RESUMO
The coexistence of heart failure (HF) and atrial fibrillation (AF) worsens the prognosis of patients. We aimed to study the inflammation, metabolism, adiposity, and fibrosis markers on epicardial and subcutaneous fat and blood, and their relationship with HF and AF. Samples from 185 patients undergoing cardiac surgery were collected. Levels of multi-markers on fat biopsies and plasma were analyzed. Patients were grouped by HF or AF presence. Plasma adiposity markers were increased in AF patients, while increased stretch markers correlated with HF. Patients with both AF and HF had higher ANP and GDF-15 levels. After excluding AF patients, plasma FABP4 was identified as the main HF predictor. Fat biopsies from AF patients showed an enhanced inflammatory profile. Higher levels of adiposity markers are associated with AF or HF, and higher stretch and fibrosis markers with combined AF and HF, suggesting a role of adiposity-fibrosis pathway in HF and AF coexistence.
Assuntos
Fibrilação Atrial , Insuficiência Cardíaca , Humanos , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/etiologia , Adiposidade , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/complicações , Fibrose , BiomarcadoresRESUMO
INTRODUCTION: In recent years, several hospitals have incorporated MRI equipment managed directly by their cardiology departments. The aim of our work is to determine the total cost per test of both CT and MRI in the setting of a Cardiology Department of a tertiary hospital. MATERIALS AND METHODS: The process followed for estimating the costs of CT and MRI tests consists of three phases: (1) Identification of the phases of the testing process; (2) Identification of the resources consumed in carrying out the tests; (3) Quantification and assessment of inputs. RESULTS: MRI involves higher personnel (EUR 66.03 vs. EUR 49.17) and equipment (EUR 89.98 vs. EUR 33.73) costs, while CT consumes higher expenditures in consumables (EUR 93.28 vs. EUR 22.95) and overheads (EUR 1.64 vs. EUR 1.55). The total cost of performing each test is higher in MRI (EUR 180.60 vs. EUR 177.73). CONCLUSIONS: We can conclude that the unit cost of each CT and MRI performed in that unit are EUR 177.73 and EUR 180.60, respectively, attributable to consumables in the case of CT and to amortization of equipment and staff time in the case of MRI.
RESUMO
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Linfoma/diagnóstico por imagem , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Prognóstico , Linfoma/patologia , Neoplasias Cardíacas/terapia , Rituximab/uso terapêutico , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Vincristina/uso terapêutico , Prednisona/uso terapêuticoRESUMO
En los últimos años hemos sido testigos del continuo desarrollo de las técnicas de imagen en cardiología. Entre ellas, la tomografía computarizada cardiaca, técnica emergente y en continua evolución. Con la posibilidad actual de realizar estudios con muy baja radiación se han ampliado sus indicaciones más allá de la coronariografía no invasiva. En el presente trabajo de revisión repasamos las novedades técnicas de la tomografía computarizada cardiaca así como sus nuevas aplicaciones.
During the last years we have witnessed an increasing development of imaging techniques applied in Cardiology. Among them, cardiac computed tomography is an emerging and evolving technique. With the current possibility of very low radiation studies, the applications have expanded and go further coronariography In the present article we review the technical developments of cardiac computed tomography and its new applications.
Assuntos
Humanos , Técnicas de Imagem Cardíaca/métodos , Tomografia Computadorizada por Raios XRESUMO
During the last years we have witnessed an increasing development of imaging techniques applied in Cardiology. Among them, cardiac computed tomography is an emerging and evolving technique. With the current possibility of very low radiation studies, the applications have expanded and go further coronariography In the present article we review the technical developments of cardiac computed tomography and its new applications.
Assuntos
Técnicas de Imagem Cardíaca/métodos , Tomografia Computadorizada por Raios X , HumanosRESUMO
Caseous calcification of the mitral annulus is an infrequent echocardiographic finding. The differential diagnosis includes other entities like tumors, abscess or thrombus. Both cardiac CT and cardiac MRI may be useful for its definitive diagnosis.
La calcificación caseosa del anillo mitral es un hallazgo ecocardiográfico poco frecuente. Debe hacerse el diagnóstico diferencial con otras entidades tales como tumores, abscesos o trombos. Para su diagnóstico definitivo además del ecocardiograma tanto el TC cardiaco como la Cardio RM pueden ser de utilidad.
Assuntos
Idoso , Feminino , Humanos , Calcinose , Endocardite Bacteriana , Doenças das Valvas Cardíacas , Valva Mitral , Ecocardiografia , Endocardite Bacteriana/microbiologia , Streptococcus agalactiae , Infecções EstreptocócicasRESUMO
Caseous calcification of the mitral annulus is an infrequent echocardiographic finding. The differential diagnosis includes other entities like tumors, abscess or thrombus. Both cardiac CT and cardiac MRI may be useful for its definitive diagnosis.
Assuntos
Calcinose/diagnóstico por imagem , Endocardite Bacteriana/diagnóstico por imagem , Doenças das Valvas Cardíacas/diagnóstico por imagem , Valva Mitral/diagnóstico por imagem , Idoso , Ecocardiografia , Endocardite Bacteriana/microbiologia , Feminino , Humanos , Infecções Estreptocócicas/diagnóstico por imagem , Streptococcus agalactiaeAssuntos
Ruptura Cardíaca/diagnóstico por imagem , Implante de Prótese de Valva Cardíaca , Insuficiência da Valva Mitral/diagnóstico por imagem , Estenose da Valva Mitral/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagem , Idoso , Diagnóstico Diferencial , Ecocardiografia Tridimensional , Ecocardiografia Transesofagiana , Feminino , Ruptura Cardíaca/etiologia , Humanos , Insuficiência da Valva Mitral/etiologia , Complicações Pós-Operatórias/etiologiaRESUMO
Left ventricle non-compaction cardiomyopathy is currently considered as a well-defined individual entity. However, it includes a broad spectrum of clinical, radiological and pathophysiological findings. In this review we describe 3 different scenarios of this entity: an isolated case with severe left ventricle dysfunction, an "associated" case in a patient with previous atrial septum defect and pulmonary stenosis and finally, as a finding in a patient with a transient cerebrovascular ischemic attack. In the 2 last cases, both asymptomatic, morphological criteria of left ventricle non-compaction were found but, ventricular function was normal and cardiac-MRI showed no late gadolinium hyperenhancement. Periodical follow-up and familial screening were recommended. Natural history and prognosis factors of this disease are still not well known. Further and longer series of patients with this diagnosis are needed to completely define radiological criteria, clinical presentation and evolution.
La miocardiopatía no compactada está considerada actualmente como una entidad independiente y bien definida. Sin embargo, presenta un espectro amplio de hallazgos clínicos, radiológicos y fisiopatológicos. En la presente revisión describimos 3 escenarios clínicos diferentes de dicha entidad: un caso con disfunción ventricular severa, un caso como entidad «asociada¼ a una cardiopatía congènita en un pacientes con un defecto del septo interauricular previo y estenosis pulmonar, y finalmente, como un hallazgo casual en un paciente con un accidente cerebrovascular transitorio. En estos 2 últimos casos se encontraron criterios morfológicos de miocardiopatía no compactada con función ventricular normal y sin presencia de realce tardío de gadolinio en el estudio de cardio-RM. En todos ellos se recomendó estudio familiar. La historia natural y el pronóstico de esta anatomía patológica no son todavía del todo conocidos. Series mayores y seguimiento más largos son necesarios para definir completamente los criterios radiológicos, la presentación clínica y la evolución de esta fascinante entidad.
Assuntos
Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Técnicas de Imagem Cardíaca , Miocárdio Ventricular não Compactado Isolado/diagnóstico , Imageamento por Ressonância MagnéticaRESUMO
Left ventricle non-compaction cardiomyopathy is currently considered as a well-defined individual entity. However, it includes a broad spectrum of clinical, radiological and pathophysiological findings. In this review we describe 3 different scenarios of this entity: an isolated case with severe left ventricle dysfunction, an "associated" case in a patient with previous atrial septum defect and pulmonary stenosis and finally, as a finding in a patient with a transient cerebrovascular ischemic attack. In the 2 last cases, both asymptomatic, morphological criteria of left ventricle non-compaction were found but, ventricular function was normal and cardiac-MRI showed no late gadolinium hyperenhancement. Periodical follow-up and familial screening were recommended. Natural history and prognosis factors of this disease are still not well known. Further and longer series of patients with this diagnosis are needed to completely define radiological criteria, clinical presentation and evolution.
