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Cardiorespiratory optimal point in post-COVID-19 patients: a cross-sectional study postCOVID19 postCOVID post COVID 19 post-COVID-1 patients crosssectional cross sectional postCOVID1 1 post-COVID- post-COVID
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Santos, Karinne Simões da Cruz
; Brito, Gabriela Menezes Gonçalves de
; Melo, Enaldo Vieira de
; Sousa, Antônio Carlos Sobral
; Martins-Filho, Paulo Ricardo
; Campos, Milena dos Santos Barros
.
Revista do Instituto de Medicina Tropical de São Paulo
- Métricas do periódico
ABSTRACT The varied clinical presentations of SARS-CoV-2 infection have raised concerns about long-term consequences, especially “long-COVID” or “post-COVID-19 syndrome.” In this context, the cardiorespiratory optimal point (COP) within the Cardiopulmonary Exercise Test (CPET) emerges as a crucial metric for evaluating functional capacities and detecting cardiovascular and pulmonary anomalies post-COVID-19. This study aimed to assess COP values among post-COVID-19 patients and categorized them based on the initial severity of their disease. In this cross-sectional study conducted in the Northeast Brazil, 80 patients (26 females and 54 males) previously infected with SARS-CoV-2 underwent CPET. We clinically stratified patients into mild, moderate, or severe COVID-19 categories and assessed COP values and other cardiorespiratory metrics. We found differences in the predicted COP between patients with mild and severe COVID-19 (p=0.042). Additionally, patients with moderate and severe COVID-19 record had an average COP value exceeding 22. Other parameters, including respiratory exchange ratio, heart rate, and oxygen uptake efficiency slope, did not differ across the groups. Patients with a history of severe COVID-19 showed altered COP values, suggesting potential discrepancies in cardiovascular and respiratory system integration. The outcomes emphasize the importance of continuous monitoring and assessment of the cardiorespiratory domain for post-COVID-19 patients. Further research is needed to understand the relationship between elevated COP in post-severe COVID-19 and its long-term prognostic implications. SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- longterm long term consequences longCOVID COVID “long-COVID postCOVID19 postCOVID post 19 “post-COVID-1 syndrome. syndrome context (COP CPET (CPET postCOVID19. 19. post-COVID-1 disease crosssectional cross sectional Brazil 8 26 (2 5 males COVID19 COVID-1 metrics p=0.042. p0042 p p=0.042 . 0 042 (p=0.042) Additionally 22 parameters ratio rate slope groups integration postsevere implications SARS-CoV postCOVID1 1 “post-COVID- post-COVID- ( COVID1 COVID- p004 p=0.04 04 (p=0.042 “post-COVID post-COVID p00 p=0.0 (p=0.04 p0 p=0. (p=0.0 p=0 (p=0. p= (p=0 (p= (p
2.
Chronotropic incompetence is associated with reduced aerobic conditioning and sedentary behavior in patients with post-acute COVID-19 syndrome postacute post acute COVID19 COVID 19 COVID-1 COVID1 1 COVID-
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Campos, Milena dos Santos Barros
; Brito, Gabriela Menezes Gonçalves de
; Santos, Karinne Simões da Cruz
; Santos, Marcos Antonio Almeida
; Martins-Filho, Paulo Ricardo
; Sousa, Antônio Carlos Sobral
.
Revista do Instituto de Medicina Tropical de São Paulo
- Métricas do periódico
ABSTRACT Post-acute COVID-19 syndrome, or long COVID, presents with persistent symptoms, including cough, dyspnea, and fatigue, extending beyond one month after SARS-CoV-2 infection. Cardiac complications such as chest pain and arrhythmias have raised concerns, with chronotropic incompetence (CI), an inadequate heart rate increase during exercise, emerging as a significant condition contributing to diminished exercise tolerance and quality of life. This study estimated the prevalence of CI and explored its association with aerobic capacity and physical activity levels in long COVID patients. A cross-sectional study was conducted at a private hospital in Sergipe, Brazil, involving 93 patients over 18 years old with persistent post-COVID-19 symptoms after confirmed SARS-CoV-2 infections. Exclusion criteria included beta-blocker use, inadequate respiratory exchange ratio, and inability to complete cardiopulmonary exercise testing (CPET). Clinical histories, CPET results, and chronotropic index calculation were used to identify CI, with logistic regression analyzing associated factors. Of the participants (mean age 45 years; average duration since COVID-19 diagnosis 120 days), 20.4% were diagnosed with CI. Logistic regression identified a strong association between CI and sedentary behavior (OR 11.80; 95% CI 2.54 to 54.78; p=0.001). Patients with CI showed lower predicted peak heart rates and maximal oxygen uptake. The prevalence of CI among long COVID patients in this study was approximately 20%, associated with decreased aerobic capacity and increased sedentary behavior. These findings highlight the need for timely diagnosis and therapeutic interventions, including cardiopulmonary rehabilitation, to enhance the quality of life in post-COVID patients with CI. The study’s cross-sectional design and its specific context have limited causality inference and generalizability, underscoring the importance of further research in diverse settings. Postacute Post acute COVID19 19 COVID-1 syndrome cough dyspnea fatigue SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- infection concerns , (CI) crosssectional cross sectional Sergipe Brazil 9 1 postCOVID19 postCOVID post post-COVID-1 infections betablocker beta blocker use ratio CPET. . (CPET) histories results factors mean 4 12 days, days days) 204 20 20.4 OR 11.80 1180 11 80 95 254 54 2.5 54.78 5478 78 p=0.001. p0001 p p=0.001 0 001 p=0.001) uptake 20% interventions rehabilitation studys s generalizability settings COVID1 COVID- SARS-CoV (CI postCOVID1 post-COVID- (CPET 20. 11.8 118 8 25 5 2. 54.7 547 7 p000 p=0.00 00 11. 54. p00 p=0.0 p0 p=0. p=0 p=
3.
Therapeutic Adherence According to the Morisky Scale in Patients with Hypertension
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Lanza, Vinícius Encenha
; Silva, Gabriel Oliveira
; Quiroga, Celi Cristina Calamita
; Cavalcante, Margaret Assad
; Barroso, Weimar Kunz Sebba
; Brandão, Andréa Araujo
; Barbosa, Eduardo Costa Duarte
; Malachias, Marcus Vinicius Bolivar
; Gomes, Marco Mota
; Amodeo, Celso
; Povoa, Rui Manoel dos Santos
; Précoma, Dalton Bertolim
; Sousa, Antônio Carlos Sobral
; Dantas, João Miguel Malta
; Cesarino, Evandro José
; Barros e Silva, Pedro G. M. de
; Veiga Jardim, Paulo Cesar B.
; Lopes, Renato D.
.
International Journal of Cardiovascular Sciences
- Métricas do periódico
Abstract Background In view of the high prevalence of hypertension and the importance of adequate drug therapy in the prevention of complications, it is necessary to know the adherence to drug treatment in this population. Objective To verify adherence to antihypertensive drug treatment in Brazilian patients with hypertension using the Morisky-Green Test (MGT), relating it with demographic data. Methods Prospective, observational, multicenter, national registry study, with 2,578 hypertensive patients participating in study I, the Brazilian Cardiovascular Registry of Arterial Hypertension (I-RBH), recruited in the five regions of Brazil. The analyses carried out on the data were descriptive statistics, qui-square tests, ANOVA, and logistic regression, adopting 5% as the significance level for the tests. Results The research shows that 56.13% of patients in the sample were female; 56.71% were elderly (≥ 65 years); 55.86% were White; 52.37% were from the Southeast Region; and 59.74% were non-adherent. Logistic regression showed an independent relationship between patients’ age, ethnicity, and region with medication adherence. Conclusion Adherence to treatment is the key to reducing high rates of cardiovascular complications. The study brings a successful outcome in the relationship between the factors ethnicity, age, and region of patients with hypertension and medication adherence. To this end, it is necessary to understand these factors, considering systematic evaluation in the care of patients with hypertension and other chronic non-communicable diseases. This study is a significant contribution to multidisciplinary teams, as it highlights which risk factors interfere with medication adherence, incorporating better strategies in health education. complications population MoriskyGreen Morisky Green MGT, MGT , (MGT) Prospective observational multicenter 2578 2 578 2,57 I IRBH, IRBH RBH (I-RBH) Brazil statistics quisquare qui square tests ANOVA 5 5613 56 13 56.13 female 5671 71 56.71 ≥ ( 6 years years) 5586 55 86 55.86 White 5237 52 37 52.37 Region 5974 59 74 59.74 nonadherent. nonadherent non adherent. adherent non-adherent age ethnicity end noncommunicable communicable diseases teams education (MGT 257 57 2,5 (I-RBH 561 1 56.1 567 7 56.7 558 8 55.8 523 3 52.3 597 59.7 25 2, 56. 55. 52. 59.
4.
Adequação Alimentar de Indivíduos com Doença Cardiovascular Conforme Diretrizes Clínicas no Programa Alimentar Brasileiro Cardioprotetor
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Brito, Luciana
; Sahade, Viviane
; Marcadenti, Aline
; Torreglosa, Camila Ragne
; Weber, Bernardete
; Bersch-Ferreira, Ângela Cristine
; Rodrigues, Isa Galvão
; Sousa, Antônio Carlos Sobral
; Gomes, Adriana Barros
; Pinheiro, Josilene Maria Ferreira
; Vasconcelos, Sandra Mary Lima
; Carlos, Daniele Maria de Oliveira
; Figueiredo Neto, José Albuquerque de
; Dantas, Clenise de Farias
; Daltro, Carla
.
Resumo Fundamento Alcançar as metas nutricionais estabelecidas pelas sociedades científicas é um desafio constante e nem sempre alcançado. Objetivo Investigar a adequação alimentar de indivíduos com doença cardiovascular (DCV), participantes do Programa Alimentar Brasileiro Cardioprotetor residentes da região Nordeste do Brasil, segundo as recomendações da Sociedade Brasileira de Cardiologia (SBC). Métodos Análise transversal com dados do estudo de implementação da Dieta Cardioprotetora Brasileira (DICA BR) que avaliou indivíduos com DCV, atendidos em centros especializados em saúde cardiovascular em oito estados do Nordeste. O consumo alimentar foi obtido por recordatório alimentar de 24 horas e a adequação da dieta seguiu as recomendações da SBC. Foram considerados significantes valores de p < 0,05. Resultados Foram estudados 647 pacientes, com média (desvio padrão) de idade de 63,1 (9,4) anos, sendo 50,2% do sexo feminino. Na avaliação da ingestão alimentar, observou-se baixa adequação de carboidratos (52,3%), proteínas (70,9%), lipídios (38,8%) e fibras (22,4%). Observou-se que a maioria das mulheres consumia dieta hipoproteica (59,2%) e idosos tinham maior inadequação no consumo de carboidratos (52,6%). Em relação a ingestão de sódio, os homens apresentaram maior ingestão (72,9%), enquanto os idosos apresentaram redução de 13%. Além disso, foi demonstrado que os homens ingeriam mais fibras (28,1%) e indivíduos com maior escolaridade tinham um consumo elevado de ácidos graxos saturados (70,5%). Conclusões A maioria dos indivíduos não alcançou as metas dietoterápicas preconizadas para prevenção cardiovascular secundária. Os achados do presente estudo reforçam a necessidade de implementação de estratégias estruturadas, a fim de estimular hábitos alimentares saudáveis nesses indivíduos. alcançado DCV , (DCV) Brasil SBC . (SBC) DICA BR 2 005 0 05 0,05 64 pacientes desvio padrão 631 63 1 63, 9,4 94 9 4 (9,4 anos 502 50 50,2 feminino observouse observou se 52,3%, 523 52,3% 52 3 (52,3%) 70,9%, 709 70,9% 70 (70,9%) 38,8% 388 38 8 (38,8% 22,4%. 224 22,4% 22 (22,4%) Observouse Observou 59,2% 592 59 (59,2% 52,6%. 526 52,6% 6 (52,6%) sódio 72,9%, 729 72,9% 72 (72,9%) 13 13% disso 28,1% 281 28 (28,1% 70,5%. 705 70,5% 5 (70,5%) secundária estruturadas (DCV (SBC 00 0,0 9, (9, 50, 52,3 (52,3% 70,9 7 (70,9% 38,8 (38,8 22,4 (22,4% 59,2 (59,2 52,6 (52,6% 72,9 (72,9% 28,1 (28,1 70,5 (70,5% 0, (9 52, (52,3 70, (70,9 38, (38, 22, (22,4 59, (59, (52,6 72, (72,9 28, (28, (70,5 ( (52, (70, (38 (22, (59 (72, (28 (52 (70 (3 (22 (5 (72 (2 (7
Abstract Background Achieving nutritional goals established by scientific societies is a constant challenge and not always achieved. Objective To investigate the dietary adequacy of individuals with cardiovascular disease (CVD), participants in the Cardioprotective Brazilian Food Program residing in the Northeast region of Brazil, according to the recommendations of the Brazilian Society of Cardiology (SBC). Methods Cross-sectional analysis with data from the study implementing the Brazilian Cardioprotective Diet (DICA BR), which evaluated individuals with CVD treated in specialized cardiovascular health centers in eight states in the Northeast region. Food consumption was obtained by 24-hour dietary records and dietary adequacy followed SBC recommendations. Values of p < 0.05 were considered significant. Results 647 patients were studied, with a mean (standard deviation) age of 63.1 (9.4) years, 50.2% of whom were female. When evaluating food intake, a low adequacy of carbohydrates (52.3%), proteins (70.9%), lipids (38.8%), and fiber (22.4%) was observed. It was observed that the majority of women consumed a low-protein diet (59.2%) and the elderly had a greater inadequacy in carbohydrate consumption (52.6%). Regarding sodium intake, men had a higher intake (72.9%), while the elderly showed a 13% reduction. Furthermore, it was shown that men ate more fiber (28.1%) and individuals with higher education had a high consumption of saturated fatty acids (70.5%). Conclusions Most individuals did not achieve the recommended dietary therapy goals for secondary cardiovascular prevention. The findings of the present study reinforce the need to implement structured strategies to encourage healthy eating habits in these individuals. achieved CVD, , (CVD) Brazil SBC. . (SBC) Crosssectional Cross sectional DICA BR, BR BR) 24hour hour 24 005 0 05 0.0 significant 64 studied standard deviation 631 63 1 63. 9.4 94 9 4 (9.4 years 502 50 2 50.2 female 52.3%, 523 52.3% 52 3 (52.3%) 70.9%, 709 70.9% 70 (70.9%) 38.8%, 388 38.8% 38 8 (38.8%) 22.4% 224 22 (22.4% lowprotein protein 59.2% 592 59 (59.2% 52.6%. 526 52.6% 6 (52.6%) 72.9%, 729 72.9% 72 (72.9%) 13 reduction Furthermore 28.1% 281 28 (28.1% 70.5%. 705 70.5% 5 (70.5%) prevention (CVD (SBC 00 0. 9. (9. 50. 52.3 (52.3% 70.9 7 (70.9% 38.8 (38.8% 22.4 (22.4 59.2 (59.2 52.6 (52.6% 72.9 (72.9% 28.1 (28.1 70.5 (70.5% (9 52. (52.3 70. (70.9 38. (38.8 22. (22. 59. (59. (52.6 72. (72.9 28. (28. (70.5 ( (52. (70. (38. (22 (59 (72. (28 (52 (70 (38 (2 (5 (72 (7 (3
5.
Adequação do Consumo de Ácidos Graxos entre Pacientes em Prevenção Cardiovascular Secundária
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Marcadenti, Aline
; Machado, Rachel H. Vieira
; Santos, Renato Hideo Nakagawa
; Kasai, Caio Cesar dos Santos
; Kovacs, Cristiane
; Bello, Annie
; de Matos, Cristina H.
; Bertacco, Renata Torres Abib
; Souza, Gabriela C.
; Schirmann, Gabriela da S.
; Nagano, Francisca Eugenia Zaina
; Poloni, Soraia
; Kik, Raquel Milani El
; Feres, Naoel Hassan
; Rodrigues, Isa G.
; Sousa, Antônio Carlos Sobral
; Pinheiro, Josilene M. F.
; Vasconcelos, Sandra Mary Lima
; Carlos, Daniele Maria de Oliveira
; Souza, Viviane Sahade
; Gomes, Adriana Barros
; Figueiredo Neto, José Albuquerque de
; Moriguchi, Emilio Hideyuki
; Izar, Maria Cristina
; Pinto, Sônia Lopes
; Bressan, Josefina
; de Souza, Simone Raimondi
; Kumbier, Magali C.
; de Araújo, Celme Barroncas Passos
; Torreglosa, Camila R.
; Weber, Bernardete
; Bersch-Ferreira, Ângela Cristine
.
Resumo Fundamento: A adesão à uma alimentação adequada em macronutrientes é fundamental para a prevenção secundária de doenças cardiovasculares. Objetivo: Avaliar a prevalência de adesão às recomendações de consumo de ácidos graxos para prevenção e tratamento de doenças cardiovasculares, e estimar se a presença de determinados fatores de risco cardiovascular estaria associada à adesão. Métodos: Estudo transversal com os dados de linha de base de 2358 participantes do estudo "Brazilian Cardioprotective Nutritional Program Trial". Dados de consumo alimentar, e fatores de risco cardiovascular foram avaliados. Foi considerada, de acordo com a Sociedade Brasileira de Cardiologia, uma ingestão adequada de ácidos graxos poli-insaturados (AGPI) ≥10% do consumo total de energia diária, para ácidos graxos monoinsaturados (AGM), 20% e para ácidos graxos saturados (AGS), <7%. Na análise estatística foi considerando nível de significância de 5%. Resultados: Nenhum participante aderiu a todas as recomendações de forma simultânea e mais da metade (1482 [62,9%]) não aderiu a nenhuma recomendação. A adesão exclusivamente à recomendação de AGS foi a mais prevalente, sendo cumprida por 659 (28%) dos participantes, seguida da adesão exclusivamente à recomendação de AGP (178 [7,6%]) e de AGM (5 [0,2%]). Não houve associação entre o número de comorbidades e a adesão às recomendações nutricionais (p =0,269). Os participantes da região Nordeste do país apresentaram maior proporção de adesão às recomendações para consumo de AGS (38,42%), e menor para ingestão de AGPI (3,52%) (p <0,001) em comparação às demais. Conclusões: Na amostra avaliada, evidenciou-se baixa adesão às recomendações nutricionais para consumo de ácidos graxos. Fundamento cardiovasculares Objetivo Métodos 235 Brazilian Trial. Trial . Trial" alimentar avaliados considerada Cardiologia poliinsaturados poli insaturados (AGPI 10 ≥10 diária AGM, , (AGM) 20 AGS, (AGS) 7 <7% 5 5% Resultados 1482 (148 62,9% 629 62 9 [62,9%] prevalente 65 28% 28 (28% 178 (17 7,6% 76 6 [7,6%] ( 0,2%. 02 0,2% 0 2 [0,2%]) p =0,269. 0269 =0,269 269 =0,269) 38,42%, 3842 38,42% 38 42 (38,42%) 3,52% 352 3 52 (3,52% <0,001 0001 001 demais Conclusões avaliada evidenciouse evidenciou 23 1 ≥1 (AGM (AGS <7 148 (14 62,9 [62,9% (28 17 (1 7,6 [7,6% 0,2 [0,2%] 026 =0,26 26 384 38,42 4 (38,42% 3,52 35 (3,52 <0,00 000 00 ≥ < 14 62, [62,9 (2 7, [7,6 0, [0,2% =0,2 38,4 (38,42 3,5 (3,5 <0,0 [62, [7, [0,2 =0, 38, (38,4 3, (3, <0, [62 [7 [0, =0 (38, (3 <0 [6 [ [0 = (38
Background: Adhering to a diet adequate in macronutrients is crucial for the secondary prevention of cardiovascular diseases. Objective: To assess the prevalence of adherence to recommendations for the consumption of dietary fatty acids for the prevention and treatment of cardiovascular diseases and to estimate whether the presence of certain cardiovascular risk factors would be associated with adherence. Methods: Cross-sectional study using baseline data from 2,358 participants included in the "Brazilian Cardioprotective Nutritional Program Trial". Dietary intake and cardiovascular risk factors were assessed. Adequate intake of polyunsaturated fatty acids (PUFA) was considered as ≥10% of total daily energy intake; for monounsaturated fatty acids (MUFA), 20%; and for saturated fatty acids (SFA), <7% according to the Brazilian Society of Cardiology. A significance level of 5% was considered in the statistical analysis. Results: No participant adhered to all recommendations simultaneously, and more than half (1,482 [62.9%]) did not adhere to any recommendation. Adherence exclusively to the SFA recommendation was the most prevalent, fulfilled by 659 (28%) participants, followed by adherence exclusively to the PUFA (178 [7.6%]) and MUFA (5 [0.2%]) recommendations. There was no association between the number of comorbidities and adherence to nutritional recommendations (p = 0.269). Participants from the Brazilian Northeast region showed a higher proportion of adherence to SFA consumption recommendations (38.42%) and lower adherence to PUFA intake (3.52%) (p <0.001) compared to other regions. Conclusions: Among the evaluated sample, there was low adherence to nutritional recommendations for dietary fatty acid consumption. Background Objective Methods Crosssectional Cross sectional 2358 2 358 2,35 Trial. Trial . Trial" assessed (PUFA 10 ≥10 MUFA, , (MUFA) 20% 20 SFA, (SFA) 7 <7 Cardiology 5 analysis Results simultaneously 1,482 1482 1 482 (1,48 62.9% 629 62 9 [62.9%] prevalent 65 28% 28 (28% 178 (17 7.6% 76 6 [7.6%] ( 0.2% 02 0 [0.2%] p 0.269. 0269 0.269 269 0.269) 38.42% 3842 38 42 (38.42% 3.52% 352 3 52 (3.52% <0.001 0001 001 regions Conclusions sample 235 35 2,3 ≥1 (MUFA (SFA < 1,48 148 48 (1,4 62.9 [62.9% (28 17 (1 7.6 [7.6% 0.2 [0.2% 026 0.26 26 38.42 384 4 (38.42 3.52 (3.52 <0.00 000 00 23 2, ≥ 1,4 14 (1, 62. [62.9 (2 7. [7.6 0. [0.2 38.4 (38.4 3.5 (3.5 <0.0 1, [62. [7. [0. 38. (38. 3. (3. <0. [62 [7 [0 (38 (3 <0 [6 [
6.
Diretriz de Tomografia Computadorizada e Ressonância Magnética Cardiovascular da Sociedade Brasileira de Cardiologia e do Colégio Brasileiro de Radiologia – 2024 202 20 2
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Magalhães, Tiago Augusto
; Carneiro, Adriano Camargo de Castro
; Moreira, Valéria de Melo
; Trad, Henrique Simão
; Lopes, Marly Maria Uellendahl
; Cerci, Rodrigo Julio
; Nacif, Marcelo Souto
; Schvartzman, Paulo R.
; Chagas, Antônio Carlos Palandrini
; Costa, Isabela Bispo Santos da Silva
; Schmidt, André
; Shiozaki, Afonso Akio
; Montenegro, Sérgio Tavares
; Piegas, Leopoldo Soares
; Zapparoli, Marcelo
; Nicolau, José Carlos
; Fernandes, Fabio
; Hadlich, Marcelo Souza
; Ghorayeb, Nabil
; Mesquita, Evandro Tinoco
; Gonçalves, Luiz Flávio Galvão
; Ramires, Felix José Alvarez
; Fernandes, Juliano de Lara
; Schwartzmann, Pedro Vellosa
; Rassi, Salvador
; Torreão, Jorge Andion
; Mateos, José Carlos Pachón
; Beck-da-Silva, Luiz
; Silva, Marly Conceição
; Liberato, Gabriela
; Oliveira, Gláucia Maria Moraes de
; Feitosa Filho, Gilson Soares
; Carvalho, Hilka dos Santos Moraes de
; Markman Filho, Brivaldo
; Rocha, Ricardo Paulo de Sousa
; Azevedo Filho, Clerio Francisco de
; Taratsoutchi, Flávio
; Coelho-Filho, Otavio Rizzi
; Kalil Filho, Roberto
; Hajjar, Ludhmila Abrahão
; Ishikawa, Walther Yoshiharu
; Melo, Cíntia Acosta
; Jatene, Ieda Biscegli
; Albuquerque, Andrei Skromov de
; Rimkus, Carolina de Medeiros
; Silva, Paulo Savoia Dias da
; Vieira, Thiago Dieb Ristum
; Jatene, Fabio Biscegli
; Azevedo, Guilherme Sant Anna Antunes de
; Santos, Raul D.
; Monte, Guilherme Urpia
; Ramires, José Antonio Franchini
; Bittencourt, Marcio Sommer
; Avezum, Alvaro
; Silva, Leonardo Sara da
; Abizaid, Alexandre
; Gottlieb, Ilan
; Precoma, Dalton Bertolim
; Szarf, Gilberto
; Sousa, Antônio Carlos Sobral
; Pinto, Ibraim Masciarelli Francisco
; Medeiros, Fábio de Morais
; Caramelli, Bruno
; Parga Filho, José Rodrigues
; Santos, Tiago Senra Garcia dos
; Prazeres, Carlos Eduardo Elias dos
; Lopes, Marcelo Antonio Cartaxo Queiroga
; Avila, Luiz Francisco Rodrigues de
; Scanavacca, Mauricio Ibrahim
; Gowdak, Luis Henrique Wolff
; Barberato, Silvio Henrique
; Nomura, Cesar Higa
; Rochitte, Carlos Eduardo
.
7.
Resposta Exagerada da Pressão Arterial Sistólica ao Exercício e Isquemia Miocárdica à Ecocardiografia sob Estresse Físico
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Martins-Santos, Cláudia Bispo
; Duarte, Lara Teles Alencar
; Ferreira-Junior, Cleovaldo Ribeiro
; Feitosa, Allexa Gabriele Teixeira
; Oliveira, Edvaldo Victor Gois
; Campos, Iana Carine Machado Bispo
; Melo, Enaldo Vieira de
; Andrade, Stephanie Macedo
; Sousa, Antônio Carlos Sobral
; Oliveira, Joselina Luzia Menezes
.
Arquivos Brasileiros de Cardiologia
- Métricas do periódico
Resumo Fundamento A associação entre resposta exagerada da pressão arterial sistólica ao exercício (REPASE) e isquemia miocárdica é controversa e pouco estudada em indivíduos com síndrome coronariana crônica estabelecida ou suspeita. Objetivo Verificar a relação entre isquemia miocárdica e REPASE em indivíduos submetidos à ecocardiografia sob estresse físico (EEF). Métodos Trata-se de estudo transversal com 14.367 indivíduos submetidos à EEF, de janeiro de 2000 a janeiro de 2022, divididos em dois grupos: G1 – composto por pacientes cuja pressão sistólica de pico apresentou incremento ≥ 90 mmHg (valor correspondente ao percentil 95 da população estudada) –, e G2 – formado por indivíduos que não apresentaram resposta hipertensiva exagerada. Os grupos foram comparados mediante os testes t de Student e qui-quadrado. Foram considerados significativos os valores de p < 0,05. Realizou-se, também, regressão logística para identificação de fatores de risco independentes para isquemia miocárdica, REPASE, queixa de precordialgia típica prévia ao exame e angina durante o teste. Resultados Dos 14.367 pacientes, 1.500 (10,4%) desenvolveram REPASE e 7.471 (52,0%) eram do sexo feminino. Os percentuais de queixa prévia de precordialgia típica, angina durante o teste e isquemia miocárdica dos pacientes com REPASE foram de 5,8%, 2,4% e 18,1% contra 7,4%, 3,9% e 24,2%, em indivíduos sem REPASE, respectivamente (p = 0,021, p = 0,004, p < 0,001). Na análise multivariada, a REPASE foi associada, independentemente, a uma menor probabilidade de isquemia miocárdica (odds ratio: 0,73; intervalo de confiança de 95%: 0,58 a 0,93; p = 0,009). Conclusão O incremento exagerado da pressão arterial sistólica durante a EEF pode ser um marcador de exclusão de isquemia miocárdica. (REPASE suspeita EEF. . (EEF) Tratase Trata se 14367 14 367 14.36 200 2022 G 9 valor quiquadrado. quiquadrado qui quadrado. quadrado qui-quadrado 005 0 05 0,05 Realizouse, Realizouse Realizou se, Realizou-se também 1500 1 500 1.50 10,4% 104 10 4 (10,4% 7471 7 471 7.47 52,0% 520 52 (52,0% feminino 58 5 8 5,8% 24 2 2,4 181 18 18,1 74 7,4% 39 3 3,9 242 24,2% 0021 021 0,021 0004 004 0,004 0,001. 0001 0,001 001 0,001) multivariada associada independentemente odds ratio 0,73 073 73 95% 058 0,5 0,93 093 93 0,009. 0009 0,009 009 0,009) (EEF 1436 36 14.3 20 202 00 0,0 150 50 1.5 10,4 (10,4 747 47 7.4 52,0 (52,0 5,8 2, 18, 7,4 3, 24,2 002 02 0,02 000 0,00 0,7 07 0, 0,9 09 143 14. 15 1. 10, (10, 7. 52, (52, 5, 7, 24, (10 (52 (1 (5 (
Abstract Background The association between exaggerated systolic blood pressure response to exercise (ESBPRE) and myocardial ischemia is controversial and little studied in patients with established or suspected chronic coronary syndrome. Objective To verify the relationship between myocardial ischemia and ESBPRE in patients undergoing exercise stress echocardiography (ESE). Methods This is a cross-sectional study with 14,367 patients undergoing ESE, from January 2000 to January 2022, divided into the following 2 groups: G1, composed of patients whose peak systolic pressure increased ≥ 90 mmHg (value corresponding to the 95th percentile of the study population), and G2, patients who did not demonstrate an exaggerated hypertensive response. The groups were compared using Student’s t and chi-square tests. P values < 0.05 were considered significant. Logistic regression was also performed to identify independent risk factors for myocardial ischemia, ESBPRE, complaints of typical chest pain prior to the exam, and angina during the test. Results Of the 14,367 patients, 1,500 (10.4%) developed ESBPRE, and 7,471 (52.0%) were female. The percentages of previous complaints of typical chest pain, angina during the test, and myocardial ischemia in patients with ESBPRE were 5.8%, 2.4% and 18.1%, compared to 7.4%, 3.9%, and 24.2%, in patients without ESBPRE, respectively (p = 0.021,p = 0.004, p < 0.001). In multivariate analysis, ESBPRE was independently associated with a lower probability of myocardial ischemia (odds ratio: 0.73; 95% confidence interval: 0.58 to 0.93; p = 0.009). Conclusion Exaggerated increase in systolic blood pressure during ESE may be a marker for excluding myocardial ischemia. (ESBPRE syndrome ESE. . (ESE) crosssectional cross sectional 14367 14 367 14,36 200 2022 G1 G 9 value th population, population , population) G2 Students Student s chisquare chi square tests 005 0 05 0.0 significant exam test 1500 1 500 1,50 10.4% 104 10 4 (10.4% 7471 7 471 7,47 52.0% 520 52 (52.0% female 58 5 8 5.8% 24 2.4 181 18 18.1% 74 7.4% 39 3 3.9% 242 24.2% 0021p 021 0004 004 0.004 0.001. 0001 0.001 001 0.001) analysis odds ratio 0.73 073 73 95 interval 058 0.5 0.93 093 93 0.009. 0009 0.009 009 0.009) (ESE 1436 36 14,3 20 202 00 0. 150 50 1,5 10.4 (10.4 747 47 7,4 52.0 (52.0 5.8 2. 18.1 7.4 3.9 24.2 02 000 0.00 0.7 07 0.9 09 143 14, 15 1, 10. (10. 7, 52. (52. 5. 18. 7. 3. 24. (10 (52 (1 (5 (
8.
Non-Targeted Self-Measured Blood Pressure and Hypertension Control in Public and Private Health Systems in Brazil NonTargeted Non Targeted SelfMeasured Self Measured
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Salazar, Gabriela de Oliveira
; Almeida, Glessiane de Oliveira
; Barreto-Filho, José Augusto Soares
; Almeida-Santos, Marcos Antônio
; Melo, Enaldo Vieira de
; Aidar, Felipe J.
; Cruz, José Ícaro Nunes
; Oliveira, Joselina Luzia Menezes
; Baumworcel, Leonardo
; Sousa, Antônio Carlos Sobral
.
International Journal of Cardiovascular Sciences
- Métricas do periódico
Abstract Background: It is estimated that more than 30% of the Brazilian population has systemic arterial hypertension (SAH), and mostly as an uncontrolled disease. The most recent Brazilian Guideline of Hypertension recommends the practice of self-measurement of blood pressure (BP) as one of the strategies for a better control of SAH, but there is no consensus about the efficiency of this tool. Objective: To assess the control of SAH and the practice of non-targeted self-measured BP (SMBP) among hypertensive users of the Unified Health System (SUS) and the Supplementary Network (SN). Methods: This is a cross-sectional, observational, analytical study, with a stratified probability sample. One thousand volunteers were investigated, being 500 from SUS and 500 from the SN. Uni and multivariate analyses were performed considering a 5% significance level. Results: Patients from SUS presented inferior sociodemographic data (schooling, social status) in relation to those of the SN (p < 0.001), and showed lower control of SAH (p = 0.014), as well as more visits to the emergency room in the past year due to hypertension (p = 0.002), and fewer regular appointments with the cardiologist (p = 0.004). SMBP was equally present in both assessed groups (p = 0.567), even though users of the SN have been more advised to not conduct such a practice (p = 0.002). SMBP (p < 0.001) was an independent factor for uncontrolled SAH both in SUS (OR = 3.424) and in the SN (OR = 3.474). Conclusion: Patients in SUS presented lower SAH control. The practice of SMBP, mostly practiced with an uncalibrated digital device, was equally present in both groups and became an independent factor of uncontrolled SAH. Background 30 , (SAH) disease selfmeasurement self measurement (BP tool Objective nontargeted non targeted selfmeasured measured (SMBP (SUS . (SN) Methods crosssectional, crosssectional cross sectional, sectional cross-sectional observational study sample investigated 50 5 level Results schooling, schooling (schooling status p 0.001, 0001 0.001 0 001 0.014, 0014 0.014 014 0.014) 0.002, 0002 0.002 002 0.002) 0.004. 0004 0.004 004 0.004) 0.567, 0567 0.567 567 0.567) 0.002. OR 3.424 3424 3 424 3.474. 3474 3.474 474 3.474) Conclusion device (SAH (SN 000 0.00 00 0.01 01 056 0.56 56 3.42 342 42 347 3.47 47 0.0 05 0.5 3.4 34 4 0. 3.
9.
Religiosity and Spirituality: The Relationship Between Psychosocial Factors and Cardiovascular Health Spirituality
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Cruz, José Icaro Nunes
; Cardozo, Adelle Cristine Lima
; Melo, Enaldo Vieira de
; Lira, Juliana Maria Chianca
; Santos, Giulia Vieira
; Salazar, Gabriela de Oliveira
; Oliveira, Bruna
; Reis, Mariano César de Souza
; Lima, Diego Maldini Borba de
; Soares, Philipi Santos
; Sousa, Antônio Carlos Sobral
; Oliveira, Joselina Luzia Menezes
.
International Journal of Cardiovascular Sciences
- Métricas do periódico
Abstract Background: Religiosity and Spirituality (R/S), despite being different entities, are multidimensional constructs, whose influence on cardiovascular health has been increasingly studied in recent decades. Objectives: To discriminate patients into subgroups according to R/S levels, in order to compare them regarding the distribution of cardiovascular comorbidities and clinical events. Methods: This is an observational, cross-sectional, analytical study. Two R/S scales were applied to a sample of patients seen at cardiology outpatient clinics. A cluster analysis was used to discriminate individuals into subgroups regarding R/S levels, which were subsequently compared regarding the frequencies of clinical variables related to cardiovascular health. A significance level of 5% was set for the statistical tests. Results: The sample included 237 patients with a mean age of 60.8 years (±10.7), of which 132 were female (55.7%). Cluster analysis (C) distinguished two groups: C1, with lower levels of R/S, and C2, with higher levels of R/S (p<0.001). C2 had a lower frequency of alcohol consumption (29.5% vs. 76.0%; p<0.001), smoking (12.9% vs. 51.0%; p<0.001), systemic arterial hypertension (SAH — 65.5% vs. 82.3%; p=0.005), dyslipidemia (58.3% vs. 77.1%; p=0.003), chronic coronary syndrome (36.7% vs. 58.3%; p=0.001), and prior cardiovascular events (15.8% vs. 36.5%; p<0.001) when compared to C1. There was also a higher frequency of females in C2 (82.0% vs. 17.7%; p<0.001). Conclusions: A better cardiovascular morbidity profile was observed in the group of patients with higher R/S levels, suggesting a probable positive relationship between R/S and cardiovascular health. Background RS , R S (R/S) entities constructs decades Objectives Methods observational crosssectional, crosssectional cross sectional, sectional cross-sectional study clinics 5 tests Results 23 608 60 8 60. ±10.7, 107 ±10.7 10 7 (±10.7) 13 55.7%. 557 55.7% . 55 (55.7%) C (C groups C1 p<0.001. p0001 p p<0.001 0 001 (p<0.001) 29.5% 295 29 (29.5 vs 76.0% 760 76 p<0.001, 12.9% 129 12 9 (12.9 51.0% 510 51 SAH 655 65 65.5 82.3% 823 82 3 p=0.005, p0005 p=0.005 005 p=0.005) 58.3% 583 58 (58.3 77.1% 771 77 1 p=0.003, p0003 p=0.003 003 p=0.003) 36.7% 367 36 (36.7 p=0.001, p=0.001 p=0.001) 15.8% 158 15 (15.8 36.5% 365 82.0% 820 (82.0 17.7% 177 17 Conclusions (R/S 2 6 ±10. (±10.7 55.7 (55.7% p000 p<0.00 00 (p<0.001 29.5 (29. 76.0 12.9 (12. 51.0 65. 82.3 p=0.00 58.3 (58. 77.1 36.7 (36. 15.8 (15. 36.5 82.0 (82. 17.7 ±10 (±10. 55. (55.7 p00 p<0.0 (p<0.00 29. (29 76. 12. (12 51. 82. p=0.0 58. (58 77. 36. (36 15. (15 (82 17. ±1 (±10 (55. p0 p<0. (p<0.0 (2 (1 p=0. (5 (3 (8 ± (±1 (55 p<0 (p<0. ( p=0 (± p< (p<0 p= (p< (p
10.
Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023 202 20 2
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Marin-Neto, José Antonio
; Rassi Jr, Anis
; Oliveira, Gláucia Maria Moraes
; Correia, Luís Claudio Lemos
; Ramos Júnior, Alberto Novaes
; Luquetti, Alejandro Ostermayer
; Hasslocher-Moreno, Alejandro Marcel
; Sousa, Andréa Silvestre de
; Paola, Angelo Amato Vincenzo de
; Sousa, Antônio Carlos Sobral
; Ribeiro, Antonio Luiz Pinho
; Correia Filho, Dalmo
; Souza, Dilma do Socorro Moraes de
; Cunha-Neto, Edecio
; Ramires, Felix Jose Alvarez
; Bacal, Fernando
; Nunes, Maria do Carmo Pereira
; Martinelli Filho, Martino
; Scanavacca, Maurício Ibrahim
; Saraiva, Roberto Magalhães
; Oliveira Júnior, Wilson Alves de
; Lorga-Filho, Adalberto Menezes
; Guimarães, Adriana de Jesus Benevides de Almeida
; Braga, Adriana Lopes Latado
; Oliveira, Adriana Sarmento de
; Sarabanda, Alvaro Valentim Lima
; Pinto, Ana Yecê das Neves
; Carmo, Andre Assis Lopes do
; Schmidt, Andre
; Costa, Andréa Rodrigues da
; Ianni, Barbara Maria
; Markman Filho, Brivaldo
; Rochitte, Carlos Eduardo
; Macêdo, Carolina Thé
; Mady, Charles
; Chevillard, Christophe
; Virgens, Cláudio Marcelo Bittencourt das
; Castro, Cleudson Nery de
; Britto, Constança Felicia De Paoli de Carvalho
; Pisani, Cristiano
; Rassi, Daniela do Carmo
; Sobral Filho, Dário Celestino
; Almeida, Dirceu Rodrigues de
; Bocchi, Edimar Alcides
; Mesquita, Evandro Tinoco
; Mendes, Fernanda de Souza Nogueira Sardinha
; Gondim, Francisca Tatiana Pereira
; Silva, Gilberto Marcelo Sperandio da
; Peixoto, Giselle de Lima
; Lima, Gustavo Glotz de
; Veloso, Henrique Horta
; Moreira, Henrique Turin
; Lopes, Hugo Bellotti
; Pinto, Ibraim Masciarelli Francisco
; Ferreira, João Marcos Bemfica Barbosa
; Nunes, João Paulo Silva
; Barreto-Filho, José Augusto Soares
; Saraiva, José Francisco Kerr
; Lannes-Vieira, Joseli
; Oliveira, Joselina Luzia Menezes
; Armaganijan, Luciana Vidal
; Martins, Luiz Cláudio
; Sangenis, Luiz Henrique Conde
; Barbosa, Marco Paulo Tomaz
; Almeida-Santos, Marcos Antonio
; Simões, Marcos Vinicius
; Yasuda, Maria Aparecida Shikanai
; Moreira, Maria da Consolação Vieira
; Higuchi, Maria de Lourdes
; Monteiro, Maria Rita de Cassia Costa
; Mediano, Mauro Felippe Felix
; Lima, Mayara Maia
; Oliveira, Maykon Tavares de
; Romano, Minna Moreira Dias
; Araujo, Nadjar Nitz Silva Lociks de
; Medeiros, Paulo de Tarso Jorge
; Alves, Renato Vieira
; Teixeira, Ricardo Alkmim
; Pedrosa, Roberto Coury
; Aras Junior, Roque
; Torres, Rosalia Morais
; Povoa, Rui Manoel dos Santos
; Rassi, Sergio Gabriel
; Alves, Silvia Marinho Martins
; Tavares, Suelene Brito do Nascimento
; Palmeira, Swamy Lima
; Silva Júnior, Telêmaco Luiz da
; Rodrigues, Thiago da Rocha
; Madrini Junior, Vagner
; Brant, Veruska Maia da Costa
; Dutra, Walderez Ornelas
; Dias, João Carlos Pinto
.
11.
I Registro de Insuficiência Cardíaca Congestiva do Estado de Sergipe, Brasil: desenho e justificativa
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Barbosa, Juliana Santos
; Costa, Jamille Oliveira
; Alves, Luciana Vieira Sousa
; Souza, Marcia Ferreira Cândido de
; Almeida-Santos, Marcos Antonio
; Oliveira, Joselina Luzia Menezes
; Barreto Filho, José Augusto Soares
; Aidar, Felipe José
; Sousa, Antônio Carlos Sobral
.
ABSTRACT The Heart Failure (HF) is responsible for a large number of hospitalizations in Brazil, but there is still a considerable gap in the scrutiny of the public health system (SUS) regarding the quality of care provided. Objective: to describe the methodology used in the VICTIM-CHF study, which aims to characterize and compare the nutritional, clinical, lifestyle, treatment received, outcomes, as well as the possible disparities observed among patients in Brazil. Methodology: This is a cross-sectional, descriptive and prospective study, carried out with patients with heart failure (HF) admitted to 4 hospitals in Sergipe, Brazil. Clinical, sociodemographic, nutritional, quality of life and outcomes (death and readmission) parameters will be investigated up to 30 days after hospital discharge. Preliminary results of ten volunteers: 70% were male, 60% adults. The most frequent etiology was ischemic (50%), 50% had HF with preserved ejection fraction (EF) and the remainder, with intermediate EF. Malnutrition, according to BMI, was present in 20% and the hospital stay was significantly (p= 0.036) longer in SUS users. Conclusion: The VICTIM-CHF Registry aims to identify opportunities for improvement in the line of care for HF users of the SUS and the supplementary health system. It is hoped that the findings of this investigation can help to optimize the strategic planning of more efficient and equitable health policies.
RESUMO A Insuficiência Cardíaca (IC) é responsável por um grande número de internações no Brasil, mas ainda existe considerável lacuna escrutinizando o sistema de saúde pública (SUS) no tocante a qualidade assistencial praticada. Objetivo: descrever a metodologia empregada no estudo VICTIM-CHF que tem como objetivo caracterizar e comparar os aspectos nutricionais, clínicos, estilo de vida, tratamento recebido, desfechos, bem como as possíveis disparidades observadas entre os pacientes Brasil, mas ainda existe considerável lacuna escrutinizando o sistema de saúde pública (SUS) no tocante a qualidade assistencial praticada. Métodologia: Trata-se de estudo transversal, descritivo e prospective, realizado com portadores de insuficiência cardíaca (IC), internados em 4 hospitais de Sergipe, Brasil. Serão investigados parâmetros clínicos, sociodemográficos, nutricionais, qualidade de vida e desfechos (morte e reinternação) até 30 dias após a alta hospitalar. Resultados preliminaries de dez voluntários: 70% eram do sexo masculine, sendo 60% adultos. A etiologia mais frequente foi a isquêmica (50%), 50% exibia IC pcom fração de ejeção (FE) preservada e o restante, com FE intermediária. Desnutrição, segundo o IMC, esteve presente em 20% e o período de internação foi, significativamente (p= 0,036) superior nos usuários do SUS. Conclusão: O Registro VICTIM-CHF visa identificar oportunidades de melhoria na linha de cuidado para a IC de usuários do SUS e do Sistema de saúde suplementar. Espera-se que os achados desta investigação possam ajudar a otimizar o planejamento estratégico de políticas de saúde mais eficientes e equânimes.
12.
[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio
Rassi Jr., Anis
Moraes Oliveira, Gláucia M.
Lemos Correia, Luís Claudio
Novaes Ramos Jr., Alberto
Hasslocher-Moreno, Alejandro Marcel
Luquetti Ostermayer, Alejandro
Sousa, Andréa Silvestre de
Amato Vincenzo de Paola, Angelo
Sobral de Sousa, Antonio Carlos
Pinho Ribeiro, Antonio Luiz
Correia Filho, Dalmo
Moraes de Souza, Dilma do Socorro
Cunha-Neto, Edecio
J. A. Ramires, Felix
Bacal, Fernando
Pereira Nunes, Maria do Carmo
Martinelli Filho, Martino
Ibrahim Scanavacca, Maurício
Magalhães Saraiva, Roberto
Alves de Oliveira Júnior, Wilson
M. Lorga-Filho, Adalberto
de Jesus Benevides de Almeida Guimarães, Adriana
Lopes Latado Braga, Adriana
Sarmento de Oliveira, Adriana
V. L. Sarabanda, Alvaro
Yecê das Neves Pinto, Ana
Assis Lopes do Carmo, André
Schmidt, André
Costa, Andréa Rodrigues da
Ianni, Barbara Maria
Markman Filho, Brivaldo
Eduardo Rochitte, Carlos
Thé Macedo, Carolina
Mady, Charles
Chevillard, Christophe
Bittencourt das Virgens, Cláudio Marcelo
Nery de Castro, Cleudson
De Paoli de Carvalho Britto, Constança Felícia
Pisani, Cristiano
do Carmo Rassi, Daniela
C. Sobral Filho, Dario
Rodrigues Almeida, Dirceu
A. Bocchi, Edimar
T. Mesquita, Evandro
de Souza Nogueira Sardinha Mendes, Fernanda
Pereira, Francisca Tatiana
Sperandio da Silva, Gilberto Marcelo
de Lima Peixoto, Giselle
Glotz de Lima, Gustavo
H. Veloso, Henrique
Turin Moreira, Henrique
Bellotti Lopes, Hugo
Masciarelli Francisco Pinto, Ibraim
Pinto Dias, João Carlos
Bemfica, João Marcos
Silva-Nunes, João Paulo
Soares Barreto-Filho, José Augusto
Kerr Saraiva, José Francisco
Lannes-Vieira, Joseli
Menezes Oliveira, Joselina Luzia
V. Armaganijan, Luciana
Martins, Luiz Cláudio
C. Sangenis, Luiz Henrique
Barbosa, Marco Paulo
Almeida-Santos, Marcos Antônio
Simões, Marcos Vinicius
Shikanai-Yasuda, Maria Aparecida
Vieira Moreira, Maria da Consolação
Higuchi, Maria de Lourdes
Costa Monteiro, Maria Rita de Cássia
Felix Mediano, Mauro Felippe
Maia Lima, Mayara
T. Oliveira, Maykon
Moreira Dias Romano , Minna
Nitz, Nadjar
de Tarso Jorge Medeiros, Paulo
Vieira Alves, Renato
Alkmim Teixeira, Ricardo
Coury Pedrosa, Roberto
Aras, Roque
Morais Torres, Rosália
dos Santos Povoa, Rui Manoel
Rassi, Sérgio Gabriel
Salles Xavier, Sérgio
Marinho Martins Alves , Silvia
B. N. Tavares, Suelene
Lima Palmeira, Swamy
da Silva Junior, Telêmaco Luiz
da Rocha Rodrigues, Thiago
Madrini Junior, Vagner
Maia da Costa , Veruska
Dutra, Walderez
This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp;
Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.
nbsp;
Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp;
The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp;
The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp;
Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.
Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou.
A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica.
Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas.
A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica.
A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp;
Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;
13.
Diretrizes, Posicionamentos e Normatizações: Documentos de Auxílio à Prática Médica
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Sousa, Antônio Carlos Sobral
; Corrêa Filho, Harry
; Nascimento, Bruno
; Issa, Aurora Castro
; Vieira, Marcelo Luiz Campos
; Markman Filho, Brivaldo
.
Arquivos Brasileiros de Cardiologia
- Métricas do periódico
14.
Subclinical Systolic Dysfunction during Chemotherapy for Breast Cancer
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Barroso, Geanne Maria Holanda de Menezes
; Teles, Júlio César Oliveira Costa
; Silva, Paulo Victor de Jesus
; Fonseca, Karin Yasmin Santos
; Aragão, Vinícius Antônio Santos
; Aquino, Marília Marques
; Melo, Enaldo Vieira de
; Ferreira, Karina Oliveira
; Assis, Ronnei José Feitosa de
; Alves, Michel Fabiano Silva
; Sousa, Antônio Carlos Sobral
; Oliveira, Joselina Luzia Menezes
.
International Journal of Cardiovascular Sciences
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Abstract Background Cardiotoxicity is the main complication related to cancer therapy. Studies indicate that global longitudinal strain is an early detector of subclinical dysfunction of the left ventricle, preceding the decline in ejection fraction (EF). However, the reproducibility of such methodology has not been tested outside specialized centers. Objectives To assess the frequency of subclinical cardiotoxicity and to compare global longitudinal strain and EF measurements during the clinical course of patients undergoing chemotherapy for breast cancer. Methods This was an observational prospective study of 78 adult women who underwent serial echocardiograms (baseline and 1, 3, and 6 months after the beginning of chemotherapy), to evaluate biplane and 3D EF and global longitudinal strain. Cardiotoxicity and subclinical dysfunction were defined according to American Society of Echocardiography/European Association of Cardiovascular Imaging criteria. Statistical significance was set at p < 0.05. Results The mean age of the patients was 50.1 ± 11.48 years. The frequency of subclinical cardiotoxicity (defined by global longitudinal strain) was 14.9% after 30 days of chemotherapy, 16.7% after 3 months, and 19.7% after 6 months, compared to 4.5%, 3%, and 6.6%, respectively, when clinical cardiotoxicity was determined according to EF. The group that developed subclinical cardiotoxicity by 30 days (group A) had a higher frequency of clinical cardiotoxicity at 3 months (p=0.028) and a lower mean biplane EF after 30 days (p= 0.036) than the group that showed no evidence of subclinical cardiotoxicity (group B). Conclusion Subclinical cardiotoxicity was frequent and began early, being associated with a drop in EF during the clinical course.
15.
Influence of Factors Affecting Quality of Life on in-Hospital Cardiovascular Events of Patients with Acute Myocardial Infarction with and without ST-segment Elevation
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Jesus, Monique Tavares de
; Costa, Ingrid Maria Novais Barros de Carvalho
; Silva, Danielle Góes da
; Silva, José Rodrigo Santos
; Barreto-Filho, José Augusto Soares
; Almeida-Santos, Marcos Antonio
; Oliveira, Joselina Luzia Meneses
; Buarque, Mirella Dornelas Batalha Moreira
; Andrade, Fabrício Anjos de
; Sousa, Antônio Carlos Sobral
.
International Journal of Cardiovascular Sciences
- Métricas do periódico
Abstract Background Acute myocardial infarction (AMI), with and without ST-segment elevation (STEMI and NSTEMI, respectively), is the principal cause of cardiovascular morbidity and mortality in Brazil and around the world. Modifiable risk factors (RF) and quality of life (QOL) may correlate with the type of AMI. Objective To evaluate the influence of QOL and RF on the type of AMI and in-hospital cardiovascular events in STEMI and NSTEMI patients. Methods This was an observational, cross-sectional study. Patients with AMI attending four referral hospitals (three private and one public) for cardiovascular disease treatment were assessed for QOL using the Brazilian version of the 36-item short form survey. A p < 0.05 was considered statistically significant. Results We evaluated 480 volunteers; 51% were treated in one of the private hospitals. In total, 55.6% presented with STEMI, and 44.4% with NSTEMI. Patients from the public hospital were 8.56 times more likely to have STEMI compared to those from the private hospitals. There was a higher prevalence of smokers in STEMI (p < 0.028) patients. QOL was not associated with the type of AMI. A negative patient perception of the physical health and pain domains was observed. Although a significant difference between the physical and the mental health domains was not observed, individual domains were correlated with some in-hospital outcomes. Conclusion There was a higher prevalence of smokers among individuals with STEMI. Domains of QOL showed a statistically significant relationship with the occurrence of in-hospital cardiovascular events, with no difference between the types of AMI.
https://doi.org/10.36660/ijcs.20190185
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