Arquivos brasileiros de cardiologia最新文献

{"title":"Ideal Blood Pressure Levels: So Long the J-Curve, Lower is Better.","authors":"Marcio Sommer Bittencourt","doi":"10.36660/abc.20250150","DOIUrl":"10.36660/abc.20250150","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 3","pages":"e20250150"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082301","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":"Primary Pericardial Angiosarcoma Complicated by Constrictive Pericarditis.","authors":"Guilherme Augusto Reissig Pereira, Maiane Maria Pauletto, Anna Paula Tscheika, Fabrício Michalski Velho, Luciano Folador","doi":"10.36660/abc.20240683","DOIUrl":"10.36660/abc.20240683","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 3","pages":"e20240683"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082364","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":"How to Incorporate Remote Dielectric Sensing System and Lung Ultrasound in Patients with Acute Congestive Heart FailureReply.","authors":"Toshihide Izumida, Teruhiko Imamura","doi":"10.36660/abc.20250053","DOIUrl":"10.36660/abc.20250053","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20250053"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082621","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":"Hypertension as another Facet of Passive Smoking.","authors":"Gilson Soares Feitosa","doi":"10.36660/abc.20250268","DOIUrl":"10.36660/abc.20250268","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 6","pages":"e20250268"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499823","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":"Brazilian Multicenter Registry of Alcohol Septal Ablation for Patients with Symptomatic Hypertrophic Obstructive Cardiomyopathy - BRASA Registry.","authors":"Pedro Jallad, Marilia Soliani, Pedro Henrique Almeida Marins, Fábio Fernandes, Edmundo Arteaga-Fernandez, Vagner Madrini, Pedro Lemos Neto, Charles Mady, Felix Ramires, Alexandre A Abizaid, Fábio Sândoli de Brito, Henrique Barbosa Ribeiro","doi":"10.36660/abc.20240626","DOIUrl":"10.36660/abc.20240626","url":null,"abstract":"<p><strong>Background: </strong>Alcohol septal ablation (ASA) is an alternative to surgical myectomy for patients with symptomatic hypertrophic obstructive cardiomyopathy (HOCM) and significant left ventricular (LV) outflow tract (LVOT) obstruction. Although widely studied worldwide, data on ASA outcomes in Brazil are still limited.</p><p><strong>Objective: </strong>To assess the safety and effectiveness of ASA in symptomatic HOCM patients receiving optimal medical therapy using current techniques across multiple centers in Brazil.</p><p><strong>Methods: </strong>Patients with HOCM and angina (classified by the Canadian Cardiovascular Society [CCS]) or dyspnea (classified by the New York Heart Association [NYHA]) class >II who did not respond to optimal medical treatment were included. The primary efficacy endpoint was defined as a reduction of more than 50% in the maximum resting LVOT gradient, with a final gradient <50 mmHg. Patients were classified as responders or nonresponders. A p-value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 41 patients (median age 66.4 years; 73% female) underwent ASA. At baseline, 93.2% were in NYHA class III/IV or CCS class III/IV. The mean LV ejection fraction (LVEF) was 66.4%, and the mean LVOT gradient was 88.4 mmHg. After 12 months, 92.8% had improved to NYHA class I/II or CCS class I/II (p<0.01). The mean LVOT gradient dropped from 88.4 mmHg to 27.0 mmHg (p=0.003), and interventricular septum (IVS) thickness decreased from 19.3 mm to 14.7 mm (p=0.048). Responders had lower baseline gradients (73.4 vs 112.6 mmHg, p=0.04) and fewer hospitalizations (21.1% vs 82.4%, p=0.04). Complete atrioventricular block occurred in 16.7% of patients, and 4.8% required pacemakers. No deaths were reported during a median follow-up of 394 days. At the last in-person evaluation, 78.4% were in functional class I/II.</p><p><strong>Conclusions: </strong>ASA is a safe, effective option for relieving symptoms in selected HOCM patients. It reduces LVOT gradient and septal thickness. Patients with higher baseline gradients were less likely to respond to the procedure.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 6","pages":"e20240626"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562336","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 Impact of Technology-Based Cardiac Rehabilitation on Exercise Capacity and Adherence in Patients with Coronary Artery Disease: An Artificial Intelligence Analysis.","authors":"Dilara Saklica, Naciye Vardar-Yagli, Melda Saglam, Deniz Yuce, Ahmet Hakan Ates, Hikmet Yorgun","doi":"10.36660/abc.20240765","DOIUrl":"10.36660/abc.20240765","url":null,"abstract":"<p><strong>Background: </strong>Exercise training programs improve exercise capacity and quality of life (QoL) in patients with coronary artery disease (CAD). Although artificial intelligence (AI) has been used to design such programs, there are still few studies evaluating their effectiveness.</p><p><strong>Objectives: </strong>This study compared the effects of technology-based and traditional programs for cardiac rehabilitation (CR) on exercise capacity and participation in patients with CAD using AI for data analysis.</p><p><strong>Methods: </strong>A total of 52 patients with CAD were randomly assigned to three groups: i) telerehabilitation group (TRG) (n=18); ii) mobile application group (MAG) (n=13); and iii) control group (CG), which received only physical activity recommendations (n=21). TRG and MAG participants completed a 12-week program with calisthenic and resistance exercises three times a week. Exercise capacity was assessed using the Incremental Shuttle Walk Test (ISWT), and QoL was measured with the Short Form-36 (SF-36). Patient feedback was analyzed using a fine-tuned BERT-based natural language processing (NLP) model. Anomaly detection methods were applied to find mismatches between self-reported adherence and ISWT results. Statistical significance was set at p<0.05.</p><p><strong>Results: </strong>Both TRG [44.4% female] (Δ=87.2±15.2 m) and MAG [50% female] (Δ=89.4±70.4 m) had significant ISWT improvements compared to CG [47.6% female] (Δ=10.9±28.2 m) (p=0.001). Adherence was higher in TRG (100%) and MAG (80%) than in CG (30%) (p<0.001). Patient-reported satisfaction, analyzed via NLP, showed a significant positive correlation with ISWT improvements (r=0.75, p<0.001). Findings show the potential of AI to support outcome assessment in CR.</p><p><strong>Conclusions: </strong>Technology-based CR programs improve exercise capacity and adherence in patients with CAD, supporting the use of AI-driven tools. NLP analysis helped link patient feedback to exercise outcomes and detect inconsistencies, showing its value in enhancing CR evaluation.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 6","pages":"e20240765"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144277017","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":"Naples Prognostic Score Predicts New-Onset Atrial Fibrillation in Patients with ST-Elevated Myocardial Infarction Undergoing Primary Angioplasty.","authors":"Dogac Oksen, Sukru Arslan, Muhammed Heja Gecit, Esra Erturk Tekin, Veysel Oktay, Okay Abaci","doi":"10.36660/abc.20240671","DOIUrl":"https://doi.org/10.36660/abc.20240671","url":null,"abstract":"<p><strong>Background: </strong>New-onset atrial fibrillation (NOAF) is a typical complication in patients with ST-segment elevated myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). Previous studies have investigated inflammation as a NOAF predictor. The Naples prognostic score (NPS) is a novel marker of inflammation and nutritional status.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the predictive power of the NPS for NOAF.</p><p><strong>Methods: </strong>This study enrolled 1537 consecutive STEMI who underwent pPCI. The patients who presented NOAF during hospital admission and those who remained in sinus rhythm (RSR) were compared in terms of baseline characteristics. Univariate and multivariate analyses were carried out to identify variables predicting NOAF development, and p< 0.05 was considered statistically significant.</p><p><strong>Results: </strong>NOAF was detected in 7.74% (n: 119) of the participants. The mean age (67.03±13.48 vs 57.84±11.31; p <0.001) and NPS (2.53±1.17 vs 2.25±1.10, p=0.008) were significantly higher in the NOAF group. Multivariate analysis revealed age (Odds ratio [OR]: 1.045 for a year, 95% confidence interval [CI]: 1.019-1.071, p=0.001), NPS (OR: 1.645, 95% CI: 0.984-2.748, p=0.037) and left atrial dimensions (OR: 2.542 for cm, 95% CI: 1.488-4.342, p=0.001) as independent predictors of NOAF.</p><p><strong>Conclusions: </strong>The NPS was an independent predictor of NOAF in STEMI patients, in addition to classical factors such as age and left atrial dimensions. This score, mostly related to an inflammatory burden, may help to predict NOAF incidence and select better potential therapies aimed at abating inflammation after myocardial infarction.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 6","pages":"e20240671"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144277015","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":"Acute Heart Failure in Patients with Chagas Cardiomyopathy: Results of the I Brazilian Heart Failure Registry (BREATHE).","authors":"Pedro Gabriel Melo de Barros E Silva, Denilson Campos Albuquerque, Renato Delascio Lopes, Paulo Roberto Nogueira, Aguinaldo F Freitas, Carlos Vieira Nascimento, Charles Mady, Elizabete Silva Dos Santos, Mauro Esteves Hernandes, Maria Alayde Mendonça Rivera, João David de Souza Neto, Alvaro Rabelo, Manoel Fernandes Canesin, Helder Reis, Anderson da Costa Armstrong, Conrado Hoffmann, Renato Hideo Nakagawa Santos, Isabella de Andrade Jesuino, Luis Eduardo Rohde, Lidia Zytinsky Moura, Fabiana Goulart Marcondes-Braga, Evandro Tinoco Mesquita, José Albuquerque de Figueiredo Neto, Ricardo Mourilhe-Rocha, Luís Beck-da-Silva, Mucio Tavares Oliveira Junior, Marcus Vinicius Simões","doi":"10.36660/abc.20240555","DOIUrl":"https://doi.org/10.36660/abc.20240555","url":null,"abstract":"<p><strong>Background: </strong>Although the clinical features of chronic Chagas' cardiomyopathy (CCC) have been well established, clinical data about the patients are scarce.</p><p><strong>Objectives: </strong>The current analysis reports the results of the I Brazilian Heart Failure Registry (BREATHE) assessing baseline characteristics and clinical outcomes of patients with acute heart failure due to CCC.</p><p><strong>Methods: </strong>BREATHE enrolled a total of 3,013 adult patients hospitalized with acute heart failure. We analyzed comparatively 261 (8.7%) patients with chronic CCC and 2,752 (91.3%) patients with other etiologies. Clinical and demographic information, cardiac structure/function data on echocardiogram and outcomes during the hospital stay and after discharge were assessed in both groups. Uni and multivariate tests were performed and a p-value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>Patients with CCC presented lower systolic blood pressure (108.3 ± 26.1 vs 128.3 ± 30.3 mmHg, p<0.001) and left ventricle ejection fraction (25.4 [19 - 36]% vs 37 [27 - 54] %, p<0.001) with higher rates of jugular vein distension (54.8% vs 38.9%, p<0.001), hepatomegaly (47.9% vs 25.6%, p<0.001), and \"cold and wet\" clinical hemodynamic profile (27.2% vs 10.6%, p<0.001). Patients with CCC presented higher rate of the composite death or heart transplantation (17.4% vs. 11.1%, p=0.004), and higher cumulative incidence of death after 3 months (16.5% vs 10.8%, p=0.017), 6 months (25.3% vs 17.2%, p=0.006), and 12 months (39.4% vs 26.6%, p<0.001). Besides, CCC was independently associated with 12-month mortality risk with odds ratio = 2.02 (95% IC: 1.47-2.77).</p><p><strong>Conclusion: </strong>Patients with CCC, hospitalized due to acute heart failure, in comparison to other etiologies, presented a higher risk profile that was associated with a poorer outcome during hospital stay and after discharge.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 5","pages":"e20240555"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144277014","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":"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}