Archivos Peruanos de cardiologia y cirugia cardiovascular最新文献

{"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}

{"title":"[Double-chambered right ventricle in a patient with hypertrophic cardiomyopathy. A case report].","authors":"Juan María Iroulart, Joaquín Ferrero, Rocío Blanco, Roshan Licht, Ana Miceli, María Natalia Pellegrini, Diego Pérez de Arenaza, Rodolfo Pizarro","doi":"10.47487/apcyccv.v6i1.440","DOIUrl":"https://doi.org/10.47487/apcyccv.v6i1.440","url":null,"abstract":"<p><p>We present the case of a 42-year-old male patient with a history of bilateral lung transplantation and chronic graft dysfunction. The patient presented to the adult emergency department due to acute heart failure. During his stay in the emergency room and in outpatient follow-up, cardiac multi-imaging led to the diagnosis of double-chambered right ventricle with associated hypertrophic cardiomyopathy. Given the presence of advanced lung disease and poor adherence to immunosuppressant medication as well as clinical follow-ups, the patient was deemed unsuitable for re-lung transplantation. The optimization of his immunosuppressive medication was prioritized, and beta-blockers were added as part of the treatment for dynamic right ventricular outflow obstruction. He was referred to pulmonary rehabilitation, currently showing a partially favorable evolution to functional class II.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 1","pages":"49-53"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082349","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":"[Anatomical variant and venous access: the challenge of persistent left vena cava in neonates].","authors":"Arianna Sofia García Calle, Vanessa Patricia Moreno Ccama, Ángel Francisco Samanez Obeso","doi":"10.47487/apcyccv.v6i1.455","DOIUrl":"https://doi.org/10.47487/apcyccv.v6i1.455","url":null,"abstract":"","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 1","pages":"58-59"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082332","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":"[Detrimental impact of acute coronary syndrome on the independence of the elderly].","authors":"Paul Coello, Inti Chaves, Paul Pacheco, Fabricio Alverca, Cristian M Garmendia","doi":"10.47487/apcyccv.v6i1.454","DOIUrl":"https://doi.org/10.47487/apcyccv.v6i1.454","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the prognostic role of functional status in older adults hospitalized for acute coronary syndrome (ACS) and the implications of the coronary event on functional decline during follow-up.</p><p><strong>Materials and methods: </strong>This was a single-center, prospective cohort study including patients aged ≥65 years hospitalized for ACS with (STEMI) or without ST-segment elevation in 2022. Patients with total dependence or lacking a care network were excluded. Functional status was assessed using the Barthel Index and the Lawton and Brody scales at admission, 30 days, and one year post-discharge. The association between initial functional status and major adverse cardiovascular events (MACE) was analyzed, as well as the impact of ACS on functional status over the short and long term.</p><p><strong>Results: </strong>A total of 110 patients older than 65 years were included (mean age 78.8±4.6 years; 61.8% male). At admission, 94.3% presented mild functional dependence according to the Barthel Index, with similar findings on the Lawton and Brody scales. At 30 days, a significant functional decline was observed (Barthel: 71.2±11.3, p<0.001; Lawton: 4.8±2.5, p=0.02), which persisted at one year. Initial functional status was not associated with MACE. ST-segment elevation ACS (STEMI) was an independent predictor of short-term functional decline (adjusted OR 1.75; p=0.04).</p><p><strong>Conclusions: </strong>In older adults with ACS, initial functional status did not predict adverse events; however, significant functional decline was observed, particularly after STEMI. This underscores the importance of personalized strategies for managing this vulnerable population.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 1","pages":"11-19"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082342","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":"[New atypical advanced interatrial block with triphasic morphology].","authors":"Jorge P Juárez-Lloclla, Marco A Lazo-Soldevilla, Sofía Rivera-Chávez, Cengiz Burak, Adrián Baranchuk","doi":"10.47487/apcyccv.v6i1.476","DOIUrl":"https://doi.org/10.47487/apcyccv.v6i1.476","url":null,"abstract":"","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 1","pages":"60-62"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082352","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}