Abnormal parasympathetic activity on the heart has been implicated in several forms of symptomatic bradycardia, especially in young and otherwise healthy individuals. Neurally mediated syncope, sinus arrest and advanced atrioventricular (AV) block have high risk of injury and serious implications on quality of life. Nonetheless, until recently, their clinical management, mainly based on behavioral measures and pacing, have often proved to be ineffective or inadequate. An alternative approach to treat this specific population, avoiding device implants and continuous drug therapy […]

Systemic arterial hypertension – or simply hypertension, in casual language – is considered the major and most common risk factor for death and disability of non-communicable diseases., Its prevalence in Europe ranges from 30% to 45%. In the United States, two thirds of the adults older than 60 years are hypertensive. In South Asia and Sub-Saharan Africa, hypertension has increased rapidly. Recently, the world prevalence of hypertension was estimated at 31%. The last three decades have witnessed the development of […]

Introduction The World Health Organization (WHO) goal to reduce mortality due to chronic non-communicable diseases (CNCD) by 2% per year requires a huge effort from countries.–This challenge for health professionals asks for a global political action on control of social measures, with cost-effective population interventions to reduce CNCD and their risk factors (RF). Health professionals should demand from their government the implementation of acceptable cost measures, such as tobacco cessation counseling, guidance on healthy feeding practices and need for regular […]

Abstract Background: Although a proportion of CSX patients have impaired brachial artery flow-mediated dilatation (FMD) in response to hyperemia, suggesting that endothelial dysfunction in these patients may be systemic and not just confined to the coronary circulation; the underlying mechanisms triggering endothelial dysfunction in these patients are still incompletely understood. Objectives: To assess the association of the index of Microcirculatory Resistance (IMR) with endothelial dysfunction and inflammation in patients with CSX. Methods: We studied 20 CSX patients and 20 age […]

Abstract Background: Hyperlipidemia, which is characterized by an elevation of lipids in the bloodstream, is a major risk factor for cardiac disease. Objectives: The present study investigated the role of fibrosis in the progression of hyperlipidemia in the mice heart, and whether mast cell activation was associated with the fibrosis process. Methods: Hyperlipidemia was produced in C57BL / 6 mice by feeding them on a high-fat diet for 8 weeks.To assess tissue fibrosis, picrosirius red staining was performed. Hematoxylin & […]

Abstract Background: Systemic sclerosis (SS) is a connective tissue abnormality characterized by fibrosis of the skin and internal organs. Cardiac involvement with consequent myocardial dysfunction in SS is associated with increased morbidity and mortality. Objective: To investigate the left ventricular (LV) diastolic function in patients with SS and preserved systolic function. Methods: Patients with SS were evaluated with two-dimensional echocardiography with tissue Doppler for analysis of chamber diameters, LV mass index (LVMI), indexed left atrial volume (iLAV), systolic function of […]

Abstract Background: The electrocardiogram (ECG) is widely used in population-based studies. However, there are few studies on electrocardiographic findings in Latin America and in Brazil. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) comprised 15,105 participants (35-74 years) from six Brazilian capitals. Objectives: To describe electrocardiographic findings in Brazilian adults without heart disease, stratified by sex, age and race/skin color. Methods: Cross-sectional study with baseline data of 11,094 adults (44.5% men) without heart disease from ELSA-Brasil. The ECGs were recorded […]

Abstract Background: Angiotensin II (Ang II), the primary effector hormone of the renin-angiotensin system (RAS), acts systemically or locally, being produced by the action of angiotensin-converting-enzyme (ACE) on angiotensin I. Although several tissue RASs, such as cardiac RAS, have been described, little is known about the presence of an RAS in the pericardial fluid and its possible sources. Locally produced Ang II has paracrine and autocrine effects, inducing left ventricular hypertrophy, fibrosis, heart failure and cardiac dysfunction. Because of the […]

Abstract Background: Different types of high-fat and/or high-energy diets have been used to induce obesity in rodents. However, few studies have reported on the effects observed at the initial stage of obesity induced by high-fat feeding on cardiac functional and structural remodelling. Objective: To characterize the initial moment of obesity and investigate both metabolic and cardiac parameters. In addition, the role of Ca2+ handling in short-term exposure to obesity was verified. Methods: Thirty-day-old male Wistar rats were randomized into two […]

Abstract Background: Left atrial appendage closure (LAAC) is an effective alternative to oral anticoagulation (OA) for the prevention of stroke in patients with non-valvular atrial fibrillation (NVAF). Objective: To present the immediate results and late outcomes of patients submitted to LAAC and included in the Brazilian Registry of Percutaneous Left Atrial Appendage Closure. Methods: 91 patients with NVAF, high stroke risk (CHA2DS2VASc score = 4.5 ± 1.5) and restrictions to OAC (HAS-BLED score = 3.6 ± 1.0) underwent 92 LAAC […]

Abstract Background: Endostatin is a circulating endogenous angiogenesis inhibitor preventing neovascularization. Previous studies demonstrated the prognostic value of Endostatin among patients with heart failure with reduced ejection fraction (HFrEF). However, the role of Endostatin among patients with heart failure with preserved ejection fraction (HFpEF) remains unclear. Objective: This study aimed to investigate the association between serum Endostatin levels, natriuretic peptide levels and the severity of left ventricular diastolic dysfunction and the diagnosis of HFpEF. Methods: Endostatin serum concentrations were measured […]

Abstract Background: International studies have reported the value of the clinical profile and laboratory findings in the diagnosis of constrictive pericarditis. However, Brazilian population data are scarce. Objective: To assess the clinical characteristics, sensitivity of imaging tests and factors related to the death of patients with constrictive pericarditis undergoing pericardiectomy. Methods: Patients with constrictive pericarditis surgically confirmed were retrospectively assessed regarding their clinical and laboratory variables. Two methods were used: transthoracic echocardiography and cardiac magnetic resonance imaging. Mortality predictors were […]

Abstract Background: Data are scarce regarding disparities in cardiovascular risk factor management between patients treated with percutaneous coronary intervention (PCI) and those treated with coronary artery bypass grafting (CABG). Objective: Whether the goal achievement rates of cardiovascular risk factors were different between PCI and CABG patients. Methods: We retrospectively reviewed the data retrieved from a clinical record database of patients admitted to Beijing Anzhen Hospital between January 1, 2014, and December 31, 2014, who underwent PCI or CABG. Results: Compared […]

Abstract Phytosterols are bioactive compounds found in foods of plant origin, which can be divided into plant sterols and plant stanols. Clinical studies consistently indicate that the intake of phytosterols (2 g/day) is associated with a significant reduction (8-10%) in levels of low-density lipoprotein cholesterol (LDL-cholesterol). Thus, several guidelines recommend the intake of 2 g/day of plant sterols and/or stanols in order to reduce LDL-cholesterol levels. As the typical western diet contains only about 300 mg/day of phytosterols, foods enriched […]

Critical analysis The diagnostic criteria described by Jenni et al. and Chin et al. are based on the measurement of NCM and CM thicknesses. However, the criteria differ regarding the cardiac cycle point at which the measurements should be taken. Chin et al. propose the measurements of NCM and CM thickness be performed at end-diastole, while Jenni et al. propose them at end-systole. The criteria proposed by Jenni et al. used an NCM/CM ratio > 2 at end-systole, generating higher […]

Additional Examinations Electrocardiogram: sinus rhythm, without cavitary overloads, complete right bundle branch block and 1st degree atrioventricular block. PR: 0.22, QRS: 0.109 with complexes rSr´ in V1 and RS in V6; AP = + 0º, AQRS = + 220º, AT = + 66º. Chest X-ray: normal cardiac area (cardiothoracic index = 0.50) and linear vascular image with increased density bordering the ventricular arch (). […]

Introduction From the earliest days of the heart surgery, the valves, when the reparation was not possible, were replaced by prosthetics using cardiopulmonary bypass. The good results of these procedures are well known. In the recent years, minimally invasive alternatives have been developed, aiming to make possible the treatment of individuals under high risk of complications and death caused by the conventional procedure. In 2002, the first transcatheter valvar implantation was made, which revolutionized the treatment of severe aortic stenosis. […]

A 68-year-old woman was admitted in our acute cardiac care unit due to cardiogenic shock. The transthoracic echocardiography (TTE) showed severe aortic stenosis, severe left ventricle (LV) systolic dysfunction (ejection fraction 20%) and a large apical thrombus (). We performed an emergent percutaneous aortic balloon valvuloplasty (). During the procedure, the coronary angiography revealed no epicardial coronary disease (). Despite some mild clinical and hemodynamic improvement (mean gradient reduced from 40 to 30 mmHg), she remained in New York Heart […]

Dear Editor, I have read the article entitled “Which Coronary Lesions Are More Prone to Cause Acute Myocardial Infarction?” by Sen et al. with great interest, recently published in journal. The investigators reported that more than 70% of the patients with acute myocardial infarction (MI) had coronary collateral circulation (CCC) with Rentrop scores of 1-3 during primary coronary angiography. This shows that most cases of acute MI in our study originated from underlying high-grade stenosis, challenging the common believe. Higher […]

Edition of August 2017, vol. 109 (2), Supl. 1, p. 1-76 In the “Atualização da Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose – 2017”, published as a supplement to the Arquivos Brasileiros de Cardiologia [Arq Bras Cardiol 2017; 109(2Supl.1):1-76], the following corrections should be considered: […]