Revista Portuguesa De Cardiologia最新文献

{"title":"Variability of the antithrombotic effect of acetylsalicylic acid with the administration of different dosages: Reality or myth?","authors":"Joana Lima Lopes ,&nbsp;Mariana Dias Passos ,&nbsp;Carolina Pereira Mateus ,&nbsp;Inês Sofia Fialho ,&nbsp;Vanessa de Oliveira ,&nbsp;Diana Sousa Mendes ,&nbsp;João Bicho Augusto ,&nbsp;David Cabrita Roque","doi":"10.1016/j.repc.2025.01.005","DOIUrl":"10.1016/j.repc.2025.01.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Acetylsalicylic acid (ASA) has both antithrombotic and anti-inflammatory effects, the latter being achieved when administered at higher doses (500 mg, 1000 mg per os). However, it is not known whether the anti-inflammatory effect decreases the antithrombotic potency of ASA. This experimental study intends to assess whether ASA maintains its antithrombotic effect when administered in an anti-inflammatory dose.</div></div><div><h3>Methods</h3><div>Twenty healthy volunteers were recruited and randomized into four groups. Each group ingested ASA 100 mg, 300 mg, 500 mg, and 1000 mg respectively. Their basal platelet function was measured using PFA-200 technology and reassessed one hour after ASA ingestion.</div></div><div><h3>Results</h3><div>The volunteers were all antiaggregated after ingestion of ASA, regardless of the dose taken. No statistical significance was found regarding age or gender. A subanalysis was performed, comparing the two groups that ingested lower dosages (100 mg and 300 mg) against the group that ingested higher dosages (500 mg and 1000 mg). The results were statistically significant, suggesting higher dosages may correspond to a higher antithrombotic effect.</div></div><div><h3>Conclusions</h3><div>Acetylsalicylic acid maintains its antithrombotic effect when administered in an anti-inflammatory dose. There is no clear association between the potency of antithrombotic effect and the ASA dose administered; however, our subanalysis suggests that higher dosages may correspond to a higher potency of antiaggregation.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 7","pages":"Pages 417-421"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182692","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":"Post-myocardial infarction patient pathways in Portugal","authors":"Ricardo Fontes-Carvalho ,&nbsp;Ana Abreu ,&nbsp;Luísa Bento ,&nbsp;Eduardo Infante de Oliveira ,&nbsp;Hélder Pereira ,&nbsp;João Freitas ,&nbsp;Hugo Pedrosa ,&nbsp;Filipe Macedo","doi":"10.1016/j.repc.2024.12.009","DOIUrl":"10.1016/j.repc.2024.12.009","url":null,"abstract":"<div><div>Acute myocardial infarction (AMI) is a condition that affects 12<!--> <!-->000 Portuguese individuals annually. In Portugal, disease management foresees three levels of services according to the Cardiology Referral Network. This study aims to characterize the path taken by AMI patients in Portugal after hospital treatment, at the different hospital levels. Subsequently, it aims to propose recommendations for improvements. A Steering Committee, composed of cardiology experts in AMI was responsible for the project methodology. A literature review was performed to systematize national and international AMI guidelines, followed by structured interviews of stakeholders involved in the management of these patients in seven hospitals different levels in Portugal. The study ended with a consensus meeting to analyze the results and develop recommendations. Regarding communication and liaison between hospitals in the referral network: a clear distinction was observed between hospitals in urban areas with a relatively small referral area for level 2 services versus inland hospitals, to which patients from broader areas were referred. From the point of view of communication between professionals regarding the patient's clinical information, only in level 3 hospitals in the referral network was there a greater interconnection of systems and consequent greater ease in information flows. The latter had structured cardiac rehabilitation programs, which included the integration of in-house and community facilities, in line with European Society of Cardiology recommendations. Finally, regarding the frequency of post-discharge hospital follow-up and the professionals involved, in most hospitals, follow-up was reported with the first visit at three months post-discharge, and then repeated, on average, every six months for a period between one and two years in non-atypical patients. There is high variability in the support and practices implemented to promote secondary prevention of AMI at different hospitals levels in Portugal. There is a need to review the patient pathway considering follow-up by Cardiology in the referring hospital until discharge from the consultation to a General Practitioner; implementation of Smoking Cessation Programs; Nutrition; Psychology and Physical Therapy, adjusted to the different hospital levels. Implementation of a cardiac rehabilitation program is key.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 7","pages":"Pages 457-463"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250522","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":"Coronary chronic total occlusions: What's in a name and how do we treat it?","authors":"Pedro Lamares Magro,&nbsp;Miguel Sousa Uva","doi":"10.1016/j.repc.2025.05.004","DOIUrl":"10.1016/j.repc.2025.05.004","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 7","pages":"Pages 441-443"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498794","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":"Finding the right dose of acetylsalicylic acid for secondary prevention of atherosclerotic cardiovascular disease","authors":"André Garcia,&nbsp;Carlos Aguiar","doi":"10.1016/j.repc.2025.06.002","DOIUrl":"10.1016/j.repc.2025.06.002","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 7","pages":"Pages 423-426"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548586","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":"Primary heart failure with preserved ejection fraction: The intertwined pathophysiology and treatment of some of the most relevant phenotypes","authors":"Ryohei Ono ,&nbsp;Luiz Menezes Falcão","doi":"10.1016/j.repc.2025.02.007","DOIUrl":"10.1016/j.repc.2025.02.007","url":null,"abstract":"<div><div>Heart failure with preserved ejection fraction (HFpEF) is characterized by diverse underlying pathophysiological mechanisms and can be divided into two subgroups based on the identification of the specific cause: primary and secondary HFpEF. Primary HFpEF is caused by primary impairments in myocardial relaxation or compliance with the contribution of several risk factors. Therefore, we have reviewed current literature on pathophysiology and treatment in patients with primary HFpEF. Patients with primary HFpEF represent specific “phenotypes” and are usually elderly, more commonly women, and often with a history of arterial hypertension, obesity, iron deficiency (ID), coronary artery disease (CAD), sleep apnea, diabetes, chronic kidney disease (CKD), and chronotropic incompetence. Some of the main pathophysiological mechanisms for each phenotype of primary HFpEF are as follows: arterial hypertension, which promotes left ventricular hypertrophy and fibrosis; obesity, which contributes through systemic inflammation and metabolic dysregulation; aging, which leads to ventricular-vascular stiffening; gender differences, with women experiencing changes due to smaller heart size and hormonal shifts; ID, which affects mitochondrial function; CAD, which impairs myocardial blood flow; diabetes, which is associated with hyperglycemia, lipotoxicity, insulin resistance, and microvascular rarefaction; CKD, which leads to hypertension, metabolic disturbance, systemic inflammation, and endothelial dysfunction; sleep apnea, which induces cardiac changes through pressure swings and hypoxia; and chronotropic incompetence, which is due to reduced cardiac β-receptor responsiveness. In conclusion, each factor intricately contributes to the complex pathophysiology of HFpEF. Understanding these interrelated mechanisms is critical for tailoring management strategies to improve outcomes in HFpEF patients.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 7","pages":"Pages 445-456"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235708","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":"Revascularization versus optimal medical therapy in chronic coronary syndrome in women: A systematic review","authors":"Mariana Caetano Coelho ,&nbsp;Ruben Baptista Ramos ,&nbsp;Imad Hassan ,&nbsp;Boban Thomas ,&nbsp;Rui Cruz Ferreira","doi":"10.1016/j.repc.2025.01.009","DOIUrl":"10.1016/j.repc.2025.01.009","url":null,"abstract":"<div><h3>Aim</h3><div>We performed a systematic review to compare revascularization to optimal medical therapy (OMT) alone in reducing mortality and improving cardiovascular outcomes in women with chronic coronary syndrome, due to obstructive coronary artery disease.</div></div><div><h3>Methods</h3><div>PUBMED/EMBASE and CINAHL were searched for randomized trials comparing routine revascularization versus OMT alone in patients with chronic coronary syndrome. We extracted data regarding cardiovascular death, myocardial infarction, heart failure and relief of angina in women. Published data from sub-group analysis in women were the primary sources.</div></div><div><h3>Results</h3><div>Four randomized clinical trials that enrolled 10<!--> <!-->722 patients followed for a mean 4.5 years of follow-up fulfilled our inclusion criteria. Two thousand four hundred one women were included in these trials. Male patients with preserved left ventricular systolic function and without left-main disease, formed the majority of trial participants. Compared with medical therapy alone, revascularization was not associated with a reduced risk of death or myocardial infarction, among women. Greater relief from angina and reduction in heart failure hospitalization was observed with revascularization in women in some studies.</div></div><div><h3>Conclusions</h3><div>Routine revascularization was not associated with improved survival or decreased rates of myocardial infarction in women when compared to OMT as an initial approach. Better relief from angina, and decreased hospitalizations due to heart failure were noted. Women continue to be underrepresented in clinical trials which limits our ability to draw robust conclusions.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 8","pages":"Pages 505-512"},"PeriodicalIF":1.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530626","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":"Portuguese National Registry on Cardiac Electrophysiology, 2021 and 2022","authors":"Sílvia Ribeiro ,&nbsp;Paulo Fonseca ,&nbsp;Pedro Semedo ,&nbsp;Alexandra Castro ,&nbsp;Daniel Bonhorst ,&nbsp;Pedro Marques ,&nbsp;Víctor Sanfins","doi":"10.1016/j.repc.2025.02.009","DOIUrl":"10.1016/j.repc.2025.02.009","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>We present the results of the national cardiac electrophysiology registry of the Portuguese Association of Arrhythmology, Pacing and Electrophysiology (APAPE) and the Portuguese Institute of Cardiac Rhythm for 2021 and 2022.</div></div><div><h3>Methods</h3><div>Data were collected from 26 electrophysiology centers registered with APAPE using an online digital platform. Data collection included information on human and technological resources, electrophysiological studies, ablations performed, atrial fibrillation (AF) ablation, and ventricular tachycardia (VT) ablation procedures.</div></div><div><h3>Results</h3><div>In the 26 centers, 4491 ablations were performed in 2021 and 4968 ablations in 2022. AF ablation was the most frequently performed procedure: 1673 ablations in 2021 and 1994 in 2022, 70% paroxysmal AF, with clinically relevant complications was reported in 1.2–1.5% of the procedures. VT ablation was performed in 294 patients in 2021 (45% with structural disease), and in 331 in 2022 (42% with structural disease). Clinically relevant complications were reported in 2.7–2.4% of the procedures (2021 and 2022, respectively).</div></div><div><h3>Conclusions</h3><div>In Portugal, the number of cardiac electrophysiology procedures is on the rise, but it has not reached the levels expected based on European Society of Cardiology data. AF ablation is the most common procedure, accounting for 37% in 2021 and 40% in 2022. VT ablation is still low. Additionally, cardioneuroablation and Brugada syndrome ablation are gaining importance at several Portuguese centers.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 8","pages":"Pages 489-499"},"PeriodicalIF":1.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530625","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":"Continuity and contribution: Three decades of the Portuguese Electrophysiology Registry","authors":"Diogo Cavaco","doi":"10.1016/j.repc.2025.06.003","DOIUrl":"10.1016/j.repc.2025.06.003","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 8","pages":"Pages 501-502"},"PeriodicalIF":1.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512631","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 apple doesn’t fall far from the tree – A Portuguese case of familial ST-segment depression","authors":"Ana Isabel Pinho ,&nbsp;Sandra Amorim ,&nbsp;Luís Adão ,&nbsp;Carla Sousa ,&nbsp;Rui André Rodrigues","doi":"10.1016/j.repc.2025.01.008","DOIUrl":"10.1016/j.repc.2025.01.008","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 8","pages":"Pages 513-517"},"PeriodicalIF":1.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250523","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":"Transient, persistent and permanent left bundle branch block?","authors":"Wan Lin,&nbsp;Xinyin Xie,&nbsp;Min Yu","doi":"10.1016/j.repc.2024.12.010","DOIUrl":"10.1016/j.repc.2024.12.010","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 8","pages":"Page 521"},"PeriodicalIF":1.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250524","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}