The endothelium is considered an active and dynamic tissue with important properties such as maintenance of blood circulation, regulation of vascular tone, microvascular permeability, signaling, and vascular angiogenesis and inflammatory response. The endothelium allows the connection among components of the circulation and body systems. Endothelial cells produce and, depending on the stimulus received, release factors that lead to vascular smooth muscle cells contraction or relaxation. Vascular tone control by the endothelium is modulated by the production and release of mediators […]

Abstract Background: There are limited data on the prognosis of deferral of lesion treatment in patients with acute coronary syndrome (ACS) based on fractional flow reserve (FFR). Objectives: To provide a systematic review of the current evidence on the prognosis of deferred lesions in ACS patients compared with deferred lesions in non-ACS patients, on the basis of FFR. Methods: We searched Medline, EMBASE, and the Cochrane Library for studies published between January 2000 and September 2017 that compared prognosis of […]

Abstract Background: Percutaneous coronary intervention (PCI) is the most frequently used invasive therapy for ischemic heart disease (IHD). Studies able to provide information about PCI’s effectiveness should be conducted in a population of real-world patients. Objectives: To assess the survival rate of IHD patients treated with PCI in the state of Rio de Janeiro (RJ). Methods: Administrative (1999-2010) and death (1999-2014) databases of dwellers aged ≥ 20 years old in the state of RJ submitted to one single PCI paid […]

Abstract Background: Restenosis after percutaneous coronary intervention in coronary heart disease remains an unsolved problem. Clusterin (CLU) (or Apolipoprotein [Apo] J) levels have been reported to be elevated during the progression of postangioplasty restenosis and atherosclerosis. However, its role in neointimal hyperplasia is still controversial. Objective: To elucidate the role Apo J in neointimal hyperplasia in a rat carotid artery model in vivo with or without rosuvastatin administration. Methods: Male Wistar rats were randomly divided into three groups: the control […]

Abstract Background: Congenital heart defects (CHD), as the most common congenital anomaly, have been reported to be associated with chromosomal abnormalities. Currently, patients with CHD are routinely offered karyotyping and chromosomal microarray (CMA) testing, but the genotype-phenotype relationship has not yet been fully established. Objective: To determine the type and frequency of chromosomal abnormalities in fetuses with CHD and to analyze pregnancy outcomes of fetuses with heart abnormalities caused by different genetic factors. Methods: A total of 362 cases of […]

Abstract Background: Genetic cascade screening is the most cost-effective method for the identification of individuals with familial hypercholesterolemia (FH), but the best strategies for the enrollment of at-risk individuals in a FH screening program are not fully known. Objective: The aim of this study is to identify the best predictors of familial enrollment into genetic screening, using features derived from tested probands. Methods: One hundred and eighty-three index-cases (ICs) with a positive genetic result that had relatives screened from 01/2011 […]

Abstract Background: In patients with acute ST-segment elevation myocardial infarction (STEMI), the time elapsed from symptom onset to receiving medical care is one of the main mortality predictors. Objective: To identify independent predictors of late presentation in patients STEMI representative of daily clinical practice. Methods: All patients admitted with a diagnosis of STEMI in a reference center between December 2009 and November 2014 were evaluated and prospectively followed during hospitalization and for 30 days after discharge. Late presentation was defined […]

Abstract Background: The current guidelines dispose recommendations to manage antiplatelet agents in the perioperative period; however, the daily medical practices lack standardization. Objectives: To asses factors associated with inadequate management of antiplatelet agents in the perioperative period of non-cardiac surgeries. Methods: Cross-sectional Study conducted in hospital from October 2014 to October 2016. The study dependent variable was a therapy that did not comply with the recommendations in the Brazilian Association of Cardiology (SBC) guidelines. The independent variables included some characteristics, […]

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 […]

Abstract Severe carotid atherosclerotic disease is responsible for 14% of all strokes, which result in a high rate of morbidity and mortality. In recent years, advances in clinical treatment of cardiovascular diseases have resulted in a significant decrease in mortality due to these causes. To review the main studies on carotid revascularization, evaluating the relationship between risks and benefits of this procedure. The data reviewed show that, for a net benefit, carotid intervention should only be performed in cases of […]

Globalization has left its mark on the 21st century. One of the many ways of defining globalization is as the integration of information, communication, and economy on a worldwide scale, with a direct influence on all levels of higher education. In this manner, the internationalization of postgraduation may be seen as a response to globalization, taking shape in the form of programs and policies put in place by academic institutions and governments in order to increase student and faculty exchanges […]

Clinical aspects The case reported is of a 36-year-old pregnant woman with repaired complex congenital heart disease, with a mechanical mitral valve prosthesis implanted 28 years before, paroxysmal atrial fibrillation, and a history of thromboembolism, a triad that characterizes a high thromboembolic risk. Notwithstanding, the patient maintained the adequate anticoagulation goal (INR = 3) until the pregnancy diagnosis, when the anticoagulation regimen of warfarin was replaced by enoxaparin due to the risk of fetal warfarin syndrome, which occurs between the […]

Introduction Evaluating patients with multivessel coronary disease using myocardial perfusion scintigraphy (MPS) remains a challenge as the extent and severity of the disease can be underestimated. This phenomenon occurs in part due to balanced ischemia and inaccuracy of traditional devices to identify small changes in coronary flow in the stress phase., New gamma cameras with cadmium and zinc telluride (CZT) detectors that are already commercially available have shown higher temporal and spatial resolution,– theoretically enabling dynamic acquisition of images and […]

A fifty-two-year-old Caucasian woman was admitted for severe epigastric pain irradiating to the back. Physical examination and electrocardiogram were normal. Laboratory tests showed leucocytosis (11100 cells/uL) and increased levels of C-reactive protein (15.6 mg/dl). Due to the suspicion of acute aortic syndrome (AAS), she underwent computed tomography (CT), which showed a low attenuation circumferential mural thickening of the aorta (43 Hounsfield units (HU)), which enhanced (73 HU) after contrast administration (-), suggestive of aortitis. Transesophageal echocardiogram also revealed thickened thoracic […]

We read with interest the article by Bassi et al., titled “Effects of Coexistence Hypertension and Type II Diabetes on Heart Rate Variability and Cardiorespiratory Fitness”, published in the issue of July 2018. The authors investigated the influence of systemic hypertension on cardiac autonomic modulation in patients with type 2 diabetes mellitus (T2DM) and assessed the heart rate variability (HRV) on exercise capacity in these patients. They concluded that hypertension negatively affects cardiac autonomic function, with greater impairment in HRV, […]

September issue of 2017, vol. 109 (3), Suppl. 1, pages 1-104 In “3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology”, consider Marcondes-Braga FG as the correct form for the name of the author Fabiana Goulart Marcondes Braga. […]