RESUMO
Heart failure with reduced ejection fraction (HFrEF) represents at least half of the cases of heart failure, which is a syndrome defined as the inability of the heart to supply the body's tissues with an adequate amount of blood under conditions of normal cardiac filling pressure. HFrEF is responsible for high costs and rates of mortality, morbidity, and hospital admissions, mainly in developed countries. Thus, the need for better diagnostic methods and therapeutic approaches and consequently better outcomes is clear. In this article, we review the principal aspects of pathophysiology and diagnosis of HFrEF, with focus on emerging biomarkers and on recent echocardiographic methods for the assessment of left ventricular function. Furthermore, we discuss several major developments in pharmacological and nonpharmacological treatment of HFrEF in the last years, including cardiac resynchronization therapy, implantable cardioverter defibrillators, and the recent and promising drug LCZ696, focusing on current indications, unanswered questions, and other relevant aspects.
Assuntos
Insuficiência Cardíaca/tratamento farmacológico , Aminobutiratos/uso terapêutico , Biomarcadores , Compostos de Bifenilo , Terapia de Ressincronização Cardíaca , Desfibriladores Implantáveis , Combinação de Medicamentos , Ecocardiografia , Eletrocardiografia , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/fisiopatologia , Coração Auxiliar , Humanos , Volume Sistólico , Tetrazóis/uso terapêutico , Valsartana , Remodelação VentricularRESUMO
OBJECTIVE: To describe the antenatal and pathological features of an immature umbilical cord teratoma associated with exomphalos, and to review the literature on this subject. CASE PRESENTATION: An abdominal wall defect, suspected to be an exomphalos, was identified during routine ultrasound examination performed at 13 weeks of gestation. The pregnancy was terminated. Fetopathological examination revealed an immature umbilical cord teratoma associated with exomphalos. Chromosomal microarray analysis was normal. CONCLUSIONS: Umbilical cord teratomas, albeit very rare, should be emphasized as a possible differential diagnosis when abdominal wall defects are detected. Since cord teratomas may lead to adverse fetal or neonatal outcomes, close follow-up of the fetus is recommended.