The clinical usefulness of any test in Medicine depends on the population studied, because even an accurate test will yield no benefit if applied to the wrong population. While sensitivity and specificity are characteristics inherent in the diagnostic method, the individual probability of having a disease when the test is positive (positive predictive value, PPV) and the probability of not having the disease when the test is negative (negative predictive value, NPV) depend on the disease prevalence in the population […]

Abstract Background: The accuracy of zero coronary calcium score as a filter in patients with chest pain has been demonstrated at the emergency room and outpatient clinics, populations with low prevalence of coronary artery disease (CAD). Objective: To test the gatekeeping role of zero calcium score in patients with chest pain admitted to the coronary care unit (CCU), where the pretest probability of CAD is higher than that of other populations. Methods: Patients underwent computed tomography for calcium scoring, and […]

Abstract Background: Depressive symptoms are independently associated with an increased risk of cardiovascular disease (CVD) among individuals with non-diagnosed CVD. The mechanisms underlying this association, however, remain unclear. Inflammation has been indicated as a possible mechanistic link between depression and CVD. Objectives: This study evaluated the association between persistent depressive symptoms and the onset of low-grade inflammation. Methods: From a database of 1,508 young (mean age: 41 years) individuals with no CVD diagnosis who underwent at least two routine health […]

Abstract Background: A family history of hypertension is associated with vascular and autonomic abnormalities, as well as an impaired neurohemodynamic response to exercise. Objective: To test the hypothesis that normotensive individuals with a family history of hypertension present an impaired peripheral vascular resistance response to exercise. Methods: The study included 37 normotensive volunteers of both sexes who were sedentary, eutrophic, and nonsmokers, comprising 23 with (FH+; 24 ± 3 years) and 14 without (FH-; 27 ± 5 years) a family […]

Abstract Background: The diterpene Sclareol has antimicrobial action, cytotoxic and cytostatic effects and anti-tumor activities. However, researches on the cardiovascular system are scarce. Objective: This study was designed to investigate the mechanisms involved in the Sclareol cardiovascular effect in normotensive and hypertensive rats. Methods: The arterial hypertension was promoted using 2-kidneys 1-clip model in rats. The effect of sclareol on blood pressure was performed by using three dose (10, 20 and 40 mg/kg). Cumulative dose-response curves for Sclareol were determined […]

Abstract Background: The endothelium is a monolayer of cells that extends on the vascular inner surface, responsible for the modulation of vascular tone. By means of the release of nitric oxide (NO), the endothelium has an important protective function against cardiovascular diseases. Objective: Verify if cis- [Ru(bpy)2(NO2)(NO)](PF6)2 (BPY) improves endothelial function and the sensibility of conductance (aorta) and resistance (coronary) to vascular relaxation induced by BPY. Methods: Normotensive (2K) and hypertensive (2K-1C) Wistar rats were used. For vascular reactivity study, […]

Abstract Backgrounds: Despite their clear therapeutic benefits, anthracycline-induced cardiotoxicity is a major concern limiting the ability to reduce morbidity and mortality associated with cancers. The early identification of anthracycline-induced cardiotoxicity is of vital importance to assess the cardiac risk against the potential cancer treatment. Objective: To investigate whether speckle-tracking analysis can provide a sensitive and accurate measurement when detecting doxorubicin-induced left ventricular injury. Methods: Wistar rats were divided into 4 groups with 8 rats each, given doxorubicin intraperitoneally at weekly […]

Abstract Background: The oxidative biomarkers play an important role in the genesis of cardiometabolic risk-related processes. Objective: To investigate the total antioxidant capacity of plasma and its association with cardiometabolic risk in non-obese and clinically healthy young adults. Methods: University students of the state of Sergipe, Brazil, aged between 18 and 25 years, were recruited for this study from May of 2013 and October of 2014. Anthropometric, clinical and biochemical parameters were measured and analyzed using protocols which were previously […]

Abstract Background: Mitral valve regurgitation (MR), present in up to 74% of the patients with severe aortic stenosis (AS), can be a negative prognostic factor when moderate or severe. The outcome of MR after percutaneous transcatheter aortic valve implantation (TAVI) and predictors associated with that outcome have not been well established in the literature. Objective: To assess the outcome of primary MR in patients submitted to TAVI and to identify associated factors. Methods: Observational study of patients with symptomatic severe […]

Abstract Background: Cell-derived microvesicles (MVs) are vesicles released from activated or apoptotic cells. However, the levels of MVs in myocardial infarction have been found inconsistent in researches. Objective: To assess the association between MVs and myocardial infarction by conducting a meta-analysis. Methods: A systematic literature search on PubMed, Embase, Cochran, Google Scholar electronic database was conducted. Comparison of the MVs levels between myocardial infarction patients and healthy persons were included in our study. Standard Mean Difference (SMD) and 95% confidence […]

Hypotension, bradycardia and renal dysfunction as obstacles to the treatment of heart failure Heart failure (HF) is a chronic, high morbidity and high cost disease. The treatment of HF due to left ventricular (LV) systolic dysfunction is well determined and is listed in Medical Guidelines. However, innumerable situations may limit treatment, causing the physician to fail to implement the guidelines. Some serious patients may not tolerate medications or recommended doses; others may have side effects. In some cases, however, there […]

Clinical aspects The patient was a 22-year-old male marathoner with fatal heart failure for 1 year. The clinical data reported were dyspnea and precordial discomfort on exertion. The patient maintained his trainings and running practice less intensely due to lower limb pain and weakness in the last months, until he was hospitalized due to chest pain, dyspnea, hemoptysis, mental confusion and syncope. During hospitalization, his clinical findings rapidly and progressively deteriorated. His electrocardiogram on admission revealed signs of right atrial […]

Introduction Variant angina is a form of angina pectoris caused by vasospasm of an epicardic coronary artery that results in myocardial ischemia that might be manifested by transient ST segment elevation on the electrocardiogram. Although it usually presents with chest pain, asymptomatic episodes are not rare., We report a case of an incidental diagnosis of asymptomatic coronary vasospam in a patient with polytrauma. […]

Case 55-year-old male with history of ischemic cardiomyopathy with previous percutaneous coronary intervention (PCI) in the anterior descending coronary artery (LAD) middle segment was admitted to our hospital for chest pains. A new coronary angiogram showed in-stent chronic total occlusion (ISCTO) of LAD receiving collaterals from right coronary artery (RCA). Left circumflex (LCX) was totally occluded and RCA presented a significant mid-segment lesion. Complete percutaneous revascularization was planned. First attempt to recanalize the LAD failed because the lesion obstructed the […]

Arq Bras Cardiol. 2017; [online].ahead print, PP.0-0 Consider correct authors’ affiliations Fábio Gazelato de Mello Franco,1 Antonio Gabriele Laurinavicius,2 Paulo A. Lotufo,3 Raquel D. Conceição,2 Fernando Morita,1 Marcelo Katz,1 Maurício Wajngarten,1 José Antonio Maluf Carvalho,1 Hayden B. Bosworth,5 Raul Dias Santos2,4 to the institutions: Hospital Israelita Albert Einstein;1 Centro de Medicina Preventiva e Programa de Cardiologia do Hospital Israelita Albert Einstein;2 Centro de Pesquisa Clínica e Epidemiológica da Universidade de São Paulo (USP);3 Unidade Clínica de Lípides Instituto do Coração […]