Abstract Background: Transthyretin amyloidosis (ATTR) is an infiltrative disease caused by abnormal protein deposition mainly in the heart and peripheral nervous system. When it affects the heart, the disease presents as restrictive cardiomyopathy; when it affects the peripheral and autonomic nervous system, it manifests as polyneuropathy, and is called familial amyloid polyneuropathy (FAP). There are two ATTR subtypes: wild-type ATTR, where there is no mutation, and mutant ATTR (ATTRm), which is characterized by a mutation in the gene encoding the […]

Abstract Hyperactivation of the sympathetic nervous system plays a central role in the pathophysiology of hypertension. The aim of this study was to assess cardiac sympathetic activity and investigate the role of myocardial123I-labelled meta-iodo benzyl guanidine ([123I] MIBG) scintigraphy in cardiovascular risk stratification of patients with resistant hypertension treated with renal denervation (RDN). Eighteen patients were included in this prospective study (mean age 56 ± 10 years old, 27.8% females). Transthoracic echocardiogram, general blood analysis and myocardial ([123I] MIBG scintigraphy […]

Case Report A 59-year-old asymptomatic female patient, with a diagnosis of a large bilateral coronary-pulmonary artery fistula made in 2007 was investigated after a cardiac murmur was identified on a routine examination. At the time, conservative treatment was chosen. Cardiac auscultation showed a more audible systolic-diastolic murmur in the upper left sternal border, with a more audible component in systole. There were no other findings in the cardiological physical examination or even the overall segmental examination. The patient had no […]

Abstract Background: Heart failure (HF) affects more than 5 million individuals in the United States, with more than 1 million hospital admissions per year. Cardiac resynchronization therapy (CRT) can benefit patients with advanced HF and prolonged QRS. A significant percentage of patients, however, does not respond to CRT. Electrical dyssynchrony isolated might not be a good predictor of response, and the last left ventricular (LV) segment to contract can influence the response. Objectives: To assess electromechanical dyssynchrony in CRT with […]

Introduction The myocardial bridge is one of the most prevalent congenital anomalies that involve the coronary circulation, and its incidence in the general population is high, affecting from 23 to 55% in necropsy studies.The impairment of the anterior descending artery is more frequent, on its proximal 2/3.In most patients, the myocardial bridges do not cause symptoms, because in order to have ischemia, there must be an imbalance between supply and consumption of oxygen. The superficial bridges, with small or slender […]

To the Editor, I have read with great interest the article entitled “Relationship between Calcium Score and Myocardial Scintigraphy in the Diagnosis of Coronary Disease” by Siqueira et al., recently published in Arquivos Brasileiros de Cardiologia 2016; 107:367-74. The investigators reported the possibility of removing extensive coronary artery disease (CAD) by means of a zero calcium score, or by indicating the presence of an extensive disease when it is severely increased, which justifies the use of this method in the […]

Introduction Coronary angiography (CAG) is the standard diagnostic method for detection of coronary artery disease (CAD). However, it is often necessary to evaluate the expression of a coronary obstruction in relation to myocardial perfusion, before defining the best patient management. Myocardial perfusion scintigraphy with technetium-99m-Sestamibi (99mTc-sestamibi) allows early detection and evaluation of disease extension and cardiovascular risk in patients with suspected or established CAD, helping in decision-making regarding the start and type of therapy to be implemented. This method has […]