Português | English

ISSN (Print): 2359-4802 | ISSN (Online): 2359-5647

Edition: 23.1 - 15 Article(s)

Editorial

Editorial

Ricardo Mourilhe Rocha

Rev Bras Cardiol. 2010;23(1):9

PDF PORT


Revista Brasileira de Cardiologia: natura non facit saltus

Roberto Esporcatte

Rev Bras Cardiol. 2010;23(1):10

PDF PORT


Editorial

Luiz Felipe P. Moreira

Rev Bras Cardiol. 2010;23(1):11

PDF PORT


Editorial

Jorge Ilha Guimarães

Rev Bras Cardiol. 2010;23(1):12

PDF PORT


Francisco Albanesi - ícone da cardiologia brasileira

Denilson Campos de Albuquerque

Rev Bras Cardiol. 2010;23(1):13-14

PDF PORT


Update Article

Hypertrophic cardiomyopathy

Cardiomiopatia hipertrófica

Marcelo Imbroinise Bittencourt; Ricardo Mourilhe Rocha; Francisco Manes Albanesi Filho

Rev Bras Cardiol. 2010;23(1):17-24

Abstract PDF PORT

Hypertrophic cardiomyopathy is a dominant autosomal genetic disorder that is relatively common (prevalence=0.2%), characterized by ventricular hypertrophy in the absence of other diseases that might cause this alteration. This might appear through an asymptomatic presentation or as severe symptoms refractory to medical treatment. The literature has recently been consolidating accurate diagnostic methods (magnetic resonance imaging), showing the outcomes of invasive types of treatment (such as septal ablation) for severe cases, and discussing new risk factors for sudden death. This examination discusses these advances and reviews classic aspects of the disease, striving to add relevant information to its practical approach.


Keywords: Hypertrophic cardiomyopathy, Sudden death, Review

Atrial fibrillation in heart failure: new advances in molecular genetics and treatment

Fibrilação atrial na insuficiência cardíaca: novos avanços na genética molecular e no tratamento

Bruno Costa do Nascimento; Evandro Tinoco Mesquita

Rev Bras Cardiol. 2010;23(1):25-34

Abstract PDF PORT

The association between atrial fibrillation (AF) and heart failure (HF) is becoming increasingly prevalent. Studies show that therapeutic advances have extended survival times for patients with HF, with AF occurring most commonly in older patients, with more advanced function class (NYHA) and among patients with normal ejection fraction heart failure. Recently published data suggest that the presence of AF is associated with an adverse prognosis for patients with HF. This paper reviews pathophysiological aspects of the association between AF and HF, exploring new prospects for rhythm control with pharmacological and invasive therapy and new strategies for preventing thromboembolic phenomena. The main contributions of molecular genetics are also presented, in an attempt to predict the appearance of AF in HF and its contribution to individualizing therapy.


Keywords: Heart failure, Atrial fibrillation, Pathophysiological, Therapeutic advances, Molecular genetics

Original Article

Transcatheter aortic valve implantation: initial experience in Rio de Janeiro state, Brazil

Implante de válvula aórtica percutânea: experiência inicial no estado do Rio de Janeiro

André Luiz Silveira Sousa; André Luiz da Fonseca Feijó; Constantino Gonzalez Salgado; Rodrigo Verney Castelo Branco; Carlos Henrique Eiras Falcão; João Alexandre Resende Assad; Flávia Candolo Pupo Barbosa; Alexandre Siciliano Colafranceschi; Nelson Ferreira Durval Gomes de Mattos; Eberhard Grube; Luiz Antônio Ferreira Carvalho

Rev Bras Cardiol. 2010;23(1):35-42

Abstract PDF PORT

BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a new treatment alternative for patients with symptomatic aortic stenosis rated as high risk for surgery. Good outcomes - mainly in Europe - must be replicable as this technique is disseminated worldwide.
OBJECTIVE: To report on the initial experience of transcatheter aortic valve implantation in the Rio de Janeiro State, Brazil.
METHODS: Five cases of TAVI with CoreValve bioprotheses, describing the procedure technique and immediate outcomes in terms of safety and effectiveness for reducing the transvalvular aortic gradient and symptoms. Mortality, adverse events and symptoms were evaluated at thirty days follow-up.
RESULTS: Five patients (4 women), 83.4±6.4 y/old, with severe aortic stenosis and symptoms of NYHA Functional Class III or IV heart failure. The logistic EuroSCORE was 20.83±12.60%. All the cases procedures were performed successfully through femoral artery access. On echocardiogram, the baseline LV-Ao mean gradient of 59.8±11.8mmHg was reduced to 13.2±7.1mmHg and the aortic valve area of 0.74±0.15cm2 increased to 1.94±0.51cm2. Permanent pacemakers had to be implanted in three cases, with the patients remaining in hospital for seven days. At thirty days, all patients remained alive with remarked relief of symptoms.
CONCLUSION: TAVI is new treatment that can reduce the transvalvular aortic gradient in cases of aortic stenosis at high risk for surgery. When performed according to protocol by a multidisciplinary team at a high complexity center, this allows the replication of international outcomes in terms of safety and effectiveness.


Keywords: Aortic valve stenosis, Cardiac valves, Aortic valve replacement, Cardiac valve protheses

Quality of information on the internet about coronary disease

Qualidade da informação na internet sobre coronariopatia

Delma Marques Hirata; Nathalia Rampini de Queiroz; Rômulo Cristovão de Souza; Lucia Brandão de Oliveira; Wolney de Andrade Martins

Rev Bras Cardiol. 2010;23(1):43-50

Abstract PDF PORT

BACKGROUND: Coronary disease is a matter of much concern among healthcare practitioners and laypersons as well. The Internet is the main source for researching data, but with no quality control for this information. In Brazil, there is also a lack of laws regulating the dissemination of healthcare information through the Internet.
OBJECTIVE: To assess the quality of the information on coronary disease available through the Internet.
Methods: The quality of information on coronary disease was assessed on four Brazilian search websites that were frequently used at that time, analyzing issues related to transparency, honesty, privacy, medical ethics, responsibility and provenance, based on the Handbook of Ethical Principles for Medicine and Healthcare Websites published by the São Paulo State Regional Medical Council (CREMESP).
RESULTS: The most frequent problem lay in the presentation rather than the content. The most reliable websites belonged to individual physicians and healthcare institutions. Most websites addressing coronary disease were not recommendable due to ethical flaws.
CONCLUSION: There is lack of control over the dissemination of information. Public policies are required that establish rules, certification, dissemination and oversight of healthcare information on the internet.


Keywords: Coronary disease, Internet, Healthcare information

Overall cardiovascular risk stratification in patients enrolled at a Family Health Unit (USF) Maceió, Alagoas state, Brazil

Estratificação do risco cardiovascular global em pacientes atendidos numa Unidade de Saúde da Família (USF) de Maceió, Alagoas

Marcus da Rocha Sampaio; Morgan Batista Oliveira de Melo; Mary Stefannie Azevedo Wanderley

Rev Bras Cardiol. 2010;23(1):51-60

Abstract PDF PORT

BACKGROUND: The Framingham risk score (FRS) has proven an effective tracking tool, and applying it in Family Health Units (USFs) is a good way to reflect the health of a population lacking this type of study.
OBJECTIVES: To estimate the risk of cardiovascular disease in absolute terms and according to the FRS, listing other risk factors.
METHODS: Observational transverse study of 127 randomly-selected medical records for patients aged >30 years, tracked for dyslipidemias and anomalous glucose homeostasis between August 2006 and August 2009. In addition to the FRS risk stratification, relationships to employability, literacy, sedentary lifestyles, fasting glucose and triglyceridemia were investigated. Risk level assessments and their associations with outcome variables were defined through statistical analyses.
RESULTS: It was ascertained that 59.05% of the subjects were at low cardiovascular risk, with a high prevalence of potentially controllable risk factors such as sedentary lifestyle, dyslipidemia, impaired fasting glucose and hypertension. High rates of unemployment and illiteracy prevailed among the women, but with no statistical significance. Classified as high risk, 78.5% of these individuals were diabetic.
CONCLUSION: Instead of a calming effect, the prevalence of low risk was offset by the high prevalence of other risk factors. This indicates that there is a need for more effective actions by these Family Health Units, with the routine application of the ERF providing better guidelines for the adoption of early intervention. However, the ERF should not be the only type of screening, as it does not encompass other risk factors that are also related to severe cardiovascular events.


Keywords: Overall cardiovascular risk, Framingham Risk Score (FRS), Family Health Unit, Cardiovascular risk factors

Extracranial carotid and vertebral artery flows in brain dead patients

Fluxos nas carótidas e artérias vertebrais extracranianas em pacientes com morte cerebral

Jaqueline Luiza Würzler Barreto; Bruno Moreira Silva; Licínio Esmeraldo da Silva; Antonio Cláudio Lucas da Nóbrega; Tania Gouvêa Thomaz

Rev Bras Cardiol. 2010;23(1):61-71

Abstract PDF PORT

BACKGROUND: Transcranial Doppler (TCD) is the most widely used method for confirming brain death (BD). Although carotid blood flow also presents a characteristic alteration in BD, this is addressed only superficially in the literature.
OBJECTIVE: To characterize carotid and vertebral artery blood flow types in BD patients through ultrasound.
METHODS: The carotid and vertebral arteries were assessed in 2 patient groups, one with BD (BDG) and a control group (CG) through the color duplex scanner (CDS). Both groups had 13 patients with no hemodynamically significant stenosis. The flow speed parameters studied were: peak systolic speed, end diastolic speed and the resistance index. As most of the data presented non-parametric distribution, the Wilcoxon and Mann-Whitney U tests were used.
RESULTS: Four flow morphologies were found in the inner branches of the carotid and vertebral arteries in the BDG patients: systolic spike, two-phase to-and-fro flow and its variant, oscillatory flow, and three-phase flow. All the morphologies found were similar to those described by the TCD for BD patients. Blood flow in the common carotid varied from normal to the morphologies described for the inner branches of the carotid, vertebral and common carotid arteries. All the BDG velocity parameters presented statistically significant differences from the control group for the inner branches of the carotid, vertebral and common carotid arteries when compared to the CG, with p<0.05.
CONCLUSION: The color duplex scanner is a promising method for brain death diagnoses.


Keywords: Flow, Carotid artery, Vertebral artery, Brain death, Ultrasound, Color duplex scanner

Preliminary Communication

Effect of capoeira on cardiovascular parameters

Efeito da prática de capoeira sobre os parâmetros cardiovasculares

Rodrigo Batista Maia; Maria do Carmo de Carvalho e Martins; Cláudio Henrique Lima Rocha; Irapuá Ferreira Ricarte; Vítor Brito da Silva; David Marcos Emérito de Araújo; Lívia de Barros Rocha Tolentino e Silva; Moisés Tolentino Bento da Silva

Rev Bras Cardiol. 2010;23(1):72-77

Abstract PDF PORT

BACKGROUND: Evaluations of cardiovascular alterations caused by fighting sports are extremely important, as there are no concise data in the literature.
OBJECTIVE: To evaluate and compare hemodynamic and anthropometric alterations among individuals engaged in capoeira (Brazil's balletic martial art) and sedentary individuals.
METHODS: The BMI and body composition were evaluated for capoeira athletes (n=15) and sedentary individuals (n=13), in addition to the BP, HR, DP and VO2máx during periods and at 1, 5 and 10 minutes).
RESULTS: There was an increase (p<0.05) in the BMI of capoeira athletes compared to the sedentary individuals. The HR at 1 min was higher (p<0.05) compared to the at-rest findings for both groups. For the 1st min, both groups presented higher values (p<0.05) for SBP, MAP and DP compared to the at-rest findings with higher VO2max values (p<0.05) recorded for the capoeira athletes.
CONCLUSION: The data suggest that, in addition to altering nutritional status, capoeira causes cardiovascular changes, enhancing cardiopulmonary fitness.


Keywords: Capoeira, Body composition, Cardiovascular system

Case Report

Isolated non-compaction of left ventricular myocardium: case report

Não compactação isolada do miocárdio ventricular esquerdo: relato de caso

Felipe Montes Pena; Beatriz Tose Costa Paiva; Ulysses da Costa Paiva Neto; Mariana Tose Costa Paiva; Jorge Elias Neto; Jamil da Silva Soares

Rev Bras Cardiol. 2010;23(1):78-81

Abstract PDF PORT

A 35-year-old woman requested the cardiology unit to conduct a clinical evaluation, presenting dyspnea on heavy exertion with palpitations and syncope. The electrocardiogram showed monomorphic ventricular extrasystoles and diffuse ventricular repolarization changes in the anterior wall. The echocardiography showed isolated non-compaction of the left ventricular myocardium, confirmed through magnetic resonance imaging. Athenolol was prescribed, and with an electrophysiological study and subsequent ablation, with electrocardiographic improvement. Her post-resolution conduct was clinically monitored, remaining asymptomatic and without medications. The pathophysiological mechanisms related to isolated non-compaction of the left ventricular myocardium are discussed, together with clinical implications and diagnostic and therapeutic approaches.


Keywords: Arrhythmia, Myocardial infarction, Heart failure

Cardiovascular Image

Complete right bundle branch block with fragmented electrical potentials and risk of sudden death

Bloqueio completo de ramo direito com potenciais elétricos fragmentados e risco de morte súbita

Alexandre Giani Marcos Dias; Paulo Ginefra; Gerson Paulo Goldwasser

Rev Bras Cardiol. 2010;23(1):82-83

PDF PORT


Letter to the editor

GN1