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How Can We Expand Knowledge to Improve Women's Cardiovascular Health in Latin America? Womens Women s America
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Rivera, Maria Alayde Mendonça

; Artucio, Carolina María

; Oliveira, Glaucia Maria Moraes de

International Journal of Cardiovascular Sciences

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2024, Volume 37 elocation e20240027

Abstract: En | Text: En | PDF: En

https://doi.org/10.36660/ijcs.20240027

A Geoprocessing Approach for Mortality and Social Vulnerability Analysis during the COVID-19 Pandemic COVID19 COVID 19 COVID-1 COVID1 1 COVID-
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Rendon, Andres Felipe Valencia

; Volschan, Isabela Mendes

; Pereira, Manoella Novais

; Monteiro, Wagner Lima

; Pimentel, Alessandra de Freitas

; Nascimento, Emilia Matos do

; Pereira, Basilio de Bragança

; Oliveira, Glaucia Maria Moraes de

International Journal of Cardiovascular Sciences

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2024, Volume 37 elocation e20230145

Abstract: En | Text: En | PDF: En

Abstract Background Brazil had high COVID-19 lethality/mortality with multiple social inequalities, where color/race was highly relevant, especially in Rio de Janeiro. Therefore, we hypothesize that COVID-19 hospitalized patients with a highly socially vulnerable background would have more significant in-hospital mortality. Objective To analyze the socioeconomic factors of social vulnerability and their association with COVID-19 mortality. Methods This work was a prospective study of 274 confirmed adult COVID-19 hospitalized patients in the University Hospital of Clementino Fraga Filho (HUCFF). The clinical features/blood chemistry information were collected from the clinical record. The ArcGIS Pro Software (Esri Gis mapping software, Redlands California-US) and a Python-based algorithm were used to determine in-app/in-map variable management relevance to the socioeconomic variables, inequity markers, and vulnerability. Our study also analyzed the transfers from other primary care institutions to our hospital in order to examine its potential delays in advanced medical care. Logistic regression and ROC curve were used to investigate in-hospital mortality for our statistical analysis. The significance level adopted in the statistical analysis was 5% Results: Male sex, total days of hospitalization, age, having more than three comorbidities, intensive care unit (ICU) admission, hemodialysis, and transfer from other hospitals showed statistical significance. Patients living in low-adequate households (p = 0.030) with high in-house individual agglomeration markers (p = 0.017) and transfers from another Primary Health Care (PHC) institution (p = 0.047) were associated with increased in-hospital mortality, with high ICU admission and mechanical ventilation. Conclusions In-hospital mortality due to COVID-19 was influenced by social individual background characteristics of vulnerability. Among other clinical parameters, these markers should be considered to predict the likelihood of complications related to the COVID-19 pandemic. COVID19 COVID 19 COVID-1 lethalitymortality lethality inequalities colorrace color race relevant Janeiro Therefore inhospital 27 HUCFF. HUCFF . (HUCFF) featuresblood features blood record Esri software CaliforniaUS California US California-US Pythonbased Python based inapp/inmap inappinmap app/in map app variables 5 Results sex hospitalization age comorbidities (ICU hemodialysis lowadequate low adequate p 0.030 0030 0 030 inhouse house 0.017 0017 017 PHC (PHC 0.047 0047 047 ventilation Inhospital In parameters pandemic COVID1 1 COVID- 2 (HUCFF inapp inmap appin 0.03 003 03 0.01 001 01 0.04 004 04 0.0 00 0.

https://doi.org/10.36660/ijcs.20230145

Disparities in Women's Cardiovascular Health in Brazil Womens Women s
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Andrade, Larissa Franco de

; Villela, Paolo Blanco

; Bichara, Jose Lucas Peres

; Bastos, Luiz Antonio Viegas de Miranda

; Oliveira, Glaucia Maria Moraes de

International Journal of Cardiovascular Sciences

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2024, Volume 37 elocation e20240106

Abstract: En | Text: En | PDF: En

https://doi.org/10.36660/ijcs.20240106

Echocardiogram in Critically ill Patients with COVID-19: ECOVID Study COVID19 COVID 19 COVID-19 COVID1 1 COVID-1 COVID-
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Gomes, Bruno Ferraz de Oliveira

; Cantisano, Armando Luis

; Menezes, Iliana Regina Ribeiro

; Azevedo, Anny de Sousa

; Silva, Thiago Moreira Bastos da

; Silva, Valdilene Lima

; Dutra, Giovanni Possamai

; Paula, Suzanna Andressa Morais de

; Mendes, Barbara Ferreira da Silva

; Carmo Junior, Plinio Resende do

; Pereira, Basilio de Bragança

; Petriz, Joao Luiz Fernandes

; Oliveira, Glaucia Maria Moraes de

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20210114

Abstract: En | Text: En | PDF: En

Abstract Background Literature is scarce on echocardiographic characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Objectives To describe echocardiographic characteristics of ICU COVID-19 patients and associate them with clinical signals/symptoms, laboratory findings and outcomes. Methods Patients with RT-PCR-confirmed COVID-19, admitted to the ICU, who underwent echocardiography were included. Clinical characteristics associated with an abnormal echocardiogram (systolic ventricular dysfunction of any degree — left and/or right ventricle — and/or high filling pressures and/or moderate to severe pericardial effusion) were analyzed. Groups were compared using the Student’s t-test, chi-square, and logistic regression. A p < 0.05 was considered statistically significant. Results A total of 140 patients met inclusion criteria, and 74 (52.9%) had an abnormal echocardiogram. A low number of left and right ventricular systolic dysfunction was observed, and 35% of the population had a normal diastolic function. In the univariate analysis, characteristics associated with abnormal echocardiogram were age, chronic kidney disease, elevated troponin, previous heart failure, and simplified acute physiology score 3 (SAPS 3). In the regression model, troponin and SAPS3 score were independent markers of abnormal echocardiogram. An abnormal echocardiogram was associated with a higher prevalence of in-hospital death (RR 2.10; 95% CI 1.04-4.24) and orotracheal intubation (RR 2.3; 95% CI 1.14-4.78). Conclusions COVID-19 has little effect on ventricular function, but it is common to find increased filling pressures. Elevated serum troponin level and SAPS3 score were the independent markers of an abnormal echocardiogram. In addition, the prevalence of in-hospital death and need for mechanical ventilation were higher in patients with abnormal echocardiogram. COVID19 COVID 19 COVID-1 ICU. . (ICU) signalssymptoms signals symptoms signals/symptoms outcomes RTPCRconfirmed RT PCR confirmed COVID19, 19, included andor or effusion analyzed Students Student s ttest, ttest t test, test t-test chisquare, chisquare chi square, square chi-square 005 0 05 0.0 significant 14 criteria 7 52.9% 529 52 9 (52.9% observed 35 function analysis age disease failure SAPS 3. 3) model inhospital hospital RR 2.10 210 2 10 95 1.044.24 104424 1.04 4.24 1 04 4 24 1.04-4.24 2.3 23 1.144.78. 114478 1.14 4.78 78 1.14-4.78) addition COVID1 COVID- (ICU 00 0. 52.9 5 (52.9 2.1 21 044 1.044.2 10442 104 1.0 424 4.2 1.04-4.2 2. 144 1.144.78 11447 114 1.1 478 4.7 1.14-4.78 52. (52. 1.044. 1044 1. 42 4. 1.04-4. 1.144.7 1144 11 47 1.14-4.7 (52 1.044 1.04-4 1.144. 1.14-4. (5 1.04- 1.144 1.14-4 ( 1.14-

https://doi.org/10.36660/ijcs.20210114

Posicionamento sobre a Saúde Cardiovascular nas Mulheres – 2022 202 20 2
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Oliveira, Glaucia Maria Moraes de

; Almeida, Maria Cristina Costa de

; Marques-Santos, Celi

; Costa, Maria Elizabeth Navegantes Caetano

; Carvalho, Regina Coeli Marques de

; Freire, Cláudia Maria Vilas

; Magalhães, Lucelia Batista Neves Cunha

; Hajjar, Ludhmila Abrahão

; Rivera, Maria Alayde Mendonça

; Castro, Marildes Luiza de

; Avila, Walkiria Samuel

; Lucena, Alexandre Jorge Gomes de

; Brandão, Andréa Araujo

; Macedo, Ariane Vieira Scarlatelli

; Lantieri, Carla Janice Baister

; Polanczyk, Carisi Anne

; Albuquerque, Carlos Japhet da Matta

; Born, Daniel

; Falcheto, Eduardo Belisário

; Bragança, Érika Olivier Vilela

; Braga, Fabiana Goulart Marcondes

; Colombo, Fernanda M. Consolim

; Jatene, Ieda Biscegli

; Costa, Isabela Bispo Santos da Silva

; Rivera, Ivan Romero

; Scholz, Jaqueline Ribeiro

; Melo Filho, José Xavier de

; Santos, Magaly Arrais dos

; Izar, Maria Cristina de Oliveira

; Azevedo, Maria Fátima

; Moura, Maria Sanali

; Campos, Milena dos Santos Barros

; Souza, Olga Ferreira de

; Medeiros, Orlando Otávio de

; Silva, Sheyla Cristina Tonheiro Ferro da

; Rizk, Stéphanie Itala

; Rodrigues, Thais de Carvalho Vieira

; Salim, Thaís Rocha

; Lemke, Viviana de Mello Guzzo

Arquivos Brasileiros de Cardiologia

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nov 2022, Volume 119 N. 5 Pages 815 - 882

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

https://doi.org/10.36660/abc.20220734

Fluidodinâmica Computacional na Avaliação do Risco Futuro de Aneurismas de Aorta Ascendente
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Almeida, Gabriela de C.

; Gomes, Bruno Alvares de Azevedo

; Azevedo, Fabiula Schwartz de

; Kalaun, Karim

; Ibanez, Ivan

; Teixeira, Pedro S.

; Gottlieb, Ilan

; Melo, Marcelo M.

; Oliveira, Glaucia Maria Moraes de

; Nieckele, Angela O.

Arquivos Brasileiros de Cardiologia

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2022, Volume 118 N. 2 Pages 448 - 460

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamentos Uma metodologia para identificação de pacientes portadores de aneurisma de aorta ascendente (AAAs) sob alto risco de remodelamento aórtico não está completamente definida. Objetivo Esta pesquisa objetiva caracterizar numericamente o fluxo sanguíneo aórtico, relacionando a distribuição do estresse mecânico resultante com o crescimento de AAAs. Métodos Estudo analítico, observacional, unicêntrico, em que um protocolo de fluidodinâmica computacional (CFD - Computacional Fluid Dynamics) foi aplicado a imagens de angiotomografia computadorizada (ATC) de aorta de pacientes portadores de AAAs. Duas ATC de aorta com pelo menos um ano de intervalo foram obtidas. Dados clínicos dos pacientes foram registrados e, a partir das imagens de ATC, foram gerados modelos tridimensionais. Foram realizados estudos do campo de velocidade e estruturas coerentes (vórtices) com o objetivo de relacioná-los ao crescimento ou não do aneurisma e, posteriormente, compará-los com os dados clínicos dos pacientes. O teste de Kolmogorov-Smirnov foi utilizado para avaliar a normalidade da amostra e o teste não-paramétrico Wilcoxon signed-rank foi aplicado para comparações de dados pareados entre os ângulos aórticos. A significância estatística foi fixada em 5%. Resultados Para o grupo que apresentou crescimento do aneurisma, a incidência do jato na parede aórtica gerou áreas de recirculação posterior ao jato, induzindo à formação de vórtices complexos, ocasionando um incremento na pressão média no endotélio aórtico. O grupo sem crescimento do aneurisma apresentou diminuição na pressão média. Conclusão Este estudo piloto mostrou que a CFD baseada em ATC pode, em um futuro próximo, ser uma ferramenta auxiliar na identificação dos padrões de fluxo associados ao processo de remodelamento de AAAs.

Abstract Background A methodology to identify patients with ascending aortic aneurysm (AsAA) under high risk for aortic growth is not completely defined Objetive This research seeks to numerically characterize the aortic blood flow by relating the resulting mechanical stress distribution with AsAA growth. Methods Analytical, observational, single-center study in which a computational fluid dynamics (CFD) protocol was applied to aortic computed tomography angiogram (CTA) images of patients with AsAA. Two CTA exams taken at a minimum interval of one year were obtained. From the CTA-gathered images, three-dimensional models were built, and clinical data were registered. Study of velocity field and coherent structures (vortices) was performed aiming to relate them to the presence or absence of aneurysm growth, as well as comparing them to the patients’ clinical data. The Kolmogorov-Smirnov test was used to evaluate the normality of the distribution, and the non-parametric Wilcoxon signed-rank test, for non-normal distribution, was used to compare the paired data of the aortic angles. Statistical significance was set at 5%. Results The incident jet in the aortic wall generated recirculation areas in the posterior region of the jet, inducing complex vortices formation in the group with aneurysm growth, leading to an average pressure increase in the ascending aortic wall between exams. In the group without aneurysm growth, the average pressure decreased. Conclusion This pilot study showed that CFD based on CTA may in the near future be a tool to help identify flow patterns associated with AsAA remodeling process.

https://doi.org/10.36660/abc.20200926

Posicionamento sobre Diagnóstico e Tratamento da Amiloidose Cardíaca – 2021
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Simões, Marcus V.

; Fernandes, Fabio

; Marcondes-Braga, Fabiana G.

; Scheinberg, Philip

; Correia, Edileide de Barros

; Rohde, Luis Eduardo P.

; Bacal, Fernando

; Alves, Silvia Marinho Martins

; Mangini, Sandrigo

; Biolo, Andréia

; Beck-da-Silva, Luis

; Szor, Roberta Shcolnik

; Marques Junior, Wilson

; Oliveira, Acary Souza Bulle

; Cruz, Márcia Waddington

; Bueno, Bruno Vaz Kerges

; Hajjar, Ludhmila Abrahão

; Issa, Aurora Felice Castro

; Ramires, Felix José Alvarez

; Coelho Filho, Otavio Rizzi

; Schmidt, André

; Pinto, Ibraim Masciarelli Francisco

; Rochitte, Carlos Eduardo

; Valicelli, Flávio Henrique

; Vieira, Marcelo Luiz Campos

; Mesquita, Cláudio Tinoco

; Ramos, Celso Dario

; Soares-Junior, José

; Romano, Minna Moreira Dias

; Mathias Junior, Wilson

; Garcia Junior, Marcelo Iório

; Montera, Marcelo Westerlund

; Melo, Marcelo Dantas Tavares de

; Silva, Sandra Marques e

; Garibaldi, Pedro Manoel Marques

; Alencar Neto, Aristóteles Comte de

; Lopes, Renato Delascio

; Ávila, Diane Xavier de

; Viana, Denizar

; Saraiva, José Francisco Kerr

; Canesin, Manoel Fernandes

; Oliveira, Glaucia Maria Moraes de

; Mesquita, Evandro Tinoco

Arquivos Brasileiros de Cardiologia

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sep 2021, Volume 117 N. 3 Pages 561 - 598

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20210718 330 downloads

Severe Cardiovascular Complications of COVID-19: a Challenge for the Physician
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Crivelari, Nathalie Cristina

; Oliveira, Gisele Queiroz de

; Park, Clarice Hyesuk Lee

; Riemma, Gregorio da Cruz

; Costa, Isabela Bispo Santos da Silva

; Lacerda, Marcus Vinícius Guimarães de

; Oliveira, Glaucia Maria Moraes de

; Darrieux, Francisco Carlos da Costa

; Sacilotto, Luciana

; Hajjar, Ludhmila Abrahão

International Journal of Cardiovascular Sciences

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oct 2020, Volume 33 N. 5 Pages 572 - 581

Abstract: En | Text: En | PDF: En

https://doi.org/10.36660/ijcs.20200125 614 downloads

Brazilian Society of Cardiology - The Women’s Letter
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Oliveira, Glaucia Maria Moraes de

; Negri, Fátima Elizabeth Fonseca de Oliveira

; Clausell, Nadine Oliveira

; Moreira, Maria da Consolação V.

; Souza, Olga Ferreira de

; Macedo, Ariane Vieira Scarlatelli

; Marino, Barbara Campos Abreu

; Polanczyk, Carisi Anne

; Lantieri, Carla Janice Baister

; Marques-Santos, Celi

; Freire, Cláudia Maria Vilas

; Nercolini, Deborah Christina

; Pedroti, Fatima Cristina Monteiro

; Barbosa, Imara Correia de Queiroz

; Santos, Magaly Arrais dos

; Braile, Maria Christiane Valéria Braga

; Paiva, Maria Sanali Moura de Oliveira

; Dracoulakis, Marianna Deway Andrade

; Holanda, Narriane Chaves

; Rolim, Patricia Toscano Rocha

; Teixeira, Roberta Tavares Barreto

; Mattos, Sandra

; Silva, Sheyla Cristina Tonheiro Ferro da

; Brandão, Simone Cristina Soares

; Lemke, Viviana de Mello Guzzo

; Lopes, Marcelo Antônio Cartaxo Queiroga

Arquivos Brasileiros de Cardiologia

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jun 2019, Volume 112 N. 6 Pages 713 - 714

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.5935/abc.20190111 1001 downloads

10.

The Year in Cardiology 2018: ABC Cardiol and RPC at a glance
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Fontes-Carvalho, Ricardo

; Oliveira, Glaucia Maria Moraes de

; Gonçalves, Lino

; Rochitte, Carlos Eduardo

Arquivos Brasileiros de Cardiologia

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feb 2019, Volume 112 N. 2 Pages 193 - 200

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.5935/abc.20190015 1319 downloads

11.

Evolution of Mortality from Diseases of the Circulatory System and of Gross Domestic Product per Capita in the Rio de Janeiro State Municipalities
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Soares, Gabriel Porto

; Klein, Carlos Henrique

; Silva, Nelson Albuquerque de Souza e

; Oliveira, Glaucia Maria Moraes de

International Journal of Cardiovascular Sciences

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apr 2018, Volume 31 N. 2 Pages 123 - 132

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamentos: As doenças do aparelho circulatório são a primeira causa de morte no Brasil e no mundo, apresentando progressiva queda durante o século XX, precedida por elevação no Produto Interno Bruto. Objetivo: Correlacionar taxas de mortalidade compensadas e ajustadas por doenças do aparelho circulatório nos Municípios do Estado do Rio de Janeiro (ERJ) entre 1979 e 2010, com o Produto Interno Bruto per capita (PIBpc) a partir de 1950. Métodos: Populações e óbitos obtidos no DATASUS/MS. Calcularam-se taxas de mortalidade por Doenças Isquêmicas do Coração (DIC), Doenças Cerebrovasculares (DCBV), e Doenças do Aparelho Circulatório (DAC), e compensadas por causas mal definidas e ajustadas pelo método direto. Dados de PIBpc foram obtidos no Instituto de Pesquisas Econômicas Aplicadas (IPEA). As taxas de mortalidade e o indicador socioeconômico foram correlacionados, pela estimação de coeficientes lineares de Pearson, para determinar a defasagem anual otimizada. Foram estimados os coeficientes de inclinação da regressão entre a dependente doença e a independente indicador socioeconômico. Resultados: Nas últimas décadas houve redução da mortalidade por DAC em todos os municípios do ERJ, esta ocorreu principalmente por queda da mortalidade por DCBV. A queda da mortalidade por doenças do aparelho circulatório foi precedida por elevação do PIBpc, com forte correlação entre o indicador e as taxas de mortalidade. Conclusão: A variação evolutiva do PIBpc demonstrou elevada correlação com a redução da mortalidade por DAC. Essas relações sinalizam a importância na melhoria das condições de vida da população para reduzir a mortalidade cardiovascular.

Abstract Background: Diseases of the circulatory system are the leading cause of death in Brazil and the world, falling progressively during the twentieth century, preceded by an increase in Gross Domestic Product. Objective: To correlate balanced and adjusted mortality rates from circulatory system diseases in the municipalities of Rio de Janeiro state between 1979 and 2010 with the gross domestic product per capita (GDPpc) beginning in 1950. Methods: Population and death data were obtained from the Department of Information and Computer Services at the National Health System/Brazilian Ministry of Health (Departamento de Informática do Sistema Único de Saúde - Ministério da Saúde - DATASUS-MS). Mortality rates were calculated for Ischemic Heart Disease (IHD), Cerebrovascular Disease (CBVD), and Circulatory System Disease (CSD); adjusted by the direct method; and balanced for ill-defined causes. The GDPpc data were obtained from the Institute of Applied Economic Research (Instituto de Pesquisas Econômicas Aplicadas - IPEA). Mortality rates were correlated with socioeconomic indicators using Pearson's linear correlation coefficient to determine the annual optimized lag time. Regression slope coefficients between the dependent disease and independent socioeconomic indicator were estimated. Results: In recent decades, there has been a reduction in mortality from CSD in all Rio de Janeiro state municipalities, mainly due to a decline in mortality from CBVD. The decline in mortality from CSD was preceded by an increase in the GDPpc, and a strong correlation was observed between this index and mortality rates. Conclusion: The evolution of the variation in GDPpc demonstrated a strong correlation with the reduction in CSD mortality. This relationship demonstrates the importance of improving the living conditions of the population to reduce cardiovascular mortality.

https://doi.org/10.5935/2359-4802.20180003 3522 downloads

12.

Influence of the tilt angle of Percutaneous Aortic Prosthesis on Velocity and Shear Stress Fields
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Gomes, Bruno Alvares de Azevedo

; Camargo, Gabriel Cordeiro

; Santos, Jorge Roberto Lopes dos

; Azevedo, Luis Fernando Alzuguir

; Nieckele, Ângela Ourivio

; Siqueira-Filho, Aristarco Gonçalves

; Oliveira, Glaucia Maria Moraes de

Arquivos Brasileiros de Cardiologia

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sep 2017, Volume 109 N. 3 Pages 231 - 240

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamento: Devido à natureza do processo de liberação da prótese percutânea, é esperada uma variabilidade do posicionamento final da válvula. A localização da prótese irá definir a posição espacial do seu orifício efetivo em relação ao ânulo aórtico. O padrão do fluxo sanguíneo em aorta ascendente está relacionado ao processo de remodelamento aórtico, além de ser dependente da disposição espacial do orifício efetivo. O efeito hemodinâmico de pequenas variações na angulação do orifício efetivo ainda não foi estudado em detalhes. Objetivo: O objetivo do presente trabalho foi implementar uma simulação in vitro do fluxo sanguíneo para caracterização do padrão hidrodinâmico, associado a pequenas variações na inclinação do orifício efetivo. Métodos: Para esse fim, foi construído um fantoma aórtico tridimensional, que reproduziu a anatomia de um paciente submetido ao implante valvar percutâneo. A análise de fluxo foi realizada através da técnica de Velocimetria por Imagens de Partícula. O padrão de escoamento em aorta ascendente foi caracterizado para seis níveis de vazão de fluxo. Além disso, foram estudados seis inclinações do orifício efetivo. Resultados: O estudo demonstrou que o orifício efetivo nos ângulos -4° e -2° direcionaram o fluxo principal para a parede anterior do modelo aórtico, induzindo um cisalhamento assimétrico e elevado nessa região. Por outro lado, os ângulos +3° e +5° mimetizam o padrão fisiológico, centralizando o fluxo principal e promovendo uma distribuição simétrica do cisalhamento. Conclusão: As medições realizadas sugerem que pequenas alterações angulares na prótese percutânea auxiliam na geração de um padrão hemodinâmico fisiológico, podendo contribuir para menor remodelamento aórtico.

Abstract Background: Due to the nature of the percutaneous prosthesis deployment process, a variation in its final position is expected. Prosthetic valve placement will define the spatial location of its effective orifice in relation to the aortic annulus. The blood flow pattern in the ascending aorta is related to the aortic remodeling process, and depends on the spatial location of the effective orifice. The hemodynamic effect of small variations in the angle of inclination of the effective orifice has not been studied in detail. Objective: To implement an in vitro simulation to characterize the hydrodynamic blood flow pattern associated with small variations in the effective orifice inclination. Methods: A three-dimensional aortic phantom was constructed, reproducing the anatomy of one patient submitted to percutaneous aortic valve implantation. Flow analysis was performed by use of the Particle Image Velocimetry technique. The flow pattern in the ascending aorta was characterized for six flow rate levels. In addition, six angles of inclination of the effective orifice were assessed. Results: The effective orifice at the -4° and -2° angles directed the main flow towards the anterior wall of the aortic model, inducing asymmetric and high shear stress in that region. However, the effective orifice at the +3° and +5° angles mimics the physiological pattern, centralizing the main flow and promoting a symmetric distribution of shear stress. Conclusion: The measurements performed suggest that small changes in the angle of inclination of the percutaneous prosthesis aid in the generation of a physiological hemodynamic pattern, and can contribute to reduce aortic remodeling.

https://doi.org/10.5935/abc.20170115 924 downloads

13.

Major Depression and Acute Coronary Syndrome-Related Factors
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Figueiredo, Jose Henrique Cunha

; Silva, Nelson Albuquerque de Souza e

; Pereira, Basilio de Bragança

; Oliveira, Glaucia Maria Moraes de

Arquivos Brasileiros de Cardiologia

Journal Metrics
- Sobre o periódico
- SciELO Analytics

mar 2017, Volume 108 N. 3 Pages 217 - 227

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamento: O transtorno depressivo maior (TDM) é um dos distúrbios mentais mais comuns em psiquiatria, sendo um fator de risco para síndrome coronariana aguda (SCA). Objetivo: Avaliar a prevalência de TDM em pacientes com SCA, assim como analisar os fatores associados através da interdependência de variáveis sociodemográficas, clínicas e de estilo de vida. Métodos: Estudo observacional, descritivo e transversal conduzido em pacientes hospitalizados consecutivamente nas unidades coronarianas de três hospitais públicos na cidade do Rio de Janeiro num período de 24 meses. Todos os participantes responderam a um questionário padrão sobre dados sociodemográficos, clínicos e de estilo de vida, assim como participaram de uma entrevista clínica estruturada do DSM-IV sobre episódio depressivo maior atual. Aplicou-se um modelo log-linear de análise multivariada para avaliar associação e interdependência, com nível de significância de 5%. Resultados: Análise de 356 pacientes (229 homens) com idade média e mediana de 60 anos (DP ± 11,42; 27-89). Encontrou-se uma prevalência pontual de TDM de 23%, e significativa associação de TDM com as variáveis sexo, estado civil, sedentarismo, classificação Killip e história de TDM. Ao controlar por sexo, observou-se associação estatisticamente significativa entre TDM e sexo, idade ≤ 60 anos, sedentarismo e história de TDM. O modelo log-linear identificou as variáveis história de TDM, sexo, sedentarismo e idade ≤ 60 anos como tendo a maior associação com TDM. Conclusão: Os resultados indicam a necessidade de abordagens distintas para diagnosticar e tratar TDM em mulheres jovens com SCA, história de TDM, sedentarismo e que não estejam em relações estáveis.

Abstract Background: Major Depressive Disorder (MDD) is one of the most common mental illnesses in psychiatry, being considered a risk factor for Acute Coronary Syndrome (ACS). Objective: To assess the prevalence of MDD in ACS patients, as well as to analyze associated factors through the interdependence of sociodemographic, lifestyle and clinical variables. Methods: Observational, descriptive, cross-sectional, case-series study conducted on patients hospitalized consecutively at the coronary units of three public hospitals in the city of Rio de Janeiro over a 24-month period. All participants answered a standardized questionnaire requesting sociodemographic, lifestyle and clinical data, as well as a structured diagnostic interview for the DSM-IV regarding ongoing major depressive episodes. A general log-linear model of multivariate analysis was employed to assess association and interdependence with a significance level of 5%. Results: Analysis of 356 patients (229 men), with an average and median age of 60 years (SD ± 11.42, 27-89). We found an MDD point prevalence of 23%, and a significant association between MDD and gender, marital status, sedentary lifestyle, Killip classification, and MDD history. Controlling for gender, we found a statistically significant association between MDD and gender, age ≤ 60 years, sedentary lifestyle and MDD history. The log-linear model identified the variables MDD history, gender, sedentary lifestyle, and age ≤ 60 years as having the greatest association with MDD. Conclusion: Distinct approaches are required to diagnose and treat MDD in young women with ACS, history of MDD, sedentary lifestyle, and who are not in stable relationships.

https://doi.org/10.5935/abc.20170028 2386 downloads

14.

Blood Pressure Treatment Adherence and Control after Participation in the ReHOT
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Jesus, Nathália Silva de

; Nogueira, Armando da Rocha

; Pachu, Cacilda Oliveira

; Luiz, Ronir Raggio

; Oliveira, Glaucia Maria Moraes de

Arquivos Brasileiros de Cardiologia

Journal Metrics
- Sobre o periódico
- SciELO Analytics

nov 2016, Volume 107 N. 5 Pages 437 - 445

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamento: A falta de adesão ao tratamento medicamentoso da hipertensão arterial sistêmica (HAS) é uma das principais causas das baixas taxas de controle da doença. Objetivo: Verificar a adesão e fatores relacionados a ela, além do controle pressórico de pacientes que participaram do ensaio clínico Resistant Hypertension Optimal Treatment (ReHOT). Método: Estudo transversal que incluiu todos os 109 pacientes que concluíram o ReHOT há pelo menos 6 meses. Foram excluídos aqueles que não responderam ao novo recrutamento após três tentativas de contato telefônico. Foi realizada avaliação do controle pressórico através de monitorização ambulatorial da pressão arterial (MAPA; PA controlada: pressão arterial [PA] sistólica e diastólica de 24 horas < 130 x 80 mmHg) e avaliação da adesão através de respostas ao questionário Morisky Medication Adherence Scale (MMAS) validado por Bloch, Melo e Nogueira (2008). A análise estatística foi realizada com o programa IBM SPSS statistics 21.0. Para verificar a normalidade da distribuição dos dados, utilizamos testes de curtose e assimetria. As variáveis relacionadas ao objeto de estudo são apresentadas por meio de estatística descritiva. Comparações entre a adesão ao tratamento e demais variáveis foi realizada com o teste t de Student para variáveis independentes e teste do qui-quadrado de Pearson ou exato de Fisher. Para a análise entre pacientes considerando a adesão ao tratamento e controle da PA, foram criados quatro grupos: G0, G1, G2 e G3. Em todos os testes estatísticos consideramos um nível de significância de 5%. Resultados: Durante o ReHOT, 80% dos pacientes apresentaram controle pressórico e adesão ao tratamento. Do total de 96 pacientes reavaliados, apenas 52,1% foram identificados como tendo HAS controlada através da avaliação da MAPA e 31,3% apresentaram adesão pelo MMAS. Quando consideradas outras medidas da MAPA, verificou-se que 64,6% dos pacientes não apresentavam descenso noturno e 23% e 12,5% apresentavam efeito do avental branco e falso controle da PA, respectivamente. A escolaridade apresentou tendência a ser um fator determinante de falta de adesão (p = 0,05). O número de medicamentos e a HAS resistente (HAR) tiveram uma relação significativa com o controle da PA medida por MAPA (p = 0,009 e p = 0,001, respectivamente). A HAR teve relação significativa com o grupo G0 (sem controle e sem adesão, p = 0,012). Conclusão: Houve redução do controle da PA e da adesão pelo MMAS após pelo menos 6 meses de participação no ensaio clínico ReHOT.

Abstract Background: Lack of adherence to pharmacological treatment is one of the main causes of low control rates in hypertension. Objective: To verify treatment adherence and associated factors, as well as blood pressure (BP) control in participants of the Resistant Hypertension Optimal Treatment (ReHOT) clinical trial. Method: Cross-sectional study including all 109 patients who had completed the ReHOT for at least 6 months. We excluded those participants who failed to respond to the new recruitment after three phone contact attempts. We evaluated the BP control by ambulatory BP monitoring (ABPM; controlled levels: 24-hour systolic and diastolic BP < 130 x 80 mmHg) and analyzed the patients' treatment adherence using the Morisky Medication Adherence Scale (MMAS) questionnaire validated by Bloch, Melo, and Nogueira (2008). The statistical analysis was performed with the software IBM SPSS statistics 21.0. We tested the normality of the data distribution with kurtosis and skewness. The variables tested in the study are presented with descriptive statistics. Comparisons between treatment adherence and other variables were performed with Student's t test for independent variables and Pearson's chi-square or Fisher's exact test. To conduct analyses among patients considering adherence to treatment and BP control, we created four groups: G0, G1, G2, and G3. We considered a 5% significance level in all tests. Results: During the ReHOT, 80% of the patients had good BP control and treatment adherence. Of 96 patients reevaluated in the present study, only 52.1% had controlled hypertension when assessed by ABPM, while 31.3% were considered adherent by the MMAS. Regarding other ABPM measures, we observed an absence of a nocturnal dip in 64.6% of the patients and a white-coat effect and false BP control in 23% and 12.5%, respectively. Patients' education level showed a trend towards being a determinant factor associated with lack of adherence (p = 0.05). Resistant hypertension and number of medications were significantly associated with BP control assessed by ABPM (p = 0.009 and p = 0.001, respectively). Resistant hypertension was also significantly associated with group G0 (patients with no control or adherence, p = 0.012). Conclusion: There was a decrease in BP control and adherence measured by the MMAS after participation of at least 6 months in the ReHOT clinical trial.

https://doi.org/10.5935/abc.20160165 2999 downloads

15.

Progression of Mortality due to Diseases of the Circulatory System and Human Development Index in Rio de Janeiro Municipalities
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Soares, Gabriel Porto

; Klein, Carlos Henrique

; Silva, Nelson Albuquerque de Souza e

; Oliveira, Glaucia Maria Moraes de

Arquivos Brasileiros de Cardiologia

Journal Metrics
- Sobre o periódico
- SciELO Analytics

oct 2016, Volume 107 N. 4 Pages 314 - 322

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamentos: As doenças do aparelho circulatório (DAC) são a principal causa de morte no Brasil e no Mundo. Objetivo: Correlacionar taxas de mortalidade compensadas e ajustadas por DAC nos Municípios do Estado do Rio de Janeiro (ERJ) entre 1979 e 2010 com o Índice de Desenvolvimento Humano (IDH) a partir de 1970. Métodos: Populações e óbitos obtidos no DATASUS/MS. Calcularam-se taxas de mortalidade por Doenças Isquêmicas do Coração (DIC), Doenças Cerebrovasculares (DCBV) e DAC ajustadas pelo método direto e compensadas por causas mal definidas. Dados de IDH foram obtidos no Instituto de Pesquisas Econômicas Aplicadas. As taxas de mortalidade e o IDH foram correlacionados pela estimação de coeficientes lineares de Pearson. Os coeficientes de correlação entre as taxas de mortalidade dos anos censitários de 1991, 2000 e 2010 e IDH nos anos censitários de 1970, 1980 e 1991 foram calculados com a defasagem de dois censos demográficos. Foram estimados os coeficientes de inclinação da regressão entre a variável dependente doença e a variável independente IDH. Resultados: Nas últimas décadas, houve redução da mortalidade por DAC em todos os municípios do ERJ principalmente por queda da mortalidade por DCBV e foi precedida por elevação do IDH, havendo forte correlação entre o indicador socioeconômico e as taxas de mortalidade. Conclusão: A variação evolutiva do IDH demonstrou elevada correlação com a redução da mortalidade por DAC. Essas relações sinalizam a importância na melhoria das condições de vida da população para reduzir a mortalidade cardiovascular.

Abstract Background: Diseases of the circulatory system (DCS) are the major cause of death in Brazil and worldwide. Objective: To correlate the compensated and adjusted mortality rates due to DCS in the Rio de Janeiro State municipalities between 1979 and 2010 with the Human Development Index (HDI) from 1970 onwards. Methods: Population and death data were obtained in DATASUS/MS database. Mortality rates due to ischemic heart diseases (IHD), cerebrovascular diseases (CBVD) and DCS adjusted by using the direct method and compensated for ill-defined causes. The HDI data were obtained at the Brazilian Institute of Applied Research in Economics. The mortality rates and HDI values were correlated by estimating Pearson linear coefficients. The correlation coefficients between the mortality rates of census years 1991, 2000 and 2010 and HDI data of census years 1970, 1980 and 1991 were calculated with discrepancy of two demographic censuses. The linear regression coefficients were estimated with disease as the dependent variable and HDI as the independent variable. Results: In recent decades, there was a reduction in mortality due to DCS in all Rio de Janeiro State municipalities, mainly because of the decline in mortality due to CBVD, which was preceded by an elevation in HDI. There was a strong correlation between the socioeconomic indicator and mortality rates. Conclusion: The HDI progression showed a strong correlation with the decline in mortality due to DCS, signaling to the relevance of improvements in life conditions.

https://doi.org/10.5935/abc.20160141 1926 downloads

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