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SUMMARY Cardiovascular diseases are the main cause of mortality in men and women worldwide, surpassing mortality from all associated neoplasms. In women, its prevalence and mortality increase at menopause, but complications of reproductive age, such as preeclampsia and eclampsia, lead to increased cardiovascular risk throughout their lives. Coronary ischemic disease is is the leading cause of death in Brazil and worldwide, with atherosclerotic disease being the principal pathophysiological mechanism. However, in women, other mechanisms are associated with myocardial ischemia, such as microcirculation disease and/or vasospasm, due to the anatomical and hormonal characteristics of women in different stages of their lives. Knowledge of the most prevalent cardiovascular diseases in women, as well as the specific risk factors, the traditional ones with the greatest impact, and the under-recognized ones, is of fundamental importance in their risk stratification, diagnosis, and management, fundamentally aiming at reducing mortality. worldwide neoplasms menopause age eclampsia lives mechanism However ischemia andor or vasospasm factors impact underrecognized under recognized stratification diagnosis management

https://doi.org/10.1590/1806-9282.2023s106

Posicionamento sobre a Saúde Cardiovascular nas Mulheres – 2022
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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: Pt En | Text: Pt En | PDF: Pt | PDF: En

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

Depression and Cardiovascular Disease in Women
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Rivera, Maria Alayde Mendonça

; Rivera, Ivan Romero

; Avila, Walkiria

; Marques-Santos, Celi

; Costa, Francisco Assis

; Ferro, Carlos Romério

; Fernandes, Jose Maria Gonçalves

International Journal of Cardiovascular Sciences

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aug 2022, Volume 35 N. 4 Pages 537 - 545

Abstract: En | Text: En | PDF: En

Abstract The prevalence of depression varies from 1 to 17% in different geographic regions, and its incidence is 70% higher in women than men. Today, depression affects more than 300 million people worldwide, affecting twice as many women from adolescence to adulthood. In addition to this earlier onset, depression in women tends to be more severe. Cardiovascular disease and depression are chronic diseases that have a major impact on cardiovascular and all-cause morbidity and mortality, with evidence of a two-way relationship between them, in which depression is a predictor of cardiovascular disease and vice versa. In females, the degree of illness and prognosis are more severe when both diseases are present, than when diagnosed alone. In patients with acute or chronic cardiovascular disease, especially women, a systematic screening for depression should be considered as a preventive strategy of cardiovascular events, aiming to reduce the risk of future events. There are still no clinical studies designed to assess the impact of antidepressant treatment on cardiovascular outcomes in women.

https://doi.org/10.36660/ijcs.20200416

Guía de práctica clínica de la Sociedad Interamericana de Cardiología sobre prevención primaria de enfermedad cardiovascular en la mujer
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Sueldo, Mildren A. del

; Rivera, María A. Mendonça

; Sánchez-Zambrano, Martha B.

; Zilberman, Judith

; Múnera-Echeverri, Ana G.

; Paniagua, María

; Campos-Alcántara, Lourdes

; Almonte, Claudia

; Paix-Gonzales, Amalia

; Anchique-Santos, Claudia V.

; Coronel, Claudine J.

; Castillo, Gabriela

; Parra-Machuca, María G.

; Duro, Ivanna

; Varletta, Paola

; Delgado, Patricia

; Volberg, Verónica I.

; Puente-Barragán, Adriana C.

; Rodríguez, Adriana

; Rotta-Rotta, Aida

; Fernández, Anabela

; Izeta-Gutiérrez, Ana C.

; Ancona-Vadillo, Ana E.

; Aquieri, Analía

; Corrales, Andrea

; Simeone, Andrea

; Rubilar, Bibiana

; Artucio, Carolina

; Pimentel-Fernández, Carolina

; Marques-Santos, Celi

; Saldarriaga, Clara

; Chávez, Christian

; Cáceres, Cristina

; Ibarrola, Dahiana

; Barranco, Daniela

; Muñoz-Ortiz, Edison

; Ruiz-Gastelum, Edith D.

; Bianco, Eduardo

; Murguía, Elena

; Soto, Enrique

; Rodríguez-Caballero, Fabiola

; Otiniano-Costa, Fanny

; Valentino, Giovanna

; Rodríguez-Cermeño, Iris B.

; Rivera, Ivan R.

; Gándara-Ricardo, Jairo A.

; Velásquez-Penagos, Jesús A.

; Torales, Judith

; Scavenius, Karina

; Dueñas-Criado, Karen

; García, Laura

; Roballo, Laura

; Kazelian, Lucía R.

; Coussirat-Liendo, Macarena

; Costa-Almeida, María C.

; Drever, Mariana

; Lujambio, Mariela

; Castro, Marildes L.

; Rodríguez-Sifuentes, Maritza

; Acevedo, Mónica

; Giambruno, Mónica

; Ramírez, Mónica

; Gómez, Nancy

; Gutiérrez-Castillo, Narcisa

; Greatty, Onelia

; Harwicz, Paola

; Notaro, Patricia

; Falcón, Rocío

; López, Rosario

; Montefilpo, Sady

; Ramírez-Flores, Sara

; Verdugo, Silvina

; Murguía, Soledad

; Constantini, Sonia

; Vieira, Thais C.

; Michelis, Virginia

; Serra, César M.

Archivos de cardiología de México

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2022, Volume 92 Suppl. 2 Pages 1 - 68

Abstract: Es | Text: Es | PDF: Es

https://doi.org/10.24875/acm.22000071 450 downloads

The REBECGA Brazilian Registry of Pregnancy and Heart Disease: Rationale and Design
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Avila, Walkiria Samuel

; Rivera, Maria Alayde Mendonça

; Marques-Santos, Celi

; Rivera, Ivan Romero

; Costa, Maria Elizabeth Navegantes Caetano

; Lucena, Alexandre Jorge Gomes de

; Freire, Claudia Maria Vilas

; Carvalho, Regina Coeli Marques de

; Born, Daniel

; Campanharo, Felipe Favorette

; Silva, Fabio Bruno

International Journal of Cardiovascular Sciences

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aug 2021, Volume 34 N. 4 Pages 452 - 458

Abstract: En | Text: En | PDF: En

Abstract Background: Maternal mortality rates in Brazil remain above the goals established by the United Nations Sustainable Development Goals. Heart disease is estimated to affect 4% of all pregnancies and remains by itself the main indirect obstetric cause of maternal death. In the last decades, a significant improvement in the prognosis of heart diseases has made pregnancy possible in women with heart disease and provided better maternal and fetal outcomes. Objective: To establish a multicenter Brazilian Registry of pregnant women with heart disease; to study the causes of immediate and late maternal mortality; and to assess the prevalence of heart disease in the country’s macro-regions. Method: This is an observational study, with retrospective and prospective stages, of the clinical and obstetric progression of pregnant women with heart disease. These women consecutively received care during pregnancy and will be followed up for up to a year after delivery at public and private hospitals with infrastructure for the execution of this project, a principal investigator, and approval by Ethics and Research Committees. Results: Our results will be presented after data collection and statistical analysis, aiming to demonstrate immediate and late maternal mortality rates, as well as the prevalence of heart disease in the country and its cardiovascular and obstetric complications during pregnancy. Conclusion: REBECGA will be the Brazilian Registry of heart disease and pregnancy and it will contribute to planning preventive measures, raising financial resources for the improvement of high-risk prenatal care, and reducing immediate and late maternal mortality due to heart disease.

https://doi.org/10.36660/ijcs.20200419

Are Women the Fragile Sex? Or are They the Singular Sex?
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Marques-Santos, Celi

; Oliveira, Gláucia Maria Moraes de

International Journal of Cardiovascular Sciences

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aug 2021, Volume 34 N. 4 Pages 344 - 346

Abstract: En | Text: En | PDF: En

https://doi.org/10.36660/ijcs.20210171

Posicionamento sobre COVID-19 e Gravidez em Mulheres Cardiopatas – Departamento de Cardiologia da Mulher da Sociedade Brasileira de Cardiologia – 2020
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Marques-Santos, Celi

; Avila, Walkiria Samuel

; Carvalho, Regina Coeli Marques de

; Lucena, Alexandre Jorge Gomes de

; Freire, Claudia Maria Vilas

; Alexandre, Elizabeth Regina Giunco

; Campanharo, Felipe Favorette

; Rivera, Maria Alayde Mendonça R.

; Costa, Maria Elizabeth Navegantes Caetano

; Castro, Marildes Luiza de

Arquivos Brasileiros de Cardiologia

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nov 2020, Volume 115 N. 5 Pages 975 - 986

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

https://doi.org/10.36660/abc.20201063 2767 downloads

Posicionamento da Sociedade Brasileira de Cardiologia para Gravidez e Planejamento Familiar na Mulher Portadora de Cardiopatia – 2020
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Avila, Walkiria Samuel

; Alexandre, Elizabeth Regina Giunco

; Castro, Marildes Luiza de

; Lucena, Alexandre Jorge Gomes de

; Marques-Santos, Celi

; Freire, Claudia Maria Vilas

; Rossi, Eduardo Giusti

; Campanharo, Felipe Favorette

; Rivera, Ivan Romero

; Costa, Maria Elizabeth Navegantes Caetano

; Rivera, Maria Alayde Mendonça

; Carvalho, Regina Coeli Marques de

; Abzaid, Alexandre

; Moron, Antonio Fernandes

; Ramos, Auristela Isabel de Oliveira

; Albuquerque, Carlos Japhet da Mata

; Feio, Claudine Maia Alves

; Born, Daniel

; Silva, Fábio Bruno da

; Nani, Fernando Souza

; Tarasoutchi, Flavio

; Costa Junior, José de Ribamar

; Melo Filho, José Xavier de

; Katz, Leila

; Almeida, Maria Cristina Costa

; Grinberg, Max

; Amorim, Melania Maria Ramos de

; Melo, Nilson Roberto de

; Medeiros, Orlando Otávio de

; Pomerantzeff, Pablo Maria Alberto

; Braga, Sérgio Luiz Navarro

; Cristino, Sonia Conde

; Martinez, Tania Leme da Rocha

; Leal, Tatiana de Carvalho Andreuci Torres

Arquivos Brasileiros de Cardiologia

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may 2020, Volume 114 N. 5 Pages 849 - 942

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

https://doi.org/10.36660/abc.20200406 10784 downloads

10.

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

11.

Suspeita de Apneia Obstrutiva do Sono definida pelo Questionário de Berlim prediz eventos em pacientes com Síndrome Coronariana Aguda
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Jesus, Eryca Vanessa S. de

; Dias-Filho, Euvaldo B.

; Mota, Bethania de M.

; Souza, Luiz de

; Marques-Santos, Celi

; Rocha, João Bosco G.

; Oliveira, Joselina L. M.

; Sousa, Antônio C. S.

; Barreto-Filho, José Augusto

Arquivos Brasileiros de Cardiologia

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sep 2010, Volume 95 N. 3 Pages 313 - 320

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

FUNDAMENTO: De um ponto de vista mecanístico, a apneia obstrutiva do sono (SAOS) pode causar distúrbios extras à homeostase cardiovascular na presença de síndrome coronariana aguda (SCA). OBJETIVO: Investigar se um diagnóstico clínico padronizado de SAOS, em pacientes com SCA, prediz o risco de eventos cardiovasculares durante hospitalização. MÉTODOS: Em um estudo de coorte prospectivo, um grupo de 200 pacientes com diagnóstico de SCA estabelecido entre Setembro de 2005 e Novembro de 2007, foram estratificados pelo Questionário de Berlim (QB) para o risco de SAOS (alto ou baixo risco). Foi testado se o subgrupo de alto risco para SAOS apresenta maior tendência à eventos cardiovasculares. O endpoint primário avaliado foi um desfecho composto de morte cardiovascular, eventos cardíacos isquêmicos recorrentes, edema pulmonar agudo e acidente vascular cerebral durante a hospitalização. RESULTADOS: Noventa e quatro (47%) dos pacientes identificados pelo QB apresentavam suspeita de SAOS. Alto risco para SAOS estava associado com uma mortalidade mais elevada, embora sem diferença estatística (4,25% vs 0,94%; p=0,189), mas com uma estatisticamente significante maior incidência de desfecho composto de eventos cardiovasculares (18,08% vs 6,6%; p=0,016). No modelo de regressão logística, os preditores multivariados de desfecho composto de eventos cardiovasculares foram idade (OR = 1,048; IC95%: 1,008 a 1,090; p=0,019), fração de ejeção do VE (OR = 0,954; IC95%: 0,920 a 0,989; p=0,010), e risco mais elevado de SAOS (OR = 3,657; IC95%: 1,216 a 10,996; p=0,021). CONCLUSÃO: O uso de um questionário simples e validado (QB) para identificar pacientes com risco mais elevado de SAOS pode ajudar a prever o desfecho cardiovascular durante a hospitalização. Além disso, nossos dados sugerem que SAOS é muito comum em pacientes com SCA.

BACKGROUND: From a mechanistic standpoint, obstructive sleep apnea (OSA) may further disturb cardiovascular homeostasis in the setting of acute coronary syndrome (ACS). OBJECTIVE: We sought to investigate if a standardized clinical diagnosis of OSA, in acute coronary syndrome patients, predicts the risk of cardiovascular events during hospitalization. METHODS: In a prospective cohort study, a group of 200 patients diagnosed with ACS between September 2005 and November 2007 were stratified by the Berlin Questionnaire (BQ) regarding the risk for OSA (high or low risk). We tested if the subgroup of high risk for OSA was prone to a higher frequency of cardiovascular events. The primary endpoint evaluated was a composite outcome of cardiovascular death, recurrent cardiac ischemic events, acute pulmonary edema and stroke during hospitalization. RESULTS: Ninety four (47%) patients assessed by the BQ were likely to have OSA. High risk for OSA was associated with a non-significant higher mortality (4.25% vs 0.94%; p=0.189), but a significant higher incidence of composite cardiovascular events (18.08% vs 6.6%; p=0.016). In the logistic regression model, multivariate predictors of composite cardiovascular events were age (OR= 1.048; 95% CI 1.008 to 1.090; p=0.019), left ventricular ejection fraction (OR= 0.954; 95% CI 0.920 to 0.989; p=0.010), and higher risk for OSA (OR= 3.657; 95% CI 1.216 to 10.996; p=0.021). CONCLUSION: The use of a simple and validated questionnaire (BQ) to identify patients with higher risk for OSA may help in the prediction of cardiovascular outcome during hospitalization. Moreover, our data suggests that OSA is very common in patients with ACS.

FUNDAMENTO: Desde un punto de vista mecanístico, la apnea obstructiva del sueño (SAOS) puede ocasionar disturbios extras a la homeostasis cardiovascular en la presencia del síndrome coronario aguda (SCA) OBJETIVO: Investigar si un diagnóstico clínico estandarizado de SAOS, en pacientes con SCA, predice el riesgo de eventos cardiovasculares durante la hospitalización. MÉTODOS: En un estudio de cohorte prospectivo, un grupo de 200 pacientes con diagnóstico de SCA elecido entre Septiembre de 2005 y Noviembre de 2007, fueron estratificados por el Cuestionario de Berlín (CB) para el riesgo de SAOS (alto o bajo riesgo). Se probó si el subgrupo de alto riesgo para SAOS presenta mayor tendencia a eventos cardiovasculares. El endpoint primario evaluado fue un desenlace conformado por muerte cardiovascular, eventos cardíacos isquémicos recurrentes, edema pulmonar agudo y accidente vascular cerebral durante la hospitalización. RESULTADOS: Noventa y cuatro (47%) de los pacientes identificados por el CB presentaban sospecha de SAOS. Alto riesgo para SAOS estaba asociado con una mortalidad más elevada, aunque sin diferencia estadística (4,25% vs 0,94%; p=0,189), pero con una estadísticamente significativa mayor incidencia de desenlace conformada por eventos cardiovasculares (18,08% vs 6,6%; p=0,016). En el modelo de regresión logística, los predictores multivariados de desenlace conformado por eventos cardiovasculares fueron edad (OR= 1,048; IC95%: 1,008 a 1,090; p=0,019), fracción de eyección del VI (OR= 0,954; IC95%: 0,920 a 0,989; p=0,010), y riesgo más elevado de SAOS (OR= 3,657; IC95%: 1,216 a 10,996; p=0,021). CONCLUSIÓN: El uso de un cuestionario sencillo y validado (CB) para identificar a pacientes con riesgo más elevado de SAOS puede ayudar a prever el desenlace cardiovascular durante la hospitalización. Además de ello, nuestros datos sugieren que SAOS es mucho común en pacientes con SCA.

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12.

Estimativa da digestibilidade aparente da matéria seca por meio de indicadores internos em eqüinos
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Stein, Rosane Barros da Silva

; Toledo, Luiz Roberto Aguiar de

; Almeida, Fernando Queiroz de

; Rodrigues, Paulo Henrique Mazza

; Lima, César Gonçalves de

; Corassa, Anderson

; Santos, Thiago Marques dos

Revista Brasileira de Zootecnia

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apr 2006, Volume 35 N. 2 Pages 504 - 511

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

Com o objetivo de comparar metodologias de estimativa do coeficiente de digestibilidade da MS (CDMS) em dietas para eqüinos, avaliaram-se o método de coleta total de fezes (CT) e o uso dos indicadores internos celulose indigestível (CELi), fibra em detergente ácido indigestível (FDAi) e cinza insolúvel em ácido (CIA). No ensaio de digestão, foram utilizadas 16 éguas adultas da raça Mangalarga Marchador, entre 3,5 a 18,4 anos de idade e 394,80 ± 46,22 kg. As dietas, isoprotéicas e isocalóricas, foram compostas de feno de coastcross (Cynodon dactylon cv. coast cross) e concentrado na proporção 60:40. Adotou-se delineamento experimental em blocos casualizados com quatro repetições em cada dieta. A avaliação das estimativas do CDMS pelos indicadores foi feita por meio de um modelo considerando-se o viés, ou seja, a diferença entre CDMS estimado pelo indicador e pela CT. Não houve efeito da idade dos animais no CDMS; entre os indicadores avaliados, a FDAi foi o que apresentou os parâmetros mais acurados. Os indicadores não diferiram quanto à precisão. Contudo, quanto à robustez, as estimativas da FDAi e da CELi foram afetadas pelo consumo de MS e pelo CDMS, enquanto a CIA foi afetada apenas pelo CDMS. As taxas de recuperação dos indicadores foram de 98,49; 94,49 e 144,5% para a FDAi, CELi e CIA, respectivamente, e apenas a da FDAi não diferiu de 100%. Os indicadores foram classificados segundo a acurácia, a precisão e a robustez na seguinte ordem: FDAi, CIA e CELi.

This research aimed to compare dry matter digestibility coefficient (DMDC) of horse diets by total feces collection (TC) and internal markers, indigestible cellulose (iCEL), indigestible acid detergent fiber (iADF) and acid insoluble ash (AIA). Sixteen adult mares of Mangalarga Marchador breed averaging from 3.5 to 18.4 years and 394.80 ± 46.22 kg were assigned to a randomized block design with four replicates. Diets were formulated to be isoprotein and isoenergetic and composed of coastcross hay (Cynodon dactylon cv. Coast cross) and 60:40 concentrate. Evaluation of DMDC estimated by the markers was performed by a model considering the bias, i.e., the difference between DMDC estimated by marker and by TC. No effect of animal age on DMDC. Among the evaluated markers, iADF was more accurate. Regarding precision, no differences were observed among markers. Concerning robustness, dry matter intake and DMDC affected iADF and iCEL estimates, whereas only DMDC affected AIA estimate. Markers recoveries were 98.49, 94.49 and 144.5% for iADF, iCEL e AIA, respectively and, only iADF recovery did not differ from 100%. Markers ranking concerning accuracy, precision and robustness were as follows: iADF, AIA and iCEL.

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