Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 9 de 9
Filtrar
1.
Cardiol J ; 30(3): 411-421, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-34490604

RESUMO

BACKGROUND: Sodium restriction is recommended for patients with heart failure (HF) despite the lack of solid clinical evidence from randomized controlled trials. Whether or not sodium restrictions provide beneficial cardiac effects is not known. METHODS: The present study is a randomized, double-blind, controlled trial of stable HF patients with ejection fraction ≤ 40%. Patients were allocated to sodium restriction (2 g of sodium/day) vs. control (3 g of sodium/day). The primary outcome was change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 20 weeks. Secondary outcomes included quality of life and adverse safety events (HF readmission, blood pressure or electrolyte abnormalities). RESULTS: Seventy patients were enrolled. Median baseline sodium consumption was 3268 (2225-4537) mg/day. Adherence to the intervention based on 24-hour urinary sodium was 32%. NT-proBNP and quality of life did not significantly change between groups (p > 0.05 for both). Adverse safety events were not significantly different between the arms (p > 0.6 for all). In the per protocol analysis, patients who achieved a sodium intake < 2500 mg/day at the intervention conclusion showed improvements in NT-proBNP levels (between-group difference: -55%, 95% confidence interval -27 to -73%; p = 0.002) and quality of life (between-group difference: -11 ± 5 points; p = 0.04). Blood pressure decreased in patients with lower sodium intake (between-group difference: -9 ± 5 mmHg; p = 0.05) without significant differences in symptomatic hypotension or other safety events (p > 0.3 for all). CONCLUSIONS: Adherence assessed by 24-hour natriuresis and by the nutritionist was poor. The group allocated to sodium restriction did not show improvement in NT-proBNP. However, patients who achieved a sodium intake < 2500 mg/day appeared to have improvements in NT-proBNP and quality of life without any adverse safety signals. CLINICALTRIALS: gov Identifier: NCT03351283.


Assuntos
Insuficiência Cardíaca , Sódio na Dieta , Humanos , Biomarcadores , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/tratamento farmacológico , Peptídeo Natriurético Encefálico , Fragmentos de Peptídeos , Qualidade de Vida , Sódio , Volume Sistólico/fisiologia
2.
Arch Cardiol Mex ; 90(Supl): 100-110, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32523138

RESUMO

The recommendations in which the Mexican Society of Cardiology (SMC) in conjunction with the National Association of Cardiologists of Mexico (ANCAM) as well as different Mexican medical associations linked to cardiology are presented, after a comprehensive and consensual review and analysis of the topics related to cardiovascular diseases in the COVID-19 pandemic. Scientific positions are analyzed and responsible recommendations on general measures are given to patients, with personal care, healthy eating, regular physical activity, actions in case of cardio-respiratory arrest, protection of the patient and health personnel as well as precise indications in the use of non-invasive cardiovascular imaging, prescription of medications, care in specific topics such as systemic arterial hypertension, heart failure, arrhythmias and acute coronary syndromes, in addition to emphasizing electrophysiology, interventionism, cardiac surgery and in cardiac rehabilitation. The main interest is to provide the medical community with a general orientation on what to do in daily practice and patients with cardiovascular diseases in the setting of this unprecedented epidemiological crisis of COVID-19.


Se presentan las recomendaciones en las cuales la Sociedad Mexicana de Cardiología (SMC) en conjunto con la Asociación Nacional de Cardiólogos de México (ANCAM), así como diferentes asociaciones médicas mexicanas vinculadas con la cardiología, después de una revisión y análisis exhaustivo y consensuado sobre los tópicos relacionados con las enfermedades cardiovasculares en la pandemia de COVID-19, se analizan posturas científicas y se dan recomendaciones responsables sobre medidas generales a los pacientes, con cuidados personales, alimentación saludable, actividad física regular, acciones en caso de paro cardiorrespiratorio, la protección del paciente y del personal de salud así como las indicaciones precisas en el uso de la imagen cardiovascular no invasiva, la prescripción de medicamentos, cuidados en tópicos específicos como en la hipertensión arterial sistémica, insuficiencia cardiaca, arritmias y síndromes coronarios agudos, además de hacer énfasis en los procedimientos de electrofisiología, intervencionismo, cirugía cardiaca y en la rehabilitación cardiaca. El interés principal es brindar a la comunidad médica una orientación general sobre el quehacer en la práctica cotidiana y pacientes con enfermedades cardiovasculares en el escenario esta crisis epidemiológica sin precedentes de COVID-19.


Assuntos
Cardiologia , Doenças Cardiovasculares/terapia , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , COVID-19 , Reabilitação Cardíaca/métodos , Procedimentos Cirúrgicos Cardíacos/métodos , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/virologia , Humanos , México , Pandemias , Sociedades Médicas
3.
Alcocer-Gamba, Marco A; Gutiérrez-Fajardo, Pedro; Cabrera-Rayo, Alfredo; Sosa-Caballero, Alejandro; Piña-Reyna, Yigal; Merino-Rajme, José A; Heredia-Delgado, José A; Cruz-Alvarado, Jaime E; Galindo-Uribe, Jaime; Rogel-Martínez, Ulises; González-Hermosillo, Jesús A; Ávila-Vanzzini, Nydia; Sánchez-Carranza, Jesús A; Jímenez-Orozco, Jorge H; Sahagún-Sánchez, Guillermo; Fanghänel-Salmón, Guillermo; Albores-Figueroa, Rosenberg; Carrillo-Esper, Raúl; Reyes-Terán, Gustavo; Cossio-Aranda, Jorge E; Borrayo-Sánchez, Gabriela; Ríos, Manuel Odín de los; Berni-Betancourt, Ana C; Cortés-Lawrenz, Jorge; Leiva-Pons, José L; Ortiz-Fernández, Patricio H; López-Cuellar, Julio; Araiza-Garaygordobil, Diego; Madrid-Miller, Alejandra; Saturno-Chiu, Guillermo; Beltrán-Nevárez, Octavio; Enciso-Muñoz, José M; García-Rincón, Andrés; Pérez-Soriano, Patricia; Herrera-Gomar, Magali; Lozoya del Rosal, José J; Fajardo-Juárez, Armando I; Olmos-Temois, Sergio G; Rodríguez-Reyes, Humberto; Ortiz-Galván, Fernando; Márquez-Murillo, Manlio F; Celaya-Cota, Manuel de J; Cigarroa-López, José A; Magaña-Serrano, José A; Álvarez-Sangabriel, Amada; Ruíz-Ruíz, Vicente; Chávez-Mendoza, Adolfo; Méndez-Ortíz, Arturo; León-González, Salvador; Guízar-Sánchez, Carlos; Izaguirre-Ávila, Raúl; Grimaldo-Gómez, Flavio A; Preciado-Anaya, Andrés; Ruiz-Gastélum, Edith; Fernández-Barros, Carlos L; Gordillo, Antonio; Alonso-Sánchez, Jesús; Cerón-Enríquez, Norma; Núñez-Urquiza, Juan P; Silva-Torres, Jesús; Pacheco-Beltrán, Nancy; García-Saldivia, Marianna A; Pérez-Gámez, Juan C; Lezama-Urtecho, Carlos; López-Uribe, Carlos; López-Mora, Gerardo E; Rivera-Reyes, Romina.
Arch. cardiol. Méx ; 90(supl.1): 100-110, may. 2020.
Artigo em Espanhol | LILACS | ID: biblio-1152852

RESUMO

Resumen Se presentan las recomendaciones en las cuales la Sociedad Mexicana de Cardiología (SMC) en conjunto con la Asociación Nacional de Cardiólogos de México (ANCAM), así como diferentes asociaciones médicas mexicanas vinculadas con la cardiología, después de una revisión y análisis exhaustivo y consensuado sobre los tópicos relacionados con las enfermedades cardiovasculares en la pandemia de COVID-19, se analizan posturas científicas y se dan recomendaciones responsables sobre medidas generales a los pacientes, con cuidados personales, alimentación saludable, actividad física regular, acciones en caso de paro cardiorrespiratorio, la protección del paciente y del personal de salud así como las indicaciones precisas en el uso de la imagen cardiovascular no invasiva, la prescripción de medicamentos, cuidados en tópicos específicos como en la hipertensión arterial sistémica, insuficiencia cardiaca, arritmias y síndromes coronarios agudos, además de hacer énfasis en los procedimientos de electrofisiología, intervencionismo, cirugía cardiaca y en la rehabilitación cardiaca. El interés principal es brindar a la comunidad médica una orientación general sobre el quehacer en la práctica cotidiana y pacientes con enfermedades cardiovasculares en el escenario esta crisis epidemiológica sin precedentes de COVID-19.


Abstract The recommendations in which the Mexican Society of Cardiology (SMC) in conjunction with the National Association of Cardiologists of Mexico (ANCAM) as well as different Mexican medical associations linked to cardiology are presented, after a comprehensive and consensual review and analysis of the topics related to cardiovascular diseases in the COVID-19 pandemic. Scientific positions are analyzed and responsible recommendations on general measures are given to patients, with personal care, healthy eating, regular physical activity, actions in case of cardio-respiratory arrest, protection of the patient and health personnel as well as precise indications in the use of non-invasive cardiovascular imaging, prescription of medications, care in specific topics such as systemic arterial hypertension, heart failure, arrhythmias and acute coronary syndromes, in addition to emphasizing electrophysiology, interventionism, cardiac surgery and in cardiac rehabilitation. The main interest is to provide the medical community with a general orientation on what to do in daily practice and patients with cardiovascular diseases in the setting of this unprecedented epidemiological crisis of COVID-19.


Assuntos
Humanos , Pneumonia Viral/epidemiologia , Cardiologia , Doenças Cardiovasculares/terapia , Infecções por Coronavirus/epidemiologia , Sociedades Médicas , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/virologia , Pandemias , Reabilitação Cardíaca/métodos , COVID-19 , Procedimentos Cirúrgicos Cardíacos/métodos , México
4.
Rev Med Inst Mex Seguro Soc ; 57(5): 314-323, 2019 Sep 02.
Artigo em Espanhol | MEDLINE | ID: mdl-32568487

RESUMO

This paper shows the importance of the guideline clinical practice as well as the centers for comprehensive care of pulmonary arterial hypertension. The current treatment of pulmonary arterial hypertension is analyzed according to its severity, stratified through the evaluation of the multiple parameters of risk and its mortality to 1 year. The prognosis of the disease is considered and the place of the combined treatment indicated in sequential manner or from the beginning.


En este trabajo se señala la importancia de las guías de actuación clínica, así como de los centros de atención integral de la hipertensión arterial pulmonar. Se analiza el tratamiento actual de la hipertensión arterial pulmonar de acuerdo a su severidad, estratificado a través de la evaluación de parámetros múltiples de riesgo y su mortalidad a 1 año. Además, se considera el pronóstico de la enfermedad y el lugar que tiene el tratamiento combinado indicado en forma secuencial o desde un inicio.


Assuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão Arterial Pulmonar/tratamento farmacológico , Quimioterapia Combinada/métodos , Antagonistas dos Receptores de Endotelina/uso terapêutico , Ativadores de Enzimas/uso terapêutico , Epoprostenol/análogos & derivados , Humanos , Inibidores da Fosfodiesterase 5/uso terapêutico , Prognóstico , Hipertensão Arterial Pulmonar/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco
5.
Int J Cardiovasc Imaging ; 35(1): 107-116, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30182321

RESUMO

Right ventricular (RV) systolic dysfunction due to acute myocardial infarction is associated with serious complications in the short-term. Acute kidney injury (AKI) is a frequent and unrecognized complication. This study aimed to assess whether RV longitudinal strain predicts AKI and short-term prognosis in patients with RV infarction. Prospective cohort of patients with RV infarction. RV function was evaluated with global and free wall right ventricular longitudinal strain (GRVLS and FWRVLS), tricuspid annular plane systolic excursion, and tricuspid S' wave. The primary endpoint was AKI defined as an increase ≥ 50% in serum creatinine and/or a decrease ≥ 25% in glomerular filtration rate during follow-up at 7 days. The secondary endpoint was death from any cause at 30 days. We included 101 patients with RV infarction (male 67%, age 66 ± 11 years). During follow-up at 7 days, 40% of patients developed AKI. At 30 days, 8% of patients died. At univariate analysis, FWRVLS was significantly associated with AKI (Hazard ratio [HR] 1.11, 95% confidence interval [CI] 1.03-1.20, p = 0.006). At multivariate analysis, only age, temporary pacemaker implant, and FWRVLS remained as independent predictors of AKI (HR 1.05, 95% CI 1.02-1.08, p = 0.002; HR 2.12, 95% CI 1.11-4.07, p = 0.023; HR 1.10, 95% CI 1.02-1.19, p = 0.018, respectively). At 30 days, patients with FWRVLS ≥ - 15.5% showed a lower survival rate than those with lower strain (84 ± 6 vs. 97 ± 2%, p = 0.021). In patients with RV infarction, FWRVLS was an independent predictor of AKI and was associated with higher mortality in the short-term.


Assuntos
Injúria Renal Aguda/etiologia , Contração Miocárdica , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações , Disfunção Ventricular Direita/etiologia , Função Ventricular Direita , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/mortalidade , Injúria Renal Aguda/fisiopatologia , Idoso , Biomarcadores/sangue , Fenômenos Biomecânicos , Creatinina/sangue , Ecocardiografia , Feminino , Taxa de Filtração Glomerular , Humanos , Rim/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Fatores de Risco , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico por imagem , Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade , Infarto do Miocárdio com Supradesnível do Segmento ST/fisiopatologia , Fatores de Tempo , Disfunção Ventricular Direita/diagnóstico por imagem , Disfunção Ventricular Direita/mortalidade , Disfunção Ventricular Direita/fisiopatologia
6.
Arch Med Res ; 49(8): 609-619, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30718149

RESUMO

INTRODUCTION: Mexico is the country with the highest mortality due to acute myocardial infarction in adults older than 45 years old according to the OECD (28 vs. 7.5% of the average). The first real-world study, RENASCA IMSS, showed a high-risk population at 65%, but 50% without reperfusion strategies. The aim was to describe the clinical presentation, treatment, and outcomes of acute coronary syndromes at the IMSS. METHODS: RENASCA IMSS is a nation-wide, prospective, longitudinal-cohort study. We include consecutive patients with an Acute Coronary Syndrome diagnosis (ACC/AHA/ESC) admitted in 177 representative hospitals of the IMSS (166 of second level and 11 of third level of attention). In an electronic database clinical, paraclinical, times, reperfusion treatment, complications, and other variables were assessed. Confidentiality was maintained in data and informed consent was obtained. Registrer calibration was performed with more than 80% of the variables and 80% of the cases. RESULTS: From March 1, 2014 to December 25, 2017; 21,827 patients were enrolled presenting an average age 63.2 ± 11.7, 75% men (16,259) and 25% women (5,568). The most frequent risk factors were: hypertension (60.5%), smoking (46.8%), diabetes (45.5%), dyslipidemia (35.3%) and metabolic syndrome (39.1%). STEMI diagnosis was established in 73.2% of the patients and NSTEMI in 26.8%. The STEMI group within the Code Infarction showed an improvement in the reperfusion therapy (34.9% before vs. 71.4% after, p ≤0.0001) and reduction of mortality (21.1 vs. 9.4%, p ≤0.0001); while the NSTEMI group showed high risk set by a GRACE score of 131.5 ± 43.7 vs. 135.9 + 41.7, p ≤0.0001. Mortality was more frequent within the STEMI group (14.9 vs. 7.6%, p ≤0.0001). CONCLUSIONS: RENASCA IMSS study represents the largest Acute Coronary Syndromes real-world study in Mexico, demonstrating that the Mexican population has a high risk. Patients with a STEMI diagnosis were more frequently enrolled and were associated with higher mortality and complications; however, there is improvement in the reperfusion therapy and in mortality with the Code Infarction strategy.


Assuntos
Síndrome Coronariana Aguda/epidemiologia , Infarto do Miocárdio sem Supradesnível do Segmento ST/epidemiologia , Fatores de Risco , Infarto do Miocárdio com Supradesnível do Segmento ST/epidemiologia , Adulto , Idoso , Estudos de Coortes , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Feminino , Hospitalização , Humanos , Hipertensão/epidemiologia , Estudos Longitudinais , Masculino , Síndrome Metabólica/epidemiologia , México/epidemiologia , Pessoa de Meia-Idade , Estudos Prospectivos , Sistema de Registros , Fumar/epidemiologia
7.
Rev Med Inst Mex Seguro Soc ; 55(5): 621-631, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-29193945

RESUMO

Pulmonary hypertension in chronic kidney disease is included in the group 5 of the pulmonary hypertension classification of the World Health Organization. Its mechanism is multifactorial and little known. Its importance has increased due to its impact on survival according to whether they received a kidney transplant, the greater risk of early renal graft loss and major hospital stays. In this review, we analyze the panorama of chronic renal disease in Mexico and Latin America, the epidemiology, pathophysiological mechanisms, the diagnostic process and the treatment of pulmonary hypertension in chronic kidney disease.


La hipertensión pulmonar de la enfermedad renal crónica está contemplada en el grupo 5 de la clasificación de hipertensión pulmonar de la Organización Mundial de la Salud. Su mecanismo es multifactorial y poco conocido. Su importancia ha incrementado debido a su impacto en la supervivencia de acuerdo a si el paciente recibió un trasplante renal, al mayor riesgo de pérdida temprana del injerto renal y a las estancias hospitalarias mayores. En esta revisión, se analiza el panorama de la enfermedad renal crónica en México y Latinoamérica, la epidemiología, los mecanismos fisiopatológicos, el proceso diagnóstico y el tratamiento de la hipertensión pulmonar en la enfermedad renal crónica.


Assuntos
Hipertensão Pulmonar/etiologia , Insuficiência Renal Crônica/complicações , Humanos , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/epidemiologia , Hipertensão Pulmonar/terapia , América Latina , México , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/fisiopatologia
8.
Rev Med Inst Mex Seguro Soc ; 54 Suppl 1: s6-s51, 2016.
Artigo em Espanhol | MEDLINE | ID: mdl-27284844

RESUMO

This Consenso Nacional de Hipertensión Arterial Sistémica (National Consensus on Systemic Arterial Hypertension) brings together experiences and joint work of 79 specialists who have been in contact with the patient affected by systemic arterial hypertension. All concepts here presented were outlined on the basis of the real world practice of Mexican hypertensive population. The consensus was developed under strict methodological guidelines. The Delphi technique was applied in two rounds for the development of an appropriate statistical analysis of the concepts exposed by all the specialists, who posed key questions, later developed by the panel of experts of the Hospital de Cardiología, and specialists from the Centro Médico Nacional. Several angles of this illness are shown: detection, diagnosis, pathophysiology, classification, treatment and prevention. The evidence analysis was carried out using PRISMA method. More than 600 articles were reviewed, leaving only the most representative in the references. This document concludes with practical and useful recommendations for the three levels of health care of our country.


Este Consenso Nacional de Hipertensión Arterial Sistémica reúne las experiencias y el trabajo conjunto de 79 especialistas que han estado en contacto con el paciente que padece hipertensión arterial sistémica. Todos los conceptos aquí presentados se plantearon con base en la práctica del mundo real de la población hipertensa de México. El consenso se desarrolló bajo lineamientos metodológicos estrictos. La técnica de Delphi se aplicó en dos vueltas para el desarrollo de un análisis estadístico apropiado de los conceptos vertidos por todos los especialistas con preguntas clave que desarrolló el panel de expertos del Hospital de Cardiología y especialistas del Centro Médico Nacional. Se presentan los aspectos de detección, diagnóstico, fisiopatología, clasificación, tratamiento y prevención. El análisis de la evidencia en la literatura se hizo utilizando el método de PRISMA para análisis de evidencia. Se revisaron más de 600 artículos y se dejaron en la bibliografía solo los más representativos. Este documento concluye con recomendaciones prácticas y de utilidad para los tres niveles de atención en salud de nuestro país.


Assuntos
Hipertensão , Anti-Hipertensivos/uso terapêutico , Biomarcadores/metabolismo , Determinação da Pressão Arterial/métodos , Terapia Combinada , Comorbidade , Técnica Delphi , Dietoterapia , Teste de Esforço , Terapia por Exercício , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Hipertensão/terapia , México/epidemiologia , Exame Físico , Fatores de Risco
9.
J Am Soc Echocardiogr ; 17(2): 192-4, 2004 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-14752497

RESUMO

Hepatocellular carcinoma is a tumor that rarely invades the inferior vena cava and right heart. We describe the case of a 63-year-old man with jaundice and a history of cryptogenic hepatic cirrhosis with diagnosis of hepatocellular carcinoma. He was referred to the echocardiography laboratory for sudden dyspnea and suggestion of pulmonary thromboembolism. Echocardiographic study reported a mass in the right atrium proceeding from the inferior vena cava.


Assuntos
Carcinoma Hepatocelular/patologia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Neoplasias Hepáticas/patologia , Ecocardiografia Transesofagiana , Átrios do Coração/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...