Archivos Peruanos de cardiologia y cirugia cardiovascular最新文献

{"title":"Follow-up of patients with myocardial ischemia without obstructive coronary lesions.","authors":"Ana Liuvys Cuba Rodríguez, Lázaro Isralys Aldama Pérez, Myder Hernández Navas, Snayder José Goelkel Pérez","doi":"10.47487/apcyccv.v6i2.472","DOIUrl":"10.47487/apcyccv.v6i2.472","url":null,"abstract":"<p><strong>Objective: </strong>The presence of coronary lesions of less than 50% in patients with myocardial ischaemia is a common diagnosis in cardiac catheterisation laboratories. The aim of this study was to determine the clinical course of patients with myocardial ischaemia in the absence of obstructive coronary lesions.</p><p><strong>Materials and methods: </strong>A prospective analytical study was conducted in 110 patients of both sexes with documented myocardial ischaemia and coronary lesions of less than 50% on coronary angiography. The follow-up period was three years.</p><p><strong>Results: </strong>The mean age was 64.5 ± 7.2 years, with a predominance of females (57%). The most prevalent risk factors were hypertension (58.2%) and dyslipidaemia (44.5%). In 8.3% of cases, re-hospitalisation was required, with heart failure reported as the leading cause (6.5%). Cardiovascular event-free survival during follow-up was 80%, and was higher in patients without coronary lesions. A higher incidence of cardiovascular events was associated with diabetes mellitus, a family history of ischaemic heart disease, and chronic kidney disease.</p><p><strong>Conclusions: </strong>Patients with myocardial ischaemia in the absence of obstructive coronary lesions experienced adverse events during follow-up, particularly those with diabetes mellitus, a family history of ischaemic heart disease, and chronic kidney disease.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 2","pages":"69-74"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological treatment of patients with chronic heart failure. Subanalysis of an Ecuadorian registry.","authors":"Luis Moreno-Rondón, María Elizabeth Ortega-Armas, Diego Pulla, Robert Alarcón Cedeño, Juan Díaz Heredia, Diego Villavicencio, Oscar Luces-Tejada, Mario Gómez, Alex Castro-Mejía","doi":"10.47487/apcyccv.v6i2.470","DOIUrl":"10.47487/apcyccv.v6i2.470","url":null,"abstract":"<p><strong>Introduction: </strong>Introduction. In Ecuador, there is limited data on the treatment of patients with heart failure (HF).</p><p><strong>Objective: </strong>This study aimed to determine the rate of use of prognosis-modifying drugs and their association with prognosis.</p><p><strong>Materials and methods: </strong>A retrospective observational study was conducted on patients with chronic HF included in the \"Los Ceibos\" registry between January 2017 and December 2022. Patients were followed for a median of 2.28 years (interquartile range [IQR]: 1.25-3.49).</p><p><strong>Results: </strong>A total of 711 patients diagnosed with HF were included. Among them, 82.7% (n=588) received angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), or angiotensin receptor-neprilysin inhibitors (ARNIs); 82.3% (n=585) received beta-blockers (BBs); and 51.3% (n=365) were treated with mineralocorticoid receptor antagonists (MRAs). Among patients with HFrEF, those receiving triple therapy (ACEI/ARB/ARNI + BB + MRA) had lower all-cause mortality compared to other groups (38.8%, log-rank p=0.014). In patients with Heart Failure with preserved Ejection Fraction (HFpEF), no mortality differences were observed according to the number of medications used (log-rank p=0.720). MRA use was not associated with a prognostic benefit in HFpEF (p>0.05). Patients receiving triple therapy with ARNI + BB + MRA had better survival during follow-up compared to any other drug combination (log-rank p=0.027).</p><p><strong>Conclusions: </strong>A high rate of ACEI/ARB/ARNI and BB use was observed. The use of triple therapy, particularly the combination of ARNI + BB + MRA, was associated with improved prognosis in patients with HFrEF over a four-year follow-up period. No prognostic benefit of MRA use was observed in patients with HFpEF.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 2","pages":"75-82"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double aortic arch in Honduras: an unusual cause of dysphagia in an adult patient. A case report.","authors":"Skarleth Paola Bock Alvarado, Andrea Nicole López García, Mónica Isabel Yanes Oviedo, Haroldo Arturo López García","doi":"10.47487/apcyccv.v6i2.482.","DOIUrl":"10.47487/apcyccv.v6i2.482.","url":null,"abstract":"<p><p>Vascular rings represent less than 1% of congenital cardiovascular anomalies, with double aortic arch being the most common variant. It is typically diagnosed in infants, with respiratory symptoms in over 90% of cases. We present the case of a 31-year-old male patient with recurrent childhood respiratory infections and asthma, who presented with progressive dysphagia. Contrast-enhanced computed tomography angiography revealed a double aortic arch with right-sided dominance, and the esophagram revealed compression of the proximal third of the esophagus. A left posterolateral thoracotomy was performed with division of the distal left arch, division of the ligamentum arteriosum, adhesions release, and thoracic aorta reconstruction. Postoperative recovery was favorable, with complete resolution of symptoms. Double aortic arch is rarely diagnosed in adulthood. This case highlights its atypical presentation, with predominant gastrointestinal symptoms, and the importance of considering it in the differential diagnosis of dysphagia.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 2","pages":"100-103"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous closure of aortopulmonary window using a muscular ventricular septal defect occluder. Instituto Nacional de Salud del Niño San Borja Lima-Peru. Case report.","authors":"Alex Ismael Catalán Cabrera, Karen Del Rosario Condori Alvino, Mónica Karem Medina Durand","doi":"10.47487/apcyccv.v6i2.465","DOIUrl":"10.47487/apcyccv.v6i2.465","url":null,"abstract":"<p><p>The aortopulmonary window is a rare congenital heart defect. Isolated aortopulmonary window, without other associated anomalies, accounts for up to 25% of all cases. Surgical closure has long been, and remains, the gold standard in many cardiovascular centres. However, percutaneous closure has emerged as a viable alternative using various types of occluder devices, selected based on the morphology, size, and rims of the defect to minimise complications such as valvular interference or coronary ostial obstruction. We report the case of an infant with an isolated aortopulmonary window successfully treated with percutaneous closure using a muscular ventricular septal defect occluder device, with no complications. The patient was discharged 48 hours after the procedure.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 2","pages":"96-99"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right ventricular uncoupling in acute heart failure with preserved or mildly reduced ejection fraction: a simple parameter to predict long-term mortality.","authors":"Lucrecia M Burgos, Lucía Campos Cervera, María A De Bortoli, Rocío C Baro Vila, Franco N Ballari, Mirta Diez","doi":"10.47487/apcyccv.v6i2.466","DOIUrl":"10.47487/apcyccv.v6i2.466","url":null,"abstract":"<p><strong>Introduction: </strong>Risk prediction in acute heart failure (AHF) has led to the development of multiple prognostic models. Emerging data highlight the prognostic significance of right ventricular (RV) to pulmonary artery (PA) uncoupling, which has been linked to adverse outcomes. Among patients with heart failure with preserved ejection fraction (HFpEF) and mildly reduced ejection fraction (HFmrEF), a highly heterogeneous group, the prognostic relevance of RV-PA uncoupling in forecasting long-term mortality is still not well defined. This study aimed to evaluate the association between RV-PA uncoupling and long-term mortality in a cohort of hospitalized HFpEF and HFmrEF patients.</p><p><strong>Materials and methods: </strong>We performed a retrospective analysis based on a prospective registry of adult patients admitted with a primary diagnosis of AHF between 2015 and 2020. Eligible patients had a left ventricular ejection fraction (LVEF) > 40%. The main outcome was all-cause mortality over long-term follow-up. RV-PA coupling was quantified using the ratio between tricuspid annular plane systolic excursion (TAPSE) and systolic pulmonary artery pressure (sPAP).</p><p><strong>Results: </strong>Out of 465 patients, simultaneous estimation of TAPSE and sPAP was feasible in 361 cases (77%). During a median follow-up of 20.9 months, 100 patients (27.7%) died. A TAPSE/sPAP ratio of 0.38 was identified as the optimal cut-off for risk discrimination. Notably, 41.8% of patients had values below this threshold. Multivariable analysis confirmed that RV-PA uncoupling (TAPSE/sPAP < 0.38) was independently associated with increased long-term mortality (HR: 2.21; 95% CI 1.26-3.81; P = 0.005).</p><p><strong>Conclusion: </strong>In patients hospitalized for AHF with preserved and mildly reduced ejection fraction, RV-PA uncoupling, as determined by the TAPSE/sPAP ratio, was independently associated with long-term all-cause mortality. This echocardiographic parameter may help identify a subgroup of patients at higher risk during follow-up.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 2","pages":"83-89"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translational medicine and atrial fibrillation: ¿What new therapies are available?]","authors":"Juan Santiago Serna-Trejos, Stefanya Geraldine Bermúdez-Moyano, Carlos Andrés Castro-Galvis","doi":"10.47487/apcyccv.v6i2.484","DOIUrl":"10.47487/apcyccv.v6i2.484","url":null,"abstract":"","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 2","pages":"110-111"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediastinitis in pediatric cardiac surgery: an unusual complication. A single-center experience.","authors":"Laura Isabel Manosalva Arciniegas, José Antonio Vargas Soler, Lyneira Juliana Guevara Rodríguez, Laura Constanza González Hakspiel, Andrés Felipe Rubio Duarte, Sara Elena Mendoza Crespo","doi":"10.47487/apcyccv.v6i2.471","DOIUrl":"10.47487/apcyccv.v6i2.471","url":null,"abstract":"<p><strong>Objectives: </strong>Mediastinitis is an unusual postoperative complication in pediatric cardiovascular surgery, associated with high morbidity and mortality. Case reports are limited, especially in Latin America, where cardiac surgery has advanced significantly.</p><p><strong>Materials and methods: </strong>A retrospective study of mediastinitis post-cardiac surgery cases at a high-complexity center in Colombia, between January 2015 and June 2023, was conducted. A detailed description of the clinical characteristics and therapeutic approaches was provided.</p><p><strong>Results: </strong>A population of 16 children with mediastinitis was characterized, predominantly male (68.7%); 62.5% were aged 1-3 months. The most common defects were transposition of the great arteries and univentricular heart. Gram-negative bacteria (37.5%) were the most common isolates, followed by gram-positive bacteria (25%). Vacuum-assisted closure (VAC) was required in 43.7% of cases.</p><p><strong>Conclusion: </strong>Advances in congenital heart disease management have led to complications such as mediastinitis, prompting the development of therapeutic strategies that would benefit from better characterization in high-complexity centers to improve outcomes.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 2","pages":"63-68"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of agitated saline contrast echocardiography in the evaluation of pulmonary hypertension.","authors":"Emilio Herrera, Jhon F Salamanca, Luisa F Durango","doi":"10.47487/apcyccv.v6i2.486","DOIUrl":"10.47487/apcyccv.v6i2.486","url":null,"abstract":"<p><p>The diagnostic approach to pulmonary hypertension using cardiac imaging, particularly echocardiography, provides a practical, accessible, and highly valuable tool. It helps establish the initial diagnostic probability, offers prognostic information, and supports aetiological assessment. The agitated saline contrast test, also referred to as bubble contrast echocardiography, can aid not only in confirming the diagnosis but also in characterising the condition and identifying various underlying causes of pulmonary hypertension.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 2","pages":"90-95"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monoclonal gammopathy progressing to systemic amyloidosis with cardiac involvement. A case report.","authors":"Germán Valenzuela-Rodríguez, Ofelia Araoz Tarco, Iván Fernández Vertiz","doi":"10.47487/apcyccv.v6i2.477","DOIUrl":"10.47487/apcyccv.v6i2.477","url":null,"abstract":"<p><p>We report a case of systemic light chain amyloidosis with cardiac involvement, preceded by a monoclonal IgG lambda gammopathy. The clinical diagnosis was based on signs of heart failure, elevated cardiac biomarkers, and characteristic imaging findings. The diagnosis was confirmed by increased levels of free light chains in blood and urine, as well as the presence of amyloid deposits in periumbilical fat and multiple segments of the gastrointestinal tract. Treatment with daratumumab, bortezomib, and dexamethasone was initiated, followed by autologous hematopoietic stem cell transplantation 22 months after diagnosis, resulting in a favourable clinical outcome.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 2","pages":"104-109"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Totally endoscopic periareolar approach for mitral valve repair. First case reported in Peru.","authors":"Josías C Ríos-Ortega, Víctor Robles-Velarde, Zoe Díaz-Chavez","doi":"10.47487/apcyccv.v6i1.449","DOIUrl":"https://doi.org/10.47487/apcyccv.v6i1.449","url":null,"abstract":"<p><p>We present the case of a 39-year-old man with a history of progressive dyspnea. Transthoracic and transesophageal echocardiography revealed severe mitral valve (MV) regurgitation due to P2 flail as well as severe tricuspid valve (TV) regurgitation. The patient underwent surgical treatment, including MV repair and TV annuloplasty, performed through a totally endoscopic periareolar approach. Postoperative evolution was satisfactory.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 1","pages":"54-57"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}