Arquivos brasileiros de cardiologia最新文献

{"title":"Causal Relationship between Television Viewing Time, Cardiovascular Diseases, and Potential Mechanisms.","authors":"Mengjin Hu, Boyu Li, Jinggang Xia, Chunlin Yin, Yuejin Yang","doi":"10.36660/abc.20230796","DOIUrl":"10.36660/abc.20230796","url":null,"abstract":"<p><strong>Background: </strong>As the predominant leisure-time sedentary behavior, television viewing was documented to increase cardiovascular diseases in observational studies, yet the causal relationship and potential mechanisms remain to be determined.</p><p><strong>Objectives: </strong>To systematically investigate the causal relationship between television viewing time, cardiovascular diseases, and potential mechanisms.</p><p><strong>Methods: </strong>We conducted a two-sample Mendelian randomization (MR) analysis to estimate causal associations with cardiovascular diseases and biomarkers of cardiometabolic risk. The random inverse-variance weighted method was used as the primary estimate. To account for multiple comparisons, a Bonferroni correction p value for cardiovascular diseases and biomarkers of cardiometabolic risk was 0.0045 and 0.0024, respectively.</p><p><strong>Results: </strong>Genetically instrumented television viewing time was associated with higher risks of type 2 diabetes (odd ratio [OR]=2.51; 95% confidence interval [CI]: 1.89-3.33; p<0.00001), hypertension (OR=2.11; 95% CI: 1.67-2.66; p<0.00001), coronary heart disease (OR=1.53; 95% CI: 1.23-1.91; p=0.00015), and heart failure (OR=1.42; 95% CI: 1.18-1.70; p=0.00017). Suggestive evidence of harmful associations was also observed for peripheral artery disease (OR=1.58; 95% CI: 1.07-2.34; p=0.02253) and ischemic stroke (OR=1.34; 95% CI: 1.10-1.63; p=0.00328). Biomarkers of cardiometabolic risk, including interleukin 10, leptin, visceral adipose, abdominal subcutaneous adipose, liver fat, body mass index, waist circumference, triglycerides, and C-reactive protein, were increased. Systolic blood pressure, heart rate, low-density lipoprotein, and total cholesterol were potentially increased while high-density lipoprotein was decreased. However, television viewing time had no effect on venous thromboembolism or pulmonary embolism.</p><p><strong>Conclusion: </strong>Television viewing time was causally associated with increased risks of cardiovascular diseases, which may be explained by metabolic and inflammatory mechanisms.</p><p><strong>Background: </strong>An overview of the effect of television viewing time on cardiovascular diseases and biomarkers of cardiometabolic risk.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 10","pages":"e20230796"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549509","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":"Restrictive versus Liberal Transfusion Strategies in Acute Myocardial Infarction and Anemia: A Meta-Analysis and Trial Sequential Analysis.","authors":"Ronaldo C Fabiano, Lara Melo, Alleh Nogueira, Douglas M Gewehr, Giuliano Generoso, Rhanderson Cardoso, Marcio S Bittencourt","doi":"10.36660/abc.20240158","DOIUrl":"10.36660/abc.20240158","url":null,"abstract":"<p><strong>Background: </strong>The optimal transfusion strategy in acute myocardial infarction (AMI)-associated anemia remains uncertain.</p><p><strong>Objectives: </strong>To compare all-cause mortality between liberal versus restrictive transfusion strategies in patients with AMI-associated anemia, using a meta-analytic approach.</p><p><strong>Methods: </strong>Pubmed, Embase, and ClinicalTrials.gov were systematically searched for randomized controlled trials (RCTs) comparing liberal and restrictive transfusion strategies in AMI-associated anemia. Random-effects meta-analysis and trial sequential analysis (TSA) were conducted to compare blood use, efficacy, and safety endpoints. The p-values were 2-sided with an α of 0.05.</p><p><strong>Results: </strong>In a pooled analysis involving 4,217 participants from three RCTs followed-up for 30 days, no statistically significant differences emerged between restrictive and liberal strategies in all-cause mortality (RR 1.03; 95% CI 0.67-1.57; p=0.90) and other efficacy endpoints (recurrent AMI, unscheduled revascularization, acute heart failure, stroke, and acute kidney injury), as well as in safety endpoints including allergic reactions, infection, and acute lung injury. TSA did not reach futility boundaries. In patients assigned to restrictive strategy, substantial differences in transfusion use were observed across RCTs, correlating with mortality rates, and likely accounting for between-study heterogeneity in treatment effects.</p><p><strong>Conclusions: </strong>In patients with AMI-associated anemia, there is no clear superiority between liberal and restrictive transfusion strategies in all-cause mortality or other major outcomes in 30 days. However, the heterogeneity observed in blood use between the restrictive groups likely explains variable findings across RCTs.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 9","pages":"e20240158"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549508","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":"Does Secondary HFpEF Exist? Yes, but it Should not be Called HFpEF.","authors":"Humberto Villacorta, Pedro Schwartzmann","doi":"10.36660/abc.20240296","DOIUrl":"https://doi.org/10.36660/abc.20240296","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 9","pages":"e20240296"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549506","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":"Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology - 2024.","authors":"Danielle Menosi Gualandro, Luciana Savoy Fornari, Bruno Caramelli, Alexandre Antonio Cunha Abizaid, Brenno Rizerio Gomes, Caio de Assis Moura Tavares, Caio Julio Cesar Dos Santos Fernandes, Carisi Anne Polanczyk, Carlos Jardim, Carolina Leticia Zilli Vieira, Claudio Pinho, Daniela Calderaro, Dirk Schreen, Fabiana Goulart Marcondes-Braga, Fábio de Souza, Francisco Akira Malta Cardozo, Flavio Tarasoutchi, Gabriel Assis Lopes Carmo, Gabriel Kanhouche, José Jayme Galvão de Lima, Luciana Dornfeld Bichuette, Luciana Sacilotto, Luciano Ferreira Drager, Luciano Janussi Vacanti, Luis Henrique Wolff Gowdak, Marcelo Luiz Campos Vieira, Marcelo Luiz Floriano Melo Martins, Márcio Silva Miguel Lima, Marcos Pita Lottenberg, Márlon Juliano Romero Aliberti, Mauricio Felippi de Sá Marchi, Milena Ribeiro Paixão, Mucio Tavares de Oliveira Junior, Pai Ching Yu, Patricia Ramos Cury, Pedro Silvio Farsky, Ranna Santos Pessoa, Rinaldo Focaccia Siciliano, Tarso Augusto Duenhas Accorsi, Vinícius Machado Correia, Wilson Mathias Junior","doi":"10.36660/abc.20240590","DOIUrl":"https://doi.org/10.36660/abc.20240590","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 9","pages":"e20240590"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514540","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":"Importance of the Correct Definition of Severe Heart Disease in the Prognosis of Individuals Considered with Retirement Due to Disability.","authors":"Maria Helena Costa de Vasconcelos, Andreza Araújo de Oliveira, Maria Eduarda da Silva Corrêa, João Marcos Bemfica Barbosa Ferreira","doi":"10.36660/abc.20240540","DOIUrl":"https://doi.org/10.36660/abc.20240540","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 9","pages":"e20240540"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514541","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 Evaluation of Chagasic and Non-Chagasic Patients Undergoing Pacemaker Implantation and Cardiac Resynchronization in a Tertiary Center.","authors":"Laís Toledo de Vasconcelos, Larissa Natany Almeida Martins, Anna Terra França, Fábio Morato de Castilho, Antônio Luiz Pinho Ribeiro","doi":"10.36660/abc.20230875","DOIUrl":"10.36660/abc.20230875","url":null,"abstract":"<p><strong>Background: </strong>Chagas cardiomyopathy (ChCC) is one of the causes of the implantation of pacemakers (PM) in many patients and has been associated with an adverse prognosis.</p><p><strong>Objectives: </strong>To compare the prognosis of the chagasic and non-chagasic populations undergoing PM and cardiac resynchronizer implantation.</p><p><strong>Methods: </strong>Observational, retrospective study, which analyzed a cohort of patients who underwent implantation of these devices, in a tertiary center, from October 2007 to December 2017, comparing the chagasic group with non-chagasic patients. The non-parametric Kaplan-Meier method was used to calculate patient survival. The significance level adopted in the statistical analysis was 5%. The primary outcome was mortality from any cause, while the secondary outcomes were the occurrence of hospitalization and the combination of hospitalization and death.</p><p><strong>Results: </strong>A total of 911 patients were included, of which 23.4% had ChCC. In a Cox analysis adjusted for sex and age, Chagas disease (ChD) was not associated with an increased risk of death (HR: 1.14, CI:95%, 0.86-1.51, p=0.365), hospitalization (HR: 0.79, CI:95%, 0.61-1.04, p=0.09) or combined outcome of death and hospitalization (HR: 0.90, CI:95%, 0.72-1 .12, p=0.49).</p><p><strong>Conclusions: </strong>ChD was not associated with an increased risk of death, hospitalization, or combined outcome of death and hospitalization, even after adjustment for sex and age. These results contrast with those of previous studies and suggest changes in the quality of care of patients with cardiomyopathy.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 9","pages":"e20230875"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514543","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":"Predictive Factors for Bleeding Risk in Patients Undergoing Valvular Surgery.","authors":"Alef de Carvalho Vieira, Renato Tambellini Arnoni, Ana Beatriz Silva Barbosa, Attila Santos Berriel, Rafael Guimarães Vianna, Mario Issa","doi":"10.36660/abc.20230453","DOIUrl":"10.36660/abc.20230453","url":null,"abstract":"<p><strong>Background: </strong>The postoperative period of heart valve surgery is challenging due to the risk of bleeding, leading to complications and increased morbidity and mortality.</p><p><strong>Objective: </strong>To develop a risk score to predict bleeding in patients after valve surgery.</p><p><strong>Methods: </strong>Retrospective study of patients operated on between 2021 and 2022. Patients with major bleeding were selected based on the BARC and Bojar criteria. A logistic regression analysis was performed for factors related to bleeding and a nomogram of scores was created. For statistical significance, p<0.05 and a 95% confidence interval were considered. The study was approved by the CEP.</p><p><strong>Results: </strong>525 patients were analyzed, with a mean age of 56 years and a predominance of females. The most common valve disease was mitral insufficiency, 8.8% had increased bleeding and 4.3% had surgical reoperations. The variables with statistical significance were tricuspid insufficiency (OR 3.31, p < 0.001), chronic kidney disease/acute kidney injury (OR 2.97, p = 0.006), preoperative hemoglobin (OR 0.73, p < 0.001), reoperations (OR 2, 5, p = 0.003), cardiopulmonary bypass (CPB) time (OR 1.12, p < 0.001), 2-valve approach OR of 2.23 (p = 0.013), use of packed red blood cells OR of 2.8 (p = 0.001). In the multiple model, tricuspid insufficiency, CPB time and preoperative hemoglobin reached statistical significance.</p><p><strong>Conclusion: </strong>CPB time, preoperative hemoglobin and tricuspid insufficiency were independently associated with postoperative bleeding. The proposed scale is plausible and can help predict the risk of bleeding.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 10","pages":"e20230453"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514547","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":"Could Less Be Worth More?","authors":"Luiz Maurino Abreu","doi":"10.36660/abc.20240557","DOIUrl":"https://doi.org/10.36660/abc.20240557","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 9","pages":"e20240557"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514539","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":"Association between Arterial Stiffness and Higher Burden of Atrial Arrhythmia in Elderly Hypertensive Patients without Atrial Fibrillation.","authors":"João Gabriel B Lage, Alexandre L Bortolotto, Luiz A Bortolotto, Renata G S Verardino, Gabrielle D Pessente, David C S Le Bihan, Rodrigo B M Barretto, Fernanda M Consolim-Colombo, Denise T Hachul, Luciana Sacilotto, Tan C Wu, Sávia C P Bueno, Esteban W R Rivarola, César J Gruppi, Silvio A Barbosa, Juliana B S Alves, Wilson Mathias, Maurício I Scanavacca, Francisco C C Darrieux","doi":"10.36660/abc.20240251","DOIUrl":"10.36660/abc.20240251","url":null,"abstract":"<p><strong>Background: </strong>Arterial stiffness is associated with higher burden of atrial arrhythmias and worsening left atrial function (conduit and reservoir), even before dilation of this cavity. PACs: premature atrial contractions; cfPWV: carotid-femoral pulse wave velocity.</p><p><strong>Background: </strong>Increased arterial stiffness is currently an independent risk factor for atrial fibrillation, but the pathophysiological mechanisms of this arrhythmia remain an area of knowledge gap to be explored.</p><p><strong>Objectives: </strong>To investigate the existence of an association between arterial stiffness and the density of premature atrial contractions (PACs) in hypertensive individuals without atrial fibrillation.</p><p><strong>Methods: </strong>Cross-sectional study with hypertensive patients without diagnosed atrial fibrillation, who were studied with speckle-tracking echocardiography to assess left atrial (LA) strain and carotid-femoral pulse wave velocity (cfPWV) to assess arterial stiffness. All patients underwent 24h-ECG Holter and laboratory tests. Significance level was set at p<0.05.</p><p><strong>Results: </strong>Seventy participants from a single centre without overt cardiovascular disease were included. The cfPWV was correlated with higher density of PACs in 24h-Holter monitoring, independently of LV mass index (1.48 [1.08-2.03], p-value 0.005). Increased cfPWV was correlated with decreased LA strain values, with Spearman correlation coefficients of -0.27 (p-value 0.027) and -0.29 (p-value 0.018) for reservoir and conduit 2D Strain, respectively.</p><p><strong>Conclusions: </strong>In this study with hypertensive patients, it was possible to demonstrate an association between arterial stiffness and higher density of atrial arrhythmias. Furthermore, arterial stiffness was associated with lower left atrial strain values for reservoir and conduit functions.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 10","pages":"e20240251"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514544","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":"First Performance of Transjugular Transcatheter Tricuspid Valve Replacement with the Lux-Valve Plus System in Latin America. A Case Report.","authors":"Vinicius Esteves, Pedro Beraldo de Andrade, Sergio Kreimer, Fernanda Almeida Esteves, Francisco Monteiro de Almeida Magalhães, Thomas Modine","doi":"10.36660/abc.20240201","DOIUrl":"10.36660/abc.20240201","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 10","pages":"e20240201"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514545","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}