Revista Portuguesa De Cardiologia最新文献

英文中文

Successful removal of right atrial thrombus using a large-bore aspiration system 大口径抽吸系统成功清除右心房血栓。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-12-01 DOI: 10.1016/j.repc.2025.06.006

Margarida G. Figueiredo , Mariana Saraiva , Melanie Ferreira , Luís Almeida Morais

引用次数: 0

Response to the Letter to the Editor “Ikigai and cardiovascular health in older adults: A missed opportunity for prevention?” 对《老年人Ikigai和心血管健康：错过了预防的机会？》

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-12-01 DOI: 10.1016/j.repc.2025.10.002

Sofia Cabral , Cristina Gavina , Hélder Pereira

引用次数: 0

The hidden legacy of a surgical triumph: Coronary anomalies after arterial switch operation 外科手术胜利的隐藏遗产：动脉转换手术后的冠状动脉异常

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-12-01 DOI: 10.1016/j.repc.2025.11.002

Sérgio Laranjo

引用次数: 0

Ikigai and cardiovascular health in older adults: A missed opportunity for prevention? 老年人的Ikigai和心血管健康：错过了预防的机会？

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-12-01 DOI: 10.1016/j.repc.2025.07.005

Mariana Alves

引用次数: 0

Lipid-lowering therapy and LDL cholesterol control among high- and very high-risk patients in Portugal: An analysis of the SANTORINI study. 降脂治疗和低密度脂蛋白胆固醇控制在葡萄牙的高风险和高危患者：圣托里尼研究的分析。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-11-28 DOI: 10.1016/j.repc.2025.10.003

Carlos Aguiar, Patrício Aguiar, João Sequeira Duarte, Victor Gil, Jorge Mimoso, Pedro Monteiro, Fausto J Pinto, Fernando Pinto, João Raposo, Pedro von Hafe, Jorge A Ruivo, Carla Teixeira, Alberico L Catapano, Kausik K Ray

Introduction and objectives: The SANTORINI study is the first large-scale, European observational study conducted following the release of the 2019 European Society of Cardiology/European Atherosclerosis Society ESC/EAS guidelines on dyslipidemia management. This analysis aims to assess lipid-lowering therapy (LLT) use and low-density lipoprotein cholesterol (LDL-C) goal attainment in patients at high or very high cardiovascular (CV) risk enrolled in Portugal.

Methods: In Portugal, 117 patients were enrolled across 10 sites between September 2020 and February 2021. Paired LDL-C values at baseline and one-year follow-up were available for 102 patients. LDL-C levels, LLT utilization patterns, and LDL-C goal attainment (as per the 2019 ESC/EAS guidelines) were assessed at both time points and compared with the broader European cohort, excluding Portuguese participants.

Results: Over the one-year follow-up, the use of statin monotherapy decreased from 49.5% to 45.2%, while combination therapy with statin and ezetimibe increased from 35.9% to 40.9%. LLT intensity was escalated in 12.8% of patients, unchanged in 79.5%, and de-escalated in 6.0%. Mean LDL-C levels were similar between baseline and one-year follow-up: corresponding values were 90.2 mg/dL and 90.1 mg/dL in high-risk patients, and 74.1 mg/dL and 75.2 mg/dL in very high-risk patients. LDL-C goal attainment declined from 34.1% to 22.7% in high-risk patients and 27.6% to 22.4% in very high-risk patients.

Conclusions: The Portuguese cohort of the SANTORINI study demonstrates both encouraging developments and ongoing challenges in the real-world management of dyslipidemia following the 2019 ESC/EAS guidelines. Reasons for lack of LLT intensification and factors underlying worsening rates for LDL-C goal attainment should be explored.

简介和目的：SANTORINI研究是2019年欧洲心脏病学会/欧洲动脉粥样硬化学会ESC/EAS关于血脂异常管理指南发布后进行的第一个大规模欧洲观察性研究。本分析旨在评估降脂治疗（LLT）的使用和低密度脂蛋白胆固醇（LDL-C）目标在葡萄牙注册的高或非常高心血管（CV）风险患者中的实现情况。方法：在葡萄牙，2020年9月至2021年2月期间，在10个地点招募了117名患者。102例患者基线和1年随访时的配对LDL-C值。在两个时间点评估LDL-C水平、LLT利用模式和LDL-C目标实现情况（根据2019年ESC/EAS指南），并与更广泛的欧洲队列（不包括葡萄牙参与者）进行比较。结果：在1年的随访中，他汀类药物单药使用率从49.5%下降到45.2%，而他汀类药物与依折替米贝联用使用率从35.9%上升到40.9%。12.8%的患者LLT强度升高，79.5%的患者强度不变，6.0%的患者强度降低。基线和一年随访期间的平均LDL-C水平相似：高危患者相应值为90.2 mg/dL和90.1 mg/dL，高危患者相应值为74.1 mg/dL和75.2 mg/dL。高危患者LDL-C目标达标率从34.1%下降到22.7%，高危患者从27.6%下降到22.4%。结论：SANTORINI的葡萄牙队列研究显示，在遵循2019年ESC/EAS指南的实际血脂异常管理中，既有令人鼓舞的发展，也存在持续的挑战。应探讨缺乏LLT强化的原因和LDL-C目标达成率恶化的潜在因素。

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引用次数: 0

Cardiogenic shock: A cardiac emergency requires cardiac leadership. 心源性休克：心脏急症需要心脏领导。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-11-28 DOI: 10.1016/j.repc.2025.11.004

Jorge Ferreira, Ricardo Fontes Carvalho

引用次数: 0

20 years of experience with the Fontan procedure: Risk factors for adverse outcomes 20年的丰坦手术经验：不良后果的危险因素。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-11-01 DOI: 10.1016/j.repc.2025.04.006

Tianyu Chen , Linjiang Han , Hailong Qiu , Zewen Chen , Jianzheng Cen , Shusheng Wen , Jimei Chen , Xiaobing Liu , Jian Zhuang

Introduction and objectives

The Fontan procedure and the management of patients with univentricular physiology have undergone significant evolution over the past five decades. However, the long-term outcomes of these patients remain not fully understood. This study aimed to evaluate the early and long-term outcomes of patients undergoing the Fontan procedure and to identify risk factors associated with adverse clinical events.

Methods

Patients who underwent the Fontan procedure between 2004 and 2023 were included in this study. Multivariable logistic regression analysis was employed to assess risk factors for early mortality, while a Cox proportional hazards regression model was used to evaluate predictors of long-term Fontan failure.

Results

A total of 400 patients were included, with a male predominance (67.3%). Median age at the time of the Fontan procedure was 5.8 years (interquartile range: 4.1–11.0 years). The distribution of ventricular morphology was as follows: dominant right ventricle (33%), dominant left ventricle (35.75%), and two well-developed ventricles (28.75%). The early mortality rate was 5.5%. The overall survival rates at 5-, 10-, and 15-years post-Fontan surgery were 97.5%, 92.6%, and 90.0%, respectively. Multivariable analysis identified asplenia (odds ratio [OR], 10.2; 95% confidence interval [CI], 2.8–36.4; p<0.01), single-stage total cavopulmonary connection (OR, 5.3; 95% CI, 1.7–16.8; p<0.01), and prolonged cardiopulmonary bypass time (OR, 1.0; 95% CI, 1.0–1.0; p<0.01) as significant predictors of early mortality. Cox regression analysis demonstrated that heterotaxy (hazard ratio [HR], 3.5; 95% CI, 1.4–8.7; p<0.01) was an independent risk factor for late Fontan failure.

Conclusion

The staged Fontan strategy was associated with reduced early mortality but did not confer significant benefits on long-term outcomes. Patients with heterotaxy were at an increased risk of late Fontan failure, highlighting the need for tailored management strategies in this high-risk population.

前言和目的：在过去的五十年里，Fontan手术和单心室生理患者的管理经历了重大的演变。然而，这些患者的长期预后仍不完全清楚。本研究旨在评估接受Fontan手术的患者的早期和长期预后，并确定与不良临床事件相关的危险因素。方法：2004年至2023年间接受Fontan手术的患者纳入本研究。采用多变量logistic回归分析评估早期死亡的危险因素，采用Cox比例风险回归模型评估长期Fontan失效的预测因素。结果：共纳入400例患者，男性居多（67.3%）。Fontan手术时的中位年龄为5.8岁（四分位数范围：4.1-11.0岁）。心室形态分布：右心室优势（33%），左心室优势（35.75%），两个心室发育良好（28.75%）。早期死亡率为5.5%。fontan手术后5年、10年和15年的总生存率分别为97.5%、92.6%和90.0%。多变量分析发现，脾功能不全（优势比[OR]， 10.2； 95%可信区间[CI]， 2.8-36.4; p < 0.01）、单期全腔肺连接（OR, 5.3; 95% CI, 1.7-16.8; p < 0.01）和延长体外循环时间（OR, 1.0; 95% CI, 1.0-1.0; p < 0.01）是早期死亡的重要预测因素。Cox回归分析显示，异质性（风险比[HR]为3.5；95% CI为1.4 ~ 8.7;p < 0.01）是晚期Fontan衰竭的独立危险因素。结论：分阶段Fontan策略与降低早期死亡率相关，但对长期预后没有显著益处。异位患者晚期Fontan失败的风险增加，突出了在这一高危人群中定制管理策略的必要性。

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Etiology of sudden cardiac arrest: Literature review and proposal for an intensive care unit study protocol 心脏骤停的病因学：文献回顾和重症监护病房研究方案的建议。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-11-01 DOI: 10.1016/j.repc.2025.04.007

João Cravo , Daniel Inácio Cazeiro , Oana Moldovan , Nuno Cortez-Dias , Doroteia Silva

Sudden cardiac arrest (SCA) affects individuals across all age groups and is defined as the sudden cessation of normal cardiac activity, leading to hemodynamic collapse. Determining the etiology of SCA is challenging due to its wide range of cardiac and noncardiac causes. Structural heart disease, mainly coronary artery disease, is predominant in older adults, while cardiomyopathies and primary electrical diseases are more common in younger individuals. Noncardiac causes, such as intracranial hemorrhage and pulmonary embolism, account for 15–25% of cases. This review examines the epidemiology, etiology, and investigation of SCA and proposes a diagnostic approach for SCA patients admitted to the emergency department and intensive care unit. The study protocol is divided into four main stages: (1) initial evaluation, identification of reversible causes, and exclusion of ischemic heart disease and extracardiac disease; (2) assessment of nonischemic cardiac causes; (3) neuroprognostication; and (4) clinical autopsy and/or genetic testing, if appropriate. We emphasize the importance of a multidisciplinary approach, involving an intensivist, cardiologist, neurologist, geneticist, and pathologist, as well as early genetic testing to identify potential heritable diseases and facilitate early referral of patient relatives. By providing this structured diagnostic algorithm, we aim to improve the management and outcomes of SCA patients.

心脏骤停（SCA）影响所有年龄组的个体，被定义为正常心脏活动突然停止，导致血液动力学崩溃。由于其广泛的心脏和非心脏原因，确定SCA的病因是具有挑战性的。结构性心脏病，主要是冠状动脉疾病，在老年人中占主导地位，而心肌病和原发性电性疾病在年轻人中更常见。非心脏原因，如颅内出血和肺栓塞，占病例的15-25%。本文综述了SCA的流行病学、病因学和调查，并提出了一种用于急诊和重症监护病房的SCA患者的诊断方法。研究方案分为四个主要阶段：(1)初步评估，确定可逆原因，排除缺血性心脏病和心外疾病；(2)评估非缺血性心脏原因；(3) neuroprognostication;(4)临床尸检和/或基因检测，如果合适的话。我们强调多学科方法的重要性，包括重症医师、心脏病专家、遗传学家和病理学家，以及早期基因检测，以识别潜在的遗传性疾病，并促进患者亲属的早期转诊。通过提供这种结构化的诊断算法，我们旨在改善SCA患者的管理和预后。

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引用次数: 0

The long Fontan crusade 漫长的十字军东征。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-11-01 DOI: 10.1016/j.repc.2025.09.001

José Fragata

引用次数: 0

Silent expansion: A case report of a young adult with ascending aortic aneurysm 无声扩张：1例年轻成人升主动脉瘤。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-11-01 DOI: 10.1016/j.repc.2025.03.009

Carla Costa , Márcio Madeira , Lígia Mendes

引用次数: 0

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