REC: CardioClinics最新文献

Regular physical activity has been associated with a significant reduction in the risk of cardiovascular disease and an improvement in the quality of life. However, vigorous physical exercise might be a trigger of sudden cardiac death in individuals with an underlying cardiovascular disease. Preparticipation screening is aimed to early detect cardiovascular disorders potentially related to sudden cardiac death in athletes. The focus of the present review is to describe the main components of preparticipation cardiovascular screening according to age, type of sport and competitive level. In addition, the relevance of implementing an emergency action plan to deal with adverse cardiovascular events is highlighted.

Cardiac masses encompass a heterogeneous set of pathologies (benign tumors, malignant neoplasms and other entities such as thrombus or vegetations) with a diverse presentation (from asymptomatic cases in which the mass is discovered incidentally to limiting symptoms). An accurate diagnosis is essential in order to guide an individualized therapeutic plan. Evaluation based on multimodal imaging techniques plays a key role in this aspect as it allows a non-invasive and detailed study of each lesion, avoiding the need for a biopsy in many cases. Treatment of cardiac masses is individualized and depends on their nature, clinical impact and patient characteristics. The prognosis of non-tumoral pathology and benign neoplasms is favorable in the majority of patients. This is not the case, however, in malignancies: mortality rate is still very high despite advances in therapy.

Introduction and objectives

Tachycardiomyopathy is a frequent cause of reversible ventricular dysfunction, whose predictors of recovery are not properly identified. Their individual estimate would be useful to carry out the corresponding invasive procedures.

Methods

This is an observational, retrospective and unicentral study. Cases diagnosed with tachycardiomyopathy were collected between September 2015 and January 2023. The sample was split into 2 study groups: the first one was used for the construction of the linear regression model by performing a multivariate analysis based on evaluating all possible equations (sample 1, 70%); whereas the second one was intended for the validation of the model (sample 2, 30%).

Results

A total of 134 patients were gathered and left ventricular ejection fraction (LVEF) at recovery (the difference between final and original LVEF) was calculated in all of them. Within sample 1, setting parameters of 16,383 models were estimated. The model selected, based on Mallows’ Cp index, was the composed of the following variables: sex, arterial hypertension (HT), LVEF at diagnosis, achievement of rhythm control, and ablation. The selected model explains about half of the individual variability of the recovered LVEF (R² 0.493). Afterwards, individual LVEF at recovery predicted by the model was compared with the observed LVEF in sample 2. No overall significant differences were observed in the R² coefficient of determination.

Conclusions

Sex, arterial hypertension, LVEF at diagnosis, achievement of rhythm control, and ablation were considered as predictors of recovered LVEF in patients with tachycardiomyopathy. This has made possible a quantitative estimate when integrating them within the model.