M. A. Pacheco, S. M. Cardoso, M. Honicky, Y. M. Moreno, Luiz Rodrigo Augustemak de Lima, Camila Souza Marcos, I. C. Back
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{"title":"HDL-Cholesterol in Children and Adolescents with Congenital Heart Disease","authors":"M. A. Pacheco, S. M. Cardoso, M. Honicky, Y. M. Moreno, Luiz Rodrigo Augustemak de Lima, Camila Souza Marcos, I. C. Back","doi":"10.36660/ijcs.20210106","DOIUrl":"https://doi.org/10.36660/ijcs.20210106","url":null,"abstract":",","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88501291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Sickle cell anemia (SCA) is a genetic disease associated with frequent episodes of acute illness. Changes in the lipid profile and a chronic inflammatory process make up the molecular aspects observed in this disease. Associations between these mechanisms and clinical manifestations could thus define severity profiles and therapeutic strategies. Objectives: To verify whether there is an association between lipid profile and clinical manifestations in patients with SCA and if there is a correlation between lipid profile and laboratory markers in this disease. Methodology: According to the PRISMA guidelines, a systematic review of the literature was conducted by searching the MEDLINE/PubMed, LILACS, SciELO, Scopus, and Cochrane databases. Articles were screened by reading the titles and abstracts, reaching those selected for full-text reading. The included studies were published between 2010 and 2020, were fully available in the databases, and addressed the proposed theme. The risk of individual bias was assessed by using the Joanna Briggs Institute checklist and the Newcastle-Ottawa scale. Results: Out of the 144 identified articles, 15 were selected for analysis, resulting in a sample size of 2,230 individuals. HDL-C, LDL-C, total cholesterol , and triglycerides were the main variables analyzed in the lipid profiles. A correlation was observed between these variables and some of the most relevant clinical events in the disease, including vaso-occlusive seizures and acute thoracic syndrome. Conclusion: Lipid metabolism disorders, especially hypocholesterolemia and hypertriglyceridemia, are linked to clinical events observed in SCA, suggesting they play a relevant role in the multifactorial pathogenesis of this disease.
{"title":"Association Between Lipid Profile and Clinical Manifestations in Sickle Cell Anemia: A Systematic Review","authors":"Marina Tejo Dantas, A. Lopes, A. Ladeia","doi":"10.36660/ijcs.20220010","DOIUrl":"https://doi.org/10.36660/ijcs.20220010","url":null,"abstract":"Introduction: Sickle cell anemia (SCA) is a genetic disease associated with frequent episodes of acute illness. Changes in the lipid profile and a chronic inflammatory process make up the molecular aspects observed in this disease. Associations between these mechanisms and clinical manifestations could thus define severity profiles and therapeutic strategies. Objectives: To verify whether there is an association between lipid profile and clinical manifestations in patients with SCA and if there is a correlation between lipid profile and laboratory markers in this disease. Methodology: According to the PRISMA guidelines, a systematic review of the literature was conducted by searching the MEDLINE/PubMed, LILACS, SciELO, Scopus, and Cochrane databases. Articles were screened by reading the titles and abstracts, reaching those selected for full-text reading. The included studies were published between 2010 and 2020, were fully available in the databases, and addressed the proposed theme. The risk of individual bias was assessed by using the Joanna Briggs Institute checklist and the Newcastle-Ottawa scale. Results: Out of the 144 identified articles, 15 were selected for analysis, resulting in a sample size of 2,230 individuals. HDL-C, LDL-C, total cholesterol , and triglycerides were the main variables analyzed in the lipid profiles. A correlation was observed between these variables and some of the most relevant clinical events in the disease, including vaso-occlusive seizures and acute thoracic syndrome. Conclusion: Lipid metabolism disorders, especially hypocholesterolemia and hypertriglyceridemia, are linked to clinical events observed in SCA, suggesting they play a relevant role in the multifactorial pathogenesis of this disease.","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89009658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The acute complications of myocardial infarction (MI), such as mechanical, arrhythmic, ischemic, and inflammatory sequelae, may be responsible for significant cardiovascular morbimortality.1 Life-threatening arrhythmias, namely ventricular fibrillation or tachycardia, may be a challenging complication requiring a prompt approach. In some cases, acute ischemia leads to polymorphic ventricular tachycardia (PVT), and, rarely, to potentially lethal torsades de pointes ventricular tachycardia.2-3 Another potential complication in the onset or after a MI is a cerebral infarction. The expression “cardiocerebral infarction” was first described by Omar et al.,5 in 2010. It can be classified as “synchronous” or “metachronous” which are simultaneous or sequential infarctions in the cerebral and coronary vascular territories, respectively.4-5 In-hospital stroke after an acute coronary syndrome is estimated around 0.9% with the highest incidence for ST segment elevation myocardial infarction (STEMI). Despite uncommon, it is a severe complication with a tough and unclear management.6-8
{"title":"Cardiocerebral Infarction: A Combination to Prevent","authors":"M. Cabral, A. Ponciano, Beatriz Santos, J. Morais","doi":"10.36660/ijcs.20210276","DOIUrl":"https://doi.org/10.36660/ijcs.20210276","url":null,"abstract":"The acute complications of myocardial infarction (MI), such as mechanical, arrhythmic, ischemic, and inflammatory sequelae, may be responsible for significant cardiovascular morbimortality.1 Life-threatening arrhythmias, namely ventricular fibrillation or tachycardia, may be a challenging complication requiring a prompt approach. In some cases, acute ischemia leads to polymorphic ventricular tachycardia (PVT), and, rarely, to potentially lethal torsades de pointes ventricular tachycardia.2-3 Another potential complication in the onset or after a MI is a cerebral infarction. The expression “cardiocerebral infarction” was first described by Omar et al.,5 in 2010. It can be classified as “synchronous” or “metachronous” which are simultaneous or sequential infarctions in the cerebral and coronary vascular territories, respectively.4-5 In-hospital stroke after an acute coronary syndrome is estimated around 0.9% with the highest incidence for ST segment elevation myocardial infarction (STEMI). Despite uncommon, it is a severe complication with a tough and unclear management.6-8","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84753556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patrícia de Souza Pinheiro, Vitor Manoel Pereira Azevedo, G. Rocha
Background: In tetralogy of Fallot, correction surgery is a priority choice, seeing that it is desirable to minimize pulmonary hypoflow and severe hypoxemia, which result in hypoxemic crises, with sudden worsening of cyanosis, tachypnea, and, in some cases, loss of consciousness, seizures, and even death. Objective: To evaluate the predicting factors of surgical mortality in children and adolescents undergoing correction of tetralogy of Fallot. Methods: Retrospective cross-sectional study carried out by consulting all surgical records of the Child and Adolescent Cardiology Service of the Brazilian National Institute of Cardiology , during the period from 2007 to 2010. Results with p values < 0.05 were considered significant . Results: The study evaluated 93 medical records. In relation to the characteristics of the population at the time of surgery, the median age was 3.69 (2.13 to 5.79) years, and 58.06% (n = 54) were male. White was the most common skin color, accounting for 55.43% (n = 51) of cases. In relation to assessment of nutritional status, median weight was 13.25 (10.10 to 17.60) kg, and body mass index was 14.49 (13.44 to 16.28) kg/m2. Down syndrome was present in 11.83% (n = 11) of the patients. All patients underwent correction surgery (n = 93, 100%). Prior cyanotic crisis was found in 53.85% (n = 49) with p = 0.013; surgical procedure duration was 218.83 ± 60.63 minutes, with p = 0.003, and lactate was 1.88 ± 1.33 mg/dL during the immediate postoperative period, with p = 0.009. Regarding the outcome of surgical death, it was found in 15.05% (n = 14) of patients. Mean follow-up lasted 5.68 ± 3.76 years. Conclusions: According to the factors analyzed, the duration of the surgical procedure, prior cyanotic crisis, and blood lactate level may be relevant to surgical mortality.
{"title":"Predicting Factors of Surgical Mortality in Children and Adolescents Undergoing Correction of Tetralogy of Fallot","authors":"Patrícia de Souza Pinheiro, Vitor Manoel Pereira Azevedo, G. Rocha","doi":"10.36660/ijcs.20200394","DOIUrl":"https://doi.org/10.36660/ijcs.20200394","url":null,"abstract":"Background: In tetralogy of Fallot, correction surgery is a priority choice, seeing that it is desirable to minimize pulmonary hypoflow and severe hypoxemia, which result in hypoxemic crises, with sudden worsening of cyanosis, tachypnea, and, in some cases, loss of consciousness, seizures, and even death. Objective: To evaluate the predicting factors of surgical mortality in children and adolescents undergoing correction of tetralogy of Fallot. Methods: Retrospective cross-sectional study carried out by consulting all surgical records of the Child and Adolescent Cardiology Service of the Brazilian National Institute of Cardiology , during the period from 2007 to 2010. Results with p values < 0.05 were considered significant . Results: The study evaluated 93 medical records. In relation to the characteristics of the population at the time of surgery, the median age was 3.69 (2.13 to 5.79) years, and 58.06% (n = 54) were male. White was the most common skin color, accounting for 55.43% (n = 51) of cases. In relation to assessment of nutritional status, median weight was 13.25 (10.10 to 17.60) kg, and body mass index was 14.49 (13.44 to 16.28) kg/m2. Down syndrome was present in 11.83% (n = 11) of the patients. All patients underwent correction surgery (n = 93, 100%). Prior cyanotic crisis was found in 53.85% (n = 49) with p = 0.013; surgical procedure duration was 218.83 ± 60.63 minutes, with p = 0.003, and lactate was 1.88 ± 1.33 mg/dL during the immediate postoperative period, with p = 0.009. Regarding the outcome of surgical death, it was found in 15.05% (n = 14) of patients. Mean follow-up lasted 5.68 ± 3.76 years. Conclusions: According to the factors analyzed, the duration of the surgical procedure, prior cyanotic crisis, and blood lactate level may be relevant to surgical mortality.","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85390143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paula Monique Chiconi de Picoli, C. Amaral, E. Trovatti
Background: Atherosclerosis is a condition in which fats, cholesterol, fibrin, and other substances accumulate into plaque on the arterial walls. Plaque can harden and narrow the arteries, in turn limiting the blood flow and resulting in diseases, such as acute myocardial infarction (AMI), ischemic stroke (IS), or peripheral arterial disease (PAD). There is a fairly high risk of a secondary atherosclerotic event if patients are not treated after the primary episode. Objective: To calculate the statistical probability of developing AMI, IS, or PAD after treating the primary disease. Methods: Data for statistical probability studies included 507,690 patients with primary atherosclerotic disease, who were in treatment during the study period and who did or did not develop a secondary atherosclerotic disease event. Result: Statistical probability data indicate that few AMI patients can develop IS (2.99%) or PAD (2.86%) as a secondary disease. Patients with primary diagnoses of IS showed a 5.07% risk of developing PAD and a 0.95% risk of developing AMI; however, PAD patients showed a higher probability for both AMI (9.17%) and IS (8.79%). Conclusion: Secondary atherosclerotic disease episodes after IS, AMI, and PAD were confirmed by statistical probability and are consistent with data from the literature. The study revealed that a primary PAD event leads to high rates of secondary episodes, and special attention should be given to the diagnosis and treatment of PAD in order to decrease the occurrence of secondary events.
{"title":"The Influence of Primary Atherosclerotic Diseases on the Occurrence of Secondary Disease","authors":"Paula Monique Chiconi de Picoli, C. Amaral, E. Trovatti","doi":"10.36660/ijcs.20210251","DOIUrl":"https://doi.org/10.36660/ijcs.20210251","url":null,"abstract":"Background: Atherosclerosis is a condition in which fats, cholesterol, fibrin, and other substances accumulate into plaque on the arterial walls. Plaque can harden and narrow the arteries, in turn limiting the blood flow and resulting in diseases, such as acute myocardial infarction (AMI), ischemic stroke (IS), or peripheral arterial disease (PAD). There is a fairly high risk of a secondary atherosclerotic event if patients are not treated after the primary episode. Objective: To calculate the statistical probability of developing AMI, IS, or PAD after treating the primary disease. Methods: Data for statistical probability studies included 507,690 patients with primary atherosclerotic disease, who were in treatment during the study period and who did or did not develop a secondary atherosclerotic disease event. Result: Statistical probability data indicate that few AMI patients can develop IS (2.99%) or PAD (2.86%) as a secondary disease. Patients with primary diagnoses of IS showed a 5.07% risk of developing PAD and a 0.95% risk of developing AMI; however, PAD patients showed a higher probability for both AMI (9.17%) and IS (8.79%). Conclusion: Secondary atherosclerotic disease episodes after IS, AMI, and PAD were confirmed by statistical probability and are consistent with data from the literature. The study revealed that a primary PAD event leads to high rates of secondary episodes, and special attention should be given to the diagnosis and treatment of PAD in order to decrease the occurrence of secondary events.","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75769515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Abreu, T. Diógenes, M. Abreu, H. Costa, A. G. P. Farias, Marcia Maria Carneiro
Background: Coronary flow and myocardial contractile performance assessed by strain magnitude increase during a dobutamine stress echocardiogram (DSE). Normal coronary flow reserve (CFR) can be attained upon completion of a DSE at age-predicted maximum heart rate (HR) (HRmax = 220 - age)] or submaximal HR [(0.85) HRmax] or before completion (early CFR). Objective: To ascertain the association between delta strain and HR in patients with early normal CFR. Methods : This prospective study included patients whose normal CFR was obtained before the DSE was completed. Percentage of resting HR (%HRrest) = [(HRrest ÷ HRmax) 100]% and %HR CFR = [(HR at the time of CFR attainment) ÷ (HRmax) 100]% were recorded. Strain was assessed in the left ventricular region of interest, and delta strain was calculated as the difference between the measures obtained at HRrest and after the DSE was completed. Strain agreement analysis for HRrest, %HRrest, and %HR CFR was performed using the kappa coefficient. The Shapiro-Wilk test was used to assess data normality, and the Mann-Whitney test was used to compare the groups. A p-value < 0.05 was considered statistically significant. Results: Strain measured -23.3% ± 4.3% at baseline and -31.1% ± 4.9% during the DSE. In delta strain > 8 absolute points, the ROC curves showed an area under the curve of 0.874 ± 0.07 for %HRrest (p = 0.001) and an area under the curve of 0.862 ± 0.07 for %HR CFR (p = 0.001). In delta strain > 8 points, %HRrest ≤ 42.6% of HRmax and %HR CFR ≤ 62.5% of HRmax showed an accuracy of 82.9% and 79.8%, respectively. Conclusion : In this study, lower HRrest and HR at the time of CFR attainment had a good association with better myocardial contractile performance, according to the change in strain magnitude.
{"title":"Strain Magnitude Assessed at Rest and During Stress Echocardiography in Patients with Normal Coronary Flow Reserve","authors":"J. Abreu, T. Diógenes, M. Abreu, H. Costa, A. G. P. Farias, Marcia Maria Carneiro","doi":"10.36660/ijcs.20210244","DOIUrl":"https://doi.org/10.36660/ijcs.20210244","url":null,"abstract":"Background: Coronary flow and myocardial contractile performance assessed by strain magnitude increase during a dobutamine stress echocardiogram (DSE). Normal coronary flow reserve (CFR) can be attained upon completion of a DSE at age-predicted maximum heart rate (HR) (HRmax = 220 - age)] or submaximal HR [(0.85) HRmax] or before completion (early CFR). Objective: To ascertain the association between delta strain and HR in patients with early normal CFR. Methods : This prospective study included patients whose normal CFR was obtained before the DSE was completed. Percentage of resting HR (%HRrest) = [(HRrest ÷ HRmax) 100]% and %HR CFR = [(HR at the time of CFR attainment) ÷ (HRmax) 100]% were recorded. Strain was assessed in the left ventricular region of interest, and delta strain was calculated as the difference between the measures obtained at HRrest and after the DSE was completed. Strain agreement analysis for HRrest, %HRrest, and %HR CFR was performed using the kappa coefficient. The Shapiro-Wilk test was used to assess data normality, and the Mann-Whitney test was used to compare the groups. A p-value < 0.05 was considered statistically significant. Results: Strain measured -23.3% ± 4.3% at baseline and -31.1% ± 4.9% during the DSE. In delta strain > 8 absolute points, the ROC curves showed an area under the curve of 0.874 ± 0.07 for %HRrest (p = 0.001) and an area under the curve of 0.862 ± 0.07 for %HR CFR (p = 0.001). In delta strain > 8 points, %HRrest ≤ 42.6% of HRmax and %HR CFR ≤ 62.5% of HRmax showed an accuracy of 82.9% and 79.8%, respectively. Conclusion : In this study, lower HRrest and HR at the time of CFR attainment had a good association with better myocardial contractile performance, according to the change in strain magnitude.","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86309838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bruna Fraga dos Santos, B. Eibel, Ana Lúcia Grasel Antunes, Claudia M. Martins, R. D. Giustina, Melina Borba Duarte, Izabele Vian da Silveira Corrêa
Background: Cardiovascular diseases are the major cause of hospitalization. Dietary salt restriction is indicated as part of clinical treatment, however, it is not always well accepted by the patients, resulting in low food intake and malnutrition. Objective: To compare acceptance of a low-sodium diet cooked with salt with a standard low-sodium diet in cardiac inpatients. Methods: A randomized controlled crossover trial in patients with low-sodium diet prescriptions (Clinical Trials NCT03481322). Patients were given a control standard low sodium diet (cooked without salt; salt [2g per meal] added by the patient at the time of consumption) on one day and on the next day patients were given the intervention diet – a low sodium diet cooked with salt (2 grams of salt, divided between preparations). Dietary acceptance was evaluated by weighing leftover food and calculating intake. A questionnaire was used to verify reasons that influenced acceptance. For data analysis, parametric data are presented as mean and standard deviation, Student’s t test was used to compare means, with significance defined as p<0.05. Results: Sixty-four patients were evaluated, with a mean age of 66 ± 11.3 years; 64% were male. There were no differences in percentage acceptance between the standard low-sodium diet and the low-sodium diet cooked with salt at lunch (p= 0.876) or at dinner (p= 0.255). Around 80% of what was offered at each meal was consumed by the patients, with no significant difference between groups. Conclusions: The low-sodium diet cooked with salt was well accepted, but there was no difference when compared with the standard low-sodium diet, which also had adequate acceptance.
{"title":"Acceptance of Low-Sodium Hospital Diet by Cardiac Patients: A Randomized Controlled Crossover Trial","authors":"Bruna Fraga dos Santos, B. Eibel, Ana Lúcia Grasel Antunes, Claudia M. Martins, R. D. Giustina, Melina Borba Duarte, Izabele Vian da Silveira Corrêa","doi":"10.36660/ijcs.20200345","DOIUrl":"https://doi.org/10.36660/ijcs.20200345","url":null,"abstract":"Background: Cardiovascular diseases are the major cause of hospitalization. Dietary salt restriction is indicated as part of clinical treatment, however, it is not always well accepted by the patients, resulting in low food intake and malnutrition. Objective: To compare acceptance of a low-sodium diet cooked with salt with a standard low-sodium diet in cardiac inpatients. Methods: A randomized controlled crossover trial in patients with low-sodium diet prescriptions (Clinical Trials NCT03481322). Patients were given a control standard low sodium diet (cooked without salt; salt [2g per meal] added by the patient at the time of consumption) on one day and on the next day patients were given the intervention diet – a low sodium diet cooked with salt (2 grams of salt, divided between preparations). Dietary acceptance was evaluated by weighing leftover food and calculating intake. A questionnaire was used to verify reasons that influenced acceptance. For data analysis, parametric data are presented as mean and standard deviation, Student’s t test was used to compare means, with significance defined as p<0.05. Results: Sixty-four patients were evaluated, with a mean age of 66 ± 11.3 years; 64% were male. There were no differences in percentage acceptance between the standard low-sodium diet and the low-sodium diet cooked with salt at lunch (p= 0.876) or at dinner (p= 0.255). Around 80% of what was offered at each meal was consumed by the patients, with no significant difference between groups. Conclusions: The low-sodium diet cooked with salt was well accepted, but there was no difference when compared with the standard low-sodium diet, which also had adequate acceptance.","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84761289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bruno G. Durante, R. Ferreira-Silva, T. T. Goya, M. Lima, A. C. T. Rodrigues, L. Drager, C. Jordão, A. Rodrigues, M. J. Alves, G. Lorenzi-Filho, C. Negrão, L. M. Ueno-Pardi
Background: Exercise training (ET) is an adjunctive treatment for obstructive sleep apnea (OSA) and its consequences. However, the effects of exercise on heart remodeling are unknown in the population with OSA. Objective: We investigated the effect of ET on markers of diastolic function, sleep parameters, and functional capacity in patients with OSA. Methods: Sedentary patients with OSA (apnea-hypopnea index, AHI ≥15 events/hr) were randomly assigned to untrained (n=18) and trained (n=20) strategies. Polysomnography, cardiopulmonary exercise test, and echocardiography were evaluated at the beginning and end of the study. ET consisted of 3 weekly sessions of aerobic exercise, resistance exercises, and flexibility training (72 sessions, completed in 11.65±0.86 months). A two-way analysis of variance (ANOVA) was used, followed by Tukey's post-hoc test. The level of statistical significance was set at p<0.05 for all analyses. Result: Thirty-eight patients were included (AHI:45±29 events/hr, age:52±7 y, body mass index: 30±4 kg/m 2 ). They had similar baseline parameters. ET caused a significant change in OSA severity (AHI:4.5±18 versus -5.7±13 events/ hr; arousal index:1.5±8 versus -6.1±13 events/hr, in untrained and trained groups respectively, p<0.05). The trained patients had an increase in functional capacity after intervention. ET improved isovolumetric relaxation time (IVRT, untrained=6.5±17.3 versus trained=-5.1±17.1 msec, p<0.05). There was a significant correlation between changes in IVRT and arousal index in the trained group (r =-0.54, p<0.05). No difference occurred in the other diastolic function parameters evaluated. Conclusion: ET promotes modest but significant improvement in AHI, functional capacity, and cardiac IVRT, a validated parameter of diastolic function.
背景:运动训练(ET)是一种辅助治疗阻塞性睡眠呼吸暂停(OSA)及其后果。然而，在OSA患者中，运动对心脏重塑的影响尚不清楚。目的:探讨ET对OSA患者舒张功能、睡眠参数和功能容量指标的影响。方法:将久坐不动的OSA(呼吸暂停-低通气指数，AHI≥15事件/小时)患者随机分为未训练组(n=18)和训练组(n=20)。在研究开始和结束时分别对多导睡眠图、心肺运动试验和超声心动图进行评估。ET包括每周3次有氧运动、阻力运动和柔韧性训练(72次，在11.65±0.86个月内完成)。采用双向方差分析(ANOVA)，然后进行Tukey事后检验。所有分析的统计学意义水平均为p<0.05。结果:纳入38例患者(AHI:45±29事件/小时，年龄:52±7岁，体重指数:30±4 kg/ m2)。他们有相似的基线参数。ET引起OSA严重程度的显著变化(AHI:4.5±18 vs -5.7±13事件/小时;唤醒指数:未训练组和训练组分别为1.5±8 vs -6.1±13事件/小时，p<0.05)。经过训练的患者在干预后功能能力有所提高。ET改善了等容松弛时间(IVRT，未训练=6.5±17.3 vs训练=-5.1±17.1 msec, p<0.05)。训练组IVRT变化与觉醒指数有显著相关(r =-0.54, p<0.05)。其他舒张功能参数评估无差异。结论:ET促进了AHI、功能容量和心脏IVRT(舒张功能的一个有效参数)适度但显著的改善。
{"title":"Effects of Exercise Training on Left Ventricular Diastolic Function Markers in Patients with Obstructive Sleep Apnea: A Randomized Study","authors":"Bruno G. Durante, R. Ferreira-Silva, T. T. Goya, M. Lima, A. C. T. Rodrigues, L. Drager, C. Jordão, A. Rodrigues, M. J. Alves, G. Lorenzi-Filho, C. Negrão, L. M. Ueno-Pardi","doi":"10.36660/ijcs.20210146","DOIUrl":"https://doi.org/10.36660/ijcs.20210146","url":null,"abstract":"Background: Exercise training (ET) is an adjunctive treatment for obstructive sleep apnea (OSA) and its consequences. However, the effects of exercise on heart remodeling are unknown in the population with OSA. Objective: We investigated the effect of ET on markers of diastolic function, sleep parameters, and functional capacity in patients with OSA. Methods: Sedentary patients with OSA (apnea-hypopnea index, AHI ≥15 events/hr) were randomly assigned to untrained (n=18) and trained (n=20) strategies. Polysomnography, cardiopulmonary exercise test, and echocardiography were evaluated at the beginning and end of the study. ET consisted of 3 weekly sessions of aerobic exercise, resistance exercises, and flexibility training (72 sessions, completed in 11.65±0.86 months). A two-way analysis of variance (ANOVA) was used, followed by Tukey's post-hoc test. The level of statistical significance was set at p<0.05 for all analyses. Result: Thirty-eight patients were included (AHI:45±29 events/hr, age:52±7 y, body mass index: 30±4 kg/m 2 ). They had similar baseline parameters. ET caused a significant change in OSA severity (AHI:4.5±18 versus -5.7±13 events/ hr; arousal index:1.5±8 versus -6.1±13 events/hr, in untrained and trained groups respectively, p<0.05). The trained patients had an increase in functional capacity after intervention. ET improved isovolumetric relaxation time (IVRT, untrained=6.5±17.3 versus trained=-5.1±17.1 msec, p<0.05). There was a significant correlation between changes in IVRT and arousal index in the trained group (r =-0.54, p<0.05). No difference occurred in the other diastolic function parameters evaluated. Conclusion: ET promotes modest but significant improvement in AHI, functional capacity, and cardiac IVRT, a validated parameter of diastolic function.","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78680378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The aging process may be associated with the accumulation of a wide variety of health damages, such as cardiovascular diseases. HF is the final common path of the majority of these diseases, and, in its refractory form, heart transplantation continues to be the best treatment choice. Objective: To describe the demographic and epidemiological profile of aging and elderly patients receiving heart transplant from 2009 to 2018. Methods: Retrospective, descriptive longitudinal study on heart transplantation in aging and elderly patients using data from medical records and institutional documents. Results : From a total of 234 transplant recipients, 127 were 45 years or older. For the demographic profile, the variables used were sex, age, marital status, home state, and profession. For the epidemiological profile, the variables used were previous diagnosis, comorbidities before and after transplantation, and survival. Age varied from 45 to 74 years, with a mean of 57 years. The male sex accounted for 58.27% of recipients, and 59.84% were from the Federal District. Chagas, dilated, and ischemic cardiomyopathy accounted for 66.14%, 18.9%, and 14.17% of transplants, respectively. The main comorbidities were Chagas disease (66.14%), malignant arrhythmia requiring cardioverter-defibrillator implantation (28.35%), arterial hypertension (27.56%), and dyslipidemia (15.75%). Mean survival was 3 years and 4 months. Conclusion: The demographic profile showed that the majority of patients were aging, male, married, and from the Federal District. The epidemiological profile showed that Chagas cardiomyopathy was the main cause of HF, followed by dilated cardiomyopathy.
{"title":"Demographic and Epidemiological Profile of Aging and Elderly Patients Receiving Heart Transplant During the Period from 2009 to 2018","authors":"Joseane de Souza Ribeiro, M.C. de Oliveira","doi":"10.36660/ijcs.20210176","DOIUrl":"https://doi.org/10.36660/ijcs.20210176","url":null,"abstract":"Background: The aging process may be associated with the accumulation of a wide variety of health damages, such as cardiovascular diseases. HF is the final common path of the majority of these diseases, and, in its refractory form, heart transplantation continues to be the best treatment choice. Objective: To describe the demographic and epidemiological profile of aging and elderly patients receiving heart transplant from 2009 to 2018. Methods: Retrospective, descriptive longitudinal study on heart transplantation in aging and elderly patients using data from medical records and institutional documents. Results : From a total of 234 transplant recipients, 127 were 45 years or older. For the demographic profile, the variables used were sex, age, marital status, home state, and profession. For the epidemiological profile, the variables used were previous diagnosis, comorbidities before and after transplantation, and survival. Age varied from 45 to 74 years, with a mean of 57 years. The male sex accounted for 58.27% of recipients, and 59.84% were from the Federal District. Chagas, dilated, and ischemic cardiomyopathy accounted for 66.14%, 18.9%, and 14.17% of transplants, respectively. The main comorbidities were Chagas disease (66.14%), malignant arrhythmia requiring cardioverter-defibrillator implantation (28.35%), arterial hypertension (27.56%), and dyslipidemia (15.75%). Mean survival was 3 years and 4 months. Conclusion: The demographic profile showed that the majority of patients were aging, male, married, and from the Federal District. The epidemiological profile showed that Chagas cardiomyopathy was the main cause of HF, followed by dilated cardiomyopathy.","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89926129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The best therapeutic strategy for chronic coronary syndrome (CCS) is still controversial. The lack of contemporaneity of medical treatment in many randomized clinical trials prior to the large-scale use of statins, antiplatelet agents, anti-diabetic drugs with cardiovascular protection, and changes in life habits with well-established goals limits the applicability of such studies in current clinical practice. Medical treatment is the only therapeutic option capable of reducing atherosclerotic damage and, therefore, of acting effectively in preventing the progression of this disease. The purpose of this brief review is to critically analyze the main contemporary studies that confront medical treatment with myocardial revascularization in CCS. randomized trial, the addition of evolocumab, a proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitor, together with statins, reduced the percent of atheroma volume (64.3% vs 47.3%) and the total atheroma volume (61.5% vs 48.9%). 13 Two recent reports unequivocally show how medical therapy can promote regression of CAD. Keraliya et al. reported the improvement of ischemia and regression of coronary atherosclerotic disease assessed by coronary CT angiography in a patient studied over a four-year interval, 15 whereas Kunhali et al. demonstrated the disappearance of angina and the angiographic regression of coronary artery obstruction seven years after the beginning of medical treatment. 16 Reinforcement for the role of medical treatment in the prognosis of this disease comes from the results of a retrospective, population-based cohort study that included 29,047 residents in the Italian Lombardy region, aged 65 years or older, who were receiving uninterrupted
{"title":"Chronic Coronary Syndrome: Medical Therapy or Myocardial Revascularization?","authors":"A. Rocha, Paulo Roberto Dutra da Silva","doi":"10.36660/ijcs.20210223","DOIUrl":"https://doi.org/10.36660/ijcs.20210223","url":null,"abstract":"The best therapeutic strategy for chronic coronary syndrome (CCS) is still controversial. The lack of contemporaneity of medical treatment in many randomized clinical trials prior to the large-scale use of statins, antiplatelet agents, anti-diabetic drugs with cardiovascular protection, and changes in life habits with well-established goals limits the applicability of such studies in current clinical practice. Medical treatment is the only therapeutic option capable of reducing atherosclerotic damage and, therefore, of acting effectively in preventing the progression of this disease. The purpose of this brief review is to critically analyze the main contemporary studies that confront medical treatment with myocardial revascularization in CCS. randomized trial, the addition of evolocumab, a proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitor, together with statins, reduced the percent of atheroma volume (64.3% vs 47.3%) and the total atheroma volume (61.5% vs 48.9%). 13 Two recent reports unequivocally show how medical therapy can promote regression of CAD. Keraliya et al. reported the improvement of ischemia and regression of coronary atherosclerotic disease assessed by coronary CT angiography in a patient studied over a four-year interval, 15 whereas Kunhali et al. demonstrated the disappearance of angina and the angiographic regression of coronary artery obstruction seven years after the beginning of medical treatment. 16 Reinforcement for the role of medical treatment in the prognosis of this disease comes from the results of a retrospective, population-based cohort study that included 29,047 residents in the Italian Lombardy region, aged 65 years or older, who were receiving uninterrupted","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90888111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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