Fernanda Rodrigues Souza, É. Campos, L. Lopes, Clesnan Mendes Rodrigues, Danilo Lemes Naves Gonçalves, M. E. Beletti, M. Mantovani, Poliana Rodrigues Alves Duarte, Alexandre Gonçalvez, E. Resende
,
，
{"title":"Physical Training Improves Cardiac Structure and Function of Rats After Doxorubicin-Induced Cardiomyopathy","authors":"Fernanda Rodrigues Souza, É. Campos, L. Lopes, Clesnan Mendes Rodrigues, Danilo Lemes Naves Gonçalves, M. E. Beletti, M. Mantovani, Poliana Rodrigues Alves Duarte, Alexandre Gonçalvez, E. Resende","doi":"10.36660/ijcs.20210095","DOIUrl":"https://doi.org/10.36660/ijcs.20210095","url":null,"abstract":",","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73709805","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}
D. Souza, A. Durço, Camila Souza Gama Rocha, L. S. R. Conceição
other factors than myocardial damage, such as sinus tachycardia, atrial fibrillation, atrial flutter, and monomorphic or polymorphic ventricular tachycardia can be involved in development of arrhythmias in these patients. 4,5 Evidence has shown that in the first 5-9 days, patients with COVID-19 have a uniform disease progression, without major changes in inflammatory or cardiac biomarkers; however, after 10-24 days, there is an increase in pro-inflammatory cytokines, mainly interleukin-6 and 1, and TNF alpha, along with increases in myoglobin, D-dimer, and C-reactive protein. 5,6 Data from basic and clinical studies have shown that inflammation plays an important role as a risk factor for long QT syndrome and Torsades de Pointes, mainly through the increase of cytokines. This directly affects myocardial electrophysiology and can lead to unfavorable outcomes of cardiac arrhythmia by increasing oxidative stress in cardiomyocytes and resident macrophages, destabilizing electrical activity, leading to prolongation of the cardiomyocyte action potential and causing lethal ventricular arrhythmias. 6 Furtehermore, Zhou et. al. 2 demonstrated an increase in D-dimer (a marker of thrombotic events) in patients with an unfavorable outcome (Figure 1).
{"title":"COVID-19 and the Beat-To-Beat Heart","authors":"D. Souza, A. Durço, Camila Souza Gama Rocha, L. S. R. Conceição","doi":"10.36660/ijcs.20210269","DOIUrl":"https://doi.org/10.36660/ijcs.20210269","url":null,"abstract":"other factors than myocardial damage, such as sinus tachycardia, atrial fibrillation, atrial flutter, and monomorphic or polymorphic ventricular tachycardia can be involved in development of arrhythmias in these patients. 4,5 Evidence has shown that in the first 5-9 days, patients with COVID-19 have a uniform disease progression, without major changes in inflammatory or cardiac biomarkers; however, after 10-24 days, there is an increase in pro-inflammatory cytokines, mainly interleukin-6 and 1, and TNF alpha, along with increases in myoglobin, D-dimer, and C-reactive protein. 5,6 Data from basic and clinical studies have shown that inflammation plays an important role as a risk factor for long QT syndrome and Torsades de Pointes, mainly through the increase of cytokines. This directly affects myocardial electrophysiology and can lead to unfavorable outcomes of cardiac arrhythmia by increasing oxidative stress in cardiomyocytes and resident macrophages, destabilizing electrical activity, leading to prolongation of the cardiomyocyte action potential and causing lethal ventricular arrhythmias. 6 Furtehermore, Zhou et. al. 2 demonstrated an increase in D-dimer (a marker of thrombotic events) in patients with an unfavorable outcome (Figure 1).","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87792769","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}
{"title":"Quality of Highly Complex Care in Cardiology","authors":"A. Issa","doi":"10.36660/ijcs.20210119","DOIUrl":"https://doi.org/10.36660/ijcs.20210119","url":null,"abstract":"","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88657244","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}
A. Felix, Marcelo Melo, T. Monteiro, M. Cola, Rafael Castro, N. Merke
Transesophageal echocardiography (TTE) and computed tomography angiography (CTA) are methods of choice for definitive diagnosis and prognostic stratification of acute aortic syndromes (AAS).1 Point-of-care ultrasound (POCUS) has important applications in the initial workup of these patients in the emergency room (ER), ruling out other potential causes of chest pain and allowing a faster diagnosis,2 although conventional transthoracic echocardiographic acoustic windows do not allow for imaging of some segments of the thoracic aorta (TA), especially the descending TA (DTA). A 49-year-old man, with a 20-day history of dorsal and abdominal pain, shortness of breath (NYHA-III) and peripheral edema was admitted to the hospital ER. He had uncontrolled systemic hypertension and a history of smoking, without a family history of aortic diseases or sudden death. At admission, the patient was unstable hemodynamically, with clinical signs of biventricular heart failure. A TTE showed dilation of all cavities, severe biventricular systolic dysfunction, a giant (10.1cm) dissecting aneurysm (DA) of ascending aorta (AAo) (Fig.1-A, Video1), with a partially thrombosed false lumen extending to the supravalvular aortic region, causing geometric distortion of the aortic root and moderate-to-severe aortic regurgitation (Fig.1-B). The entry tear was nicely depicted in two-dimensional/threedimensional TTE from a right parasternal window (Figures 1-C,D, Video2), located in tubular AAo. The dissection extended to the descending thoracic aorta (DTA) and abdominal segments, with a large and highly pressurized false lumen. The posterior path of the dilated DTA in the thorax was easily accessible by ultrasound using a matrix probe, through a non-conventional left interscapular window, with good definition of intimal flap, spontaneous contrast and thrombus in the false lumen, in short-axis and longitudinal view (Figures 2 A, B, C, Video3), and nicely depicted by three-dimensional reconstructed images (Figure 2-D, Video4). These findings were confirmed by CTA, showing a giant Stanford type A DA (Figures 2-E-F). AAS are life-threatening conditions with high morbidity and mortality, especially when there is a delay in diagnosis and adequate treatment.3 POCUS as a first line approach for patients with suspected AAS in the ER can provide important data for a faster and more accurate diagnosis, detecting also signs of complications as pericardial effusion, pericardial tamponade, left and right ventricular dysfunction, acute aortic regurgitation, periaortic hematoma and hemothorax, supporting the need for urgent intervention. The DTA is not well visualized with conventional TTE windows, and a dorsal window is not currently cited as part of the routine investigation in the guidelines.4,5 We propose the use of a new echocardiographic window, the Left InterScapular Approach (LISA), for POCUS screening of patients with suspected AAS, even without pleural effusion. In cases where there is
{"title":"A New Kid on the Block in POCUS: “LISA”","authors":"A. Felix, Marcelo Melo, T. Monteiro, M. Cola, Rafael Castro, N. Merke","doi":"10.36660/ijcs.20210285","DOIUrl":"https://doi.org/10.36660/ijcs.20210285","url":null,"abstract":"Transesophageal echocardiography (TTE) and computed tomography angiography (CTA) are methods of choice for definitive diagnosis and prognostic stratification of acute aortic syndromes (AAS).1 Point-of-care ultrasound (POCUS) has important applications in the initial workup of these patients in the emergency room (ER), ruling out other potential causes of chest pain and allowing a faster diagnosis,2 although conventional transthoracic echocardiographic acoustic windows do not allow for imaging of some segments of the thoracic aorta (TA), especially the descending TA (DTA). A 49-year-old man, with a 20-day history of dorsal and abdominal pain, shortness of breath (NYHA-III) and peripheral edema was admitted to the hospital ER. He had uncontrolled systemic hypertension and a history of smoking, without a family history of aortic diseases or sudden death. At admission, the patient was unstable hemodynamically, with clinical signs of biventricular heart failure. A TTE showed dilation of all cavities, severe biventricular systolic dysfunction, a giant (10.1cm) dissecting aneurysm (DA) of ascending aorta (AAo) (Fig.1-A, Video1), with a partially thrombosed false lumen extending to the supravalvular aortic region, causing geometric distortion of the aortic root and moderate-to-severe aortic regurgitation (Fig.1-B). The entry tear was nicely depicted in two-dimensional/threedimensional TTE from a right parasternal window (Figures 1-C,D, Video2), located in tubular AAo. The dissection extended to the descending thoracic aorta (DTA) and abdominal segments, with a large and highly pressurized false lumen. The posterior path of the dilated DTA in the thorax was easily accessible by ultrasound using a matrix probe, through a non-conventional left interscapular window, with good definition of intimal flap, spontaneous contrast and thrombus in the false lumen, in short-axis and longitudinal view (Figures 2 A, B, C, Video3), and nicely depicted by three-dimensional reconstructed images (Figure 2-D, Video4). These findings were confirmed by CTA, showing a giant Stanford type A DA (Figures 2-E-F). AAS are life-threatening conditions with high morbidity and mortality, especially when there is a delay in diagnosis and adequate treatment.3 POCUS as a first line approach for patients with suspected AAS in the ER can provide important data for a faster and more accurate diagnosis, detecting also signs of complications as pericardial effusion, pericardial tamponade, left and right ventricular dysfunction, acute aortic regurgitation, periaortic hematoma and hemothorax, supporting the need for urgent intervention. The DTA is not well visualized with conventional TTE windows, and a dorsal window is not currently cited as part of the routine investigation in the guidelines.4,5 We propose the use of a new echocardiographic window, the Left InterScapular Approach (LISA), for POCUS screening of patients with suspected AAS, even without pleural effusion. In cases where there is ","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75407368","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}
Giana de Freitas Rodrigues, D. R. Vieira, P. Ruschel, C. Seelig, C. Coronel, S. Barbiero
Background : Participating in therapeutic operative groups with nutritional and psychological interventions might influence the recovery of patients in cardiopulmonary rehabilitation programs. Objective: To evaluate the effectiveness of group interventions on the nutritional profile, stress, and quality of life of patients in cardiopulmonary rehabilitation. Methods : In this randomized clinical trial, adult patients of the Cardiopulmonary and Metabolic Rehabilitation (CPMR) unit were randomized into control group (CG), receiving standard follow-up assessment by the CPMR unit, and intervention group (IG), which additionally participated in 6 meetings of an interdisciplinary group with a nutritionist and a psychologist. Anthropometric data and results from a food frequency questionnaire (FFQ), Lipp’s Inventory of Stress Symptoms for Adults (ISSL), and the 12-Item Short Form Health Survey (SF-12) were analyzed. Student’s t-tests, Generalized Estimation Equations (GEE), Mann-Whitney tests, and Bonferroni tests were used for statistical analyses, with a significance level of 5%. Results : The sample consisted of 76 patients: 31 in the IG (64±9.2 years old) and 45 in the CG (61.4±11.8 years old). There was a significant reduction (p<0.001) in weight, body mass index, and waist circumference, and an increase (p=0.010) in the consumption of healthy food only in the IG. The consumption of unhealthy food was reduced in both groups (p<0.001), the physical aspect of quality of life improved (p=0.018), and women presented better physical (p=0.011) and mental results (p=0.008). Conclusions: This group intervention was effective regarding the nutritional status of patients in cardiopulmonary rehabilitation. The physical aspect of quality of life showed improvements in both groups.
{"title":"Interdisciplinary Group Intervention on Nutritional Profile, Quality of Life, and Stress During Cardiopulmonary Rehabilitation: A Randomized Clinical Trial","authors":"Giana de Freitas Rodrigues, D. R. Vieira, P. Ruschel, C. Seelig, C. Coronel, S. Barbiero","doi":"10.36660/ijcs.20200295","DOIUrl":"https://doi.org/10.36660/ijcs.20200295","url":null,"abstract":"Background : Participating in therapeutic operative groups with nutritional and psychological interventions might influence the recovery of patients in cardiopulmonary rehabilitation programs. Objective: To evaluate the effectiveness of group interventions on the nutritional profile, stress, and quality of life of patients in cardiopulmonary rehabilitation. Methods : In this randomized clinical trial, adult patients of the Cardiopulmonary and Metabolic Rehabilitation (CPMR) unit were randomized into control group (CG), receiving standard follow-up assessment by the CPMR unit, and intervention group (IG), which additionally participated in 6 meetings of an interdisciplinary group with a nutritionist and a psychologist. Anthropometric data and results from a food frequency questionnaire (FFQ), Lipp’s Inventory of Stress Symptoms for Adults (ISSL), and the 12-Item Short Form Health Survey (SF-12) were analyzed. Student’s t-tests, Generalized Estimation Equations (GEE), Mann-Whitney tests, and Bonferroni tests were used for statistical analyses, with a significance level of 5%. Results : The sample consisted of 76 patients: 31 in the IG (64±9.2 years old) and 45 in the CG (61.4±11.8 years old). There was a significant reduction (p<0.001) in weight, body mass index, and waist circumference, and an increase (p=0.010) in the consumption of healthy food only in the IG. The consumption of unhealthy food was reduced in both groups (p<0.001), the physical aspect of quality of life improved (p=0.018), and women presented better physical (p=0.011) and mental results (p=0.008). Conclusions: This group intervention was effective regarding the nutritional status of patients in cardiopulmonary rehabilitation. The physical aspect of quality of life showed improvements in both groups.","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78710645","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: There have been scattered reports indicating the possibility that applied magnetic fields can lower human blood viscosity, which has been considered as encouraging for decreasing blood pressure as a result of greater fluidity. Additional motivation comes from partial studies in animals showing some response of vascular variables to magnetic fields. Recently developed FeNbB magnets enable topical application to appropriate sites of much stronger permanent magnetic fields than previously available. Objectives: To establish whether powerful magnetic fields permanently applied along important arteries of the human body can lower blood pressure and, if so, to what extent. Methods : Ambulatory blood pressure tests were performed on 70 patients, half of them wearing real magnets, while the other 35 patients were wearing a similar placebo. Magnets or placebo devices were assigned at random. Each patient underwent two consecutive ambulatory 24-hour blood pressure (BP) tests; the first without a device and the second one with a device. Results: Results were compiled and analyzed only after the last measurement was completed. Individual responses, average values, standard deviations, information content, and Student’s t test showed that no difference was found between measurements in either group. Conclusion: Permanent strong magnetic fields applied along the main arteries of the human body do not alter blood pressure. This was observed both in statistical terms and in individuals as well.
{"title":"Possible Effects of Oriented Magnetic Fields on Human Blood Pressure","authors":"Eugenio E. Vogel, Nataly Belmar, B. Stockins","doi":"10.36660/ijcs.20200289","DOIUrl":"https://doi.org/10.36660/ijcs.20200289","url":null,"abstract":"Background: There have been scattered reports indicating the possibility that applied magnetic fields can lower human blood viscosity, which has been considered as encouraging for decreasing blood pressure as a result of greater fluidity. Additional motivation comes from partial studies in animals showing some response of vascular variables to magnetic fields. Recently developed FeNbB magnets enable topical application to appropriate sites of much stronger permanent magnetic fields than previously available. Objectives: To establish whether powerful magnetic fields permanently applied along important arteries of the human body can lower blood pressure and, if so, to what extent. Methods : Ambulatory blood pressure tests were performed on 70 patients, half of them wearing real magnets, while the other 35 patients were wearing a similar placebo. Magnets or placebo devices were assigned at random. Each patient underwent two consecutive ambulatory 24-hour blood pressure (BP) tests; the first without a device and the second one with a device. Results: Results were compiled and analyzed only after the last measurement was completed. Individual responses, average values, standard deviations, information content, and Student’s t test showed that no difference was found between measurements in either group. Conclusion: Permanent strong magnetic fields applied along the main arteries of the human body do not alter blood pressure. This was observed both in statistical terms and in individuals as well.","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91182290","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}
M. A. Oliveira, Thais Aguiar Nascimento, G. Feitosa-Filho, L. Ritt, C. Cruz, M. S. Rocha
Chagas disease is a tropical disease that is neglected worldwide, contributing substantially to the burden of morbidity and mortality in populations and exerting a considerable socioeconomic effect when cardiac alterations develop (20-30% of infected individuals).1-6 Sudden cardiac death is the most common cause of death (55-65% of patients with Chagas disease). In general, the final stage consists of malignant ventricular arrhythmia, resulting from an interaction between the anatomical substrate (fibrosis) and a functional trigger that creates areas of heterogeneous electrophysiological conduction and, consequently, cardiac electrical instability7-11 In parallel, some evidence suggests that cardiac autonomic dysfunction is a relevant, intense, independent, and early phenomenon in the natural history of the disease, acting as a trigger for malignant arrhythmias and thus representing a potential marker of risk.12-20 Although important prognostic factors have already been described, the stratification of risk remains a challenge. Rassi et al. proposed a simple risk score Int J Cardiovasc Sci. 2022; 35(6), 708-717 708
恰加斯病是一种在世界范围内被忽视的热带疾病，在很大程度上造成了人群发病率和死亡率的负担，并在发生心脏改变时产生相当大的社会经济影响(占感染者的20-30%)。心脏性猝死是最常见的死亡原因(占恰加斯病患者的55-65%)。一般来说，最后阶段包括恶性室性心律失常，由解剖底物(纤维化)和功能触发物之间的相互作用引起，功能触发物产生异质电生理传导区域，从而导致心电不稳定7-11。同时，一些证据表明，心脏自主神经功能障碍是该疾病自然史中相关的、强烈的、独立的早期现象。作为恶性心律失常的触发因素，因此代表着潜在的风险标志。12-20虽然已经描述了重要的预后因素，但风险分层仍然是一个挑战。Rassi等人提出了一种简单的风险评分方法，journal of cardiovascular Sci. 2022;35(6)， 708-717
{"title":"Dysautonomia Evaluation by Holter in Chagas Heart Disease","authors":"M. A. Oliveira, Thais Aguiar Nascimento, G. Feitosa-Filho, L. Ritt, C. Cruz, M. S. Rocha","doi":"10.36660/ijcs.20200405","DOIUrl":"https://doi.org/10.36660/ijcs.20200405","url":null,"abstract":"Chagas disease is a tropical disease that is neglected worldwide, contributing substantially to the burden of morbidity and mortality in populations and exerting a considerable socioeconomic effect when cardiac alterations develop (20-30% of infected individuals).1-6 Sudden cardiac death is the most common cause of death (55-65% of patients with Chagas disease). In general, the final stage consists of malignant ventricular arrhythmia, resulting from an interaction between the anatomical substrate (fibrosis) and a functional trigger that creates areas of heterogeneous electrophysiological conduction and, consequently, cardiac electrical instability7-11 In parallel, some evidence suggests that cardiac autonomic dysfunction is a relevant, intense, independent, and early phenomenon in the natural history of the disease, acting as a trigger for malignant arrhythmias and thus representing a potential marker of risk.12-20 Although important prognostic factors have already been described, the stratification of risk remains a challenge. Rassi et al. proposed a simple risk score Int J Cardiovasc Sci. 2022; 35(6), 708-717 708","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90896965","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}
D. D. Nascimento, C. Botton, Felipe Vargas Santos, Márcia Cristina Rover, Marília Santos Moura, Bruna Muller Leão, B. Schaan
Background: Frailty is a biological syndrome suggested as a better predictor of morbimortality than chronological age. Objective: To assess associations between frailty and morbimortality outcomes in postoperative cardiac surgery. Methods: A retrospective cohort study was conducted with cardiac surgery patients. Frailty and maximal inspiratory pressure (MIP) were assessed before surgery. Postoperative outcomes were: extracorporeal circulation time; use of vasopressor; mean arterial pressure (MAP); red blood cell (RBC) transfusion; cardiac arrhythmia and/or heart arrest; presence of intra-aortic balloon pump; antibiotic use; extubation time; length of stay in the intensive care unit (ICU); length of postoperative stay; mortality. One-way ANOVA was used to compare postoperative variables between frailty categories; Spearman was used to evaluate the correlations between frailty and postoperative variables. Age, sex, and MIP were introduced into multiple regression models to find the independent association between postoperative variables and frailty. A significance level of p < 0.05 was adopted. Results: The medical records of 200 patients were analyzed (65.7±7.2 years; 68.5% men; 63.5% non-frail, 22.5% pre-frail, 14% frail). Frailty was not a predictor of postoperative outcomes. Age was an independent predictor for alterations in MAP (PR: 1.028, 95% CI: 1.003-1.053, p=0.025), need for RBC transfusion (PR: 1.034, 95% CI: 1.007-1.062, p=0.014), longer extubation time (PR: 1.052, 95% CI: 1.023-1.083, p<0.001), length of stay in the ICU (ß: 0.031, 95% CI: 0.010-0.053, p=0.005), length of postoperative stay (ß: 0.017, 95% CI: 0.003-0.031, p=0.015). Conclusions: Frailty was not a predictor of morbimortality following cardiac surgery in middle-aged and older adults; however, age did predict morbidities in this setting.
{"title":"Is Frailty Syndrome a Predictor of Morbimortality in Postoperative Cardiac Surgery? – A Retrospective Cohort Study","authors":"D. D. Nascimento, C. Botton, Felipe Vargas Santos, Márcia Cristina Rover, Marília Santos Moura, Bruna Muller Leão, B. Schaan","doi":"10.36660/ijcs.20210180","DOIUrl":"https://doi.org/10.36660/ijcs.20210180","url":null,"abstract":"Background: Frailty is a biological syndrome suggested as a better predictor of morbimortality than chronological age. Objective: To assess associations between frailty and morbimortality outcomes in postoperative cardiac surgery. Methods: A retrospective cohort study was conducted with cardiac surgery patients. Frailty and maximal inspiratory pressure (MIP) were assessed before surgery. Postoperative outcomes were: extracorporeal circulation time; use of vasopressor; mean arterial pressure (MAP); red blood cell (RBC) transfusion; cardiac arrhythmia and/or heart arrest; presence of intra-aortic balloon pump; antibiotic use; extubation time; length of stay in the intensive care unit (ICU); length of postoperative stay; mortality. One-way ANOVA was used to compare postoperative variables between frailty categories; Spearman was used to evaluate the correlations between frailty and postoperative variables. Age, sex, and MIP were introduced into multiple regression models to find the independent association between postoperative variables and frailty. A significance level of p < 0.05 was adopted. Results: The medical records of 200 patients were analyzed (65.7±7.2 years; 68.5% men; 63.5% non-frail, 22.5% pre-frail, 14% frail). Frailty was not a predictor of postoperative outcomes. Age was an independent predictor for alterations in MAP (PR: 1.028, 95% CI: 1.003-1.053, p=0.025), need for RBC transfusion (PR: 1.034, 95% CI: 1.007-1.062, p=0.014), longer extubation time (PR: 1.052, 95% CI: 1.023-1.083, p<0.001), length of stay in the ICU (ß: 0.031, 95% CI: 0.010-0.053, p=0.005), length of postoperative stay (ß: 0.017, 95% CI: 0.003-0.031, p=0.015). Conclusions: Frailty was not a predictor of morbimortality following cardiac surgery in middle-aged and older adults; however, age did predict morbidities in this setting.","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88626958","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}
N. S. Nunes, E. T. Mesquita, Claudio Tinoco Mesquita, P. R. Benchimol-Barbosa
). Due to the mismatch between the degree of left ventricular hypertrophy on the transthoracic echocardiogram and the ECG findings, an investigation focused on CA was initiated. The following were ordered: cardiac magnetic resonance imaging (Figure 2), which showed a pattern suggestive of CA; 24-hour urine and blood immunofixation; and serum free light chain assay, which excluded the AL type as the cause of amyloid deposition. Myocardial scintigraphy with technetium pyrophosphate showed grade 3 uptake in the cardiac area (Figure 2), which raised high suspicion of ATTR, and, finally, genetic testing confirmed the Val142Ile mutation. Six months after diagnosis, the patient began complaining of fatigue on exertion and systemic venous
{"title":"First-degree Atrioventricular Block as an Early Marker of Advanced Disease of the Conduction System in a Patient with Hereditary Val142Ile Cardiac Amyloidosis","authors":"N. S. Nunes, E. T. Mesquita, Claudio Tinoco Mesquita, P. R. Benchimol-Barbosa","doi":"10.36660/ijcs.20210081","DOIUrl":"https://doi.org/10.36660/ijcs.20210081","url":null,"abstract":"). Due to the mismatch between the degree of left ventricular hypertrophy on the transthoracic echocardiogram and the ECG findings, an investigation focused on CA was initiated. The following were ordered: cardiac magnetic resonance imaging (Figure 2), which showed a pattern suggestive of CA; 24-hour urine and blood immunofixation; and serum free light chain assay, which excluded the AL type as the cause of amyloid deposition. Myocardial scintigraphy with technetium pyrophosphate showed grade 3 uptake in the cardiac area (Figure 2), which raised high suspicion of ATTR, and, finally, genetic testing confirmed the Val142Ile mutation. Six months after diagnosis, the patient began complaining of fatigue on exertion and systemic venous","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78518791","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：