Argentine Journal of Cardiology最新文献

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Left Ventricle Functional Assessment by Three-Dimensional Echocardiography in Patients with Systemic Lupus Erythematosus 三维超声心动图评价系统性红斑狼疮患者左心室功能
Argentine Journal of Cardiology Pub Date : 2018-01-15 DOI: 10.7775/rac.85.6.9992
A. Saad, F. Cintora, Daiana Sol Pinasco, Claudia N. Villalba, J. P. Vinicki, F. Paniego, O. Grosso, C. S. Berensztein
{"title":"Left Ventricle Functional Assessment by Three-Dimensional Echocardiography in Patients with Systemic Lupus Erythematosus","authors":"A. Saad, F. Cintora, Daiana Sol Pinasco, Claudia N. Villalba, J. P. Vinicki, F. Paniego, O. Grosso, C. S. Berensztein","doi":"10.7775/rac.85.6.9992","DOIUrl":"https://doi.org/10.7775/rac.85.6.9992","url":null,"abstract":"Background: Systemic lupus erythematosus frequently presents subclinical myocardial involvement; this has an early onset and predicts mortality. The analysis of myocardial deformation (strain) by three-dimensional speckle tracking echocardiography could be useful in the assessment of myocardial function. Objective: The aim of this study was to assess left ventricular structure and systolic function through the analysis of threedimensional deformation. Methods: Thirty seven women with systemic lupus erythematosus (age 35±10 years) and no history of structural heart disease and 20 controls (34±8 years) were included in the study. Two-dimensional and three-dimensional echocardiography was performed according to the recommendations of the American Society of Echocardiography to acquire global longitudinal strain, radial strain, circumferential strain and strain area. Systemic lupus erythematosus activity was estimated with the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI), considering a score ≥4 as active disease. Results: There were no differences in age, risk factors, blood pressure, and heart rate between both groups. From a structural point of view, both atria presented larger size in the systemic lupus erythematosus group. This group of patients presented lower global longitudinal strain (-19.7±2.7 vs. -21.1±2.5, p=0.009), global radial strain (50.7±8.7 vs. 56.5±5.6; p=0.02) and global strain area (-32.1±3.9 vs. -34.7±2.1, p=0.004). This decrease was even more marked in women with active systemic lupus erythematosus. Conclusions: All deformation parameters were reduced in patients with systemic lupus erythematosus, which could be due to incipient alterations of left ventricular systolic function.","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"155 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132443620","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}
引用次数: 0
Should we quantify the diameters of the right heart in relation to the body surface area 我们应该量化右心的直径与体表面积的关系吗
Argentine Journal of Cardiology Pub Date : 2017-12-15 DOI: 10.7775/RAC.85.6.12043
Guadalupe J Romero, A. Lescano, Diego A. Crippa, I. Constantin, N. Gonzalez, H. G. S. María, M. González, V. Darú, H. Grancelli
{"title":"Should we quantify the diameters of the right heart in relation to the body surface area","authors":"Guadalupe J Romero, A. Lescano, Diego A. Crippa, I. Constantin, N. Gonzalez, H. G. S. María, M. González, V. Darú, H. Grancelli","doi":"10.7775/RAC.85.6.12043","DOIUrl":"https://doi.org/10.7775/RAC.85.6.12043","url":null,"abstract":"Background: The evaluation of the right heart cavities represents a challenge for echocardiography, given the impossibility of their approach to a geometric model. Moreover, there are no recommendations on the need to adjust right heart dimensions to body surface area. Objective: The aim of this study was to establish the relationship between right heart chamber dimensions and body surface area in a population with no evidence of cardiopulmonary disease. Methods: The study included patients attending the echocardiography laboratory for a regular health examination. Patients with cardiac disease, right or left ventricular dysfunction, significant valve diseases, known pulmonary disease or pulmonary systolic pressure ≥45 mmHg were excluded from the study. Patients’ affiliation, weight (kg), height (meters), and body surface area (m2) data were recorded. Right heart measurements were based on guideline recommendations. The population was distributed in quartiles according to body surface area (25%-50%-75%-100%). Simple regression analysis was performed between each dimension of the right heart and body surface area. Results: A prospective, consecutive, observational and descriptive cohort study was performed including 1,045 patients with the following characteristics: mean age 41±15.1 years, 53% men, mean weight 77.4±19.6 kg, height 1.69±0.09 and BSA 1.89±0.87 m². Significant differences were observed in each of the variables according to the distribution by quartiles. A positive correlation was demonstrated between all right heart dimensions and body surface area. Conclusions: Body surface area is an important determinant of right heart dimensions measured by echocardiography. We therefore suggest the use of measurements indexed by body surface area, since it could influence clinical decision making.","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130893440","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}
引用次数: 0
Spontaneous Variability of QTc Interval in Patients with Congenital Long QT Syndrome 先天性长QT综合征患者QTc间期的自发变异性
Argentine Journal of Cardiology Pub Date : 2017-11-30 DOI: 10.7775/RAC.85.5.10292
H. Yoo, Alan Sommi, Isabel V Konopka, M. Principato, Norma Pizzarelli, Rita B Tepper, P. Fernandez, H. Garro, J. Carbajales, R. Acunzo
{"title":"Spontaneous Variability of QTc Interval in Patients with Congenital Long QT Syndrome","authors":"H. Yoo, Alan Sommi, Isabel V Konopka, M. Principato, Norma Pizzarelli, Rita B Tepper, P. Fernandez, H. Garro, J. Carbajales, R. Acunzo","doi":"10.7775/RAC.85.5.10292","DOIUrl":"https://doi.org/10.7775/RAC.85.5.10292","url":null,"abstract":"Introduccion: La medicion del intervalo QTc es una herramienta indispensable para diagnosticar y estratificar el riesgo de eventos cardiacos adversos en los pacientes (p) con los sindromes de QT largo (SQTL) hereditarios. Los intervalos QTc pueden variar en forma ostensible y prolongarse de manera intermitente solo antes, durante o despues de un evento arritmico. Objetivos: Determinar si, en los pacientes con SQTL, existen variaciones significativas de los intervalos QTc cuando se los mide en varias oportunidades. Material y metodos: Se midieron la duracion de los intervalos QTc en tres ECG registrados cada 7 dias, en 25 pacientes con SQTL y 15 controles sanos. Resultados: Los intervalos QTc variaron de manera significativa en ambos grupos. Los valores minimos y maximos de QTc fueron de 492 mseg (rango intercuartil [RIC] 25-75: 463,5-501,5) y 522 mseg (RIC: 503,5-543) en pacientes con SQTL (p < 0,0001), respectivamente. En los individuos sanos, dichos valores fueron de 409 mseg(RIC: 395-418) y 423 mseg (RIC: 413431) (p < 0,001). En el 56% de los pacientes, las mediciones de los intervalos QTc oscilaron por encima y por debajo de 500 mseg. El 24% tuvo un intervalo QTc siempre por debajo de 500 mseg y el 20% siempre por encima. El intervalo QTc siempre fue mayor de 500 mseg en el 50% de los sintomaticos y en el 10,5% de los asintomaticos. Conclusiones: En los pacientes con SQTL, los intervalos QTc varian significativamente. Una unica determinacion no es suficiente para estratificar el riesgo.","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122348841","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}
引用次数: 0
Evaluation of Low-Molecular-Weight Heparin Dose Adjusted by Weight for Patients with Cardiovascular Disease 心血管疾病患者按体重调整低分子肝素剂量的评价
Argentine Journal of Cardiology Pub Date : 2017-11-29 DOI: 10.7775/RAC.85.5.11655
Leonardo Celano, Dario Cazañas, Claudio Hadid, D. Toro, C. Ingino, C. Labadet
{"title":"Evaluation of Low-Molecular-Weight Heparin Dose Adjusted by Weight for Patients with Cardiovascular Disease","authors":"Leonardo Celano, Dario Cazañas, Claudio Hadid, D. Toro, C. Ingino, C. Labadet","doi":"10.7775/RAC.85.5.11655","DOIUrl":"https://doi.org/10.7775/RAC.85.5.11655","url":null,"abstract":"","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132123816","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}
引用次数: 0
ST-segment Elevation Acute Myocardial Infarction in Women in Argentina. Subanalysis of the CONAREC XVII Registry 阿根廷女性st段抬高急性心肌梗死。CONAREC第十七届登记处的子分析
Argentine Journal of Cardiology Pub Date : 2017-11-22 DOI: 10.7775/rac.85.5.10771
J. Costabel, L. Burgos, M. P. Duczynski, I. Cigalini, C. L. Godoy, E. Giordanino, S. G. Zamora, G. Perez, Nicolás González, R. Iglesias
{"title":"ST-segment Elevation Acute Myocardial Infarction in Women in Argentina. Subanalysis of the CONAREC XVII Registry","authors":"J. Costabel, L. Burgos, M. P. Duczynski, I. Cigalini, C. L. Godoy, E. Giordanino, S. G. Zamora, G. Perez, Nicolás González, R. Iglesias","doi":"10.7775/rac.85.5.10771","DOIUrl":"https://doi.org/10.7775/rac.85.5.10771","url":null,"abstract":"Introduccion: El infarto agudo de miocardio es una de las principales causas de muerte entre las mujeres. Objetivos: Analizar las caracteristicas del infarto con elevacion del segmento ST en mujeres argentinas. Material y metodos: Estudio observacional, realizado con los datos del registro CONAREC XVII. Resultados: De un total de 694 pacientes, 150 eran mujeres cuya edad media era de 69,2 ± 13,7 anos vs. 59,9 ± 11,5 anos en varones (p = 0,001). Las mujeres presentaron mayor prevalencia de diabetes (29,3% vs. 19,9%, p = 0,010) mientras que el tabaquismo fue mayor en varones (71% vs. 45,3%, p = 0,001). No se hallaron diferencias en sintomas de presentacion, tiempos de isquemia, o tratamientos de reperfusion. Las mujeres tuvieron mayor proporcion de lesion de unico vaso, con mas infartos Killip y Kimbal C-D (15,3% vs. 7,5% (p = 0,001) y mayor requerimiento de inotropicos (21,3% vs. 8,6% (p = 0,001)). Ademas, presentaron significativamente mayor porcentaje de sangrado y de complicaciones mecanicas (4,7% vs. 1,3%, p = 0,017) sin diferencias en el porcentaje de mortalidad. Sin embargo, en el analisis multivariado no se encontro relacion entre el sexo femenino y la mala evolucion hemodinamica o complicaciones. Conclusiones: Las mujeres presentan un perfil de riesgo cardiovascular diferente, con infartos con elevacion del ST con peor impacto hemodinamico y complicaciones intrahospitalarias. El sexo no resulto constituir un elemento individualmente ligado a ello, sino que parece agrupar una serie de factores que implican peor tolerancia al infarto.","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"28 7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125692577","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}
引用次数: 0
Letters between Pedro Cossio (1900-1986), Luis Becú (1927-1997) and Francisco Torrent Guasp (1931-2005)
Argentine Journal of Cardiology Pub Date : 2017-10-10 DOI: 10.7775/AJC.85.3.11218
J. Trainini, J. Herreros, P. Cossio
{"title":"Letters between Pedro Cossio (1900-1986), Luis Becú (1927-1997) and Francisco Torrent Guasp (1931-2005)","authors":"J. Trainini, J. Herreros, P. Cossio","doi":"10.7775/AJC.85.3.11218","DOIUrl":"https://doi.org/10.7775/AJC.85.3.11218","url":null,"abstract":"Este material inedito y de investigacion fue realizado en el archivo de la casa de Francisco Torrent Guasp, Denia, Espana, en junio de 2017. En el marco de la elaboracion de la biografia de Francisco Torrent Guasp se hallo una correspondencia del medico e investigador espanol con dos figuras de la cardiologia argentina, Pedro Cossio y Luis Becu. Francisco Torrent Guasp a partir del ano 1954 realizo investigaciones anatomicas en las cuales demostro que la arquitectura cardiaca es una banda muscular plegada en doble helicoide para conformar ambos ventriculos. Esta anatomia determina una funcion de torsion de la banda durante la sistole y de destorsion durante la fase isovolumetrica, la cual es activa con gasto energetico para producir un efecto de succion. De esta forma el corazon consta de tres tiempos: sistole, succion y diastole.(1) Pedro Cossio fue el iniciador de la Revista y la Sociedad Argentina de Cardiologia. De gran trayectoria docente impulso el inicio de la cardiologia moderna en la Argentina. Sus trabajos sobre hemodinamia cardiaca e intervencionismo debieron haberle llevado al Premio Nobel, en palabras de quienes lo recibieron por este desarrollo.","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125750908","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}
引用次数: 0
Patent Foramen Ovale 卵圆孔未闭
Argentine Journal of Cardiology Pub Date : 2017-10-10 DOI: 10.7775/rac.85.3.11367
A. Lakowsky, J. M. Lewkowicz
{"title":"Patent Foramen Ovale","authors":"A. Lakowsky, J. M. Lewkowicz","doi":"10.7775/rac.85.3.11367","DOIUrl":"https://doi.org/10.7775/rac.85.3.11367","url":null,"abstract":"PFO (Patent foramen ovale) is a persistent opening in the wall of the heart which did not close completely after birth (opening required before birth for transfer of oxygenated blood via the umbilical cord). This opening can cause a shunt of blood from right to left , but more often there is a movement of blood from the left side of the heart (high pressure) to the right side of the heart (low pressure).","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"207 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133929577","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}
引用次数: 0
Quality Improvement Project to Reduce Prescription Errors in Patients Hospitalized due to Cardiovascular Diseases 减少因心血管疾病住院患者处方错误的质量改进项目
Argentine Journal of Cardiology Pub Date : 2017-09-26 DOI: 10.7775/AJC.85.4.9259
L. Seoane, M. Benzadón, G. Daquarti, S. Mitrione, N. Vecchio, Clara Ametrano, J. Furmento, D. Conde, A. A. D. Lima
{"title":"Quality Improvement Project to Reduce Prescription Errors in Patients Hospitalized due to Cardiovascular Diseases","authors":"L. Seoane, M. Benzadón, G. Daquarti, S. Mitrione, N. Vecchio, Clara Ametrano, J. Furmento, D. Conde, A. A. D. Lima","doi":"10.7775/AJC.85.4.9259","DOIUrl":"https://doi.org/10.7775/AJC.85.4.9259","url":null,"abstract":"Background: Prescription errors are a common problem which threatens hospitalized patients’ safety, particularly in critical care areas. Objective: The aim of the study was to evaluate the effectiveness of a quality improvement project to reduce prescription errors in patients hospitalized due to cardiovascular diseases. Methods: A quality improvement project was implemented to reduce in-hospital prescription errors. The three main components of the project were: mandatory supervision of indications, use of a software program that organizes physicians’ indications by biological systems, and implementation of a rule with universal format for the prescription of medications, including a dictionary of abbreviations and normalized dilutions. Before the implementation of these changes, the number of weakly prescription errors was assessed, stratified by hospitalization area. The impact of the project was analyzed by dividing the samples into four consecutive 9-week periods (one period before the intervention and three periods after the intervention), comparing the number of errors detected in each period. The indications of 180 patients were randomly evaluated in each period. Results: A total of 720 prescriptions were analyzed. The implementation of an improvement project reduced the number of errors rapidly and consistently over time (median of 85 before the intervention, IQR 70-95, and 26 after the intervention, IQR 21-37; p=0.0004). Conclusion: The quality improvement project produced a significant reduction in the number of prescription errors in patients hospitalized due to cardiovascular disease","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125201627","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}
引用次数: 0
Usefulness of Adenosine Testing in the Differential Diagnosis Between Fasciculoventricular Pathways and Wolff-Parkinson-White-type Ventricular Preexcitation 腺苷检测在束状室传导途径和wolff - parkinson - white型心室预兴奋鉴别诊断中的价值
Argentine Journal of Cardiology Pub Date : 2017-09-18 DOI: 10.7775/ajc.85.4.9288
Andrés Bochoeyer, Natalia Schnetzer, Mauricio Pelliza, J. Díez, R. Rabinovich, C. Militello, María Grippo
{"title":"Usefulness of Adenosine Testing in the Differential Diagnosis Between Fasciculoventricular Pathways and Wolff-Parkinson-White-type Ventricular Preexcitation","authors":"Andrés Bochoeyer, Natalia Schnetzer, Mauricio Pelliza, J. Díez, R. Rabinovich, C. Militello, María Grippo","doi":"10.7775/ajc.85.4.9288","DOIUrl":"https://doi.org/10.7775/ajc.85.4.9288","url":null,"abstract":"Introduccion: El diagnostico de preexcitacion ventricular tipo Wolff-Parkinson-White generalmente es sencillo a partir del electrocardiograma. No obstante, en los pacientes con manifestaciones electrocardiograficas minimas o sutiles, la confirmacion diagnostica y la diferenciacion con otras formas de preexcitacion, como las fibras fasciculoventriculares, plantea dificultades. La prueba de adenosina se presenta como una herramienta util para tal fin. Objetivo: Describir nuestra experiencia con el uso de adenosina en el diagnostico diferencial de pacientes con minima preexcitacion ventricular. Material y metodos: De 313 pacientes consecutivos con diagnostico de Wolff-Parkinson-White, se analizaron 28 pacientes con preexcitacion minima en el electrocardiograma que puso en duda el diagnostico. Resultados: La prueba de adenosina permitio descartar Wolff-Parkinson-White en 26 pacientes al documentarse bloqueo auriculoventricular de primer, segundo y/o tercer grado transitorio, sin cambios en el patron de activacion ventricular. En 20 pacientes se realizo estudio electrofisiologico, que confirmo la presencia de vias accesorias fasciculoventriculares en 16 casos. Conclusion: Ante la sospecha de Wolff-Parkinson-White, la prueba de adenosina resulto eficaz y segura para establecer o descartar el diagnostico.","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122893414","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}
引用次数: 0
Clinical Significance of Impaired Liver Function Tests in Decompensated Heart Failure 失代偿性心力衰竭患者肝功能受损的临床意义
Argentine Journal of Cardiology Pub Date : 2017-09-06 DOI: 10.7775/ajc.85.3.10288
Enrique B. Fairman, V. Mauro, Adrián Charask, Y. C. Costa, Santiago E. Marrodán, Emiliano G. Spampinato, Alesis Raffaeli, Franco Bottini, C. Barrero
{"title":"Clinical Significance of Impaired Liver Function Tests in Decompensated Heart Failure","authors":"Enrique B. Fairman, V. Mauro, Adrián Charask, Y. C. Costa, Santiago E. Marrodán, Emiliano G. Spampinato, Alesis Raffaeli, Franco Bottini, C. Barrero","doi":"10.7775/ajc.85.3.10288","DOIUrl":"https://doi.org/10.7775/ajc.85.3.10288","url":null,"abstract":"Background: Therapeutic progress in chronic heart failure has not been reflected in decompensated patients, compelling the need for new therapeutic and prognostic tools. Although liver function tests are part of routine admission studies, their clinical significance is not clearly established. Objective: The aim of this study was to evaluate the prognostic relevance of liver function tests in decompensated heart failure. Methods: The study analyzed the prevalence and in-hospital mortality association of elevated (at least twice the normal value) total bilirubin (TB), alkaline phosphatase (APh) and alanine aminotransferase (ALT) or aspartate aminotransferase (AST) in 700 consecutive patients admitted into two coronary care units due to decompensated heart failure, with liver function tests at admission, and no previous liver disease. Results: In 20.8% of cases, patients presented some abnormal liver function test: 6%, increased TB, 12.6% increased ALT or AST and 12.6% increased APh. In the univariate analysis [(OR (95% CI)], any abnormal liver function test [2.34 (1.18-4.65)], TB [4.05 (1.66-9.83)], ALT/AST [3.56 (1.72-7.34)] but not APh was associated with higher in-hospital mortality. In the multivariate model, cardiogenic shock [9.48 (2.31-38.78)], TB [3.61 (1.29-10.04)], AST/ALT [2.83 (1.28-6.25)], renal failure at admission [3.55 (1.48-8.49)] and history of chronic obstructive pulmonary disease [2.66 (1.21-5.87)] were independently associated with mortality. Conclusions: Accessible tests such as liver function assessment provide additional prognostic information at admission. In an unselected patient population, abnormal liver function may probably express increased vulnerability rather than hemodynamic impairment.","PeriodicalId":447734,"journal":{"name":"Argentine Journal of Cardiology","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126076589","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}
引用次数: 0
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