RESUMO
Background: Follow-up after hospital discharge of SARS-CoV-2 survivors represents a huge burden on the healthcare system. We attempt to assess the utility of symptoms and health-related quality of life questionnaire (SF-12) to identify SARS CoV2 pulmonary sequelae. Methods: Prospective, non-interventional follow-up study. A cardiopulmonary exercise test, functional respiratory test (PFT), SF12 questionnaire were performed after hospitalization at six months after the first positive PCR smear. Results: 41 patients were included, female (39%), mean age 57.3 ± 13.7 years. 70% persisted with symptoms. 46% presented a maximum oxygen consumption below 80% of predicted. SF-12 physical domain score was significantly reduced in patients with altered PFT (32.7 vs. 45.9; p < 0.001) and obtained the best sensitivity and specificity to identify PFT alterations (AUC 0.862, Sensitivity 85.7%, Specificity 81.5%). Conclusions: SF-12 questionnaire shows high sensitivity and specificity to detect SARS CoV2 survivors with pulmonary function alterations.
Antecedentes y objetivos: El seguimiento tras el alta hospitalaria de los supervivientes de SARS-CoV-2 representa una enorme carga para el sistema sanitario. Intentamos evaluar la utilidad de los síntomas y el cuestionario de calidad de vida (SF-12) para identificar los pacientes con secuelas pulmonares por SARS-CoV-2. Materiales y métodos: Estudio de seguimiento prospectivo observacional. Después de la hospitalización, a los 6 meses del primer frotis con PCR positiva se realizaron: una prueba de esfuerzo cardiopulmonar, pruebas funcionales respiratorias (PFR) y se aplicó el cuestionario SF-12. Resultados: Se incluyó a 41 pacientes, el 39% eran mujeres, con una edad media de 57,3 ± 13,7 años. El 70% persistía con síntomas. El 46% presentó un consumo máximo de oxígeno por debajo del 80% del predicho. La puntuación del dominio físico del SF-12 fue significativamente más baja en pacientes con PFR alteradas (32,7 vs. 45,9; p < 0,001) y obtuvo la mejor sensibilidad y especificidad para identificar las alteraciones de las PFR (AUC 0,862; sensibilidad 85,7% y especificidad 81,5%). Conclusiones: El cuestionario de calidad de vida SF-12 presenta una alta sensibilidad y especificidad para detectar a los sobrevivientes de SARS-CoV-2 con alteraciones de la función pulmonar.
RESUMO
Background: Follow-up after hospital discharge of SARS-CoV-2 survivors represents a huge burden on the healthcare system. We attempt to assess the utility of symptoms and health-related quality of life questionnaire (SF-12) to identify SARS CoV2 pulmonary sequelae.MethodsProspective, non-interventional follow-up study. A cardiopulmonary exercise test, functional respiratory test (PFT), SF12 questionnaire were performed after hospitalization at six months after the first positive PCR smear.Results41 patients were included, female (39%), mean age 57.3±13.7 years. 70% persisted with symptoms. 46% presented a maximum oxygen consumption below 80% of predicted. SF-12 physical domain score was significantly reduced in patients with altered PFT (32.7 vs. 45.9; p<0.001) and obtained the best sensitivity and specificity to identify PFT alterations (AUC 0.862, Sensitivity 85.7%, Specificity 81.5%).ConclusionsSF-12 questionnaire shows high sensitivity and specificity to detect SARS CoV2 survivors with pulmonary function alterations. (AU)
Antecedentes y objetivos: El seguimiento tras el alta hospitalaria de los supervivientes de SARS-CoV-2 representa una enorme carga para el sistema sanitario. Intentamos evaluar la utilidad de los síntomas y el cuestionario de calidad de vida (SF-12) para identificar los pacientes con secuelas pulmonares por SARS-CoV-2.Materiales y métodosEstudio de seguimiento prospectivo observacional. Después de la hospitalización, a los 6 meses del primer frotis con PCR positiva se realizaron: una prueba de esfuerzo cardiopulmonar, pruebas funcionales respiratorias (PFR) y se aplicó el cuestionario SF-12.ResultadosSe incluyó a 41 pacientes, el 39% eran mujeres, con una edad media de 57,3±13,7 años. El 70% persistía con síntomas. El 46% presentó un consumo máximo de oxígeno por debajo del 80% del predicho. La puntuación del dominio físico del SF-12 fue significativamente más baja en pacientes con PFR alteradas (32,7 vs. 45,9; p<0,001) y obtuvo la mejor sensibilidad y especificidad para identificar las alteraciones de las PFR (AUC 0,862; sensibilidad 85,7% y especificidad 81,5%).ConclusionesEl cuestionario de calidad de vida SF-12 presenta una alta sensibilidad y especificidad para detectar a los sobrevivientes de SARS-CoV-2 con alteraciones de la función pulmonar. (AU)
Assuntos
Humanos , Coronavirus , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave , Qualidade de Vida , Seguimentos , Estudos Prospectivos , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Follow-up after hospital discharge of SARS-CoV-2 survivors represents a huge burden on the healthcare system. We attempt to assess the utility of symptoms and health-related quality of life questionnaire (SF-12) to identify SARS CoV2 pulmonary sequelae. METHODS: Prospective, non-interventional follow-up study. A cardiopulmonary exercise test, functional respiratory test (PFT), SF12 questionnaire were performed after hospitalization at six months after the first positive PCR smear. RESULTS: 41 patients were included, female (39%), mean age 57.3±13.7 years. 70% persisted with symptoms. 46% presented a maximum oxygen consumption below 80% of predicted. SF-12 physical domain score was significantly reduced in patients with altered PFT (32.7 vs. 45.9; p<0.001) and obtained the best sensitivity and specificity to identify PFT alterations (AUC 0.862, Sensitivity 85.7%, Specificity 81.5%). CONCLUSIONS: SF-12 questionnaire shows high sensitivity and specificity to detect SARS CoV2 survivors with pulmonary function alterations.
Assuntos
COVID-19 , SARS-CoV-2 , Adulto , Idoso , COVID-19/diagnóstico , Teste para COVID-19 , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Inquéritos e QuestionáriosAssuntos
COVID-19 , Teste de Esforço , Ecocardiografia sob Estresse , Seguimentos , Humanos , SARS-CoV-2 , SobreviventesRESUMO
No disponible
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Ecocardiografia sob Estresse/métodos , Síndrome Coronariana Aguda/diagnóstico por imagem , Atropina/administração & dosagem , Padrões de Prática Médica , Assistência Ambulatorial/métodosRESUMO
No disponible
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Quarentena/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Imobilização/efeitos adversos , Embolia Pulmonar/epidemiologia , Trombose Venosa/epidemiologia , Pandemias/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Fatores de RiscoAssuntos
Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Embolia Pulmonar/etiologia , Quarentena , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19 , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Controle de Infecções , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Embolia Pulmonar/epidemiologia , Fatores de Risco , Comportamento Sedentário , Espanha/epidemiologiaRESUMO
Mitral valve prolapse (MVP) is a common and benign condition. However, some anatomic forms have been recently associated with life-threatening ventricular arrhythmias and sudden cardiac death. Imaging MVP holds the promise of individualized MVP risk assessment. Noninvasive imaging techniques available today are playing an increasingly important role in the diagnosis, prognosis and monitoring of MVP. In this article, we will review the current evidence on arrhythmogenic MVP, with special focus on the utility of echocardiography and CMR for identifying benign and "malignant" forms of MVP. The clinical relevance of this manuscript lies in the value of imaging technology to improve MVP risk prediction, including those arrhythmic-MVP cases with a higher risk of sudden cardiac death.
RESUMO
Aortic root rupture and cardiac tamponade during transcatheter aortic valve implantation is a frightening complication with high mortality rate. A conservative management of this complication could represent an initial strategy, especially in high-risk patients, to avoid emergent cardiac surgery. This conservative management includes: Immediate detection of pericardial effusion by echocardiography, a fast instauration of pericardial drainage, auto-transfusion and anticoagulation reversal. We describe two cases of patients who suffered this complication and were treated successfully with this initial approach.
Assuntos
Cardiomegalia/complicações , Cardiomegalia/diagnóstico por imagem , Comorbidade , Transtornos de Deglutição/etiologia , Átrios do Coração/diagnóstico por imagem , Idoso de 80 Anos ou mais , Cardiomegalia/patologia , Transtornos de Deglutição/diagnóstico , Progressão da Doença , Dispneia/diagnóstico , Dispneia/etiologia , Ecocardiografia/métodos , Feminino , Átrios do Coração/patologia , Humanos , Monitorização Fisiológica/métodos , Radiografia Torácica/métodos , Doenças Raras , Medição de Risco , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X/métodosAssuntos
Adenosina/análogos & derivados , Intervenção Coronária Percutânea , Inibidores da Agregação Plaquetária/uso terapêutico , Cloridrato de Prasugrel/uso terapêutico , Antagonistas do Receptor Purinérgico P2Y/uso terapêutico , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Adenosina/uso terapêutico , Idoso , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Microvasos , Pessoa de Meia-Idade , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico por imagem , Infarto do Miocárdio com Supradesnível do Segmento ST/fisiopatologia , TicagrelorRESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência da Valva Aórtica/complicações , Hemorragia Subaracnóidea/complicações , Mialgia/etiologia , Artralgia/etiologia , Febre/etiologiaAssuntos
Endocardite Bacteriana/diagnóstico , Hemorragia/etiologia , Doenças da Boca/etiologia , Dermatopatias/etiologia , Infecções Estafilocócicas/diagnóstico , Endocardite Bacteriana/complicações , Endocardite Bacteriana/patologia , Pé/patologia , Mãos/patologia , Hemorragia/diagnóstico , Hemorragia/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças da Boca/diagnóstico , Doenças da Boca/patologia , Soalho Bucal/patologia , Dermatopatias/diagnóstico , Dermatopatias/patologia , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/patologia , Hemorragia Subaracnóidea/diagnóstico por imagem , Hemorragia Subaracnóidea/etiologiaRESUMO
PURPOSE: Heart failure (HF) with preserved ejection fraction (HFPEF) is the most prevalent type of HF in nonhospitalized patients, but its pathophysiology remains poorly understood. The aim of our study was to assess the existence of interatrial dyssynchrony (IAD), a potentially treatable condition, in the development of HF symptoms. METHODS: Consecutive patients with new onset of shortening of breath, referred for suspected HF, were screened. In all cases, a transthoracic echocardiography, ECG, and determination of plasma BNP level were performed at initial consultation. Patients were diagnosed according to current guidelines. Patients with HF and reduced ejection fraction were excluded. Later, the time from P-wave onset on the ECG to peak negative strain (atrial contraction) was determined using speckle tracking echocardiography; the time difference between both atria (ms) was used as an index of IAD. RESULTS: Sixty-six patients were included. Mean age was 74 ± 8 years (74% female, 77% hypertensive). HFPEF patients (n = 32) showed an increased IAD as compared to subjects with non-HF (n = 34; interatrial time difference 72.7 ± 27 vs. 28 ± 7 ms, P < 0.001). IAD showed a significant correlation with BNP levels, diastolic pattern, and echocardiographic parameters indicative of elevated LV filling pressures. LA function assessed by LA strain rate was not significantly different between HPPEF patients with and without IAD > 60 ms. CONCLUSIONS: We showed that IAD was present at initial stages of symptomatic HFPEF. It might be an important mechanism involved in the development of symptoms in HFPEF and a potential target amenable to be treated with device therapy.
Assuntos
Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/fisiopatologia , Idoso , Função Atrial/fisiologia , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/fisiopatologia , Humanos , Masculino , Volume Sistólico/fisiologia , UltrassonografiaRESUMO
Transcatheter closure of the left atrial appendage with the Amplatzer™ cardiac plug device and double antiplatelet treatment for 3 mo has become an alternative treatment for patients with atrial fibrillation at high embolism risk and contraindications for chronic oral anticoagulation. The inadequate implantation of the left atrial appendage closure device and the discontinuation of double antiplatelet therapy are well-known as factors related to device thrombosis. Nevertheless, device thrombosis after adequate implantation requiring surgical treatment or restarting chronic oral anticoagulation has been reported and can reach 15% of patients. The connector pin thrombosis of the Amplatzer™ cardiac plug, despite a good adherence to antiplatelet treatment, has been recently described as a potential mechanism for device thrombosis. Our clinical case reports the management of this condition for the first time, showing that the early detection of thrombotic complications by transesophageal echocardiography permits solving this serious complication with medical treatment only.