Arquivos brasileiros de cardiologia最新文献

{"title":"The Role of 3D Printing in Cardiac Surgery for Congenital Heart Diseases.","authors":"Vitor Ramos","doi":"10.36660/abc.20240798","DOIUrl":"10.36660/abc.20240798","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 12","pages":"e20240798"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401050","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":"Worse Prognosis of STEMI Patients during Off-Hours: What are we Missing?","authors":"Marco Antônio Smiderle Gelain, Henrique Barbosa Ribeiro","doi":"10.36660/abc.20240701","DOIUrl":"10.36660/abc.20240701","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 11","pages":"e20240701"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401034","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":"Oral Anticoagulation with VKAs: Quality Above All!","authors":"Letícia Braga Ferreira, André Assis Lopes do Carmo","doi":"10.36660/abc.20240795","DOIUrl":"https://doi.org/10.36660/abc.20240795","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20240795"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660057","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 Brugada Syndrome: A Case of Successful Radiofrequency Catheter Ablation.","authors":"Mirella Esmanhotto Facin, Cristiano Faria Pisani, Luciana Sacilotto, Francisco Carlos da Costa Darrieux, Nelson Samesima, Maurício Ibrahim Scanavacca","doi":"10.36660/abc.20240501","DOIUrl":"10.36660/abc.20240501","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20240501"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574906","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":"Clinical Outcomes and Mortality in Patients with Implantable Cardioverter-Defibrillator for Primary Prevention.","authors":"Ahmet Anıl Başkurt, Sema Güneri, Reşit Yiğit Yılancıoğlu, Oğuzhan Ekrem Turan, Emin Evren Özcan","doi":"10.36660/abc.20240348","DOIUrl":"10.36660/abc.20240348","url":null,"abstract":"<p><strong>Background: </strong>Implantable cardioverter-defibrillator (ICD) is indicated for primary prevention in patients with left ventricular ejection fraction (LVEF) ≤ 35% and New York Heart Association class II or III heart failure despite 3 months of optimal medical therapy. However, studies that support this recommendation are over 20 years old, and they may not reflect modern heart failure patients' characteristics.</p><p><strong>Objectives: </strong>Retrospectively evaluate patients who received an ICD for primary prevention.</p><p><strong>Methods: </strong>All-cause and sudden death rates were compared in patients who received ICD between January 1, 2015 and March 1, 2020 and those who did not accept ICD. Variables were analyzed at a 95% confidence interval, and p < 0.05 was considered as significant.</p><p><strong>Results: </strong>When comparing mortality rates between patients with and without ICD, 67 of 228 patients (29.4%) in the ICD group and 39 of 150 patients (26%) in the control group died from all causes (p = 0.473). Age, LVEF, BNP value, and hospitalization were found to be independent predictors of all-cause mortality. Patients with BNP above 508.5, LVEF below 24.5%, and age over 68.5 years had a 25-fold increased all-cause mortality. Coronary artery disease was not found to be an independent risk factor. Survival in the control group was statistically significantly better in the first months. Although there was no statistical difference in the long term, survival was numerically better in the ICD arm. This could be attributed to the fact that ICD implantations were performed on patients with worse clinical conditions. The higher survival rate observed in patients with ICD may be due to the fact that they came in for device control and remained in follow-up.</p><p><strong>Conclusions: </strong>With advances in the treatment of heart failure, ICD implantation should be performed in selected patients.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20240348"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574905","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":"In-Hospital Mortality Predictors in Patients with Acute Myocardial Infarction and Cardiogenic Shock Using Intra-Aortic Balloon Pump.","authors":"Rossana Dall'Orto Elias, Isabella Pedrosa Assunção, Julliane Vasconcelos Joviano Santos, Maria da Gloria Rodrigues-Machado, José Luiz Barros Pena","doi":"10.36660/abc.20230496","DOIUrl":"10.36660/abc.20230496","url":null,"abstract":"<p><strong>Background: </strong>Patients with ST-segment elevation myocardial infarction (STEMI) and cardiogenic shock (CS) have a high risk of death. New types of mechanical devices have limited availability in Brazil. The use of intra-aortic balloon pump (IABP), although new guidelines downgraded its recommendation, is the most widely used mechanical support strategy. However, little is known about the clinical predictors of its effectiveness in reducing mortality in this group of patients.</p><p><strong>Objectives: </strong>To assess the predictors of IABP effectiveness in reducing in-hospital mortality in patients with STEMI and CS.</p><p><strong>Methods: </strong>This observational, retrospective, descriptive, single-center study involved 98 patients with STEMI and CS treated with IABP, in an intensive care unit. We compared patients who survived (42 men and 13 women) and those did not (30 men and 13 women) using clinical predictors of IABP effectiveness in reducing in-hospital death, considering a statistical significance level of 5% (p < 0.05).</p><p><strong>Results: </strong>The use of IABP in patients less than 1 day after infarction (odds ratio [OR]: 0.12; 95% confidence interval [CI]: 0.02 to 0.85; p = 0.034) was a factor that increased the risk of in-hospital death. Younger age (OR: 1.09; 95% CI: 1.02 to 1.16; p = 0.010) and dyslipidemia (OR: 0.19; 95% CI: 0.05 to 0.81; p = 0.024) were predictors of reduced in-hospital mortality. For each additional year of age, the risk of death increased 1.07-fold.</p><p><strong>Conclusion: </strong>In patients with STEMI and CS, the use of IABP reduced in-hospital mortality when it was used for 2 or more days, as well as in younger patients and those with dyslipidemia. Additional studies are needed to confirm these findings.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20230496"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506719","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":"Preoperative Predictors of Hospital Readmission within 5 Years Following CABG: Cohort Analysis of the REPLICCAR II Database.","authors":"Carlos Alberto Sancio Junior, Fabiane Letícia de Freitas, Gabrielle Barbosa Borgomoni, Daniella de Lima Pes, Pedro Horigoshi Reis, Pedro Gabriel Melo de Barros E Silva, Marcelo Arruda Nakazone, Marcos Gradim Tiveron, Valquiria Pelisser Campagnucci, Luiz Augusto Lisboa, Luís Alberto Oliveira Dallan, Fabio Biscegli Jatene, Omar Asdrúbal Vilca Mejia","doi":"10.36660/abc.20240420","DOIUrl":"https://doi.org/10.36660/abc.20240420","url":null,"abstract":"<p><strong>Background: </strong>Reducing hospital readmissions following coronary artery bypass grafting (CABG) surgeries is essential to optimizing medium- and long-term patient outcomes.</p><p><strong>Objective: </strong>To analyze preoperative predictors associated with all-cause and cardiac readmissions within 5 years following CABG.</p><p><strong>Methods: </strong>We analyzed 1,387 patients who underwent CABG between June 2017 and July 2019 using data from the multicenter REPLICCAR II registry. Follow-up was carried out by telephone interviews using a questionnaire structured in the REDCap platform. Statistical analysis included univariate and multivariate methods, with Cox regression and internal validation through calibration and discrimination tests. A significance level of 5% was applied.</p><p><strong>Results: </strong>The cumulative incidence of all-cause readmission was 27.69%, with a mean follow-up of 4.3 years and a mean time to readmission of 2.4 years. Multivariate regression analysis indicated the following predictors of higher all-cause readmission risk: lower body mass index (HR=0.97, p=0.032), history of myocardial infarction (HR=1.27, p=0.024), diabetes mellitus (HR=1.35, p=0.004), renal failure (HR=1.62, p=0.004), and higher STS score (HR=1.22, p<0.001). A moderate correlation was observed between readmission and mortality (Rho=0.55).</p><p><strong>Conclusions: </strong>This analysis demonstrates that lower body mass index, history of myocardial infarction, diabetes mellitus, renal failure, and elevated STS scores are significant predictors of increased hospital readmission risk following CABG.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20240420"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660063","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":"How Cardiovascular Physical Examination Impacts Clinical Decision-Making in Various Scenarios of Cardiac Valvular Diseases.","authors":"Isabella Silveira Teixeira, Vinícius Lima Borges, Natan Viola, Henrique Turin Moreira, Antonio Pazin Filho, André Schmidt, José Antônio Marin-Neto, Minna Moreira Dias Romano","doi":"10.36660/abc.20240272","DOIUrl":"https://doi.org/10.36660/abc.20240272","url":null,"abstract":"<p><strong>Background: </strong>Complementary diagnostic examinations have replaced the importance of Physical Examination (PE) in Clinical Decision-making (CDM). 1. Medical clinical practice has lost confidence in Physical Examination (PE) compared to complementary diagnostic examinations (CE). More importance has been deposited on Echocardiography (ECHO) in cardiac valvular dysfunction scenarios. No studies have measured the impact of cardiac PE in Clinical Decision-making (CDM). 2. Discrepancies between PE findings and ECHO reports are common and may impact CDM in different forms. 3. PE has proven essential to enhancing diagnosis confidence and grading of dysfunction in cardiac valvular dysfunctions. ECHO still plays a significant importance in CDM, even when discordant from physical examination. 4. The number of solicitations of an invasive test such as Cardiac Catheterization (CATE) is influenced by PE. The number of orderings was higher when volunteers did not perform a PE.</p><p><strong>Objective: </strong>To evaluate the impact of cardiovascular PE in scenarios of cardiac valvular diseases.</p><p><strong>Methods: </strong>An interventional study with volunteers' patients having or not having the opportunity to perform PE in scenarios of valvopathies. The PE was simulated in a high-fidelity cardiopulmonary simulator. Volunteers received questions about CDM before and after receiving an ECHO Concordant or ECHO Discordant report. Cohen´s kappa coefficient and square contingency tables compared diagnostic accuracy. ANOVA tests compared the number of requested tests; the significance level was set as p < 0.05.</p><p><strong>Results: </strong>Sixty volunteers performed 239 clinical observations in 4 valvular dysfunctions. The diagnostic accuracy of valvular dysfunction was good (kappa = 0.935, p < 0.001). After receiving ECHO reports, the accuracy was worse without PE (p = 0.0047). The confidence level in diagnosis was 28.18% higher when PE was performed (p < 0.01). However, after receiving ECHO reports, diagnostic confidence levels were only 4% higher in the group with PE (p = 0.03). There were significantly more CATE requests when PE was not performed (p = 0.0326). The indication of valvular intervention was not related to having or not having the opportunity to perform PE (79 with PE vs 78 without PE, p = 0.0607), but was influenced by ECHO Concordant vs ECHO Discordant reports (p < 0.001).</p><p><strong>Conclusions: </strong>Performing PE enhanced diagnosis confidence in valvulopathy scenarios and correct dysfunction grading. Treatment decisions were more based on ECHO reports than on PE when they were discordant, and requests for CATE increased when volunteers had no chance to perform PE.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20240272"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660053","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":"Prediction of Rehospitalization in Cardiac Bypass Surgery.","authors":"Antônio Rafael Alves de Sá, Victoria Alves Prado, Mateus Augusto Felix de Melo, Pâmela Marillac Rodrigues Feijó de Melo, Maria Clara Filgueira Borba, Achilles de Souza Andrade, Jorge Fernando Pereira Silva, Johnnatas Mikael Lopes","doi":"10.36660/abc.20240706","DOIUrl":"https://doi.org/10.36660/abc.20240706","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20240706"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660061","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":"Spirituality/Religiosity and Adherence to Treatment in Hypertensive Individuals.","authors":"Yanne da Silva Camargo, Aliny Serafim Borges Ferreira, Luana Araújo Macedo Scalia, Patrícia Magnabosco, Aline Guarato da Cunha Bragato, Maria Beatriz Guimarães Raponi, Nelson Dinamarco, Valéria Nasser Figueiredo","doi":"10.36660/abc.20240558","DOIUrl":"10.36660/abc.20240558","url":null,"abstract":"<p><strong>Background: </strong>Adherence to drug and non-drug treatment for hypertension has a major socioeconomic impact, in addition to reducing the risk of cardiovascular events and morbidity and mortality. It is known that spirituality and religiosity can be incorporated into coping and managing hypertension.</p><p><strong>Objective: </strong>To analyze possible factors associated with adherence to treatment in hypertensive patients and the role of spirituality/religiosity in this context.</p><p><strong>Methods: </strong>Observational, cross-sectional, quantitative study, carried out with 237 hypertensive individuals monitored in a large Brazilian teaching hospital. Sociodemographic, clinical and lifestyle data were collected, in addition to measuring anthropometric data and performing a physical examination. To determine adherence to drug and non-drug treatment for hypertension, the QATSAH instrument was used and, to assess the level of spirituality/religiosity, the Duke Religion Index and the Brief Multidimensional Measure of Religiousness/Spirituality were applied.</p><p><strong>Results: </strong>Higher levels of adherence to treatment were observed when aged ≥65 years, physically active, and who did not consume alcohol (p<0.05). Regarding religiosity and spirituality, intrinsic religiosity (β = 0.24, 95%CI [0.22, 1.13], p = 0.004), values and beliefs (β = -0.18, 95%CI [-1.58, -0.20], p = 0.012), and forgiveness (β = 0.16, 95%CI [0.13, 1.19], p = 0.015) were statistically significant predictors of treatment adherence. Organizational religiosity, non-organizational religiosity, and daily spiritual experiences were not significant.</p><p><strong>Conclusion: </strong>Greater intrinsic religiosity, lower scores in Values and Beliefs and higher scores in Forgiveness increase the level of medication and non-medication adherence in hypertensive individuals.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 2","pages":"e20240558"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506720","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}