Chemodiversity essential oil from three species of Croton (Euphorbiaceae) and assessment of antimicrobial potential.

The Croton genus is known for its various biological properties, which inspired this study to investigate the anti-bacterial pro-perties and chemodiversity of the essential oils of three Croton species: Croton blanchetianus, Croton jacobinensis, and Croton nepetifolius. The essential oils were characterised by gas chromatography (GC-MS) and demonstrated anti-bacterial activity against Staphylococcus aureus and Escherichia coli using the disc diffusion method. The essential oil composition of C. blanchetianus showed bicyclogermacrene (16.04%) and spathulenol (16.44%) as the main compounds. In C. jacobinensis, bicyclogermacrene (22.04%), caryophyllene (17.95%), and ß-phellandrene (12.30%) were the most prevalent. Meanwhile, C. nepetifolius's essential oil consisted mainly of bicyclogermacrene (17.69%), caryophyllene (15.15%), and germacrene D (11.78%). The principal component analysis (PCA) results showed three distinct chemotypes for each Croton species, suggesting that they have well-defined and unique chemical profiles. Interestingly, the three Croton species demonstrated activity only against Staphylococcus aureus bacteria.

Efficacy of green tea and its extract, epigallocatechin-3-gallate, in the reduction of cariogenic microbiota in children: a randomized clinical trial.

OBJECTIVE: This study was conducted to evaluate and compare the antimicrobial efficacy of green tea and its extract epigallocatechin-3-gallate (EGCG) as a mouthwash in children. DESIGN: The study group included 47 children aged 5-12 years at high caries risk and prevalence. Children selected were asked to rinse with one of the substances (EGCG, green tea, chlorhexidine and distilled water) for one min. A non-stimulated salivary sample (2 mL) was collected at baseline and after rinsing. The concentration of cariogenic microorganisms (mutans streptococci and lactobacilli) was determined before and after rinsing based on the count of colony-forming units (CFU). CFU were counted with the aid of a stereomicroscope through the perfunctory identification of the morphological characteristics of CFU. The microbial reduction percentage was then calculated. RESULTS: The analysis of the effectiveness of the treatments showed that there was a significant reduction in relation to the values obtained before and after the mouthwash, both for mutans streptococci (pCHX = 0.001; pEGCG = 0.001; pGreen Tea = 0.005; pDistilled Water = 0.018) and lactobacilli (pCHX = 0.001; pEGCG = 0.002; pGreen Tea = 0.008; pDistilled Water = 0.033). The percentage of microbial reduction of both cariogenic microorganisms caused by the EGCG solution was higher than green tea and distilled water, but less than CHX. The percentage of microbial reduction by the EGCG solution for mutans streptococci was 79.9%, green tea 68.3%, distilled water 50.6% and CHX 95.5%. For lactobacilli, the percentage reduction of all solutions was relatively lower when compared to mutans streptococci. For the EGCG solution it was 72.09%, followed by green tea 59.17% and distilled water 41.96%, but less than CHX 86.02%. CONCLUSION: Rinsing with EGCG solution reduced the levels of mutans streptococci and lactobacilli in the oral cavity of children. Although EGCG had better antimicrobial activity than green tea, this study supports the effectiveness of both as an antibacterial mouthwash option. Both EGCG and green tea could be used as alternatives to chlorhexidine-based mouthwashes.

Cost-Effectiveness of Rheumatic Heart Disease Echocardiographic Screening in Brazil: Data from the PROVAR+ Study: Cost-effectiveness of RHD screening in Brazil.

Introduction: In recent years, new technologies - noticeably ultra-portable echocardiographic machines - have emerged, allowing for Rheumatic Heart Disease (RHD) early diagnosis. We aimed to perform a cost-utility analysis to assess the cost-effectiveness of RHD screening with handheld devices in the Brazilian context. Methods: A Markov model was created to assess the cost-effectiveness of one-time screening for RHD in a hypothetical cohort of 11-year-old socioeconomically disadvantaged children, comparing the intervention to standard care using a public perspective and a 30-year time horizon. The model consisted of 13 states: No RHD, Undiagnosed Asymptomatic Borderline RHD, Diagnosed Asymptomatic Borderline RHD, Untreated Asymptomatic Definite RHD, Treated Asymptomatic Definite RHD, Untreated Mild Clinical RHD, Treated Mild Clinical RHD, Untreated Severe Clinical RHD, Treated Severe Clinical RHD, Surgery, Post-Surgery and Death. The initial distribution of the population over the different states was derived from primary echo screening data. Costs of the different states were derived from the Brazilian public health system database. Transition probabilities and utilities were derived from published studies. A discount rate of 3%/year was used. A cost-effectiveness threshold of $25,949.85 per Disability Adjusted Life Year (DALY) averted is used in concordance with the 3x GDP per capita threshold in 2015. Results: RHD echo screening is cost-effective with an Incremental Cost-Effectiveness Ratio of $10,148.38 per DALY averted. Probabilistic modelling shows that the intervention could be considered cost-effective in 70% of the iterations. Conclusion: Screening for RHD with hand held echocardiographic machines in 11-year-old children in the target population is cost-effective in the Brazilian context. Highlights: A cost-effectiveness analysis showed that Rheumatic Heart Disease (RHD) echocardiographic screening utilizing handheld devices, performed by non-physicians with remote interpretation by telemedicine is cost-effective in a 30-year time horizon in Brazil.The model included primary data from the first large-scale RHD screening program in Brazilian underserved populations and costs from the Unified Health System (SUS), and suggests that the Incremental Cost-Effectiveness Ratio of the intervention is considerably below the acceptable threshold for Brazil, even after a detailed sensitivity analysis.Considering the high prevalence of subclinical RHD in Brazil, and the significant economic burden posed by advanced disease, these data are important for the formulation of public policies and surveillance approaches.Cost-saving strategies first implemented in Brazil by the PROVAR study, such as task-shifting to non-physicians, computer-based training, routine use of affordable devices and telemedicine for remote diagnosis may help planning RHD control programs in endemic areas worldwide.

Investigation of F-BAR domain PACSIN proteins uncovers membrane tubulation function in cilia assembly and transport.

The intracellular ciliogenesis pathway requires membrane trafficking, fusion, and reorganization. Here, we demonstrate in human cells and zebrafish that the F-BAR domain containing proteins PACSIN1 and -2 play an essential role in ciliogenesis, similar to their binding partner and membrane reorganizer EHD1. In mature cilia, PACSINs and EHDs are dynamically localized to the ciliary pocket membrane (CPM) and transported away from this structure on membrane tubules along with proteins that exit the cilium. PACSINs function early in ciliogenesis at the ciliary vesicle (CV) stage to promote mother centriole to basal body transition. Remarkably, we show that PACSIN1 and EHD1 assemble membrane t7ubules from the developing intracellular cilium that attach to the plasma membrane, creating an extracellular membrane channel (EMC) to the outside of the cell. Together, our work uncovers a function for F-BAR proteins and membrane tubulation in ciliogenesis and explains how the intracellular cilium emerges from the cell.

Publisher Correction: Investigation of F-BAR domain PACSIN proteins uncovers membrane tubulation function in cilia assembly and transport.

In the original version of this Article, the fifth sentence of the abstract incorrectly read 'Remarkably, we show that PACSIN1 and EHD1 assemble membrane t7ubules from the developing intracellular cilium that attach to the plasma membrane, creating an extracellular membrane channel (EMC) to the outside of the cell.', and should have read 'Remarkably, we show that PACSIN1 and EHD1 assemble membrane tubules from the developing intracellular cilium that attach to the plasma membrane, creating an extracellular membrane channel (EMC) to the outside of the cell.'. This has been corrected in both the PDF and HTML versions of the Article.

Integration of echocardiographic screening by non-physicians with remote reading in primary care.

INTRODUCTION: Heart disease (HD) accounts for high morbidity and mortality in Brazil. Underserved populations often suffer long delays in diagnosis. We aimed to evaluate the feasibility of integrating screening echocardiography (echo) with remote interpretation in the established primary care system (PC) in Brazil and to assess HD prevalence. METHODS: Over 11 months, 20 healthcare workers (four physicians, four nurses, and 12 technicians) at 16 PC centres were trained on simplified handheld echo protocols. Three screening (SC) groups, including all consented patients aged 17-20, 35-40 and 60-65 years, and patients referred (RF) for clinical indications underwent focused echo. Studies were remotely interpreted through telemedicine. Significant HD was defined as moderate/severe valve disease, ventricular dysfunction/hypertrophy, pericardial effusion, wall-motion abnormalities and congenital heart disease. RESULTS: Total 1004 patients underwent echo; 299 (29.8%) in the SC group. Median age was 51±18 years, 63.9% females; 42.7% had cardiovascular symptoms. Significant HD was found in 354 (35.3%) patients (23.4% in SC vs 40.3% in RF group, p<0.001). Prevalence was higher in patients in the SC group aged >60 years (29.2%), compared with 35-40 (14.9%) and under 20 (16.5%), p=0.012. Comparing SC to RF groups, moderate/severe left ventricular dysfunction was observed in 4.1% vs 8.1%, p=0.03, mitral regurgitation in 8.9% vs 20.3%, p<0.001 and aortic stenosis in 5.4% vs 4.3%, p=0.51. CONCLUSIONS: Integration focused echo into PC is feasible in Brazil as a strategy to deliver cardiovascular care to low-resourced areas through task shifting. The burden of HD observed suggests this tool may improve early diagnosis and referral.

Influências dos transtornos de sono-vigília sobre a saúde cardiovascular na atenção primária à saúde / Influencia de los trastornos del sueñovigilia sobre la salud cardiovascular en la atención primaria a la salud / Influences of sleep-wake disorders on cardiovascular health in primary health care

Objetivos: discutir os fatores prejudiciais ao sono e suas influências sobre a saúde cardiovascular na percepção de hipertensos atendidos por uma Unidade Básica de Saúde brasileira. Método: estudo descritivo, de abordagem qualitativa, realizado em um serviço de Atenção Básica Mineiro, Brasil. Foram coletados dados de caracterização e entrevista individual em profundidade, em 2019, com 40 hipertensos de idade ?18 anos. Os dados de caracterização foram analisados com apoio do Microsoft Excel-365 para frequências e as entrevistas no Nvivo Pró-11. Resultados: as participantes, predominantemente mulheres, idosas, aposentadas, relataram sono de má qualidade e uso de fármacos ansiolíticos/antidepressivos. Duas categorias discursivas emergiram: Sono e repouso preservados como determinantes da qualidade de vida e saúde; e Insônia: uma realidade cotidiana ligada aos condicionantes psicossociais, biológicos e ambientais. Considerações finais: a insônia gera impactos negativos na saúde cardiovascular e na qualidade de vida, necessitando de cuidados especializados no âmbito da enfermagem cardiovascular.

Objetivos: discutir los factores dañinos al sueño y sus influencias sobre la salud cardiovascular en la percepción de hipertensos atendidos por una Unidad Básica de Salud brasileña. Método: estudio descriptivo, de abordaje cualitativo, realizado en un servicio de Atención Básica Minero, Brasil. Se recogieron datos de caracterización y entrevista individual en profundidad, en 2019, con 40 hipertensos de edad ?18 años. Los datos de caracterización fueron analizados con el apoyo de Microsoft Excel-365 para frecuencias y las entrevistas en el Nvivo Pro-11. Resultados: las participantes, predominantemente mujeres, ancianas, jubiladas, relataron sueño de mala calidad y uso de fármacos ansiolíticos/antidepresivos. Dos categorías discursivas surgieron: Sueño y reposo preservados como determinantes de la calidad de vida y salud; e Insomnio: una realidad cotidiana ligada a los condicionantes psicosociales, biológicos y ambientales. Consideraciones finales: el insomnio genera impactos negativos en la salud cardiovascular y en la calidad de vida, necesitando de cuidados especializados en el ámbito de la enfermería cardiovascular.

Objective: to discuss the harmful factors to sleep and their influence on cardiovascular health in the perception of hypertensive patients assisted by a Brazilian Basic Health Unit. Method: a descriptive study with a qualitative approach, conducted in a primary care service in Minas Gerais, Brazil. Characterization data and in-depth individual interviews were collected in 2019, with 40 hypertensive patients aged ?18 years. The characterization data were analyzed with the support of Microsoft Excel-365 for frequencies and the interviews in Nvivo Pró-11. Results: the participants, predominantly women, elderly, retired, reported poor sleep quality and use of anxiolytic/antidepressant drugs. Two discursive categories emerged: Sleep and rest preserved as determinants of quality of life and health; and Insomnia: an everyday reality linked to psychosocial, biological and environmental conditions. Final considerations: insomnia generates negative impacts on cardiovascular health and quality of life, requiring specialized care in cardiovascular nursing.

Myocardial Viability on Cardiac Magnetic Resonance.

The study of myocardial viability is of great importance in the orientation and management of patients requiring myocardial revascularization or angioplasty. The technique of delayed enhancement (DE) is accurate and has transformed the study of viability into an easy test, not only for the detection of fibrosis but also as a binary test detecting what is viable or not. On DE, fibrosis equal to or greater than 50% of the segmental area is considered as non-viable, whereas that below 50% is considered viable. During the same evaluation, cardiac magnetic resonance (CMR) may also use other techniques for functional and perfusion studies to obtain a global evaluation of ischemic heart disease. This study aims to highlight the current concepts and broadly emphasize the use of CMR as a method that over the last 20 years has become a reference in the detection of infarction and assessment of myocardial viability. Resumo O estudo de viabilidade miocárdica é de grande importância para a orientação e manejo de pacientes que necessitam de cirurgia de revascularização miocárdica ou angioplastia. A técnica de realce tardio (RT) é precisa e transformou o estudo de viabilidade em um teste fácil, não só para a detecção de fibrose, mas também como um modelo binário para a detecção do que é ou não é viável. Uma fibrose identificada pelo RT é considerada como não viável quando igual ou maior do que 50% da área segmentar e como viável quando menor que 50%. A ressonância magnética cardíaca (RMC) também pode lançar mão de outras técnicas para estudo funcional e de perfusão para uma avaliação global da doença isquêmica do coração no mesmo exame. Este estudo tem como objetivo destacar os conceitos atuais e enfatizar amplamente o uso da RMC como um método que nos últimos 20 anos se tornou referência na detecção de infarto e avaliação de viabilidade miocárdica.

Barreiras e facilitadores para o encaminhamento de pacientes com doença pulmonar obstrutiva crônica à reabilitação pulmonar e indicação à prática de atividade física: um estudo qualitativo / Barriers and facilitators for referring patients with chronic obstructive pulmonary disease to pulmonary rehabilitation and physical activity recommendation: a qualitative study

Introdução: A doença pulmonar obstrutiva crônica (DPOC) possui alta prevalência e gera altos custos aos sistemas de saúde. A reabilitação pulmonar (RP) é uma intervenção não-farmacológica que gera benefícios clínicos para os pacientes e economia de gastos para o sistema de saúde devido a redução do número de exacerbações da doença e internações hospitalares. Embora fortemente recomendada, a RP tem sido subutilizada havendo um baixo índice de indicações. Objetivo: Identificar as barreiras e os facilitadores para o encaminhamento de pacientes com DPOC à RP e à prática de atividade física. Métodos: Estudo qualitativo, realizado com médicos atuantes na atenção primária à saúde (APS) e uso de entrevistas semiestruturadas. As entrevistas foram gravadas e transcritas literalmente e submetidas a análise de conteúdo. Itens (trechos) identificados nos discursos e relacionados ao encaminhamento de pacientes com DPOC à RP e à prática de atividade física foram classificados como barreiras ou facilitadores. Tal classificação se baseou entre os quatorze domínios da Theoretical Domains Framework (TDF) e suas definições para identificar determinantes de comportamento entre os participantes relevantes para a mudança na prática clínica. Resultados: Setecentos e cinquenta e seis itens foram identificados nos discursos de vinte e um participantes e classificados como sendo barreiras (n= 279, 37%) ou facilitadores (n= 477, 63%) relacionados principalmente aos domínios da TDF de "Conhecimento" (n= 245, 32%), "Contexto e recursos ambientais" (n= 124, 16%) e "Papel e identidade social/profissional" (n= 107, 14%). Conclusão: As principais barreiras identificadas foram relacionadas aos programas de RP devido ao conhecimento restrito dos profissionais médicos sobre programas de RP, a disponibilidade reduzida de locais que oferecem estes programas e as dificuldades de acesso dos pacientes à RP. Os principais facilitadores identificados foram relacionados a orientação e o conhecimento pelos médicos sobre os benefícios da atividade física e a presença dos grupos de exercícios fornecidos na APS.

Introduction: Chronic obstructive pulmonary disease (COPD) has a high prevalence and entails high costs to health systems. Pulmonary rehabilitation (PR) is a non-pharmacological intervention that generates clinical benefits for patients and cost savings for the health system due to a reduced number of exacerbations and hospitalizations. Although strongly recommended, PR has been underutilized, with a low rate of indications. Objective: To identify barriers and facilitators for referring patients with COPD to PR and physical activity. Method: Qualitative study was carried out with medical staff working in primary health care using semi-structured interviews. The interviews were recorded, transcribed literally and underwent content analysis. Items (text excerpts) identified in the speeches and related to the referral of patients with COPD to PR and physical activity were classified according to as barriers or facilitators, and among the fourteen domains of the Theoretical Domains Framework (TDF) and its definitions; aiming to identify the determinants of behaviour which were relevant to change in clinical practice. Results: Seven hundred and fifty-six items were identified in the speeches of twenty-one participants and classified as barriers (n= 279, 37%) or facilitators (n= 477, 63%) mainly related to the TDF domains of "Knowledge" (n= 245, 32%), "Context and environmental resources" (n=124, 16%) and "Role and social/professional identity" (n= 107, 14%). Conclusion: The main barriers identified were related to referring patients PR due to lack of knowledge by medical staff about PR programs, the limited number of programs available, and the restricted access to PR program locations. The main facilitators were related to physical activity, mainly the medical staff's knowledge on physical activity benefits and availability of exercise group activities delivered at primary health care centres.

Pacientes asmáticos adultos recebem orientações sobre atividade física? Uma abordagem com métodos mistos / Do adult asthmatic patients receive guidance on physical activity? A mixed methods approach

Introdução: A asma é uma doença respiratória caracterizada por sintomas como sibilo à ausculta pulmonar, dispneia e tosse, causados por limitação variável ao fluxo aéreo expiratório. A prática de atividades física pode auxiliar o controle da doença. Objetivo: Investigar o nível de atividade física de asmáticos adultos, e como estes indivíduos reportam receber orientação dos profissionais de saúde quanto à realização de atividade física. Método: Este estudo de métodos mistos foi realizado com indivíduos asmáticos, com idade superior a 18 anos. Os participantes realizaram teste de função pulmonar, responderam questionários sobre atividade física e entrevista semiestruturada. A entrevista foi realizada com questões voltadas ao tema central da pesquisa, as respostas foram transcritas de forma literal e analisadas por meio de metodologia da análise de conteúdo. Resultados: Vinte e cinco indivíduos participaram do estudo, a maioria do sexo feminino (n = 18; 72,0%) e idade média de 36 anos. A maioria dos indivíduos eram "irregularmente ativos" dos tipos A e B (n = 13; 52,0%). Foram identificados sete temas principais nos discursos: "conhecimento sobre os efeitos da atividade física regular" (n = 23; 92,0%), "atividade física específica para pacientes asmáticos" (n = 21; 84,0%), e "influência da orientação de um profissional de saúde" (n = 20; 80,0%). Conclusão: Os indivíduos asmáticos reportaram receber orientações dos profissionais de saúde quanto aos benefícios da prática regular de atividade física. Porém, estas informações podem ser insuficientes quanto ao tipo e frequência dos exercícios, modalidades apropriadas, manejo de possíveis sintomas durante ou após a prática da atividade e como preveni-los. Orientações adequadas sobre a prática da atividade regular para indivíduos asmáticos podem contribuir para o automanejo da doença.

Introduction: Asthma is a respiratory disease characterized by symptoms of wheezing, dyspnea, and cough, caused by some degree of limitation to expiratory airflow. Engagement in regular physical activity can help control the disease. Objective: To assess physical activity levels in asthmatic adults and to investigate how these individuals report guidance received from health professionals regarding physical activity. Method: This mixed-methods study included asthmatic adults aged 18 years or over. Participants underwent pulmonary function tests, completed physical activity questionnaires, and did a semistructured interview. The interview consisted of questions focused on the central topic of interest, and responses were transcribed literally and then analyzed using content analysis methods. Results: Twenty-five individuals participated in the study, most were female (n=18; 72.0%), and mean age was 36 years. Most individuals were classified as "irregularly active" (n=8; 32.0%). Seven main topics were identified in content analysis, including "knowledge about the effects of regular physical activity" (n=23; 92.0%), "specific physical activity for asthmatic patients" (n=21; 84.0%), and "influence of guidance from a health professional" (n=20; 80.0%). Conclusion: Asthmatic individuals reported having received guidance from health professionals regarding the benefits of engagement in regular physical activity. However, there is insufficient information regarding type and frequency of exercise, appropriate modalities, and management of possible symptoms during or after the activity and how to prevent them. Adequate guidance on regular activity for asthmatic individuals may contribute to self-management of the disease.

Estresse Psicossocial e Hipertensão Arterial Sistêmica: Representações Sociais à Luz dos Estressores de Neuman / Psychosocial stress and systemic arterial hypertension: social representations in the light of neuman stressors

Objetivo: discutir as representações sociais do estresse psicossocial de hipertensos à luz dos estressores de Neuman. Método: investigação qualitativa delineada na abordagem processual da Teoria das Representações Sociais, realizado numa Unidade Básica de Saúde em Minas Gerais, Brasil, com 30 participantes hipertensos. Coletado dados de caracterização e entrevistas individuais gravadas, a partir de questões norteadoras. Tratamento de dados com análise de conteúdo, com apoio em softwares SPSS versão 24 e NVivo Pro11. Atendidos todos os aspectos ético-legais de pesquisa. Resultados: elencadas duas categorias: 1) Percepções dos estresses diários nas atividades laborais e relações cotidianas; 2) Enfrentamento dos estressores psicossociais e suas repercussões sobre a saúde cardiovascular. Conclusão: as representações sociais do estresse psicossocial foram reconhecidas como influenciáveis sobre a hipertensão e oriundas dos estressores identificados cotidianamente, os quais devem ser controlados pela enfermagem. (AU)

Objective: To discuss social representations of psychosocial stress in hypertensive patients in light of Neuman's stressors. Method: Qualitative research outlined in the procedural approach of the Theory of Social Representations, conducted in a Basic Health Unit in Minas Gerais, Brazil, with 30 hypertensive participants. Collected characterization data and individual interviews recorded from guiding questions. Data analysis with content analysis supported by SPSS version 24 and NVivo Pro11. Met all ethical and legal aspects of research. Results: Two categories are listed: 1) Perceptions of daily stress in work activities and daily relationships; 2) Coping with psychosocial stressors and their repercussions on cardiovascular health. Conclusion: the social representations of psychosocial stress were recognized as influential on hypertension and derived from stressors identified daily which should be controlled by nursing. (AU)

Objetivo: Discutir las representaciones sociales del estrés psicosocial en pacientes hipertensos a la luz de los estresores de Neuman. Método: Investigación cualitativa descrita en el enfoque procesal de la Teoría de las Representaciones Sociales, realizada en una Unidad Básica de Salud en Minas Gerais, Brasil, con 30 participantes hipertensos. Datos de caracterización recopilados y entrevistas individuales registradas a partir de preguntas orientadoras. Análisis de datos con análisis de contenido compatible con SPSS versión 24 y el software NVivo Pro11. Cumplió con todos los aspectos éticos y legales de la investigación. Resultados: Se enumeran dos categorías: 1) Percepciones del estrés diario en las actividades laborales y las relaciones diarias; 2) Hacer frente a los estresores psicosociales y sus repercusiones en la salud cardiovascular. Conclusión: Las representaciones sociales del estrés psicosocial fueron reconocidas como influyentes en la hipertensión y derivadas de estresores identificados diariamente que deben ser controlados por la enfermeira. (AU)

Myocardial Viability on Cardiac Magnetic Resonance / Viabilidade Miocárdica pela Ressonância Magnética Cardíaca

Abstract The study of myocardial viability is of great importance in the orientation and management of patients requiring myocardial revascularization or angioplasty. The technique of delayed enhancement (DE) is accurate and has transformed the study of viability into an easy test, not only for the detection of fibrosis but also as a binary test detecting what is viable or not. On DE, fibrosis equal to or greater than 50% of the segmental area is considered as non-viable, whereas that below 50% is considered viable. During the same evaluation, cardiac magnetic resonance (CMR) may also use other techniques for functional and perfusion studies to obtain a global evaluation of ischemic heart disease. This study aims to highlight the current concepts and broadly emphasize the use of CMR as a method that over the last 20 years has become a reference in the detection of infarction and assessment of myocardial viability.

Resumo O estudo de viabilidade miocárdica é de grande importância para a orientação e manejo de pacientes que necessitam de cirurgia de revascularização miocárdica ou angioplastia. A técnica de realce tardio (RT) é precisa e transformou o estudo de viabilidade em um teste fácil, não só para a detecção de fibrose, mas também como um modelo binário para a detecção do que é ou não é viável. Uma fibrose identificada pelo RT é considerada como não viável quando igual ou maior do que 50% da área segmentar e como viável quando menor que 50%. A ressonância magnética cardíaca (RMC) também pode lançar mão de outras técnicas para estudo funcional e de perfusão para uma avaliação global da doença isquêmica do coração no mesmo exame. Este estudo tem como objetivo destacar os conceitos atuais e enfatizar amplamente o uso da RMC como um método que nos últimos 20 anos se tornou referência na detecção de infarto e avaliação de viabilidade miocárdica.