Arquivos brasileiros de cardiologia最新文献

{"title":"Endothelial Function by Flow-Mediated Dilation (FMD) in the Brachial Artery in Hypertensive Patients.","authors":"Elaine Alves Santos Tessier, Carla Daltro, Eduardo Martins Netto, Glauco Moniz de Aragão Doria, Andrea Jimena Gutierrez Peredo, Fabio Bulhões, Roque Aras, Ryan A Harris","doi":"10.36660/abc.20240533","DOIUrl":"10.36660/abc.20240533","url":null,"abstract":"<p><strong>Background: </strong>High blood pressure (BP) values have traditionally been associated with the risk of ischemic heart disease, stroke, chronic kidney disease, and early mortality. The brachial artery FMD after cuff deflation has become the standard parameter for quantifying endothelial function, being a useful surrogate outcome due to its non-invasiveness, close correlation with coronary endothelial function, and association with the incidence of long-term coronary events.</p><p><strong>Objectives: </strong>To test hypotheses of correlation between the FMD and several blood parameters and to compare parameters between altered and non-altered FMD groups, and between hypertensive patients in the resistant hypertension groups (RHTN and non-RHTN).</p><p><strong>Methods: </strong>Seventy-two volunteers from a referral hypertension outpatient clinic participated in this prospective cross-sectional study, in which several patient variables were compared between the altered FMD (n = 38) and non-altered FMD (n = 34) groups, and also between the RHTN (n = 49) and non-RHTN (n = 23) groups. The variables that would explain the FMD were also investigated in this study. Statistical analyses were performed using parametric methods when the assumptions were met, and non-parametric methods otherwise. The significance level adopted in the statistical analysis was 5%.</p><p><strong>Results: </strong>The results showed a significant positive correlation between the FMD and LDL (p = 0.204, p = 0.042) and between FMD and triglycerides (p = 0.247, p = 0.037). Glycated hemoglobin was higher in the RHTN group (p = 0.020), potassium was higher in the non-RHTN group (p = 0.029), and C-reactive protein was higher in the RHTN group (p = 0.04). For the other comparisons, no statistically significant differences were found.</p><p><strong>Conclusion: </strong>LDL and triglycerides are FMD predictors, and the RHTN and non-RHTN groups differ in terms of the amount of potassium, protein C, and glycated hemoglobin. The altered and non-altered FMD groups differ only in terms of triglycerides.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 5","pages":"e20240533"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227898","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":"Mortality and Ventricular Arrhythmia in Patients with Early Ventricular Repolarization.","authors":"Hugo Baldisserotto, Barbara Adelmann de Lima, Marco Aurélio Lumertz Saffi, Anderson Donelli da Silveira, Marcia Leonardi Baldisserotto, Tiago Luiz Luz Leiria","doi":"10.36660/abc.20240516","DOIUrl":"10.36660/abc.20240516","url":null,"abstract":"<p><strong>Background: </strong>Recent research has linked early repolarization (ER) with increased ventricular fibrillation risk, especially in leads V1-V3 and in inferior and lateral regions. However, data on the Brazilian population are limited.</p><p><strong>Objective: </strong>To estimate the impact of ER on survival and the occurrence of ventricular arrhythmias (VA) in patients over a 10-year period at a university hospital.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with ER on electrocardiogram from the hospital database. Descriptive analysis was conducted to describe patients' profile and characteristics. Kaplan-Meier method was utilized to analyze survival curves, with the log-rank test employed to assess differences between ER types. Cox regression models were applied to evaluate the risks of death and VA, calculating both gross and adjusted hazard ratios. The level of significance adopted in the statistical analysis was 5%.</p><p><strong>Results: </strong>The study population was predominantly male, average age of 45.6 years; 2.7% experienced VA (five in the group with lateral ER, four in the group with inferior ER group, and four in the ER inferolateral group). Significant differences were observed in age, sex, and HFrEF between the groups. Regarding all-cause mortality, 2.3% of patients died (five in the group with lateral ER, one in the group with inferior ER group, and five in the ER inferolateral group). Only age showed a statistically significant difference. There were significant differences in both death and VA between the groups (p=0.7 and p=0.5, respectively).</p><p><strong>Conclusion: </strong>ER did not lead to a higher incidence of VA or all-cause mortality in this cohort.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20240516"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082650","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 Effect of Coronary Artery Bypass Graft Surgery on Contractile Function and Symptoms in Patients with Left Ventricular Dysfunction.","authors":"Fernando Bassan, Roberto Esporcatte, Marcelo Goulart Correia, Octavio Drummond Guina, Guilherme de Souza Weigert, Gracielle Christine do Nascimento Oliveira","doi":"10.36660/abc.20240486","DOIUrl":"10.36660/abc.20240486","url":null,"abstract":"<p><strong>Background: </strong>The degree of left ventricular (LV) dysfunction is an independent risk factor for poor outcomes in patients with chronic coronary syndrome. Coronary artery bypass graft (CABG) is the standard care for the management of ischemic heart failure to improve symptoms and prognosis. However, the predictors of improvement are still uncertain.</p><p><strong>Objective: </strong>To assess the effect of myocardial revascularization on LV function and symptoms in patients with CCS and reduced left ventricular ejection fraction (LVEF), as well as to identify the improvement predictors.</p><p><strong>Methods: </strong>We retrospectively analyzed the data and clinical status of 136 consecutive patients with LVEF<50% that underwent CABG. During clinical follow-up echocardiographic LV function was reassessed at the short-term (3.6 months) and long-term (30.8 months), and compared to baseline.</p><p><strong>Results: </strong>Mean pre-operative LVEF was 40.9 ± 8.6% and wall motion score index (WMSI) was 1.99 ± 0.36, both improving at long-term to 48.1 ± 15.0% (p<0.001) and 1.75 ± 0.49 (p<0.001), respectively. We observed that 55.7% of the patients presented an improvement of LVEF≥10% and 58.1% in WMSI ≥10%. Univariate logistic regression analysis revealed that cerebrovascular disease was the only variable to be predictor of LVEF improvement. At the end of follow-up, we observed a reduction in the rate of patients in functional class III/IV when compared to baseline (65.4 vs. 10.3% - p<0.001).</p><p><strong>Conclusions: </strong>Patients with CCS and reduced LVEF undergoing CABG experienced improvement in both LV contractile function and size, with beneficial response in functional class.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20240486"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082687","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":"Analysis of Ventricular Repolarization in Hypertensive Patients: Influence of Nocturnal Blood Pressure Dipping.","authors":"Marco Aurélio Goulart, Dalmo Antonio Ribeiro Moreira, Fernando Yue Cesena, Jonathan Batista Souza, Antonio Gabriele Laurinavicius, Fernanda Marciano Consolim-Colombo, Márcio Gonçalves de Sousa","doi":"10.36660/abc.20240725","DOIUrl":"10.36660/abc.20240725","url":null,"abstract":"<p><p>Changes in ventricular repolarization are associated with ventricular arrhythmias and higher mortality. The association between a non-dipper blood pressure pattern and changes in ventricular repolarization remains controversial. This study sought to compare ventricular repolarization measurements (QT interval, QTc, Tp-Te, Tp-Te/QT, and QTd) in hypertensive dippers and non-dippers. Secondary objectives are to compare measurements between controlled and uncontrolled hypertensive patients, as well as resistant and non-resistant hypertensive patients. This observational, cross-sectional study involved patients monitored in a Hypertension Service. The level of significance adopted in the statistical analysis was 5%. A total of 130 participants were admitted. The mean age was 67.4 years, with 72% presenting some form of target organ damage. Repolarization measurements did not differ between dippers and non-dippers. However, within the resistant hypertension group, when compared to the non-resistant, differences were observed in the QT interval in V5 (433.3 ms vs. 420.9 ms, p = 0.046), Tp-Te in both V2 (85.4 ms vs. 78.7 ms, p = 0.049) and V5 (84.6 ms vs. 74.6 ms, p = 0.006), Tp-Te/QT in V5 (0.19 vs. 0.18, p = 0.019), Sokolow-Lyon index (18.8 mm vs. 15.7 mm, p = 0.011), and Cornell index (14.2 mm vs. 11.2 mm, p = 0.002), aged-adjusted values. In this high cardiovascular risk hypertensive population, no difference in repolarization measures was found between dippers and non-dippers. However, this is the first study to demonstrate increased ventricular repolarization measures in patients with resistant hypertension.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20240725"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112998","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":"Record-Breaking Endurance of 366 Marathons in 366 Days: A Case Study.","authors":"Francis Ribeiro de Souza, Renato Delascio Lopes, Guilherme Wesley Peixoto da Fonseca, Rodrigo Bellio de Mattos Barretto, Antonio Carlos Battaglia Filho, Renata Margarida do Val, Roberto Kalil-Filho, Maria-Janieire de Nazaré Nunes Alves","doi":"10.36660/abc.20240838","DOIUrl":"10.36660/abc.20240838","url":null,"abstract":"<p><strong>Background: </strong>A Brazilian athlete has proposed setting a new world record for consecutive marathons by running 366 marathons in 366 consecutive days. The impact of such a feat on the cardiovascular system is unknown.</p><p><strong>Objective: </strong>To monitor the cardiovascular system to assess the athlete's cardiovascular adaptations or maladaptations over the period.</p><p><strong>Methods: </strong>During the pre-study evaluation, we conducted the pre-participation clinical evaluation (PPE) composed of anamnesis, electrocardiogram, blood test, and functional capacity by maximum cardiopulmonary exercise test (CPET). At follow-up, serial CPET, body composition assessment, blood sample, and echocardiogram were periodically performed for 12 months.</p><p><strong>Results: </strong>At PPE, male, 43-year-old, height: 1.83 m, weight: 76.9 kg, maximum oxygen consumption (VO2max): 52 ml/kg/min, body fat: 12.6%, systolic and diastolic blood pressure: 120/80 mmHg, blood glucose: 92 mg/dL, total cholesterol (TC): 185 mg/dL, high-sensitivity C-reactive protein (hs-CRP): 0.08 mg/dL, creatine phosphokinase (CPK): 183 U/L, and high-sensitivity troponin T (hs-TnT): 7.1 ng/L. At follow-up, the average of VO2max remained at 48.7 ± 1.2 ml/kg/min, left ventricular ejection fraction (LVEF) at 62 ± 2%, LV strain global longitudinal at 19 ± 1%, LV mass index at 83 ± 7 g/m2, hs-CRP at 0.07 ± 0.01 mg/L, CPK at 169 ± 36 U/L, hs-TnT at 8.2 ± 1.4 ng/L, and no malignant arrhythmias were observed.</p><p><strong>Conclusion: </strong>The athlete's cardiovascular system had adapted to an extremely high volume of consecutive marathons at moderate intensity for one year and remained functioning at normal range. In addition, the athlete set a new world record for most consecutive days to run a marathon, recognized by Guinness World Records.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 5","pages":"e20240838"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328119","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 and Echocardiographic Particularities of Hypertrophic Cardiomyopathy in a Brazilian Population and its Prognostic Impact.","authors":"Georgina Del Cisne Jadán Luzuriaga, Edmundo Arteaga-Fernandez, Viviane Tiemi Hotta, Barbara Ianni, Luciano Nastari, Felix Ramires, Guilherme Wesley Peixoto da Fonseca, Charles Mady, Fábio Fernandes, Juliano Novaes Cardoso","doi":"10.36660/abc.20240640","DOIUrl":"10.36660/abc.20240640","url":null,"abstract":"<p><strong>Background: </strong>Hypertrophic cardiomyopathy (HCM) presents echocardiographic abnormalities that are important for diagnosis and prognosis. Data are scarce in the Brazilian literature.</p><p><strong>Objective: </strong>To assess clinical and echocardiographic characteristics and disease progression in a Brazilian cohort of patients with HCM.</p><p><strong>Methods: </strong>This retrospective cohort included patients with HCM aged ≥ 18 years. Patients with moderate or severe aortic stenosis and those undergoing septal reduction were excluded. The significance level adopted in the statistical analysis was 5%.</p><p><strong>Results: </strong>The study included 1244 patients, between 2010 and 2022, with a mean follow-up time of 7.7 ± 4.5 years; 53.6% of patients were men. Mean age was 54.6 ± 16.5 years, and mean left ventricular ejection fraction (LVEF) was 65.8% ± 7.6. We observed LVEF ≤ 50% in 5.8% of patients, asymmetric form in 88.7%, and septal hypertrophy in 85.4%. We found systolic anterior motion of the mitral valve in 30.1% of patients, left ventricular outflow tract obstruction in 30.7%, and septum ≥ 28 mm in 7.2%. Only 1 patient had ventricular aneurysm. Atrial fibrillation/flutter occurred in 9.6% of patients. Overall mortality occurred in 232 patients (1.3%/year). Patients with B-type natriuretic peptide (BNP) > 200 pg/ml, left atrium ≥ 45 mm, and LVEF ≤ 50% had higher mortality (p < 0.001). Age and atrial fibrillation/flutter were also associated with mortality.</p><p><strong>Conclusions: </strong>The majority of patients had LVEF > 50%, asymmetric hypertrophy, and septal predominance. BNP, LA diameter, LVEF ≤ 50%, age, and atrial fibrillation/flutter were associated with worse prognosis.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20240640"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082511","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 Cardiovascular Risk Factors and Carotid Plaques in a Population-Based Study - The SHIP-Brazil Study.","authors":"Fernanda Burger Zimmermann, Sérgio Luiz Zimmermann, Marcelo Burger Zimmermann, Enrico Klug Beraldi, Mateus Campanelli Franco da Rocha, Bruno Pereira de Oliveira Zabot, Siegmar Starke, Ernani Tiaraju de Santa Helena, Marcello Ricardo Paulista Markus","doi":"10.36660/abc.20240546","DOIUrl":"10.36660/abc.20240546","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerotic disease is a relevant cause of morbidity and mortality in the general population, and it is important to detect factors that can influence its prevention.</p><p><strong>Objective: </strong>To evaluate the association of cardiovascular risk factors with carotid plaques in participants of the Study of Health in Pomerania (SHIP) - Brazil.</p><p><strong>Methods: </strong>A total of 1,953 participants were assessed for the presence of cardiovascular risk factors (hypertension, dyslipidemia, type 2 diabetes, obesity, smoking and physical inactivity) and sociodemographic variables (gender, age group, Germanic culture, color/race self-declared, and alcohol consumption), waist circumference measurement, waist-to-hip ratio and waist-to-height ratio. The presence of carotid plaques was analyzed by ultrasound. The association between the study variables and carotid plaques was assessed using the Chi-square test. A p-value < 0.05 was considered significant.</p><p><strong>Results: </strong>Plaques were present in 56.5% of hypertensive patients (p<0.001), 49.8% of dyslipidemic patients (p<0.001), 62% of diabetic patients (p<0.001), 52% of smokers, 29% of those who had never smoked (p<0.001), 39.5% of sedentary people and 33.1% of non-sedentary people (p=0.014), 43.7% of obese people and 26.1% of eutrophic people (p<0.001).</p><p><strong>Conclusion: </strong>Carotid plaques were prevalent in men, aged between 60 and 79, white, hypertensive, dyslipidemic, diabetic, smokers, sedentary and obese, illiterate, in economic class A1/A2, and of Germanic culture, and low alcohol consumption.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 3","pages":"e20240546"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014901","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 Dynamic Duo\": The New Management of Drug Treatment for Heart Failure with Mildly Reduced or Preserved Ejection Fraction.","authors":"Plínio José Whitaker Wolf, Edileide Barros Correia, João Manoel Rossi Neto, Marco Aurelio Finger, Carolina Casadei Santos, Marcos de Oliveira Vasconcellos, Larissa Ventura Ribeiro Bruscky, Ana Cristina de Souza Murta, Yoná Afonso Francisco, Fabiano Castro Albrecht, Juliana Jangelavicin Barbosa, Eduardo Mikio Sassaki, Bruno Noshang Blaas, Bianca Fernandes Távora Arruda, Fernanda de Brito Fortuna, Victor Bemfica de Mello Mattos","doi":"10.36660/abc.20240676","DOIUrl":"10.36660/abc.20240676","url":null,"abstract":"<p><p>The \"Fantastic Four,\" a term coined in 2021 to refer to the four key drug pillars in the treatment of heart failure with reduced ejection fraction (beta-blockers, renin-angiotensin system and neprilysin inhibitors, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors, or SGLT2 inhibitors), has demonstrated excellent performance in reducing morbidity and mortality in this setting. However, in heart failure with mildly reduced or preserved ejection fraction, the same benefits were not observed with this combined treatment where, for many years, management in this context was limited to diuretics and comorbidity control. Recently, however, new therapeutic options have emerged, demonstrating effectiveness in reducing cardiovascular outcomes in this specific group: the \"Dynamic Duo\"-comprising SGLT2 inhibitors and Finerenone-has shown promising results, alongside the introduction of semaglutide as a potential \"wild card\" treatment for patients with obesity. Despite the ongoing need for therapies that significantly reduce overall mortality, these new treatments have effectively lowered hospitalization rates and improved symptoms in such patients. As a result, a new era in heart failure management is beginning.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 5","pages":"e20240676"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176364","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 Obesity on the Safety and Efficacy of Antithrombotic Therapy: A Systematic Review and Meta-Analysis.","authors":"Beatriz Rocha Darzé, Queila Oliveira Borges, Mateus S Viana, Eduardo Sahade Darzé, Luiz Eduardo Fonteles Ritt","doi":"10.36660/abc.20240544","DOIUrl":"10.36660/abc.20240544","url":null,"abstract":"<p><strong>Background: </strong>Obese individuals have been historically underrepresented in clinical trials. Considering their association with a higher risk of venous thromboembolism (VTE) and acute coronary syndrome (ACS), it is necessary to establish a more suitable anticoagulation regimen for this group of patients.</p><p><strong>Objectives: </strong>To evaluate the influence of obesity on the safety and efficacy of antithrombotic therapy in patients with ACS or VTE.</p><p><strong>Methods: </strong>This is a systematic review and meta-analysis that used 5 main international databases. We selected clinical trials or observational studies that compared the occurrence of clinical outcomes (mortality or bleeding) between obese and non-obese patients using parenteral anticoagulants for the treatment of ACS or VTE. P value < 0.05 was used for all analyses.</p><p><strong>Results: </strong>Six articles, with a total of 40,939 patients, were eligible, being 3 randomized clinical trials and 3 retrospective cohorts. Of the patients, 87.7% had ACS. The incidence of major bleeding was similar between groups (relative risk [RR]: 0.90, 95% confidence interval [CI]: 0.77 to 1.04, p = 0.14). The outcome remained comparable when studies were analyzed separately by anticoagulant: enoxaparin (RR: 0.87, 95% CI, 0.70 to 1.08, p = 0.21) or unfractionated heparin (RR: 0.96, 95% CI, 0.79 to 1.17, p = 0.67). The mortality rate was measured in only 2 studies, both in ACS, and it was lower in obese patients (RR: 0.71, 95% CI 0.59 to 0.87, p = 0.0007).</p><p><strong>Conclusion: </strong>In patients treated for VTE or ACS, rates of bleeding were comparable between obese and non-obese patients, regardless of the anticoagulant used. The lower mortality rate observed in obese patients may represent the effect of unaccounted confounding.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20240544"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176362","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":"Non-Invasive Central Blood Pressure and Intracranial Waveform Assessment in Hypertensive Patients: A Cross-Sectional Study.","authors":"Sayuri Inuzuka, Mikaelle Costa Correia, Matheus Martins da Costa, Thiago Oliveira Costa, Priscila Valverde de Oliveria Vitorino, Polyana Vulcano de Toledo Piza, Gustavo Frigieri, Ana Luiza Lima Sousa, Antonio Coca, Weimar Kunz Sebba Barroso","doi":"10.36660/abc.20240778","DOIUrl":"10.36660/abc.20240778","url":null,"abstract":"<p><strong>Background: </strong>There is a strong association between hypertension and cerebrovascular disease, mainly with stroke and cognitive impairment. However, but the mechanistic of this relationship are not completely understood.</p><p><strong>Objective: </strong>To analyze the relationship of central, peripheral blood pressure (BP) and arterial stiffness, with intracranial pressure (ICP) in long-term chronic hypertensive patients.</p><p><strong>Methods: </strong>Adult individuals were consecutively included in the study from November 2022 to August 2023. The cut-off point identified to define intracranial hypertension (ICHT) by the wave peak (P2/P1) ratio was > 1.2, and the cut-off for time to peak (TTP) was > 0.25. The level of significance adopted in the statistical analysis was 5%.</p><p><strong>Results: </strong>A total of 145 patients (32 male, 113 female) with long-term hypertension (average of time since diagnoses 20 ± 12 years) were evaluated over a period of 10 months. The median age was 69.0 (61.8 - 75.7) years and median body mass index 29.0 (25.4 - 33.1) kg/m2. Median value of P2/P1 ratio for all cohort was 1.4 (1.2 - 1.5) and TTP 0.24 (0.21 - 0.29). The analysis was performed considering presence or not of ICHT, and parameters of central BP and pulse wave velocity. There was higher central systolic (SBP), diastolic blood pressure (DBP), and peripheral DBP among patients with ICHT based on the P2/P1 ratio.</p><p><strong>Conclusions: </strong>Central SBP levels are more linked to ICHT than office peripheral SBP measurements, while DBP measurements are similar, raising questions about the most suitable BP assessment method for hypertensive patients with cerebrovascular damage.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 5","pages":"e20240778"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082721","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}