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1.
Anaesthesia ; 75 Suppl 1: e165-e173, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31903570

RESUMO

Peri-operative risk estimation has traditionally focused on assessing the likelihood of postoperative morbidity and mortality using pre-operative functional assessment. Although this strategy is currently recommended by most major society guidelines, contemporary evidence suggests that cardiac biomarker measurement has important advantages over pre-operative functional assessment. These advantages include superior predictive discrimination and inclusion of the postoperative course in risk estimation. In this review, we provide an overview of the evidence supporting the peri-operative utilisation, compare risk estimation methods and discuss which patients may benefit most from cardiac biomarker screening. We also discuss protocols for biomarker screening and management of patients with abnormal results.


Assuntos
Cardiopatias/diagnóstico , Assistência Perioperatória/métodos , Biomarcadores , Humanos
3.
Int Heart J ; 60(6): 1448, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31787633

RESUMO

We are pleased to announce that the following 3 articles have been selected for the UEDA Heart Awards for the Year 2019. FIRST PLACEA Novel Truncating LMNA Mutation in Patients with Cardiac Conduction Disorders and Dilated CardiomyopathyHiroshi Kawakami, Akiyoshi Ogimoto, Naohito Tokunaga, Kazuhisa Nishimura, Hideo Kawakami, Haruhiko Higashi, Chiharuko Iio, Tamami Kono, Jun Aono, Teruyoshi Uetani, Takayuki Nagai, Katsuji Inoue, Jun Suzuki, Shuntaro Ikeda, Takafumi Okura, Yasumasa Ohyagi, Yasuharu Tabara, Jitsuo HigakiInt Heart J 2018; 59 (3): 531-541. SECOND PLACEAssociation Between the Presence or Severity of Coronary Artery Disease and Pericardial Fat, Paracardial Fat, Epicardial Fat, Visceral Fat, and Subcutaneous Fat as Assessed by Multi-Detector Row Computed TomographyYoko Ueda, Yuhei Shiga, Yoshiaki Idemoto, Kohei Tashiro, Kota Motozato, Rie Koyoshi, Takashi Kuwano, Kanta Fujimi, Masahiro Ogawa, Keijiro Saku, Shin-ichiro MiuraInt Heart J 2018; 59 (4): 695-704. THIRD PLACECatecholamine-Induced Senescence of Endothelial Cells and Bone Marrow Cells Promotes Cardiac Dysfunction in MiceGoro Katsuumi, Ippei Shimizu, Yohko Yoshida, Yuka Hayashi, Ryutaro Ikegami, Masayoshi Suda, Takayuki Wakasugi, Masaaki Nakao, Tohru MinaminoInt Heart J 2018; 59 (4): 837-844. November 2019International Heart Journal Association.


Assuntos
Distinções e Prêmios , Cardiopatias/diagnóstico , Cardiopatias/etiologia , Animais , Modelos Animais de Doenças , Humanos , Camundongos
4.
Tex Heart Inst J ; 46(3): 219-221, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31708708

RESUMO

Bioprosthetic valve thrombosis was previously considered to be a relatively rare complication of surgical or transcatheter bioprosthetic valve replacement. Although echocardiograms can reliably show the characteristic findings of prosthetic valve stenosis, differentiating between thrombus formation and pannus overgrowth as the underlying cause of prosthetic valve dysfunction can be challenging. We present the case of a 75-year-old man who underwent transthoracic Doppler echocardiography in the presence of an elevated valvular gradient 2 years after his aortic valve had been surgically replaced with a bioprosthesis. The echocardiographic findings suggested prosthetic valve stenosis. Cardiac computed tomography, performed to distinguish between thrombus formation and pannus overgrowth, revealed hypoattenuated leaflet thickening and reduced leaflet mobility, which suggested thrombus. After the patient took oral anticoagulants for 3 months, images showed complete resolution of the previous abnormalities, thus confirming the diagnosis of bioprosthetic valve thrombosis. We found cardiac computed tomography valuable when evaluating our patient who had an elevated prosthetic valve gradient.


Assuntos
Estenose da Valva Aórtica/cirurgia , Valva Aórtica/diagnóstico por imagem , Bioprótese/efeitos adversos , Cardiopatias/diagnóstico , Trombose/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Substituição da Valva Aórtica Transcateter/efeitos adversos , Idoso , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/diagnóstico , Diagnóstico Diferencial , Ecocardiografia Doppler , Ecocardiografia Transesofagiana , Cardiopatias/etiologia , Próteses Valvulares Cardíacas/efeitos adversos , Humanos , Masculino , Desenho de Prótese
5.
High Blood Press Cardiovasc Prev ; 26(5): 361-373, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31650516

RESUMO

High blood pressure (BP) is becoming a growing health issue even in children and adolescents. Moreover, BP elevation in youth frequently translates into children and adult hypertension contributing to the development of cardiovascular disease. The detection of early markers of vascular damage, potentially leading to overt cardiovascular disease, is important for clinical decisions about if and how to treat hypertension and can be useful in monitoring the effectiveness of the treatment. The purpose of this review is to summarize the actual knowledge about subclinical organ damage (SOD) in hypertensive children and adolescents and its association with cardiovascular disease in children and young adults. Our focus is especially put on left ventricular mass, pulse wave velocity, carotid intima-media thickness and microalbuminuria. We also want to address the scientific evidence about possible regression of SOD and cardiovascular risk with the use of behavioural and specific anti-hypertensive therapy. Indications from current guidelines are critically discussed.


Assuntos
Albuminúria/epidemiologia , Pressão Sanguínea , Cardiopatias/epidemiologia , Hipertensão/epidemiologia , Nefropatias/epidemiologia , Doenças Vasculares/epidemiologia , Adolescente , Fatores Etários , Albuminúria/diagnóstico , Albuminúria/fisiopatologia , Doenças Assintomáticas , Criança , Feminino , Cardiopatias/diagnóstico , Cardiopatias/fisiopatologia , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Nefropatias/diagnóstico , Nefropatias/fisiopatologia , Masculino , Fatores de Risco , Doenças Vasculares/diagnóstico , Doenças Vasculares/fisiopatologia , Remodelação Vascular , Rigidez Vascular
6.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190016.SUPL.2, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31596387

RESUMO

OBJECTIVE: To analyze the risk factors associated with the self-reported medical diagnosis of heart disease in Brazil. METHODS: This is a cross-sectional study, analyzing information from 60,202 adult participants of the Brazilian National Health Survey in 2013. Heart disease was defined by self-reported medical diagnosis of heart disease. We analyzed associations between the occurrence of disease and sociodemographic characteristics, health conditions and lifestyle. A hierarchical binary logistic regression model was used. RESULTS: The prevalence of self-reported diagnosis of heart disease in Brazil was 4.2% (confidence interval of 95% [95%CI] 4.0 ‒ 4.3) and was associated with females (odds ratio [OR] = 1.1; 95%CI 1.1 ‒ 1.1), people 65 years old or older (OR = 4.7; 95%CI 3.3 ‒ 5.6), poor or very poor health conditions (OR = 4.1; 95%CI 3.5 ‒ 4.6) and fair health conditions (OR = 2.4; 95%CI 2.2 ‒ 2.7), hypertensive individuals (OR = 2.4; 95%CI 2.2 ‒ 2.7), those with increased cholesterol (OR = 1.6; 95%CI 1.5 ‒ 1.8), overweight individuals (OR = 1.5; 95%CI 1.4 ‒ 1.8) and obese individuals (OR = 2.0; 95%CI 1.7 ‒ 2.2), sedentary behavior (OR = 1.5; 95%CI 1.02 ‒ 2.1), former smokers (OR = 1.4; 95%CI 1.3 ‒ 1.6) or current smokers (OR = 1.2; 95%CI 1.03 ‒ 1.3) and the consumption of fruits and vegetables 5 or more days each week (OR = 1.5; 95%CI 1.1 ‒ 1.5). CONCLUSION: The importance of knowledge on the prevalence of heart disease and associated risk factors in the present Brazilian epidemiological context must be emphasized because it guides actions to control and prevent cardiovascular diseases, the leading cause of death in Brazil and worldwide.


Assuntos
Autoavaliação Diagnóstica , Inquéritos Epidemiológicos/métodos , Cardiopatias/diagnóstico , Cardiopatias/epidemiologia , Autorrelato/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Valores de Referência , Medição de Risco , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Adulto Jovem
8.
Zhongguo Yi Liao Qi Xie Za Zhi ; 43(5): 341-344, 2019 Sep 30.
Artigo em Chinês | MEDLINE | ID: mdl-31625331

RESUMO

OBJECTIVE: A method for dynamically collecting and processing ECG signals was designed to obtain classification information of abnormal ECG signals. METHODS: Firstly, the ECG eigenvectors were acquired by real-time acquisition of ECG signals combined with discrete wavelet transform, and then the ECG fuzzy information entropy was calculated. Finally, the Euclidean distance was used to obtain the semantic distance of ECG signals, and the classification information of abnormal signals was obtained. RESULTS: The device could effectively identify abnormal ECG signals on an embedded platform based on the Internet of Things, and improved the diagnosis accuracy of heart diseases. CONCLUSIONS: The fuzzy diagnosis device of ECG signal could accurately classify the abnormal signal and output an online signal classification matrix with a high confidence interval.


Assuntos
Eletrocardiografia , Cardiopatias , Algoritmos , Arritmias Cardíacas , Lógica Fuzzy , Cardiopatias/diagnóstico , Humanos , Internet , Processamento de Sinais Assistido por Computador , Análise de Ondaletas
9.
Medicine (Baltimore) ; 98(38): e17256, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567998

RESUMO

RATIONALE: Cardiac amyloidosis, considered for the last years to be a rare disease, is one of the determinants of HFpEF. The non-specific clinical presentation and the difficulties related to endomyocardial biopsy have made cardiac amyloidosis an underdiagnosed clinical entity. Improvement of non-invasive diagnostic techniques and the development of new therapies increased clinical awareness for this form of restrictive cardiomyopathy. We here summarize echocardiography and Tc-HDP scintigraphy findings in 6 cases of cardiac amyloidosis and review the literature data of this progressive and fatal cardiomyopathy. PATIENTS CONCERNS: The main clinical manifestations were fatigue, low exercise tolerance and edemas. The right heart failure symptoms usually dominated the clinical picture. DIAGNOSES: All cases were evaluated by echocardiography; 3 cases were further examined by bone scintigraphy and 4 cases a peripheral biopsy was performed. Electrocardiography showed low-voltage QRS complexes and "pseudo-infarct" pattern in the precordial leads, contrary to the echocardiographic aspect, which revealed thickening of ventricle walls. Biatrial dilation and diastolic disfunction were observed. Impaired systolic function was detected in advanced stages of the disease. Tc-HDP scintigraphy revealed cardiac uptake of radiopharmaceutical and managed to confirm the diagnosis in 1 case of cardiac amyloidosis in which salivary gland biopsy was negative. INTERVENTIONS: The treatment was based on managing fluid balance, with the mainstream therapy represented by diuretics. Neurohormonal agents, usually used in heart failure treatment were avoided, due to poor tolerance and worsening of disease course. The management of these 6 cases was challenging due to the refractory manifestation of congestive heart failure. OUTCOMES: During follow-up, 4 of the 6 patients from the current study died in the first year after the final diagnosis was established. LESSONS: Nuclear imaging of cardiac amyloidosis has a revolutionary development nowadays. Bone scintigraphy presents promising results for identifying patients at early stages of disease and to differentiate between cardiac amyloidosis types. Further studies are necessary for the standardization of imaging protocol and development of non-invasive diagnostic tools, especially in assessing the response to treatment and disease progression, for which little is known.


Assuntos
Amiloidose/diagnóstico por imagem , Ecocardiografia , Cardiopatias/diagnóstico por imagem , Cintilografia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Amiloidose/diagnóstico , Amiloidose/patologia , Difosfonatos , Feminino , Coração/diagnóstico por imagem , Cardiopatias/diagnóstico , Cardiopatias/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Miocárdio/patologia , Compostos de Organotecnécio
11.
Rev Esp Cardiol (Engl Ed) ; 72(10): 795, 2019 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31561875
12.
Adv Exp Med Biol ; 1161: 37-44, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31562620

RESUMO

The term cardiovascular diseases (CVD) refers to disorders of heart and blood vessels, and include coronary heart disease, cerebrovascular disease, peripheral vascular disease, and heart failure, among others. Atherosclerosis is a common background of these diseases. It is not infrequent that some acute diseases, such as coronary syndromes, appear superimposed on a chronic arterial disease. Acute coronary syndromes (ACS), found worldwide among the leading causes of death, can be the origin of disabling chronic CVD such as heart failure [46]. Clinical and experimental evidence associates this group of alterations with an inflammatory process that takes part in its pathophysiology. In fact, inflammation is one of the most important factors for its initiation, progression, and consolidation [6].


Assuntos
Biomarcadores , Cardiopatias , Inflamação , Síndrome Coronariana Aguda , Animais , Aterosclerose , Biomarcadores/sangue , Doença Crônica , Cardiopatias/diagnóstico , Cardiopatias/fisiopatologia , Humanos
13.
West J Emerg Med ; 20(5): 810-817, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31539339

RESUMO

INTRODUCTION: Sudden cardiac death is a rare cause of death in young athletes. Current screening techniques include history and physical exam (H and P), with or without an electrocardiogram (ECG). Adding point of care cardiac ultrasound has demonstrated benefits, but there is limited data about implementing this technology. We evaluated the feasibility of adding ultrasound to preparticipation screening for collegiate athletes. METHODS: We prospectively enrolled 42 collegiate athletes randomly selected from several sports. All athletes were screened using a 14-point H and P based on 2014 American College of Cardiology (ACC) and American Heart Association (AHA) guidelines, ECG, and cardiac ultrasound. RESULTS: We screened 11 female and 31 male athletes. On ultrasound, male athletes demonstrated significantly larger interventricular septal wall thickness (p = 0.002), posterior wall thickness (p <0.001) and aortic root breadth (p = 0.002) compared to females. Based on H and P and ECGs alone and a combination of H and P with ECG, no athletes demonstrated a positive screening for cardiac abnormalities. However, with combined H and P, ECG, and cardiac ultrasound, one athlete demonstrated positive findings. CONCLUSIONS: We believe that adding point of care ultrasound to the preparticipation exam of college athletes is feasible. This workflow may provide a model for athletic departments' screening.


Assuntos
Atletas , Morte Súbita Cardíaca/prevenção & controle , Cardiopatias/diagnóstico , Programas de Rastreamento/métodos , Sociedades , Estudantes , Universidades , Adolescente , Morte Súbita Cardíaca/epidemiologia , Ecocardiografia , Eletrocardiografia , Feminino , Cardiopatias/epidemiologia , Humanos , Incidência , Masculino , Esportes , Estados Unidos/epidemiologia , Adulto Jovem
15.
Rev Port Cardiol ; 38(7): 511-514, 2019 07.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31522938

RESUMO

An 83-year-old woman with a 10-year history of rheumatoid arthritis was admitted for urinary tract infection with exacerbation of chronic kidney disease and decompensated heart failure of unknown etiology. Transesophageal echocardiography (TEE) showed a vegetation involving the posterior mitral valve leaflet, and a hypothesis of infective endocarditis was proposed. Empirical antibiotic therapy was initiated. TEE was repeated after antibiotic therapy, and showed persistence of the original vegetation and revealed the presence of another, smaller vegetation. Clinical investigation revealed no infectious process, and so a diagnosis of nonbacterial thrombotic endocarditis (NBTE) was established. Anticoagulant therapy was started immediately. The NBTE lesion had disappeared on the follow-up echocardiogram two months after anticoagulant therapy.


Assuntos
Endocardite não Infecciosa/complicações , Ventrículos do Coração , Trombose/etiologia , Idoso de 80 Anos ou mais , Ecocardiografia Transesofagiana , Endocardite não Infecciosa/diagnóstico , Feminino , Cardiopatias/diagnóstico , Cardiopatias/etiologia , Humanos , Trombose/diagnóstico
16.
Vasc Health Risk Manag ; 15: 253-258, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31496715

RESUMO

Antiphospholipid syndrome (APS) is an autoantibody-mediated acquired thrombophilia characterized by venous and/or arterial thromboses, pregnancy morbidity (predominantly repeated fetal losses), and the presence of phospholipid antibodies. The estimated annual incidence of APS is 5 new cases per 100,000 people. The most common thrombotic events in patients with APS in order of frequency are stroke, transient ischemic attack, deep vein thrombosis, and pulmonary embolism. Patients with APS may develop an intracardiac thrombus, which is a life-threatening complication with a high risk of increased morbidity and mortality; however, it is treatable by surgical removal, extensive anticoagulant administration, and prevention of other complications. Catastrophic APS, which is a rare and severe condition diagnosed based on rapidly progressive thromboembolic events involving three or more organs, systems, or tissues, occurs in less than 1% of all patients with APS. We herein report an autopsy case of catastrophic APS in a 12-year-old Thai boy with multiple thromboembolic events including intracardiac thrombus formation with a positive lupus anticoagulant test result. To the best of our knowledge, this is the youngest reported patient with APS to date.


Assuntos
Síndrome Antifosfolipídica/complicações , Cardiopatias/etiologia , Tromboembolia/etiologia , Síndrome Antifosfolipídica/sangue , Síndrome Antifosfolipídica/diagnóstico , Síndrome Antifosfolipídica/terapia , Autopsia , Biomarcadores/sangue , Doença Catastrófica , Criança , Evolução Fatal , Cardiopatias/sangue , Cardiopatias/diagnóstico , Cardiopatias/terapia , Humanos , Inibidor de Coagulação do Lúpus/sangue , Masculino , Tromboembolia/sangue , Tromboembolia/diagnóstico , Tromboembolia/terapia
17.
Artigo em Inglês | MEDLINE | ID: mdl-31497937

RESUMO

A 61-year-old male who lived for 30 years in a rural area presented chest pain of 3 months duration. Multiple hydatid cysts (Echinococcus granulosus) were diagnosed in the pericardium and the mediastinum by echocardiography and computed tomography. The cysts were removed successfully with the patient on cardiopulmonary bypass and beating heart.  This video tutorial shows how we removed the cysts, using the puncture-aspiration and enucleation technique.  Few videos of this technique exist, and we believe that this tutorial is a helpful demonstration of how to handle mediastinal and pericardial hydatid cysts.


Assuntos
Equinococose/cirurgia , Cardiopatias/cirurgia , Doenças do Mediastino/cirurgia , Procedimentos Cirúrgicos Torácicos/métodos , Equinococose/diagnóstico , Equinococose/parasitologia , Ecocardiografia , Cardiopatias/diagnóstico , Cardiopatias/parasitologia , Humanos , Masculino , Doenças do Mediastino/diagnóstico , Doenças do Mediastino/parasitologia , Mediastino , Pessoa de Meia-Idade , Pericárdio , Tomografia Computadorizada por Raios X
18.
Pan Afr Med J ; 33: 114, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31489092

RESUMO

Introduction: Sudden death that occurs during sporting activity affects patients with ignored heart disease. Black athlete's ECG has been little studied and the features of this ethnic group have been discussed. This study aims to study the epidemiological profile and the peculiarities of repolarization of black athletes. Methods: We conducted a descriptive study of black athletes selected among all the athletes followed in the sectoral Center of Sports Science and Medicine in Sousse over a period of 8 months from March to October 2014. Data were collected using a medical questionnaire. Results: Data on 35 athletes were collected, with a male predominance (94,28%), with an average age of 24,34 years. Four athletes had left ventricular hypertrophy on cardiac ultrasound. There were 8 athletes with atrioventricular block degree I and 8 athletes with electrical type of left ventricular hypertrophy (LVH). ST segment changes were more marked at the level of precordial leads. Five athletes (14.2%) had inverted T waves in V2 and V3. These were the same athletes who ST-segment depression in these same leads. Early repolarization was found in 3 athletes. All these cases had notch signaling. Conclusion: Black athletes have quite specific electrical modifications which are important to know. However, our sample is not sufficiently large to certify these results. A comparative study of white athletes would be very interesting.


Assuntos
Arritmias Cardíacas/diagnóstico , Atletas , Cardiopatias/diagnóstico , Hipertrofia Ventricular Esquerda/diagnóstico , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano , Arritmias Cardíacas/epidemiologia , Bloqueio Atrioventricular/diagnóstico , Bloqueio Atrioventricular/epidemiologia , Morte Súbita/prevenção & controle , Ecocardiografia , Eletrocardiografia/métodos , Feminino , Cardiopatias/epidemiologia , Humanos , Hipertrofia Ventricular Esquerda/epidemiologia , Masculino , Estudos Retrospectivos , Esportes , Inquéritos e Questionários , Adulto Jovem
19.
Praxis (Bern 1994) ; 108(11): 741-749, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31480954

RESUMO

CME: Nocturnal Dyspnea Abstract. Nocturnal dyspnea has a broad range of differential diagnoses of sometimes serious and even life-threatening illnesses. Systematic assessment starts with taking a detailed medical history to characterize the dyspnea and evaluate possible underlying diseases. The subsequent clinical and complementary evaluation should be targeted to detect possible diseases of the upper and lower respiratory tract, the lungs, disorders of control of breathing, heart diseases as well as neurological and, after exclusion of other causes, mental illnesses.


Assuntos
Dispneia , Cardiopatias , Diagnóstico Diferencial , Dispneia/diagnóstico , Dispneia/etiologia , Cardiopatias/complicações , Cardiopatias/diagnóstico , Humanos
20.
Presse Med ; 48(12): 1393-1400, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31471091

RESUMO

An ECG is recommended by the French Society of Cardiology in the screening of a competitive athlete. An intense and prolonged physical activity (>4 hours of intense sport/week) can lead to a physiological electric remodeling. In addition to physical activity (type, intensity, duration), the ECG should be interpreted according to the athlete's ethnicity and age. It is necessary to know the physiological modifications related to sport practice to avoid either false reassurances or the realization of unjustified additional examinations because of a wrong interpretation. The latest athlete ECG classification published in 2017 can be used to identify in which athlete additional tests are recommended (figure 1).


Assuntos
Atletas , Eletrocardiografia , Cardiopatias/diagnóstico , Esportes , Cardiologia/métodos , Cardiologia/normas , Diagnóstico Diferencial , Técnicas de Diagnóstico Cardiovascular/normas , Eletrocardiografia/métodos , Eletrocardiografia/normas , Exercício/fisiologia , Humanos , Programas de Rastreamento/métodos , Programas de Rastreamento/normas , Padrões de Referência , Esportes/normas
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