Revista Portuguesa De Cardiologia最新文献

{"title":"Validation of an Aerobic Fitness Questionnaire to estimate VO2 peak in a cohort of adult cardiac patients – Is it enough?","authors":"Maria Rita Lima ,&nbsp;Rita Amador ,&nbsp;João Presume ,&nbsp;Gonçalo Cunha ,&nbsp;Luís Moreno ,&nbsp;Anaí Durazzo ,&nbsp;Claudio Gil Araújo ,&nbsp;Miguel Mendes","doi":"10.1016/j.repc.2024.10.005","DOIUrl":"10.1016/j.repc.2024.10.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Cardiopulmonary exercise testing (CPET) is the gold standard for quantifying aerobic functional capacity, yet it is costly and not widely available. The CLINIMEX Aerobic Fitness Questionnaire (C-AFQ) may be a practical alternative as it estimates oxygen consumption at peak exercise (VO₂ peak) based on patients’ responses to a list of activities with known energy requirements. However, its applicability in cardiac patients is unclear and has not yet been studied. This study aims to assess the C-AFQ performance in predicting VO₂ peak, measured via CPET, in adult patients with confirmed heart disease.</div></div><div><h3>Methods</h3><div>This was a single-center prospective study enrolling consecutive patients who underwent CPET from April/2022 to January/2023. The main indication for CPET was measuring aerobic functional capacity for cardiovascular risk stratification.</div></div><div><h3>Results</h3><div>A total of 124 patients (mean age 62<!--> <!-->±<!--> <!-->12 years, 75% male, 59% in the early phase post-myocardial infarction, 61% had heart failure, mean left ventricular ejection fraction 47<!--> <!-->±<!--> <!-->12%) with maximal CPET were included. Overall, a strong correlation was found between CPET and C-AFQ VO₂ peak values (r=0.723, p&lt;0.001). However, when performing a Bland–Altman plot analysis, we found a heightened confidence interval for the agreement between CPET and C-AFQ VO₂ peak: 0.62<!--> <!-->±<!--> <!-->6.93 (95% CI −12.96–14.21) mL kg⁻¹ min⁻¹. CPET VO₂ peak and the VO₂ peak estimated by the exercise test protocol were related (r=0.777, p&lt;0.001).</div></div><div><h3>Conclusion</h3><div>Although cardiorespiratory fitness estimation from the C-AFQ performs well in a large population, the utility of this questionnaire to estimate cardiorespiratory fitness in this study's population sample has limited value. However, it may be useful to aid physicians in choosing the adequate exercise test protocol that best fits an individual patient.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 4","pages":"Pages 219-228"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014518","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 contribution of genetics to the understanding and management of cardiomyopathies: Part 1","authors":"Isabel Cardoso ,&nbsp;Sofia Nunes ,&nbsp;Pedro Brás ,&nbsp;José Miguel Viegas ,&nbsp;Miguel Marques Antunes ,&nbsp;André Ferreira ,&nbsp;Inês Almeida ,&nbsp;Inês Custódio ,&nbsp;Conceição Trigo ,&nbsp;Sérgio Laranjo ,&nbsp;Rafael Graça ,&nbsp;Rui Cruz Ferreira ,&nbsp;Mário Oliveira ,&nbsp;Sílvia Aguiar Rosa ,&nbsp;Diana Antunes","doi":"10.1016/j.repc.2024.11.012","DOIUrl":"10.1016/j.repc.2024.11.012","url":null,"abstract":"<div><div>Genetics has assumed a pivotal role in clarifying the pathophysiology of cardiomyopathies, facilitating molecular diagnosis, and enabling effective family screening. The advent of next-generation sequencing has revolutionized genetic testing by enabling cost-effective, high-throughput analysis. It is imperative for cardiovascular physicians to mainstream genetic testing into their clinical decision-making. Although a definitive genotype-phenotype correlation may not always be evident, several genotypes have emerged as valuable risk predictors for disease severity and progression. European guidelines emphasize the importance of genetic tests for predicting clinical outcome in cardiomyopathies. While further research is essential to bridge existing gaps in the genetic evidence on cardiomyopathies, there is considerable potential for significant advancements.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 4","pages":"Pages 245-254"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484402","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":"Pulmonary arterial aneurysm in a pulmonary hypertension patient","authors":"Joana Lima Lopes ,&nbsp;Filipa Ferreira","doi":"10.1016/j.repc.2024.11.015","DOIUrl":"10.1016/j.repc.2024.11.015","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 5","pages":"Pages 333-334"},"PeriodicalIF":1.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744337","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}

{"title":"The contribution of genetics to the understanding and management of cardiomyopathies: Part 2","authors":"Isabel Cardoso ,&nbsp;Mafalda Melo ,&nbsp;Pedro Brás ,&nbsp;José Miguel Viegas ,&nbsp;Inês Almeida ,&nbsp;Sofia Nunes ,&nbsp;Inês Custódio ,&nbsp;Conceição Trigo ,&nbsp;Sérgio Laranjo ,&nbsp;Rafael Graça ,&nbsp;Rui Cruz Ferreira ,&nbsp;Mário Oliveira ,&nbsp;Sílvia Aguiar Rosa ,&nbsp;Diana Antunes","doi":"10.1016/j.repc.2024.11.016","DOIUrl":"10.1016/j.repc.2024.11.016","url":null,"abstract":"<div><div>Cardiomyopathies may present as a manifestation of various inherited syndromes. Recognizing the rarity and diagnostic challenges of syndromic and metabolic cardiomyopathies is crucial, as their identification holds significant implications for targeted treatment and enables the use of specific risk stratification tools. Genetics has assumed a pivotal role in clarifying the pathophysiology of cardiomyopathies, facilitating molecular diagnosis, and enabling effective family screening. The advent of next-generation sequencing has revolutionized genetic testing, enabling cost-effective, high-throughput analyses, facilitating the diagnosis of these rare conditions, and allowing the provision of specific management and therapeutics.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 5","pages":"Pages 321-329"},"PeriodicalIF":1.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744338","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}

{"title":"Strategic Plan for Cardiovascular Health in Portugal – Portuguese Society of Cardiology (PESCP-SPC) – Part II","authors":"Sofia Cabral ,&nbsp;Cristina Gavina ,&nbsp;Manuel Almeida ,&nbsp;Alexandra Sousa ,&nbsp;Ana Rita Francisco ,&nbsp;Eduardo Infante Oliveira ,&nbsp;Kevin Domingues ,&nbsp;Luísa Moura Branco ,&nbsp;Sílvia Monteiro ,&nbsp;Sofia Alegria ,&nbsp;Rui Baptista ,&nbsp;Ana Abreu ,&nbsp;Carla Sousa ,&nbsp;Daniel Caeiro ,&nbsp;Daniel Seabra ,&nbsp;Diogo Cavaco ,&nbsp;Elisabete Martins ,&nbsp;Maria Luísa Bento ,&nbsp;Nuno Ferreira ,&nbsp;Nuno Marques ,&nbsp;Hélder Pereira","doi":"10.1016/j.repc.2025.03.003","DOIUrl":"10.1016/j.repc.2025.03.003","url":null,"abstract":"<div><div><em>The Strategic Plan for Cardiovascular Health in Portugal</em> is an initiative of the Portuguese Society of Cardiology, developed together with the European Society of Cardiology to create a European Cardiovascular Health Plan, an initiative which has now been endorsed by the Council of the European Union. Building upon its conceptual framework, the Portuguese Society of Cardiology moved to the implementation phase by establishing Working Groups composed of experts in priority areas. Guided by strategic pillars, these groups formulated proposals for action encompassing health promotion, primary prevention and health determinants, screening and early diagnosis, secondary prevention, as well as rehabilitation and quality of life promotion. This document outlines the results and messages from this project.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 5","pages":"Pages 303-319"},"PeriodicalIF":1.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674588","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}

{"title":"Hemodynamic effect of outpatient levosimendan infusion assessed daily using the CardioMEMS™ invasive remote monitoring system","authors":"Ana Rita Teixeira ,&nbsp;Francisco Barbas de Albuquerque ,&nbsp;Tiago Pereira-da-Silva ,&nbsp;António Valentim Gonçalves ,&nbsp;Rita Ilhão Moreira ,&nbsp;Ana Teresa Timóteo ,&nbsp;João Alves ,&nbsp;Sofia Barquinha ,&nbsp;Rita Mata ,&nbsp;Mariline Dias ,&nbsp;Duarte Cacela ,&nbsp;Rui Cruz Ferreira","doi":"10.1016/j.repc.2024.11.014","DOIUrl":"10.1016/j.repc.2024.11.014","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Levosimendan infusion in the outpatient setting improves the clinical status of heart failure (HF) patients, although its hemodynamic effects are not entirely known. Remote monitoring using the CardioMEMS™ system enables daily assessment of pulmonary artery pressure (PAP) and estimation of cardiac output (CO). We aimed to assess the hemodynamic effects of outpatient levosimendan infusion using CardioMEMS™.</div></div><div><h3>Methods</h3><div>All patients admitted for 6-hour levosimendan infusion (performed every 14 days) and using the CardioMEMS™ remote monitoring system were included in a prospective single-center registry. Clinical and laboratory data were recorded. Systolic, diastolic, and mean PAP, heart rate, CO, and stroke volume (SV) were assessed daily.</div></div><div><h3>Results</h3><div>A total of 25 sessions were performed in three patients. There were no adverse events or significant therapy adjustments. There was a significant reduction in diastolic PAP the day after levosimendan infusion compared to baseline (day prior to infusion) (24.1±4.1 mmHg vs. 21.6±2.9 mmHg, p=0.006). Thereafter, diastolic PAP stabilized and remained significantly lower than baseline up to day 10. There were no significant differences in systolic PAP, mean PAP, heart rate, CO, or SV at any timepoint analyzed, although there was a nonsignificant increase in CO with a peak at day 6.</div></div><div><h3>Conclusion</h3><div>Outpatient levosimendan infusion was associated with an early reduction in diastolic PAP, which was maintained for 10 days. The CardioMEMS™ system may enable a better understanding of outpatient hemodynamics in advanced HF. To our knowledge, there are no published data on this subject.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 5","pages":"Pages 281-288"},"PeriodicalIF":1.6,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587687","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}

{"title":"A Portuguese expert panel position paper on the management of heart failure with preserved ejection fraction – Part II: Unmet needs and organization of care in Portugal","authors":"José Silva-Cardoso ,&nbsp;Emília Moreira ,&nbsp;Rachel Tavares de Melo ,&nbsp;Pedro Moraes-Sarmento ,&nbsp;Nuno Cardim ,&nbsp;Mário Oliveira ,&nbsp;Cristina Gavina ,&nbsp;Brenda Moura ,&nbsp;Inês Araújo ,&nbsp;Paulo Santos ,&nbsp;Marisa Peres ,&nbsp;Cândida Fonseca ,&nbsp;João Pedro Ferreira ,&nbsp;Irene Marques ,&nbsp;Aurora Andrade ,&nbsp;Rui Baptista ,&nbsp;Dulce Brito ,&nbsp;Rui Cernadas ,&nbsp;Jonathan dos Santos ,&nbsp;Adelino Leite-Moreira ,&nbsp;Joana Pimenta","doi":"10.1016/j.repc.2024.12.004","DOIUrl":"10.1016/j.repc.2024.12.004","url":null,"abstract":"<div><div>In Portugal, a 15.2% prevalence of heart failure with preserved ejection fraction (HFpEF) was recently identified among those aged ≥50 years. HFpEF represents 90% of Portuguese heart failure patients.</div><div>HFpEF management in Portugal is challenging due to patient heterogeneity, diagnostic and therapeutic complexity, and organizational constraints on the healthcare system.</div><div>Considering the above, a panel of Portuguese experts convened to address HFpEF management within the national context. This was done in a two-paper set.</div><div>This, the second paper, identifies unmet needs and suggests a set of measures to improve the current organization of HFpEF management in Portugal. Our purpose is to create a multidisciplinary integrated care system, ensuring a seamless connection between hospitals and primary care. Additionally, we propose a practical approach to the management of HFpEF, including a roadmap for screening, diagnosis, referral and treatment. The aim is to help clinicians improve HFpEF management throughout the disease trajectory.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 5","pages":"Pages 291-302"},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587681","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}

{"title":"Unraveling the genetic basis of subclinical atherosclerosis: Early genetic detection can improve cardiovascular prevention.","authors":"Débora Sá, Maria Isabel Mendonça, Marco Serrão, Francisco Sousa, Gonçalo Abreu, Eva Henriques, Sofia Borges, Sónia Freitas, Mariana Rodrigues, Graça Guerra, Ilídio Ornelas, António Drumond, Ana Célia Sousa, Roberto Palma Dos Reis","doi":"10.1016/j.repc.2025.01.003","DOIUrl":"10.1016/j.repc.2025.01.003","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Decoding the genetic basis of coronary artery disease (CAD) through an intermediate phenotype - coronary calcification - can help us to better understand this deadly disease and enable the creation of better therapeutic strategies. This work aims to assess the relationship between a set of single nucleotide polymorphisms (SNPs) previously associated with CAD and coronary artery calcium (CAC) score in a Portuguese asymptomatic population.</p><p><strong>Methods: </strong>A prospective study was conducted in a cohort of 1284 subjects (aged 59.3±8.9 years, 73.6% males) without CAD. CAC score was performed using cardiac computed tomography. Thirty-three SNPs were genotyped using TaqMan real-time PCR. Anthropometric, conventional, and biochemical risk factors were evaluated. Bivariate and multivariate regression analysis estimated variables associated with the CAC score.</p><p><strong>Results: </strong>PHACTR1 rs1332844 C>T, a downstream regulator of the endothelin-1 gene, showed a significant association with CAC score (p=0.015), together with CDKN2B-AS1 variants rs4977574 A>G (p=0.002) and rs1333049 G>C (p=0.010) in the 9p21.3 locus. MTHFD1L rs6922269 G>A variant encoding a mitochondrial enzyme responsible for homocysteine remethylating showed protection against artery calcification (p=0.013). After multivariate logistic regression, PHACTR1 rs1332844 (CT+TT) (OR=1.478; p=0.009) and CDKN2B-AS1 rs4977574 (GG) (OR=1.479; p=0.002) remained in the equation as independently associated with arterial calcification. MTHFD1L rs6922269 (AA) also remained associated with a lower CAC score (OR=0.558; p=0.027).</p><p><strong>Conclusion: </strong>This study showed that three genetic variants previously linked with CAD are associated with CAC in asymptomatic populations. Understanding these genetic factors, combined with conventional risk factors, could guide lifestyle changes or pharmacologic interventions to mitigate CAD risk before the disease becomes clinical.</p>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587693","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}

{"title":"Sex-related differences in ST-segment elevation myocardial infarction: A Portuguese multicenter national registry analysis","authors":"Carolina Miguel Gonçalves ,&nbsp;Mariana Carvalho ,&nbsp;Adriana Vazão ,&nbsp;Margarida Cabral ,&nbsp;André Martins ,&nbsp;Fátima Saraiva ,&nbsp;João Morais ,&nbsp;on behalf of ProACS Investigators","doi":"10.1016/j.repc.2024.06.005","DOIUrl":"10.1016/j.repc.2024.06.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Sex differences among patients with acute myocardial infarctions remain a matter of debate. Inequalities in presentation, diagnosis, treatment, and prognosis are frequently observed, contributing to a worse prognosis in women. The aim of this study was to investigate sex-related differences in Portuguese ST-segment elevation myocardial infarction (STEMI) patients.</div></div><div><h3>Methods</h3><div>The authors conducted a retrospective analysis of STEMI patients included in the Portuguese Registry on Acute Coronary Syndromes, between October 2010 and 2022. The two co-primary endpoints were in-hospital and one-year mortality.</div></div><div><h3>Results</h3><div>A total of 14<!--> <!-->470 STEMI patients were studied. Women were underrepresented with 3721 individuals (25.7%). They were significantly older (70 vs. 62 years, p&lt;0.001), with higher prevalence of cardiovascular risk factors, and underwent less frequently coronary angiography (84.4% vs. 88.5%, p&lt;0.001) and guideline-directed medical therapy (e.g., aspirin 92.5% vs. 95.4%, beta blockers 79.2% vs. 83%, p&lt;0.001). Furthermore, they experienced more complications, such as congestive heart failure (23.4% vs. 14.6%), ischemic stroke (47% vs. 40%), and in-hospital mortality (8.5% vs. 4.1%) (p&lt;0.001 for all comparisons). Similarly, they presented higher one-year mortality (11.5% vs. 6.3%, p&lt;0.001). However, after a multivariate analysis testing significant clinical variables, female sex remained an independent predictor for in-hospital (odds ratio=1.633; 95% CI [1.065–2.504]; p=0.025), but not for one-year mortality.</div></div><div><h3>Conclusions</h3><div>This analysis reveals sex-related disparities in Portuguese STEMI patients. Despite limitations inherent to registry-based analysis, women were significantly older, with increased cardiovascular risk, less treated, and with higher in-hospital mortality. These disparities should be a concern for clinicians to further improve outcomes and move toward equitable medical care.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 3","pages":"Pages 167-176"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113886","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":"Multidisciplinary cardiorenal program for heart failure patients: Improving outcomes through comprehensive care","authors":"Rita Calça ,&nbsp;Anabela Malho ,&nbsp;Ana Teresa Domingos ,&nbsp;Raquel Menezes Fernandes ,&nbsp;Francisca Gomes da Silva ,&nbsp;Carlos Aguiar ,&nbsp;António Tralhão ,&nbsp;Jorge Ferreira ,&nbsp;Anabela Rodrigues ,&nbsp;Cândida Fonseca ,&nbsp;Patrícia Branco","doi":"10.1016/j.repc.2024.09.003","DOIUrl":"10.1016/j.repc.2024.09.003","url":null,"abstract":"<div><div>The cardiorenal program (CRP), implemented within a specialized heart failure and kidney disease clinic, encompasses a multidisciplinary approach to the management of patients with heart failure and kidney disease. It focuses on optimizing therapy and improving patient outcomes. The CRP includes a range of services, including clinical evaluation, diagnostic testing, medical treatment, and patient education. The program provides comprehensive care for patients with cardiorenal syndrome, and includes a variety of healthcare professionals, such as cardiologists, nephrologists, pharmacists, and nurses, working together to provide the best possible care. The program also incorporates specific performance indicators to continuously evaluate and improve patient outcomes. The CRP's integrated multidisciplinary care and patient-centered approach is promising for the management of patients with cardiorenal syndrome.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 3","pages":"Pages 179-187"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014442","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}