Carlos Eduardo Rochitte In this special editorial, we would like to pay tribute to an icon of Brazilian Cardiology who was directly responsible for developing one of the greatest cardiology institutions in the world, The Heart Institute (InCor), at the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (USP). In the words of 3 people who were very close to him (Professors Kalil, Mady, and Protásio da Luz), we shall remember the career and […]

Abstract Background Low schooling has been considered an important modifiable risk factor for the development of cardiovascular disease for a long time. Despite that, whether this factor impacts the outcomes following ST-segment elevation myocardial infarction (STEMI) is poorly understood. Objective To investigate whether schooling stands as an independent risk factor for mortality in STEMI patients. Methods STEMI-diagnosed patients were consecutively enrolled from a prospective cohort (Brasilia Heart Study) and categorized according to years of study quartiles (0-3, 4-5, 6-10 and […]

Abstract Background Primary percutaneous coronary intervention is considered the “gold standard” for coronary reperfusion. However, when not available, the drug-invasive strategy is an alternative method and the electrocardiogram (ECG) has been used to identify reperfusion success. Objectives Our study aimed to assess ST-Segment changes in post-thrombolysis and their power to predict recanalization and using the angiographic scores TIMI-flow and Myocardial Blush Grade (MBG) as an ideal reperfusion criterion. Methods 2,215 patients with ST-Segment Elevation Myocardial Infarction (STEMI) undergoing fibrinolysis [(Tenecteplase)-TNK] […]

Abstract Background Despite constant improvement and refinement of the prostheses, the decision between mechanical and biological valves for aortic valve replacement is still controversial. Objective To compare outcomes of aortic valve replacement with bioprosthesis and mechanical prosthesis. Methods This was an observational, historical cohort study with review of medical records. A total of 202 patients who underwent heart valve replacement surgery between 2004 and 2008 were selected, with a mean follow-up of 10 years. The level of significance set at […]

Abstract Background The significant increase in cardiovascular diseases in developing countries alerts about their impact on underprivileged populations. Objective To identify the relationship of clusters of metabolic syndrome (MS) components with atherosclerosis and chronic inflammation among adults and elderly. Methods Cross-sectional analysis using data from two population-based cohort studies in Florianópolis, Southern Brazil (EpiFloripa Adult Cohort Study, n = 862, 39.9±11.5 years; EpiFloripa Aging Cohort Study, n = 1197, 69.7±7.1 years). Blood pressure (BP), waist circumference (WC), and lipid and […]

Abstract Background Ischemic heart disease (IHD) is the leading cause of death among cardiovascular diseases (CVD). Objective To describe the sociodemographic profile and analyze the trend in the mortality rate due to IHD, according to sex and by age group, in the states of the Northeast region of Brazil, from 1996 to 2016. Methods Ecological study involving IHD mortality in the northeastern states. Variables analyzed: sex, age, education, marital status, ICD-10 category and state of residence. Crude and standardized rates […]

Abstract Background In 2015, the number of infants with congenital malformations (CMs) per 100 000 live births (LBs) was 2368 (7.6%) worldwide, of whom 10.6% died in the first year of life, 43% due to malformations of the circulatory system (MCSs), a scenario similar to what occurs in Brazil. Objective To assess, per Brazilian macroregion, whether diagnosis of MCS at birth and death due to MCS in the first year of life associate with human development index (HDI) and with […]

Abstract Background Resting heart rate (RHR) may be a useful screening tool for cardiovascular risk. However, RHR cutoff points, an interesting clinical approach, have never been described in young populations. Objective To establish RHR cutoff points in Brazilian adolescents and to analyze whether cutoff points are associated with cardiovascular risk factors. Methods The sample was composed of 6,794 adolescents (10 to 19 years old). Blood pressure and RHR were assessed by oscillometric device. Body mass index and waist circumference were […]

Abstract Background Coronary artery fistula (CAF) is a direct connection of one or more coronary arteries to cardiac chambers or a large vessel; it may be associated with congenital heart disease. Objective To establish CAF pathway patterns from echocardiographic data and to correlate them with clinical aspects and congenital heart disease. Methods A total of 7.183 medical records of children under the age of five years with cardiac disease submitted to color Doppler echocardiography and Spearman’s Correlation test were used […]

Abstract Background Obesity is a chronic low-grade inflammation condition related to cardiac disorders. However, the mechanism responsible for obesity-related cardiac inflammation is unclear. The toll-like receptor 4 (TLR-4) belongs to a receptor of the transmembrane family responsible for the immune response whose activation stimulates the production of proinflammatory cytokines. Objective To test whether the activation of the TLR-4 receptor participates in the obesity cardiomyopathy process, due to cytokine production through NF-ĸB activation. Methods Male Wistar rats were randomized into two […]

Abstract Background In paroxysmal atrial fibrillation (PAF), pulmonary vein isolation using cryoballoon (CB-PVI) has similar efficacy as radiofrequency ablation (RF-PVI) has. In redo ablation procedures following RF-PVI, PV reconnection is high, whereas in patients with redo following CB-PVI, information is scarce. Objective To determine the sites of PV reconnection in patients who underwent redo ablation after initial CB-PVI. Methods Patients who underwent an AF redo procedure, following an initial CB-PVI for PAF were included. LA electroanatomic mapping was used. A […]

Abstract Background Endothelial progenitor cells (EPCs) play an important role in maintaining endothelial function. Metabolic syndrome (MetS) is associated with EPC dysfunction. Although physical exercise has a beneficial impact on EPC activity, its mechanism is not completely clear yet. Objective The purpose of this study is to investigate the effects of physical exercise on the functions of EPCs and the underlying mechanisms in patients with MetS. Methods Volunteers with MetS were divided into exercise group (n=15) and control group (n=15). […]

Abstract Background The concentration of high-complexity services in Aracaju, Sergipe can impose certain disparity in the quality of care for the patients with ST-segment elevation acute myocardial infarction (STEMI) (STEMI) who receive care from Brazil’s Unified Health System (SUS, acronym in Portuguese) and whose symptoms started in other health regions of the state. Objective To evaluate disparities in access to reperfusion therapies and 30-day mortality, among patients with STEMI, who were users of SUS, in each of the 7 health […]

Abstract Chagas disease (CD) is caused by Trypanosoma Cruzi. This parasite can infect several organs of the human body, mainly the heart, causing inflammation, fibrosis, arrhythmias, and cardiac remodeling, promoting long-term Chronic Chagas Cardiomyopathy (CCC). However, little scientific evidence has elucidated the molecular mechanisms that govern the pathophysiological processes in this disease. MicroRNAs (miRNAs) are regulators of post-transcriptional gene expression that modulate signaling pathways, participating in pathophysiological mechanisms in CD, but the understanding of miRNAs in this disease is limited. […]

Introduction Hypoplasia of the left heart is characterized by very small dimensions of the left cardiac cavities, represented by the left atrium, mitral valve, left ventricle, aortic ring and ascending aorta. Systemic circulation thus becomes dependent on the ductus arteriosus with reverse flow from the hypertensive pulmonary artery to the descending aorta, and also to the ascending aorta. Coronary circulation is also dependent on this reverse flow, which is why there is a high chance of myocardial infarction, even in […]

Introduction Dyspnea is one of the most frequent adverse reaction of ticagrelor, leading to premature discontinuation in 15-20% of the patients. The mechanism is unclear, but it is thought to be related to increased tissue adenosine concentrations or to the direct reversible inhibition of P2Y12 receptors on sensory neurons. Theophylline has been used as a bronchodilator since 1922, and its effects seem to be partly mediated through nonselective adenosine receptors blockade. […]

Introduction Heart failure (HF) with reduced ejection fraction (HFrEF) leads to mortality and impairment in one’s quality of life, and causes a major impact on the healthcare system. Despite trials showing the benefits of angiotensin receptor–neprilysin inhibitor (ARNI) over angiotensin-converting enzyme inhibitors (ACEi), and the superiority of sodium-glucose cotransporter-2 inhibitors (SGLT2i) over placebos, current guidelines still recommend ACEi, mineralocorticoid receptor antagonists (MRA), and beta-blockers as first-line therapy in HFrEF.– In this letter, we will discuss the potential benefits and risks […]

The complex post-surgical anatomy after the Senning procedure presents several challenges for catheter ablation. Transbaffle approach allows access to the pulmonary venous atrium and better catheter manipulation. However, this modified transseptal puncture can be challenging to perform. The authors present the case of a 29-year-old woman who underwent a Senning procedure for dextro-transposition of the great arteries. The patient had recurrent episodes of atrial flutter despite adequate antiarrhythmic therapy and was referred for catheter ablation. […]

Reply Sudden cardiac death (SCD) is considered the most dramatic complication of hypertrophic cardiomyopathy (HCM) with an estimated annual incidence of 0.5–1%. Over the years, the ACC/AHA and the ESC have published consensus guidelines providing different approaches for SCD risk stratification based on independent clinical predictors. Despite the relatively low accuracy of these markers, current strategies are considered to have a reasonable discriminatory power for the recognition of high-risk patients. However, prognostic assessment is challenging in HCM, especially in low […]

1. Introduction The Department of Ergometry, Exercise, Nuclear Cardiology and Cardiovascular Rehabilitation (DERC), through its commission on Health and Diagnosis of Cardiovascular Diseases in Women and in association with the Sports Cardiology Study Group (GECESP) and the Cardiopulmonary Rehabilitation and Metabolic Study Group (GERCPM), has prepared this position paper in accordance with Brazilian Society of Cardiology norms to guide health professionals regarding the prescription of physical exercise during pregnancy and the postpartum period, as well as to strengthen the relationship […]

Definitions of Recommendations and Evidence […]

March 2021 Issue, vol. 116 (3), pages 383-392 In Original Article “Prognostic Value of Lung Ultrasound for Clinical Outcomes in Heart Failure Patients: A Systematic Review and Meta-Analysis”, with DOI number: https://doi.org/10.36660/abc.20190662, published in the Journal Arquivos Brasileiros de Cardiologia, 116(3):383-392, on page 383, correct the name of the institution Chengdu City First People’s Hospital to: Department of Cardiology, Chengdu First People’s Hospital; correct the name of the institution Chengdu Sixth People’s Hospital to: Department of Cardiology, The Sixth People’s […]