Arquivos Brasileiros de Cardiologia最新文献

{"title":"Construction and Validation of a Protocol Targeting Patients on Oral Anticoagulation with Warfarin.","authors":"Hannah Cardoso Barbosa, Heloisa de Carvalho Torres, João Antônio de Queiroz Oliveira, Rebeca Priscilla de Melo Santos, Josiane Moreira da Costa, Leonardo Gonçalves Miranda, Adriana Silvina Pagano, Marcus Fernando da Silva Praxedes, Maria Auxiliadora Parreiras Martins","doi":"10.36660/abc.20220576","DOIUrl":"10.36660/abc.20220576","url":null,"abstract":"<p><strong>Background: </strong>Warfarin is an oral anticoagulant that is very useful in preventing thromboembolism, though it is considered a drug with a high risk of causing adverse events. Considering the practical challenges in controlling oral anticoagulation, the patients on warfarin could benefit from educational strategies aimed at behavioral changes, active participation in self-care, and adherence to drug therapy.</p><p><strong>Objective: </strong>The aim was to construct and validate the EmpoderACO protocol for behavioral changes in warfarin patients.</p><p><strong>Methods: </strong>The methodological steps were: definition of concepts and domains of self-care, identification of objectives, construction and selection of items, assessment of content validity, and pre-test in the target population.</p><p><strong>Results: </strong>Relevance, adequacy, clarity, and internal reliability of the instrument's items were assessed by a multidisciplinary judges committee (JC) through the E-surv web platform, obtaining an average agreement of ≥0.91. The understanding of the instrument measured by the target population revealed adequate clarity with a coefficient average of 0.96.</p><p><strong>Conclusion: </strong>EmpoderACO can aid in qualifying the communication process between medical professionals and patients, as well as in improving adherence to both treatment and clinical outcomes, and can be replicated in healthcare settings.</p>","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":"120 6","pages":"e20220576"},"PeriodicalIF":2.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10547737","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":"Triglycerides-Glucose İndex and Coronary Slow Flow: A New Diagnostic Tool?","authors":"Maria Cristina Costa de Almeida,&nbsp;Marildes Luiza de Castro","doi":"10.36660/abc.20230373","DOIUrl":"https://doi.org/10.36660/abc.20230373","url":null,"abstract":"","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":"120 6","pages":"e20230373"},"PeriodicalIF":2.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10389683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10548714","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":"Analysis of low-density lipoprotein in diabetic patients using the Martin/Hopkins and Sampson equationsReply.","authors":"Cristian Rodrigues do Nascimento,&nbsp;Rodrigo Mendes,&nbsp;Carlos Alberto de Lima Botelho Filho,&nbsp;Romero Henrique de Almeida Barbosa,&nbsp;Pedro Pereira Tenório","doi":"10.36660/abc.20220859","DOIUrl":"https://doi.org/10.36660/abc.20220859","url":null,"abstract":"","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":"120 5","pages":"e20220859"},"PeriodicalIF":2.6,"publicationDate":"2023-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10348386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10176074","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":"Influence of Arm Fat on the Indirect Measurement of Blood Pressure: A Statistical and Machine Learning Approach.","authors":"Paôla de Oliveira Souza,&nbsp;José Maria Parente de Oliveira,&nbsp;Letícia Helena Januário","doi":"10.36660/abc.20220484","DOIUrl":"10.36660/abc.20220484","url":null,"abstract":"<p><strong>Background: </strong>The indirect measurement of blood pressure (BP) is known to be influenced by many factors such as the technique, observer, and equipment; however, the influence of arm composition has not been investigated yet.</p><p><strong>Objective: </strong>To identify the influence of arm fat on the indirect measurement of blood pressure using statistical inference and machine learning models.</p><p><strong>Methods: </strong>Cross-sectional study, with 489 healthy young adults aged from 18 to 29 years old. Measurements of arm length (AL), arm circumference (AC) and arm fat index (AFI) were taken. BP was measured in both arms simultaneously. Data were processed using Python 3.0 and its specific packages for descriptive analysis, regression and cluster analysis. Significance levels: 5% for all calculations.</p><p><strong>Results: </strong>BP and anthropometric measurements were different between the hemi-bodies. In the right arm, systolic blood pressure (SBP), AL and AFI were higher, while AC was similar compared with the left arm. AL and AC showed positive correlation with SBP. According to the regression model, for a fixed value of AC and AL, SBP readings could be reduced by a mean of 1.80 mmHg in the right arm, and 1.62 mmHg in the left arm for every 10% increase in AFI. Clustering analysis corroborated the regression results.</p><p><strong>Conclusion: </strong>There was a significant influence of AFI on BP readings. SBP had a positive correlation with AL and AC, and a negative correlation with AFI, suggesting the need for further investigations on the relationship between BP and percentages of arm muscle and fat.</p>","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":"120 5","pages":"e20220484"},"PeriodicalIF":2.6,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10348388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232428","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":"mRNA, miRNA, lncRNA, ceRNA: The Future of Cardiovascular Research?","authors":"Gustavo Augusto Ferreira Mota,&nbsp;Mariana Gatto,&nbsp;Cristina Schmitt Gregolin,&nbsp;Sérgio Luiz Borges de Souza,&nbsp;Marina Politi Okoshi","doi":"10.36660/abc.20230209","DOIUrl":"https://doi.org/10.36660/abc.20230209","url":null,"abstract":"","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":"120 4","pages":"e20230209"},"PeriodicalIF":2.6,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10263425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232427","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":"MINOCA Phenotypes - A Challenge for Patient-Specific Management.","authors":"Sofiya Lypovetska","doi":"10.36660/abc.20220705","DOIUrl":"10.36660/abc.20220705","url":null,"abstract":"<p><p>Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a puzzling clinical phenomenon with an unclear prognosis, characterized by evidence of myocardial infarction (MI) with normal or near-normal coronary arteries on angiography1. Currently, there are no guidelines for management, and many patients are discharged without a determined etiology, often meaning that optimal treatment gets postponed.We report three MINOCA case studies with main pathophysiological cardiac causes, particularly epicardial, microvascular, and non-ischemic, prompting differential management. The patients presented with acute chest pain, troponin raise, and no angiographically significant coronary disease.In this study, we analyzed the etiology, clinical diagnosis, and treatment of MINOCA concerning the relevant literature.MINOCA is considered to be a dynamic working diagnosis, including coronary, myocardial, and non-coronary disorders. Prospective studies and registries are needed to improve patient care and outcome.</p>","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":"120 6","pages":"e20220705"},"PeriodicalIF":2.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10263403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10174598","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":"Prognostic Assessment of Fractional Flow Reserve in Different Strata in Patients with Coronary Artery Disease.","authors":"Denise Pellegrini,&nbsp;Paulo R A Caramori,&nbsp;Ricardo Czarnobai Soccol,&nbsp;Ricardo Lasevitch,&nbsp;Gustavo Luís Agostini,&nbsp;Alice Dussin,&nbsp;Flavio Vinicius Costa Ferreira,&nbsp;Mario Bernardes Wagner,&nbsp;Luiz Carlos Bodanese","doi":"10.36660/abc.20211051","DOIUrl":"https://doi.org/10.36660/abc.20211051","url":null,"abstract":"<p><strong>Background: </strong>There are limited real-world data on the clinical course of untreated coronary lesions according to their functional severity.</p><p><strong>Objective: </strong>To evaluate the 5-year clinical outcomes of patients with revascularized lesions with fractional flow reserve (FFR) ≤ 0.8 and patients with non-revascularized lesions with FFR > 0.8.</p><p><strong>Methods: </strong>The FFR assessment was performed in 218 patients followed for up to 5 years. Participants were classified based on FFR into ischemia group (≤ 0.8, intervention group, n = 55), low-normal FFR group (> 0.8-0.9, n = 91), and high-normal FFR group (> 0.9, n = 72). The primary endpoint was major adverse cardiac events (MACEs), a composite of death, myocardial infarction, and need for repeat revascularization. The significance level was set at 0.05; therefore, results with a p-value < 0.05 were considered statistically significant.</p><p><strong>Results: </strong>Most patients were male (62.8%) with a mean age of 64.1 years. Diabetes was present in 27%. On coronary angiography, the severity of stenosis was 62% in the ischemia group, 56.4% in the low-normal FFR group, and 54.3% in the high-normal FFR group (p<0.05). Mean follow-up was 3.5 years. The incidence of MACEs was 25.5%, 13.2%, and 11.1%, respectively (p=0.037). MACE incidence did not differ significantly between the low-normal and high-normal FFR groups.</p><p><strong>Conclusion: </strong>Patients with FFR indicative of ischemia had poorer outcomes than those in non-ischemia groups. There was no difference in the incidence of events between the low-normal and high-normal FFR groups. Long-term studies with a large sample size are needed to better assess cardiovascular outcomes in patients with moderate coronary stenosis with FFR values between 0.8 and 1.0.</p>","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":"120 6","pages":"e20211051"},"PeriodicalIF":2.6,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10263408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10174602","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":"Investigation of the Relationship Between Triglycerides-Glucose İndex and Coronary Slow Flow: A Retrospective Case-Control Study.","authors":"Mustafa Kaplangoray,&nbsp;Kenan Toprak,&nbsp;Fuat Başanalan,&nbsp;Ali Palice,&nbsp;Cihan Aydın,&nbsp;Aykut Demirkıran,&nbsp;Yusuf Cekici","doi":"10.36660/abc.20220679","DOIUrl":"https://doi.org/10.36660/abc.20220679","url":null,"abstract":"<p><strong>Background: </strong>Coronary slow flow (CSF) refers to delayed distal vessel opacification in the absence of epicardial coronary artery stenosis. The etiopathogenic mechanism of CSF is still unclear.</p><p><strong>Objectives: </strong>This study investigates the relationship between CSF and the triglyceride-glucose (TyG) index.</p><p><strong>Methods: </strong>The study sample consisted of 118 CSF patients and 105 patients with normal coronary flow (NCF). The coronary flow rate was measured via the Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) method in all patients. The TyG index was calculated as the logarithm of the [fasting triglyceride (mg/dL)×fasting glucose (mg/dL)]/2 value. A significance level of < 0.05 was adopted as statistically significant.</p><p><strong>Results: </strong>The TyG index, low-density lipoprotein (LDL), body mass index (BMI), neutrophil-to-lymphocyte ratio (NLR) and TFC values, male ratio, and the ratio of smokers were higher, whereas high-density lipoprotein (HDL) levels were significantly lower in the CSF group compared to the NCF group (p<0,05). The correlation analysis revealed that CSF was significantly correlated with TyG index, BMI, NLR, and HDL values. The strongest of these correlations was between CSF and TyG index (r= 0.57, p<0.001). Additionally, the multivariate analysis revealed that TyG index, BMI, NLR ratio, and male gender were independent predictors for CSF (p<0.05). Receiver operating characteristic (ROC) curve analysis indicated that a cut-off value of ≥ 9.28 for the TyG index predicted CSF with a sensitivity of 78% and a specificity of 78.1% [Area under the curve (AUC): 0.868 and 95% Confidence Interval (CI): 0.823-0.914].</p><p><strong>Conclusion: </strong>The findings of this study revealed a very strong relationship between CSF and TyG index.</p>","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":"120 6","pages":"e20220679"},"PeriodicalIF":2.6,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10389274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10547682","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":"Isolated Aneurysmal Dilatation of the Right Atrium, with Surgical Resolution, in a 53-Year-Old Adult.","authors":"Edmar Atik,&nbsp;Alessandra Costa Barreto,&nbsp;Maria Angélica Binotto,&nbsp;Marcelo B Jatene","doi":"10.36660/abc.20220870","DOIUrl":"https://doi.org/10.36660/abc.20220870","url":null,"abstract":"Introdução A dilatação aneurismática isolada do átrio direito é uma anomalia congênita rara. Sua identificação ocorre em vários grupos etários, desde o feto até a idade adulta. A manifestação clínica dessa anomalia é variada, conforme a magnitude da dilatação, desde pacientes assintomáticos, em geral em crianças e jovens, até presença de arritmias supraventriculares de difícil controle, insuficiência cardíaca direita, obstrução de vias aéreas, pneumonia e eventos tromboembólicos, em adultos. O diagnóstico é estabelecido após verificação de cardiomegalia em exames rotineiros radiográficos e confirmado posteriormente por ecocardiograma. Chama a atenção nesta patologia o tamanho desproporcional do átrio direito em relação às outras cavidades cardíacas, estando o anel tricúspide também dilatado, mas com valva tricúspide conservada. A insuficiência tricúspide que acompanha o quadro decorre assim da dilatação do anel valvar. A recomendação da correção cirúrgica daí passa a ser profilática na idade infantil dada a boa evolução verificada posteriormente. O diagnóstico diferencial engloba a anomalia de Ebstein, o derrame pericárdico e tumores torácicos mediastinais. O tratamento antiarrítmico e a medicação antitrombótica, representada por AAS, geralmente iniciam a conduta clínica, dada a presença de arritmias supraventriculares e de trombos cavitários, mais encontrados na idade adulta.1-12 A cirurgia de ressecção atrial, idealizada inicialmente por Morrow e Behrendt em 1968,13 foi orientada aos pacientes sintomáticos. O bom resultado cirúrgico foi atestado por esses autores em mulher de 23 anos, com flutter atrial e cardiomegalia, com aneurisma do átrio direito. Verificou-se nesta paciente boa evolução, em ritmo sinusal e sem sintomas após a correção efetuada. Desde esse início, tornou-se preconizada a conduta cirúrgica, tendo se estendido mesmo a pacientes assintomáticos, como procedimento eletivo e preventivo das complicações conhecidas.1,2 Seu diagnóstico durante a vida fetal tem orientado a conduta cirúrgica eletiva nos primeiros anos de vida.2,3 A evolução longa descrita em alguns casos não operados, com 69 e 88 anos de idade, não expressa benignidade em geral, como observado nesta doença com muitas complicações evolutivas.4,5","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":"120 6","pages":"e20220870"},"PeriodicalIF":2.6,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10263404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10174599","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":"Intracardiac Echocardiography Must Be Used in All Patients Who Underwent AF Ablation?","authors":"Cristiano F Pisani,&nbsp;Mauricio Scanavacca","doi":"10.36660/abc.20230290","DOIUrl":"https://doi.org/10.36660/abc.20230290","url":null,"abstract":"Short editorial related to the article: Atrial Fibrillation Ablation: Impact of Intracardiac Echocardiography in Reducing Procedure Time and Hospitalization","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":"120 5","pages":"e20230290"},"PeriodicalIF":2.6,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10263402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10174600","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}