Revista Portuguesa De Cardiologia最新文献

{"title":"Early versus late cardiac magnetic resonance in the diagnosis of myocardial infarction with non-obstructive coronary arteries","authors":"Inês Macedo Conde ,&nbsp;Mariana Salazar ,&nbsp;Vítor Hugo Pereira ,&nbsp;Catarina Vieira ,&nbsp;Carlos Galvão Braga ,&nbsp;Cátia Oliveira","doi":"10.1016/j.repc.2023.12.010","DOIUrl":"10.1016/j.repc.2023.12.010","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Myocardial infarction with non-obstructive coronary arteries (MINOCA) is responsible for about 10% of all acute myocardial infarctions (AMI). Therapeutic strategies and prognosis depend on the underlying etiology, and a multimodal approach is essential. The objectives of this study were to characterize the group of patients diagnosed with MINOCA and to valuate the diagnostic yield of cardiovascular magnetic resonance (CMR).</p></div><div><h3>Methods</h3><p>This was a retrospective, observational, and analytical study, including 516 patients admitted for a non-ST-elevation MI and with no significant coronary disease on coronary angiography between January 2016 and September 2021.</p></div><div><h3>Results</h3><p>After the inclusion criteria, 163 patients remained of the 516 admitted to the study. They were divided into four groups based on the CMR results: MINOCA (n=51), Takotsubo syndrome (n=37), myocarditis (n=33), and without diagnosis (n=42). Most patients diagnosed with MINOCA were female with a mean age of 61.06±13.83 years. CMR identified the diagnosis in 74.2% of patients admitted for suspected acute MI, in which coronary angiography showed the absence of significant obstructions. The median time between hospital admission and CMR was significantly shorter in the groups that had a diagnosis compared with the group with no diagnosis (p=0.038), with a significant increase in diagnostic profitability if CMR was performed up to 14 days after admission (p=0.022). There were no deaths of cardiovascular etiology during the follow-up period.</p></div><div><h3>Conclusions</h3><p>CMR was fundamental as it identified the diagnosis in three out of four patients; it should be performed in the first 14 days.</p></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 7","pages":"Pages 417-425"},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000751/pdfft?md5=2a081c6904082a91e45c99a770a71b24&pid=1-s2.0-S0870255124000751-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140961","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":"Coronary atherosclerotic burden in veteran athletes: The relationship between cardiovascular risk and volume of exercise","authors":"Joana Certo Pereira ,&nbsp;Rita Santos ,&nbsp;Francisco Moscoso Costa ,&nbsp;José Monge ,&nbsp;Pedro de Araújo Gonçalves ,&nbsp;Hélder Dores","doi":"10.1016/j.repc.2024.03.001","DOIUrl":"10.1016/j.repc.2024.03.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>The association between exercise and coronary atherosclerosis still remains unclarified. We aimed to analyze the prevalence of high coronary atherosclerotic burden in veteran athletes, considering cardiovascular (CV) risk and volume of exercise.</p></div><div><h3>Methods</h3><p>A total of 105 asymptomatic male veteran athletes (48±5.6 years old) were studied. A high coronary atherosclerotic burden was defined as one of the following characteristics in coronary computed tomography angiography: calcium score &gt;100, &gt;75th percentile, obstructive plaques, involving left main, three-vessels or two-vessels including proximal anterior descending artery, segment involvement score &gt;5 or CT-adapted Leaman score ≥5. CV risk was stratified by SCORE2 and volume of exercise by metabolic equivalent task score.</p></div><div><h3>Results</h3><p>Most athletes (n=88) were engaged in endurance sports for 17.1±9.8 years, with a median exercise volume of 66 [IQR 44–103] metabolic equivalent of tasks/hour/week. The mean Systematic Coronary Risk Evaluation 2 was 2.8±1.5%; 76.9% of athletes had a low-moderate risk and none a very high risk. High coronary atherosclerotic burden was present in 25.7% athletes. Athletes with high cardiovascular risk and high exercise volume (above the median) showed significantly high coronary atherosclerotic burden compared to those with low-moderate risk and high volume (50.0% vs. 15.6%; p=0.017). Among athletes with low to moderate risk, a high volume of exercise tended to be protective, while in those with low volume, there was similar rate of high coronary atherosclerotic burden, regardless of CV risk.</p></div><div><h3>Conclusions</h3><p>A combination of higher volume of exercise and high cardiovascular risk revealed the worst association with coronary atherosclerosis in veteran athletes. The relationship between these variables is controversial, but integrating exercise characteristics and risk assessment into preparticipation evaluation is essential.</p></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 7","pages":"Pages 377-384"},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000799/pdfft?md5=fa6027608d96a82d972fa1cb592a945a&pid=1-s2.0-S0870255124000799-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765034","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 bidirectional association between cardiovascular disease and cancer: Is there an increased risk of cancer among heart failure patients?","authors":"Júlia Cristina Toste","doi":"10.1016/j.repc.2024.05.003","DOIUrl":"10.1016/j.repc.2024.05.003","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":" ","pages":"415-416"},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960395","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":"Chronic thromboembolic pulmonary hypertension: A comprehensive review of pathogenesis, diagnosis, and treatment strategies.","authors":"Daniel Inácio Cazeiro, Miguel Azaredo Raposo, Tatiana Guimarães, Nuno Lousada, David Jenkins, João R Inácio, Susana Moreira, Ana Mineiro, Céline Freitas, Susana Martins, Ricardo Ferreira, Rita Luís, Nuno Cardim, Fausto J Pinto, Rui Plácido","doi":"10.1016/j.repc.2024.04.006","DOIUrl":"10.1016/j.repc.2024.04.006","url":null,"abstract":"<p><p>Chronic thromboembolic pulmonary hypertension (CTEPH) is part of group 4 of the pulmonary hypertension (PH) classification and generally affects more than a third of patients referred to PH centers. It is a three-compartment disease involving proximal (lobar-to-segmental) and distal (subsegmental) pulmonary arteries that are obstructed by persistent fibrothrombotic material, and precapillary pulmonary arteries that can be affected as in pulmonary arterial hypertension. It is a rare complication of pulmonary embolism (PE), with an incidence of around 3% in PE survivors. The observed incidence of CTEPH in the general population is around six cases per million but could be three times higher than this, as estimated from PE incidence. However, a previous venous thromboembolic episode is not always documented. With advances in multimodality imaging and therapeutic management, survival for CTEPH has improved for both operable and inoperable patients. Advanced imaging with pulmonary angiography helps distinguish proximal from distal obstructive disease. However, right heart catheterization is of utmost importance to establish the diagnosis and hemodynamic severity of PH. The therapeutic strategy relies on a stepwise approach, starting with an operability assessment. Pulmonary endarterectomy (PEA), also known as pulmonary thromboendarterectomy, is the first-line treatment for operable patients. Growing experience and advances in surgical technique have enabled expansion of the distal limits of PEA and significant improvements in perioperative and mid- to long-term mortality. In patients who are inoperable or who have persistent/recurrent PH after PEA, medical therapy and/or balloon pulmonary angioplasty (BPA) are effective treatment options with favorable outcomes that are increasingly used. All treatment decisions should be made with a multidisciplinary team that includes a PEA surgeon, a BPA expert, and a chest radiologist.</p>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471850","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":"Polytetrafluoroethylene graft for anomalous left coronary artery from the pulmonary artery: 6-Year patency","authors":"","doi":"10.1016/j.repc.2024.02.011","DOIUrl":"10.1016/j.repc.2024.02.011","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 11","pages":"Pages 643-644"},"PeriodicalIF":1.6,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437694","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":"Tuberculous submitral aneurysm: A rare cardiac presentation of a common pathogen.","authors":"Usnish Adhikari, Harikrishnan Sivadasanpillai, Bineesh K Radhakrishnan, Mohamed Iliyas","doi":"10.1016/j.repc.2024.03.002","DOIUrl":"10.1016/j.repc.2024.03.002","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437695","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":"“O meu coração bate saudável” – Results from a pilot project for health education in Portuguese children","authors":"Ana Teresa Timóteo ,&nbsp;Maria Carmo Cachulo ,&nbsp;Paulo Dinis ,&nbsp;Luís Negrão ,&nbsp;Inês Barreiros-Mota ,&nbsp;Hélder Dores ,&nbsp;Lino Gonçalves","doi":"10.1016/j.repc.2023.09.005","DOIUrl":"10.1016/j.repc.2023.09.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Childhood offers an excellent window of opportunity to start interventions to promote behavioral changes before unhealthy lifestyles become established, leading to cardiovascular diseases. The goal of this pilot educational project for children is the promotion of healthy lifestyles and cardiovascular health.</p></div><div><h3>Methods</h3><p>This project was implemented in 4th grade children and included teacher-led classroom activities, a lesson given by a cardiologist and a practical lesson with dietitians. The teacher received a manual containing information on the topics to be discussed in class with the pupils and the children received a book that addresses cardiovascular risk factors and prevention. The components included were diet (D), physical activity (PA) and human body and heart awareness (BH). At the beginning and at the end of the schoolyear, a questionnaire was applied to the children to assess knowledge (K), attitudes (A) and habits (H) on these topics.</p></div><div><h3>Results</h3><p>A total of 73 children from two schools from an urban district public school in Lisbon, in a low to medium income area, participated in the project. Following the intervention, there was a 9.5% increase in the overall KAH score, mainly driven by the PA component (14.5%) followed by the BH component (12.3%). No improvement was observed for component D. The benefits were also more significant in children from a lower income area, suggesting that socioeconomic status is a determinant in the response obtained.</p></div><div><h3>Conclusions</h3><p>An educational project for cardiovascular health can be implemented successfully in children aged 9 years, but longer and larger studies are necessary.</p></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 6","pages":"Pages 301-310"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255123004699/pdfft?md5=df5e4f949ffb3ebbe112d0ba3a381bb6&pid=1-s2.0-S0870255123004699-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720180","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":"Management of life-threatening ventricular arrhythmias: What is going on with autonomic neuromodulation","authors":"Sofia Jacinto ,&nbsp;João Reis ,&nbsp;Mário Martins Oliveira","doi":"10.1016/j.repc.2023.11.004","DOIUrl":"10.1016/j.repc.2023.11.004","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 6","pages":"Pages 357-359"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000155/pdfft?md5=3faa69e1216877cf661a3a41cd843fb4&pid=1-s2.0-S0870255124000155-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713219","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":"Cardiac hydatid cysts: Please do not waste time","authors":"Valdano Manuel,&nbsp;Zoinez Sotto Garcia","doi":"10.1016/j.repc.2023.08.009","DOIUrl":"10.1016/j.repc.2023.08.009","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 6","pages":"Page 361"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000027/pdfft?md5=3e43872b0c91a4ec99bdfd55f7426a70&pid=1-s2.0-S0870255124000027-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378633","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":"Long-term prognosis of idiopathic ventricular fibrillation: An eighteen-year experience from a tertiary center","authors":"Cátia Oliveira ,&nbsp;Ana Pinho ,&nbsp;Luís Santos ,&nbsp;Ricardo Alves Pinto ,&nbsp;Sílvia Oliveira ,&nbsp;Helena Moreira ,&nbsp;Miguel Rocha ,&nbsp;Pedro Palma ,&nbsp;Gonçalo Pestana ,&nbsp;Marta Madeira ,&nbsp;Ana Lebreiro ,&nbsp;Luís Adão","doi":"10.1016/j.repc.2024.04.001","DOIUrl":"10.1016/j.repc.2024.04.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Idiopathic ventricular fibrillation (IVF) is diagnosed in patients who survive sudden cardiac arrest (SCA), preferably with documented ventricular fibrillation (VF), without any identifiable structural or electrical abnormality. Current evidence provides limited guidance on the diagnosis and follow-up of these patients. Our aim was to assess the clinical outcomes of survivors of an aborted SCA attributed to IVF.</p></div><div><h3>Methods</h3><p>We retrospectively collected clinical data from all patients who survived SCA and implanted a cardiac defibrillator (ICD) between 2005 and 2023.</p></div><div><h3>Results</h3><p>A total of 38 patients, 36.8% female, with a mean age of 44±14 years old were included. Median follow-up time was 8.7 years (interquartile range (IQR) 4.7–14.7 years). All patients underwent a comprehensive diagnostic evaluation that excluded structural and coronary disease. During follow-up, underlying diagnoses were established in 34.2% of the whole cohort. Genetic testing, performed in 37.2%, revealed underlying diagnoses in 57.1% of those tested, compared to only 26.3% of patients who did not undergo genetic testing [p=0.035, OR=5.1 (95% confidence interval (CI) 1.2–21.5)]. Mortality was 10.5% (due to non-arrhythmic causes) and 36.8% patients received appropriate therapies with a median time to first ICD therapy of 39 [5.4–47.3] months.</p></div><div><h3>Conclusion(s)</h3><p>Etiological diagnosis and recurrence prediction in patients with IVF remains challenging, even with extensive diagnostic evaluation and long-term follow-up. In our study, genetic testing enhanced diagnostic yield. Consistent with previous findings, our cohort experienced a notable arrhythmic recurrence, with no cardiac deaths, underlining the pivotal role of ICD implantation in these patients.</p></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"43 6","pages":"Pages 331-336"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0870255124000805/pdfft?md5=b62746d7fe7f96fad299dfef4cd89c06&pid=1-s2.0-S0870255124000805-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140771558","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}