Revista Portuguesa De Cardiologia最新文献

{"title":"Portuguese recommendations for the management of transthyretin amyloid cardiomyopathy (Part 1 of 2): Screening, diagnosis and treatment. Developed by the Task Force on the management of transthyretin amyloid cardiomyopathy of the Working Group on Myocardial and Pericardial Diseases of the Portuguese Society of Cardiology","authors":"Nuno Marques , Sílvia Aguiar Rosa , Filipa Cordeiro , Raquel Menezes Fernandes , Catarina Ferreira , Dina Bento , Dulce Brito , Nuno Cardim , Luís Lopes , Olga Azevedo","doi":"10.1016/j.repc.2024.11.009","DOIUrl":"10.1016/j.repc.2024.11.009","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 ","pages":"Pages 7-48"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402629","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":"Development of a predictive nomogram for postoperative acute respiratory distress syndrome in Stanford type A aortic dissection patients: A retrospective study.","authors":"Huanan Liu, Hua Lu, Zhaoming Lin, Xiaoshen Zhang","doi":"10.1016/j.repc.2024.10.006","DOIUrl":"10.1016/j.repc.2024.10.006","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>This retrospective study aimed to develop a nomogram to predict the risk of postoperative acute respiratory distress syndrome (ARDS) in patients with Stanford type A acute aortic dissection.</p><p><strong>Methods: </strong>The study included patients who underwent surgical repair for Stanford type A acute aortic dissection between January 2020 and December 2023. Demographic data, surgical details, intraoperative information, and postoperative outcomes were collected. Univariate logistic regression was used for preliminary predictor screening, and a multivariate logistic regression model was constructed and presented as a nomogram. The nomogram's performance was evaluated using the area under the receiver operating characteristics (ROC) curve calibration plots, and decision curve analysis (DCA). Internal validation was performed using bootstrap resampling.</p><p><strong>Results: </strong>The study included 142 patients, 41 (28.873%) of whom developed ARDS postoperatively. Multivariate logistic regression identified body mass index (BMI), postoperative procalcitonin (PCT), cardiopulmonary bypass (CPB) time, and low albumin as independent risk factors for postoperative ARDS in type A acute aortic dissection patients. These factors were used to develop the nomogram, which demonstrated good predictive performance with an area under the ROC curve of 0.809 (95% confidence interval: 0.721-0.881). The nomogram was successfully validated by calibration plots and DCA.</p><p><strong>Conclusions: </strong>BMI, PCT, CPB time, and low albumin are independent risk factors for postoperative ARDS in type A acute aortic dissection patients. The constructed nomogram provides an effective tool for predicting the risk of ARDS, aiding in the prevention and management of this complication in patients undergoing aortic surgery.</p>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054007","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":"Safety and effectiveness of pulsed field ablation for pulmonary vein isolation in atrial fibrillation patients: One-year single center experience.","authors":"Rita Reis Santos, Rita Bello, Pedro G Santos, Daniel Matos, Gustavo Rodrigues, João Carmo, Francisco Costa, Pedro Carmo, Francisco Morgado, Diogo Cavaco, Pedro Adragão","doi":"10.1016/j.repc.2024.09.006","DOIUrl":"10.1016/j.repc.2024.09.006","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Pulmonary vein (PV) isolation is one of the cornerstones of rhythm-control therapy for symptomatic atrial fibrillation (AF) patients. Pulsed field ablation (PFA) is a novel ablation modality that involves the application of electrical pulses causing cellular death, and it has preferential tissue specificity. In this study, we aimed to share a one-year single center experience of AF ablation with PFA.</p><p><strong>Methods: </strong>Single center, retrospective study of consecutive patients undergoing PVI using the pentaspline PFA catheter between June 2022 and July 2023. Data on demographic, procedural, and electrocardiographic recurrence (assessed after a three-month blanking period) were analyzed.</p><p><strong>Results: </strong>One hundred twenty-three consecutive patients were included (62±11 years, 59% male), with a mean CHA₂DS₂-VASc score of 2±1 points, median left ventricular ejection fraction of 61% [IQR 60-65%] and a median left atrial volume index (by CT scan) of 55 mL/m² [IQR 41-67 mL/m²]. Fifty-two percent of patients presented paroxysmal AF and 21 patients (17%) underwent a redo ablation. Median procedure time was 83 min [IQR 59-117 min] and median fluoroscopy time was 11.6 min [IQR 8.2-15.6 min]; posterior wall isolation was performed in 43 (35%). Two patients (1.6%) experienced acute cardiac tamponade, immediately treated with pericardiocentesis. Other complications were primarily vascular, in 4% of cases (three femoral hematomas, one femoral pseudoaneurysms, one arteriovenous fistula). Over 290 (IQR 169-387) days of follow-up, considering electrocardiographic recurrence beyond the blanking period, 9% of patients had AF recurrence (two with paroxysmal AF and nine with persistent AF).</p><p><strong>Conclusions: </strong>Pulsed field ablation for PVI and posterior wall ablation was an efficient and safe procedure with low rate of complications and high percentage of patients were free from AF in short-term follow-up. We need more studies to evaluate long-term success.</p>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053938","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":"Multiple giant coronary aneurysms: A rare form of coronary artery disease","authors":"Joana Lima Lopes ,&nbsp;Sérgio Bravo Baptista ,&nbsp;Ana Rita Ferreira ,&nbsp;Pedro Magno ,&nbsp;João Bicho Augusto","doi":"10.1016/j.repc.2024.07.008","DOIUrl":"10.1016/j.repc.2024.07.008","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 1","pages":"Pages 75-76"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299204","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":"When cardiotoxicity demonstrated in Cardio-oncology is investigated in other contexts: Research into the cardiovascular effects of antiangiogenic drugs used in ophthalmology","authors":"Júlia Cristina Toste","doi":"10.1016/j.repc.2024.11.003","DOIUrl":"10.1016/j.repc.2024.11.003","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 1","pages":"Pages 37-39"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689138","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":"Clinical features and long-term outcomes in patients under 35 years with coronary artery disease: Nested case–control study","authors":"Pablo Juan-Salvadores ,&nbsp;Dahyr Olivas-Medina ,&nbsp;Luis Mariano de la Torre Fonseca ,&nbsp;Cesar Veiga ,&nbsp;Silvia Campanioni ,&nbsp;Francisco Caamaño Isorna ,&nbsp;Andrés Iñiguez Romo ,&nbsp;Víctor Alfonso Jiménez Díaz","doi":"10.1016/j.repc.2024.06.004","DOIUrl":"10.1016/j.repc.2024.06.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Coronary artery disease (CAD) is a globally significant cardiovascular condition, ranking among the leading causes of morbidity and mortality. CAD has been predominantly associated with advanced age and classic cardiovascular risk factors. However, over the past decades, there has been a concerning rise in its occurrence among young adults, including patients under 35 years old. The present study analyzes the clinical features and outcomes of patients aged ≤35 years with CAD, compared to two age-matched control groups.</div></div><div><h3>Method</h3><div>A nested case–control study of ≤35-year-old patients referred for coronary angiography due to clinical suspicion of CAD. Patients were divided into three groups: patients ≤35 years with CAD, subjects ≤35 years without CAD, and young patients ≥36–40 years with CAD.</div></div><div><h3>Results</h3><div>Of the 19<!--> <!-->321 coronary angiographies performed at our center over 10 years, 408 (2.1%) patients were ≤40 years old, 109 patients aged ≤35 years. Risk factors that showed a relationship with the presence of CAD were smoking (OR 2.49; 95% CI 1.03–6.03; p=0.042) and family history of coronary disease (OR 6.70; 95% CI 1.46–30.65; p=0.014). The group aged ≤35 years with CAD exhibited a risk of major cardiovascular adverse events (MACE) (HR 13.3; 95% CI 1.75–100; p&lt;0.001) than subjects ≤35 years without CAD. The probability of major adverse cardiovascular events was associated with being ≤35 years old, diabetes, dyslipidemia, and depression.</div></div><div><h3>Conclusion</h3><div>Patients aged ≤35 exhibited a poor long-term prognosis, with a high risk of new revascularization and acute myocardial infarction during the follow-up period. Focusing on preventive measures can have a significant impact on overall prognosis.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 1","pages":"Pages 13-21"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127085","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 ventricular global longitudinal strain is associated with filling pressure and cardiac output in an outpatient setting: Insights from CardioMEMS™","authors":"Francisco Barbas de Albuquerque ,&nbsp;Rita Teixeira ,&nbsp;Tiago Pereira-da-Silva ,&nbsp;Vera Ferreira ,&nbsp;António Valentim Gonçalves ,&nbsp;Rita Ilhão Moreira ,&nbsp;Ana Teresa Timóteo ,&nbsp;Ana Galrinho ,&nbsp;Luísa Branco ,&nbsp;Pedro Rio ,&nbsp;João Alves ,&nbsp;Sofia Barquinha ,&nbsp;Duarte Cacela ,&nbsp;Rui Cruz Ferreira","doi":"10.1016/j.repc.2024.05.008","DOIUrl":"10.1016/j.repc.2024.05.008","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Left ventricular global longitudinal strain (LVGLS) is an indicator of myocardial function in patients with heart failure with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). Nevertheless, it is not clear whether LVGLS correlates with filling pressures and cardiac output (CO) in an ambulatory setting. We aimed to assess whether LVGLS is associated with invasive pulmonary artery pressures (PAP) and CO in outpatients using the invasive remote monitoring CardioMEMS™ system.</div></div><div><h3>Methods</h3><div>This single-center, prospective observational study included patients with HFrEF undergoing remote monitoring using the CardioMEMS™ system, between January 2020 and December 2022. Repeated transthoracic echocardiography (TTE) studies were performed in each patient and invasive hemodynamic data were obtained during the TTE studies using the CardioMEMS™ system. Univariate and multivariate models were used to assess the potential association between LVGLS and invasive PAP and CO.</div></div><div><h3>Results</h3><div>Twelve patients were included and 46 TTE studies were analyzed. LVGLS was correlated with diastolic (d) PAP (r=0.403, p=0.041) and CO (r=−0.426, p=0.039) in the univariate analysis. In multivariate models, LVGLS was an independent predictor of dPAP and CO, but not mean PAP or systolic PAP. The variation of LVGLS between TTE studies was correlated with the variation of dPAP during follow-up (r=0.60, p=0.017).</div></div><div><h3>Conclusions</h3><div>In a cohort of HFrEF patients under invasive hemodynamic remote monitoring, LVGLS was independently associated with invasive filling pressures and CO, in an outpatient setting. These findings reinforce the value of LVGLS for the management of outpatients with HFrEF.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 1","pages":"Pages 1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113883","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":"Recommendations for the use of natriuretic peptides for early diagnosis of heart disease in patients with diabetes: A consensus report by SPEDM, SPC, NEDM-SPMI and APMGF","authors":"João Sérgio Neves ,&nbsp;Rui Baptista ,&nbsp;Estêvão Azevedo de Pape ,&nbsp;Manuel Rodrigues Pereira ,&nbsp;Rita Paulos ,&nbsp;Jonathan Pinheiro dos Santos ,&nbsp;Cristina Gavina ,&nbsp;João Jácome de Castro","doi":"10.1016/j.repc.2024.07.010","DOIUrl":"10.1016/j.repc.2024.07.010","url":null,"abstract":"<div><div>Diabetes <em>mellitus</em> is a significant risk factor for the development of heart disease (HD), with heart failure (HF) being one of the early manifestations of the disease in this population. The diagnostic process is challenging and contributes to a significant number of undiagnosed cases of HD among individuals with diabetes. This is largely due to the non-specific nature of symptoms and signs in the initial stages of disease, making early detection elusive. Timely identification and prevention of HD in patients with diabetes have the potential to significantly improve patient prognosis and alleviate the growing burden of this population on the national healthcare system.</div><div>Natriuretic peptides (BNP and NT-proBNP) have been recognized as reliable, cost-effective biomarkers for detecting HD and can be further used as risk assessment biomarkers in asymptomatic patients. Despite being recommended in several European and American guidelines to rule-out and rule-in HF, the routine use of these biomarkers for the diagnosis of HDs in patients with diabetes has only recently been proposed by the American Diabetes Association (ADA) and has not yet been implemented in Portugal. Therefore, a multidisciplinary panel of experts from four medical societies, the Portuguese Society of Endocrinology, Diabetes and Metabolism, the Portuguese Society of Cardiology, the Diabetes Study Group from the Portuguese Society of Internal Medicine and the Portuguese Association of Family Medicine were convened to discuss and establish consensus recommendations for natriuretic peptide screening in patients with diabetes and its integration into routine diabetes management protocols.</div><div>This manuscript draws on the consensus recommendations from four Portuguese medical societies, offering clear guidance on natriuretic peptides use tailored to Portuguese clinical practice. Accordingly, this consensus advises the use of NT-proBNP analysis for all patients with diabetes aged 50 years and older, or under 50 if they have risk factors and/or comorbidities. Adjusted rule-out and rule-in values for age, sex and risk factors are provided. NT-proBNP levels above 125 pg/mL should prompt additional testing and cardiovascular investigation. Routine evaluation every two to three years for low-risk patients and annually for high-risk patients is proposed when NT-proBNP is below 125 pg/mL and in the absence of suspected heart disease.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 1","pages":"Pages 57-67"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639991","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":"Premature coronary artery disease primary prevention – Searching for the Holy Grail","authors":"Jorge Alcaravela","doi":"10.1016/j.repc.2024.11.002","DOIUrl":"10.1016/j.repc.2024.11.002","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 1","pages":"Pages 23-25"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649263","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":"Strategic Plan for Cardiovascular Health in Portugal – Portuguese Society of Cardiology (PESCP-SPC)","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;Hélder Pereira","doi":"10.1016/j.repc.2024.11.006","DOIUrl":"10.1016/j.repc.2024.11.006","url":null,"abstract":"<div><div>The <em>Strategic Plan for Cardiovascular Health in Portugal</em> is an initiative of the Portuguese Society of Cardiology, aligned with efforts by the European Society of Cardiology and the World Heart Federation to develop national plans, at a local level within the cultural and socio-economic contexts, focused on cardiovascular health. The overarching goal is to promote and ensure the continuous and sustained improvement of cardiovascular health in the Portuguese population.</div><div>The methodology identified key challenges and opportunities for the medium term, highlighted priority areas for intervention, and proposed strategic lines of action. This article outlines the project's design and establishes a guiding framework for the proposed actions, which will be drawn up by designated expert groups and communicated subsequently.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 1","pages":"Pages 41-56"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773663","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}