ABSTRACT
Abstract Background: Cardiac resynchronization therapy (CRT) is an effective treatment for patients with heart failure. Objective: To evaluate the response of CRT in maximal inspiratory pressure (MIP), peak expiratory flow (PEF), and exercise tolerance as determined by the six-minute walk test (6MWT) in patients with HF. Methods: This study used the 6MWT and Manovacuometer to assess functional capacity in relation to activities of daily living, in which fatigue and dyspnea are common. Results: After six months of CRT, this study identified improvements in the 6MWT, p<0.05; MIP, p=0.01; and PEF, p=0.03. Conclusion: After CRT, this study showed a significant improvement in MIP, PEF, and exercise tolerance. However, further studies are warranted to demonstrate the relevance of these findings.
Subject(s)
Humans , Female , Women , Heart Diseases/epidemiology , Cause of Death , Heart Diseases/prevention & controlABSTRACT
Resumo O mundo mudou em apenas alguns meses após o surgimento da doença do novo coronavírus 2019 (COVID-19), causada por um betacoronavírus denominado síndrome respiratória aguda grave por coronavírus 2 (SARS-CoV-2). A COVID-19 foi declarada uma pandemia pela Organização Mundial da Saúde (OMS) em 11 de março de 2020. O Brasil apresenta atualmente o segundo maior índice de mortalidade por COVID-19 do mundo, perdendo apenas para os EUA. A pandemia da COVID-19 está se espalhando rapidamente pelo mundo, com mais de 181 países afetados. O presente editorial se refere ao artigo publicado nos Arquivos Brasileiros de Cardiologia: "Aumento de óbitos domiciliares devido a parada cardiorrespiratória em tempos de pandemia de COVID-19"1 Seus principais resultados mostram um aumento gradual na taxa de paradas cardiorrespiratórias extra-hospitalares durante a pandemia da doença por coronavírus 2019 (COVID-19) na cidade de Belo Horizonte, Minas Gerais, Brasil. Seus dados demonstram um aumento proporcional de 33% dos óbitos domiciliares em março de 2020 em relação aos períodos anteriores. O estudo é o primeiro artigo brasileiro a demonstrar a mesma tendência observada em outros países.
Abstract The world changed in just a few months after the emergence of the novel coronavirus disease 2019 (COVID-19), caused by a beta coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Brazil currently has the world's second-highest COVID-19 death toll, second only to the USA. The COVID-19 pandemic is spreading fast in the world with more than 181 countries affected. This editorial refers to the article published in Arquivos Brasileiros de Cardiologia: "Increase in home deaths due to cardiorespiratory arrest in times of COVID-19 pandemic."1 Their main results show a gradual increase in the rate of out-of-hospital cardiac arrest during the Coronavirus disease 2019 (COVID-19) pandemic in the city of Belo Horizonte, Minas Gerais, Brazil. Their data demonstrate a proportional increase of 33% of home deaths in March 2020 compared to previous periods. Their study is the first Brazilian paper to demonstrate the same trend observed in other countries.
Subject(s)
Humans , Out-of-Hospital Cardiac Arrest , COVID-19 , Brazil/epidemiology , Pandemics , SARS-CoV-2Subject(s)
Chagas Disease/history , Trypanosoma cruzi , Americas , Chagas Disease/epidemiology , Endemic DiseasesABSTRACT
Resumo Fundamento A doença cardiovascular representa a principal causa de mortalidade no mundo. Calcificações parietais nas artérias podem ser visualizadas e quantificadas por tomografia computadorizada (TC) em estágios iniciais e subclínicos, sendo expressa em escore de cálcio (EC). Com esse número, é possível estimar o prognóstico de eventos cardiovasculares futuros. Objetivos Correlacionar a detecção e quantificação do EC pela TC do tórax utilizando como padrão-ouro a TC cardíaca sincronizada ao eletrocardiograma. Métodos Estudo transversal e descritivo que selecionou pacientes (n=73) consecutivos para investigação de doença arterial coronariana estável e que realizaram TC cardíaca no período de junho de 2013 a outubro de 2014. Realizado protocolo com TC do tórax e EC, em aparelho de 64 canais. Os valores de p<0,05 foram considerados estatisticamente significativos. Resultados Na avaliação por paciente, após a transformação logarítmica a média do EC sincronizado foi de 8,7 e na TC de tórax foi de 9,4. Prevalência de doença de 49,3% (n= 36). A sensibilidade foi de 97,2% e a especificidade de 100,0%. Observou-se excelente correlação entre os métodos (r= 0,993 com p<0,001). Na avaliação por segmento, a média do EC sincronizado foi de 3,0. Já a média do EC na TC de tórax foi de 3,2. Prevalência de doença de 29,5% (n= 86), com sensibilidade de 95,3% e especificidade de 97,5%. Observou-se também excelente correlação entre os métodos (r= 0,985 com p<0,001). Conclusão O EC sincronizado e não sincronizado têm boa correlação entre si e não mostram resultados estatisticamente diferentes. (Arq Bras Cardiol. 2020; 115(3):493-500)
Abstract Background Cardiovascular disease is the leading cause of mortality in the world. Parietal calcifications of the arteries may be visualized and quantified at initial and subclinical states by computed tomography (CT), and expressed as calcium score (CS). It is possible to estimate the prognosis of future cardiovascular events using this score. Objectives To correlate the detection and quantification of the CS obtained by chest CT with that obtained by electrocardiography (ECG)-synchronized cardiac computed tomography (the gold-standard). Method Cross-sectional, descriptive study of 73 consecutive patients in investigation for coronary artery disease who underwent cardiac CT between June 2013 and October 2014. Chest computed tomography and CS protocols were performed in a 64-channel TC scanner. P-values <0.05 were considered statistically significant. Results In the per-patient analysis, after logarithmic transformation, mean CS was 8.7 and 9.4 by the ECG-synchronized method and chest CT, respectively. The prevalence of disease was 49.3% (n=36), with a sensitivity of 97.2% and specificity of 100.0%. There was an excellent correlation between the methods (r= 0.993, p<0.001). In the per-segment analysis, after logarithmic transformation, mean CS was 3.0 and 3.2 by the ECG-synchronized method and chest CT, respectively. The prevalence of disease was 29.5% (n=86), with a sensitivity of 95.3% and specificity of 97.5%. There was an excellent correlation between the methods (r= 0.985, p<0.001). Conclusion ECG-synchronized CT is well correlated with the non-ECG-synchronized CT for CS determination, without statistical difference between the methods. (Arq Bras Cardiol. 2020; 115(3):493-500)
Subject(s)
Humans , Coronary Artery Disease/diagnostic imaging , Calcium , Thorax , Tomography, X-Ray Computed , Cross-Sectional Studies , Coronary AngiographyABSTRACT
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 imagingABSTRACT
Resumo Os recentes avanços ao nível de hardware e a crescente exigência de personalização dos cuidados associados às necessidades urgentes de criação de valor para os pacientes contribuíram para que a Inteligência Artificial (IA) promovesse uma mudança significativa de paradigma nas mais diversas áreas do conhecimento médico, em particular em Cardiologia, por sua capacidade de apoiar a tomada de decisões e melhorar o desempenho diagnóstico e prognóstico. Nesse contexto, o presente trabalho faz uma revisão não-sistemática dos principais trabalhos publicados sobre IA em Cardiologia, com foco em suas principais aplicações, possíveis impactos e desafios.
Abstract The recent advances at hardware level and the increasing requirement of personalization of care associated with the urgent needs of value creation for the patients has helped Artificial Intelligence (AI) to promote a significant paradigm shift in the most diverse areas of medical knowledge, particularly in Cardiology, for its ability to support decision-making and improve diagnostic and prognostic performance. In this context, the present work does a non-systematic review of the main papers published on AI in Cardiology, focusing on its main applications, potential impacts and challenges.