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1.
Pneumologie ; 74(1): 24-34, 2020 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-31863422

RESUMEN

Sarcoidosis is a multisystemic granulomatous disorder which affects the respiratory system in the majority of the cases. Symptomatic cardiac manifestations are found in less than 10 % of the affected cohorts and show a large heterogeneity based on the ethnic background. Cardiac sarcoidosis is not only found in patients with rhythmogenic heart disease, such as atrial and ventricular fibrillation but also in all phenotypes of cardiomyopathy. The overall morbidity and mortality caused by cardiac sarcoidosis in Germany remains unclear and large prospective international observational studies.underline the importance of this disease entity. This consensus paper on diagnostic and therapeutic algorithms for cardiac sarcoidosis is based on a current literature search and forms an expert opinion statement under the auspices of the German Respiratory Society and the German Cardiac Society. The rationale of this statement is to provide algorithms to facilitate clinical decision-making based on the individual case situation.


Asunto(s)
Cardiología/normas , Guías de Práctica Clínica como Asunto , Sarcoidosis Pulmonar/diagnóstico , Sarcoidosis Pulmonar/terapia , Cardiomiopatías , Consenso , Alemania/epidemiología , Humanos , Comunicación Interdisciplinaria , Neumología/normas , Sociedades Médicas
4.
Kardiologiia ; 59(12): 54-63, 2019 Dec 11.
Artículo en Ruso | MEDLINE | ID: mdl-31849312

RESUMEN

Increase in life expectancy during the second part of the 20th century is accompanied by increase in proportion of elderly and senile age population. However, despite the increase in life expectancy, the prevalence of most chronic diseases and functional impairments rises with age. Elderly and senile age is associated with the risk of cardiovascular diseases (CVD), therefore the problem of managing elderly patients with CVD becomes especially urgent.


Asunto(s)
Cardiología , Enfermedades Cardiovasculares , Geriatría , Anciano , Enfermedad Crónica , Humanos , Esperanza de Vida
5.
Anatol J Cardiol ; 22(Suppl 2): 25-28, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31670715

Asunto(s)
Cardiología
7.
Presse Med ; 48(12): 1387-1392, 2019 Dec.
Artículo en Francés | MEDLINE | ID: mdl-31679896

RESUMEN

The GERS-P (Exercise Rehabilitation Sports Prevention Group of the French Society of Cardiology) has decided to update current guidelines regarding the practice of EKG stress tests. Since the last update dates from 1997, the GERS judged it necessary to integrate data from new works and advancements made in the last 20 years. Good clinical practices and safety conditions are better defined regarding the structure, location, material, staff competency, as well as convention with hospital structures. The diagnosis of coronary artery disease remains the principal indication for a stress test. Interpretation of the results is crucial - it must be multivariate and provide either a low, intermediate or strong probability of the existence of coronary lesions, taking into account the studied population (risk factors, age, sex and symptoms). We no longer have to talk about a "positive, negative or litigious" test. Several new indications for a stress test have been defined for the assessment of cardiac pathologies. With such indications, the use of gas expiration measurements is highly recommended in order to provide a precise prognosis for all the various cardiac pathologies : congenital, ischemic, valvular, cardiomyopathy, congestive heart failure, rhythm and conduction disorders, pacemaker fine-tuning, or pulmonary hypertension. Indications for stress tests and contraindications are defined according to different population subgroups, for instance : athletes, women, children, the elderly, asymptomatic patients, diabetics, hypertensive patients, peripheral arteritis disease patients, or in the context of a non-cardiac surgery pre-op visit. The new guidelines are considerably different from those dating from 1997 and further pinpoint the relevance and importance of an EKG stress test within the arsenal of complementary cardiologic exams. With the improvements made in providing diagnostic value in CAD, as well as better prognostic value for any underlying pathology, the indication for an EKG stress test has extended to all cardiovascular disease.


Asunto(s)
Cardiología/normas , Prueba de Esfuerzo/normas , Cardiología/organización & administración , Enfermedad de la Arteria Coronaria/diagnóstico , Técnicas de Diagnóstico Cardiovascular/normas , Ejercicio/fisiología , Prueba de Esfuerzo/métodos , Humanos , Pronóstico , Sociedades Médicas/normas
12.
Presse Med ; 48(11 Pt 1): 1288-1294, 2019 Nov.
Artículo en Francés | MEDLINE | ID: mdl-31727484

RESUMEN

Menopause is associated with a significant increase in arterial and metabolic risk. Systolic hypertension is common in post-menopausal women. Measurement of blood pressure should be repeated systematically at each visit. Ambulatory blood pressure measurements should be encouraged, especially to detect nocturnal hypertension and to prevent more efficiently women at risk. Self-testing of hypertension by home blood pressure should be encouraged at menopause. Antihypertensive treatment should be initiated after ambulatory blood pressure monitoring in association with reinforced lifestyle. Furthermore, global level of cardiovascular risk should take into account before starting antihypertensive treatment. There are no women specificities in the choice of the initial treatment except thiazide diuretics which should be preferred in osteoporotic women. In hypertensive women and with disabling climacteric symptoms under 60 and within 10 years after the onset of menopause, post-menopausal hormone therapy can be offered in absence of arterial or venous contraindications. A preliminary discussion between gynecologist, cardiologist and general practionner is necessary before deciding to treat a post-menopausal women for her climacteric symptoms. A clear information on the benefit-risk balance of post-menopausal hormone therapy should be given to the women. The information should be recorded in the medical file. Cooperation between cardiologists, gynecologists and general practionners should be promoted in France, to optimize the care pathways in these women at risk and to improve medical practices.


Asunto(s)
Hipertensión , Posmenopausia , Factores de Edad , Antihipertensivos/uso terapéutico , Determinación de la Presión Sanguínea/métodos , Cardiología , Femenino , Ginecología , Humanos , Hipertensión/complicaciones , Hipertensión/diagnóstico , Hipertensión/prevención & control , Hipertensión/terapia , Persona de Mediana Edad , Grupo de Atención al Paciente , Medicina de Precisión , Autocuidado , Factores de Tiempo
13.
Presse Med ; 48(11 Pt 1): 1301-1305, 2019 Nov.
Artículo en Francés | MEDLINE | ID: mdl-31727486

RESUMEN

Menopause requires the implementation of organized screening and dedicated care pathways in collaboration with the attending physician, the gynaecologist-obstetrician and the cardiovascular physician. It will be necessary to take into account the hormonal specificities of the cardiovascular risk, in order to know-how to properly prescribe hormonal treatments.


Asunto(s)
Vías Clínicas/organización & administración , Hipertensión/terapia , Menopausia , Cardiología , Femenino , Francia , Ginecología , Humanos , Hipertensión/diagnóstico , Persona de Mediana Edad , Obstetricia , Grupo de Atención al Paciente/organización & administración
14.
Presse Med ; 48(11 Pt 1): 1249-1256, 2019 Nov.
Artículo en Francés | MEDLINE | ID: mdl-31727491

RESUMEN

Cardiovascular diseases are become the primary cause of death in women. The cardiovascular risk of the woman has unknown specificities and remains underestimated. At equal age, women have more cardio vascular risk factors than men. All these specificities must be taken into account for an optimized evaluation of cardiovascular risk and for improvement of CV management in women. Some traditional risk factors are more deleterious in women such as hypertension, tobacco, diabetes or psycho-social stress and they are less well controlled compared to men. Women are also exposed to hormonal risk factors (contraception, pregnancy and menopause) or to emergent risk situations (migraine with aura, endometriosis, polycystic ovary syndrome, auto-immune diseases…). Conversely, lifestyle measures (regular physical activity, no smoking, healthy diet, stress management) are extremely effective in primary and secondary prevention in women. Predicting the risk of cardiovascular events in women is difficult because the classic risk scores (SCORE, Framingham…) do not take into account hormonal CV specificities and underestimate the women CV risk. Until then, only the specific women AHA stratification of CVR allowed for appropriate care for them. Recently, at the initiative of the French Society of hypertension, a consensus of experts proposed a stratification of CVR adapted to French women, to help practitioners in their care, especially for the two hormonal periods as contraception and menopause.


Asunto(s)
Enfermedades Cardiovasculares/etiología , Cardiología , Enfermedades Cardiovasculares/prevención & control , Anticoncepción/efectos adversos , Angiopatías Diabéticas/etiología , Endometriosis/complicaciones , Femenino , Francia , Ginecología , Humanos , Hipertensión/complicaciones , Menopausia , Grupo de Atención al Paciente , Síndrome del Ovario Poliquístico/complicaciones , Embarazo , Prevención Primaria , Medición de Riesgo , Factores de Riesgo , Prevención Secundaria , Factores Sexuales , Fumar/efectos adversos , Sociedades Médicas , Estrés Psicológico/complicaciones
15.
Rev Esp Cardiol (Engl Ed) ; 72(12): 1054-1064, 2019 Dec.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31727564

RESUMEN

INTRODUCTION AND OBJECTIVES: This article presents the data corresponding to automated implantable cardioverter-defibrillator (ICD) implants in Spain reported to the Spanish Registry in 2018. METHODS: The data in this registry include both primary implants and generator replacements and were gathered from a data collection sheet voluntarily completed by implantation centers. RESULTS: In 2018, 6421 implant sheets were received compared with 7077 reported by Eucomed (European Confederation of Medical Suppliers Associations). This represents data on 90.7% of the devices implanted in Spain. Compliance ranged between 99.6% for the field "name of the implanting hospital" and 12.4% for "population of residence". A total of 173 hospitals reported their data to the registry, representing a slight decrease compared with hospitals participating in 2017 (n=181). CONCLUSIONS: After the reduction in ICD implants in 2017, the number of implants increased in 2018, with the highest number of ICDs implanted in Spain. The total number of implants remains much lower than the European Union average, with substantial differences between autonomous communities.


Asunto(s)
Arritmias Cardíacas/terapia , Cardiología , Desfibriladores Implantables/estadística & datos numéricos , Electrofisiología/estadística & datos numéricos , Sistema de Registros , Sociedades Médicas , Recolección de Datos , Femenino , Humanos , Masculino , Estudios Retrospectivos , España
16.
Herzschrittmacherther Elektrophysiol ; 30(4): 371-376, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31729548

RESUMEN

Although atrial fibrillation (AF) is the most common cardiac arrhythmia, its management remains complex and depends on several variables. Over the past decade, catheter ablation has been widely used as an effective method for rhythm control in AF patients. Therefore, AF ablation has been the focus of many studies in recent years. Given the complexity of AF management and catheter ablation, several guidelines have been developed to regulate and direct management of AF patients. The European Society of Cardiology (ESC), together with the European Heart Rhythm Association (EHRA) and the European Association of Cardiothoracic Surgeons (EACTS), has been regulating the European guidelines, while the American Heart Association (AHA), along with the American College of Cardiology (ACC) and the Heart Rhythm Society (HRS), is publishing the US guidelines. Additionally, HRS, EHRA, and the Society of Thoracic Surgeons, along with representatives from heart rhythm societies from different parts of the world, have developed an "expert consensus statement on catheter and surgical ablation of AF." This article reviews and compares the most recent guidelines and consensus document on AF catheter ablation.


Asunto(s)
Fibrilación Atrial , Ablación por Catéter , Cardiología , Consenso , Humanos , Estados Unidos
17.
Rev Esp Cardiol (Engl Ed) ; 72(12): 1043-1053, 2019 Dec.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31732434

RESUMEN

INTRODUCTION AND OBJECTIVES: The Working Group on Cardiac Catheterization and Interventional Cardiology presents its annual report on the activity data for 2018. METHODS: Data were voluntarily provided by participating centers. The information was introduced online and was analyzed by the Steering Committee of the Working Group on Cardiac Catheterization and Interventional Cardiology. RESULTS: In 2018, data were reported by 109 hospitals, 83 of these centers are public. A total of 157 632 diagnostic procedures (140 670 coronary angiograms) were performed. This year, the number of percutaneous coronary interventions increased to 72 520 (2.2% increase). There was also an increase in the complexity of coronary interventions: 10.6% in chronic total occlusions and 4.2% in unprotected left main treatment. A total of 21 261 interventional procedures were performed in the acute myocardial infarction setting, of which 91% were primary angioplasties (9.6% higher than in 2017). A total of 108398 stents were implanted, of which 93.8% were drug-eluting stents (3.5% increase). Radial approach was used in 89.4% of interventional procedures. The number of transcatheter aortic valve implantations continued to increase (25.3% increase, n=3537), as well as the number of percutaneous mitral valve repair procedures (21.4% increase, n=328), left atrial appendage closures (10.6% increase, n=644) and patent foramen ovale closures (81% increase, n=514). CONCLUSIONS: An increase in diagnostic and therapeutic procedures was reported in 2018, particularly in primary percutaneous coronary interventions. The use of the radial approach and complex procedures also increased. The number of structural procedures rose significantly, following the trend seen in recent years.


Asunto(s)
Cateterismo Cardíaco/estadística & datos numéricos , Cardiología , Enfermedad de la Arteria Coronaria/cirugía , Intervención Coronaria Percutánea/estadística & datos numéricos , Sistema de Registros/estadística & datos numéricos , Sociedades Médicas , Enfermedad de la Arteria Coronaria/diagnóstico , Humanos , Estudios Retrospectivos , España
18.
Rev Esp Cardiol (Engl Ed) ; 72(12): 1031-1042, 2019 Dec.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31732435

RESUMEN

INTRODUCTION AND OBJECTIVES: This report presents the findings of the 2018 Spanish Catheter Ablation Registry. METHODS: Data collection was retrospective. A standardized questionnaire was completed by each of the participating centers. RESULTS: Data sent by 100 centers were analyzed, with a total number of 16566 ablation procedures performed (the highest historically reported in this registry) for a mean of 165.5±127.9 and a median of 119 procedures per center. The ablation targets most frequently treated were atrial fibrillation (n=4234; 25.6%), atrioventricular nodal re-entrant tachycardia (n=3525; 21.3%) and cavotricuspid isthmus (n=3425; 20.7%). A new peak was observed in the ablation of atrial fibrillation, increasing the distance from the other substrates. The overall success rate was 91%. The rate of major complications was 2.2%, and the mortality rate was 0.04%. A total of 2.1% of the ablations were performed in pediatric patients. CONCLUSIONS: The Spanish Catheter Ablation Registry enrolls systematically and continuously enrolls the ablation procedures performed in Spain, showing a progressive increasing in the number of ablations over the years, with a high success rate and low percentage of complications.


Asunto(s)
Arritmias Cardíacas/cirugía , Cardiología , Ablación por Catéter/estadística & datos numéricos , Técnicas Electrofisiológicas Cardíacas/métodos , Sistema de Registros/estadística & datos numéricos , Sociedades Médicas , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/fisiopatología , Recolección de Datos , Femenino , Humanos , Masculino , Estudios Retrospectivos , España
19.
Rev Esp Cardiol (Engl Ed) ; 72(11): 954-962, 2019 Nov.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31611149

RESUMEN

INTRODUCTION AND OBJECTIVES: The present report updates the clinical characteristics and outcomes of heart transplant in Spain to 2018. METHODS: Prospective registry of all the heart transplants performed between 1984 and 2018 in Spain. Specifically, temporal trends in clinical characteristics and outcomes are described for the period from 2009 to 2017. RESULTS: In 2018, 321 transplants were performed (8494 since 1984; 2719 between 2009 and 2018). Compared with the previous year, the number of transplants performed in 2018 rose by 52% in recipients younger than 16 years and by 42% in those older than 60 years. In the last decade, significant temporal trends were observed in recipient characteristics (better pretransplant renal function, higher rates of diabetes, more urgent transplants, and greater use of pretrasplant circulatory support, particularly ventricular assist devices), donor characteristics (higher donor age, more female donors, and higher frequencies of cerebrovascular cause of death and predonation cardiac arrest and lower ischemia time). Survival significantly improved in the last decade, mainly due to lower mortality due to primary graft failure. CONCLUSIONS: The number of heart transplants is increasing in Spain, with a progressive improvement in survival.


Asunto(s)
Cardiología , Insuficiencia Cardíaca/cirugía , Trasplante de Corazón/estadística & datos numéricos , Sistema de Registros , Sociedades Médicas , Adolescente , Adulto , Femenino , Insuficiencia Cardíaca/epidemiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , España/epidemiología , Tasa de Supervivencia/tendencias , Adulto Joven
20.
Rev Esp Cardiol (Engl Ed) ; 72(12): 1065-1075, 2019 Dec.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31611150

RESUMEN

There is currently no other hot topic like the ability of current technology to develop capabilities similar to those of human beings, even in medicine. This ability to simulate the processes of human intelligence with computer systems is known as artificial intelligence (AI). This article aims to clarify the various terms that still sound foreign to us, such as AI, machine learning (ML), deep learning (DL), and big data. It also provides an in-depth description of the concept of AI and its types; the learning techniques and technology used by ML; cardiac imaging analysis with DL; and the contribution of this technological revolution to classical statistics, as well as its current limitations, legal aspects, and initial applications in cardiology. To do this, we conducted a detailed PubMed search on the evolution of original contributions on AI to the various areas of application in cardiology in the last 5 years and identified 673 research articles. We provide 19 detailed examples from distinct areas of cardiology that, by using AI, have shown diagnostic and therapeutic improvements, and which will aid understanding of ML and DL methodology.


Asunto(s)
Algoritmos , Inteligencia Artificial , Técnicas de Imagen Cardíaca/métodos , Cardiología/métodos , Aprendizaje Profundo , Aprendizaje Automático , Humanos
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