Arquivos brasileiros de cardiologia最新文献

{"title":"Characteristics Associated with Prevalent Atrial Fibrillation and Risk Profile for Incident Atrial Fibrillation an Elderly Population from ELSA-Brasil.","authors":"Bernardo Boccalon, Murilo Foppa, Luisa C C Brant, Marcelo M Pinto-Filho, Antonio L Ribeiro, Bruce B Duncan, Angela Barreto Santiago Santos","doi":"10.36660/abc.20240487","DOIUrl":"10.36660/abc.20240487","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is an arrhythmia causing significant symptoms and raising the risk of complications.</p><p><strong>Objectives: </strong>To evaluate the association of clinical, electrocardiographic, and echocardiographic parameters with prevalent atrial fibrillation or flutter (AFF) and assess the risk profile for incident AFF using the AF prediction scores CHARGE-AF and EHR in an elderly population from a developing country.</p><p><strong>Methods: </strong>We included all participants in ELSA-Brasil aged 60 and over whose diagnosis of AFF could be defined through self-report or electrocardiogram and who had echocardiography performed at the study's baseline. For statistical analysis, results with p values < 0.05 were considered statistically significant.</p><p><strong>Results: </strong>Among the 2,088 participants (65 ± 4.1 years; 53% women), 88 (4.2%) had AFF. Those with AFF were older and had higher rates of heart failure (HF), previous myocardial infarction, left bundle branch block (LBBB), prolonged QT interval, supraventricular extrasystoles, and sinus bradycardia. They also had larger left atrial and left ventricular dimensions, and lower left ventricular ejection fraction (LVEF). Multivariable analysis showed that HF, LBBB, larger left atrium, and lower LVEF were independently associated with AFF. The 5-year risk for incident AFF was low (< 2.5%) in 63% and high (> 5%) in 12% of individuals according to the CHARGE-AF score, and low in 67% and high in 13% according to the EHR.</p><p><strong>Conclusion: </strong>AFF was found in 4.2% of this older Brazilian cohort. AFF was linked to HF history, LBBB, left atrial dilation, and reduced LVEF. Additionally, 12% to 13% of patients in sinus rhythm were at high risk for AFF. Monitoring clinical, electrocardiographic, and echocardiographic parameters can aid in early identification of high-risk individuals.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 1","pages":"e20240487"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660047","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":"Heart Rate Reduction after Effort Test Is Higher in Physically Active Adults without Familial Cardiovascular Risk Factor.","authors":"Larissa de Almeida Dourado, Paulo Magno Martins Dourado, Jaciara Gomes de Oliveira, Evandra Maria da Silva, João Paulo de Almeida Dourado, Pedro Gabriel Senger Braga","doi":"10.36660/abc.20240435","DOIUrl":"10.36660/abc.20240435","url":null,"abstract":"<p><p>The objective of this study is to investigate the influence of physical activity on heart rate (HR) recovery, after treadmill exercise testing, in asymptomatic adults, with and without familial risk factors (FR) for cardiovascular disease. Two hundred and fifty (250) adults of both sexes aged 18 to 59 years were included in the study. None of the participants had a history of cardiovascular disease or used medications for chronic diseases. All individuals underwent exercise testing using the Ellestad protocol. Delta values were calculated by subtracting peak HR from HR in the first, second, fourth, and sixth minutes of recovery. The family history of cardiovascular disease and physical activity were documented. For statistical analysis, ANOVA was performed, followed by Bonferroni or Kruskall-Wallis multiple comparisons, followed by Dunn's multiple comparisons. The delta values at the first, second, fourth, and sixth minutes of recovery were lower in individuals who did not engage in physical activity and had no family cardiovascular risk factor, compared to those who were physically active and had no family risk factor. No differences in delta values were observed between physically active individuals with cardiovascular risk factors and physically inactive individuals with a family history at the time points studied. In individuals without a family risk factor, physical activity appears to enhance autonomic control, increasing the capacity to reduce HR after exercise. However, this effect was not evident in those with a family risk factor, as physical activity did not impact recovery HR.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 1","pages":"e20240435"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191516","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":"Characteristics Associated with Prevalent Atrial Fibrillation and Risk Profile for Incident Atrial Fibrillation an Elderly Population from ELSA-Brasil.","authors":"Bernardo Boccalon, Murilo Foppa, Luisa C C Brant, Marcelo M Pinto Filho, Antonio L Ribeiro, Bruce B Duncan, Angela Barreto Santiago Santos","doi":"10.36660/abc.20240487","DOIUrl":"10.36660/abc.20240487","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is an arrhythmia causing significant symptoms and raising the risk of complications.</p><p><strong>Objectives: </strong>To evaluate the association of clinical, electrocardiographic, and echocardiographic parameters with prevalent atrial fibrillation or flutter (AFF) and assess the risk profile for incident AFF using the AF prediction scores CHARGE-AF and EHR in an elderly population from a developing country.</p><p><strong>Methods: </strong>We included all participants in ELSA-Brasil aged 60 and over whose diagnosis of AFF could be defined through self-report or electrocardiogram and who had echocardiography performed at the study's baseline. For statistical analysis, results with p values < 0.05 were considered statistically significant.</p><p><strong>Results: </strong>Among the 2,088 participants (65 ± 4.1 years; 53% women), 88 (4.2%) had AFF. Those with AFF were older and had higher rates of heart failure (HF), previous myocardial infarction, left bundle branch block (LBBB), prolonged QT interval, supraventricular extrasystoles, and sinus bradycardia. They also had larger left atrial and left ventricular dimensions, and lower left ventricular ejection fraction (LVEF). Multivariable analysis showed that HF, LBBB, larger left atrium, and lower LVEF were independently associated with AFF. The 5-year risk for incident AFF was low (< 2.5%) in 63% and high (> 5%) in 12% of individuals according to the CHARGE-AF score, and low in 67% and high in 13% according to the EHR.</p><p><strong>Conclusion: </strong>AFF was found in 4.2% of this older Brazilian cohort. AFF was linked to HF history, LBBB, left atrial dilation, and reduced LVEF. Additionally, 12% to 13% of patients in sinus rhythm were at high risk for AFF. Monitoring clinical, electrocardiographic, and echocardiographic parameters can aid in early identification of high-risk individuals.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 1","pages":"e20240487"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401057","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":"Outcomes of Guideline-Recommended Percutaneous Coronary Intervention in Women with Obstructive Coronary Artery Disease: A Longitudinal Cohort Study.","authors":"Tacianne Rolemberg Braga Delamain, José Henrique Herrmann Delamain, Sergio Luiz Navarro Braga, Ricardo Costa, Dimytri Alexandre Alvim de Siqueira, Fausto Feres, Marinella Patrizia Centemero","doi":"10.36660/abc.20240249","DOIUrl":"10.36660/abc.20240249","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown that women with coronary artery disease (CAD) are less likely to undergo angiography and have less favorable outcomes after percutaneous coronary intervention (PCI).</p><p><strong>Objectives: </strong>Assess the outcomes of women with acute coronary syndrome (ACS) and stable CAD (lesion>50%) treated with contemporary PCI using DES.</p><p><strong>Methods: </strong>Observational, longitudinal cohort study with prospective follow-up included all female patients ≥ 18 years admitted at a tertiary public cardiovascular center in Brazil from January 2019 to December 2020. The level of significance adopted in the statistical analysis was 5%.</p><p><strong>Results: </strong>1146 women (average age 65 years) underwent guideline-recommended PCI. Risk factors were frequent (hypertension: 88%, dyslipidemia: 85%, diabetes: 47.5%), and 69% were admitted due to ACS. Radial access was used in 59% of patients; 1516 vessels were treated with 1725 stents implanted (1.5 stents/patient). PCI was successful in 97.7%, in-hospital death occurred in 1.2%, peri-procedural MI in 3.6%, and TIA in 0.4%. Predictors of in-hospital major adverse cardiac and cerebrovascular events (MACCE): previous stroke (OR: 2.97; CI: 1.06-7.15; p= 0.023), CKD (OR: 3.11; CI: 1.49-6.20; p= 0.002), and at least one procedural failure during PCI (OR: 10.2; CI: 1.17-5.9; p<0.001). The average follow-up was 576.2 days in 1047 patients. All-cause mortality occurred in 5.3%, cardiac death in 3.5%, recurrent ACS in 8%, and additional revascularization procedures in 5.5%. The predictors for MACCE during FU were hospital admission for ACS for the index PCI (OR: 1.58; HR: 1.06-2.35; p=0.023) and the presence of MACCE during hospitalization (OR: 6.66; HR: 2.42- 18.3; p< 0.001).</p><p><strong>Conclusion: </strong>In this pioneering study involving 1146 patients treated by contemporary PCI and followed for almost 2 years, we obtained very encouraging in-hospital and mid-term results.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 1","pages":"e20240249"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191519","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":"Influence of Insertion/Deletion Polymorphism of the Angiotensin Converting Enzyme Gene on Adiposity and Cardiac Function in Patients with Heart Failure.","authors":"Marla Darlene Machado Vale, Édina Caroline Ternus Ribeiro, Ingrid da Silveira Knobloch, Ida Vanessa Doederlein Schwartz, Fernanda Sperb-Ludwig, Gabriela Corrêa Souza","doi":"10.36660/abc.20240204","DOIUrl":"10.36660/abc.20240204","url":null,"abstract":"<p><strong>Background: </strong>The angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism (rs4340) is associated with the pathogenesis of heart failure (HF). This polymorphism may contribute to a greater propensity for severe HF and excess weight.</p><p><strong>Objective: </strong>To evaluate adiposity, cardiac function, and their association with ACE I/D polymorphism in HF patients.</p><p><strong>Methods: </strong>Cross-sectional study with ambulatory individuals ≥18 years diagnosed with HF. Genetic analysis was performed using polymerase chain reaction followed by agarose gel electrophoresis. Left ventricular ejection fraction (LVEF) was determined by echocardiography. Nutritional status was assessed using body mass index, while adiposity was analyzed using bioelectrical impedance analysis (BIA), waist circumference, waist-to-hip ratio, and waist-to-height ratio. The adopted significance level was 5% (p < 0.05).</p><p><strong>Results: </strong>Seventy-one individuals were included, with a mean age of 55.8 ± 13.0 years, predominantly male (66.2%), with functional class I and II (90.9%), and a median LVEF of 30% (24-40). The prevalence of overweight was 38%, class I obesity was 23.9%, and class II and III obesity was 12.7%, with 50.7% exhibiting excess adiposity as assessed by BIA. A total of 88 D alleles and 54 I alleles of the ACE gene were identified. Regarding ACE genotypes, 38.1% were DD, 47.8% were ID, and 14.1% were II. In the multivariate analysis, the D allele (DD + ID genotypes versus II) was associated with LVEF (PR 0.995; 95% CI 0.991-1.000; p = 0.048) and with the etiology of HF (dilated cardiomyopathy: PR 1.283; 95% CI 1.039-1.583; p = 0.021). No independent association was found with adiposity.</p><p><strong>Conclusion: </strong>The presence of the D allele of the ACE polymorphism is associated with LVEF and HF etiology. Despite overweight being prevalent in the sample, no independent associations were found.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 1","pages":"e20240204"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026060","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":"Serum Nitric Oxide, Endothelin-1 Correlates Post-Procedural Major Adverse Cardiovascular Events among Patients with Acute STEMI.","authors":"Huihui Guo, Qi Qu, Jiechao Lv","doi":"10.36660/abc.20240248","DOIUrl":"10.36660/abc.20240248","url":null,"abstract":"<p><strong>Background: </strong>ST-segment elevation myocardial infarction (STEMI) is a common and severe form of acute myocardial infarction (AMI).</p><p><strong>Objectives: </strong>The study aimed to investigate the relationship between serum nitric oxide (NO) and endothelin-1 (ET-1) levels with the severity of STEMI and their predictive value for major adverse cardiovascular events (MACE) within one year after percutaneous coronary intervention (PCI) in STEMI patients.</p><p><strong>Methods: </strong>The retrospective study was conducted on 269 STEMI patients who underwent PCI. The patients were categorized into two groups: those who developed MACE (112 cases) and those who did not (157 cases) within one year. NO and ET1 levels were measured in collected serum using enzyme-linked immunosorbent assay. Receive-operating characteristics (ROC) curve was used to analyze the prognostic potential of NO and ET1 individually and in combination, p<0.05 was considered statistically significant.</p><p><strong>Results: </strong>Significant differences were noted between the two groups concerning age, Killip classification, left ventricular ejection fraction, cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), as well as serum NO and ET-1 levels. The study observed that patients who developed MACE had lower serum NO and higher ET-1 levels upon admission. Further analysis revealed a significant inverse relationship between serum NO and ET-1 levels and the severity of myocardial infarction. A combined detection model, -0.082 * NO + 0.059 * ET-1, demonstrated promising prognostic value for the occurrence of MACE within one year post-PCI.</p><p><strong>Conclusions: </strong>Serum NO and ET-1 levels serve as valuable prognostic markers for MACE in STEMI patients undergoing PCI, exhibiting a strong correlation with AMI severity.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 1","pages":"e20240248"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026067","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":"Association between Estimated Small Dense Low-Density Lipoprotein-cholesterol (sdLDL-C) and Atherosclerotic Cardiovascular Disease Risk.","authors":"Shutang Zhang, Jinjie Du, Peng Wang, Min Lei, Canye Zhong, Yang Ou, Zhen Sun","doi":"10.36660/abc.20240265","DOIUrl":"10.36660/abc.20240265","url":null,"abstract":"<p><strong>Background: </strong>A new formula for estimating small, dense, low-density lipoprotein cholesterol (sdLDL-C) based on the results of the standard lipid panel is proposed.</p><p><strong>Objectives: </strong>To assess the association between estimated sdLDL-C (EsdLDL-C) and atherosclerotic cardiovascular disease (ASCVD) risk.</p><p><strong>Methods: </strong>A total of 12,192 participants from the Korea National Health and Nutrition Examination Survey (KNHANES) database between 2010 and 2020 were included in this cross-sectional study. EsdLDL-C was calculated as EsdLDL-C= LDL-C - [1.43 × LDL-C - (0.14 × (ln (TG) × LDL-C)) - 8.99]. Logistic regression analyses were utilized to assess the association between EsdLDL-C and ASCVD risk. Subgroup analyses were performed based on age, body mass index (BMI), hypertension, and diabetes. An odds ratio (OR) with a 95% confidence interval (CI) was used for evaluation. P<0.05 was considered statistically significant.</p><p><strong>Results: </strong>Among 12,192 participants, 1,239 (10.16%) had ASCVD. The mean sdLDL-C of participants was estimated to be 42.43±14.75 mg/dL using the formula. Elevated EsdLDL-C levels (OR=1.33; 95%CI, 1.06-1.66) were associated with an increased risk of ASCVD. Subgroup analyses found that there may be an interaction between EsdLDL-C (Pinteraction= 0.001) or non-HDL-C (Pinteraction= 0.015) and hypertension on ASCVD risk.</p><p><strong>Conclusions: </strong>Elevated estimated sdLDL-C levels were associated with the risk of ASCVD, and estimated sdLDL-C might be an alternative to sdLDL-C measurement for ASCVD risk assessment.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 1","pages":"e20240265"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191426","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":"Mendelian Randomization in Atrial Fibrillation.","authors":"Protasio Lemos Da Luz","doi":"10.36660/abc.20240682","DOIUrl":"10.36660/abc.20240682","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 11","pages":"e20240682"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857233","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":"Serum Glycogen Synthase 3 Beta Levels: A Promissory Marker for Patients with Heart Failure.","authors":"Claudia Aznar Alesso, João Queda, Dania Mohty, Vera Maria Cury Salemi","doi":"10.36660/abc.20240684","DOIUrl":"10.36660/abc.20240684","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 11","pages":"e20240684"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815247","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 ACCEPT Study and the Management of Ischemic Myocardial Disease in Brazil: Challenges and Opportunities in a Continental Country.","authors":"Henrique Tria Bianco","doi":"10.36660/abc.20240604","DOIUrl":"10.36660/abc.20240604","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 11","pages":"e20240604"},"PeriodicalIF":0.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815251","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}