Revista Portuguesa De Cardiologia最新文献

{"title":"Cooperar para cuidar: cardiologia entre Portugal e Moçambique","authors":"Rui Plácido, Bebiana Faria, António Pires, Ana Filipa Amador, Diogo Ferreira, José Ricardo, Jorge Moreira, Víctor Gil","doi":"10.1016/j.repc.2026.03.015","DOIUrl":"10.1016/j.repc.2026.03.015","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 9","pages":"Pages 541-542"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406572","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":"What is the optimal long-term management strategy after acute myocarditis?","authors":"Marta Afonso Nogueira","doi":"10.1016/j.repc.2026.06.005","DOIUrl":"10.1016/j.repc.2026.06.005","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 9","pages":"Pages 511-512"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370450","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":"Dual left anterior descending artery type IV: The role of coronary computed tomography angiography – anatomical classification and risk","authors":"Jéni Quintal, Tatiana Duarte, Filipe Seixo, António Pinheiro Candjondjo, Catarina Lagoas Pohle, Ricardo Santos","doi":"10.1016/j.repc.2026.03.017","DOIUrl":"10.1016/j.repc.2026.03.017","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 9","pages":"Pages 545-547"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498315","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":"OCT-documented cutting-balloon fenestration of intramural hematoma in right coronary artery dissection","authors":"Ricardo Carvalheiro, André Grazina, Tiago Mendonça","doi":"10.1016/j.repc.2026.03.012","DOIUrl":"10.1016/j.repc.2026.03.012","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 8","pages":"Pages 463-464"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354564","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":"Exploring the impact of the GJA4 rs618675 variant on cardiovascular prevention","authors":"Maria Isabel Mendonça,&nbsp;Roberto Palma dos Reis,&nbsp;Débora Sá,&nbsp;Francisco Sousa,&nbsp;Eva Henriques,&nbsp;Sofia Borges,&nbsp;Sónia Freitas,&nbsp;Mariana Rodrigues,&nbsp;Graça Guerra,&nbsp;António Drumond,&nbsp;Ana Célia Sousa","doi":"10.1016/j.repc.2026.03.013","DOIUrl":"10.1016/j.repc.2026.03.013","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The gap junction alpha-4 (<em>GJA4</em>) gene, which encodes connexin37, regulates endothelial function and influences inflammation, platelet adhesion, and thrombus formation in vascular endothelial cells, which may favour atherosclerosis and cardiovascular (CV) events. The main objective was to assess whether the <em>GJA4</em> rs618675 T&gt;C variant is a risk factor for the onset of CV events in an asymptomatic Portuguese population.</div></div><div><h3>Methods</h3><div>One thousand four hundred twenty-one individuals without CV disease (52.2±8.3 years, 73.6% male) were followed up during a mean of 7.3±6.0 years, and CV events were recorded. <em>GJA4</em> rs618675 T&gt;C was genotyped by real-time PCR (TaqMan), and four genetic models were created. We analyzed traditional, biochemical and clinical risk factors. We performed bivariate analysis and adjusted logistic regression with respective OR. Kaplan–Meier estimated event-free survival and Cox regression, adjusted for confounding, evaluated the association between four genetic models and CV events (HR).</div></div><div><h3>Results</h3><div>Wild TT genotype, TC, and CC were 50.6%, 39.2%, and 10.1% in the CV events group and 66.2%, 30.4% and 3.4% in the non-events group (p=0.001). After logistic regression, the codominant model (CCvsTT and CTvsTT) showed an OR of 3.9 (p=0.002). Kaplan–Meier showed 87.6% event-free time for TT and 64.8% for CC (p=0.005). Adjusted Cox regression identified the codominant model as the best predictor (HR=2.8; p=0.008), together with male gender (HR=2.1; p=0.020), age (HR=1.1; p=0.001), hypertension (HR=1.9; p=0.014), smoking (HR=1.9; p=0.010), and leukocytosis (HR=1.2; p=0.003).</div></div><div><h3>Conclusion</h3><div>We have demonstrated that the CC variant of <em>GJA4</em> is significantly associated with CV events. Further investigations into this biomarker may improve CV risk prediction, leading to better primary prevention.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 8","pages":"Pages 421-429"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382874","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":"Connexin 37 and cardiovascular events in a Madeiran cohort","authors":"Rui Providência","doi":"10.1016/j.repc.2026.07.001","DOIUrl":"10.1016/j.repc.2026.07.001","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 8","pages":"Pages 431-432"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680218","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":"Comunicações","authors":"","doi":"10.1016/S0870-2551(26)00301-X","DOIUrl":"10.1016/S0870-2551(26)00301-X","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 ","pages":"Pages S1-S43"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149072141","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":"Feasibility and safety of parallel Shockwave® balloon percutaneous mitral valvuloplasty for degenerative mitral stenosis","authors":"Daniel Inácio Cazeiro,&nbsp;Diogo Ferreira,&nbsp;Fábio Viveiros,&nbsp;Catarina Oliveira,&nbsp;Tiago Rodrigues,&nbsp;Ana Rita Francisco,&nbsp;Cláudia Moreira Jorge,&nbsp;Pedro Cardoso,&nbsp;Fausto J. Pinto,&nbsp;João Silva Marques","doi":"10.1016/j.repc.2026.03.006","DOIUrl":"10.1016/j.repc.2026.03.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Degenerative mitral valve stenosis (DMS) associated with mitral annular calcification (MAC) poses significant diagnostic and therapeutic challenges. Surgical treatment and conventional percutaneous mitral commissurotomy are often contraindicated, and alternative transcatheter options remain limited and associated with high morbidity and mortality. Lithotripsy-assisted balloon valvuloplasty has recently emerged as a novel percutaneous strategy for selected patients. The objective of this article is to report on an initial feasibility and safety experience of lithotripsy-assisted balloon valvuloplasty without the use of noncompliant balloon post-dilatation.</div></div><div><h3>Methods</h3><div>We conducted a prospective, single-center study including consecutive patients with symptomatic severe DMS deemed unsuitable for surgery who underwent lithotripsy-assisted balloon valvuloplasty between August and October 2025. The cases were performed under conscious sedation using intracardiac echocardiography guidance. The procedure consisted of a single transseptal puncture accommodating two deflectable sheaths and simultaneous dual-balloon intravascular lithotripsy, without adjunctive noncompliant balloon valvuloplasty. The primary endpoint was technical success according to the Mitral Valve Academic Research Consortium criteria. Safety endpoints included 30-day major procedure-related morbidity and mortality.</div></div><div><h3>Results</h3><div>Three patients (median age 73 years; 67% female) underwent lithotripsy-assisted balloon valvuloplasty. Median baseline noninvasive and invasive transmitral mean gradients were 16 mmHg and 11 mmHg, respectively, decreasing to 7 mmHg after lithotripsy-assisted balloon valvuloplasty. No worsening of baseline mitral regurgitation was observed. There were no major periprocedural complications; one patient experienced a transient, self-limited period of junctional rhythm.</div></div><div><h3>Conclusions</h3><div>This proof-of-concept study of lithotripsy-assisted balloon valvuloplasty using a dual deflectable sheath, dual-balloon lithotripsy strategy was feasible and safe in selected patients with DMS. This approach may represent a promising therapeutic option for patients with limited alternatives, warranting further investigation in larger prospective studies.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 8","pages":"Pages 409-415"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662883","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 expert consensus statement on renal denervation for the management of hypertension endorsed by the Portuguese Association of Interventional Cardiology of the Portuguese Society of Cardiology (APIC-SPC) and the Portuguese Society of Hypertension (SPH)","authors":"Joana Delgado Silva,&nbsp;Vitória Cunha,&nbsp;Luís Nogueira-Silva,&nbsp;Rita Calé,&nbsp;Francisca Abecasis,&nbsp;Gonçalo Batista,&nbsp;José Mesquita Bastos,&nbsp;Manuel Almeida,&nbsp;Fernando Martos Gonçalves","doi":"10.1016/j.repc.2026.03.011","DOIUrl":"10.1016/j.repc.2026.03.011","url":null,"abstract":"<div><div>This national expert consensus statement, endorsed by the Portuguese Association of Interventional Cardiology of the Portuguese Society of Cardiology (APIC-SPC) and the Portuguese Society of Hypertension (SPH), provides practical guidance on the appropriate use of renal denervation for blood pressure management in adults with uncontrolled hypertension in spite of optimally tolerated guideline-directed therapy and lifestyle measures. It synthesizes evidence from contemporary sham-controlled trials and large real-world registries, which show sustained blood pressure reductions with both radiofrequency and ultrasound systems, and a favorable and consistent safety profile, while acknowledging remaining uncertainties in long-term clinical outcomes and individual response prediction. The document emphasizes rigorous patient selection within a structured pathway coordinated by multidisciplinary hypertension teams. It outlines organizational requirements for centers performing renal denervation, key elements of pre-procedural imaging and peri-procedural management, and a standardized follow-up strategy using office, home, and ambulatory monitoring to enable timely therapy adjustment. Beyond resistant hypertension, this statement discusses carefully selected scenarios in which RDN may be considered as an adjunctive option, while reinforcing that renal denervation is not first-line therapy and should be integrated into a comprehensive hypertension care. This consensus aims to clarify for which patients renal denervation may be a viable therapeutic option, identify the main clinical and procedural considerations for its implementation, and promote its optimal and safe use through appropriate patient selection and multidisciplinary evaluation.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 8","pages":"Pages 437-446"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354538","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":"Rediscovering digitalis in heart failure with reduced ejection fraction: Current evidence and expert survey on contemporary use","authors":"António Valentim Gonçalves,&nbsp;Ricardo Carvalheiro,&nbsp;António Fiarresga,&nbsp;Tiago Pereira-da-Silva,&nbsp;Nuno Cardim","doi":"10.1016/j.repc.2026.03.014","DOIUrl":"10.1016/j.repc.2026.03.014","url":null,"abstract":"<div><div>Digitalis glycosides are among the oldest therapies for heart failure (HF) with reduced ejection fraction, yet their contemporary role remains debated. Clinical data now indicate that the predominant clinical benefits of digitalis appear to derive from autonomic and neurohormonal modulation (enhanced vagal activity, attenuation of sympathetic drive, and suppression of renin–angiotensin–aldosterone activation) rather than from classical positive inotropy. At low serum concentrations, these effects translate into improved rate control, reduced congestion, and fewer decompensations with a lower risk of toxicity, whereas higher “inotropic” levels are associated with proarrhythmia and excess mortality. This review summarises the mechanistic and pharmacokinetic differences between digoxin and digitoxin, appraises evidence from PROVED, RADIANCE and DIG, and integrates emerging outcome data from DIGIT-HF, which showed that low-dose digitoxin added to contemporary guideline-directed therapy reduces the composite of death or HF hospitalisation. Finally, this review also provides valuable insights from a 2025 survey of Portuguese HF specialists into real-world clinical practice regarding digitalis use. With 55 experts responding, the survey highlights a predominant, selective application of digitalis glycosides, primarily after optimization of foundational HF therapies, consistent with guideline recommendations. Perceived benefits focus on rate control and symptom relief, while concerns about toxicity, the need for monitoring, and gaps in modern trial evidence continue to restrict broader adoption. Together, current data support a repositioning of digitalis as a low-dose, concentration-guided, neurohormonal modulator and rate-control agent for carefully selected patients with HF with reduced ejection fraction, an approach that ongoing and future trials should further refine.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"45 8","pages":"Pages 447-457"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382932","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}