Arquivos brasileiros de cardiologia最新文献

{"title":"Association between Self-Care Behaviors and Inadequate Glycemic Control in ELSA-Brasil Participants with Type 2 Diabetes.","authors":"Gisele de Souza Tupinambá, Odaleia Barbosa de Aguiar, Bruno Pereira de Moura, Maria Inês Schmidt, Maria Del Carmen Bisi Molina, Rosane Harter Griep, Maria de Jesus Mendes da Fonseca","doi":"10.36660/abc.20240867","DOIUrl":"10.36660/abc.20240867","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes is a prevalent chronic condition, often associated with metabolic and cardiovascular complications.</p><p><strong>Objective: </strong>This study aimed to evaluate the association between self-care behaviors, such as consumption of ultra-processed foods, vegetables, greens and fruits, physical activity, adherence to pharmacological treatment and smoking, and inadequate glycemic control in ELSA-Brasil participants with type 2 diabetes.</p><p><strong>Methods: </strong>This is a cross-sectional study with 2,567 individuals, in which the associations between the variables of interest were analyzed by multiple logistic regression (p<0.05).</p><p><strong>Results: </strong>Adherence to pharmacological treatment was the only behavior consistently associated with inadequate glycemic control. Participants with low adherence were more than twice as likely to have inadequate levels of glycated hemoglobin (OR: 2.09; 95%CI 1.14-4.10). Consumption of ultra-processed foods and insufficient intake of leafy vegetables showed initial associations that did not remain significant after adjustments, suggesting the influence of additional factors, such as socioeconomic conditions.</p><p><strong>Conclusion: </strong>These results reinforce the need for interventions that combine health education, self-care support and public policies aimed at equality of treatment access, contributing to glycemic control and the reduction of complications associated with type 2 diabetes.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 6","pages":"e20240867"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610574","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":"Direct Oral Anticoagulants versus Aspirin for Secondary Stroke Prevention in Patients with Embolic Stroke of Undetermined Source: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Juan Armando Talavera, Larissa Teixeira, Thomas Costa Alexandre, Denilsa Navalha, Tathiane Brum Gibicoski, Nicole Fernandez, Jeffrey Healey, Luciana Armaganijan, Guilherme Dagostin de Carvalho","doi":"10.36660/abc.20240586","DOIUrl":"10.36660/abc.20240586","url":null,"abstract":"<p><p>Embolic stroke of undetermined source (ESUS) accounts for around 20% of ischemic strokes. The ideal treatment for secondary prevention in ESUS remains unclear. This study aimed to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the safety and efficacy of direct oral anticoagulants (DOACs) versus aspirin in patients with ESUS. A systematic search of PubMed, Embase, Cochrane, and Web of Science databases was conducted for eligible trials until March 2024. The primary outcome was recurrent stroke, while safety outcomes included major bleeding and clinically relevant non-major bleeding (CRNMB). Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated for analysis. Four RCTs were included, involving 13,970 patients, half of whom were randomized to the DOACs group. Over a mean follow-up of 16 months, DOACs did not significantly reduce recurrent stroke (HR: 0.95; 95% CI: 0.81-1.09; p=0.44), ischemic stroke (HR: 0.91; 95% CI: 0.79-1.06; p=0.23), all-cause mortality (HR: 1.11; 95% CI: 0.87-1.42; p=0.40), or major bleeding (HR: 1.56; 95% CI: 0.85%-2.86; p=0.15) compared to aspirin. However, DOACs were associated with a significantly higher risk of CRNMB (HR: 1.54; 95% CI: 1.23-1.92; p=0.0002). Subgroup analysis revealed no significant differences in stroke recurrence among patients with low or high CHA2-DS2-VASc scores. DOACs did not demonstrate superior efficacy over aspirin in preventing recurrent stroke among ESUS patients and were linked to an increased risk of CRNMB.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 6","pages":"e20240586"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610575","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 Main Coronary Artery Angioplasty for the Treatment of Extrinsic Compression in Patients with Pulmonary Hypertension.","authors":"Luciana Dornfeld Bichuette, Daniela Calderaro, Pedro Alves Lemos Neto, Eduardo Kaiser Ururahy Nunes Fonseca, Luiza Sarmento Tatagiba, Tulio Martins Vieira, Yally Priscila Pessoa Nascimento, Marcela Araujo Castro, Taysa Antônia Félix Silva, Yuri de Deus Montalverne Parente, Caio Julio Fernandes, Francisco Akira Malta Cardozo, Cesar Higa Nomura, Pedro Henrique Almeida Marins, Rogerio Souza, Carlos Vianna Poyares Jardim","doi":"10.36660/abc.20250002","DOIUrl":"10.36660/abc.20250002","url":null,"abstract":"<p><strong>Background: </strong>The most common clinical presentation of pulmonary hypertension (PH) includes exertional dyspnea, signs of systemic congestion, and syncope. Angina pectoris can also be a relevant manifestation, especially in cases where the left main coronary artery (LMCA) is externally compressed by a dilated pulmonary artery. However, significant gaps remain regarding the most appropriate diagnostic and therapeutic strategies for coronary obstruction in this clinical scenario.</p><p><strong>Objectives: </strong>To assess the feasibility and impact of coronary angioplasty with stent implantation on symptom relief in patients with PH and extrinsic compression of LMCA.</p><p><strong>Methods: </strong>This descriptive study included 12 patients with PH who were followed at the Pulmonary Circulation Outpatient Clinic of the Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. All patients underwent coronary angioplasty with stent implantation to treat extrinsic compression of LMCA.</p><p><strong>Results: </strong>A total of 12 patients were analyzed, with a mean age of 47.9 years, predominantly with group 1 PH and under specific therapy. All procedures achieved excellent immediate results, with angina relief observed at 30 days. During a mean follow-up of 33 months, no procedure-related complications were reported, and angina symptoms remained controlled. Four patients died due to progressive heart failure.</p><p><strong>Conclusion: </strong>The findings support the feasibility of coronary angioplasty as a strategy for symptomatic relief of angina in patients with LMCA compression associated with PH. Further studies are needed to evaluate the impact of this intervention on hard clinical outcomes, as well as the role of screening in asymptomatic patients.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 7","pages":"e20250002"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791003","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 of Endothelial Activation and Stress Index with Risk of Cardiovascular Disease and All-cause Mortality in Patients with Osteoarthritis.","authors":"Ruoyan Li, Chaoqun Feng, Kexin Lin, Nan Wang, Xiaohong Fan","doi":"10.36660/abc.20250012","DOIUrl":"10.36660/abc.20250012","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis is a prevalent type of arthritis characterized by chronic degenerative changes in the musculoskeletal system, which can result in joint damage and chronic pain.</p><p><strong>Objective: </strong>This study was to investigate the associations between the endothelial activation and stress index (EASIX) and the increased risk of atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality among patients diagnosed with osteoarthritis.</p><p><strong>Methods: </strong>The cohort study encompassed 2028 individuals aged 40-79 years with osteoarthritis, utilizing data from the National Health and Nutrition Examination Surveys (NHANES) database spanning the years 2007 to 2018. The univariate weighted logistic regression model and weighted Cox model were respectively established to screen possible confounders. A significance level of p < 0.05 was adopted for all statistical analyses.</p><p><strong>Results: </strong>The study revealed an elevated risk of ASCVD in correlation with an increased log (EASIX) (Odds Ratio: 1.94, with 95% Confidence Interval:1.57-2.41). When compared to individuals with log (EASIX)< -1.29, those with a log (EASIX) > -0.78 demonstrated a heightened risk of ASCVD (Odds Ratio: 2.31, with 95% Confidence Interval:1.68-3.18). A higher log (EASIX) value was also linked to an increased risk of mortality from all causes (Hazard Ratio: 1.59, with 95% Confidence Interval:1.14 -2.23). Among individuals diagnosed with osteoarthritis, those exhibiting log (EASIX)> -0.78 faced a greater risk of dying from any cause, as compared to patients with log (EASIX) <-1.29.</p><p><strong>Conclusion: </strong>The presence of a high EASIX index was linked to an increased risk of ASCVD and all-cause mortality among patients with osteoarthritis.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 7","pages":"e20250012"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790991","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":"Esophageal Temperature Monitoring during Atrial Fibrillation Ablation: A Randomized Study.","authors":"Daniel Moreira Costa Moura, Renner Augusto Raposo Pereira, Cristiano Faria Pisani, Tan Chen Wu, Muhieddine Omar Chokr, Carina Abigail Hardy, Sissy Lara de Melo, Francisco Carlos da Costa Darrieux, Denise Tessariol Hachul, Mauricio Ibrahim Scanavacca","doi":"10.36660/abc.20250056","DOIUrl":"10.36660/abc.20250056","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein isolation (PVI) for atrial fibrillation (AF) ablation carries a risk of esophageal thermal injury (ETI), which can lead to severe complications.</p><p><strong>Objective: </strong>To evaluate three luminal esophageal temperature (LET) monitoring strategies and assess their effectiveness in reducing the incidence of ETI.</p><p><strong>Methods: </strong>Patients with AF were randomized into three PVI groups according to the temperature monitoring strategy: no LET monitoring (Group 1), LET monitoring with a single-sensor probe (SSP) thermometer (Group 2), and LET monitoring with a multisensor probe (MSP) thermometer (Group 3). In Group 1, AF ablation was performed at a fixed power of 20 W on the left atrial posterior wall. In Groups 2 and 3, AF ablation power was titrated based on LET measurements, with a cutoff temperature of 37.5 °C. Each group included 20 patients. A two-sided p-value <0.05 was considered statistically significant. The trial was registered on ClinicalTrials.gov (#NCT03645070) and International Clinical Trials Registry Platform (#RBR-2yvgyf).</p><p><strong>Results: </strong>All patients underwent PVI and esophagogastroduodenoscopy. No ETI was observed in patients monitored with an MSP thermometer. In contrast, five patients without LET monitoring and six patients monitored with an SSP thermometer developed ETI (p=0.006). Higher temperatures were recorded with an MSP thermometer (37.9 vs. 38.45 °C, p=0.018). There were no significant differences in PVI duration or total radiofrequency application time (p=0.250 and p=0.253, respectively).</p><p><strong>Conclusions: </strong>LET monitoring with an MSP thermometer during PVI significantly reduces the incidence of ETI compared to no monitoring or SSP monitoring. Implementing advanced LET monitoring strategies may enhance patient safety without compromising procedural efficiency.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 7","pages":"e20250056"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790992","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":"Atrioesophageal Fistula After Catheter Ablation of Atrial Fibrillation: Can We Really Prevent It?","authors":"Luiz Eduardo Montenegro Camanho","doi":"10.36660/abc.20250148","DOIUrl":"10.36660/abc.20250148","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 3","pages":"e20250148"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227896","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":"Exercise Stress Test For Detecting High-Risk Accessory Pathways In Patients With Wolff-Parkinson-White Syndrome.","authors":"Fabricio Vassallo","doi":"10.36660/abc.20250194","DOIUrl":"10.36660/abc.20250194","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20250194"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176361","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":"Nutritional Indices and Postoperative Atrial Fibrillation: The Triglyceride-Cholesterol-Body Weight Index.","authors":"Zulkif Tanriverdi","doi":"10.36660/abc.20250171","DOIUrl":"10.36660/abc.20250171","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 4","pages":"e20250171"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176363","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":"Detecting Familial Hypercholesterolemia in Adolescents: Universal Screening is Key.","authors":"Fernando Yue Cesena","doi":"10.36660/abc.20250178","DOIUrl":"10.36660/abc.20250178","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 3","pages":"e20250178"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176360","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":"Detection and Location of Myocardial Infarction Using Electrocardiogram: Validation by Cardiovascular Magnetic Resonance Imaging.","authors":"Maria Catarina de Melo Dias Guerra, André Gustavo da Silva Rezende, Tiago Augusto Magalhães, William Azem Chalela, Augusto Hiroshi Uchida, Rafael Almeida Fonseca, Nevelton Heringer Filho, Jürgen Beuther, Guilherme Garcia, Eduardo Cavalcanti Lapa Dos Santos, Ulisses Ramos Montarroyos, Renata Ávila Cintra, José Antônio Franchine Ramires, Carlos Eduardo Rochitte","doi":"10.36660/abc.20240309","DOIUrl":"https://doi.org/10.36660/abc.20240309","url":null,"abstract":"<p><strong>Background: </strong>In the assessment of ischemic heart disease, cardiac magnetic resonance (CMR) is considered the gold standard for detecting and locating myocardial infarction (MI), but electrocardiogram (ECG) is less expensive and more widely available. Recognition of MI on ECG outside the acute phase is challenging; Q waves are absent in a significant proportion of patients and may reduce or disappear over time. Although ECG is widely used in the initial assessment of previous infarction, studies to validate ECG using CMR as a reference in the context of chronic coronary disease are limited.</p><p><strong>Objectives: </strong>To evaluate the diagnostic performance of ECG in detecting and locating CMR-defined MI.</p><p><strong>Methods: </strong>This study included 352 individuals who underwent CMR and ECG, 241 patients with previous MI confirmed by CMR and 111 controls with normal CMR. Their ECG tracings were analyzed by 2 observers, who were blinded to the CMR, for detection and location of MI following to the Fourth Brazilian Society of Cardiology Guidelines on the Analysis and Issuance of Electrocardiographic Reports. The significance level adopted was 5% (p < 0.05).</p><p><strong>Results: </strong>ECG showed good performance for detecting previous MI, with sensitivity of 69.3% (64.5% to 74.1%), specificity of 99.1% (98.1% to 100%), and accuracy of 78.7% (74.4% to 83.0%). However, in locating MI in accordance with CMR, its accuracy was unsatisfactory.</p><p><strong>Conclusions: </strong>When compared to CMR, ECG was shown to be a method with good accuracy for detecting previous MI, but not for defining its location.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 3","pages":"e20240309"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082782","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}