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Acometimento do Ventrículo Direito na Cardiomiopatia por Depósito de Glicogênio (PRKAG2): Análise Ecocardiográfica Convencional e Avançada
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Pena, José Luiz Barros

; Melo, Fabricio Junqueira de

; Santos, Wander Costa

; Moura, Isabel Cristina Gomes

; Nakashima, Gabriela Pansanato

; Freitas, Natalia Costa

; Sternick, Eduardo Back

Arquivos Brasileiros de Cardiologia

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dec 2022, Volume 119 N. 6 Pages 902 - 909

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

Resumo Fundamento A síndrome do PRKAG2 é uma doença hereditária autossômica dominante rara, de início precoce. Objetivamos descrever os achados ecocardiográficos do ventrículo direito (VD) usando modalidades bi e tridimensionais (2D e 3D), incluindo índices de deformação miocárdica nesta cardiomiopatia. Também objetivamos demonstrar se esta técnica poderia identificar alterações na função do VD que pudessem distinguir quaisquer achados particulares. Métodos Trinta pacientes com síndrome do PRKAG2 (R302Q e H401Q) geneticamente comprovada, 16 (53,3%) do sexo masculino, com idade média de 39,1 ± 15,4 anos, foram submetidos a exame ecocardiográfico completo. A visão de 4 câmaras com foco no VD foi adquirida para medições 2D e 3D. Os testes t de Student ou Wilcoxon-Mann-Whitney foram usados para comparar as variáveis numéricas entre 2 grupos, e p < 0,05 foi considerado significativo. Resultados Doze pacientes (40%) tiveram marca-passo implantado por 12,4 ± 9,9 anos. A espessura diastólica média da parede livre do VD foi de 7,9 ± 2,9 mm. O strain longitudinal de 4 câmaras do VD (SL4VD), incluindo a parede livre e o septo interventricular, foi de -17,3% ± 6,7%, e o strain longitudinal da parede livre do VD (SLPLVD) foi de −19,1% ± 8,5%. A razão apical do SLPLVD mediu 0,63 ± 0,15. A fração de ejeção (FE) 3D média do VD foi de 42,6% ± 10,9% e abaixo dos limites normais em 56,7% dos pacientes. Correlação positiva ocorreu entre FE 3D do VD, SL4VD e SLPLVD, principalmente para pacientes sem marca-passo (p = 0,006). Conclusão O envolvimento do VD em PRKAG2 é frequente e ocorre em diferentes graus. A ecocardiografia é uma ferramenta valiosa na detecção de anormalidades miocárdicas do VD nesta condição. O uso de SL4VD 2D, SLPLVD e FE 3D oferecem indicadores confiáveis de disfunção sistólica do VD nesta cardiomiopatia rara e desafiadora.

Abstract Background PRKAG2 syndrome is a rare, early-onset autosomal dominant inherited disease. We aimed to describe the right ventricle (RV) echocardiographic findings using two and three-dimensional (2D and 3D) modalities including myocardial deformation indices in this cardiomyopathy. We also aimed to demonstrate whether this technique could identify changes in RV function that could distinguish any particular findings. Methods Thirty patients with genetically proven PRKAG2 (R302Q and H401Q), 16 (53.3%) males, mean age 39.1 ± 15.4 years, underwent complete echocardiography examination. RV-focused, 4-chamber view was acquired for 2D and 3D measurements. Student’s t or Wilcoxon-Mann-Whitney tests were used to compare numerical variables between 2 groups, and p < 0.05 was considered significant. Results Twelve patients (40%) had a pacemaker implanted for 12.4 ± 9.9 years. RV free wall mean diastolic thickness was 7.9 ± 2.9 mm. RV 4-chamber longitudinal strain (RV4LS), including the free wall and interventricular septum, was –17.3% ± 6.7%, and RV free wall longitudinal strain (RVFWLS) was −19.1% ± 8.5%. The RVFWLS apical ratio measured 0.63 ± 0.15. Mean RV 3D ejection fraction (EF) was 42.6% ± 10.9% and below normal limits in 56.7% of patients. Positive correlation occurred between RV 3DEF, RV4LS, and RVFWLS, especially for patients without a pacemaker (p = 0.006). Conclusion RV involvement in PRKAG2 syndrome is frequent, occurring in different degrees. Echocardiography is a valuable tool in detecting RV myocardial abnormalities in this condition. The use of 2D RV4LS, RVFWLS, and 3DEF offers reliable indicators of RV systolic dysfunction in this rare, challenging cardiomyopathy.

https://doi.org/10.36660/abc.20210801

Cardiomiopatia PRKAG2
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Sternick, Eduardo Back

Arquivos Brasileiros de Cardiologia

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nov 2022, Volume 119 N. 5 Pages 689 - 690

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

https://doi.org/10.36660/abc.20220694

Acometimento do Ventrículo Direito na Cardiomiopatia por Depósito de Glicogênio (PRKAG2): Análise Ecocardiográfica Convencional e Avançada
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Pena, José Luiz Barros

; Melo, Fabricio Junqueira de

; Santos, Wander Costa

; Moura, Isabel Cristina Gomes

; Nakashima, Gabriela Pansanato

; Freitas, Natalia Costa

; Sternick, Eduardo Back

Arquivos Brasileiros de Cardiologia

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2022, N. ahead

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

https://doi.org/10.36660/abc.20210801

How Echocardiographic Deformation Indices Can Distinguish Different Types of Left Ventricular Hypertrophy
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Pena, José Luiz Barros

; Santos, Wander Costa

; Araújo, Stanley de Almeida

; Dias, Glauber Monteiro

; Sternick, Eduardo Back

Arquivos Brasileiros de Cardiologia

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nov 2018, Volume 111 N. 5 Pages 758 - 759

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

https://doi.org/10.5935/abc.20180223 793 downloads

Internationalization is Necessary, But is it Enough?
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Oliveira, Gláucia Maria Moraes de

; Lorenzo, Andrea De

; Colombo, Fernanda Marciano Consolim

; Sternick, Eduardo Back

; Brandão, Andréa Araujo

; Kaiser, Sergio Emanuel

; Quadros, Alexandre Schaan de

; Kalil, Renato Abdala Karam

; Scaramello, Christianne Brêtas Vieira

; Laurindo, Francisco Rafael Martins

; Hajjar, Ludhmila Abrahão

Arquivos Brasileiros de Cardiologia

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oct 2018, Volume 111 N. 4 Pages 626 - 628

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

https://doi.org/10.5935/abc.20180212 627 downloads

Cryptogenic Acute Ischemic Stroke: Assessment of the Performance of a New Continuous Long-Term Monitoring System in the Detection of Atrial Fibrillation
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Sampaio, Rogerio Ferreira

; Gomes, Isabel Cristina

; Sternick, Eduardo Back

Arquivos Brasileiros de Cardiologia

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aug 2018, Volume 111 N. 2 Pages 122 - 131

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

Resumo Fundamentos: Monitorização prolongada permite maior detecção de fibrilação atrial (FA) em pacientes com acidente vascular cerebral (AVC) isquêmico criptogênico. Não há consenso sobre a duração ideal da monitorização ou o valor prognóstico da FA de curta duração. Objetivos: Avaliar o desempenho de um novo sistema de monitorização ambulatorial (PoIP) com transmissão por telefonia celular, comparado ao Holter 24 horas, e a ocorrência de arritmias comparando pacientes com e sem AVC ou ataque isquêmico transitório (AIT). Métodos: Pacientes consecutivos com e sem AVC/AIT, sem FA, foram pareados pelo escore de propensão. Foi utilizado Holter 24 horas e o PoIP por 7 dias. Resultados: Selecionamos 52 de 84 pacientes (26 com AVC/AIT agudo e 26 controles). O tempo de conexão foi de 156,5 ± 22,5 horas e o de gravação no servidor foi de 148,8 ± 20,8 horas, com perdas de 6,8 e 11,4%, respectivamente. Houve maior tempo de conexão nos pacientes ambulatoriais (164,3 ± 15,8 h) que nos hospitalizados (148,8 ± 25,6h) (p = 0,02) com tempo de gravação semelhante (153,7 ± 16,9 e 143 ± 23,3 h). Detectamos FA pelo Holter em 1 paciente com AVC e pela monitorização prolongada em 7 (1 controle e 6 AVC). Não houve diferença na incidência de outras arritmias entre os grupos. Conclusões: Holter e PoIP tiveram desempenho equivalente nas primeiras 24 horas. O menor tempo de monitorização nos pacientes hospitalizados ocorreu por sinal de baixa intensidade. Perda de dados (4,5%) ocorreu por discrepância entre protocolos de transmissão (2,5G) e recepção pelas antenas (3G). A incidência de arritmias não diferiu entre os grupos AVC/AIT e controle.

Abstract Background: Long-term monitoring has been advocated to enhance the detection of atrial fibrillation (AF) in patients with stroke. Objective: To evaluate the performance of a new ambulatory monitoring system with mobile data transmission (PoIP) compared with 24-hour Holter. We also aimed to evaluate the incidence of arrhythmias in patients with and without stroke or transient ischemic attack. Methods: Consecutive patients with and without stroke or TIA, without AF, were matched by propensity score. Participants underwent 24-hour Holter and 7-day PoIP monitoring. Results: We selected 52 of 84 patients (26 with stroke or TIA and 26 controls). Connection and recording times were 156.5 ± 22.5 and 148.8 ± 20.8 hours, with a signal loss of 6,8% and 11,4%, respectively. Connection time was longer in ambulatory (164.3 ± 15.8 h) than in hospitalized patients (148.8 ± 25.6 h) (p = 0.02), while recording time did not differ between them (153.7 ± 16.9 and 143.0 ± 23.3 h). AF episodes were detected in 1 patient with stroke by Holter, and in 7 individuals (1 control and 6 strokes) by PoIP. There was no difference in the incidence of arrhythmias between the groups. Conclusions: Holter and PoIP performed equally well in the first 24 hours. Data transmission loss (4.5%) occurred by a mismatch between signal transmission (2.5G) and signal reception (3G) protocols in cell phone towers (3G). The incidence of arrhythmias was not different between stroke/TIA and control groups.

https://doi.org/10.5935/abc.20180112 4309 downloads

Factors Associated with Post-Sternotomy Mediastinitis. Case-Control Study
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Pinto, Débora Cristine Gomes

; Bahia Neto, Antônio Fernandino de Castro

; Gonçalves, Flávia Lage

; Gomes, Isabel Cristina

; Sternick, Eduardo Back

; Almeida, Alessandra Maciel

; Jentzsch, Nulma Souto

International Journal of Cardiovascular Sciences

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apr 2018, Volume 31 N. 2 Pages 163 - 172

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

Resumo Fundamentos: A mediastinite é uma infecção grave pós-esternotomia mediana com prognóstico ruim, mesmo com diagnóstico e tratamento precoces. Objetivos: Avaliar o perfil dos pacientes submetidos à esternotomia, identificar fatores de risco para o desenvolvimento da mediastinite e avaliar o diagnóstico bacteriológico dos pacientes com esta infecção. Métodos: Estudo caso-controle realizado em um hospital de Belo Horizonte (MG) com pacientes submetidos à esternotomia mediana entre janeiro de 2015 e janeiro de 2016. A amostra foi de 65 pacientes, sendo 13 casos e 52 controles (1:4). Na análise estatística, foram adotados os testes t de Student, Mann-Whitney e exato de Fisher, além de regressão logística, ao nível de significância de 5%. Resultados: Houve predominância do sexo masculino (63,1%), e a idade média foi 58,8 ±10,3 anos. A evolução a óbito ocorreu em 9,2% dos pacientes e em 23,1% dos que apresentaram mediastinite. A cirurgia de revascularização do miocárdio foi realizada em 75,4% dos casos. Predominância do sexo masculino, maior tempo de internação, febre pós-cirúrgica, óbitos e maior número de fatores de risco foram características mais observadas nos pacientes que desenvolveram mediastinite. O microrganismo mais encontrado em pacientes com infecção mediastinal foi Staphylococcus aureus (30,7%), além de elevada ocorrência de bactérias Gram-negativas (46,2%). Conclusão: Esforços devem ser concentrados para o controle dos fatores de risco antes do procedimento, além do aprimoramento de medidas que possam diminuir ou eliminar o surgimento da mediastinite, visando à prevenção e ao melhor controle de infecções.

Abstract Background: Mediastinitis is a severe post-median sternotomy infection with poor prognosis, even with early diagnosis and treatment. Objectives: To evaluate the profile of patients submitted to sternotomy, identify the risk factors for the development of mediastinitis and evaluate the bacteriological diagnosis of patients with this infection. Methods: Case-control study carried out in a large hospital in Belo Horizonte (MG, Brazil) in patients submitted to median sternotomy, from January 2015 to January 2018. The sample consisted of 65 patients, of which 13 were cases and 52, controls (1:4). For the statistical analysis, Student’s t test, Mann-Whitney test and Fisher exact test were used, in addition to logistic regression, with a level of significance of 5%. Results: There was a predominance of males (63.1%), and the mean age was 58.8 ± 10.3 years. Evolution to death occurred in 9.2% of the patients and in 23.1% of those with mediastinitis. Myocardial revascularization was performed in 75.4% of the cases. Predominance of male gender, longer hospitalization time, post-surgical fever and death, and a greater number of risk factors were more frequent characteristics in patients who developed mediastinitis. The most common microorganism found in patients with mediastinal infection was Staphylococcus aureus (30.7%), in addition to a high occurrence of Gram-negative bacteria (46,2%). Conclusion: The results are in accordance with the literature. Efforts should be focused on the control of risk factors prior to the procedure, in addition to improving measures that can decrease or eliminate the onset of mediastinitis, aiming at infection prevention and control.

https://doi.org/10.5935/2359-4802.20180004 1612 downloads

Reprocessing of Medical Products in Electrophysiology
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Kuniyoshi, Ricardo Ryoshim

; Sternick, Eduardo Back

; Nadalin, Elenir

; Hachul, Denise Tessariol

Arquivos Brasileiros de Cardiologia

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feb 2017, Volume 108 N. 2 Pages 169 - 172

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

https://doi.org/10.5935/abc.20170010 2003 downloads

Executive Summary of the II Brazilian Guidelines for Atrial Fibrillation
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Magalhães, Luiz Pereira de

; Figueiredo, Marcio Jansen de Oliveira

; Cintra, Fatima Dumas

; Saad, Eduardo Benchimol

; Kuniyoshi, Ricardo Ryoshim

; Menezes Lorga Filho, Adalberto

; D'Avila, Andre Luiz Buchele

; Paola, Angelo Amato Vincenzo de

; Kalil, Carlos Antonio Abunader

; Moreira, Dalmo Antonio Ribeiro

; Sobral Filho, Dario Celestino

; Sternick, Eduardo Back

; Darrieux, Francisco Carlos da Costa

; Fenelon, Guilherme

; Lima, Gustavo Glotz de

; Atié, Jacob

; Mateos, José Carlos Pachón

; Moreira, José Marcos

; Vasconcelos, José Tarcísio Medeiros de

; Zimerman, Leandro Ioschpe

; Silva, Luiz Roberto Leite da

; Silva, Marcio Augusto

; Scanavacca, Mauricio Ibrahim

; Souza, Olga Ferreira de

Arquivos Brasileiros de Cardiologia

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dec 2016, Volume 107 N. 6 Pages 501 - 508

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

https://doi.org/10.5935/abc.20160190 2024 downloads

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