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2.
Int. j. cardiovasc. sci. (Impr.) ; 36: e20220041, 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1421790

ABSTRACT

Abstract Background Cardiovascular risk factors are prognostic factors in coronavirus disease 2019 (COVID-19) and have been scarcely studied in Brazil. Objective The aim of this study was to assess the impact of cardiovascular risk factors on the outcomes of patients admitted for COVID-19. Methods From July 2020 to February 2021, 200 patients from two public hospitals were enrolled. Patients were included if they had typical symptoms or signs of COVID-19, a positive real-time polymerase chain reaction test (RT-PCR) for COVID-19, and an age above 18 years. This is a prospective, observational, and longitudinal study. Data were collected within 24 h of admission. The primary endpoint was a combination of hospital lethality, mechanical ventilation, hemodialysis, or length of hospital stay >28 days. Continuous variables were compared with the Student's t-test for independent samples or the Mann-Whitney test. For comparisons of proportions, the χ 2 test was applied. ROC curves and survival curves were constructed. Multivariate logistic regression was performed to identify independent predictors of events. The level of significance was 0.05. Results There were 98 (49%) events during the hospital course, and 72 (36%) died in the hospital. Patients with a primary endpoint were older and more likely to have a history of hypertension, diabetes, chronic obstructive pulmonary disease (COPD), and chronic kidney disease (CKD). Vital signs at admission associated with events were diastolic blood pressure, respiratory rate, and oxygen saturation in ambient air (O 2 Sat). Serum creatinine >1.37 mg/dL at admission had a sensitivity of 51.6 and a specificity of 82% to predict the primary endpoint, with an area under the curve (AUC) of 0.68. In multivariate analysis, age, diabetes, CKD, and COPD were independent predictors of the primary endpoint. Age and CKD were independent predictors of in-hospital lethality. Conclusion Cardiovascular risk factors, such as diabetes and CKD, were related to a worse prognosis in patients hospitalized with COVID-19 in this sample from two public hospitals in the state of Rio de Janeiro.

3.
Arq. bras. cardiol ; 117(3): 561-598, Sept. 2021. tab, graf
Article in English, Portuguese | LILACS, CONASS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1339180
4.
Int. j. cardiovasc. sci. (Impr.) ; 33(3): 227-232, May-June 2020. tab, graf
Article in English | LILACS | ID: biblio-1134357

ABSTRACT

Abstract Background: Hepatic congestion is a frequent finding in patients with heart failure (HF). Physical examination has limitations in quantifying systemic congestion and requires correlation with echocardiographic and laboratory data (usually B-type natriuretic peptide, BNP, or N-terminal pro-B type natriuretic peptide, NT-proBNP). Hepatic elastography evaluates liver stiffness using a transducer that transmits low-frequency vibrations (50 Hz), and the speed of shear waves propagating through the tissues is measured by ultrasound. The faster the vibrations propagate in the hepatic parenchyma, the stiffer the liver, which, in case of HF, can be correlated with hepatic congestion. Objective: In this systematic review, case-controls, cohort studies, and randomized clinical trials were searched in MEDLINE, LILACS and Cochrane Database of Systematic Review, to evaluate the use of elastography in the detection of hepatic congestion in patients with HF. Methods: From the 49 articles retrieved, seven were selected for review, according to the inclusion and exclusion criteria. The most used methods for the diagnosis and evaluation of HF were echocardiography combined with BNP and NT-proBNP measurements. Results: Elastography performed at bedside was able to establish a significant correlation between increased liver stiffness and increased venous capillary pressure. In addition, liver elastography performed at hospital discharge was able to predict rehospitalization and mortality. Conclusion: Liver elastography is a non-invasive method that can be useful in predicting prognosis and mortality of individuals with HF, contributing to the clinical management of these patients.


Subject(s)
Elasticity Imaging Techniques/methods , Heart Failure/physiopathology , Heart Failure/diagnostic imaging , Prognosis , Cohort Studies , Natriuretic Peptides/blood , Heart Failure/mortality , Hospitalization , Liver Diseases/diagnostic imaging
5.
Int. j. cardiovasc. sci. (Impr.) ; 33(3): 299-302, May-June 2020. tab, graf
Article in English | LILACS | ID: biblio-1134362

ABSTRACT

Abstract The heart and lung are target organs in systemic sclerosis (SSc) and similar symptoms (dyspnea and cough) may make the differential diagnosis between the two lesions difficult. In addition, complete atrioventricular block (CAVB) is a rare complication of this disease. This case report is about a patient with SSc and pulmonary fibrosis who was admitted to the emergency room with CAVB, heart failure (HF) and progressive worsening of the underlying disease.


Subject(s)
Humans , Male , Middle Aged , Pulmonary Fibrosis/complications , Scleroderma, Diffuse/complications , Atrioventricular Block/complications , Pulmonary Fibrosis/diagnosis , Cough , Scleroderma, Diffuse/diagnosis , Scleroderma, Diffuse/drug therapy , Early Diagnosis , Diagnosis, Differential , Dyspnea , Atrioventricular Block/diagnosis , Hypertension, Pulmonary
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