Revista Portuguesa De Cardiologia最新文献

英文中文

Polytetrafluoroethylene graft for anomalous left coronary artery from the pulmonary artery: 6-Year patency 从肺动脉移植聚四氟乙烯治疗左冠状动脉异常：6 年通畅。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-19 DOI: 10.1016/j.repc.2024.02.011

引用次数: 0

“O meu coração bate saudável” – Results from a pilot project for health education in Portuguese children "O meu cora<s:1> O bate saudável"——葡萄牙儿童健康教育试点项目的成果。

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2023.09.005

Ana Teresa Timóteo , Maria Carmo Cachulo , Paulo Dinis , Luís Negrão , Inês Barreiros-Mota , Hélder Dores , Lino Gonçalves

Introduction and objectives

Childhood offers an excellent window of opportunity to start interventions to promote behavioral changes before unhealthy lifestyles become established, leading to cardiovascular diseases. The goal of this pilot educational project for children is the promotion of healthy lifestyles and cardiovascular health.

Methods

This project was implemented in 4th grade children and included teacher-led classroom activities, a lesson given by a cardiologist and a practical lesson with dietitians. The teacher received a manual containing information on the topics to be discussed in class with the pupils and the children received a book that addresses cardiovascular risk factors and prevention. The components included were diet (D), physical activity (PA) and human body and heart awareness (BH). At the beginning and at the end of the schoolyear, a questionnaire was applied to the children to assess knowledge (K), attitudes (A) and habits (H) on these topics.

Results

A total of 73 children from two schools from an urban district public school in Lisbon, in a low to medium income area, participated in the project. Following the intervention, there was a 9.5% increase in the overall KAH score, mainly driven by the PA component (14.5%) followed by the BH component (12.3%). No improvement was observed for component D. The benefits were also more significant in children from a lower income area, suggesting that socioeconomic status is a determinant in the response obtained.

Conclusions

An educational project for cardiovascular health can be implemented successfully in children aged 9 years, but longer and larger studies are necessary.

前言和目标:儿童时期提供了一个极好的机会窗口，可以在不健康的生活方式形成并导致心血管疾病之前开始干预措施，促进行为改变。这一儿童教育试点项目的目标是促进健康的生活方式和心血管健康。方法:本项目在四年级儿童中实施，包括教师主导的课堂活动，心脏病专家的课程和营养师的实践课程。老师收到了一本手册，其中包含与学生在课堂上讨论的主题的信息，孩子们收到了一本关于心血管风险因素和预防的书。包括饮食(D)、体力活动(PA)和人体与心脏意识(BH)。在学年开始和结束时，对孩子们进行了问卷调查，以评估关于这个主题的知识(K)，态度(a)和习惯(H)。结果:共有73名来自中低收入地区里斯本一所城市公立学校的儿童参与了该项目。通过干预，总体KAH评分增加了9.5%，主要由PA成分(14.5%)驱动，其次是BH成分(12.3%)。D成分未见改善。低收入地区的儿童受益更显著，这表明社会经济地位是获得回应的决定因素。结论:心血管健康教育项目可以在9岁儿童中成功实施，但需要更长时间和更大规模的研究。

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引用次数: 0

Management of life-threatening ventricular arrhythmias: What is going on with autonomic neuromodulation 处理危及生命的室性心律失常：自律神经调节是怎么回事？

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2023.11.004

Sofia Jacinto , João Reis , Mário Martins Oliveira

引用次数: 0

Cardiac hydatid cysts: Please do not waste time 心脏水瘤囊肿：请不要浪费时间。

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2023.08.009

Valdano Manuel, Zoinez Sotto Garcia

引用次数: 0

Long-term prognosis of idiopathic ventricular fibrillation: An eighteen-year experience from a tertiary center 特发性心室颤动的长期预后：一家三级医疗中心十八年来的经验。

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2024.04.001

Cátia Oliveira , Ana Pinho , Luís Santos , Ricardo Alves Pinto , Sílvia Oliveira , Helena Moreira , Miguel Rocha , Pedro Palma , Gonçalo Pestana , Marta Madeira , Ana Lebreiro , Luís Adão

Introduction and objectives

Idiopathic ventricular fibrillation (IVF) is diagnosed in patients who survive sudden cardiac arrest (SCA), preferably with documented ventricular fibrillation (VF), without any identifiable structural or electrical abnormality. Current evidence provides limited guidance on the diagnosis and follow-up of these patients. Our aim was to assess the clinical outcomes of survivors of an aborted SCA attributed to IVF.

Methods

We retrospectively collected clinical data from all patients who survived SCA and implanted a cardiac defibrillator (ICD) between 2005 and 2023.

Results

A total of 38 patients, 36.8% female, with a mean age of 44±14 years old were included. Median follow-up time was 8.7 years (interquartile range (IQR) 4.7–14.7 years). All patients underwent a comprehensive diagnostic evaluation that excluded structural and coronary disease. During follow-up, underlying diagnoses were established in 34.2% of the whole cohort. Genetic testing, performed in 37.2%, revealed underlying diagnoses in 57.1% of those tested, compared to only 26.3% of patients who did not undergo genetic testing [p=0.035, OR=5.1 (95% confidence interval (CI) 1.2–21.5)]. Mortality was 10.5% (due to non-arrhythmic causes) and 36.8% patients received appropriate therapies with a median time to first ICD therapy of 39 [5.4–47.3] months.

Conclusion(s)

Etiological diagnosis and recurrence prediction in patients with IVF remains challenging, even with extensive diagnostic evaluation and long-term follow-up. In our study, genetic testing enhanced diagnostic yield. Consistent with previous findings, our cohort experienced a notable arrhythmic recurrence, with no cardiac deaths, underlining the pivotal role of ICD implantation in these patients.

导言和目的特发性心室颤动（IVF）的诊断对象是心脏骤停（SCA）后存活的患者，最好是有记录的心室颤动（VF），但没有任何可识别的结构或电异常。目前的证据为这些患者的诊断和随访提供了有限的指导。我们的目的是评估因体外受精而流产的 SCA 幸存者的临床结局。方法我们回顾性地收集了 2005 年至 2023 年间所有 SCA 幸存者的临床数据，并植入了心脏除颤器（ICD）。中位随访时间为 8.7 年（四分位数间距 (IQR) 4.7-14.7 年）。所有患者都接受了全面的诊断评估，排除了结构性和冠状动脉疾病。在随访过程中，34.2%的患者确诊了潜在疾病。37.2%的患者接受了基因检测，其中57.1%的患者确诊了潜在疾病，而未接受基因检测的患者中只有26.3%确诊了潜在疾病[P=0.035，OR=5.1（95% 置信区间（CI）1.2-21.5）]。死亡率为 10.5%（非心律失常原因所致），36.8% 的患者接受了适当的治疗，首次 ICD 治疗的中位时间为 39 [5.4-47.3] 个月。在我们的研究中，基因检测提高了诊断率。与之前的研究结果一致，我们的研究队列中出现了明显的心律失常复发，但没有心脏性死亡，这凸显了 ICD 植入在这些患者中的关键作用。

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引用次数: 0

Outcomes of ventricular tachycardia ablation in patients with ischemic and non-ischemic cardiomyopathy: A propensity-score matched analysis 缺血性和非缺血性心肌病患者室性心动过速消融术的疗效：倾向评分匹配分析

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2024.04.002

Daniel A. Gomes , Mariana Sousa Paiva , Daniel Matos , Ana Rita Bello , Gustavo Rodrigues , João Carmo , Jorge Ferreira , Francisco Moscoso Costa , Pedro Galvão Santos , Pedro Carmo , Diogo Cavaco , Francisco Bello Morgado , Pedro Adragão

Introduction and objectives

Catheter ablation (CA) is effective in the treatment of ventricular tachycardia (VT). Although some observational data suggest patients with non-ischemic cardiomyopathy (NICM) have less favorable outcomes when compared to those with an ischemic etiology (ICM), direct comparisons are rarely reported. We aimed to compare the outcomes of VT ablation in a propensity-score matched population of ICM or NICM patients.

Methods

Single-center retrospective study of consecutive patients undergoing VT ablation from 2012 to 2023. A propensity score (PS) was used to match ICM and NICM patients in a 1:1 fashion according to age, sex, left ventricular ejection fraction (LVEF), NYHA class, electrical storm (ES) at presentation, and previous endocardial ablation. The outcomes of interest were VT-free survival and all-cause mortality.

Results

The PS yielded two groups of 71 patients each (mean age 63±10 years, 92% male, mean LVEF 35±10%, 36% with ES at presentation, and 23% with previous ablation), well matched for baseline characteristics. During a median follow-up of 2.3 (interquartile range IQR 1.3–3.8) years, patients with NICM had a significantly lower VT-free survival (53.5% vs. 69.0%, log-rank p=0.037), although there were no differences regarding all-cause mortality (22.5% vs. 16.9%, log-rank p=0.245). Multivariate analysis identified NICM (HR 2.34 [95% CI 1.32–4.14], p=0.004), NYHA class III/IV (HR 2.11 [95% CI 1.11–4.04], p=0.024), and chronic kidney disease (HR 2.23 [95% CI 1.25–3.96], p=0.006), as independent predictors of VT recurrence.

Conclusion

Non-ischemic cardiomyopathy patients were at increased risk of VT recurrence after ablation, although long-term mortality did not differ.

导言和目的导管消融（CA）是治疗室性心动过速（VT）的有效方法。尽管一些观察性数据表明，非缺血性心肌病（NICM）患者的疗效不如缺血性病因（ICM）患者，但很少有直接比较的报道。我们的目的是比较 ICM 或 NICM 患者中倾向得分匹配人群的 VT 消融结果。根据年龄、性别、左心室射血分数 (LVEF)、NYHA 分级、发病时的电风暴 (ES) 和既往心内膜消融情况，采用倾向评分 (PS) 对 ICM 和 NICM 患者进行 1:1 匹配。结果 PS 两组各 71 例患者（平均年龄 63±10岁，92% 为男性，平均 LVEF 35±10%，36% 在发病时有 ES，23% 曾做过消融术），基线特征完全匹配。在中位随访 2.3 年（四分位间距 IQR 1.3-3.8）期间，NICM 患者的无 VT 生存率明显较低（53.5% 对 69.0%，log-rank p=0.037），尽管全因死亡率方面没有差异（22.5% 对 16.9%，log-rank p=0.245）。多变量分析发现，NICM（HR 2.34 [95% CI 1.32-4.14]，P=0.004）、NYHA III/IV 级（HR 2.11 [95% CI 1.11-4.04]，P=0.024）和慢性肾病（HR 2.23 [95% CI 1.25-3.96]，P=0.结论非缺血性心肌病患者消融术后VT复发风险增加，但长期死亡率并无差异。

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引用次数: 0

Idiopathic ventricular fibrillation: A never ending “clinical” history 特发性心室颤动：永无止境的 "临床 "史

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2024.05.001

João Primo

引用次数: 0

The potential for health education to target cardiovascular risk factors at an age when it really matters 健康教育有可能在真正重要的年龄段针对心血管风险因素开展教育。

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2024.02.001

António Manuel Pires

引用次数: 0

Surgical aortic valve replacement in octogenarians: Single-center perioperative outcomes and five-year survival 八旬老人主动脉瓣置换手术：单中心围手术期疗效和 5 年生存率。

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2024.02.003

Tiago R. Velho , João Gonçalves , Rafael Maniés Pereira , Ricardo Ferreira , André Sena , Nádia Junqueira , Eurídice Ângelo , Nuno Carvalho Guerra , Mário Mendes , Ricardo Arruda Pereira , Ângelo Nobre

Introduction and objectives

Aortic stenosis is the most common valvular heart disease. The number of octogenarians proposed for intervention is growing due to increased lifespan. In this manuscript we aim to evaluate perioperative outcome and long-term survival after surgical aortic valve replacement (SAVR) in octogenarians, comparing patients with low surgical risk (EuroscoreII <4%) with intermediate-high risk (EuroscoreII ≥4%).

Methods

A retrospective observational single-center cohort study with 195 patients aged ≥80 years old, who underwent SAVR between 2017 and 2021, was conducted. Patients were divided into two groups according to EuroscoreII: (1) Low risk (EuroscoreII <4%) with intermediate-high risk (EuroscoreII ≥4%). Continuous variables are presented in median (IQR), analyzed using Wilcoxon rank sum test; categorical variables in percentages, analyzed using chi-squared test; and survival was analyzed by Kaplan–Meier, open cohort, and the log-rank test was performed.

Results

The overall median age was 82 (IQR 81–83), with 4.6% of the patients ≥85 years old. 23.6% of the patients presented EuroscoreII ≥4%. No complications were observed in 26.2%, with a significantly higher rate in intermediate-high risk patients. Postoperative need for hemodynamic support was the most frequent complication, followed by postoperative acute kidney injury and the use of blood products. Overall median ICU stay was three days (2–4) and hospital length of stay (LOS) six days (5–8). Patients with intermediate-high risk and those with complications had longer ICU LOS. At 12 months, overall survival was 96.4%, at three years 94.1% and 5 years 75.4%. Patients with low surgical risk had higher survival proportions up to 5 years.

Conclusion

SAVR in patients ≥80 years is associated with low in-hospital mortality, although a significant proportion of patients develop complications. Long-term follow-up up to five years after surgery is acceptable in octogenarians with low surgical risk.

导言和目标：主动脉瓣狭窄是最常见的瓣膜性心脏病。由于寿命的延长，建议进行介入治疗的八旬老人越来越多。在这篇手稿中，我们旨在评估八旬老人主动脉瓣置换术（SAVR）后的围手术期结果和长期存活率，并对手术风险低（EuroscoreII 方法）的患者进行比较：一项回顾性观察性单中心队列研究，研究对象为2017-2021年间接受SAVR的195名年龄≥80岁的患者。根据EuroscoreII将患者分为两组：1）低风险（EuroscoreIIResults：总体中位年龄为82岁（IQR 81-83），4.6%的患者年龄≥85岁。23.6%的患者欧洲评分II≥4%。26.2%的患者未出现并发症，中高风险患者的并发症发生率明显更高。术后需要血流动力学支持是最常见的并发症，其次是术后急性肾损伤和使用血制品。重症监护室总住院时间中位数为 3 天（2-4 天），住院时间中位数为 6 天（5-8 天）。中高风险患者和有并发症的患者的重症监护室住院时间更长。12个月的总生存率为96.4%，3年为94.1%，5年为75.4%。手术风险低的患者5年生存率更高：结论：对年龄≥80岁的患者进行SAVR手术的院内死亡率较低，但有相当一部分患者会出现并发症。对于手术风险较低的八旬老人，术后5年的长期随访是可以接受的。

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引用次数: 0

The challenge of choosing the right prosthesis for the right patient – The devil is in the details "为合适的病人选择合适的假体所面临的挑战--细节决定成败"。

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2024.05.004

Gonçalo F. Coutinho

引用次数: 0

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