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Chloroquine and hydroxychloroquine induced cardiomyopathy: A systematic review of literature 氯喹和羟氯喹引起的心肌病：文献系统综述
Q4 Medicine
REC: CardioClinics
Pub Date : 2025-07-01 DOI: 10.1016/j.rccl.2025.01.011
Vanda Devesa Neto , João Gouveia Fiúza , Inês Pires , Luís Ferreira Santos , António Costa

Introduction and objectives

Chloroquine (CQ) and hydroxychloroquine (HCQ), initially developed for malaria prophylaxis, are now widely used in rheumatic diseases, such as systemic lupus erythematosus and rheumatoid arthritis. Despite their therapeutic benefits, these drugs can induce cardiotoxicity, particularly cardiomyopathy. This systematic review evaluates the prevalence, clinical features, and diagnostic challenges of CQ/HCQ-induced cardiomyopathy.

Methods

A comprehensive literature search was conducted in PubMed, EMBASE, and Cochrane databases, identifying 60 studies reporting 79 cases of CQ/HCQ-induced cardiomyopathy. Inclusion criteria required histopathological confirmation via endomyocardial biopsy. Data on clinical presentations, diagnostic findings, and outcomes were extracted and analyzed.

Results

Patients were predominantly female (76%), with a median age of 56 years. The cardiomyopathies observed included hypertrophic, dilated, and restrictive forms, frequently presenting with heart failure and conduction disorders, such as atrioventricular block and arrhythmias. Cardiac magnetic resonance imaging and endomyocardial biopsy revealed characteristic toxicological changes, including myocyte vacuolization and fibrosis. Management often involved discontinuation of therapy, but severe cases progressed to cardiac transplantation or resulted in mortality (19%).

Conclusions

CQ/HCQ-induced cardiomyopathy is an underrecognized complication with significant morbidity and mortality. Early detection through continuous cardiac monitoring in patients on long-term CQ/HCQ therapy is crucial. Effective management, including timely drug discontinuation, may improve outcomes, although prognosis remains guarded in advanced stages.
氯喹（CQ）和羟氯喹（HCQ）最初用于疟疾预防，现在广泛用于风湿病，如系统性红斑狼疮和类风湿关节炎。尽管它们具有治疗效果，但这些药物可引起心脏毒性，特别是心肌病。本系统综述评估了CQ/ hcq诱导的心肌病的患病率、临床特征和诊断挑战。方法在PubMed、EMBASE和Cochrane数据库中进行综合文献检索，发现60篇研究报告了79例CQ/ hcq诱导的心肌病。纳入标准需要通过心肌内膜活检进行组织病理学确认。提取并分析了临床表现、诊断结果和结果的数据。结果患者以女性为主（76%），中位年龄56岁。观察到的心肌病包括肥厚型、扩张型和限制性，经常表现为心力衰竭和传导障碍，如房室传导阻滞和心律失常。心脏磁共振成像和心内膜活检显示特征性毒理学改变，包括心肌细胞空泡化和纤维化。治疗通常涉及停止治疗，但严重病例进展为心脏移植或导致死亡（19%）。结论scq / hcq诱发的心肌病是一种未被充分认识的并发症，其发病率和死亡率均较高。通过持续心脏监测对长期CQ/HCQ治疗的患者进行早期检测至关重要。有效的管理，包括及时停药，可能改善预后，尽管在晚期仍需谨慎预后。
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引用次数: 0
Coronary artery calcium score in patients with non-ST-segment elevation acute coronary syndrome 非st段抬高急性冠状动脉综合征患者冠状动脉钙评分
Q4 Medicine
REC: CardioClinics
Pub Date : 2025-07-01 DOI: 10.1016/j.rccl.2025.02.002
Samuel Del Castillo García, Ignacio Iglesias Gárriz, Carmen Garrote Coloma, Javier Vara Manso, José Félix Corral Fernández, David Alonso Rodríguez, Felipe Fernández Vázquez

Introduction and objectives

Coronary artery calcium (CAC) score is a marker of coronary atherosclerotic burden and can provide diagnostic and prognostic information in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). This study aims to evaluate the relationship between CAC and the need for revascularization in patients with NSTEACS.

Methods

We included prospectively 276 patients aged ≥ 18 years admitted with NSTEACS. A computed tomography was performed to measure CAC, categorized into groups: 0 Agatston units (AU), 1–100 AU, 101–400 AU, and > 400 AU. All patients underwent invasive coronary angiography.

Results

The median CAC score was 221 AU. A total of 62.7% of patients underwent revascularization; the proportion of revascularization increased with CAC, with 25% in the CAC = 0 group and 83.3% in the high CAC (> 400 AU) group. The CAC score demonstrated a negative predictive value of 69.4% for ruling out significant stenosis.

Conclusions

The CAC score is significantly associated with the need for revascularization in patients with NSTEACS, highlighting the atherosclerotic burden and its potential in risk stratification and clinical decision-making.
.
简介和目的冠状动脉钙（CAC）评分是冠状动脉粥样硬化负荷的标志，可以为非st段抬高急性冠状动脉综合征（NSTEACS）患者提供诊断和预后信息。本研究旨在评估非steacs患者CAC与血运重建需求之间的关系。方法前瞻性纳入276例年龄≥18岁的NSTEACS患者。计算机断层扫描测量CAC，分为：0 Agatston单位（AU）、1-100 AU、101-400 AU和>；400个AU。所有患者均行有创冠状动脉造影。结果CAC评分中位数为221 AU。62.7%的患者接受了血管重建术；血运重建比例随CAC升高而增加，CAC = 0组为25%，高CAC组为83.3% (>；400 AU)组。CAC评分对排除明显狭窄的阴性预测值为69.4%。结论CAC评分与非steacs患者的血运重建需求显著相关，突出了动脉粥样硬化负担及其在风险分层和临床决策中的潜力。
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引用次数: 0
Calcio coronario en el SCASEST: ¿una realidad hoy en día? SCASEST中的冠状动脉钙：今天的现实？
Q4 Medicine
REC: CardioClinics
Pub Date : 2025-07-01 DOI: 10.1016/j.rccl.2025.04.004
Javier Maíllo , Rocío Eiros , Candelas Pérez del Villar
{"title":"Calcio coronario en el SCASEST: ¿una realidad hoy en día?","authors":"Javier Maíllo ,&nbsp;Rocío Eiros ,&nbsp;Candelas Pérez del Villar","doi":"10.1016/j.rccl.2025.04.004","DOIUrl":"10.1016/j.rccl.2025.04.004","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"60 3","pages":"Pages 161-163"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687507","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}
引用次数: 0
Sofosbuvir and QT interval: A new chapter in the safety profile of direct-acting antivirals 索非布韦和QT间期：直接作用抗病毒药物安全性的新篇章
Q4 Medicine
REC: CardioClinics
Pub Date : 2025-07-01 DOI: 10.1016/j.rccl.2025.04.003
Carlos Minguito Carazo , Moisés Rodríguez Mañero
{"title":"Sofosbuvir and QT interval: A new chapter in the safety profile of direct-acting antivirals","authors":"Carlos Minguito Carazo ,&nbsp;Moisés Rodríguez Mañero","doi":"10.1016/j.rccl.2025.04.003","DOIUrl":"10.1016/j.rccl.2025.04.003","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"60 3","pages":"Pages 164-166"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687508","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}
引用次数: 0
Características clínicas e impacto de la duración del complejo QRS en pacientes con bloqueo completo de rama izquierda QRS复合物对左支完全阻塞患者的临床特征和持续时间的影响
Q4 Medicine
REC: CardioClinics
Pub Date : 2025-07-01 DOI: 10.1016/j.rccl.2024.10.006
Belén Jiménez Azzaoui , Raúl Gascueña Rubia , Julia Gómez Diego , Carlos De Blas Ruiz , Inmaculada Fernández Rozas , Alberto Esteban-Fernández
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引用次数: 0
Formación en cuidados intensivos cardiológicos: situación actual, modelos formativos y propuestas de mejora 心脏重症监护培训：现状、培训模式和改进建议
Q4 Medicine
REC: CardioClinics
Pub Date : 2025-07-01 DOI: 10.1016/j.rccl.2024.10.005
Pablo Legarra Oroquieta , David González Calle , Jordi Bañeras , Ana Hurtado Doce , Elena Collado Lledó
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引用次数: 0
Electrocardiographic alterations during direct-acting antiviral therapy against hepatitis C virus 丙型肝炎病毒直接抗病毒治疗期间的心电图改变
Q4 Medicine
REC: CardioClinics
Pub Date : 2025-07-01 DOI: 10.1016/j.rccl.2025.02.004
Olga Neva López-García , Daniel García-Arribas , Carmen Olmos , María José Devesa Medina , Javier Higueras Nafría , Sonia Izquierdo Rubio , Francisca Cuenca Alarcón , Maite Maroto Castellanos , Ana Fernández-Vega , Alejandro Cruz-Utrilla , Pablo Martínez-Vives , Enrique Rey

Introduction and objectives

QTc interval alterations have been described in patients receiving sofosbuvir. Our objective was to evaluate the effect of anti-hepatitis C virus drugs on the human cardiac conduction system.

Methods

We included all patients with hepatitis C virus infection that started treatment with direct-acting antivirals in a tertiary hospital between May 2016 and March 2017. Three electrocardiograms were performed in them: before starting treatment; during treatment; and at least 3 weeks after finished treatment. Heart rate, PR, QRS, and QTc intervals were compared between patients with and without sofosbuvir. Patients were followed for a mean time of 41.9 weeks.

Results

A total of 101 patients were studied, 61 received treatment with sofosbuvir and 40 without sofosbuvir. No differences were found between the 2 groups regarding heart rate, and PR intervals. There was a statistically significant enlargement of QTc in patients with sofosbuvir at the fourth week of treatment (415.3 ms vs 420.8 ms) that returned to baseline values once finalized (411.1 ms; P = .029). These differences were not observed in patients without sofosbuvir.

Conclusions

We observed a statistically significant prolongation of the QTc interval at the fourth week of treatment in patients with sofosbuvir, which returned to baseline levels once the treatment was finished. Further prospective studies are needed to assess the clinical relevance of these findings.
介绍和目的在接受索非布韦治疗的患者中有qtc间期改变的描述。我们的目的是评价抗丙型肝炎病毒药物对人心脏传导系统的影响。方法纳入2016年5月至2017年3月在某三级医院接受直接抗病毒药物治疗的所有丙型肝炎病毒感染患者。三个心电图表现在:在开始治疗;治疗期间;治疗结束后至少3周。比较使用索非布韦和不使用索非布韦患者的心率、PR、QRS和QTc间期。患者的平均随访时间为41.9周。结果101例患者接受索非布韦治疗61例，未接受索非布韦治疗40例。两组在心率和PR间隔方面没有发现差异。使用索非布韦的患者在治疗第四周的QTc （415.3 ms vs 420.8 ms）有统计学意义的增加，一旦结束(411.1 ms；p = .029)。在不使用索非布韦的患者中没有观察到这些差异。结论：我们观察到索非布韦治疗第四周时QTc间隔有统计学意义的延长，治疗结束后QTc间隔恢复到基线水平。需要进一步的前瞻性研究来评估这些发现的临床相关性。
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引用次数: 0
Cómo tratar a los pacientes con insuficiencia cardiaca y fracción de eyección ligeramente reducida 如何治疗射精率略低的心力衰竭患者
Q4 Medicine
REC: CardioClinics
Pub Date : 2025-07-01 DOI: 10.1016/j.rccl.2024.10.007
Carlos de Blas Ruiz , Maitane Fernández Ustoa , Julia Gómez Diego , Belén Jiménez Azzaoui , Inmaculada Fernández Rozas , Alberto Esteban Fernández
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引用次数: 0
Cor triatriatum sinistrum in adulthood: A case report 成年后心房三裂1例
Q4 Medicine
REC: CardioClinics
Pub Date : 2025-07-01 DOI: 10.1016/j.rccl.2024.11.002
Margarida Cabral , Luís Graça Santos , Catarina Ruivo , João Morais
{"title":"Cor triatriatum sinistrum in adulthood: A case report","authors":"Margarida Cabral ,&nbsp;Luís Graça Santos ,&nbsp;Catarina Ruivo ,&nbsp;João Morais","doi":"10.1016/j.rccl.2024.11.002","DOIUrl":"10.1016/j.rccl.2024.11.002","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"60 3","pages":"Pages 234-235"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687511","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}
引用次数: 0
Índice de autores 作者索引
Q4 Medicine
REC: CardioClinics
Pub Date : 2025-05-01 DOI: 10.1016/S2605-1532(25)00108-6
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