Archivos de cardiologia de Mexico最新文献

Objectives: This study aimed to compare various aspects among coronavirus disease 2019 (COVID-19) patients admitted to general wards versus intensive care units (ICUs) in Latin American (LATAM), including demographics, comorbidities, imaging and laboratory findings, complications, treatments, and predictors of mortality.

Materials and methods: Data from the LATAM cardiopulmonary imaging registry of hospitalized COVID-19 patients (RIMAC) were analyzed. RIMAC is a prospective observational study conducted from March to December 2020 across 12 tertiary centers in nine LATAM countries.

Results: Out of 1,435 patients, 49.34% were admitted to general wards and 50.66% to ICUs. Significant differences were observed between the two groups. ICU patients had a higher incidence of comorbidities, elevated biomarker levels, and complications such as kidney and heart failure, and required more intensive treatments. They also showed more severe imaging findings and had longer hospital stays with higher mortality rates compared to ward patients.

Conclusion: The study highlighted significant disparities between COVID-19 patients admitted to general wards and ICUs in LATAM. These disparities encompassed clinical severity, resource utilization, and mortality rates. Older age, obesity, extensive lung infiltrates, and kidney failure emerged as predictors of mortality. These findings underscore the need for tailored management strategies based on the severity of illness among COVID-19 patients in LATAM.

In 1936, Ignacio Chávez submitted a proposal to the Mexican government for the creation of a cardiology institute. He had studied in Paris, Berlin, and other European cities in 1926. Upon his return to Mexico, he founded the Cardiology Service at the General Hospital in Mexico City, the first of its kind in the country. The National Institute of Cardiology of Mexico was inaugurated on April 18, 1944, becoming one of the first cardiology institutes in the world. Chávez explained the purpose of this new institute: "We were born with the purpose of studying, researching, and controlling heart diseases." According to him, the institute should be a place where cardiovascular diseases could be addressed comprehensively, combining clinical practice with research and teaching to provide effective knowledge for patient care and scientific advancement. "A health center is for the patient, of course; but something more than that is necessary: a great school for doctors, a great laboratory for researchers, and a social instrument of human help," he said. This vision was summarized in the words: love and science at the service of the heart. Chávez successfully institutionalized cardiology in Mexico. From its inception, the institute became an internationally recognized center, attracting students from various countries. Alfredo de Micheli noted that under Chávez's influence and example, new institutions emerged in the national medical field and expanded onto the international stage. The institute founded by Chávez became a model for similar institutions on other continents and a driving force in the international cardiology movement. Chávez's legacy was a work of love, intelligence, and culture, dedicated to the heart and the care of humanity.

Objective: Pulmonary atresia with intact ventricular septum (PA-IVS) is a rare congenital heart disease characterized by a wide morphological spectrum that can be associated with abnormalities in the coronary circulation such as sinusoids, fistulas, stenosis or atresia. Some patients do not present ventriculo-coronary fistulas or intramyocardial sinusoids, other patients do present ventriculo-coronary connections, but only some of the latter will have right ventricle-dependent coronary circulation (RVDCC); timely establishment of the diagnosis of RVDCC is essential, since the prognosis of these patients is generally fatal. There are reports of patients with this type of coronary circulation (RVDCC) who were undergone to univentricular physiology, but this treatment option remains controversial, so the purpose of this manuscript is to share three cases with PA-IVS and RVDCC, their outcome and the reflections they provide us.

Method: We conducted a cross-sectional, descriptive, observational study of patients with PA-IVS and RVDCC without atresia of the coronary ostium during the study period.

Results: Three patients were identified, the clinical and angiographic characteristics and their evolution are described, and a new technique or maneuver for transient percutaneous decompress of the right ventricle is described theoretically for those cases where there is doubt about RVDCC during the angiographic study.

Conclusions: An accurate diagnosis regarding the existence of RVDCC is vital. In some cases, the interpretation of angiography for the diagnosis of RVDCC can be difficult to pinpoint and in many cases, it can be operator dependent, however we consider that is necessary to have a technique or maneuver that can objectively and without doubts determine RVDCC in those cases where angiography is not totally conclusive and thus be able to offer the best therapeutic option.

Atrial fibrillation (AF) is the most common arrhythmia, affecting approximately 33.5 millions of people worldwide. Unfortunately, the prevalence of this arrhythmia will increase within the following two decades, resulting in a higher mortality rate and a higher economic burden for public health services. Obesity, specifically central obesity, plays an essential role in developing AF by increasing pericardial fat and epicardial adipose tissue thickness, generating a chronic inflammation state where dysregulation of the serum concentration of several proinflammatory proteins occurs and indirectly promotes AF. Therefore, recent research has focused on analyzing the circulating concentration of different molecules, including pro and anti-inflammatory adipokines, and their association with AF. Herein, we review several studies addressing the association of adipokines with the onset or recurrence of AF to establish such association as a potential biomarker for the prevention or adequate treatment of this arrhythmia. We concluded that the insight into this topic is very controversial and needs further research.

The following article seeks to describe the clinical characterization of patients with congenital complete atrioventricular block. Information was collected from different sources, among which is the presentation of the pathology and its impact on the fetus, and the main basis was look for an association between the use of medications and its prognosis. Within the treatment to be used in patients with fetal atrioventricular block, the use of steroids, beta-adrenergic stimulators, plasma, etc., is mentioned; however, their use is controversial, since there are still many studies in which it is not defined whether they are used in isolation or together to improve the patient's condition. Steroids are the medications most used in this pathology and also the most studied, although their use has decreased the development of hydrops and preventing a type II atrioventricular block from progressing to a complete one, it can also cause greater loss of amniotic fluid, causing oligohydramnios that could cause fetal damage. Due to this, the assessment of the use of different medications will depend on the patient's clinical condition and multidisciplinary management should be addressed in the perinatal period to improve the prognosis of the patient and the mother.