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1.
Almeida, André Luiz Cerqueira; Melo, Marcelo Dantas Tavares de; Bihan, David Costa de Souza Le; Vieira, Marcelo Luiz Campos; Pena, José Luiz Barros; Del Castillo, José Maria; Abensur, Henry; Hortegal, Renato de Aguiar; Otto, Maria Estefania Bosco; Piveta, Rafael Bonafim; Dantas, Maria Rosa; Assef, Jorge Eduardo; Beck, Adenalva Lima de Souza; Santo, Thais Harada Campos Espirito; Silva, Tonnison de Oliveira; Salemi, Vera Maria Cury; Rocon, Camila; Lima, Márcio Silva Miguel; Barberato, Silvio Henrique; Rodrigues, Ana Clara; Rabschkowisky, Arnaldo; Frota, Daniela do Carmo Rassi; Gripp, Eliza de Almeida; Barretto, Rodrigo Bellio de Mattos; Silva, Sandra Marques e; Cauduro, Sanderson Antonio; Pinheiro, Aurélio Carvalho; Araujo, Salustiano Pereira de; Tressino, Cintia Galhardo; Silva, Carlos Eduardo Suaide; Monaco, Claudia Gianini; Paiva, Marcelo Goulart; Fisher, Cláudio Henrique; Alves, Marco Stephan Lofrano; Grau, Cláudia R. Pinheiro de Castro; Santos, Maria Veronica Camara dos; Guimarães, Isabel Cristina Britto; Morhy, Samira Saady; Leal, Gabriela Nunes; Soares, Andressa Mussi; Cruz, Cecilia Beatriz Bittencourt Viana; Guimarães Filho, Fabio Villaça; Assunção, Bruna Morhy Borges Leal; Fernandes, Rafael Modesto; Saraiva, Roberto Magalhães; Tsutsui, Jeane Mike; Soares, Fábio Luis de Jesus; Falcão, Sandra Nívea dos Reis Saraiva; Hotta, Viviane Tiemi; Armstrong, Anderson da Costa; Hygidio, Daniel de Andrade; Miglioranza, Marcelo Haertel; Camarozano, Ana Cristina; Lopes, Marly Maria Uellendahl; Cerci, Rodrigo Julio; Siqueira, Maria Eduarda Menezes de; Torreão, Jorge Andion; Rochitte, Carlos Eduardo; Felix, Alex.
Arq. bras. cardiol ; 120(12): e20230646, dez. 2023. tab, graf
Article in Portuguese | LILACS-Express | LILACS, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1527794
2.
ABC., imagem cardiovasc ; 36(1): e20230006, abr. 2023. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1517806

ABSTRACT

A regurgitação tricúspide (RT) importante está associada à alta morbidade e mortalidade. Como o tratamento cirúrgico da RT isolada tem sido associado à alta mortalidade, as intervenções transcateter na valva tricúspide (VT) têm sido utilizadas para o seu tratamento, com risco relativamente mais baixo. Há um atraso na intervenção da RT e provavelmente está relacionado a uma compreensão limitada da anatomia da VT e do ventrículo direito, além da subestimação da gravidade da RT. Nesse cenário, faz-se necessário o conhecimento anatômico abrangente da VT, a fisiopatologia envolvida no mecanismo de regurgitação, assim como a sua graduação mais precisa. A VT tem peculiaridades anatômica, histológica e espacial que fazem a sua avalição ser mais complexa, quando comparado à valva mitral, sendo necessário o conhecimento e treinamento nas diversas técnicas ecocardiográficas que serão utilizadas frequentemente em combinação para uma avaliação precisa. Esta revisão descreverá a anatomia da VT, o papel do ecocardiograma no diagnóstico, graduação e fisiopatologia envolvida na RT, as principais opções atuais de tratamento transcateter da RT e a avaliação do resultado após intervenção transcateter por meio de múltiplas modalidades ecocardiográficas.(AU)


Severe tricuspid regurgitation (TR) is associated with high morbidity and mortality. Given that surgical treatment of TR alone has been associated with high mortality, transcatheter interventions in the tricuspid valve (TV) have been used for its treatment, with relatively lower risk. There is a delay in intervention for TR, and this is probably related to a limited understanding of the anatomy of the TV and the right ventricle, in addition to an underestimation of the severity of TR. In this scenario, it is necessary to have comprehensive anatomical knowledge of the TV, the pathophysiology involved in the mechanism of regurgitation, and more accurate grading. The TV has anatomical, histological, and spatial peculiarities that make its assessment more complex when compared to the mitral valve, requiring knowledge and training in the various echocardiographic techniques that will often be used in combination for accurate assessment. This review will describe the anatomy of the TV, the role of echocardiography in the diagnosis, grading, and pathophysiology involved in TR; the main transcatheter treatment options currently available for TR; and the assessment of outcomes after transcatheter intervention by means of multiple echocardiographic modalities.(AU)


Subject(s)
Humans , Male , Female , Tricuspid Valve/anatomy & histology , Tricuspid Valve Insufficiency/surgery , Tricuspid Valve Insufficiency/physiopathology , Pericardial Effusion/complications , Tricuspid Valve Insufficiency/mortality , Echocardiography/methods , Echocardiography, Transesophageal/methods , Echocardiography, Doppler, Color/methods , Echocardiography, Three-Dimensional/methods , Endocarditis/complications , Transcatheter Aortic Valve Replacement/methods
3.
Arq Bras Cardiol ; 120(12): e20230646, 2023 Dec.
Article in Portuguese, English | MEDLINE | ID: mdl-38232246

ABSTRACT

Central Illustration : Position Statement on the Use of Myocardial Strain in Cardiology Routines by the Brazilian Society of Cardiology's Department Of Cardiovascular Imaging - 2023 Proposal for including strain in the integrated diastolic function assessment algorithm, adapted from Nagueh et al.67 Am: mitral A-wave duration; Ap: reverse pulmonary A-wave duration; DD: diastolic dysfunction; LA: left atrium; LASr: LA strain reserve; LVGLS: left ventricular global longitudinal strain; TI: tricuspid insufficiency. Confirm concentric remodeling with LVGLS. In LVEF, mitral E wave deceleration time < 160 ms and pulmonary S-wave < D-wave are also parameters of increased filling pressure. This algorithm does not apply to patients with atrial fibrillation (AF), mitral annulus calcification, > mild mitral valve disease, left bundle branch block, paced rhythm, prosthetic valves, or severe primary pulmonary hypertension.


Figura Central : Posicionamento do Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia sobre o Uso do Strain Miocárdico na Rotina do Cardiologista ­ 2023 Proposta de inclusão do strain no algoritmo integrado de avaliação da função diastólica, adaptado e traduzido de Nagueh et al. 67 AE: átrio esquerdo; Ap: duração da onda A reversa pulmonar; Am: duração da onda A mitral; DD: disfunção diastólica; FEVEr: fração de ejeção do ventrículo esquerdo reduzida; IT: insuficiência tricúspide; SAEr: strain do AE de reservatório; SLGVE: strain longitudinal global do ventrículo esquerdo. Se remodelamento concêntrico, confirmar com SLGVE. Na presença de FEVEr, tempo de desaceleração da onda E mitral (TDE) < 160 ms e onda S < D pulmonar também são parâmetros de pressão de enchimento aumentada. Esse algoritmo não se aplica a pacientes com fibrilação atrial (FA), calcificação do anel mitral ou valvopatia mitral maior que discreta, bloqueio de ramo esquerdo (BRE), ritmo de marca-passo, próteses valvares ou hipertensão pulmonar (HP) primária grave.


Subject(s)
Atrial Fibrillation , Cardiology , Ventricular Dysfunction, Left , Humans , Echocardiography, Doppler , Brazil , Atrial Fibrillation/diagnostic imaging , Heart Atria/diagnostic imaging , Ventricular Function, Left
4.
Arq Bras Cardiol ; 115(5): 1006-1043, 2020 11.
Article in English, Portuguese | MEDLINE | ID: mdl-33295473
5.
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 | CONASS, LILACS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1142267
8.
Arq. bras. cardiol ; 113(1): 135-181, July 2019. tabela, gráfico
Article in English | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1022874

ABSTRACT

In accordance with the "Standards for the Elaboration of Guidelines, Positions and Normations" sanctioned by the Brazilian Society of Cardiology, this document was written to update the "Echocardiography Indication Guidelines" of 2009. The new document is not intended to be a comprehensive review of echocardiography, but rather an indispensable basic guide to support the rational clinical decision-making of the physician requesting the exam for adult patients. Although it considers the recent technological advances of echocardiography, its purpose is not to describe in detail echocardiography methods, but to summarize in a clear and concise way the main situations in which echocardiography brings benefit to the diagnosis and/or therapeutic orientation of the individual. This manuscript chose to highlight the class of recommendation, as described below: Class I: conditions for which there is conclusive evidence or, in the absence thereof, general agreement that the examination procedure is useful and safe. Class II: conditions for which there is conflicting evidence and/or divergence of opinion on the utility and/or safety of the examination. Class-IIa: evidence or opinions favorable to the examination. Most experts approve. Class IIb: utility and/or safety less well established, with divergent opinions. Class III: conditions for which there is evidence or consensus that the examination is not useful and, in some cases, may even be harmful. In addition, the level of evidence was also described, as follows: A: several concordant randomized clinical trials or robust meta-analyses; B: less robust meta-analysis data or single randomized clinical study or observational studies; C: expert opinion.(AU)


Subject(s)
Humans , Echocardiography , Practice Guideline
9.
J Am Soc Echocardiogr ; 30(11): 1111-1118, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28927558

ABSTRACT

BACKGROUND: Patients with acute leukemia (AL) have a higher rate of congestive heart failure than patients with other cancers. AL may predispose to cardiac dysfunction before chemotherapy because of high cytokine release or direct leukemic myocardial infiltration. The aims of this study were to evaluate whether AL is associated with abnormalities of myocardial structure and function before chemotherapy and to identify possible risk factors associated with these myocardial changes. METHODS: Using an echocardiographic database, 76 patients with AL and 76 patients without cancer matched for age, gender, hypertension, and the presence of diabetes were retrospectively selected. Subsequently, to assess the effect of a nonhematologic malignancy, 28 women in each group were matched with women with breast cancer. Left ventricular (LV) mass, volumes, ejection fraction, and global longitudinal strain (GLS) were measured before chemotherapy. RESULTS: The patients were predominantly male (63%), with a median age of 51 years, and had low prevalence of cardiovascular risk factors. Despite similar LV ejection fractions, patients with AL had higher LV mass and volumes and lower GLS (-19.3 ± 2.7% vs -20.9 ± 1.9%, P < .001) than patients without cancer. Similarly, GLS was lower in women with AL compared with women with breast cancer or without cancer. Among patients with AL, high body mass index, low LV ejection fraction, and a small number of circulating lymphocytes were all independently associated with low GLS. CONCLUSIONS: Patients with AL had higher LV volumes and lower GLS than patients without cancer and lower GLS than patients with breast cancer, suggesting that AL by itself may be associated with these cardiac alterations.


Subject(s)
Antineoplastic Agents/therapeutic use , Echocardiography/methods , Leukemia/complications , Stroke Volume/physiology , Ventricular Dysfunction, Left/diagnosis , Ventricular Function, Left/physiology , Acute Disease , Adult , Female , Follow-Up Studies , Humans , Leukemia/drug therapy , Male , Middle Aged , Retrospective Studies , Time Factors , Ventricular Dysfunction, Left/etiology
10.
J Am Soc Echocardiogr ; 30(5): 454-460, 2017 May.
Article in English | MEDLINE | ID: mdl-28262302

ABSTRACT

BACKGROUND: During the development of heart failure (HF), the changes of contraction timing pattern and temporal heterogeneity of segmental contraction happen early and may precede both symptomatic HF and the decrease in left ventricular ejection fraction (LVEF). In patients treated with anthracyclines, both symptomatic HF and the decrease of LVEF are detected once significant myocardial injury has occurred. The aim of the current study was to investigate whether changes in the timing of contraction can be detected early after anthracyclines therapy. METHODS: Forty-one women (50 ± 11 years old) with newly diagnosed breast cancer were prospectively enrolled in two centers and underwent an echocardiogram before and after anthracyclines. Peak longitudinal myocardial systolic strain was measured on the apical four- and two-chamber views. The time to peak systolic longitudinal strain (TP), ejection time (ET), isovolumic contraction time (IVCT), systolic time, and diastolic time were measured using strain curves and Doppler tracings and compared before and after anthracyclines. The heterogeneity of contraction (dyssynchrony) was measured by the SD of the TP of all segments. RESULTS: Anthracyclines treatment was associated with an increase in heart rate (HR) and a decrease in TP. TP was correlated with HR. TP/ET was independent of HR and inversely correlated to peak strain both at baseline and after anthracyclines. TP/ET increased after anthracyclines (1.26 ± 0.19 to 1.31 ± 0.22; P < .001), and this increase was correlated with the decrease in strain. The increase in TP/ET was due to an increase in IVCT/ET. A similar degree of dyssynchrony was found at baseline and after anthracyclines. CONCLUSIONS: Anthracyclines treatment induces an increase in the duration of contraction, mainly by increasing the IVCT. This increase is correlated to the decrease in strain and may therefore have additional prognostic value.


Subject(s)
Anthracyclines/administration & dosage , Anthracyclines/adverse effects , Breast Neoplasms/drug therapy , Myocardial Contraction/drug effects , Ventricular Dysfunction, Left/chemically induced , Ventricular Dysfunction, Left/physiopathology , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/adverse effects , Boston , Breast Neoplasms/physiopathology , Controlled Before-After Studies , Excitation Contraction Coupling/drug effects , Female , Heart Failure/chemically induced , Heart Failure/diagnostic imaging , Heart Failure/physiopathology , Humans , Middle Aged , Quebec , Reproducibility of Results , Sensitivity and Specificity , Stroke Volume , Treatment Outcome , Ultrasonography/methods , Ventricular Dysfunction, Left/diagnostic imaging
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