Revista Portuguesa De Cardiologia最新文献

英文中文

Bilateral patent ductus arteriosus anomaly 双侧动脉导管未闭异常。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2026-02-01 DOI: 10.1016/j.repc.2025.09.010

Leizhi Ku , Xiaojing Ma

引用次数: 0

Handgrip strength in heart failure: The “stethoscope” of the muscle? 心力衰竭的握力：肌肉的“听诊器”？

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2026-02-01 DOI: 10.1016/j.repc.2025.12.003

Jonathan dos Santos

引用次数: 0

Revealing the regulatory mechanism of Astragaloside IV in treating chronic heart failure through network pharmacology and animal experiments 通过网络药理学和动物实验揭示黄芪甲苷治疗慢性心力衰竭的调控机制。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2026-02-01 DOI: 10.1016/j.repc.2025.10.005

Chaoqun Xing , Haichen Guan , Xuemei Zhang , Xuanan Xiang , Zhiyong Yao

Introduction and objectives

Astragaloside IV (AS-IV) is an active compound that has demonstrated significant therapeutic potential for chronic heart failure (CHF), but its mechanism remains unclear. This study aimed to explore the regulatory mechanisms of AS-IV in the treatment of CHF.

Methods

The therapeutic targets and signaling pathways of AS-IV on CHF were predicted using network pharmacology. Molecular docking techniques were then used to validate these predicted results. Additionally, in vivo experiments were carried out for further validation, including echocardiographic studies, ELISA analysis, HWI measurements, HE staining, Hoechst staining, and Western blotting analysis.

Results

Network pharmacology analysis showed that cell apoptosis and the PI3K-Akt signaling pathway may be the primary mechanisms for AS-IV in the treatment of CHF. Molecular docking has shown that AS-IV has a relatively high binding affinity to core targets. In vivo experiments have shown that AS-IV improves cardiac dysfunction caused by CHF, reduces biomarker levels, alleviates cardiac hypertrophy, attenuates myocardial pathological changes, inhibits myocardial apoptosis, and up-regulates the expression levels of P-PI3K and P-AKT proteins.

Conclusion

This study demonstrates that AS-IV delays the progression of CHF, which may be achieved by inhibiting myocardial apoptosis via activating the PI3K-AKT signaling pathway. These findings have laid the foundation for research and application of AS-IV in CHF treatment.

黄芪甲苷（Astragaloside IV, AS-IV）是一种治疗慢性心力衰竭（CHF）的活性化合物，但其作用机制尚不清楚。本研究旨在探讨AS-IV在CHF治疗中的调控机制。方法：应用网络药理学方法预测AS-IV对慢性心力衰竭的治疗靶点和信号通路。然后使用分子对接技术验证这些预测结果。此外，还进行了体内实验以进一步验证，包括超声心动图研究、ELISA分析、HWI测量、HE染色、Hoechst染色和western blotting分析。结果：网络药理学分析显示，细胞凋亡和PI3K-Akt信号通路可能是AS-IV治疗CHF的主要机制。分子对接表明AS-IV对核心靶点具有较高的结合亲和力。体内实验表明，AS-IV可改善CHF所致心功能障碍，降低生物标志物水平，减轻心肌肥厚，减轻心肌病理改变，抑制心肌凋亡，上调P-PI3K和P-AKT蛋白表达水平。结论：本研究表明，AS-IV可能通过激活PI3K-AKT信号通路抑制心肌凋亡，从而延缓CHF的进展。这些发现为AS-IV在CHF治疗中的研究和应用奠定了基础。

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引用次数: 0

From network pharmacology to preclinical trials: Embracing modern translational validation of traditional Chinese medicine 从网络药理学到临床前试验：拥抱中医药的现代转化验证。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2026-02-01 DOI: 10.1016/j.repc.2026.01.001

André M. Leite-Moreira , Adelino F. Leite Moreira

引用次数: 0

Cardio-oncology meets pharmacoeconomics: Cardiovascular toxicity matters in cll treatment decisions. 心血管肿瘤学与药物经济学：心血管毒性影响细胞治疗决策。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2026-01-30 DOI: 10.1016/j.repc.2026.01.005

Júlia Cristina Toste

引用次数: 0

Response letter - Integrating Natriuretic Peptide Screening in Diabetic Patients: Practical Insights from a Neurosurgical Perspective. 回复信-整合糖尿病患者的利钠肽筛查：从神经外科角度的实际见解。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2026-01-30 DOI: 10.1016/j.repc.2026.01.006

João Sérgio Neves, Rui Baptista, Estêvão Azevedo de Pape, Manuel Rodrigues Pereira, Rita Paulos, Jonathan Pinheiro Dos Santos, Cristina Gavina, João Jácome de Castro

引用次数: 0

Hypertension prevalence in Portugal: A systematic review and meta-analysis of population-based studies. 葡萄牙高血压患病率：基于人群研究的系统回顾和荟萃分析。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2026-01-28 DOI: 10.1016/j.repc.2025.11.008

Jorge A Ribeiro Pereira, Renato G Bandeira-de-Mello, Vanessa Piccoli, José M Calheiros

Background: Hypertension is a major risk factor for cardiovascular diseases and a critical public health issue globally. In Portugal, hypertension is common among older adults. Also, recent trends suggest that its prevalence may have changed over the last decade following the 2009 implementation of a public policy regulating the maximum amount of salt allowed in bread.

Objective: This systematic review and meta-analysis aimed to determine the prevalence of hypertension in Portugal across different age groups and genders, analyzing trends over the past two decades.

Methods: A systematic literature search was conducted using the PubMed and Cochrane databases, as well as additional sources including publications from the Statistics Portugal and the Portuguese National Health Institute. Population-based cross-sectional and cohort studies reporting the prevalence of hypertension among Portuguese adults, published between 2000-2020, were included. The overall prevalence of hypertension was estimated using a random effects meta-analysis model.

Results: The overall prevalence of hypertension in Portugal was 31% (95% confidence interval (CI): 25.0%-37%, I²: 99.80%), with a prevalence of 34% in men (95% CI: 24%-46%, I²: 99.74%) and 33% in women (95% CI: 28%-38%, I²: 98.72%). Studies that measured blood pressure reported a higher prevalence (38%, 95% CI: 33%-43%, I²: 97.75%) compared to self-reported hypertension (24%, 95% CI: 21%-27%, I²: 99.20%). A downward trend in prevalence was observed in more recently published studies, especially in adults aged <35 years (from 17%, 95% CI: 12%-22%, I²: 0.81%, to 6%, 95% CI: 5%-8%, I²: 0.01%), and in individuals ≥65 years old from both sexes (from 80%, 95% CI: 77%-84%, I²: 61.09%, to 73%, 95% CI: 70%-77%, I²: 63.69%).

Conclusion: Despite recent decreases, hypertension remains highly prevalent in Portugal, particularly among older adults. Self-reported data tend to underestimate the true prevalence of hypertension compared to blood pressure measurements.

背景：高血压是心血管疾病的主要危险因素，也是全球重大的公共卫生问题。在葡萄牙，高血压在老年人中很常见。此外，最近的趋势表明，在2009年实施了一项公共政策，规定面包中允许的最大含盐量之后，其流行程度在过去十年中可能发生了变化。目的：本系统综述和荟萃分析旨在确定葡萄牙不同年龄组和性别的高血压患病率，分析过去20年的趋势。方法：使用PubMed和Cochrane数据库进行系统的文献检索，以及来自葡萄牙统计局和葡萄牙国家卫生研究所的出版物。纳入了2000-2020年间发表的葡萄牙成年人高血压患病率的基于人群的横断面和队列研究。使用随机效应荟萃分析模型估计高血压的总体患病率。结果：葡萄牙高血压总患病率为31%(95%可信区间（CI）： 25.0%-37%, I²：99.80%)，其中男性患病率为34% (95% CI: 24%-46%, I²：99.74%)，女性患病率为33% （95% CI: 28%-38%, I²：98.72%）。测量血压的研究报告的高血压患病率（38%,95% CI: 33%-43%, I²：97.75%）高于自我报告的高血压患病率（24%,95% CI: 21%-27%, I²：99.20%）。在最近发表的研究中观察到患病率呈下降趋势，特别是在老年人中。结论：尽管最近有所下降，但高血压在葡萄牙仍然非常普遍，特别是在老年人中。与血压测量相比，自我报告的数据往往低估了高血压的真实患病率。

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引用次数: 0

Costs and consequences of cardiovascular toxicity due to Bruton's tyrosine kinase inhibitors in chronic lymphocytic leukemia. 慢性淋巴细胞白血病布鲁顿酪氨酸激酶抑制剂引起的心血管毒性的成本和后果。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2026-01-27 DOI: 10.1016/j.repc.2025.11.007

Débora Figueira, João Costa, Manuela Fiuza, Andreia Magalhães, Mariana Paiva, Mariana Saraiva, Pedro Gonçalves-Teixeira, Margarida Borges

Introduction and objectives: BTK inhibitors (BTKis) have revolutionized the treatment landscape of chronic lymphocytic leukemia (CLL). However, a higher risk of cardiovascular toxicity is reported among CLL patients treated with BTKis. This study aims to estimate the costs and consequences of cardiovascular toxicity associated with the different BTKis used for CLL treatment in Portugal.

Methods: The incidence rates and health-related outcomes consequences among CLL patients, including bleeding events, de novo atrial fibrillation (AF) and hypertension were retrieved from the literature for the different BTKis. Direct medical costs (payers' perspective) associated with diagnosis, monitoring and treatment of cardiovascular toxicity were calculated for one year. Inpatient costs were derived from the Portuguese Hospital Morbidity Database. Outpatient costs were estimated from an expert panel.

Results: Incidence rates per 100 CLL BTKis-treated patients ranged from 38.0 (acalabrutinib) to 70.3 (zanubrutinib) for bleeding, from 5.4 (zanubrutinib) to 14.9 (ibrutinib) for AF, and from 6.6 (acalabrutinib) to 36.7 (zanubrutinib) for hypertension. Incidence rates of health outcomes related to AF (stroke and heart failure) were higher among ibrutinib-treated patients, whereas health outcomes related to hypertension (angina, myocardial infarction, heart failure and peripheral arterial disease) were higher among zanubrutinib-treated patients. Total costs per 100 CLL BTKis-treated patients over the first year were EUR 38803.10, EUR 82,683.61, and EUR 86,084.56 for acalabrutinib, zanubrutinib, and ibrutinib, respectively. In subsequent years, costs decreased by 47%, 43%, and 39%, respectively.

Conclusion: The clinical and economic burden of cardiovascular toxicity associated with BTKis treatment among CLL patients is high, with ibrutinib showing the highest impact in comparison to the more selective BTKis.

简介和目的：BTK抑制剂（BTKis）已经彻底改变了慢性淋巴细胞白血病（CLL）的治疗前景。然而，据报道，接受BTKis治疗的CLL患者心血管毒性风险更高。本研究旨在评估葡萄牙用于CLL治疗的不同BTKis相关的心血管毒性的成本和后果。方法：从不同btki的文献中检索CLL患者的发生率和健康相关结局，包括出血事件、新发心房颤动（AF）和高血压。计算了与心血管毒性的诊断、监测和治疗相关的一年直接医疗费用（付款人的观点）。住院费用来源于葡萄牙医院发病率数据库。门诊费用由专家小组估计。结果：每100名接受btkis治疗的CLL患者中，出血的发病率从38.0（阿卡鲁替尼）到70.3（扎鲁替尼），房颤的发病率从5.4（阿卡鲁替尼）到14.9（伊鲁替尼），高血压的发病率从6.6（阿卡鲁替尼）到36.7（扎鲁替尼）。在伊鲁替尼治疗的患者中，与房颤（中风和心力衰竭）相关的健康结局发生率较高，而与高血压（心绞痛、心肌梗死、心力衰竭和外周动脉疾病）相关的健康结局发生率在扎鲁替尼治疗的患者中较高。acalabrutinib、zanubrutinib和ibrutinib第一年每100名CLL btkis治疗患者的总成本分别为38803.10欧元、82,683.61欧元和86,084.56欧元。在随后的几年中，成本分别下降了47%、43%和39%。结论：在CLL患者中，与BTKis治疗相关的心血管毒性的临床和经济负担很高，与更具选择性的BTKis相比，伊鲁替尼的影响最大。

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引用次数: 0

Cardiopulmonary exercise stress testing in Portugal: A national survey of cardiologist members of the Portuguese Society of Cardiology. 葡萄牙的心肺运动压力测试：葡萄牙心脏病学会心脏病专家成员的全国调查。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2026-01-27 DOI: 10.1016/j.repc.2025.10.007

Eduardo M Vilela, Luísa Bento, Alexandre Antunes, Luís Oliveira, Miguel Mendes, Ana Abreu, Anaí Durazzo, Gonçalo Cunha, Hélder Dores, Hélder Pereira, João Gameiro, Lino Gonçalves, Madalena Teixeira, Mário Santos, Paulo Dinis, Ricardo Fontes-Carvalho, Sandra Amorim, Cristina Gavina

Introduction and objectives: Cardiopulmonary exercise testing (CPET) provides relevant data in several clinical contexts. Although reports highlight its application across various moments of the cardiovascular continuum, from heart failure (HF) to the assessment of athletes, its implementation has been described as suboptimal. This study aimed to assess perspectives on CPET training and usage patterns among cardiologists in Portugal.

Methods: An online questionnaire divided into three parts (participant characteristics, training and application of CPET and knowledge assessment) was structured and sent to members of the Portuguese Society of Cardiology. The study population comprised physicians with a medical specialty in cardiology (specialists or residents from the second year onwards).

Results: 70 individuals (52.9% male, 57.1% ≤ 50 years-old) provided valid answers. Most (58.6%) had access to CPET in their workplace, while 65.7% reported using it in their clinical practice; HF was the most frequent indication for use. Just under half of participants (48.6%) had not dedicated or intended to dedicate time to CPET during residency, lack of access, interest, and time were the most frequently reported reasons. Less than half of those who participated in CPET exams during residency thought they had become proficient in its use. Most participants (97.1%) reported that specific training during residency could improve usage.

Conclusions: This survey provides up to date information on CPET implementation, highlighting challenges and areas of potential improvement, such as training and accessibility. These findings may provide a framework for optimizing the use of this key test in cardiovascular medicine.

前言和目的：心肺运动试验（CPET）为几种临床情况提供了相关数据。虽然报告强调了它在心血管连续体的各个时刻的应用，从心力衰竭（HF）到运动员的评估，但它的实施被描述为次优。本研究旨在评估葡萄牙心脏病专家对CPET培训和使用模式的看法。方法：制作在线问卷，分为参与者特征、CPET培训与应用、知识评估三部分，并发送给葡萄牙心脏病学会会员。研究人群包括具有心脏病学医学专业的医生（第二年以后的专家或住院医师）。结果：70人提供了有效答案，其中男性占52.9%，年龄≤50岁者占57.1%。大多数人（58.6%）在工作场所使用CPET， 65.7%的人在临床实践中使用CPET；心衰是最常见的适应症。不到一半的参与者（48.6%）在住院期间没有专门或打算专门花时间进行CPET，缺乏访问，兴趣和时间是最常见的原因。在住院医师期间参加CPET考试的人中，只有不到一半的人认为他们已经熟练使用CPET。大多数参与者（97.1%）报告住院期间的特定培训可以提高使用率。结论：这项调查提供了CPET实施的最新信息，突出了挑战和潜在改进的领域，如培训和可及性。这些发现可能为优化这一关键测试在心血管医学中的应用提供一个框架。

{"title":"Cardiopulmonary exercise stress testing in Portugal: A national survey of cardiologist members of the Portuguese Society of Cardiology.","authors":"Eduardo M Vilela, Luísa Bento, Alexandre Antunes, Luís Oliveira, Miguel Mendes, Ana Abreu, Anaí Durazzo, Gonçalo Cunha, Hélder Dores, Hélder Pereira, João Gameiro, Lino Gonçalves, Madalena Teixeira, Mário Santos, Paulo Dinis, Ricardo Fontes-Carvalho, Sandra Amorim, Cristina Gavina","doi":"10.1016/j.repc.2025.10.007","DOIUrl":"https://doi.org/10.1016/j.repc.2025.10.007","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Cardiopulmonary exercise testing (CPET) provides relevant data in several clinical contexts. Although reports highlight its application across various moments of the cardiovascular continuum, from heart failure (HF) to the assessment of athletes, its implementation has been described as suboptimal. This study aimed to assess perspectives on CPET training and usage patterns among cardiologists in Portugal.</p><p><strong>Methods: </strong>An online questionnaire divided into three parts (participant characteristics, training and application of CPET and knowledge assessment) was structured and sent to members of the Portuguese Society of Cardiology. The study population comprised physicians with a medical specialty in cardiology (specialists or residents from the second year onwards).</p><p><strong>Results: </strong>70 individuals (52.9% male, 57.1% ≤ 50 years-old) provided valid answers. Most (58.6%) had access to CPET in their workplace, while 65.7% reported using it in their clinical practice; HF was the most frequent indication for use. Just under half of participants (48.6%) had not dedicated or intended to dedicate time to CPET during residency, lack of access, interest, and time were the most frequently reported reasons. Less than half of those who participated in CPET exams during residency thought they had become proficient in its use. Most participants (97.1%) reported that specific training during residency could improve usage.</p><p><strong>Conclusions: </strong>This survey provides up to date information on CPET implementation, highlighting challenges and areas of potential improvement, such as training and accessibility. These findings may provide a framework for optimizing the use of this key test in cardiovascular medicine.</p>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Initial experience with the extravascular implantable cardioverter-defibrillator: workflow, feasibility and safety. 血管外植入式心律转复除颤器的初步经验：工作流程、可行性和安全性。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2026-01-23 DOI: 10.1016/j.repc.2025.10.006

Ana Lousinha, Hagen Kahlbau, Sara Coelho, Sofia Jacinto, Rodrigo Sousa, Margarida Paulo, Susana Covas, Abel Domingues, Ana Trindade, Sílvia Aguiar Rosa, Nuno Cardim, Rui Cruz Ferreira, Mário Oliveira

Introduction and objectives: Implantable cardioverter-defibrillators (ICDs) are among the most effective interventions for the prevention of sudden cardiac death. However, traditional transvenous systems are associated with venous access and intracardiac lead complications. Subcutaneous ICDs (S-ICD), which were developed to overcome these complications, are unable to provide anti-tachycardia pacing (ATP) or pause prevention pacing. The extravascular ICD (EV-ICD) is a recent technological innovation designed to mitigate these limitations by enabling cardioversion, defibrillation and pacing without entering the central venous system. Our aim was to assess the initial experience with the new EV-ICD system, as a valid alternative to transvenous ICD and S-ICD, including patient selection, implantation technique, procedure feasibility and safety, functional parameters, and immediate clinical outcomes.

Methods: We conducted an observational study of all patients who underwent EV-ICD implantation between November 2024 and June 2025 at two centers. Demographic, clinical, imaging, pharmacologic and procedural data were analyzed.

Results: A total of 11 patients were included, with a mean age of 36.3 years (range 19-59); 27% were female. Main diagnoses included hypertrophic cardiomyopathy (n=3), left ventricular non-dilated cardiomyopathy (n=3), dilated cardiomyopathy (n=2), Brugada syndrome (n=1), polymorphic ventricular tachycardia (n=1) and arrhythmogenic right ventricular cardiomyopathy (n=1). There were no procedural or peri-procedural complications. The mean procedure duration ("skin-to-skin") was 68.2 minutes (range 60-78). Median fluoroscopy time was 3.9 minutes (range 2.5-6.2). Defibrillation threshold (DFT) testing was successful in all cases. During the follow-up, two patients received an inappropriate shock, one due to sinus tachycardia and the other due to oversensing of myopotentials.

Conclusions: Our initial experience with the EV-ICD confirms the feasibility and safety of the procedure. This novel system may offer an effective alternative for selected populations, especially young patients with extended life expectancy and high cumulative device exposure. The rate of inappropriate shocks remains a concern and improvements are required to reduce these events.

简介和目的：植入式心律转复除颤器（ICDs）是预防心源性猝死最有效的干预措施之一。然而，传统的经静脉系统与静脉通路和心内导联并发症有关。为了克服这些并发症而开发的皮下icd （S-ICD）无法提供抗心动过速起搏（ATP）或暂停预防起搏。血管外ICD （EV-ICD）是最近的一项技术创新，旨在通过在不进入中心静脉系统的情况下实现心律转复、除颤和起搏来减轻这些限制。我们的目的是评估新的EV-ICD系统的初步经验，作为经静脉ICD和S-ICD的有效替代方案，包括患者选择、植入技术、手术可行性和安全性、功能参数和即时临床结果。方法：我们对2024年11月至2025年6月在两个中心接受EV-ICD植入的所有患者进行了一项观察性研究。对人口学、临床、影像学、药理学和手术资料进行分析。结果：共纳入11例患者，平均年龄36.3岁（范围19-59岁）；27%是女性。主要诊断为肥厚性心肌病（n=3）、左室非扩张型心肌病（n=3）、扩张型心肌病（n=2）、Brugada综合征（n=1）、多形性室性心动过速（n=1）、致心律失常性右室心肌病（n=1）。无术中或术中并发症。平均手术时间（“皮肤对皮肤”）为68.2分钟（范围60-78）。中位透视时间3.9分钟（范围2.5-6.2分钟）。除颤阈值（DFT）测试在所有病例中均成功。在随访中，两名患者接受了不适当的电击，一名是由于窦性心动过速，另一名是由于对肌电位的过度感知。结论：我们对EV-ICD的初步经验证实了该手术的可行性和安全性。这种新颖的系统可能为特定人群提供有效的替代方案，特别是预期寿命延长和高累积装置暴露的年轻患者。不适当冲击的发生率仍然令人关切，需要改进以减少这些事件。

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