Revista Portuguesa De Cardiologia最新文献

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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

Ventricular tachycardia ablation in non-ischemic cardiomyopathy: A Sisyphean task? 非缺血性心肌病的室性心动过速消融术：一项艰巨的任务？

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.2024.05.006

Guilherme Portugal

引用次数: 0

Are we missing an opportunity? Prehospital delay in patients with acute ischemic stroke and known atrial fibrillation 我们是否错失良机？急性缺血性脑卒中和已知心房颤动患者的院前延误。

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.2023.11.005

Marta Magriço , Miguel Serôdio , João Nuno Ramos , Rita Ventura , André Sobral-Pinho , João Pedro Marto , Miguel Viana-Baptista

Introduction and Objectives

The follow-up of patients with atrial fibrillation (AF) presents an opportunity to alert patients and their families on how to recognize and act in the event of stroke. Our aim was to compare stroke recognition-to-door time and prehospital stroke code activation in patients with known AF (KAF) and AF detected after stroke (AFDAS).

Methods

We performed a retrospective cohort study of consecutive patients receiving acute recanalization treatment for acute ischemic stroke between January 2016 and August 2022, with AF as a potential stroke cause. Patients were divided into KAF and AFDAS, and stroke recognition-to-door time and prehospital stroke code activation were compared. In the KAF subgroup, we assessed whether the use of preadmission anticoagulation was associated with the studied prehospital parameters.

Results

We included 438 patients, 290 female (66.2%), mean age 79.3±9.4 years. In total, 238 patients had KAF (54.3%) and 200 (45.7%) had AFDAS. Of those with KAF, 114 (48.1%) were pretreated with anticoagulation. Patients with KAF and AFDAS had no differences in stroke recognition-to-door time (74.0 [55.0–101.0] vs. 78.0 [60.0–112.0] min; p=0.097) or prehospital stroke code activation [148 (64.6%) vs. 128 (65.3%); p=0.965]. In the KAF subgroup, preadmission anticoagulation did not influence stroke recognition-to-door time or mode of hospital admission.

Conclusion

Stroke recognition-to-door time and prehospital stroke code activation were similar between patients with known or newly diagnosed AF. Preadmission anticoagulation treatment also did not affect the studied parameters. Our findings highlight a missed opportunity to promote stroke knowledge in patients followed due to AF.

导言和目标：对心房颤动（AF）患者的随访为提醒患者及其家属在发生卒中时如何识别和采取行动提供了机会。我们的目的是比较已知心房颤动患者（KAF）和中风后发现心房颤动患者（AFDAS）的中风识别到门时间和院前中风代码激活情况：我们对 2016 年 1 月至 2022 年 8 月间因急性缺血性卒中接受急性再通治疗的连续患者进行了回顾性队列研究，房颤是卒中的潜在原因。研究人员将患者分为 KAF 和 AFDAS 两组，并比较了卒中识别到门时间和院前卒中代码激活情况。在 KAF 亚组中，我们评估了入院前抗凝药的使用是否与所研究的院前参数相关：我们共纳入了 438 名患者，其中 290 名女性（66.2%），平均年龄为 79.3±9.4 岁。共有 238 名患者患有 KAF（54.3%），200 名患者患有 AFDAS（45.7%）。在 KAF 患者中，114 人（48.1%）接受了抗凝治疗。KAF 患者和 AFDAS 患者的卒中识别到门时间（74.0 [55.0-101.0] 分钟 vs. 78.0 [60.0-112.0] 分钟；p=0.097）或院前卒中代码激活时间（148 (64.6%) vs. 128 (65.3%)；p=0.965）无差异。在 KAF 亚组中，入院前的抗凝治疗并不影响卒中识别到入院的时间或入院方式：结论：已知心房颤动或新诊断心房颤动的患者的卒中识别至入院时间和院前卒中代码激活时间相似。入院前的抗凝治疗也不会影响研究参数。我们的研究结果凸显了在心房颤动患者中宣传卒中知识所错失的良机。

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引用次数: 0

Ghost in the heart: A case of post ischemia left ventricular false tendon rupture 心脏里的幽灵一例缺血后左心室假腱断裂。

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.2023.10.008

Mostafa Yahyazadeh Andevari, Reza Hali

引用次数: 0

Current and future challenges: Exploring new opportunities in stroke education for atrial fibrillation patients 当前和未来的挑战：探索心房颤动患者卒中教育的新机遇。

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.2024.04.004

Alexandre Amaral e Silva

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 : 2024-05-15 DOI: 10.1016/j.repc.2024.05.004

Gonçalo F Coutinho

引用次数: 0

Predictors of systolic function recovery after atrial fibrillation ablation in heart failure patients 心力衰竭患者心房颤动消融术后收缩功能恢复的预测因素。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-05-01 DOI: 10.1016/j.repc.2024.02.008

Introduction and Objectives

Atrial fibrillation (AF) and heart failure (HF) often coexist. AF catheter ablation improves left ventricular ejection fraction (LVEF), but its impact varies between patients. We aimed to identify predictors of LVEF improvement in HF patients with impaired LVEF undergoing AF ablation.

Methods

We conducted a retrospective single-center study in HF patients with LVEF <50% undergoing AF catheter ablation between May 2016 and May 2022. The primary endpoint was the LVEF recovery rate (‘responders’). Secondary endpoints were one-year safety and effectiveness. We also aimed to validate a prediction model for LVEF recovery.

Results

The study included 100 patients (79% male, median age 60 years, 70% with probable tachycardia-induced cardiomyopathy [TIC], mean LVEF 37%, 29% with paroxysmal AF). After a median follow-up of 12 months after catheter ablation, LVEF improved significantly (36±10% vs. 53±10%, p<0.001), with an 82% responder rate. A suspected diagnosis of TIC (OR 4.916 [95% CI 1.166–20.732], p=0.030), shorter QRS duration (OR 0.969 [95% CI 0.945–0.994], p=0.015), and smaller left ventricle (OR 0.893 [95% CI 0.799–0.999], p=0.049) were independently associated with LVEF improvement. Freedom from any documented atrial arrhythmia was 86% (64% under antiarrhythmic drugs), and the rate of adverse events was 2%. The prediction model had a good discriminative performance (AUC 0.814 [95% CI 0.681–0.947]).

Conclusion

In AF patients with HF and impaired LVEF, suspected TIC, shorter QRS duration, and smaller LV diameter were associated with LVEF recovery following AF catheter ablation.

导言和目标：心房颤动（AF）和心力衰竭（HF）常常同时存在。房颤导管消融可改善左心室射血分数（LVEF），但其影响因患者而异。我们旨在确定接受房颤消融术的 LVEF 受损的 HF 患者 LVEF 改善的预测因素：我们对 LVEF 低的心房颤动患者进行了一项回顾性单中心研究：研究纳入了 100 名患者（79% 为男性，中位年龄为 60 岁，70% 可能患有心动过速诱发的心肌病 [TIC]，平均 LVEF 为 37%，29% 患有阵发性房颤）。导管消融术后中位随访 12 个月，LVEF 显著改善（36±10% vs. 53±10%，pConclusion）：对于伴有心房颤动和 LVEF 受损的房颤患者，疑似 TIC、较短的 QRS 持续时间和较小的左心室直径与房颤导管消融后 LVEF 的恢复有关。

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引用次数: 0

Left bundle branch block-induced dilated cardiomyopathy: Definitions, pathophysiology, and therapy 左束支传导阻滞性扩张型心肌病：定义、病理生理学和治疗。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-04-12 DOI: 10.1016/j.repc.2024.02.004

Left bundle branch block (LBBB) is a frequent finding in patients with heart failure (HF), particularly in those with dilated cardiomyopathy (DCM). LBBB has been commonly described as a consequence of DCM development. However, a total recovery of left ventricular (LV) function after cardiac resynchronization therapy (CRT), observed in patients with LBBB and DCM, has led to increasing acknowledgement of LBBB-induced dilated cardiomyopathy (LBBB-iDCM) as a specific pathological entity. Its recognition has important clinical implications, as LBBB-iDCM patients may benefit from an early CRT strategy rather than medical HF therapy only. At present, there are no definitive diagnostic criteria enabling the universal identification of LBBB-iDCM, and no defined therapeutic approach in this subgroup of patients. This review compiles the main findings about LBBB-iDCM pathophysiology and the current proposed diagnostic criteria and therapeutic approach.

左束支传导阻滞（LBBB）是心力衰竭（HF）患者，尤其是扩张型心肌病（DCM）患者的常见病。LBBB 通常被描述为 DCM 发展的结果。然而，在 LBBB 和 DCM 患者中观察到的心脏再同步化疗法（CRT）后左室（LV）功能的完全恢复，使人们越来越认识到 LBBB 诱导的扩张型心肌病（LBBB-iDCM）是一种特殊的病理实体。对它的认识具有重要的临床意义，因为 LBBB-iDCM 患者可能会从早期 CRT 策略中获益，而不仅仅是接受药物高频治疗。目前，还没有明确的诊断标准能够普遍识别 LBBB-iDCM，也没有针对该亚组患者的明确治疗方法。本综述汇编了有关 LBBB-iDCM 病理生理学的主要研究结果以及目前提出的诊断标准和治疗方法。

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IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-04-01 DOI: 10.1016/S0870-2551(24)00154-9

引用次数: 0

Congresso Português de Cardiologia 2024 - Rumo à evidência e inovação 2024 年葡萄牙心脏病学大会 - 走向实证与创新

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-04-01 DOI: 10.1016/S0870-2551(24)00147-1

引用次数: 0

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