Arquivos brasileiros de cardiologia最新文献

{"title":"High-Power Short Duration or Pulsed Field Ablation: What is the Best Choice for AF Ablation?","authors":"José Carlos Pachon-M, Enrique I Pachon-M, Tasso J Lobo, Tomas G Santillana-P, Carlos Thiene C Pachon","doi":"10.36660/abc.20250057","DOIUrl":"https://doi.org/10.36660/abc.20250057","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20250057"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value-Based Healthcare in Cardiology: How to Integrate a more Comprehensive View into Medical Decision-Making?","authors":"Pedro Gabriel Melo de Barros E Silva, Valter Furlan, Renato D Lopes, André Volschan, Paulo Cesar Pereira de Souza, Carisi Anne Polanczyk","doi":"10.36660/abc.20240668","DOIUrl":"10.36660/abc.20240668","url":null,"abstract":"<p><p>Value-based healthcare is a patient-centered concept that provides a broad view of all parties involved in the care process. This model is designed to achieve the best possible patient outcomes while maintaining cost sustainability. In its classic description, value-based care is the relationship between outcomes that matter to the patient and the costs required to achieve them. Later, other variables were considered in this equation, such as appropriateness and user experience, to make this model more replicable. With a view that aligns the interests of patients, physicians, and payers, value-based healthcare has great potential to improve medical practice sustainably. After more than a decade of discussions and publications, putting this concept into practice is still challenging and dynamic. Value-based healthcare has gained importance and should become a transformative model for health ecosystems. Medical compensation aligned with these principles appears to be a promising path toward such transformation. Nevertheless, the application of this concept depends on a more straightforward definition of the health value parameters in different clinical scenarios. Cardiology is a specialty that usually has a solid evidence base for medical decision-making and this generates great potential for the application of health value elements. In this article, the authors outline a review of the main concepts of value-based healthcare and its potential applications in cardiology.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20240668"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating Patients with Heart Failure with Reduced Ejection Fraction (HFrEF) and Atrial Fibrillation: We Need to Talk About the Fifth Pillar.","authors":"Mauricio Pimentel, Lucas Simonetto Faganello, Ana Paula Arbo Magalhães, Eduardo Caberlon, Leandro Ioschpe Zimerman","doi":"10.36660/abc.20240585","DOIUrl":"https://doi.org/10.36660/abc.20240585","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20240585"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parameter Predicting Postoperative Atrial Fibrillation in Coronary Artery Bypass Grafting Patients: Triglyceride-Cholesterol-Body Weight Index.","authors":"İlhan Koyuncu, Emin Koyun","doi":"10.36660/abc.20240607","DOIUrl":"https://doi.org/10.36660/abc.20240607","url":null,"abstract":"<p><strong>Background: </strong>Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, particularly coronary artery bypass grafting (CABG). Despite advances in surgical techniques, POAF remains a significant cause of morbidity and mortality.</p><p><strong>Objectives: </strong>This study investigates the potential of the Triglyceride-Cholesterol-Body weight Index (TCBI) as a predictor of POAF, focusing on the impact of nutritional status on surgical outcomes.</p><p><strong>Methods: </strong>This retrospective study included 321 patients who underwent CABG surgery between January 2010 and January 2024. TCBI was calculated using preoperative blood samples and compared between those who developed POAF and those who did not. Statistical analyses, including Cox regression and ROC analysis, were performed to assess the predictive value of TCBI for POAF. P<0.05 was considered statistically significant.</p><p><strong>Results: </strong>Patients who developed POAF had significantly lower TCBI (1790.8 ± 689, 3413.3±1232, p<0.001, respectively) levels compared to those without POAF. Also, age (p<0.001), the frequency of hypertension (p=0.009), CRP (p=0.03), and WBC (p=0.02) values were also significantly higher in patients who developed POAF.TCBI was identified as an independent predictor of POAF (OR: 0.998, 95% CI: 0.997-0.999, p<0.001), with a cut-off value of 1932.4 predicting POAF with 75% sensitivity and 78% specificity.</p><p><strong>Conclusion: </strong>The TCBI is a reliable indicator for predicting POAF in CABG patients. Preoperative identification of patients with low TCBI could lead to targeted interventions, reducing postoperative complications and improving outcomes. Optimizing nutritional status before surgery may mitigate the risk of POAF.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20240607"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Lymphoma: A Case Report.","authors":"Leticia Ferraz Pamplona, Kelly Barnabé Serpa de Oliveira, João Ancelmo Dos Reis Neto, Luis Antelo Bustamante, Januário Manoel de Souza, Flávia Fernandes Silva Zacchi, Juliana Brenande de Oliveira Brito, Salomon Soriano Ordinola Rojas","doi":"10.36660/abc.20240299","DOIUrl":"https://doi.org/10.36660/abc.20240299","url":null,"abstract":"<p><p>Cardiac tumors are rare. Primary cardiac lymphoma is defined as non-Hodgkin lymphoma that involves only the heart and/or pericardium. It is an aggressive tumor with a poor prognosis and its symptoms may be nonspecific. A definitive diagnosis can only be obtained through histopathological study, and chemotherapy is the main treatment strategy. This case is about a 71-year-old male patient, with a rare form of primary cardiac tumor. He had postoperative complications such as acute pulmonary edema and the need for a pacemaker, which occurred after tumor resection requiring reconstruction of the vena cava and suture of the right atrium. Primary cardiac lymphoma is a tumor that is difficult to diagnose because it has a vague and non-specific symptomatic presentation. However, it should always be included as a differential diagnosis of cardiac masses. Early diagnosis can significantly improve the prognosis and increase the survival rate of patients by quickly referring them for specific treatment.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20240299"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial Fibrillation Catheter Ablation: Electroporation Against High-Power Short Duration Radiofrequency.","authors":"Rita Reis Santos, Rita Amador, Pedro Galvão Santos, Daniel Matos, Gustavo Rodrigues, João Carmo, Francisco Costa, Pedro Carmo, Francisco Morgado, Diogo Cavaco, Mauricio Scanavacca, Pedro Adragão","doi":"10.36660/abc.20240542","DOIUrl":"https://doi.org/10.36660/abc.20240542","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein isolation (PVI) is crucial in treating symptomatic atrial fibrillation (AF). New ablation technologies, such as pulse-field ablation (PFA) and high-power short-duration (HPSD) have emerged in the electrophysiology lab. However, no study has compared the outcomes of these approaches.</p><p><strong>Objective: </strong>To compare the efficacy and safety of PFA and HPSD in AF symptomatic patients.</p><p><strong>Methods: </strong>Single-centre, retrospective study of consecutive patients undergoing PVI with PFA or HPSD between May and December 2022. Demographic data, procedural data, and AF recurrence beyond the blanking period, were analysed. Comparative analysis between both techniques was performed. A P-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total 101 patients were included (61±11 years, 75% men); 56% of patients had paroxysmal AF and 19% underwent a redo ablation. Forty-five percent of patients underwent HPSD ablation and 55% PFA. Comparing HPSD and PFA, HPSD had a lower fluoroscopy time (5min [IQR 3-7min]vs 13min [IQR 10-16min], p<0.001), but higher procedure time (97min [IQR 75-142]vs 88min [IQR 66-111], p=0.13). Posterior wall isolation (PWI) was performed in 5 (11%) HPSD vs 20 (36%) PFA patients (p=0.004). There was only one case of major complication, a patient with cardiac tamponade following PFA, who was treated with pericardiocentesis. Over 384 (IQR 341 -545) days of follow-up, 76 patients (75%) were in sinus rhythm, while 25% of patients had AF recurrence: 10 PFA patients and 15 HPSD patients (p=0.06).</p><p><strong>Conclusions: </strong>Both PFA and HPSD were found to be feasible and safe procedures. PFA resulted in shorter procedure times, and lower AF recurrence rates, mainly when PWI was performed. Although analysis in a real-world scenario is still scarce, both techniques seem to be efficient, with a low AF recurrence rate.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20240542"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Search Continues for Better Markers That Aid in the Diagnosis and Prevention of Atrial Fibrillation and its Complications.","authors":"Dario Celestino Sobral Filho","doi":"10.36660/abc.20250044","DOIUrl":"https://doi.org/10.36660/abc.20250044","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 1","pages":"e20250044"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Hospital Mortality in Patients Presenting Cardiogenic Shock After Myocardial Infarction: Does it Benefit Using an Intra-Aortic Balloon Pump?","authors":"Fernando Arturo Effio Solis, Adriana Brentegani, Marcelo Luiz Campos Vieira","doi":"10.36660/abc.20250080","DOIUrl":"https://doi.org/10.36660/abc.20250080","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20250080"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Frequency of Cardiovascular Diseases in Rheumatoid Arthritis in Brazil: 10-year Cohort Study with DATASUS Databases.","authors":"Roberto Gamarski, Fernando Ferreira de Castro, Jose Antonio Sena do Nascimento, Mirhelen Mendes de Abreu","doi":"10.36660/abc.20240313","DOIUrl":"https://doi.org/10.36660/abc.20240313","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular outcomes in patients with rheumatoid arthritis (RA) have been extensively explored in the literature concerning biological factors.</p><p><strong>Objectives: </strong>This nationwide retrospective cohort study aimed to explore the distribution of cardiovascular events in patients with RA in Brazil, assisted by the Unified Health System (SUS), and to identify factors associated with these outcomes.</p><p><strong>Methods: </strong>Patients aged ≥ 18 years were identified from the Brazilian Unified Health System Database (DATASUS) through RA ICD-10 codes and their therapeutic procedures according to SUS guidelines. RA patients treated with disease-modifying antirheumatic drugs (DMARDs) were categorized as biological users and non-biological (synthetic) users. Cardiovascular outcomes, including acute coronary artery disease (ACAD), heart failure, and cerebrovascular accident (CVA), were analyzed. Patients were also categorized based on treatment patterns (switch or constant users). Socioeconomic status was assessed using the FIRJAN Municipal Development Index (IFDM). Descriptive analyses identified population distribution and cardiovascular outcomes, and multiple logistic regression explored associated factors. The statistical significance adopted was p < 0.05.</p><p><strong>Results: </strong>Among the 4,321 patients with RA treated with DMARDS, 198 cardiovascular outcomes (4.68%) were identified. The majority were female (3,398 [80.3%]) with a mean age of 54.2 (standard deviation 12.8) years, predominantly from the Southeast Region (2,421 [57.2%]). The predominant overall IFDM was > 0.8 (47.5%). Advanced age, the presence of cardiovascular risk factors, and the use of synthetic DMARDs were associated with cardiovascular outcomes.</p><p><strong>Conclusion: </strong>Cardiovascular outcomes in patients with RA are common and are associated with age, comorbidities, and the drugs used for treatment.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20240313"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Errata.","authors":"","doi":"10.36660/abc.20250119","DOIUrl":"https://doi.org/10.36660/abc.20250119","url":null,"abstract":"<p><p>[This corrects the article doi: 10.36660/abc.20240296].</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20250119"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}