Revista Portuguesa De Cardiologia最新文献

英文中文

Real-world evaluation of vascular complications and comorbidities in Portuguese patients with type 2 diabetes: Results from the cMORE study 葡萄牙 2 型糖尿病患者血管并发症和合并症的实际评估：cMORE 研究的结果。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-12-01 DOI: 10.1016/j.repc.2024.04.011

Sílvia Alão , Tomás Silva , António Pedro Leite , Medina do Rosário , Cristina Carvalho , Joana Coelho , Hélder Ferreira , Raquel Ferreira , Joana Abreu , Margarida Rosa , Sofia Azevedo , Cláudia Cunha , Capela Daniel , Belén Juane , Renata Arantes Sousa , Ana Catarina Casais , on behalf of the cMORE study group

Introduction and objectives

Type 2 diabetes poses a significant health challenge in Portugal, increasing the susceptibility to complications/comorbidities such as hypertension, obesity, and cardiovascular (CV) disease. This study aimed to evaluate the prevalence of type 2 diabetes-related vascular complications/comorbidities and their pharmacological management in Portugal.

Methods

cMORE was a non-interventional, cross-sectional, multicenter study conducted in 32 Portuguese primary healthcare units between October 2020 and 2022. Secondary data, including sociodemographic, anthropometric, clinical information, cardiometabolic comorbidities, HbA_1c levels, lipid parameters and medication, were collected from electronic medical records.

Results

Seven hundred and eighty adult patients with type 2 diabetes were included, predominantly male (55.5%), with an average age of 67.7 years and a mean disease duration of 10.5 years. Family history of type 2 diabetes (43.1%) and CV disease (32.1%) was prevalent. Mean HbA_1c was 7.0%, progressively increasing with disease duration (p<0.001). Microvascular and macrovascular complications occurred in 38.1% and 19.6% of patients, respectively. The most prevalent comorbidities included overweight/obesity (85.5%), dyslipidemia (85.4%), and hypertension (82.6%). Multimorbidity burden was significant (99.3%) and positively correlated with older age, larger waist circumference, and overweight/obesity. Longer type 2 diabetes duration was associated with higher odds of diabetic retinopathy and CV disease/procedures, while dyslipidemia and hypertension were linked with older age, regardless of disease duration. Most patients received oral antidiabetic medications (94.6%), primarily biguanides (92.4%), followed by DPP-4 (39.1%) and SGLT2 inhibitors (34.2%).

Conclusions

The cMORE study reveals a substantial burden of vascular complications/comorbidities among Portuguese patients with type 2 diabetes. Despite the high multimorbidity rates, effective type 2 diabetes management is observed, emphasizing the country's commitment to personalized care.

导言和目标：2 型糖尿病对葡萄牙的健康构成了重大挑战，增加了高血压、肥胖和心血管疾病等并发症/合并症的易感性。本研究旨在评估葡萄牙2型糖尿病相关血管并发症/合并症的患病率及其药物治疗情况。方法：cMORE是一项非干预性、横断面、多中心研究，于2020年10月至2022年在葡萄牙32个初级医疗保健单位进行。从电子病历中收集二级数据，包括社会人口学、人体测量、临床信息、心脏代谢合并症、HbA1c水平、血脂参数和用药情况：纳入的 780 名 2 型糖尿病成年患者主要为男性（55.5%），平均年龄 67.7 岁，平均病程 10.5 年。2型糖尿病家族史（43.1%）和心血管疾病家族史（32.1%）普遍存在。平均 HbA1c 为 7.0%，随着病程的延长而逐渐升高（p 结论：cMORE研究显示，葡萄牙2型糖尿病患者的血管并发症/合并症负担沉重。尽管2型糖尿病患者的多病症发病率很高，但他们仍得到了有效的管理，这也凸显了葡萄牙对个性化医疗的承诺。

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引用次数: 0

Rare images of a unileaflet mitral valve 单叶二尖瓣的罕见图像。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-12-01 DOI: 10.1016/j.repc.2024.04.007

Nikolaos Miaris , Dimitrios-Persefs Zampelis , Konstantina Ntalekou , Maria Karakosta , Alkistis-Eleni Kalesi , Nearchos Kasinos

引用次数: 0

Initial experience with orbital atherectomy in a non-surgical center in Portugal 葡萄牙一家非手术中心眼眶动脉粥样硬化切除术的初步经验。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-12-01 DOI: 10.1016/j.repc.2024.03.005

Daniel Faria, Hugo Vinhas, João Bispo, João Guedes, Sandrine Marto, Hugo Palmeiro, Patrícia Franco, Jorge Mimoso

Introduction and objectives

Percutaneous coronary intervention (PCI) of severely calcified lesions is associated with a higher risk of procedural complications, suboptimal stent expansion, and in-stent restenosis. Lesion preparation with orbital atherectomy (OA) in severely calcified lesions has been shown to increase procedural success and decrease reintervention rates. In this study, we sought to report the procedural safety and efficacy of our initial experience with OA in a non-surgical center in Portugal.

Methods

Patients with severely calcified coronary lesions who were treated with intended intravascular ultrasound (IVUS) guided OA were included in a prospective single-center registry. We evaluated several endpoints, including: debulking success, defined <50% residual stenosis severity after OA; procedural success, defined as stent implantation according to Optimal-IVUS PCI criteria; use of additional calcium debulking strategies; and procedural complications, including coronary no-reflow, dissection, perforation or side branch occlusion. Patients were followed up for 30 days to assess early cardiovascular or procedure-related death, myocardial infarction, myocardial injury and reintervention.

Results

Between January 2023 and September 2023, 37 patients and 53 coronary arteries underwent OA. IVUS imaging was used in all cases. Debulking and procedural success were achieved in 90.5% and 97.3% of cases, respectively. In 26 (49.1%) lesions, additional calcium debulking techniques were needed. Procedural complications occurred in three cases and one patient died during hospitalization.

Conclusion

Our initial experience with OA for heavily calcified coronary lesions demonstrated high procedural success and overall favorable clinical outcomes.

导言和目的：严重钙化病变的经皮冠状动脉介入治疗（PCI）与较高的手术并发症、支架扩张不理想和支架内再狭窄风险相关。在严重钙化病变中使用眶内动脉粥样硬化切除术（OA）进行病变准备已被证明可提高手术成功率并降低再介入率。在这项研究中，我们试图报告我们在葡萄牙一家非手术中心使用 OA 的初步经验的程序安全性和有效性：方法：一项前瞻性单中心登记研究纳入了在血管内超声（IVUS）引导下接受OA治疗的严重钙化冠状动脉病变患者。我们评估了几个终点，包括：剥离成功率、定义结果：2023 年 1 月至 2023 年 9 月期间，37 名患者和 53 条冠状动脉接受了 OA。所有病例均采用了 IVUS 成像。分别有 90.5% 和 97.3% 的病例获得了剥脱和手术成功。26例（49.1%）病变需要额外的钙质清除技术。3例患者出现了手术并发症，1例患者在住院期间死亡：我们对重度钙化冠状动脉病变进行OA手术的初步经验表明，手术成功率很高，总体临床效果良好。

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引用次数: 0

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-12-01 DOI: 10.1016/j.repc.2024.08.004

Luís Bronze

引用次数: 0

Infective endocarditis of the mitral valve with involvement of the left atrium: A rare finding. 二尖瓣感染性心内膜炎累及左心房：罕见的发现

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-11-12 DOI: 10.1016/j.repc.2024.10.004

Inês Araújo, João Cravo, Ana Rita Maurício, Joana Rigueira, Catarina Sousa

引用次数: 0

Doxorubicin-induced cardiotoxicity - Are plants the answer? 多柔比星诱发的心脏毒性--植物是答案吗？

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-10-23 DOI: 10.1016/j.repc.2024.10.003

Pedro Mendes-Ferreira, Adelino F Leite-Moreira

引用次数: 0

Diagnostic prediction rules in acute pulmonary embolism: Is it acceptable to compromise safety? 急性肺栓塞的诊断预测规则：牺牲安全性是否可以接受？

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-10-01 DOI: 10.1016/j.repc.2024.08.001

Sílvio Leal

引用次数: 0

Regional myocardial infarction networks: How to improve quality 地区心肌梗死网络：如何提高质量。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-10-01 DOI: 10.1016/j.repc.2024.08.003

Jorge Mimoso

引用次数: 0

Experience from a regional percutaneous coronary intervention center: Aiming to assess and improve quality of care 地区经皮冠状动脉介入治疗中心的经验：旨在评估和提高护理质量。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-10-01 DOI: 10.1016/j.repc.2024.02.007

Introduction and Objectives

Ischemic heart disease is the single most common cause of death in Europe. Mortality in patients presenting with ST-elevation myocardial infarction (STEMI) is associated with many factors, one of which is the time delay to treatment. The purpose of this work is to analyze the coronary pathway in our region in terms of timing, taking into consideration the place of first medical contact (FMC).

Methods

Consecutive patients admitted to our center with STEMI to undergo percutaneous coronary intervention (PCI) between 2013 and 2022 were analyzed. Age, gender, and time delays were collected. Analysis was performed with IBM SPSS version 28 for a significance level of 0.05.

Results

We found that non-PCI centers had a significantly greater FMC to diagnosis delay and diagnosis to wire delay compared to other places of origin. Only 2.2% of patients met the 10-min FMC to diagnosis target; 44.8% met the target of 90 min from diagnosis to wire in transferred patients, while 40.6% met the 60-min target for patients admitted to a PCI center. Median patient, electrocardiogram (ECG) and logistic delays are 92.0±146.0 min, 19.0±146.0 min and 15.5±46.3 min, respectively.

Conclusion

A significant difference between state-of-the-art targets and reality was found, depending on the place of FMC, with the worst delays in non-PCI centers. Patient delay, ECG delay, FMC to diagnosis and logistic delay are identified as key areas in which to intervene.

导言和目标缺血性心脏病是欧洲最常见的单一死因。ST段抬高型心肌梗死（STEMI）患者的死亡率与许多因素有关，其中之一就是治疗时间的延误。这项工作的目的是分析本地区冠状动脉路径的时间安排，同时考虑到首次医疗接触（FMC）的地点。方法对 2013 年至 2022 年期间本中心收治的 STEMI 患者进行经皮冠状动脉介入治疗（PCI）的连续患者进行分析。收集了患者的年龄、性别和延迟时间。结果我们发现，与其他来源地相比，非PCI中心的FMC到诊断延迟时间和诊断到导线延迟时间明显更长。只有 2.2% 的患者达到了从 FMC 到诊断的 10 分钟目标；44.8% 的转院患者达到了从诊断到接线 90 分钟的目标，而 40.6% 的 PCI 中心入院患者达到了 60 分钟的目标。患者、心电图（ECG）和逻辑延迟的中位数分别为（92.0±146.0）分钟、（19.0±146.0）分钟和（15.5±46.3）分钟。患者延迟、心电图延迟、FMC 到诊断以及物流延迟被认为是需要干预的关键领域。

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引用次数: 0

Response to the letter “Cardio-oncology guidelines, structural heart disease and Kounis syndrome in the upcoming guidelines” 对 "即将发布的指南中的心肿瘤指南、结构性心脏病和库尼斯综合征 "一信的回复。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-10-01 DOI: 10.1016/j.repc.2024.07.002

Miguel Nobre Menezes , Marta Tavares da Silva , Andreia Magalhães , Bruno Melica , Júlia Cristina Toste , Rita Calé , Manuel Almeida , Manuela Fiuza , Eduardo Infante de Oliveira

引用次数: 0

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