Revista Portuguesa De Cardiologia最新文献

{"title":"Outcomes of ventricular tachycardia ablation in patients with ischemic and non-ischemic cardiomyopathy: A propensity-score matched analysis","authors":"Daniel A. Gomes ,&nbsp;Mariana Sousa Paiva ,&nbsp;Daniel Matos ,&nbsp;Ana Rita Bello ,&nbsp;Gustavo Rodrigues ,&nbsp;João Carmo ,&nbsp;Jorge Ferreira ,&nbsp;Francisco Moscoso Costa ,&nbsp;Pedro Galvão Santos ,&nbsp;Pedro Carmo ,&nbsp;Diogo Cavaco ,&nbsp;Francisco Bello Morgado ,&nbsp;Pedro Adragão","doi":"10.1016/j.repc.2024.04.002","DOIUrl":"10.1016/j.repc.2024.04.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Catheter ablation (CA) is effective in the treatment of ventricular tachycardia (VT). Although some observational data suggest patients with non-ischemic cardiomyopathy (NICM) have less favorable outcomes when compared to those with an ischemic etiology (ICM), direct comparisons are rarely reported. We aimed to compare the outcomes of VT ablation in a propensity-score matched population of ICM or NICM patients.</p></div><div><h3>Methods</h3><p>Single-center retrospective study of consecutive patients undergoing VT ablation from 2012 to 2023. A propensity score (PS) was used to match ICM and NICM patients in a 1:1 fashion according to age, sex, left ventricular ejection fraction (LVEF), NYHA class, electrical storm (ES) at presentation, and previous endocardial ablation. The outcomes of interest were VT-free survival and all-cause mortality.</p></div><div><h3>Results</h3><p>The PS yielded two groups of 71 patients each (mean age 63±10 years, 92% male, mean LVEF 35±10%, 36% with ES at presentation, and 23% with previous ablation), well matched for baseline characteristics. During a median follow-up of 2.3 (interquartile range IQR 1.3–3.8) years, patients with NICM had a significantly lower VT-free survival (53.5% vs. 69.0%, log-rank p=0.037), although there were no differences regarding all-cause mortality (22.5% vs. 16.9%, log-rank p=0.245). Multivariate analysis identified NICM (HR 2.34 [95% CI 1.32–4.14], p=0.004), NYHA class III/IV (HR 2.11 [95% CI 1.11–4.04], p=0.024), and chronic kidney disease (HR 2.23 [95% CI 1.25–3.96], p=0.006), as independent predictors of VT recurrence.</p></div><div><h3>Conclusion</h3><p>Non-ischemic cardiomyopathy patients were at increased risk of VT recurrence after ablation, although long-term mortality did not differ.</p></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 6","pages":"Pages 341-349"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000829/pdfft?md5=8f5f6df5645a6aa7b2fa9be1fb62bf84&pid=1-s2.0-S0870255124000829-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140775856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic ventricular fibrillation: A never ending “clinical” history","authors":"João Primo","doi":"10.1016/j.repc.2024.05.001","DOIUrl":"10.1016/j.repc.2024.05.001","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 6","pages":"Pages 337-339"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124001355/pdfft?md5=240862b492342aec819af7dd2a2c76bd&pid=1-s2.0-S0870255124001355-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential for health education to target cardiovascular risk factors at an age when it really matters","authors":"António Manuel Pires","doi":"10.1016/j.repc.2024.02.001","DOIUrl":"10.1016/j.repc.2024.02.001","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 6","pages":"Pages 362-363"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S087025512400012X/pdfft?md5=71e65b352c292fe396d66ed542d6e231&pid=1-s2.0-S087025512400012X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical aortic valve replacement in octogenarians: Single-center perioperative outcomes and five-year survival","authors":"Tiago R. Velho ,&nbsp;João Gonçalves ,&nbsp;Rafael Maniés Pereira ,&nbsp;Ricardo Ferreira ,&nbsp;André Sena ,&nbsp;Nádia Junqueira ,&nbsp;Eurídice Ângelo ,&nbsp;Nuno Carvalho Guerra ,&nbsp;Mário Mendes ,&nbsp;Ricardo Arruda Pereira ,&nbsp;Ângelo Nobre","doi":"10.1016/j.repc.2024.02.003","DOIUrl":"10.1016/j.repc.2024.02.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Aortic stenosis is the most common valvular heart disease. The number of octogenarians proposed for intervention is growing due to increased lifespan. In this manuscript we aim to evaluate perioperative outcome and long-term survival after surgical aortic valve replacement (SAVR) in octogenarians, comparing patients with low surgical risk (EuroscoreII &lt;4%) with intermediate-high risk (EuroscoreII ≥4%).</p></div><div><h3>Methods</h3><p>A retrospective observational single-center cohort study with 195 patients aged ≥80 years old, who underwent SAVR between 2017 and 2021, was conducted. Patients were divided into two groups according to EuroscoreII: (1) Low risk (EuroscoreII &lt;4%) with intermediate-high risk (EuroscoreII ≥4%). Continuous variables are presented in median (IQR), analyzed using Wilcoxon rank sum test; categorical variables in percentages, analyzed using chi-squared test; and survival was analyzed by Kaplan–Meier, open cohort, and the log-rank test was performed.</p></div><div><h3>Results</h3><p>The overall median age was 82 (IQR 81–83), with 4.6% of the patients ≥85 years old. 23.6% of the patients presented EuroscoreII ≥4%. No complications were observed in 26.2%, with a significantly higher rate in intermediate-high risk patients. Postoperative need for hemodynamic support was the most frequent complication, followed by postoperative acute kidney injury and the use of blood products. Overall median ICU stay was three days (2–4) and hospital length of stay (LOS) six days (5–8). Patients with intermediate-high risk and those with complications had longer ICU LOS. At 12 months, overall survival was 96.4%, at three years 94.1% and 5 years 75.4%. Patients with low surgical risk had higher survival proportions up to 5 years.</p></div><div><h3>Conclusion</h3><p>SAVR in patients ≥80 years is associated with low in-hospital mortality, although a significant proportion of patients develop complications. Long-term follow-up up to five years after surgery is acceptable in octogenarians with low surgical risk.</p></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 6","pages":"Pages 311-320"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000696/pdfft?md5=18df2bcc522b97bb00032405dec1fc04&pid=1-s2.0-S0870255124000696-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The challenge of choosing the right prosthesis for the right patient – The devil is in the details","authors":"Gonçalo F. Coutinho","doi":"10.1016/j.repc.2024.05.004","DOIUrl":"10.1016/j.repc.2024.05.004","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 6","pages":"Pages 364-366"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124001392/pdfft?md5=6a3b865d3804980bf77198f87f831abf&pid=1-s2.0-S0870255124001392-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141056001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventricular tachycardia ablation in non-ischemic cardiomyopathy: A Sisyphean task?","authors":"Guilherme Portugal","doi":"10.1016/j.repc.2024.05.006","DOIUrl":"10.1016/j.repc.2024.05.006","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 6","pages":"Pages 351-352"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124001410/pdfft?md5=08833990784900fae56d19509c3b0269&pid=1-s2.0-S0870255124001410-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are we missing an opportunity? Prehospital delay in patients with acute ischemic stroke and known atrial fibrillation","authors":"Marta Magriço ,&nbsp;Miguel Serôdio ,&nbsp;João Nuno Ramos ,&nbsp;Rita Ventura ,&nbsp;André Sobral-Pinho ,&nbsp;João Pedro Marto ,&nbsp;Miguel Viana-Baptista","doi":"10.1016/j.repc.2023.11.005","DOIUrl":"10.1016/j.repc.2023.11.005","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>The follow-up of patients with atrial fibrillation (AF) presents an opportunity to alert patients and their families on how to recognize and act in the event of stroke. Our aim was to compare stroke recognition-to-door time and prehospital stroke code activation in patients with known AF (KAF) and AF detected after stroke (AFDAS).</p></div><div><h3>Methods</h3><p>We performed a retrospective cohort study of consecutive patients receiving acute recanalization treatment for acute ischemic stroke between January 2016 and August 2022, with AF as a potential stroke cause. Patients were divided into KAF and AFDAS, and stroke recognition-to-door time and prehospital stroke code activation were compared. In the KAF subgroup, we assessed whether the use of preadmission anticoagulation was associated with the studied prehospital parameters.</p></div><div><h3>Results</h3><p>We included 438 patients, 290 female (66.2%), mean age 79.3±9.4 years. In total, 238 patients had KAF (54.3%) and 200 (45.7%) had AFDAS. Of those with KAF, 114 (48.1%) were pretreated with anticoagulation. Patients with KAF and AFDAS had no differences in stroke recognition-to-door time (74.0 [55.0–101.0] vs. 78.0 [60.0–112.0] min; p=0.097) or prehospital stroke code activation [148 (64.6%) vs. 128 (65.3%); p=0.965]. In the KAF subgroup, preadmission anticoagulation did not influence stroke recognition-to-door time or mode of hospital admission.</p></div><div><h3>Conclusion</h3><p>Stroke recognition-to-door time and prehospital stroke code activation were similar between patients with known or newly diagnosed AF. Preadmission anticoagulation treatment also did not affect the studied parameters. Our findings highlight a missed opportunity to promote stroke knowledge in patients followed due to AF.</p></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 6","pages":"Pages 321-325"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000659/pdfft?md5=7cde4552f871f628f9d46e840a1b7704&pid=1-s2.0-S0870255124000659-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139941020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ghost in the heart: A case of post ischemia left ventricular false tendon rupture","authors":"Mostafa Yahyazadeh Andevari,&nbsp;Reza Hali","doi":"10.1016/j.repc.2023.10.008","DOIUrl":"10.1016/j.repc.2023.10.008","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 6","pages":"Pages 353-355"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S087025512400009X/pdfft?md5=91fd808afd5a1e96a113ac247e1530ea&pid=1-s2.0-S087025512400009X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139564744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current and future challenges: Exploring new opportunities in stroke education for atrial fibrillation patients","authors":"Alexandre Amaral e Silva","doi":"10.1016/j.repc.2024.04.004","DOIUrl":"10.1016/j.repc.2024.04.004","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 6","pages":"Pages 327-329"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124001148/pdfft?md5=49599fa206246c5305e12118ae1b8c7e&pid=1-s2.0-S0870255124001148-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"The challenge of choosing the right prosthesis for the right patient - The devil is in the details\".","authors":"Gonçalo F Coutinho","doi":"10.1016/j.repc.2024.05.004","DOIUrl":"https://doi.org/10.1016/j.repc.2024.05.004","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}