Revista Portuguesa De Cardiologia最新文献

{"title":"Dyslipidemia in primary care patients – Treatment and control (LANTERN study) Algarve","authors":"Sara Teixeira,&nbsp;Adriana Justo Correia,&nbsp;Manuela Castro,&nbsp;Ana Margarida Pombo,&nbsp;Ana Palhau,&nbsp;Davide Reis,&nbsp;Inês Costa,&nbsp;Jonathan Silva,&nbsp;Pedro Tavares,&nbsp;Rui Estevens,&nbsp;Rui Vicente Miranda","doi":"10.1016/j.repc.2026.04.006","DOIUrl":"10.1016/j.repc.2026.04.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Cardiovascular disease (CVD) is the leading cause of mortality in Portugal. Dyslipidemia, particularly elevated LDL-C, is a key modifiable risk factor. European guidelines recommend LDL-C targets based on cardiovascular (CV) risk, yet treatment gaps persist. This study aimed to evaluate LDL-C control and management in primary care patients with dyslipidemia in the Algarve, according to the 2019/2021 ESC/EAS guidelines.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted using electronic health records from nine Family Health Units in the Algarve. Adults aged ≥40 years with a diagnosis of dyslipidemia (ICPC-2 code T93) were included. CV risk was assessed using SCORE2/OP for patients in primary prevention; LDL-C levels and treatment strategies were analyzed.</div></div><div><h3>Results</h3><div>Among 2904 patients (mean age 66.4 years; 54.5% female), 79% were classified as being high or very high risk. Only 15.7% achieved LDL-C targets. Among high/very high-risk patients, 88% were above recommended LDL-C thresholds. 29.9% of patients received no pharmacological treatment, and 47% were on low/moderate-intensity statins. High-intensity statins alone or in combination therapy were used in only 14.4% of cases.</div></div><div><h3>Conclusions</h3><div>LDL-C target achievement remains suboptimal in Portuguese primary care, particularly in high-risk patients. The underuse of intensive treatment highlights opportunities for improving CV prevention, especially through updated risk assessment tools like SCORE2/OP.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 9","pages":"Pages 465-474"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680810","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":"Prognosis of acute myocarditis beyond hospitalization: Results of a long-term prospective study","authors":"Marta Vilela,&nbsp;Ana Margarida Martins,&nbsp;Daniel Cazeiro,&nbsp;Joana Rigueira,&nbsp;Rui Plácido,&nbsp;Dulce Brito,&nbsp;Ana G. Almeida,&nbsp;Fausto J. Pinto,&nbsp;Miguel Nobre Menezes","doi":"10.1016/j.repc.2026.02.008","DOIUrl":"10.1016/j.repc.2026.02.008","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>To assess long-term outcomes of acute myocarditis (AM).</div></div><div><h3>Methods</h3><div>Prospective, single-center observational study including patients admitted with AM between 2007 and 2022, followed at a tertiary cardiology center. Follow-up (FUP) included annual clinical evaluations, treadmill testing, Holter and echocardiography. Statistical analysis was performed using chi-square test and Cox regression.</div></div><div><h3>Results</h3><div>We included 158 patients, 12.7% female, with a mean age of 32<!--> <!-->±<!--> <!-->12 years. Most presented with chest pain (94.3%). Severe complications, including cardiogenic shock or arrhythmic storm, occurred in 3.6%. Upon admission, the mean left ventricle ejection fraction (LVEF) was 57%. Out of the 140 patients who underwent cardiac magnetic resonance imaging (CMR), myocardial oedema and late gadolinium enhancement (LGE) were present in 47.8% and 88.5%, respectively. During a mean FUP time of 6<!--> <!-->±<!--> <!-->4.3 years, 13.3% patients were readmitted, 80.9% of them due to recurrent myocarditis. Only one patient with LVEF &lt;50% at admission did not recover at FUP. No patients exhibited significant arrhythmias during Holter monitoring or treadmill stress tests. Six patients died at FUP. Three patients had experienced fulminant myocarditis (FM) at index admission; two of them died due to CV causes. There was a statistically significant association between death and fulminant presentation during index admission (p&lt;0.001).</div></div><div><h3>Conclusion</h3><div>AM in adults typically followed a benign course with favorable short- and long-term outcomes. In contrast, a small but significant subset with FM had a markedly poorer prognosis, with severe recurrences frequently proving fatal. Clinical presentation was the sole determinant of prognosis, prompting consideration of whether patients with milder cases truly require extended FUP.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 9","pages":"Pages 501-509"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382889","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":"Primary prevention ICD implantation in patients with left bundle branch block and nonischemic cardiomyopathy","authors":"Zhengyu Lin,&nbsp;Xinyin Xie,&nbsp;Hui Zeng,&nbsp;Xuanyan Zhong,&nbsp;Min Yu","doi":"10.1016/j.repc.2026.08.001","DOIUrl":"10.1016/j.repc.2026.08.001","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 9","pages":"Pages 551-552"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697753","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":"Impact of sodium-glucose cotransporter 2 inhibitors on blood glucose levels in patients with heart failure with reduced ejection fraction without diabetes","authors":"Yasser Ahmed Abd El Hady,&nbsp;Abd Allah Shahat Ali Abd Elaziz,&nbsp;Abeer Adly Mahmoud","doi":"10.1016/j.repc.2026.04.007","DOIUrl":"10.1016/j.repc.2026.04.007","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Sodium-glucose cotransporter 2 inhibitors (SGLT2) were initially developed as antihyperglycemic agents for the management of type 2 diabetes mellitus (T2DM). This study sought to evaluate the impact of sodium-glucose cotransporter 2 inhibitors on blood glucose levels in patients with HFrEF without diabetes.</div></div><div><h3>Methods</h3><div>This randomized controlled trial included 130 patients with HF classified as NYHA class II to IV and without diabetes, with an ejection fraction (EF) below 40% as determined by echocardiography within the preceding three months. Baseline assessments included serum creatinine, random and fasting blood glucose, 2-hour postprandial glucose, HbA1c, urine acetone, BMI, blood pressure, and serum electrolytes (sodium, potassium, magnesium, ionized calcium, and phosphorus). After three months of treatment, all these clinical and laboratory parameters were reassessed in both groups.</div></div><div><h3>Results</h3><div>Treatment led to significant improvements in cardiac function, including reductions in left ventricular diameters and volumes, and increases in ejection fraction, tricuspid annular plane systolic excursion, and right ventricular fractional area change (p&lt;0.05). Glycemic control also improved, with significant decreases in fasting, postprandial, HbA1c, and random blood glucose (p&lt;0.001). Serum creatinine, magnesium, and phosphorus levels increased significantly (p&lt;0.001). Adverse events were minimal, with only one patient showing urine acetone positivity (1.5%, p=0.99), and no symptomatic hypoglycemia, ketoacidosis, or significant hypotension occurred.</div></div><div><h3>Conclusions</h3><div>SGLT2 inhibitors safely reduce blood glucose in patients with HFrEF without diabetes without causing hypoglycemia, highlighting their potential cardiovascular and metabolic benefits and supporting their use in this population.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 9","pages":"Pages 487-496"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680745","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":"Dyslipidemia in the dark: the LANTERN Algarve study and the LDL-C control gap in Portuguese primary care","authors":"Daniel Caldeira","doi":"10.1016/j.repc.2026.08.002","DOIUrl":"10.1016/j.repc.2026.08.002","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 9","pages":"Pages 475-477"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946002","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":"Beyond glycemia: What SGLT2 inhibitors in non-diabetic heart failure really teach us","authors":"Cândida Fonseca,&nbsp;Dulce Brito","doi":"10.1016/j.repc.2026.08.003","DOIUrl":"10.1016/j.repc.2026.08.003","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 9","pages":"Pages 497-499"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148942010","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":"A cardiomyopathy puzzle: What is relevant and what is incidental?","authors":"Inês Pereira de Miranda,&nbsp;Filipa Gerardo,&nbsp;Rodrigo Brandão,&nbsp;João Bicho Augusto","doi":"10.1016/j.repc.2026.03.016","DOIUrl":"10.1016/j.repc.2026.03.016","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 9","pages":"Pages 543-544"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498320","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":"All-cause mortality benefits of attending phase 3 cardiac rehabilitation: A systematic review","authors":"Inês Aguiar-Ricardo,&nbsp;Daniel Inácio Cazeiro,&nbsp;Pedro Alves da Silva,&nbsp;Catarina Sena Silva,&nbsp;Ana Abrantes,&nbsp;Nelson Cunha,&nbsp;Maria Clarissa Rodrigues,&nbsp;Ana Rita Cardoso Andrade,&nbsp;Rita Pinto,&nbsp;Daniel Caldeira,&nbsp;Fausto J. Pinto,&nbsp;Ana Abreu","doi":"10.1016/j.repc.2025.11.014","DOIUrl":"10.1016/j.repc.2025.11.014","url":null,"abstract":"<div><h3>Aim</h3><div>The primary objective of this study was to assess the impact of attending a phase 3 cardiac rehabilitation (CR) program on all-cause mortality.</div></div><div><h3>Methods</h3><div>We conducted a systematic review using database searches (MEDLINE and Cochrane Central Register of Controlled Trials) up to December 2022 to identify studies that compared adult patients undergoing phase 3 of CR with those receiving usual care.</div></div><div><h3>Results</h3><div>Out of a total of 1867 identified articles, eight met the eligibility criteria (two randomized controlled trials (RCT) and six non-RCT) and were included (n=60<!--> <!-->939 patients; 82% male, average age of 62±11 years). Phase 3 of a CR program showed a significant association with reduced mortality rates, with a hazard ratio (HR) of 0.56 (95% CI 0.49–0.65), with minimal evidence of statistical heterogeneity. The studies presented a range of differently structured CR programs. They varied in duration, training methods, and components.</div></div><div><h3>Conclusion</h3><div>This systematic review demonstrates that attending a phase 3 CR program has the beneficial effect of reducing mortality among patients with cardiovascular disease, in particular those with coronary artery disease. These findings highlight the importance of CR participation on a long-term basis and reinforce the value of increasing the number of specialized worldwide and optimizing patient referrals to participate in a long-term phase 3 CR program.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 9","pages":"Pages 513-523"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680784","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":"Ramping ubiquitinomics for the design of new sex-specific therapeutic strategies for aortic valve stenosis: Study protocol","authors":"Fábio Trindade,&nbsp;Ana Grego,&nbsp;Daniel Seabra-Carvalho,&nbsp;Cláudia Sousa-Mendes,&nbsp;Carla Sousa,&nbsp;Francisca Saraiva,&nbsp;Adelino Leite-Moreira,&nbsp;Cristina Gavina,&nbsp;Rita Nogueira-Ferreira,&nbsp;Sandra Marisa Oliveira","doi":"10.1016/j.repc.2026.05.004","DOIUrl":"10.1016/j.repc.2026.05.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Aortic valve stenosis (AVS) is a growing healthcare burden and a paradigmatic example of sexual dimorphism in cardiovascular disease. Degenerative AVS results from valve fibrosis and calcification, affecting mainly women and men, respectively. Despite &gt;20 years of clinical trials testing drugs such as statins, actaciguat, or vitamin K, aortic valve replacement (AVR) remains the only effective treatment. Evidence points to the relevance of protein ubiquitination in AVS progression, yet a holistic characterization of the ubiquitinome using mass spectrometry (MS) is lacking. Such an approach could uncover new targets for proteolysis-targeting chimeras (PROTACs), which remain underexplored in cardiovascular disease. RUBITAV aims to characterize the ubiquitinome landscape associated with fibrotic and calcific transformation of the valve and unveil sex-specific therapeutic targets. RUBITAV also aims to test the effect of modulating ubiquitinated proteins with PROTACs to mitigate fibrosis and calcification.</div></div><div><h3>Methods</h3><div>Aortic valves will be collected from a sex-balanced and comorbidities-matched AVS cohort and dissected into morphologically normal, fibrotic, and calcified sections. Following protein extraction, ubiquitinated proteins will be enriched and quantified by MS. Putative sex-specific targets identified using bioinformatics will be modulated <em>in vitro</em> with PROTACs using valve interstitial cells maintained under pro-fibrotic or pro-calcific conditions. The primary outcome is defined as the % reduction in fibrosis (females) and calcification (males).</div></div><div><h3>Results</h3><div>Not applicable.</div></div><div><h3>Conclusion</h3><div>RUBITAV is expected to advance our understanding of the role of protein ubiquitination in AVS, identify new sex-specific therapeutic targets, and pave the way for the application of PROTACs in the treatment of AVS.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 9","pages":"Pages 529-539"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537563","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":"Left bundle branch area pacing in LBBB-induced cardiomyopathy: Is the defibrillator component necessary?","authors":"Ugur Canpolat","doi":"10.1016/j.repc.2026.06.006","DOIUrl":"10.1016/j.repc.2026.06.006","url":null,"abstract":"<div><span><figure><span><img><ol><li><span><span>Download: <span>Download high-res image (187KB)</span></span></span></li><li><span><span>Download: <span>Download full-size image</span></span></span></li></ol></span></figure></span></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 9","pages":"Pages 549-550"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580927","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}