Arquivos brasileiros de cardiologia最新文献

{"title":"Survival Analysis and Factors Associated with Mortality in Heart Failure Patients in the ELSA-Brasil Cohort.","authors":"Ana Paula de Oliveira Lédo, Sheila Maria Alvim Matos, Maria da Conceição Almeida, Luciana Pereira Fernandes, Roque Aras","doi":"10.36660/abc.20240705","DOIUrl":"https://doi.org/10.36660/abc.20240705","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is one of the leading causes of morbidity and mortality worldwide. Few studies have evaluated the survival and prognostic factors of patients with this condition in light of the therapeutic advances of recent decades.</p><p><strong>Objectives: </strong>To describe the survival, possible factors associated with mortality, and clinical characteristics of participants with HF in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).</p><p><strong>Methods: </strong>The cohort followed 15105 participants from 2008 to 2023. Sociodemographic variables, laboratory tests, electrocardiogram, two-dimensional echocardiogram, lifestyle habits, comorbidities, and medication use were evaluated. Survival probability was estimated using Kaplan-Meier curves and log-rank tests. Cox regression modeling was used to calculate the crude and adjusted Hazard Ratios (HR) with their respective 95% confidence intervals. The significance criterion was p<0.05.</p><p><strong>Results: </strong>During the inclusion phase, 251 participants with an HF diagnosis were selected (2008-2010). Over approximately 12.3 years of follow-up, 48 (19%) died. The overall survival of participants with HF at 2, 6, 10, and 12.3 years of follow-up was 96%, 89%, 82%, and 80%, respectively. The mortality risk was 4.5 times higher (HR: 4.46; 95% CI: 3.3-5.9) compared to the unaffected group (p<0.01), and even after applying an adjusted model, the mortality risk remained twice as high (HR: 1.77; 95% CI: 1.3-2.4). Variables associated with a worse prognosis included male sex, advanced age, systolic dysfunction (LVEF<45%), hypertension, diabetes mellitus, and chronic kidney disease.</p><p><strong>Conclusion: </strong>We found high mortality among participants with HF in the ELSA-Brasil cohort.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 6","pages":"e20240705"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144277016","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 ELSA-Brasil Study and Our Myocardial Deformation.","authors":"Márcio S M Lima","doi":"10.36660/abc.20250265","DOIUrl":"10.36660/abc.20250265","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 6","pages":"e20250265"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499824","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":"Left and Right Ventricular Strain in an Adult Brazilian Population from ELSA-Brasil Study: Reference Values and their Determinants.","authors":"Eduardo Gatti Pianca, Murilo Foppa, Giulia Bevilacqua Schmitz, Wilson Cañon-Montañez, Bruce Bartholow Duncan, Angela Barreto Santiago Santos","doi":"10.36660/abc.20240634","DOIUrl":"10.36660/abc.20240634","url":null,"abstract":"<p><strong>Background: </strong>Impaired left ventricular (LV) and right ventricular functions are important predictors of cardiovascular risk. Global longitudinal strain (GLS) provides superior sensitivity for assessing systolic function compared to traditional parameters, enhancing diagnostic accuracy in various cardiac conditions. However, GLS reference values in diverse populations are lacking.</p><p><strong>Objectives: </strong>To establish reference values for LVGLS and right ventricular free wall longitudinal strain (RVFWLS) in a Brazilian multiethnic population without cardiovascular risk factors or disease. We also explore how clinical and echocardiographic factors influence GLS distribution, addressing a gap in global guidelines that often rely on data from homogeneous or geographically distant populations.</p><p><strong>Methods: </strong>We included 1,048 participants from the ELSA-Brasil cohort who underwent echocardiography with GLS analysis. A healthy subsample (n = 527) was defined by excluding individuals with cardiovascular or renal disease, hypertension, or diabetes to establish GLS reference ranges. The prevalence of abnormal GLS was assessed, and factors associated with reduced LVGLS and RVFWLS were identified. Statistical significance was defined as p < 0.05.</p><p><strong>Results: </strong>In the healthy subsample (mean age 50.2 years, 59% female), mean LVGLS was 19.0% (95% confidence interval: 14.3 to 23.8) and RVFWLS was 28.3% (95% confidence interval: 22.3 to 34.3). Females exhibited higher LVGLS and RVFWLS values than males, with no significant age-related differences. Abnormal LVGLS and RVFWLS were observed in 3.8% and 1.6% of participants, respectively. Lower LVGLS was associated with obesity, hypertension, and diabetes; reduced RVFWLS correlated with higher body mass index and LV mass.</p><p><strong>Conclusions: </strong>We propose reference values for LVGLS and RVFWLS in a large Brazilian cohort, highlighting associations with cardiovascular comorbidities and ventricular structure.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 6","pages":"e20240634"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328120","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":"Prognostic Applications of Current Clinical Scores in Heart Failure with Preserved Ejection Fraction: A Prospective Cohort Study.","authors":"Fernando Colares Barros, Jéssica Cristina de Cezaro, Pietro Donelli Costa, Giovanni Donelli Costa, Angela Barreto Santiago Santos, Eduardo Gatti Pianca, Willian Roberto Menegazzo, Fernando Luís Scolari, Anderson Donelli da Silveira","doi":"10.36660/abc.20240852","DOIUrl":"10.36660/abc.20240852","url":null,"abstract":"<p><strong>Background: </strong>The H2FPEF and HFA-PEFF scores were developed to support the diagnosis of heart failure with preserved ejection fraction (HFpEF) and may also help predict cardiovascular outcomes.</p><p><strong>Objective: </strong>To assess the prognostic value of these scores in a cohort of individuals with HFpEF.</p><p><strong>Methods: </strong>This prospective study was conducted at a tertiary hospital in Brazil between March 2019 and December 2021. After clinical evaluation, echocardiography, and exercise testing, the H2FPEF and HFA-PEFF scores were calculated. Patients were classified into intermediate probability groups (H2FPEF: 2-5 points; HFA-PEFF: 2-4 points) and high probability groups (H2FPEF >5 points; HFA-PEFF >4 points). The primary outcome was a composite of all-cause mortality and hospitalizations due to HFpEF. Statistical significance was set at p<0.05.</p><p><strong>Results: </strong>A total of 103 patients were followed for an average of 888 days (±291). The mean age was 69 years (±8.3), and 61% were women. Twenty-seven patients (26.2%) experienced primary outcomes, totaling 32 events-11 deaths and 21 hospitalizations due to HFpEF. In the receiver operating characteristic (ROC) curve analysis, the H2FPEF score showed better predictive ability for the outcomes (area under the curve [AUC]: 0.637, 95% CI: 0.518-0.756, p=0.035) compared to the HFA-PEFF score (AUC: 0.572, 95% CI: 0.448-0.696, p=0.270). In the Kaplan-Meier analysis, high-probability classification by both scores was significantly associated with the occurrence of outcomes (log-rank p=0.034), compared to the intermediate score group or patients with differing classifications between the two scores.</p><p><strong>Conclusions: </strong>The H2FPEF score showed better performance than the HFA-PEFF score in predicting outcomes in patients with HFpEF. Findings from this contemporary study conducted in Brazil contribute to risk stratification in clinical practice.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 6","pages":"e20240852"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328121","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":"Revisiting a Timeless Skill: The Physical Examination in the Age of Technology-Driven Medicine.","authors":"Sofia Cabral","doi":"10.36660/abc.20250124","DOIUrl":"10.36660/abc.20250124","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20250124"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014898","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":"Technologies for Better Blood Pressure Control: Do the Applications Offer the Necessary Quality?","authors":"Roberto Dischinger Miranda, Bruna de Oliveira Laurindo, Maria Eduarda Augusto Licco","doi":"10.36660/abc.20250085","DOIUrl":"10.36660/abc.20250085","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20250085"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065342","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":"Spirituality and Cardiovascular Disease: Valuing Cultural Sensitivity in Cardiology.","authors":"Giancarlo Lucchetti","doi":"10.36660/abc.20250143","DOIUrl":"https://doi.org/10.36660/abc.20250143","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20250143"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060558","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":"Survival with ICD in Heart Failure: Truly Necessary or Just a Selection Bias?","authors":"Fernanda Almeida Andrade","doi":"10.36660/abc.20250142","DOIUrl":"https://doi.org/10.36660/abc.20250142","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20250142"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048609","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":"Cardiac Response to Stress: Influence of Vortioxetine.","authors":"Rodrigo Guimarães Vieira de Carvalho, Gustavo Augusto Ferreira Mota, Milene Vitória Sampaio Sobral, Ana Paula Coelho Figueira Freire, Francis Lopes Pacagnelli","doi":"10.36660/abc.20250105","DOIUrl":"https://doi.org/10.36660/abc.20250105","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20250105"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030943","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":"Effectiveness and Safety of Edoxaban in the Routine Clinical Care of Atrial Fibrillation Patients in Brazil: Prospective 1-Year Follow-Up Study - EdoBRA.","authors":"Dalton Bertolim Precoma, Rafael Paletta da Silva, Luiz Carlos Santana Passos, Conrado Roberto Hoffman Filho, Fábio Serra Silveira, José Tarcísio Medeiros de Vasconcelos, Sérgio Luiz Zimmermann, Artur Haddad Herdy, Alessandra Ritter, Daniely Freitas-Alves, José Francisco Kerr Saraiva","doi":"10.36660/abc.20240589","DOIUrl":"10.36660/abc.20240589","url":null,"abstract":"<p><strong>Background: </strong>Edoxaban, an orally administered anticoagulant, has been shown to be safe and effective in preventing stroke in atrial fibrillation (AF) patients. Given its widespread use since approval, evaluating edoxaban's real-world performance in the Brazilian clinical context is crucial.</p><p><strong>Objective: </strong>The study aimed to report the one-year safety and effectiveness of edoxaban in AF patients in Brazil.</p><p><strong>Methods: </strong>EdoBRA is a multi-center, prospective, observational investigation conducted across 30 Brazilian research sites. Bleeding events were considered as safety measures and cardiovascular events were considered for effectiveness measures. Descriptive analyses were performed. Kaplan-Meier curves were generated for time-to-event analysis and a 95% confidence interval was used as appropriate.</p><p><strong>Results: </strong>Among the 705 enrolled participants, 590 were included in the analysis for having at least one follow-up or one reported event. Mean (±SD) CHA2DS2-VASc risk score was 3 (3.3 ± 1.6) and the mean HAS-BLED risk score was 2 (1.8 ± 1.2). During the one-year follow-up period, nine major bleedings events were reported, including five cases of gastrointestinal bleeding (IP 0.85 [95% CI =0.82; 0.88]). Among the cardiovascular events recorded (N = 68), there were four stroke events (IP 0.68 [CI 95% 0.65;0.71]), one transient ischemic attack (IP 0.17 [CI 95% (0.16;0.18]) and 1 event was Venous Thromboembolic Events (IP 0.17 [CI 95% (0.16;0.18]). No systemic embolic event was exhibited by any patient.</p><p><strong>Conclusion: </strong>In an elderly population with several comorbidities routinely treated with edoxaban for AF, the rates of cardiovascular event and major bleeding were low.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20240589"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059662","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}