Revista Portuguesa De Cardiologia最新文献

英文中文

Response to Letter to the Editor, regarding “Use of direct oral anticoagulants in patients with stroke transferred for thrombectomy” 对致编辑的信的回复，关于“直接口服抗凝剂在卒中患者中用于取栓术”。

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.2025.10.001

Gustavo C. Santo , Ana Isabel Rodrigues

引用次数: 0

Dapagliflozin: A new frontier in mitochondrial cardioprotection 达格列净：线粒体心脏保护的新前沿。

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.2025.09.004

Carla Marques , Henrique Girão

引用次数: 0

Left atrial appendage aneurysm: An unexpected finding in a patient with asymptomatic atrial fibrillation 左心房附件动脉瘤：无症状心房颤动患者的意外发现。

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.2025.03.010

Javier Cantalapiedra Romero , Carlos Izurieta , Marta Zielonka

引用次数: 0

Dapagliflozin alleviates isoprenaline-induced cardiac hypertrophy by promoting mitophagy via AMPKα2 signaling pathway 达格列净通过AMPKα2信号通路促进线粒体自噬减轻异丙肾上腺素诱导的心肌肥厚。

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.2025.05.008

Yue Feng, Zixiong Zhu, Xin Jing, Yibo Zhang, Yubin He, Xuewen Li

Introduction and objectives

The global prevalence of heart failure (HF) has been increasing in recent years, posing a significant threat to human health. Several studies have shown that impaired mitophagy accelerates HF progression. Dapagliflozin (DAPA) has demonstrated cardioprotective effects in HF patients. This study aims to investigate the therapeutic effects of DAPA on cardiomyocyte hypertrophy and its underlying mechanism.

Methods

The working concentration of isoprenaline (ISO) was determined through combined quantitative real-time polymerase chain reaction (qPCR) and CCK-8 assays. H9c2 cells were stimulated with ISO to induce a hypertrophy model. Cellular hypertrophy was quantified by qPCR and TRITC-phalloidin staining. Mitochondrial ultrastructure and functional integrity was assessed by transmission electron microscopy and JC-1 staining. Mitophagy levels were measured using Western blotting and co-localization assays. AMPKα2 expression levels were determined via Western blotting. Following AMPKα2 siRNA transfection, cellular hypertrophy and mitophagy levels were reassessed.

Results

ISO markedly induced cardiomyocyte hypertrophy, mitochondrial damage and mitophagy inhibition, whereas DAPA effectively attenuated these pathologica changes, with AMPK agonists demonstrating comparable cardioprotective effects. In ISO-treated H9c2 cells, AMPKα2 expression was reduced, while DAPA significantly upregulated its expression. Notably, AMPKα2 inhibition significantly weakened DAPA's protective effect on ISO-induced hypertrophy and mitochondrial injury.

Conclusion

DAPA exerts cardioprotective effects by mitigating ISO-induced cardiac hypertrophy and preserving mitochondrial integrity, mediated through AMPKα2-dependent activation of mitophagy.

前言和目标：近年来，心力衰竭（HF）的全球患病率不断上升，对人类健康构成重大威胁。一些研究表明，线粒体自噬受损会加速心衰的进展。达格列净（DAPA）在心衰患者中显示出心脏保护作用。本研究旨在探讨DAPA对心肌细胞肥厚的治疗作用及其机制。方法：采用实时定量聚合酶链反应（qPCR）和CCK-8联合测定异丙肾上腺素（ISO）的工作浓度。用ISO刺激H9c2细胞，形成细胞肥大模型。采用qPCR和TRITC-Phalloidin染色定量检测细胞肥大。透射电镜和JC-1染色观察线粒体超微结构和功能完整性。用Western blotting和共定位法测定线粒体自噬水平。Western blotting检测AMPKα2的表达水平。转染AMPKα2 siRNA后，重新评估细胞肥大和有丝分裂水平。结果：ISO显著诱导心肌细胞肥大、线粒体损伤和线粒体自噬抑制，而DAPA有效地减轻了这些病理变化，AMPK激动剂显示出类似的心脏保护作用。在iso处理的H9c2细胞中，AMPKα2表达降低，而DAPA显著上调其表达。值得注意的是，AMPKα2抑制显著削弱了DAPA对iso诱导的肥大和线粒体损伤的保护作用。结论：DAPA通过ampk α2依赖性的线粒体自噬激活，减轻iso诱导的心肌肥厚，维持线粒体完整性，发挥心肌保护作用。

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引用次数: 0

Letter to the Editor, regarding the “Use of direct oral anticoagulants in patients with stroke transferred for thrombectomy” recently published by Rodrigues 致编辑的信，关于Rodrigues最近发表的“直接口服抗凝剂在卒中患者中用于取栓”。

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.2025.09.005

Matija Zupan , Senta Frol

引用次数: 0

The impact of the COVID-19 pandemic on arterial hypertension monitoring in Portugal COVID-19大流行对葡萄牙动脉高血压监测的影响

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-10-01 DOI: 10.1016/j.repc.2025.06.005

Diogo Mendes , Daniel Figueiredo , Carlos Alves , Ricardo Amaral , Beatriz Costa , Ana Penedones , Francisco Batel-Marques

Introduction and objectives

This study aimed to evaluate the impact of the COVID-19 pandemic on healthcare provided to patients with arterial hypertension in Portugal.

Methods

The pre-pandemic and pandemic periods were compared using publicly available data on performance and health outcome indicators from the Portuguese National Health Service (NHS). Pre-pandemic data were modeled to project hypothetical scenarios without a pandemic using an exponential smoothing algorithm, and then compared with data collected during the COVID-19 pandemic. A cohort model was developed to estimate the number of all-cause deaths and years of life lost (YLL) due to the reduction in blood pressure (BP) monitoring and in BP records <150/90 mmHg during the first two years of the pandemic. Microsoft Excel® was used for statistical analyses.

Results

There was a 26.4% relative reduction in the number of patients with hypertension under 65 years of age with at least one BP measurement, and a 21.8% relative reduction in the proportion of patients with BP <150/90 mmHg during the first two years of the pandemic. The model projections were 176 additional deaths and 3287 YLL among the Portuguese population of patients with hypertension.

Conclusions

The disruption in BP testing in Portugal during the pandemic increased hypertension-associated morbidity and mortality, with significant YLL. The long-term implications of impaired monitoring of patients with hypertension should be assessed, and proactive strategies implemented to mitigate the increase in hypertension morbidity and mortality associated with the COVID-19 pandemic.

前言和目的：本研究旨在评估COVID-19大流行对葡萄牙动脉高血压患者医疗保健的影响。方法：利用葡萄牙国家卫生服务（NHS）的绩效和健康结果指标的公开数据，对大流行前和大流行时期进行比较。使用指数平滑算法对大流行前的数据进行建模，以预测没有大流行的假设情景，然后与COVID-19大流行期间收集的数据进行比较。建立了一个队列模型来估计由于血压（BP）监测和血压记录的降低而导致的全因死亡和生命年损失（YLL）的数量。结果：65岁以下至少有一次血压测量的高血压患者数量相对减少26.4%，BP患者比例相对减少21.8%。大流行期间葡萄牙血压检测的中断增加了高血压相关的发病率和死亡率，并伴有显著的YLL。应评估高血压患者监测受损的长期影响，并实施积极主动的战略，以减轻与COVID-19大流行相关的高血压发病率和死亡率的上升。

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引用次数: 0

Quality of life score association with other patient-reported outcomes: Validating Minnesota Living with Heart Failure Questionnaire to Portuguese 生活质量评分与其他患者报告结果的关联：验证明尼苏达州心力衰竭患者对葡萄牙人的问卷调查。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-10-01 DOI: 10.1016/j.repc.2025.03.005

Irene Marques , Sofia Viamonte , Milton Severo , António Gomes Pinto , Cândida Fonseca , Henrique Cyrne Carvalho

Introduction and objectives

Pragmatic validated instruments are needed to assess quality of life (QoL) in the real-world care of heart failure (HF) patients. This study aimed to validate the Minnesota Living with Heart Failure Questionnaire (MLHFQ) in European Portuguese and to search for associations with other patient-reported outcomes (PROs).

Methods

This is a single-center prospective study with two samples of HF patients, used for MLHFQ translation, cultural adaptation and validation. Validation sample included patients managed in a multidisciplinary HF clinic between February 29, 2016, and February 29, 2020.

Results

The validation sample included 294 HF patients, with a median age of 78 years, 53.1% female sex, 45.2% with reduced left ventricle ejection fraction (LVEF) and 43.9% with preserved LVEF. The principal component analysis identified three components, representing three groups of questions from the MLHFQ, each related to one domain and subscore: physical, emotional and social. The validated version showed a reliable general factor and good internal consistency. MLHFQ total score was associated with all the other variables studied. All the scores were strongly associated with NYHA functional class. Associations were found between the physical score and both the Borg fatigue score and the six-minute walking distance. Emotional score was associated with both anxiety and depression scores from Hospital Anxiety and Depression Scale.

Conclusions

This study validated the MLHFQ in Portuguese and revealed the existence of three subscores. It enables the pragmatic assessment of the QoL of Portuguese HF patients, particularly of those with preserved LVEF, and future research concerning PROs.

简介和目的：需要实用的、经过验证的工具来评估心力衰竭（HF）患者的生活质量（QoL）。本研究旨在验证欧洲葡萄牙语的明尼苏达州心力衰竭患者生活问卷（MLHFQ），并寻找与其他患者报告的结果（PROs）的关联。方法：这是一项单中心前瞻性研究，有两个HF患者样本，用于MLHFQ翻译、文化适应和验证。验证样本包括2016年2月29日至2020年2月29日期间在一家多学科心衰诊所就诊的患者。结果：验证样本包括294例HF患者，中位年龄为78岁，女性53.1%，左心室射血分数（LVEF）降低45.2%，LVEF保存43.9%。主成分分析确定了三个组成部分，代表MLHFQ中的三组问题，每组问题与一个领域和子分数有关：身体，情感和社会。验证版总体因子可靠，内部一致性好。MLHFQ总分与所研究的所有其他变量相关。所有评分均与NYHA功能等级密切相关。身体评分与博格疲劳评分和6分钟步行距离之间存在关联。情绪得分与医院焦虑抑郁量表的焦虑和抑郁得分相关。结论：本研究验证了葡萄牙语的MLHFQ，并揭示了三个分值的存在。它使葡萄牙HF患者，特别是保留LVEF的患者的生活质量的实用评估，以及有关PROs的未来研究成为可能。

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引用次数: 0

Wait time impact on prognosis for patients awaiting an aortic valve replacement 等待时间对等待主动脉瓣置换术患者预后的影响。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-10-01 DOI: 10.1016/j.repc.2024.11.020

Inês Machado Martins , Carla Oliveira Ferreira , Cátia Costa Oliveira , Carlos Galvão Braga , Jorge Marques

Introduction and objectives

The only effective treatment for severe aortic stenosis (AS) is aortic valve replacement (AVR). The intervention should happen as soon as possible to lower the risk of heart failure and death. We aimed to assess the time between referral to the surgery center and performing the AVR for a sample of patients with severe AS diagnosis, as well as the impact it may have on hospitalization and mortality.

Methods

This was a retrospective study including 241 patients with severe AS submitted to AVR at the surgery center between January 2018 and December 2021, or patients that died during that period.

Results

In a total of 174 ambulatory patients who underwent AVR, 82.2% had surgical aortic valve replacement (SAVR) and 17.8% transcatheter aortic valve implantation (TAVI). The median wait time for SAVR and TAVI was 226 and 426 days, respectively. From a total of 56 hospitalized patients who underwent AVR, 89.3% had SAVR and 10.7% TAVI. The mean wait time for SAVR and TAVI was 9 and 15 days, respectively. While waiting for intervention, 13% of patients were hospitalized and 6% died.

Conclusions

The wait times for AVR found in our study are substantially longer than recommended for outpatient regimen. Extended wait times are linked to an increasing incidence of adverse events.

简介和目的：主动脉瓣置换术是治疗严重主动脉瓣狭窄的唯一有效方法。干预应尽快进行，以降低心力衰竭和死亡的风险。我们的目的是评估转诊到手术中心和对严重AS诊断的患者进行AVR之间的时间，以及它可能对住院和死亡率的影响。方法：这是一项回顾性研究，包括2018年1月至2021年12月期间在手术中心接受AVR治疗的241例严重AS患者，或在此期间死亡的患者。结果：174例行AVR的非住院患者中，82.2%行手术主动脉瓣置换术（SAVR）， 17.8%行经导管主动脉瓣植入术（TAVI）。SAVR和TAVI的中位等待时间分别为226天和426天。在56例接受AVR的住院患者中，89.3%有SAVR， 10.7%有TAVI。SAVR和TAVI的平均等待时间分别为9天和15天。在等待干预期间，13%的患者住院，6%的患者死亡。结论：在我们的研究中发现，AVR的等待时间大大长于门诊方案的推荐时间。等待时间的延长与不良事件发生率的增加有关。

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引用次数: 0

Genetic aspects of congenital heart disease in heterotaxy syndrome 先天性心脏病异位综合征的遗传方面。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-10-01 DOI: 10.1016/j.repc.2025.05.007

Nur Nabihah Ahmad Rafie , Putri Yubbu , Shankar Aissvarya , Rajendran Pujita , Nurul Huda Musa , Noor Haliza Mohamed Ibrahim , Karuppiah Thilakavathy

Abnormal arrangement of thoracoabdominal organs, situs ambiguous, is also known as heterotaxy syndrome (HTX). It has been frequently linked with congenital heart diseases (CHD), which are commonly reported as atrioventricular septal defects (AVSD), atrial septal defects (ASD), ventricle septal defects (VSD), transposition of the great artery, and pulmonary stenosis or atresia. Two HTX categories are right atrial isomerism (RAI) and left atrial isomerism (LAI), which are distinguished by the organ's sidedness as well as their complexity. The etiology of the syndrome is being studied widely, where recent studies are more focused on the effect of gene variants present in affected individuals. DNAH11, DNAH5, ZIC3, NODAL, and LEFTY are among the genes studied and associated with HTX. DNAH11 and DNAH5 are associated with ciliary function while ZIC3, NODAL and LEFTY are associated with signaling pathways. As multiple genes are involved, HTX has been reported to have an autosomal dominant, autosomal recessive or X-linked inheritance patterns, depending on the causative genes in the individual. This review aims to summarize several previously reported HTX gene variants, inheritance patterns, as well as the cardiac and extracardiac clinical manifestations.

胸腹脏器异常排列，位置不明确，也被称为异位综合征（HTX）。它经常与先天性心脏病（CHD）有关，通常报道为房室间隔缺损（AVSD）、房间隔缺损（ASD）、室间隔缺损（VSD）、大动脉转位和肺动脉狭窄或闭锁。HTX分为右心房异构体（RAI）和左心房异构体（LAI）两类，它们以器官的侧边性和复杂性来区分。该综合征的病因学正在被广泛研究，最近的研究更多地集中在受影响个体中存在的基因变异的影响上。DNAH11、DNAH5、ZIC3、NODAL和LEFTY都是与HTX相关的基因。DNAH11和DNAH5与纤毛功能有关，ZIC3、NODAL和LEFTY与信号通路有关。由于涉及多个基因，据报道HTX具有常染色体显性、常染色体隐性或x连锁遗传模式，这取决于个体的致病基因。本文旨在总结几种先前报道的HTX基因变异、遗传模式以及心脏和心脏外的临床表现。

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A narrow path 一条狭窄的小路。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2025-10-01 DOI: 10.1016/j.repc.2025.03.007

Rodrigo Silva , Sofia Nogueira-Fernandes , Carina Arantes , João Maciel , Vítor Hugo Pereira , Catarina Vieira , Sérgia Rocha

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