Arquivos Brasileiros de Cardiologia最新文献

{"title":"Scaffolds for Use in Blood Vessel Bioengineering: What are the Prospects?","authors":"Leonardo Rufino Garcia, André Monti Garzesi, Flávio de Souza Brito, Marcello Laneza Felicio, Matheus Bertanha","doi":"10.36660/abc.20230341","DOIUrl":"https://doi.org/10.36660/abc.20230341","url":null,"abstract":"","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10547738","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":"Is it Time to Revisit Fractional Flow Reserve Thresholds?","authors":"Fernando Mendes Sant'Anna, Lucas Bonacossa Sant'Anna, Sérgio Lívio Menezes Couceiro","doi":"10.36660/abc.20230363","DOIUrl":"https://doi.org/10.36660/abc.20230363","url":null,"abstract":": Prognostic Assessment of Fractional Flow Reserve in Different Strata in Patients with Coronary Artery Disease","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10365011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10548220","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":"Use of Warfarin in Oral Anticoagulation Therapy: Challenges and EmpoderACO Strategy for Promoting Patient Empowerment in Self-Care.","authors":"Carina Carvalho Silvestre, Sabrina Cerqueira-Santos","doi":"10.36660/abc.20230335","DOIUrl":"https://doi.org/10.36660/abc.20230335","url":null,"abstract":"","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10547736","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 Environment and the Heart.","authors":"Antonio Eduardo Monteiro de Almeida, Ricardo Stein","doi":"10.36660/abc.20230119","DOIUrl":"https://doi.org/10.36660/abc.20230119","url":null,"abstract":"Meio Ambiente; Equilíbrio Ecológico/métodos; Poluição Ambiental; Prevenção e Controle; Estresse Oxidativo; Doenças Cardiovasculares. Nosso planeta está enfrentando uma crise sem precedentes relacionada às mudanças climáticas e à perda de biodiversidade, evidências essas que têm ameaçado a saúde dos nossos ecossistemas, comunidades, assim como modificado o estilo de vida dos seres que vivem na terra. Por sinal, muitos cientistas têm afirmado que “temos anos e não décadas para combater essa crise”.","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10365009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10548224","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":"Transcatheter Valve Replacement in Patients with Aortic Valve Stenosis: An Overview of Systematic Reviews and Meta-Analysis with Different Populations.","authors":"Henrique Diegoli,&nbsp;Marcia Regina Dias Alves,&nbsp;Lucas Miyake Okumura,&nbsp;Caroline Kroll,&nbsp;Dayane Silveira,&nbsp;Luiz Henrique Picolo Furlan","doi":"10.36660/abc.20220701","DOIUrl":"https://doi.org/10.36660/abc.20220701","url":null,"abstract":"<p><strong>Background: </strong>Randomized controlled trials (RCTs) and observational studies have compared the efficacy and safety of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis.</p><p><strong>Objectives: </strong>Compare TAVR and SAVR in patients with different surgical risks, population characteristics, and different transcatheter prosthetic valves.</p><p><strong>Methods: </strong>An overview of systematic reviews (SRs) was conducted following a structured protocol. Results were grouped by surgical risk, population characteristics, and different valves. RCTs in the SRs were reanalyzed through meta-analyses, and the results were summarized using the GRADE method. The adopted level of statistical significance was 5%.</p><p><strong>Results: </strong>Compared to SAVR, patients with high surgical risk using TAVR had a lower risk of (odds ratio, 95% confidence interval, absolute risk difference) atrial fibrillation (AF) (0.5, 0.29-0.86, -106/1000) and life-threatening bleeding (0.29, 0.2-0.42, -215/1000). Patients with intermediate surgical risk had a lower risk of AF (0.27, 0.23-0.33, -255/1000), life-threatening bleeding (0.15, 0.12-0.19, -330/1000), and acute renal failure (ARF) (0.4, 0.26-0.62, -21/1000). Patients with low surgical risk had a lower risk of death (0.58, 0.34-0.97, -16/1000), stroke (0.51, 0.28-0.94, -15/1000), AF (0.16, 0.12-0.2, -295/1000), life-threatening bleeding (0.17, 0.05-0.55, -76/1000), and ARF (0.27, 0.13-0.55, -21/1000), and had a higher risk of permanent pacemaker implantation (PPI) (4.22, 1.27-14.02, 141/1000). Newer generation devices had a lower risk of AF than older generations, and patients using balloon-expandable devices did not experience higher risks of PPI.</p><p><strong>Conclusions: </strong>This paper provides evidence that patients at low, intermediate, and high surgical risks have better outcomes when treated with TAVR compared with SAVR.</p>","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10365004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10548225","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":"Mental Health in Cardiologists: A Real Concern.","authors":"Protásio Lemos da Luz","doi":"10.36660/abc.20230028","DOIUrl":"https://doi.org/10.36660/abc.20230028","url":null,"abstract":"Estudo recente1 mostrou que 1 em cada 4 cardiologistas sofre de distúrbios emocionais incluindo estresse e outras alterações psiquiátricas. Assédio emocional, discriminação, ser divorciado e idade inferior a 55 anos foram fatores predisponentes. O estudo é internacional e incluiu 5931 cardiologistas entrevistados em 2019, abrangendo todos os continentes. Os respondedores à pesquisa representam apenas 8% dos convidados a participarem dela. A maioria são europeus, brancos, casados e com filhos. Indivíduos em começo de carreira foram os mais afetados. A América Latina contribuiu com 17,7% das respostas. Homens constituíram 77,4% da amostra e mulheres, 22,6%. Portanto, trata-se de amostra seleta que pode não representar todo espectro da população cardiológica. Distúrbios emocionais foram relatados por 28% dos entrevistados. Houve considerável variação regional, mas a América do Sul mostrou o maior índice de distúrbios psicológicos, chegando a 39,3%; já na Ásia observaram-se os índices mais baixos (20,1%). Mulheres foram mais propensas a esses distúrbios, mas também procuraram ajuda psicológica com maior frequência. Esse achado corrobora pesquisa anterior que observou que suicídios são mais frequentes entre mulheres médicas do que na população geral.2","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10365000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10176636","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":"Comparison of Cardioplegic Solutions in Coronary Bypass Surgery Over Autophagy and Apoptosis Mechanisms.","authors":"Elif Funda Sener,&nbsp;Zuhal Hamurcu,&nbsp;Serpil Taheri,&nbsp;Reyhan Tahtasakal,&nbsp;Nesrin Delibasi,&nbsp;Deniz Elcik,&nbsp;Ecmel Mehmetbeyoglu,&nbsp;Aydin Tuncay,&nbsp;Fatma Dal,&nbsp;Keziban Korkmaz Bayram,&nbsp;Isın Gunes,&nbsp;Omer Naci Emirogullari","doi":"10.36660/abc.20220479","DOIUrl":"https://doi.org/10.36660/abc.20220479","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) due to myocardial ischemia causes permanent loss of heart tissue.</p><p><strong>Objectives: </strong>We aimed to demonstrate the possible damage to the myocardium at the molecular level through the mechanisms of autophagy and apoptosis in coronary bypass surgery patients.</p><p><strong>Methods: </strong>One group was administered a Custodiol cardioplegia solution, and the other group was administered a Blood cardioplegia solution. Two myocardial samples were collected from each patient during the operation, just before cardiac arrest and after the aortic cross-clamp was released. The expressions of autophagy and apoptosis markers were evaluated. The level of statistical significance adopted was 5%.</p><p><strong>Results: </strong>The expression of the BECLIN gene was significant in the myocardial tissues in the BC group (p=0.0078). CASPASE 3, 8, and 9 gene expression levels were significantly lower in the CC group. Postoperative TnT levels were significantly different between the groups (p=0.0072). CASPASE 8 and CASPASE 9 gene expressions were similar before and after aortic cross-clamping (p=0.8552, p=0.8891). In the CC group, CASPASE 3, CASPASE 8, and CASPASE 9 gene expression levels were not found to be significantly different in tissue samples taken after aortic cross-clamping (p=0.7354, p=0.0758, p=0.4128, respectively).</p><p><strong>Conclusions: </strong>With our findings, we believe that CC and BC solutions do not have a significant difference in terms of myocardial protection during bypass operations.</p>","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10364987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10548223","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":"Determining Percentiles of Atherosclerotic Cardiovascular Risk According to Sex and Age in a Healthy Brazilian Population.","authors":"Fernando Yue Cesena,&nbsp;Nea Miwa Kashiwagi,&nbsp;Carlos Andre Minanni,&nbsp;Raul D Santos","doi":"10.36660/abc.20220552","DOIUrl":"https://doi.org/10.36660/abc.20220552","url":null,"abstract":"<p><strong>Background: </strong>Expressing the risk of atherosclerotic cardiovascular disease (ASCVD) as percentiles of the distribution according to sex and age may provide a better perception of the risk.</p><p><strong>Objectives: </strong>To determine percentiles of the 10-year ASCVD risk distribution according to sex and age in a sample of the Brazilian population; to characterize individuals at low 10-year risk but high risk percentile.</p><p><strong>Methods: </strong>We analyzed individuals aged 40 to 75 years who underwent routine health evaluations from 2010 to 2020. Persons with known clinical ASCVD, diabetes mellitus, chronic kidney disease, or LDL-cholesterol ≥ 190 mg/dL were excluded. The 10-year ASCVD risk was calculated by the ACC/AHA pooled cohort equations. Local polynomial regression was used to determine risk percentiles. Two-sided p-values < 0.050 were considered statistically significant.</p><p><strong>Results: </strong>Our sample comprised 54,145 visits (72% male, median age [interquartile range] 48 [43, 53] years). We constructed sex-specific graphs plotting age against ASCVD risk corresponding to the 10th, 25th, 50th, 75th, and 90th percentiles. Most males up to 47 years and females up to 59 years above the 75th percentile had a 10-year risk < 5%. Individuals at low 10-year risk and risk percentile ≥ 75th had a high prevalence of excess weight and median (interquartile range) LDL-cholesterol levels 136 (109, 158) mg/dL (males) and 126 (105, 147) mg/dL (females).</p><p><strong>Conclusions: </strong>We established ASCVD risk percentiles according to sex and age in a large sample of the Brazilian population. This approach may increase risk awareness and help identify younger persons at low 10-year risk who may benefit from more aggressive risk factor control.</p>","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10547734","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":"An Atypical Non-Cardiac Presentation of Hypertrophic Cardiomyopathy.","authors":"André Alexandre,&nbsp;Carla Roque,&nbsp;Isabel Sá,&nbsp;João Silveira,&nbsp;Severo Torres","doi":"10.36660/abc.20220933","DOIUrl":"https://doi.org/10.36660/abc.20220933","url":null,"abstract":"Supplementary Video 2) revealed moderate asymmetric septal LV hypertrophy (interventricular septum thickness 14 mm, posterior wall thickness 9 mm), mildly reduced LV ejection fraction (45%), apical akinesia, and an image suggestive of thrombus, explaining the cardioembolic stroke. Cardiovascular magnetic resonance (CMR) confirmed the diagnosis of HCM, with extensive apical fibrosis and akinesia of the apical segments, outlining an apical aneurysm and thrombus (Figure 2). Coronary angiography was performed regarding the possibility of concomitant ischemic heart disease, ruling out obstructive coronary artery disease. Serologic examination for Trypanosoma cruzi was negative. The patient was started on systemic anticoagulation with a vitamin K antagonist (VKA). Considering the diagnosis of HCM with extensive apical fibrosis and an apical aneurism, after patient-shared decision-making, it was decided to place a subcutaneous implantable cardioverter-defibrillator (S-ICD). He was discharged after 18 days. At the 1-year follow-up, control transthoracic echocardiography showed complete resolution of the apical thrombus, and the patient remained on systemic anticoagulation with a VKA. HCM is a relatively common but still underdiagnosed cardiac disease. 1 This case illustrates an extremely rare and life-threatening non-cardiac first presentation of HCM. This unusual HCM phenotype with a thin-walled, scarred LV apical aneurysm is associated with an increased risk of sudden arrhythmic death and thromboembolic stroke. 2,3","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10530233","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":"Are We Reaching the End of the Evolutionary Road to Metallic Drug-Eluting Stents? Which 4th Generation Stents Do We Need?","authors":"Manuel Sousa Almeida","doi":"10.36660/abc.20230302","DOIUrl":"https://doi.org/10.36660/abc.20230302","url":null,"abstract":"Short Editorial related to the article: Real-World Assessment of an Ultrathin Strut, Sirolimus-Eluting Stent in Patients with ST-Elevation Myocardial Infarction Submitted to Primary Percutaneous Coronary Intervention (INSTEMI Registry)","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10547739","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}