Arquivos brasileiros de cardiologia最新文献

{"title":"Electrocardiographic Prognostic Marker in Pulmonary Arterial Hypertension: RS Time.","authors":"Emin Koyun, Anil Sahin, Ahmet Yilmaz, Ferhat Dindas, Idris Bugra Cerik, Gorkem Berna Koyun","doi":"10.36660/abc.20240083","DOIUrl":"10.36660/abc.20240083","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension is a condition that involves the remodeling of the right ventricle. Ongoing remodeling is also associated with disease prognosis. During the restructuring process, complex changes such as hypertrophy and dilatation may also be reflected in electrocardiographic parameters.</p><p><strong>Objectives: </strong>Our study aimed to investigate the relationship between prognosis and electrocardiographic parameters in patients with pulmonary arterial hypertension.</p><p><strong>Methods: </strong>The study was designed retrospectively and included patients diagnosed with pulmonary arterial hypertension between 2010 and 2022. The patients were divided into two groups based on their survival outcome. Various parameters, including electrocardiographic, demographic, echocardiographic, catheter, and blood parameters, were compared between the two groups. A p-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>In the multivariate Cox analyses, the parameters that were found to be independently associated with survival were the 6-minute walk test, mean pulmonary artery pressure, presence of pericardial effusion, and time between the beginning of the QRS and the peak of the S wave (RS time) (p<0.05 for each). Of all the parameters, RS time demonstrated the best diagnostic performance (AUC:0.832). In the survival analysis, a significant correlation was found between RS time and survival when using a cut-off value of 59.5 ms (HR: 0.06 [0.02-0.17], p < 0.001).</p><p><strong>Conclusions: </strong>According to the results of our study, a longer RS time is associated with poor prognosis in patients with pulmonary arterial hypertension. We can obtain information about the course of the disease with a simple, non-invasive parameter.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 9","pages":"e20240083"},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303232","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":"Pathogenesis, Assessment, and Treatment of Coronary Microcirculation Dysfunction.","authors":"Bing Ji, Xue-Bo Liu","doi":"10.36660/abc.20230767","DOIUrl":"10.36660/abc.20230767","url":null,"abstract":"<p><p>Cardiovascular disease is the predominant cause of mortality on a global scale. Research indicates that women exhibit a greater likelihood of presenting with non-obstructive coronary artery disease (CAD) when experiencing symptoms of myocardial ischemia in comparison to men. Additionally, women tend to experience a higher burden of symptoms relative to men, and despite the presence of ischemic heart disease, they are frequently reassured erroneously due to the absence of obstructive CAD. In cases of ischemic heart disease accompanied by symptoms of myocardial ischemia but lacking obstructive CAD, it is imperative to consider coronary microvascular dysfunction as a potential underlying cause. Coronary microvascular dysfunction, characterized by impaired coronary flow reserve resulting from functional and/or structural abnormalities in the microcirculation, is linked to adverse cardiovascular outcomes. Lifestyle modifications and the use of anti-atherosclerotic and anti-anginal medications may offer potential benefits, although further clinical trials are necessary to inform treatment strategies. This review aims to explore the prevalence, underlying mechanisms, diagnostic approaches, and therapeutic interventions for coronary microvascular dysfunction.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 8","pages":"e20230767"},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127521","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":"Echocardiographic Findings in Children of Patients Diagnosed with PRKAG2 Syndrome.","authors":"Dinamar Amador Dos Santos Neto, Igor de Souza Neto, Alice Pinheiro Barbosa, Eduardo Back Sternick, José Luiz Barros Pena","doi":"10.36660/abc.20230531","DOIUrl":"10.36660/abc.20230531","url":null,"abstract":"<p><strong>Background: </strong>PRKAG2 syndrome typically manifests in adolescence and early adulthood, progressing with left ventricular hypertrophy, arrhythmias, and risk of sudden death. Findings of echocardiographic markers before clinical manifestation in children of patients affected by the disease can facilitate prevention strategies and therapeutic planning for this patient group.</p><p><strong>Objective: </strong>To identify the existence of echocardiographic findings that manifest early in children of parents affected by PRKAG2 syndrome, while they are still asymptomatic.</p><p><strong>Methods: </strong>In this cross-sectional observational study, 7 participants who were children of parents with established diagnosis of PRKAG2 syndrome, between the ages of 9 months and 12 years, with proven genetic diagnosis, underwent conventional and advanced echocardiography. Their findings were compared to those of a control group composed of 7 age- and sex-matched volunteers who were healthy from a cardiovascular point of view. P values < 0.05 were considered significant.</p><p><strong>Results: </strong>Conventional echocardiography showed statistically significantly higher values in the case group for left atrium, interventricular septum, left ventricular posterior wall, indexed ventricular mass, and relative wall thickness (p < 0.05). Global longitudinal systolic strain on 2-dimensional echocardiography did not show statistical significance between the case and control groups. None of the parameters on 3-dimensional echocardiography showed statistical significance between groups.</p><p><strong>Conclusion: </strong>Children diagnosed with PRKAG2 showed echocardiographic findings indicative of a tendency toward cardiac hypertrophy. Echocardiography can be a useful tool in the evaluation and follow-up of this patient group before the onset of clinical manifestations.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 8","pages":"e20230531"},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127588","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":"Pulmonary Arterial Hypertension and Cardioprotective Interventions.","authors":"Elida Paula Benquique Ojopi, Carolina Rodrigues Tonon, Katashi Okoshi, Marina Politi Okoshi","doi":"10.36660/abc.20240445","DOIUrl":"10.36660/abc.20240445","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 7","pages":"e20240445"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303218","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":"Cardiomyopathy in Children and Adolescents in the Era of Precision Medicine.","authors":"Ana Flávia Mallheiros Torbey, Raquel Germer Toja Couto, Aurea Grippa, Eduarda Corrêa Maia, Sara Aimée Miranda, Marcos Adriano Cardoso Dos Santos, Elion Tavares Peres, Olimpio Patrick Silva Costa, Everton Mattos de Oliveira, Evandro Tinoco Mesquita","doi":"10.36660/abc.20230154","DOIUrl":"10.36660/abc.20230154","url":null,"abstract":"<p><p>In childhood and adolescence, cardiomyopathies have their own characteristics and are an important cause of heart failure, arrhythmias, sudden death, and indication for heart transplantation. Diagnosis is a challenge in daily practice due to its varied clinical presentation, heterogeneous etiologies, and limited knowledge of tools related to clinical and molecular genetics. However, it is essential to recognize the different phenotypes and prioritize the search for the etiology. Recent advances in precision medicine have made molecular diagnosis accessible, which makes it possible to individualize therapeutic approaches, stratify the prognosis, and identify individuals in the family who are at risk of developing the disease. The objective of this review is to emphasize the particularities of cardiomyopathies in pediatrics and how the individualized approach impacts the therapy and prognosis of the patient. Through a systematized approach, the five-stage protocol used in our service is presented. These stages bring together clinical evaluation for determining the morphofunctional phenotype, identification of etiology, classification, establishment of prognosis, and the search for personalized therapies.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 9","pages":"e20230154"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514538","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":"Ablation of Atrioventricular Nodal Reentrant Tachycardia with Focal Cryoablation, Compared with Radiofrequency Ablation: Single-Center Experience.","authors":"Caner Topaloğlu, Francesco Fici, Philippe van de Borne, Uğur Taşkin, Mustafa Dogdus, Serkan Saygi, Istemihan Tengiz","doi":"10.36660/abc.20230604","DOIUrl":"10.36660/abc.20230604","url":null,"abstract":"<p><strong>Background: </strong>The ablation of atrioventricular nodal reentrant tachycardia (AVNRT) with cryoablation is an alternative to radiofrequency (RF) ablation in patients due to the low risk of total atrioventricular block. An increase in early-late recurrences after cryoablation is reported as an important disadvantage.</p><p><strong>Objectives: </strong>In this study, we aimed to compare the acute procedural success and the long-term recurrence rates of patients, with AVNRT who underwent methods.</p><p><strong>Methods: </strong>73 patients with AVNRT were included in the study: 32 with cryoablation and 41 with RF ablation. There was no statistically significant difference between acute procedural success in methods. The ablation procedure was performed by an operator experienced in arrhythmology. The choice of RF or cryoablation was made in the electrophysiology laboratory based on the material already available during the procedure. After the procedure, the patients were evaluated every 3 months for 2 years in polyclinic control. The significance level adopted in the statistical analysis was 5%.</p><p><strong>Results: </strong>The 2 groups of patients were homogeneous. The fluoroscopy time (p<0.001) was shorter, but atrium-his (p=0.004) and his-ventricular (p=0.015) times were longer in the cryoablation group. There was no significant difference, in terms of acute procedural success, post-procedure jump without a single echo, and presence of echo and jump.</p><p><strong>Conclusions: </strong>Cryoablation requires less fluoroscopy time and is a safe non-inferior alternative to RF ablation in patients with AVNRT. The risk of AV block is a significant problem with the use of RF energy, making it less suitable for use in young and physically active patients.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 9","pages":"e20230604"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334243","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":"Lack of Anticoagulant Use in Patients with Atrial Fibrillation and Increased Risk of Thromboembolic Events According to Sex: Insights from a Multicentric Brazilian Study.","authors":"Emiliano Medei, Renata Moll-Bernardes, Martha V T Pinheiro, Andréa S Sousa, Barbara Abufaiad, Andre Feldman, Guilherme D'andrea Saba Arruda, Thiago Libano Csernik Monteiro, Fabio Augusto De Luca, Benhur Davi Henz, Denilson C Albuquerque, Antonio Aurelio P Fagundes Junior, Marcia M Noya-Rabelo, Angelina Silva Camiletti, Rose Mary Frajtag, Ronir R Luiz, Olga F Souza","doi":"10.36660/abc.20240310","DOIUrl":"10.36660/abc.20240310","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia, and its presentation differs according to age and sex. Recent studies have revealed differences in AF among various demographic groups, including the Latin American population.</p><p><strong>Objectives: </strong>To better understand potential disparities in AF prevalence and treatment strategies in the Brazilian population through data from a large multicentric prospective registry.</p><p><strong>Methods: </strong>The Rede D'Or AF registry is a multicenter prospective observational study including patients aged ≥ 18 years with AF who were seen in the emergency department of 32 tertiary hospitals in Brazil. Patients were characterized according to sex and other baseline characteristics and were classified according to previous anticoagulant use. The lack of anticoagulant use in patients with previous indications was analyzed. Statistical significance was set at 5%.</p><p><strong>Results: </strong>The study data were from a total of 1955 patients enrolled. Male sex was more prevalent, and men were younger than the women. Due to an increased prevalence of previous AF episode and a higher CHA2DS2-VASc score, more women had indications for anticoagulant therapy; however, a significant proportion was not receiving this treatment. From 29 in-hospital deaths, 15 patients had previous indication for anticoagulation, but only 3 were using anticoagulants.</p><p><strong>Conclusion: </strong>This study revealed sex-related differences in the Brazilian population of patients with AF that are consistent with trends in high-income countries. The promotion of better implementation of anticoagulant and antithrombotic therapies to reduce the risk of death and thromboembolic events among women with AF in Brazil is crucial.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 9","pages":"e20240310"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334245","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":"Prognostic Value of PRECİSE DAPT Score on Short- and Long-Term Outcomes in MINOCA Patients with Acute Coronary Syndrome.","authors":"Tolga Onuk, Fuat Polat, Bariş Yaylak, Ali Nazmi Çalik, Semih Eren, Şükrü Akyüz","doi":"10.36660/abc.20230791","DOIUrl":"https://doi.org/10.36660/abc.20230791","url":null,"abstract":"<p><strong>Background: </strong>Myocardial infarction with non-obstructive coronary arteries (MINOCA) constitutes a significant subset of acute myocardial infarctions (AMI) with uncertain prognostic markers. Early risk assessment is crucial to identify MINOCA patients at risk of adverse outcomes.</p><p><strong>Objectives: </strong>This study aimed to evaluate the predictive capacity of the PRECISE-DAPT score in assessing short- and long-term prognoses in MINOCA patients presenting with ST-segment elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI).</p><p><strong>Methods: </strong>Among 741 MINOCA patients, the PRECISE-DAPT score was computed to analyze its association with in-hospital and follow-up major adverse cardiovascular events (MACE). Parameters showing significance in MACE (+) groups underwent statistical analysis: univariate logistic regression for in-hospital events and univariate Cox regression for follow-up events. For statistical significance, a predefined level of α = 0.05 was adopted. Parameters demonstrating significance proceeded to multiple logistic regression for in-hospital events and multivariate Cox regression for follow-up events.</p><p><strong>Results: </strong>In-hospital MACE occurred in 4.1% of patients, while 58% experienced follow-up MACE. Hemoglobin levels and the PRECISE-DAPT Score were identified as independent parameters for in-hospital MACE. Furthermore, ejection fraction (EF%) and the PRECISE-DAPT Score emerged as independent predictors of follow-up MACE.</p><p><strong>Conclusions: </strong>The study revealed that a higher PRECISE-DAPT score was significantly associated with increased risks of both in-hospital and long-term major adverse cardiovascular events in MINOCA patients presenting with acute coronary syndrome (ACS), underscoring the score's potential in risk stratification for this patient cohort.</p><p><strong>Background: </strong>_ PRECISE-DAPT score predicts MACE risk in MINOCA patients.</p><p><strong>Background: </strong>_ Hemoglobin level and PRECISE-DAPT score predict in-hospital MACE.</p><p><strong>Background: </strong>_ Ejection fraction and PRECISE-DAPT score predict long-term MACE.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 5","pages":"e20230791"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11185829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482878","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 and Cardiovascular Risk: Direct Association with Blood Pressure Values.","authors":"Rui Póvoa","doi":"10.36660/abc.20240459","DOIUrl":"10.36660/abc.20240459","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 7","pages":"e20240459"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303217","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":"Polygenic Risk Scores: The Next Step for Improved Risk Stratification in Coronary Artery Disease?","authors":"Ricardo Stein, Filipe Ferrari, Diego García-Giustiniani","doi":"10.36660/abc.20240252","DOIUrl":"10.36660/abc.20240252","url":null,"abstract":"<p><p>Despite significant advances in the management of coronary artery disease (CAD) and reductions in annual mortality rates in recent decades, this disease remains the leading cause of death worldwide. Consequently, there is an ongoing need for efforts to address this situation. Current clinical algorithms to identify at-risk patients are particularly inaccurate in moderate-risk individuals. For this reason, the need for ancillary tests has been suggested, including predictive genetic screening. As genetic studies rapidly expand and genomic data becomes more accessible, numerous genetic risk scores have been proposed to identify and evaluate an individual's susceptibility to developing diseases, including CAD. The field of genetics has indeed made substantial contributions to risk prediction, particularly in cases where children have parents with premature CAD, resulting in an increased risk of up to 75%. The polygenic risk scores (PRSs) have emerged as a potentially valuable tool for understanding and stratifying an individual's genetic risk. The PRS is calculated as a weighted sum of single-nucleotide variants present throughout the human genome, identifiable through genome-wide association studies, and associated with various cardiometabolic diseases. The use of PRSs holds promise, as it enables the development of personalized strategies for preventing or diagnosing specific pathologies early. Furthermore, it can complement existing clinical scores, increasing the accuracy of individual risk prediction. Consequently, the application of PRSs has the potential to impact the costs and adverse outcomes associated with CAD positively. This narrative review provides an overview of the role of PRSs in the context of CAD.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 9","pages":"e20240252"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334247","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}