and widely known as chronic coronary syndromes (CCS). This paper intends to briefly describe the most relevant data from the latest evidence and to reflect on the meaning of myocardial ischemia when making clinical decisions about revascularization in the year 2023. We need to distinguish at least 4 subtypes of CCS: severe left main coronary artery (LMCA) lesion/severe proximal multivessel lesions; severe diffuse multivessel disease; severe focal lesion; and non-severe diffuse disease/without angiographically significant lesions, with microcirculation involvement. These are all synonyms of atherosclerosis and vascular dysfunction with considerable overlapping. The role of clinical cardiology is to be able to include the patient in the right part of the spectrum in order to maximize the treatment benefits. This analysis will not include microvascular disease with no significant epicardial lesions, as it demands a different approach. Concisely, evaluation ideally involves invasive tests of coronary physiology, including an acetylcholine test to rule out epicardial (and microcirculation) vasospasm, as well as the calculation of the coronary flow reserve and the microcirculatory resistance index. Furthermore, if a non-invasive evaluation is chosen, quantification of the absolute flow via a cardiac positron emission tomography (PET) is the most informative test. (1,2) Another possibility is the semiquantitative evaluation provided by the stress ECG through the anterior descending artery flow reserve. Please note that an abnormal flow reserve cannot be ruled out by absence of myocardial ischemia on a “conventional” single photon emission computed tomography (SPECT) or a stress echo. (3) Further understanding of ischemic heart disease has increased, and the paradigm is changing again. From the anatomy to the ischemia, a little more than two decades have passed, ¿and now from the ischemia to the anatomy again? As reflected by the guidelines from nearly all scientific associations, a short time ago, (4,5) the presence of myocardial ischemia ≥10% was considered as high-risk for events and was an unquestioned cut-off point when deciding on an invasive revascularization strategy for chronic coronary disease. Ischemia was the focus of every decision. This outdated concept has been updated by the extensive observational study performed by Dr. Rory Hachamovitch et al. from Cedars-Sinai Medical Center and published in Circulation in 2003, which included more than 10 300 patients. (6) With all the evidence and data from the ISCHEMIA study, one question shocked the clinical scenario three years ago: has significant isc","PeriodicalId":34966,"journal":{"name":"Revista Argentina de Cardiologia","volume":"27 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77999525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Valve Implant Infective Endocarditis. Surgical Resolution with Homograft","authors":"Guillermo Gutierrez, Manuel Clusa, Mariana Lopez Daneri, Sergio Baratta, Eduardo Martino, Jorge Bilbao","doi":"10.7775/rac.v91.i3.20639","DOIUrl":"https://doi.org/10.7775/rac.v91.i3.20639","url":null,"abstract":"","PeriodicalId":34966,"journal":{"name":"Revista Argentina de Cardiologia","volume":"157 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135046132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality and Tobacco Consumption: the Population Attributable Fraction Method as a Tool to Estimate Damage","authors":"M. Giorgi","doi":"10.7775/rac.v91.i3.20644","DOIUrl":"https://doi.org/10.7775/rac.v91.i3.20644","url":null,"abstract":"Do all risk factors influence the incidence of events in the same way? The answer is “no”, and one of the main reasons mentioned by some cardiovascular medicine specialists is the INTERHEART study (1), which shows that the magnitude of the association among nine conditions or cardiovascular risk factors is heterogeneous with respect to the incidence of a first acute myocardial infarction (AMI). For example, the odds ratios (ORs) observed were 1) 1.91 for history of arterial hypertension; 2) 2.37 for diabetes; 3) 2.87 for smoking (smokers vs. non-smokers); 4) 3.25 for an elevated ApoB/ApoA1 ratio, among others. This information has had healthcare consequences: it provided us with evidence to establish a hierarchy or prioritization of health problems in order to avoid overwhelming patients and support their long-term efforts. However, the INTERHEART study also provided population health information by widely spreading the concept of risk or population attributable fraction (PAF) –a “measure to estimate the proportion of cases that are attributed to a given exposure”– among healthcare professionals. (2) Thus, considering the contribution of each of these risk factors to the incidence of a first AMI event, the hierarchy defined by the ORs was modified since the PAF was 1) 49.2% for an elevated ApoB/ApoA1 ratio; 2) 35.7% for smoking; 3) 17.9% for history of arterial hypertension; and 4) 3.9% for diabetes. Same data, but different information: on the one hand, a more “clinical-related” perspective and, on the other hand, an epidemiologicalrelated perspective. The epidemiological perspective is used to understand population health problems, evaluate the results of the actions (or lack of actions) and propose improvements. The epidemiological approach has had some relevant milestones in our country and in the region, such as the publications of the CARMELA Study (3,4) and the National Survey of Risk Factors conducted","PeriodicalId":34966,"journal":{"name":"Revista Argentina de Cardiologia","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82050711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"I Confess that I Have Lived","authors":"Ricardo Iglesias","doi":"10.7775/rac.v91.i3.20628","DOIUrl":"https://doi.org/10.7775/rac.v91.i3.20628","url":null,"abstract":"","PeriodicalId":34966,"journal":{"name":"Revista Argentina de Cardiologia","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135046173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of symptomatic unruptured abdominal aortic aneurysms: state of the art","authors":"F. Garagoli, M. L. F. Recalde, A. Izaguirre","doi":"10.7775/rac.v91.i3.20636","DOIUrl":"https://doi.org/10.7775/rac.v91.i3.20636","url":null,"abstract":"Symptomatic unruptured abdominal aortic aneurysm (AAA) refers to a group of patients with intact AAA but who present abdominal and/or lumbar pain attributed to the aneurysm. This form of clinical presentation is potentially fatal, since its etiopathogenesis, involving acute changes in the aortic wall, including inflammation, increases the probability of impending rupture. It is clear that these patients should be referred to AAA repair. However, the timing of the intervention is controversial. Therefore, the aim of the present work was to review updated information on the diagnostic-therapeutic approach of symptomatic unruptured AAA","PeriodicalId":34966,"journal":{"name":"Revista Argentina de Cardiologia","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84054108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"he Period after Vesalius. The Emergence of Physiology","authors":"Jorge C. Tranini","doi":"10.7775/rac.v91.i3.20640","DOIUrl":"https://doi.org/10.7775/rac.v91.i3.20640","url":null,"abstract":"","PeriodicalId":34966,"journal":{"name":"Revista Argentina de Cardiologia","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79066211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"I Confess That I Have Lived","authors":"R. Iglesias","doi":"10.7775/rac.v91.i3.20501","DOIUrl":"https://doi.org/10.7775/rac.v91.i3.20501","url":null,"abstract":"","PeriodicalId":34966,"journal":{"name":"Revista Argentina de Cardiologia","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72980359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Myocardial Infarction Due to Coronary Embolism in a Young Woman with Mechanical Aortic Valve Prosthesis and Anomalous Origin of Two Coronary Vessels: A Case Report","authors":"Fernando Araque-Villaquirán, Raul Vallejo-Serna, Monica Fernandes Pineda, Alvaro Herrera Escandon","doi":"10.7775/rac.v91.i3.20638","DOIUrl":"https://doi.org/10.7775/rac.v91.i3.20638","url":null,"abstract":"","PeriodicalId":34966,"journal":{"name":"Revista Argentina de Cardiologia","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81009602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}