Revista Portuguesa De Cardiologia最新文献

{"title":"Temporal trends and outcomes of rotational atherectomy: A single-centre experience","authors":"Mafalda Griné ,&nbsp;Manuel Oliveira-Santos ,&nbsp;João Borges-Rosa ,&nbsp;Joana Delgado Silva ,&nbsp;Vítor Matos ,&nbsp;Marco Costa ,&nbsp;Lino Gonçalves","doi":"10.1016/j.repc.2024.09.005","DOIUrl":"10.1016/j.repc.2024.09.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Rotational atherectomy (RA) is widely used for the management of calcified coronary stenoses. However, there is limited data on its use, trends, and outcomes. We sought to report our twelve-year experience with RA and explore the trends and outcomes of percutaneous coronary intervention (PCI) with this device.</div></div><div><h3>Methods</h3><div>Our institutional PCI database was queried to identify all cases of RA-PCI performed between January 2009 and December 2020. We analysed peri-procedural outcomes and major adverse cardiovascular events (MACE) during follow-up: cardiovascular death, myocardial infarction, and target lesion revascularization.</div></div><div><h3>Results</h3><div>Four hundred ten procedures (2.8% of total PCI volume) in 388 patients were included. Mean age was 72.3<!--> <!-->±<!--> <!-->9.3 years, 74.0% were male, 53.6% had diabetes, and 33.8% presented with acute coronary syndrome. There was a significant increase in median SYNTAX score (p_trend=0.003) and the proportion of type B2/C lesions (p_trend=0.003). Transradial access was preferred (60.0% overall) with a growing trend over time (p_trend=0.003). Maximum burr size was &lt;1.75 mm in 88.0% of cases (burr-to-artery ratio of 0.49<!--> <!-->±<!--> <!-->0.07). Angiographic success rate was consistently high (96.6% overall). Complications were recorded in 9.0% of procedures, with a temporal decline (p_trend=0.029). Clinical follow-up was available for 357 patients (median time of 40 months). At one year, MACE rate was 12.1% with no significant temporal changes.</div></div><div><h3>Conclusions</h3><div>RA-PCI was a safe and effective procedure with a high rate of angiographic success and few complications, particularly in recent years, in line with significant technical improvements. The MACE incidence is acceptable considering the clinical risk and angiographic complexity.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 4","pages":"Pages 205-214"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014350","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":"Rotational atherectomy. Is it still the main tool in hard rock combat?","authors":"Jorge Guardado","doi":"10.1016/j.repc.2025.02.004","DOIUrl":"10.1016/j.repc.2025.02.004","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 4","pages":"Pages 215-217"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537975","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 Portuguese expert panel position paper on the management of heart failure with preserved ejection fraction – Part I: Pathophysiology, diagnosis and treatment","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.2024.11.011","DOIUrl":"10.1016/j.repc.2024.11.011","url":null,"abstract":"<div><div>Heart failure (HF) with preserved ejection fraction (HFpEF) affects more than 50% of HF patients worldwide, and more than 70% of HF patients aged over 65. This is a complex syndrome with a clinically heterogeneous presentation and a multifactorial pathophysiology, both of which make its diagnosis and treatment challenging.</div><div>A Portuguese HF expert panel convened to address HFpEF pathophysiology and therapy, as well as appropriate management within the Portuguese context. This initiative resulted in two position papers that examine the most recently published literature in the field.</div><div>The present Part I includes a review of the HFpEF literature covering pathophysiology, clinical presentation, diagnosis and treatment, including pharmacological and non-pharmacological strategies.</div><div>Part II, the second paper, addresses the development of a holistic and integrated HFPEF clinical care system within the Portuguese context that is capable of reducing morbidity and mortality and improving patients’ functional capacity and quality of life.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 4","pages":"Pages 233-243"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469747","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":"An unusual finding in severe mitral regurgitation complicated with hypoxemia: The importance of three-dimensional echocardiography","authors":"Inês Ferreira Neves ,&nbsp;Francisco Barbas de Albuquerque ,&nbsp;Ruben Ramos ,&nbsp;Rui Rodrigues ,&nbsp;Ana Galrinho","doi":"10.1016/j.repc.2024.11.013","DOIUrl":"10.1016/j.repc.2024.11.013","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 4","pages":"Pages 255-256"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469748","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":"Aerobic fitness questionnaires – Still not enough to estimate VO2 peak in cardiac patients!","authors":"Ana Abreu","doi":"10.1016/j.repc.2025.03.001","DOIUrl":"10.1016/j.repc.2025.03.001","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 4","pages":"Pages 229-231"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587684","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":"Revisiting the “cholesterol paradox” in heart failure. Is LDL-cholesterol a target of treatment or a marker of risk?","authors":"Rui Gomes,&nbsp;Carlos Aguiar","doi":"10.1016/j.repc.2025.03.002","DOIUrl":"10.1016/j.repc.2025.03.002","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 4","pages":"Pages 201-203"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587690","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":"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}