Argentine Journal of Cardiology最新文献

{"title":"Pulmonary Artery Aneurysm in an Adult Patient","authors":"A. Ginesi, I. Nogués, A. Aguirre","doi":"10.7775/AJC.87.1.14560","DOIUrl":"https://doi.org/10.7775/AJC.87.1.14560","url":null,"abstract":"Pulmonary artery aneurysm (PAA) is an uncommon but potentially lethal clinical entity, with low incidence and prevalence and difficult diagnosis. Pulmonary artery aneurysm can be congenital or acquired. Congenital PAA can develop secondary to cardiac malformations causing pulmonary arterial hypertension, such as persistent ductus arteriosus, and ventricular or atrial septal defects, while acquired PAA can be secondary to trauma, infection, and connective tissue disorders, among other causes. (1) Patients with this condition can be asymptomatic or present with dyspnea, chest pain, and even hemoptysis, a sign of aneurysm rupture. This condition may progress to death unless early surgical intervention is performed. Diagnosis can be achieved with Doppler echocardiography, while high-resolution computed tomography scan and magnetic resonance angiography are the gold standard for diagnosis. Optimal treatment of PAA remains uncertain. Wall stress is the most important determinant of progression to rupture; therefore, conservative treatment is suggested for asymptomatic patients with no pulmonary hypertension. Surgical therapy is indicated in case of risk of rupture, such as PAA >5.5 cm, increase in aneurysm diameter >0.5 cm in the last 6 months, thrombus formation in the aneurysmal sac, emergence of clinical symptoms, and signs of rupture or dissection. (2) These images correspond to a magnetic resonance angiography with gadolinium of a 70-year-old male patient with history of Amplatzer atrial septal defect closure in 2008, after ischemic stroke and congenital pulmonary valve stenosis treated with balloon angioplasty in the same year. Figures show a great aneurysmal dilatation of the main pulmonary artery and of the right and left pulmonary arteries of 66 mm and 26 mm, respectively.","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"122 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123710549","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":"Prognostic Value of Clinical Presentation in Acute Heart Failure Syndromes","authors":"C. Belziti, F. Garagoli, Agustin Favini, J. Chiabrando, E. Rossi, L. Barbagelata, J. Denes, R. Pizarro","doi":"10.7775/ajc.87.1.13871","DOIUrl":"https://doi.org/10.7775/ajc.87.1.13871","url":null,"abstract":"Introduccion: La insuficiencia cardiaca es una patologia con una elevada prevalencia y morbimortalidad. Es un cuadro muy heterogeneo, y no existe unanimidad en su clasificacion. Objetivo: Comparar la incidencia de mortalidad hospitalaria y anual, y de reinternaciones durante el primer ano de seguimiento, segun la forma de presentacion clinica. Materiales y metodos: Se evaluo una cohorte retrospectiva de 758 ​pacientes consecutivos del plan de salud de nuestro hospital e  internados en unidad de cuidados intensivos cardiologicos con insuficiencia cardiaca aguda. Se realizo un analisis descriptivo, y de sobrevida, y se evaluo la asociacion entre la forma de presentacion clinica y la mortalidad anual. Resultados: La terapeutica y el uso de recursos fueron diferentes en las distintas presentaciones. La mortalidad hospitalaria global fue del 6,3%, siendo del 5,4% para el EAP, 4,9% para la SV y 40,7% para el SC (p<0,001). La tasa de incidencia de mortalidad cada 100 pacientes-ano seguidos fue de 40 (IC95% 31-51) en EAP, 45 (IC95% 39-52) en SV y 102 (IC95% 60-172) en SC, siendo la incidencia de mortalidad anual global del 34.3%. En el analisis multivariable, la mortalidad anual para el SC tuvo un HR de 3.39 (IC95% 1,79-6,44) con respecto al EAP. No hubo diferencias estadisticamente significativas en las reinternaciones. Conclusiones: En pacientes con insuficiencia cardiaca aguda, la presentacion clinica se asocio con mortalidad al ano de seguimiento. Los pacientes con shock cardiogenico al ingreso tuvieron peor pronostico en comparacion con el resto de los grupos.","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115700022","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":"Characteristics of Adults Older Than 75 Years in the ARGEN-IAM-ST Registry","authors":"Y. C. Costa, A. Caccavo, Adrián Charask, K. Moreno, C. Cassano, J. Gagliardi","doi":"10.7775/ajc.87.1.12558","DOIUrl":"https://doi.org/10.7775/ajc.87.1.12558","url":null,"abstract":"Background: Older adults represent a growing population in clinical practice.Objectives: The aim of this study was to learn the clinical characteristics and outcome of older adults hospitalized with myocardialinfarction in Argentina.Methods: Patients included in the ARGEN-IAM-ST registry were analyzed depending on whether they were older or youngerthan 75 years of age.Results: Among the 1,714 patients included in the registry, 233 (13.6%) were aged 75 years or older. These patients hadgreater prevalence of female sex and hypertension and lower incidence of smoking habits, while the prevalence of diabetes,dyslipidemia, anterior myocardial infarction and time from onset of symptoms was similar. They were less likely to receivereperfusion therapy and progression to heart failure (31% vs. 14%; p <0.01), reinfarction (3.9 vs. 1.4%; p=0.009), minorbleeding (7.7% vs. 3.2%; p <0.002) and mortality (21.5% vs. 6.7%, p <0.001) were more common.Conclusions: Older adults with myocardial infarction have a more unfavorable outcome and mortality is three times greaterthan that of patients <75 years.","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128528151","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":"Oral Anticoagulation in Endovascular Aortic Reinterventions","authors":"Mariano A. Castelli, Ignacio J. de Luca, Guillermo Pfund, Julián Balestrini, F. Belcastro, P. Zaefferer","doi":"10.7775/AJC.87.1.13764","DOIUrl":"https://doi.org/10.7775/AJC.87.1.13764","url":null,"abstract":"Introduccion: La endofuga es la principal causa de reintervencion despues del tratamiento endovascular de aorta. Algunos pacientesnecesitan anticoagulacion oral prolongada, lo cual puede aumentar la incidencia de endofugas posoperatorias.Objetivos: Nuestro objetivo es determinar si la anticoagulacion oral posoperatoria tiene impacto en la incidencia de endofugas.Material y metodos: Este analisis retrospectivo incluyo todos los pacientes con aneurisma de aorta abdominal tratados por viaendovascular entre 2009 y 2014 en nuestro centro. Se determinaron dos grupos de pacientes de acuerdo con la necesidad de anticoagulacionoral y se comparo entre ambos grupos la mortalidad relacionada con la aorta; la supervivencia libre de reintervenciones,de cualquier endofuga y de endofugas no tipo II; supervivencia libre de un punto final compuesto por mortalidad relacionada con laaorta, reintervenciones y endofugas, y la reduccion del diametro del saco aneurismatico.Resultados: De 341 pacientes tratados, 33 (9,67%) estaban anticoagulados. No hubo diferencias entre ambos grupos en terminos demortalidad relacionada con la aorta (2,59% vs. 3,03%, p = ns), supervivencia libre de reintervenciones (84,04% vs. 86,2%; p = ns),supervivencia libre de cualquier endofuga (82% vs. 89%; p = 0,81) o supervivencia libre de endofugas no tipo II (88% vs. 88%; p =0,52). Al analizar la supervivencia libre del punto final compuesto tampoco se encontraron diferencias significativas (80% vs. 85%; p= ns). La reduccion promedio del diametro del saco aneurismatico fue de 5,19 mm y 3,51 mm (p = 0,2).Conclusiones: No se registro diferencia en ninguno de los resultados analizados. La anticoagulacion oral posoperatoria no tuvo impactoen los resultados del tratamiento endovascular de aorta.","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"144 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122003113","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":"Sudden Death is Uncommon in Chronic Chagas Disease without Evident Heart Disease","authors":"Julián González, J. Fragola, F. Azzato, J. Milei","doi":"10.7775/AJC.87.1.14511","DOIUrl":"https://doi.org/10.7775/AJC.87.1.14511","url":null,"abstract":"In 2012, our group published a systematic review (1)in this Journal, analyzing the available updated evidenceabout the incidence of sudden death (SD) in theindeterminate phase of Chagas disease.On that occasion, a bibliographic search in Pubmedand SciELO was performed until March 2011using the following keywords: “Chagas” and “follow-up Studies [MeSH] or prognos*[Text Word] orpredict*[Text Word] or course*[Text Word]”. Thissearch provided 1,058 articles, 19 of which compliedwith the initial search criteria, and only 15 includedenough data to constitute a group of asymptomatic indeterminatechagasic patients with normal ECG.","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"255 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121055477","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":"Efficiency and Safety of Radial Access versus Femoral Access in Percutaneous Coronary Intervention","authors":"M. Abud, Lucio T. Padilla, G. Pedernera, P. Spaletra, P. Lamelas, A. Candiello, I. Cigalini, J. A. N. Lecaro, J. Belardi, F. Cura","doi":"10.7775/AJC.87.1.13846","DOIUrl":"https://doi.org/10.7775/AJC.87.1.13846","url":null,"abstract":"Background: Radial access has been associated with many advantages in percutaneous coronary intervention compared with femoralaccess. However, many international registries have reported poor adherence to this technique. Objectives: The aim of this study was to evaluate the safety, efficacy and operational efficiency of percutaneous coronary interventionaccording to the access site and the clinical presentation of the patient. Methods: A single-center, retrospective registry of patients with coronary artery disease undergoing percutaneous coronary interventionwas conducted from March 2009 to June 2018 according to the vascular access. A Cox proportional-hazards model was usedto analyze the association between vascular access and risk of major cardiovascular events, and a logistic regression model was appliedto assess the relationship between major bleeding and access site complications. Total hospital stay and total hospitalizationcosts were measured to evaluate the operational efficiency. Results: A total of 8,155 percutaneous coronary interventions (mean follow-up of 1,448.6±714.1 days), via radial access (n=5,706)or femoral access (n=2,449), were included in the study. At 30 days, the risk of major cardiovascular events was significantly lowerwith the radial access (HR 0.66 [0.5-0.88], p=0.004), at the expense of a reduction in all-cause mortality. In addition, radial accesssignificantly reduced the risk of major bleeding (HR 0.33 [0.16-0.67], p=0.002) and access site complications (HR 0.72 [0.53-0.98],p=0.038). A significant interaction was observed between the vascular access site and the risk of events according to the clinicalpresentation on admission. Use of radial access was associated with a significant reduction in the length of total hospital stay (≈30%)and total hospitalization costs (≈15%).Conclusions: The use of radial access in percutaneous coronary intervention was safe and effective compared with the femoralaccess, with lower rates of major cardiovascular events at 30 days, lower risk of major bleeding and of access site complications.Moreover, radial access was associated with greater operational efficiency during hospitalization.","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128772857","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":"Combined Use of Sacubitril and Valsartan in Acute Myocardial Infarction","authors":"B. Buchholz","doi":"10.7775/ajc.87.1.14672","DOIUrl":"https://doi.org/10.7775/ajc.87.1.14672","url":null,"abstract":"","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"272 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122188891","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":"In-Hospital and 30-Day Mortality After Percutaneous Aortic Valve Implantation. Usefulness of Different Surgical Risk Scores","authors":"I. Cigalini, E. Zaidel, R. Villarreal, M. Bettinotti, Á. S. Liprandi, M. Sztejfman","doi":"10.7775/rac.87.2.10531","DOIUrl":"https://doi.org/10.7775/rac.87.2.10531","url":null,"abstract":"","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"131 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127373099","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 in an Adolescent with Kawasaki Disease","authors":"R. Levin, Marcela A Degrange, R. Porcile","doi":"10.7775/RAC.87.2.14648","DOIUrl":"https://doi.org/10.7775/RAC.87.2.14648","url":null,"abstract":"","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115946078","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":"SAC President´s 2019 Opening Speech","authors":"Ana Salvati","doi":"10.7775/ajc.87.1.14634","DOIUrl":"https://doi.org/10.7775/ajc.87.1.14634","url":null,"abstract":"","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117021401","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}