Revista Portuguesa De Cardiologia最新文献

英文中文

“Observe, simulate, execute and mentor”: A contemporary approach to learning in Interventional Cardiology "观察、模拟、执行和指导"：介入心脏病学的现代学习方法。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-07-01 DOI: 10.1016/j.repc.2024.05.002

Rita Calé

引用次数: 0

Hypertrophic cardiomyopathy: Paradigm shifts in the last 30 years (Part 1) 肥厚型心肌病：过去 30 年的范式转变（第一部分）。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-07-01 DOI: 10.1016/j.repc.2023.10.013

Nuno Cardim

引用次数: 0

Early versus late cardiac magnetic resonance in the diagnosis of myocardial infarction with non-obstructive coronary arteries 早期与晚期心脏磁共振在诊断 MINOCA 中的对比。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-07-01 DOI: 10.1016/j.repc.2023.12.010

Inês Macedo Conde , Mariana Salazar , Vítor Hugo Pereira , Catarina Vieira , Carlos Galvão Braga , Cátia Oliveira

Introduction and objectives

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is responsible for about 10% of all acute myocardial infarctions (AMI). Therapeutic strategies and prognosis depend on the underlying etiology, and a multimodal approach is essential. The objectives of this study were to characterize the group of patients diagnosed with MINOCA and to valuate the diagnostic yield of cardiovascular magnetic resonance (CMR).

Methods

This was a retrospective, observational, and analytical study, including 516 patients admitted for a non-ST-elevation MI and with no significant coronary disease on coronary angiography between January 2016 and September 2021.

Results

After the inclusion criteria, 163 patients remained of the 516 admitted to the study. They were divided into four groups based on the CMR results: MINOCA (n=51), Takotsubo syndrome (n=37), myocarditis (n=33), and without diagnosis (n=42). Most patients diagnosed with MINOCA were female with a mean age of 61.06±13.83 years. CMR identified the diagnosis in 74.2% of patients admitted for suspected acute MI, in which coronary angiography showed the absence of significant obstructions. The median time between hospital admission and CMR was significantly shorter in the groups that had a diagnosis compared with the group with no diagnosis (p=0.038), with a significant increase in diagnostic profitability if CMR was performed up to 14 days after admission (p=0.022). There were no deaths of cardiovascular etiology during the follow-up period.

Conclusions

CMR was fundamental as it identified the diagnosis in three out of four patients; it should be performed in the first 14 days.

导言和目标：冠状动脉非阻塞性心肌梗死（MINOCA）约占急性心肌梗死（AMI）总数的 10%。治疗策略和预后取决于潜在的病因，因此必须采用多模式方法。确定被诊断为 MINOCA 的患者群体的特征。评估心血管磁共振（CMR）的诊断率：这是一项回顾性、观察性和分析性研究，纳入了2016年1月至2021年9月期间因非ST段抬高型心肌梗死入院且冠状动脉造影检查无明显冠状动脉疾病的516名患者：在符合纳入标准后，516 名入院患者中还剩下 163 名患者。根据CMR结果，他们被分为四组：MINOCA组（51人）、Takotsubo综合征组（37人）、心肌炎组（33人）和未确诊组（42人）。大多数确诊为 MINOCA 的患者为女性，平均年龄（61.06±13.83）岁。在因疑似急性心肌梗死入院的患者中，有 74.2% 的患者通过 CMR 确定了诊断，而冠状动脉造影显示这些患者没有明显的梗阻。与未确诊组相比，确诊组从入院到进行CMR检查的中位时间明显更短（P=0.038），如果在入院后14天内进行CMR检查，则确诊率会显著提高（P=0.022）。在随访期间，没有人因心血管病因死亡：CMR具有重要意义，因为它能确定四分之三患者的诊断；CMR应在入院后14天内进行。

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引用次数: 0

Coronary atherosclerotic burden in veteran athletes: The relationship between cardiovascular risk and volume of exercise 老运动员的冠状动脉粥样硬化负担：心血管风险与运动量之间的关系。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-07-01 DOI: 10.1016/j.repc.2024.03.001

Joana Certo Pereira , Rita Santos , Francisco Moscoso Costa , José Monge , Pedro de Araújo Gonçalves , Hélder Dores

Introduction and objectives

The association between exercise and coronary atherosclerosis still remains unclarified. We aimed to analyze the prevalence of high coronary atherosclerotic burden in veteran athletes, considering cardiovascular (CV) risk and volume of exercise.

Methods

A total of 105 asymptomatic male veteran athletes (48±5.6 years old) were studied. A high coronary atherosclerotic burden was defined as one of the following characteristics in coronary computed tomography angiography: calcium score >100, >75th percentile, obstructive plaques, involving left main, three-vessels or two-vessels including proximal anterior descending artery, segment involvement score >5 or CT-adapted Leaman score ≥5. CV risk was stratified by SCORE2 and volume of exercise by metabolic equivalent task score.

Results

Most athletes (n=88) were engaged in endurance sports for 17.1±9.8 years, with a median exercise volume of 66 [IQR 44–103] metabolic equivalent of tasks/hour/week. The mean Systematic Coronary Risk Evaluation 2 was 2.8±1.5%; 76.9% of athletes had a low-moderate risk and none a very high risk. High coronary atherosclerotic burden was present in 25.7% athletes. Athletes with high cardiovascular risk and high exercise volume (above the median) showed significantly high coronary atherosclerotic burden compared to those with low-moderate risk and high volume (50.0% vs. 15.6%; p=0.017). Among athletes with low to moderate risk, a high volume of exercise tended to be protective, while in those with low volume, there was similar rate of high coronary atherosclerotic burden, regardless of CV risk.

Conclusions

A combination of higher volume of exercise and high cardiovascular risk revealed the worst association with coronary atherosclerosis in veteran athletes. The relationship between these variables is controversial, but integrating exercise characteristics and risk assessment into preparticipation evaluation is essential.

引言和目的运动与冠状动脉粥样硬化之间的关系仍未明确。考虑到心血管（CV）风险和运动量，我们旨在分析退役运动员中冠状动脉粥样硬化高负担的发生率。方法共研究了 105 名无症状的男性退役运动员（48±5.6 岁）。在冠状动脉计算机断层扫描血管造影中，冠状动脉粥样硬化负荷高被定义为以下特征之一：钙化评分>100，>75百分位数，阻塞性斑块，涉及左主干、三支血管或包括近前降支动脉在内的两支血管，节段受累评分>5或CT适配Leaman评分≥5。结果大多数运动员（88 人）从事耐力运动（17.1±9.8 年），中位运动量为 66 [IQR 44-103] 代谢当量任务/小时/周。系统冠状动脉风险评估 2 的平均值为 2.8±1.5%；76.9% 的运动员为中低风险，无一人为极高风险。25.7%的运动员存在高冠状动脉粥样硬化负担。与中低风险和高运动量的运动员相比，心血管风险高和运动量大（高于中位数）的运动员冠状动脉粥样硬化负荷明显较高（50.0% 对 15.6%；P=0.017）。在中低风险的运动员中，高运动量往往具有保护作用，而在低运动量的运动员中，无论心血管风险如何，冠状动脉粥样硬化负荷高的比例相似。这些变量之间的关系尚存在争议，但将运动特征和风险评估纳入参赛前评估至关重要。

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引用次数: 0

Chronic thromboembolic pulmonary hypertension: A comprehensive review of pathogenesis, diagnosis, and treatment strategies. 慢性血栓栓塞性肺动脉高压：全面回顾发病机制、诊断和治疗策略。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-28 DOI: 10.1016/j.repc.2024.04.006

Daniel Inácio Cazeiro, Miguel Azaredo Raposo, Tatiana Guimarães, Nuno Lousada, David Jenkins, João R Inácio, Susana Moreira, Ana Mineiro, Céline Freitas, Susana Martins, Ricardo Ferreira, Rita Luís, Nuno Cardim, Fausto J Pinto, Rui Plácido

Chronic thromboembolic pulmonary hypertension (CTEPH) is part of group 4 of the pulmonary hypertension (PH) classification and generally affects more than a third of patients referred to PH centers. It is a three-compartment disease involving proximal (lobar-to-segmental) and distal (subsegmental) pulmonary arteries that are obstructed by persistent fibrothrombotic material, and precapillary pulmonary arteries that can be affected as in pulmonary arterial hypertension. It is a rare complication of pulmonary embolism (PE), with an incidence of around 3% in PE survivors. The observed incidence of CTEPH in the general population is around six cases per million but could be three times higher than this, as estimated from PE incidence. However, a previous venous thromboembolic episode is not always documented. With advances in multimodality imaging and therapeutic management, survival for CTEPH has improved for both operable and inoperable patients. Advanced imaging with pulmonary angiography helps distinguish proximal from distal obstructive disease. However, right heart catheterization is of utmost importance to establish the diagnosis and hemodynamic severity of PH. The therapeutic strategy relies on a stepwise approach, starting with an operability assessment. Pulmonary endarterectomy (PEA), also known as pulmonary thromboendarterectomy, is the first-line treatment for operable patients. Growing experience and advances in surgical technique have enabled expansion of the distal limits of PEA and significant improvements in perioperative and mid- to long-term mortality. In patients who are inoperable or who have persistent/recurrent PH after PEA, medical therapy and/or balloon pulmonary angioplasty (BPA) are effective treatment options with favorable outcomes that are increasingly used. All treatment decisions should be made with a multidisciplinary team that includes a PEA surgeon, a BPA expert, and a chest radiologist.

慢性血栓栓塞性肺动脉高压（CTEPH）属于肺动脉高压（PH）分类的第 4 组，通常影响三分之一以上转诊至 PH 中心的患者。它是一种三腔疾病，涉及被持久性纤维血栓物质阻塞的近端（叶至节段）和远端（节段下）肺动脉，以及可能像肺动脉高压一样受影响的毛细血管前肺动脉。它是肺栓塞（PE）的一种罕见并发症，在 PE 存活者中的发病率约为 3%。在普通人群中，CTEPH 的观察发病率约为每百万人中有 6 例，但根据 PE 发病率估算，可能比这一数字高出三倍。然而，先前的静脉血栓栓塞发作并不总能被记录下来。随着多模式成像和治疗管理的进步，可手术和不可手术患者的 CTEPH 存活率都有所提高。先进的肺血管造影术有助于区分近端和远端阻塞性疾病。然而，右心导管检查对于确定 PH 的诊断和血液动力学严重程度至关重要。治疗策略采用循序渐进的方法，首先进行可手术性评估。肺动脉内膜切除术（PEA），又称肺血栓内膜切除术，是可手术患者的一线治疗方法。随着经验的积累和手术技术的进步，肺动脉内膜剥脱术的远端范围不断扩大，围手术期和中长期死亡率也有了显著改善。对于无法手术或 PEA 术后 PH 持续/复发的患者，药物治疗和/或球囊肺血管成形术（BPA）是有效的治疗方案，效果良好，越来越多地得到应用。所有治疗决定都应由一个多学科团队做出，该团队应包括一名 PEA 外科医生、一名 BPA 专家和一名胸部放射科医生。

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引用次数: 0

Polytetrafluoroethylene graft for anomalous left coronary artery from the pulmonary artery: 6-Year patency. 从肺动脉移植聚四氟乙烯治疗左冠状动脉异常：6 年通畅。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-19 DOI: 10.1016/j.repc.2024.02.011

Cuitláhuac Arroyo-Rodríguez, Cyntia Zulema Machain-Leyva, Cesa Iván Vásquez-Serna, Francisco López-Borbón, Gerardo Rangel-Guerrero, Armando González-García, Francisco A Martínez-Hernández

引用次数: 0

Tuberculous submitral aneurysm: A rare cardiac presentation of a common pathogen. 结核性腹膜下动脉瘤：一种常见病原体的罕见心脏表现。

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-19 DOI: 10.1016/j.repc.2024.03.002

Usnish Adhikari, Harikrishnan Sivadasanpillai, Bineesh K Radhakrishnan, Mohamed Iliyas

引用次数: 0

“O meu coração bate saudável” – Results from a pilot project for health education in Portuguese children "O meu cora<s:1> O bate saudável"——葡萄牙儿童健康教育试点项目的成果。

IF 1.8 4区医学 Q3 Medicine

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2023.09.005

Ana Teresa Timóteo , Maria Carmo Cachulo , Paulo Dinis , Luís Negrão , Inês Barreiros-Mota , Hélder Dores , Lino Gonçalves

Introduction and objectives

Childhood offers an excellent window of opportunity to start interventions to promote behavioral changes before unhealthy lifestyles become established, leading to cardiovascular diseases. The goal of this pilot educational project for children is the promotion of healthy lifestyles and cardiovascular health.

Methods

This project was implemented in 4th grade children and included teacher-led classroom activities, a lesson given by a cardiologist and a practical lesson with dietitians. The teacher received a manual containing information on the topics to be discussed in class with the pupils and the children received a book that addresses cardiovascular risk factors and prevention. The components included were diet (D), physical activity (PA) and human body and heart awareness (BH). At the beginning and at the end of the schoolyear, a questionnaire was applied to the children to assess knowledge (K), attitudes (A) and habits (H) on these topics.

Results

A total of 73 children from two schools from an urban district public school in Lisbon, in a low to medium income area, participated in the project. Following the intervention, there was a 9.5% increase in the overall KAH score, mainly driven by the PA component (14.5%) followed by the BH component (12.3%). No improvement was observed for component D. The benefits were also more significant in children from a lower income area, suggesting that socioeconomic status is a determinant in the response obtained.

Conclusions

An educational project for cardiovascular health can be implemented successfully in children aged 9 years, but longer and larger studies are necessary.

前言和目标:儿童时期提供了一个极好的机会窗口，可以在不健康的生活方式形成并导致心血管疾病之前开始干预措施，促进行为改变。这一儿童教育试点项目的目标是促进健康的生活方式和心血管健康。方法:本项目在四年级儿童中实施，包括教师主导的课堂活动，心脏病专家的课程和营养师的实践课程。老师收到了一本手册，其中包含与学生在课堂上讨论的主题的信息，孩子们收到了一本关于心血管风险因素和预防的书。包括饮食(D)、体力活动(PA)和人体与心脏意识(BH)。在学年开始和结束时，对孩子们进行了问卷调查，以评估关于这个主题的知识(K)，态度(a)和习惯(H)。结果:共有73名来自中低收入地区里斯本一所城市公立学校的儿童参与了该项目。通过干预，总体KAH评分增加了9.5%，主要由PA成分(14.5%)驱动，其次是BH成分(12.3%)。D成分未见改善。低收入地区的儿童受益更显著，这表明社会经济地位是获得回应的决定因素。结论:心血管健康教育项目可以在9岁儿童中成功实施，但需要更长时间和更大规模的研究。

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引用次数: 0

Cardiac hydatid cysts: Please do not waste time 心脏水瘤囊肿：请不要浪费时间。

IF 1.8 4区医学 Q3 Medicine

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2023.08.009

Valdano Manuel, Zoinez Sotto Garcia

引用次数: 0

Management of life-threatening ventricular arrhythmias: What is going on with autonomic neuromodulation 处理危及生命的室性心律失常：自律神经调节是怎么回事？

IF 1.8 4区医学 Q3 Medicine

Revista Portuguesa De Cardiologia

Pub Date : 2024-06-01 DOI: 10.1016/j.repc.2023.11.004

Sofia Jacinto , João Reis , Mário Martins Oliveira

引用次数: 0

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