Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 90
Filter
2.
Arq. bras. cardiol ; 118(2): 422-432, 2022. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1364337

ABSTRACT

Resumo Fundamento Amiloidose sistêmica é uma doença com manifestações clínicas diversas. O diagnóstico envolve suspeita clínica, aliada a métodos complementares. Objetivo Descrever o perfil clínico, laboratorial, eletrocardiográfico e de imagem no acometimento cardíaco da amiloidose sistêmica. Métodos Estudo de uma amostra de conveniência, analisando dados clínicos, laboratoriais, eletrocardiográficos, ecocardiográficos, medicina nuclear e ressonância magnética. Considerou-se significância estatística quando p < 0,05. Resultados Avaliaram-se 105 pacientes (com mediana de idade de 66 anos), sendo 62 homens, dos quais 83 indivíduos apresentavam amiloidose por transtirretina (ATTR) e 22 amiloidose por cadeia leve (AL). Na ATTR, 68,7% eram de caráter hereditário (ATTRh) e 31,3% do tipo selvagem (ATTRw). As mutações mais prevalentes foram Val142Ile (45,6%) e Val50Met (40,3%). O tempo de início dos sintomas ao diagnóstico foi 0,54 e 2,15 anos nas formas AL e ATTR (p < 0,001), respectivamente. O acometimento cardíaco foi observado em 77,9% dos ATTR e 90,9% dos AL. Observaram-se alterações de condução atrioventricular em 20% e intraventricular em 27,6% dos pacientes, sendo 33,7 % na ATTR e 4,5% das AL (p = 0,006). A forma ATTRw apresentou mais arritmias atriais que os ATTRh (61,5% x 22,8%; p = 0,001). Ao ecocardiograma a mediana da espessura do septo na ATTRw x ATTRh x AL foi de 15 mm x 12 mm x 11 mm (p = 0,193). Observou-se BNP elevado em 89,5% dos indivíduos (mediana 249 ng/mL, IQR 597,7) e elevação da troponina em 43,2%. Conclusão Foi possível caracterizar, em nosso meio, o acometimento cardíaco na amiloidose sistêmica, em seus diferentes subtipos, através da história clínica e dos métodos diagnósticos descritos.


Abstract Background Systemic amyloidosis is a disease with heterogeneous clinical manifestations. Diagnosis depends on clinical suspicion combined with specific complementary methods. Objective To describe the clinical, laboratory, electrocardiographic, and imaging profile in patients with systemic amyloidosis with cardiac involvement. Methods This study was conducted with a convenience sample, analyzing clinical, laboratory, electrocardiographic, echocardiographic, nuclear medicine, and magnetic resonance data. Statistical significance was set at p < 0.05. Results A total of 105 patients were evaluated (median age of 66 years), 62 of whom were male. Of all patients, 83 had transthyretin (ATTR) amyloidosis, and 22 had light chain (AL) amyloidosis. With respect to ATTR cases, 68.7% were the hereditary form (ATTRh), and 31.3% were wild type (ATTRw). The most prevalent mutations were Val142Ile (45.6%) and Val50Met (40.3%). Time from onset of symptoms to diagnosis was 0.54 and 2.15 years, in the AL and ATTR forms, respectively (p < 0.001). Cardiac involvement was observed in 77.9% of patients with ATTR and in 90.9% of those with AL. Alterations were observed in atrioventricular and intraventricular conduction in 20% and 27.6% of patients, respectively, with 33.7% in ATTR and 4.5% in AL (p = 0.006). In the ATTRw form, there were more atrial arrhythmias than in ATTRh (61.5% versus 22.8%; p = 0.001). On echocardiogram, median septum thickness in ATTRw, ATTRh, and AL was 15 mm, 12 mm, and 11 mm, respectively (p = 0.193). Elevated BNP was observed in 89.5% of patients (median 249, ICR 597.7), and elevated troponin was observed in 43.2%. Conclusion In this setting, it was possible to characterize cardiac involvement in systemic amyloidosis in its different subtypes by means of clinical history and the diagnostic methods described.


Subject(s)
Humans , Male , Female , Adult , Cardiology , Amyloid Neuropathies, Familial/diagnostic imaging , Amyloidosis/diagnostic imaging , Cardiomyopathies/diagnostic imaging , Referral and Consultation , Brazil , Prealbumin/genetics , Echocardiography
3.
Arq. bras. cardiol ; 117(3): 561-598, Sept. 2021. tab, graf
Article in English, Portuguese | SES-SP, LILACS, SES-SP, CONASS, SESSP-IDPCPROD, SES-SP | ID: biblio-1339180
9.
Int. j. cardiovasc. sci. (Impr.) ; 33(6): 705-712, Nov.-Dec. 2020. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1143109

ABSTRACT

Abstract The well-known occurrence of Chagas disease in endemic areas has become a worldwide problem, and cardiac magnetic resonance allows the early detection of cardiac involvement and complications of this disease. Cardiac magnetic resonance is a useful tool in all phases of Chagas disease, and new promising techniques using T1 mapping and extracellular volume measurements are able to detect cardiac involvement even earlier than conventional techniques.

11.
Hajjar, Ludhmila Abrahão; Costa, Isabela Bispo Santos da Silva da; Lopes, Marcelo Antônio Cartaxo Queiroga; Hoff, Paulo Marcelo Gehm; Diz, Maria Del Pilar Estevez; Fonseca, Silvia Moulin Ribeiro; Bittar, Cristina Salvadori; Rehder, Marília Harumi Higuchi dos Santos; Rizk, Stephanie Itala; Almeida, Dirceu Rodrigues; Fernandes, Gustavo dos Santos; Beck-da-Silva, Luís; Campos, Carlos Augusto Homem de Magalhães; Montera, Marcelo Westerlund; Alves, Sílvia Marinho Martins; Fukushima, Júlia Tizue; Santos, Maria Verônica Câmara dos; Negrão, Carlos Eduardo; Silva, Thiago Liguori Feliciano da; Ferreira, Silvia Moreira Ayub; Malachias, Marcus Vinicius Bolivar; Moreira, Maria da Consolação Vieira; Valente Neto, Manuel Maria Ramos; Fonseca, Veronica Cristina Quiroga; Soeiro, Maria Carolina Feres de Almeida; Alves, Juliana Barbosa Sobral; Silva, Carolina Maria Pinto Domingues Carvalho; Sbano, João; Pavanello, Ricardo; Pinto, Ibraim Masciarelli F; Simão, Antônio Felipe; Dracoulakis, Marianna Deway Andrade; Hoff, Ana Oliveira; Assunção, Bruna Morhy Borges Leal; Novis, Yana; Testa, Laura; Alencar Filho, Aristóteles Comte de; Cruz, Cecília Beatriz Bittencourt Viana; Pereira, Juliana; Garcia, Diego Ribeiro; Nomura, Cesar Higa; Rochitte, Carlos Eduardo; Macedo, Ariane Vieira Scarlatelli; Marcatti, Patricia Tavares Felipe; Mathias Junior, Wilson; Wiermann, Evanius Garcia; Val, Renata do; Freitas, Helano; Coutinho, Anelisa; Mathias, Clarissa Maria de Cerqueira; Vieira, Fernando Meton de Alencar Camara; Sasse, André Deeke; Rocha, Vanderson; Ramires, José Antônio Franchini; Kalil Filho, Roberto.
Arq. bras. cardiol ; 115(5): 1006-1043, nov. 2020. tab, graf
Article in Portuguese | SES-SP, LILACS, SES-SP, CONASS, SESSP-IDPCPROD, SES-SP | ID: biblio-1142267
12.
Arq. bras. cardiol ; 115(4): 720-775, out. 2020. tab, graf
Article in Portuguese | SES-SP, LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1131346
13.
Arq. bras. cardiol ; 115(1): 111-126, jul. 2020. graf
Article in Portuguese | SES-SP, LILACS, SES-SP | ID: biblio-1131250

ABSTRACT

Resumo A pandemia da doença causada pelo novo coronavírus (COVID-19) trouxe grandes desafios para o sistema de saúde devido ao aumento exponencial do número de pacientes acometidos. A racionalização de recursos e a indicação correta e criteriosa de exames de imagem e procedimentos intervencionistas tornaram-se necessárias, priorizando a segurança do paciente, do ambiente e dos profissionais da saúde. Esta revisão visa auxiliar e orientar os profissionais envolvidos na realização desses exames e procedimentos a fazê-los de forma eficaz e segura.


Abstract The coronavirus disease 2019 (COVID-19) pandemic is a huge challenge to the health system because of the exponential increase in the number of individuals affected. The rational use of resources and correct and judicious indication for imaging exams and interventional procedures are necessary, prioritizing patient, healthcare personnel, and environmental safety. This review was aimed at guiding health professionals in safely and effectively performing imaging exams and interventional procedures.


Subject(s)
Humans , Pneumonia, Viral/complications , Cardiovascular Surgical Procedures/statistics & numerical data , Cardiovascular Diseases/surgery , Practice Guidelines as Topic , Coronavirus Infections/complications , Betacoronavirus , Pneumonia, Viral/epidemiology , Echocardiography , Cardiovascular Diseases/complications , Cardiovascular Diseases/diagnostic imaging , Coronavirus Infections/epidemiology , Communicable Diseases, Emerging/epidemiology , Pandemics , SARS-CoV-2 , COVID-19
14.
Arq. bras. cardiol ; 114(5): 805-816, maio 2020. tab, graf
Article in Portuguese | SES-SP, LILACS, SES-SP | ID: biblio-1131225

ABSTRACT

Resumo Frente à pandemia da doença causada pelo novo coronavírus (COVID-19), o manejo do paciente com fator de risco e/ou doença cardiovascular é desafiador nos dias de hoje. As complicações cardiovasculares evidenciadas nos pacientes com COVID-19 resultam de vários mecanismos, que vão desde lesão direta pelo vírus até complicações secundárias à resposta inflamatória e trombótica desencadeada pela infecção. O cuidado adequado do paciente com COVID-19 exige atenção ao sistema cardiovascular em busca de melhores desfechos.


Abstract In face of the pandemic of the novel coronavirus disease 2019 (COVID-19), the management of patients with cardiovascular risk factors and/or disease is challenging. The cardiovascular complications evidenced in patients with COVID-19 derive from several mechanisms, ranging from direct viral injury to complications secondary to the inflammatory and thrombotic responses to the infection. The proper care of patients with COVID-19 requires special attention to the cardiovascular system aimed at better outcomes.


Subject(s)
Humans , Pneumonia, Viral/complications , Cardiovascular Diseases/virology , Health Personnel/standards , Coronavirus Infections/complications , Betacoronavirus , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/therapy , Cardiovascular Physiological Phenomena , Risk Factors , Cardiopulmonary Resuscitation/standards , Practice Guidelines as Topic , Coronavirus Infections , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Ventricular Dysfunction/etiology , Pandemics , Patient Care/standards , Heart/physiopathology
17.
Arq. bras. cardiol ; 114(2): 284-292, Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1088875

ABSTRACT

Abstract Background: Diastolic dysfunction, commonly evaluated by echocardiography, is an important early finding in many cardiomyopathies. Cardiac magnetic resonance (CMR) often requires specialized sequences that extends the test time. Recently, feature-tracking imaging has been made available, but still requires expensive software and lacks clinical validation. Objective: To assess diastolic function in patients with aortic valve disease (AVD) and compare it with normal controls by evaluating left ventricular (LV) longitudinal displacement by CMR. Methods: We compared 26 AVD patients with 19 normal controls. Diastolic function was evaluated as LV longitudinal displacement in 4-chamber view cine-CMR images using steady state free precession (SSFP) sequence during the entire cardiac cycle with temporal resolution < 50 ms. The resulting plot of atrioventricular junction (AVJ) position versus time generated variables of AVJ motion. Significance level of p < 0.05 was used. Results: Maximum longitudinal displacement (0.12 vs. 0.17 cm), maximum velocity during early diastole (MVED, 0.6 vs. 1.4s-1), slope of the best-fit line of displacement in diastasis (VDS, 0.22 vs. 0.03s-1), and VDS/MVED ratio (0.35 vs. 0.02) were significantly reduced in AVD patients compared with controls, respectively. Aortic regurgitation showed significantly worse longitudinal LV shortening compared with aortic stenosis. Higher LV mass indicated worse diastolic dysfunction. Conclusions: A simple linear measurement detected significant differences on LV diastolic function between AVD patients and controls. LV mass was the only independent predictor of diastolic dysfunction in these patients. This method can help in the evaluation of diastolic dysfunction, improving cardiomyopathy detection by CMR, without prolonging exam time or depending on expensive software.


Resumo Fundamentos: A disfunção diastólica, comumente avaliada por ecocardiografia, é um importante achado precoce na maioria das cardiomiopatias. A ressonância magnética cardíaca (RMC) frequentemente requer sequências específicas que prolongam o tempo de exame. Recentemente, métodos de imagens com monitoramento de dados (feature-tracking) foram desenvolvidos, mas ainda requerem softwares caros e carecem de validação clínica. Objetivos: Avaliar a função diastólica em pacientes com doença valvar aórtica (DVA) e compará-la a controles normais pela medida do deslocamento longitudinal do ventrículo esquerdo (VE) por RMC. Métodos: Nós comparamos 26 pacientes com DVA com 19 controles normais. A função diastólica foi avaliada como uma medida do deslocamento longitudinal do VE nas imagens de cine-RMC no plano quatro câmaras usando a sequência steady state free precession (SSFP) durante todo o ciclo cardíaco com resolução temporal < 50 ms. O gráfico resultante da posição da junção atrioventricular versus tempo gerou variáveis de movimento da junção atrioventricular. Utilizamos nível de significância de p < 0,005. Resultados: Deslocamento longitudinal máximo (0,12 vs. 0,17 cm), velocidade máxima em início de diástole (0,6 vs. 1,4s-1), velocidade máxima na diástase (0,22 vs. 0,03s-1) e a razão entre a velocidade máxima na diástase e a velocidade máxima em diástole inicial (0,35 vs. 0,02) foram significativamente menores nos pacientes com DVA em comparação aos controles normais, respectivamente. Pacientes com insuficiência aórtica apresentaram medidas de encurtamento longitudinal do VE significativamente piores em comparação aqueles com estenose aórtica. O aumento da massa ventricular esquerda indicou pior disfunção diastólica. Conclusões: Esta simples medida linear detectou diferenças significativas na função diastólica do VE entre pacientes com DVA e controles normais. A massa ventricular esquerda foi o único preditor independente de disfunção diastólica nesses pacientes. Este método pode auxiliar na avaliação da disfunção diastólica, melhorando a detecção de cardiomiopatias por RMC sem prolongar o tempo de exame ou depender de caros softwares.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aortic Valve Insufficiency/physiopathology , Aortic Valve Stenosis/physiopathology , Ventricular Dysfunction, Left/physiopathology , Diastole/physiology , Aortic Valve Insufficiency/diagnostic imaging , Aortic Valve Stenosis/diagnostic imaging , Reference Values , Atrioventricular Node/physiopathology , Atrioventricular Node/diagnostic imaging , Time Factors , Bundle of His/physiopathology , Bundle of His/diagnostic imaging , Case-Control Studies , Linear Models , Retrospective Studies , Ventricular Function, Left/physiology , Ventricular Dysfunction, Left/diagnostic imaging , Statistics, Nonparametric , Magnetic Resonance Imaging, Cine/methods
18.
Int. j. cardiovasc. sci. (Impr.) ; 33(1): 57-64, Jan.-Feb. 2020. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1090642

ABSTRACT

Abstract Background: Although associated with traditional cardiovascular risk factors, it is unclear whether obesity alone is associated with coronary artery disease (CAD). Objective: To investigate the role of obesity as a risk factor for CAD, defined by coronary computed tomography angiography (CCTA). Methods: This study retrospectively included 1,814 patients referred for CCTA in a hospital in São Paulo, from August 2010 to July 2012. CAD was identified by coronary calcium score and presence of coronary stenosis > 50%. Images were analyzed by two specialists, and the coronary findings were compared between obese and non-obese groups. A multivariate analysis model was used to assess obesity as an independent variable for the occurrence of obstructive CAD. Results: Among the study population, mean age was 58.5 +/- 11.5 years, 22.8% were obese (BMI = 30 kg/m2) and 66.3% were male. The prevalence of obstructive CAD was 18.4% in both groups. Obese patients had higher median calcium score compared to non-obese subjects (14.7 vs. 1.4, respectively, p = 0.019). In the multivariate analysis, obesity was not an independent factor for obstructive CAD (coefficient = -0.035, p = 0.102). Conclusion: Although no differences were observed in the prevalence of obstructive CAD between obese and non-obese individuals, coronary calcium scores were significantly in lower the latter group.

SELECTION OF CITATIONS
SEARCH DETAIL