Arquivos brasileiros de cardiologia最新文献

{"title":"Allopurinol versus Trimetazidine as Antianginal: A Randomized Clinical Trial.","authors":"Luiz Antonio Machado Cesar, Bruno Mahler Mioto","doi":"10.36660/abc.20240500","DOIUrl":"10.36660/abc.20240500","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 8","pages":"e20240500"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303219","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":"Comparative Analysis of ECG and Holter Monitoring in the Assessment of Heart Rate in Heart Failure with Reduced Ejection Fraction and Sinus Rhythm.","authors":"Fabio Eduardo Camazzola, Pedro Vellosa Schwartzmann, Marcelo Sabedotti, Rafael Massuti, Tulio Zortea, Vitoria Chen, Ana Carolina Guimarães Maggi, Francine Fonseca de Souza, Andressa da Silva Cardoso, Luciano da Silva Selistre","doi":"10.36660/abc.20230771","DOIUrl":"https://doi.org/10.36660/abc.20230771","url":null,"abstract":"<p><strong>Background: </strong>Heart rate (HR) has shown prognostic value in patients with heart failure with reduced ejection fraction (HFrEF) and sinus rhythm. However, the method of measurement is debated in the literature.</p><p><strong>Objectives: </strong>To compare HR on Holter with 3 resting electrocardiograms (ECG1, ECG2, and ECG3) in patients with HFrEF and sinus rhythm.</p><p><strong>Methods: </strong>This was a cross-sectional study with 135 patients with heart failure with ejection fraction ≤ 40% and sinus rhythm. HR was assessed by ECG and Holter. Analyses included intraclass correlation coefficient (ICC), robust regression, root mean squared error, Bland-Altman, and area under the receiver operating characteristic (ROC) curve. A significance level of 0.05 and Bonferroni-Holm adjustment were adopted to minimize type I errors.</p><p><strong>Results: </strong>The median [interquartile range] age and ejection fraction were 65 years [16] and 30% [11], respectively. The ICC of the 3 ECGs was 0.922 (95% confidence interval: 0.892; 0.942). The robust regression coefficients for ECG1 and ECG3 were 0.20 (95% confidence interval: 0.12; 0.29) and 0.21 (95% confidence interval: 0.06; 0.36). The robust R2 was 0.711 (95% confidence interval: 0.628; 0.76). In the Bland-Altman agreement analysis, the limits of agreement were -17.0 (95% confidence interval: -19.0; -15.0) and 32.0 (95% confidence interval: 30.0; 34.0). The area under the ROC curve was 0.896 (95% confidence interval: 0.865; 0.923).</p><p><strong>Conclusion: </strong>The HR on ECG showed high agreement with the HR on Holter, validating its clinical use in patients with HFrEF and sinus rhythm. However, agreement was suboptimal in one third of patients with HR below 70 bpm on ECG; thus, 24-hour Holter monitoring should be considered in this context.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 8","pages":"e20230771"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082924","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":"Causality and Severity of Adverse Reactions and Biochemical Changes to Benznidazole Treatment in Patients with Chronic Chagas Disease.","authors":"Alanna Carla da Costa Belmino, Emanuela Kelly Silva Sousa, José Damião da Silva Filho, Eduardo Arrais Rocha, Francisca Mylena Melgaço Nunes, Tiago Lima Sampaio, Leones Fernandes Evangelista, Bruna Ribeiro Duque, Isabel Cristina da Silva Araújo, José Igor de Oliveira Jacó, Maria de Fátima Oliveira","doi":"10.36660/abc.20230787","DOIUrl":"10.36660/abc.20230787","url":null,"abstract":"<p><strong>Background: </strong>Chagas disease (CD) is a serious public health problem in Latin America. Benznidazole (BNZ) is used for the treatment of CD and, despite its wide use, little information is available about its toxicity and mechanisms of adverse drug reactions (ADR).</p><p><strong>Objectives: </strong>To identify and classify clinical and laboratory adverse reactions caused by BNZ in terms of causality and severity.</p><p><strong>Methods: </strong>Prospective cohort study from January 2018 to December 2021. Treatment follow-up included visits and biochemical tests (complete blood count, liver and kidney function tests) before, during and after treatment. ADR were classified according to causality and severity. In the statistical analysis, the significance level was set at p<0.05.</p><p><strong>Results: </strong>Forty patients with chronic CD were included. A high prevalence of ADR was observed 161 ADR in 30 patients [90%]; of these, 104 (64.6%) were classified as possible and 57 (35.4%) as probable. The ADR were classified as moderate and mild. Of the 40 patients, nine (22.5%) discontinued treatment. ADR associated with treatment discontinuation and interventions were those that affected the dermatological system, central and peripheral nervous system and sense organs such as ageusia. Mild hematological and biochemical changes such as lymphopenia were observed after 30 days of treatment.</p><p><strong>Conclusion: </strong>Many patients were able to complete the treatment even with ADR, which can be attributed to the successful follow-up strategy with symptomatic treatment and counseling, leading to patient's awareness of symptoms and treatment adherence.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 8","pages":"e20230787"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303222","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":"Why Treat Chronic Forms of Chagas Disease with Benznidazole if Adverse Reactions are Very Frequent?","authors":"Alejandro Marcel Hasslocher-Moreno","doi":"10.36660/abc.20240426","DOIUrl":"10.36660/abc.20240426","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 8","pages":"e20240426"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303230","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":"More Hospital Complications in Women after Cabg Even for Reduced Surgical Times: Call to Action for Equity in Quality Improvement.","authors":"Leonardo Lacava, Fabiane Letícia de Freitas, Gabrielle Barbosa Borgomoni, Pedro Gabriel Melo de Barros E Silva, Marcelo Arruda Nakazone, Valquiria Pelisser Campagnucci, Marcos Gradim Tiveron, Luiz Augusto Lisboa, Fabio Biscegli Jatene, Omar Asdrúbal Vilca Mejia","doi":"10.36660/abc.20240012","DOIUrl":"10.36660/abc.20240012","url":null,"abstract":"<p><strong>Background: </strong>Analyses of extensive registries indicate adverse outcomes for women undergoing coronary artery bypass grafting (CABG) surgery, while randomized studies often lack representativeness.</p><p><strong>Objective: </strong>To compare adjusted hospital outcomes between men and women undergoing CABG.</p><p><strong>Methods: </strong>From July 2017 to June 2019, 3991 patients underwent primary isolated CABG, both electively and urgently, in 5 hospitals in the state of São Paulo, Brazil. To mitigate demographic differences between men and women, populations were adjusted using propensity score matching (PSM). The outcomes considered for analysis were those used by the STS Adult Database. The analyses were performed using R software, with a significance set at p<0.05.</p><p><strong>Results: </strong>After PSM (1:1), each group included 1089 patients. Regarding intraoperative variables, men exhibited longer cardiopulmonary bypass (CPB) time (p<0.001), surgical time (p<0.001), a higher number of distal anastomoses (p<0.001), and increased use of arterial grafts. Regarding outcomes, women had a higher incidence of deep sternal wound infection (p=0.006), prolonged Intensive Care Unit stay (p=0.002), increased need for an intra-aortic balloon pump (p=0.04), higher blood transfusion rates (p<0.001), higher 30-day hospital readmission rates after surgery (p=0.002) and higher mortality rate (p=0.03).</p><p><strong>Conclusions: </strong>Although men had longer CPB times, a greater number of arterial grafts, and a greater number of distal anastomoses, immediate results after CABG were poorer in women.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 8","pages":"e20240012"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019884","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":"Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy - 2024.","authors":"Fabio Fernandes, Marcus V Simões, Edileide de Barros Correia, Fabiana Goulart Marcondes-Braga, Otavio Rizzi Coelho-Filho, Cláudio Tinoco Mesquita, Wilson Mathias Junior, Murillo de Oliveira Antunes, Edmundo Arteaga-Fernández, Carlos Eduardo Rochitte, Felix José Alvarez Ramires, Silvia Marinho Martins Alves, Marcelo Westerlund Montera, Renato Delascio Lopes, Mucio Tavares de Oliveira Junior, Fernando Luis Scolari, Walkiria Samuel Avila, Manoel Fernandes Canesin, Edimar Alcides Bocchi, Fernando Bacal, Lidia Zytynski Moura, Eduardo Benchimol Saad, Mauricio Ibrahim Scanavacca, Bruno Pereira Valdigem, Manuel Nicolas Cano, Alexandre Antonio Cunha Abizaid, Henrique Barbosa Ribeiro, Pedro Alves Lemos Neto, Gustavo Calado de Aguiar Ribeiro, Fabio Biscegli Jatene, Ricardo Ribeiro Dias, Luis Beck-da-Silva, Luis Eduardo Paim Rohde, Marcelo Imbroinise Bittencourt, Alexandre da Costa Pereira, José Eduardo Krieger, Humberto Villacorta Junior, Wolney de Andrade Martins, José Albuquerque de Figueiredo Neto, Juliano Novaes Cardoso, Carlos Alberto Pastore, Ieda Biscegli Jatene, Ana Cristina Sayuri Tanaka, Viviane Tiemi Hotta, Minna Moreira Dias Romano, Denilson Campos de Albuquerque, Ricardo Mourilhe-Rocha, Ludhmila Abrahão Hajjar, Fabio Sandoli de Brito Junior, Bruno Caramelli, Daniela Calderaro, Pedro Silvio Farsky, Alexandre Siciliano Colafranceschi, Ibraim Masciarelli Francisco Pinto, Marcelo Luiz Campos Vieira, Luiz Claudio Danzmann, Silvio Henrique Barberato, Charles Mady, Martino Martinelli Filho, Ana Flavia Malheiros Torbey, Pedro Vellosa Schwartzmann, Ariane Vieira Scarlatelli Macedo, Silvia Moreira Ayub Ferreira, Andre Schmidt, Marcelo Dantas Tavares de Melo, Moysés Oliveira Lima Filho, Andrei C Sposito, Flávio de Souza Brito, Andreia Biolo, Vagner Madrini Junior, Stephanie Itala Rizk, Evandro Tinoco Mesquita","doi":"10.36660/abc.20240415","DOIUrl":"10.36660/abc.20240415","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 7","pages":"e202400415"},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857385","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":"Torsemide versus Furosemide in the Treatment of Heart Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Larissa Teixeira, Nicole Felix, Denilsa D P Navalha, Rafael Ferreira, Mariana R C Clemente, Thiago Madeira, Alleh Nogueira, Lucas Tramujas","doi":"10.36660/abc.20230825","DOIUrl":"https://doi.org/10.36660/abc.20230825","url":null,"abstract":"<p><p>Furosemide is the most used diuretic for volume overload symptoms in patients with heart failure (HF). Recent data suggested that torsemide may be superior to furosemide in this setting. However, whether this translates into better clinical outcomes in this population remains unclear. To assess whether torsemide is superior to furosemide in the setting of HF. We performed a systematic review and meta-analysis of RCTs comparing the efficacy of torsemide versus furosemide in patients with HF. PubMed, Embase, and Web of Science were searched for eligible trials. Outcomes of interest were all-cause hospitalizations, hospitalizations for HF (HHF), hospitalizations for all cardiovascular causes, all-cause mortality, and NYHA class improvement. Echocardiographic parameters were also assessed. We applied a random-effects model to calculate risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI) and a 0.05 level of significance. 12 RCTs were included, comprising 4,115 patients. Torsemide significantly reduced HHF (RR 0.60; 95% CI, 0.43-0.83; p=0.002; I2=0%), hospitalization for cardiovascular causes (RR 0.72; 95% CI, 0.60-0.88; p=0.0009; I2=0%), and improved LVEF (MD 4.51%; 95% CI, 2.94 to 6.07; p<0.0001; I2=0%) compared with furosemide. There was no significant difference in all-cause hospitalizations (RR 0.93; 95% CI, 0.86-1.00; p=0.04; I2=0%), all-cause mortality (RR 0.98; 95% CI, 0.87-1.10; p=0.73; I2=0%), NYHA class improvement (RR 1.25; 95% CI, 0.92-1.68; p=0.15; I2=0%), or NYHA class change (MD -0.04; 95% CI, -0.24 to 0.16; p=0.70; I2=15%) between groups. Torsemide significantly reduced hospitalizations for HF and cardiovascular causes, also improving LVEF.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 6","pages":"e20230825"},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753549","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":"Can Artificial Intelligence Change our Interpretation of Cardiovascular Risk Scores?","authors":"Maria Cristina Meira Ferreira, Glaucia Maria Moraes de Oliveira","doi":"10.36660/abc.20240280","DOIUrl":"https://doi.org/10.36660/abc.20240280","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 4","pages":"e20240280"},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753548","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":"Understanding Cardiac Alterations in Familial Partial Lipodystrophy: Insights from Echocardiography.","authors":"Silvio Henrique Barberato","doi":"10.36660/abc.20240305","DOIUrl":"https://doi.org/10.36660/abc.20240305","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 6","pages":"e20240305"},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629506","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 Challenge of Effective Secondary Stroke Prophylaxis in Chagas Patients.","authors":"Vinícius Viana Abreu Montanaro","doi":"10.36660/abc.20240008","DOIUrl":"10.36660/abc.20240008","url":null,"abstract":"","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"121 5","pages":"e20240008"},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629435","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}