Resumo Fundamento: A insuficiência cardíaca (IC) é responsável por alta carga de internações hospitalares. A sua forma de apresentação está relacionada ao prognóstico da doença. Objetivos: Descrever a associação entre o perfil hemodinâmico de admissão hospitalar na IC aguda, baseado em congestão (úmido ou seco) e perfusão (frio ou quente), e desfechos de mortalidade, tempo de internação e chance de reinternação. Métodos: Estudo de coorte, envolvendo pacientes do projeto "Boas Práticas Clínicas em Cardiologia", internados por IC aguda em hospitais públicos brasileiros, entre março de 2016 a dezembro de 2019, com seguimento de seis meses. Foram realizadas análises das características populacionais e do perfil hemodinâmico de admissão, além de análises de sobrevivência pelos modelos de Cox para associação entre o perfil de admissão e mortalidade, e regressão logística para chance de reinternação, considerando nível de significância estatística de 5%. Resultados: Foram avaliados 1978 pacientes, com idade média foi 60,2 (±14,8) anos e fração de ejeção média do ventrículo esquerdo de 39,8% (±17,3%). Houve altas taxas de mortalidade no seguimento de seis meses (22%), com associação entre os perfis hemodinâmicos frios e a mortalidade hospitalar (HR=1,72; IC95% 1,27-2,31; p < 0,001) e em 6 meses (HR= 1,61, IC 95% 1,29-2,02). A taxa de reinternação em 6 meses foi de 22%, sendo maior para os pacientes admitidos em perfis úmidos (OR 2,30; IC95% 1,45-3,65; p < 0,001). Conclusões: A IC aguda no Brasil apresenta altas taxas de mortalidade e reinternações e os perfis hemodinâmicos de admissão hospitalar são bons marcadores prognósticos dessa evolução. Fundamento (IC hospitalares doença Objetivos úmido seco frio quente, quente , quente) Métodos coorte Boas Cardiologia, Cardiologia Cardiologia" brasileiros 201 2019 5 5% Resultados 197 602 60 2 60, ±14,8 148 14 8 (±14,8 398 39 39,8 ±17,3%. 173 ±17,3% . 17 3 (±17,3%) 22 22% (22%) HR=1,72 HR172 HR 1 72 (HR=1,72 IC95 1,272,31 127231 1,27 2,31 27 31 1,27-2,31 0,001 0001 0 001 HR= (HR 161 61 1,61 95 1,292,02. 129202 1,29 2,02 29 02 1,29-2,02) OR 2,30 230 30 1,453,65 145365 1,45 3,65 45 65 1,45-3,65 0,001. Conclusões evolução 20 19 ±14, (±14, 39, ±17,3 (±17,3% (22% HR=1,7 HR17 7 (HR=1,7 IC9 272 1,272,3 12723 127 1,2 231 2,3 1,27-2,3 0,00 000 00 16 1,6 9 292 1,292,02 12920 129 202 2,0 1,29-2,02 23 453 1,453,6 14536 145 1,4 365 3,6 4 1,45-3,6 ±14 (±14 ±17, (±17,3 (22 HR=1, HR1 (HR=1, 1,272, 1272 12 1, 2, 1,27-2, 0,0 1,292,0 1292 1,29-2,0 1,453, 1453 36 3, 1,45-3, ±1 (±1 ±17 (±17, (2 HR=1 (HR=1 1,272 1,27-2 0, 1,292, 1,29-2, 1,453 1,45-3 ± (± (±17 ( 1,27- 1,292 1,29-2 1,45- 1,29-

Abstract Background: Heart failure (HF) contributes to a high burden of hospitalization, and its form of presentation is associated with disease prognosis. Objectives: To describe the association of hemodynamic profile of acute HF patients at hospital admission, based on congestion (wet/dry) and perfusion (cold/warm), with mortality, hospital length of stay and risk of readmission. Methods: Cohort study, with patients participating in the "Best Practice in Cardiology" program, admitted for acute HF in Brazilian public hospitals between March 2016 and December 2019, with a six-month follow-up. Characteristics of the population and hemodynamic profile at admission were analyzed, in addition to survival analysis using Cox proportional hazard model for associations between hemodynamic profile at admission and mortality, and logistic regression for the risk of rehospitalization, using a statistical significance level of 5%. Results: A total of 1,978 patients were assessed, with mean age of 60.2 (±14.8) years and mean left ventricular ejection fraction of 39.8% (±17.3%). A high six-month mortality rate (22%) was observed, with an association of cold hemodynamic profiles with in-hospital mortality (HR=1.72, 95%CI 1.27-2.31; p < 0.001) and six-month mortality (HR= 1.61, 95%CI 1.29-2.02). Six-month rehospitalization rate was 22%, and higher among patients with wet profiles (OR 2.30; 95%CI 1.45-3.65; p < 0.001). Conclusions: Acute HF is associated with high mortality and rehospitalization rates. Patient hemodynamic profile at admission is a good prognostic marker of this condition. Background (HF hospitalization prognosis Objectives wet/dry wetdry dry (wet/dry cold/warm, coldwarm cold/warm , warm (cold/warm) readmission Methods study Best Cardiology program 201 2019 sixmonth six month followup. followup follow up. up follow-up analyzed 5 5% Results 1978 1 978 1,97 assessed 602 60 2 60. ±14.8 148 14 8 (±14.8 398 39 39.8 ±17.3%. 173 ±17.3% . 17 3 (±17.3%) 22% 22 (22% observed inhospital HR=1.72, HR172 HR 72 (HR=1.72 95CI CI 95 1.272.31 127231 1.27 2.31 27 31 1.27-2.31 0.001 0001 0 001 HR= (HR 161 61 1.61 1.292.02. 129202 1.29 2.02 29 02 1.29-2.02) Sixmonth Six OR 2.30 230 30 1.453.65 145365 1.45 3.65 45 65 1.45-3.65 0.001. Conclusions rates condition (cold/warm 20 197 97 1,9 6 ±14. (±14. 39. ±17.3 (±17.3% (22 HR=1.72 HR17 7 (HR=1.7 9 272 1.272.3 12723 127 1.2 231 2.3 1.27-2.3 0.00 000 00 16 1.6 292 1.292.02 12920 129 202 2.0 1.29-2.02 23 453 1.453.6 14536 145 1.4 365 3.6 4 1.45-3.6 19 1, ±14 (±14 ±17. (±17.3 (2 HR=1.7 HR1 (HR=1. 1.272. 1272 12 1. 2. 1.27-2. 0.0 1.292.0 1292 1.29-2.0 1.453. 1453 36 3. 1.45-3. ±1 (±1 ±17 (±17. ( HR=1. (HR=1 1.272 1.27-2 0. 1.292. 1.29-2. 1.453 1.45-3 ± (± (±17 HR=1 1.27- 1.292 1.29-2 1.45- 1.29-

RESUMO No Brasil, a miocardiopatia chagásica constitui a terceira causa mais comum de indicação para transplante cardíaco (TxC). A hipertensão arterial pulmonar (HAP) é uma condição grave frequentemente presente em pacientes com insuficiência cardíaca (IC) terminal que piora o prognóstico daqueles submetidos a TxC. O mecanismo etiológico da HAP é multifatorial, sendo o aumento da pressão de enchimento ventricular um dos principais. Recentemente, entretanto, vários trabalhos procuraram demonstrar o papel do processo inflamatório local, contribuindo para o enrijecimento das artérias pulmonares e o surgimento ou piora da HAP no cenário da IC. Objetivos: Avaliar o processo inflamatório nas artérias pulmonares de transplantados cardíacos chagásicos (TxC-C) e não chagásicos (TxC-NC), com e sem HAP, por meio da concentração tecidual das citocinas inflamatórias obtidas no momento do TxC. Métodos: Os níveis das interleucinas (IL)-6, IL-1β, e do fator de necrose tumoral alfa [tumor necrosis factor alpha) (TNF-α)] e de neutrófilos CD68 e CD66b foram aferidos em fragmentos das artérias pulmonares de pacientes TxC-C e TxC-NC com e sem HAP. Resultados: Não houve diferença estatisticamente significativa (p ≥ 0,05) entre os níveis dos biomarcadores inflamatórios aferidos nas artérias pulmonares dos TxC-C e TxC-NC com ou sem HAP. Conclusão: Observamos que os pacientes TxC-C e TxC-NC com ou sem HAP apresentam níveis semelhantes de marcadores inflamatórios expressos no tecido das artérias pulmonares. Tal fato sugere que a HAP dos pacientes TxC-C e TxC-NC é um processo que se relaciona com a própria IC e pode não ter relação com o perfil inflamatório dos pacientes. Brasil TxC . (TxC) (HAP (IC multifatorial principais Recentemente entretanto local Objetivos TxCC C (TxC-C TxCNC, TxCNC NC , (TxC-NC) Métodos IL6, IL6 IL 6, 6 (IL)-6 IL1β, IL1β ILβ 1β, 1β β IL-1β tumor alpha TNFα TNF α (TNF-α) CD CD6 CDb b Resultados p 0,05 005 0 05 Conclusão (TxC (TxC-NC (IL)- (TNF-α 0,0 00 (IL) 0, (IL

ABSTRACT In Brazil, Chagas cardiomyopathy is the third most common cause of indication for heart transplantation (HTx). Pulmonary arterial hypertension (PAH) is a severe condition frequently present in patients with terminal heart failure that worsens the prognosis of patients undergoing HTx. The etiological mechanism of PAH is multifactorial, with increased ventricular filling pressure being one of the main ones. Recently, however, several studies have sought to demonstrate the role of the local inflammatory process in contributing to the stiffening of the pulmonary arteries and the emergence or worsening of PAH in the heart failure (HF) setting. Objectives: To evaluate the inflammatory process in the pulmonary arteries of chagasic HTx (HTx-C) and non-chagasic (HTx-NC) patients, with and without PAH, through the tissue concentration of inflammatory cytokines obtained at the time of HTx. Methods: The levels of interleukins (IL)-6, IL-1β, TNF-α, and CD68 and CD66b neutrophils were measured in fragments of the pulmonary arteries of HTx-C and HTx-NC patients with and without PAH. Results: No statistically significant difference (p ≥ 0.05) between the inflammatory biomarkers measured in HTx-C and HTx-NC pulmonary arteries, with or without PAH. Conclusion: We observed that HTx-C and HTx-NC patients present the same levels of inflammatory markers expressed in the pulmonary artery tissue, whether or not they have PAH. This fact suggests that PAH in HTx-C and HTx-NC patients is a process that is related to HF itself and not to the patients’ inflammatory profile. Brazil . (HTx) (PAH multifactorial ones Recently however (HF setting Objectives HTxC C (HTx-C nonchagasic non HTxNC NC (HTx-NC Methods IL6, IL6 IL 6, 6 (IL)-6 IL1β, IL1β ILβ 1β, 1β β IL-1β TNFα, TNFα TNF α, α TNF-α CD CD6 CDb b Results p 0.05 005 0 05 Conclusion profile (HTx (IL)- 0.0 00 (IL) 0. (IL

The publication Cardiovascular Statistics – Brazil aims to provide an annual compilation of data and research on the epidemiology of CVDs in Brazil.&nbsp; The report integrates official statistics from the Brazilian Ministry of Health and other governmental entities alongside data from the GBD project, coordinated by the IHME at the University of Washington. Additionally, it incorporates data derived from various sources and scientific studies, including cohorts and registries, that relate to CVDs and their associated risk factors. This publication is intended for a wide range of individuals, including researchers, clinicians, patients, healthcare policymakers, media professionals, the general public, and other interested parties seeking extensive national data about heart disease and stroke.&nbsp; Volunteer researchers from various Brazilian universities and research institutions carry out the project. The group is led by a five-member steering committee (ALPR, CAP, DCM, GMMO, and LCCB). The Brazilian Society of Cardiology fully supports this initiative, and the project receives collaborative support from the GBD Brazil Network and an International Committee (GAR, PP, and TAG) from both the IHME/University of Washington (GAR) and the World Heart Federation (PP and TAG).&nbsp;

A publicação Estatística Cardiovascular – Brasil tem por objetivo fornecer uma compilação anual dos dados e das pesquisas sobre a epidemiologia das DCV no Brasil.&nbsp; Este documento integra as estatísticas oficiais do Ministério da Saúde do Brasil e outras entidades governamentais ao lado de dados do projeto GBD, coordenado pelo IHME da Universidade de Washington. Além disso, incorpora dados derivados de várias fontes e estudos científicos, inclusive coortes e registros, relacionados às DCV e fatores de risco associados. Esta publicação destina-se a um público variado, incluindo pesquisadores, clínicos, pacientes, formuladores de políticas de saúde, profissionais da mídia, o público em geral e todos aqueles que buscam dados nacionais abrangentes sobre DCV e acidente vascular cerebral. Pesquisadores voluntários de várias universidades e instituições de pesquisa brasileiros realizaram este projeto. O grupo é liderado por um comitê diretivo com cinco membros (ALPR, CAP, DCM, GMMO e LCCB). A Sociedade Brasileira de Cardiologia apoia integralmente esta iniciativa e o projeto recebe colaboração da Rede GBD Brasil1 e do GBD International Committee (GAR, PP e TAG) do IHME/Universidade de Washington (GAR) e da World Heart Federation (PP e TAG).&nbsp;

OBJECTIVE: To describe the degree of difficulty that HIV-infected patients have with therapy treatment. INTRODUCTION: Patients’ perceptions about their treatment are a determinant factor for improved adherence and a better quality of life. METHODS: Two cross-sectional analyses were conducted in public AIDS referral centers in Brazil among patients initiating treatment. Patients interviewed at baseline, after one month, and after seven months following the beginning of treatment were asked to classify and justify the degree of difficulty with treatment. Logistic regression was used for analysis. RESULTS: Among 406 patients initiating treatment, 350 (86.2%) and 209 (51.5%) returned for their first and third visits, respectively. Treatment perceptions ranged from medium to very difficult for 51.4% and 37.3% on the first and third visits, respectively. The main difficulties reported were adverse reactions to the medication and scheduling. A separate logistic regression indicated that the HIV-seropositive status disclosure, symptoms of anxiety, absence of psychotherapy, higher CD4+ cell count (> 200/mm³) and high (> 4) adverse reaction count reported were independently associated with the degree of difficulty in the first visit, while CDC clinical category A, pill burden (> 7 pills), use of other medications, high (> 4) adverse reaction count reported and low understanding of medical orientation showed independent association for the third visit. CONCLUSIONS: A significant level of difficulty was observed with treatment. Our analyses suggest the need for early assessment of difficulties with treatment, highlighting the importance of modifiable factors that may contribute to better adherence to the treatment protocol.