共查询到20条相似文献，搜索用时 515 毫秒
1.
Henrique Guedes Nuno Moreno Rui Pontes dos Santos Leonor Marques Daniel Seabra Adriana Pereira Aurora Andrade Paula Pinto 《Revista portuguesa de cardiologia》2018,37(4):333-338
Introduction and Aim
Myotonic dystrophy type 1 (DM1) is a multisystem disease in which cardiac involvement is common. The aim of this study was to identify early changes in left atrial (LA) mechanics and left ventricular (LV) systolic function in patients with myotonic dystrophy type 1 using three-dimensional (3D) speckle tracking echocardiography (3D-STE).Methods
This observational study included 25 patients with DM1 and 25 healthy volunteers. We assessed LA and LV global strain parameters using 3D-STE.Results
Patients with DM1 showed significantly lower longitudinal LA strain (22.85%±5.06 vs. 26.82%±5.15; p=0.008 in univariate analysis and p=0.026 in multivariate analysis) and global LV longitudinal strain (-13.55%±1.82 vs. -16.11%±1.33; p<0.001 in univariate analysis and p<0.001 in multivariate analysis), which was not observed with LA area tracking (p=0.412) or LV global circumferential strain (p=0.879), global radial strain (p=0.058), area tracking (p=0.092) or twist (p=0.992).Conclusion
LA and LV global longitudinal strain is significantly decreased in patients with DM1, which may be an early marker of subclinical dysfunction in these patients. 相似文献2.
Filipa Cordeiro Pedro Silva Mateus Sílvia Leão Miguel Moz Joana Trigo Catarina Ferreira Sofia Silva Carvalho Alberto Ferreira José Ilídio Moreira 《Revista portuguesa de cardiologia》2018,37(10):799-807
Introduction
We sought to assess the prognostic impact of left atrial (LA) size on long-term outcomes of ST-segment elevation myocardial infarction (STEMI).Methods
We studied 200 consecutive patients admitted to a single center between January 2010 and December 2014 with non-fatal STEMI treated with primary percutaneous coronary intervention (pPCI) who underwent a comprehensive echocardiographic examination at discharge. LA volume was estimated by the area-length method. The left atrium was classified as normal, mildly, moderately or severely enlarged by LA volume index (LAVI). The endpoints were defined as all-cause mortality, a cardiac composite endpoint (all-cause mortality, reinfarction, unplanned revascularization and hospitalization for heart failure) and a cardiovascular composite endpoint (cardiac endpoint plus atrial fibrillation and ischemic stroke) during follow-up.Results
In this STEMI population, 58% had normal LA size, 22.5% had mild LA enlargement, 10% had moderate LA enlargement and 9.5% had severe LA enlargement. During a median follow-up of 28 (IQR 21-38) months, 14 (7.0%) patients died, 53 (26.5%) had the cardiac and 58 (29%) the cardiovascular composite endpoints. There was a stepwise increase in the incidence of all-cause mortality (p=0.020) and both cardiac (p<0.001) and cardiovascular (p<0.001) endpoints with each increment of LAVI class. In multivariate analysis, severe LA enlargement by LAVI was an independent predictor of all-cause mortality (HR: 11.153; 95% CI: 1.924-64.642, p=0.007) and the cardiac (HR: 4.351; 95% CI: 1.919-9.862, p<0.001) and cardiovascular (HR: 4.351; 95% CI: 1.919-9.862, p<0.001) endpoints during follow-up.Conclusions
This contemporary study confirms the prognostic effect of LA size at discharge, applying the most recent reference values in STEMI patients treated with pPCI. 相似文献3.
Patricia Palau Eloy Domínguez Eduardo Núñez José María Ramón Laura López Joana Melero Juan Sanchis Alejandro Bellver Enrique Santas Antoni Bayes-Genis Francisco J. Chorro Julio Núñez 《Revista espa?ola de cardiología》2018,71(4):250-256
Introduction and objectives
Heart failure with preserved ejection fraction (HFpEF) is a highly prevalent syndrome with an elevated risk of morbidity and mortality. To date, there is scarce evidence on the role of peak exercise oxygen uptake (peak VO2) for predicting the morbidity burden in HFpEF. We sought to evaluate the association between peak VO2 and the risk of recurrent hospitalizations in patients with HFpEF.Methods
A total of 74 stable symptomatic patients with HFpEF underwent a cardiopulmonary exercise test between June 2012 and May 2016. A negative binomial regression method was used to determine the association between the percentage of predicted peak VO2 (pp-peak VO2) and recurrent hospitalizations. Risk estimates are reported as incidence rate ratios.Results
The mean age was 72.5 ± 9.1 years, 53% were women, and all patients were in New York Heart Association functional class II to III. Mean peak VO2 and median pp-peak VO2 were 10 ± 2.8 mL/min/kg and 60% (range, 47-67), respectively. During a median follow-up of 276 days [interquartile range, 153-1231], 84 all-cause hospitalizations in 31 patients (41.9%) were registered. A total of 15 (20.3%) deaths were also recorded. On multivariate analysis, accounting for mortality as a terminal event, pp-peak VO2 was independently and linearly associated with the risk of recurrent admission. Thus, and modeled as continuous, a 10% decrease of pp-peak VO2 increased the risk of recurrent hospitalizations by 32% (IRR, 1.32; 95%CI, 1.03-1.68; P = .028).Conclusions
In symptomatic elderly patients with HFpEF, pp-peak VO2 predicts all-cause recurrent admission.Full English text available from: www.revespcardiol.org/en 相似文献4.
Sílvia Aguiar Rosa Ana Agapito Rui M. Soares Lídia Sousa José Alberto Oliveira Ana Abreu Ana Sofia Silva Sandra Alves Helena Aidos Fátima F. Pinto Rui Cruz Ferreira 《Revista portuguesa de cardiologia》2018,37(5):399-405
Aim
The aim of the study was to compare functional capacity in different types of congenital heart disease (CHD), as assessed by cardiopulmonary exercise testing (CPET).Methods
A retrospective analysis was performed of adult patients with CHD who had undergone CPET in a single tertiary center. Diagnoses were divided into repaired tetralogy of Fallot, transposition of the great arteries (TGA) after Senning or Mustard procedures or congenitally corrected TGA, complex defects, shunts, left heart valve disease and right ventricular outflow tract obstruction.Results
We analyzed 154 CPET cases. There were significant differences between groups, with the lowest peak oxygen consumption (VO2) values seen in patients with cardiac shunts (39% with Eisenmenger physiology) (17.2±7.1 ml/kg/min, compared to 26.2±7.0 ml/kg/min in tetralogy of Fallot patients; p<0.001), the lowest percentage of predicted peak VO2 in complex heart defects (50.1±13.0%) and the highest minute ventilation/carbon dioxide production slope in cardiac shunts (38.4±13.4). Chronotropism was impaired in patients with complex defects. Eisenmenger syndrome (n=17) was associated with the lowest peak VO2 (16.9±4.8 vs. 23.6±7.8 ml/kg/min; p=0.001) and the highest minute ventilation/carbon dioxide production slope (44.8±14.7 vs. 31.0± 8.5; p=0.002). Age, cyanosis, CPET duration, peak systolic blood pressure, time to anaerobic threshold and heart rate at anaerobic threshold were predictors of the combined outcome of all-cause mortality and hospitalization for cardiac cause.Conclusion
Across the spectrum of CHD, cardiac shunts (particularly in those with Eisenmenger syndrome) and complex defects were associated with lower functional capacity and attenuated chronotropic response to exercise. 相似文献5.
Hai-jian Liu Jian Guo Qin-hua Zhao Lan Wang Wen-lan Yang Jing He Su-gang Gong Jin-ming Liu 《The American journal of the medical sciences》2017,353(3):216-223
Background
To study the relationship between chronotropic incompetence (CI) and disease severity and to assess the effect of CI on exercise capacity in patients with chronic obstructive pulmonary disease (COPD).Materials and Methods
Arterial blood gas analysis, pulmonary function test and cardiopulmonary exercise testing were conducted in 60 patients with stable COPD and 45 healthy volunteers. CI was defined using the chronotropic response index (CRI = (peak heart rate-resting heart rate) / (220-age-resting heart rate). Based on CRI, patients with COPD were divided into the normal chronotropic group (n = 23) and CI group (n = 37).Results
CI was present in 61.7% of the patients with COPD. Exercise capacity (peak oxygen uptake as percentage of predicted value, peak VO2%pred), peak heart rate and CRI were significantly lower in patients with COPD than in controls. However, resting heart rate was significantly higher than in controls. FEV1%pred and exercise capacity were significantly decreased in the CI group when compared with those in the normotropic group. There was significant association between CRI with FEV1%pred and peak VO2%pred. Multivariate regression analysis showed that CRI and FEV1%pred were independent predictors of exercise capacity in patients with COPD. A cutoff of 0.74 for the CRI showed a specificity of 94.1% in predicting patients with a peak VO2%pred < 60%.Conclusions
CRI was associated with disease severity in patients with COPD. CI may be an important parameter to reflect exercise capacity in patients with COPD. 相似文献6.
Lamiaa khedr Abdelfatah Elasfar Soha Hekal Ehab ElGendy Mohamed Abdulaal Hatem Elsokkary Medhat Ashmawy 《The Egyptian Heart Journal》2018,70(2):101-106
Objective
In patients with coronary artery disease (CAD), there are several studies that assessed the left ventricular (LV) function by strain (S) and strain rate (SR) imaging. The aim of this study is to evaluate the function of both atria in patients with CAD using strain and strain rate imaging, and to correlate this with the severity of CAD.Methods
We conducted a prospective, single center case control study for 40 consecutive patients who presented to our department with chronic stable angina and were candidates for invasive coronary angiography. We enrolled patients from December 2013 to May 2014 and each patient was subjected to echocardiographic assessment of E/e′ of mitral valve, left atrial volume index (LAVI), right atrial volume index (RAVI), and peak atrial longitudinal strain (es) and strain rate (SR) during LV systole. This was followed by invasive coronary angiography for assessment of the severity of CAD using Gensini score. Patients were classified according to angiographic results into 3 groups: Group I (Gensini score?=?zero), Group II (Gensini score?>?0 and?<?20) and Group III (Gensini score?≥?20).Results
There was no statistically significant difference between the three groups in either LA volumes (Vmin, Vmax) and distensibility with p value of 0.272, 0.126, and 0.243 respectively or RA volumes and distensibility with a p value of 0.671, 0.183, and 0.259 respectively. On the other hand, LA & RA systolic S and SR were significantly lower among CAD patients in comparison with the group of normal coronaries. Mean LA S and SR was decreased in group III than group II (15.97?±?3.73, 21.8?±?6.75 % and 1.11?±?0.30, 1.81?±?1.23?s?1) with p value of 0.005&0.041 respectively. RA systolic S and SR were significantly lower in the 2 groups with CAD than the group with normal coronaries with a p value of 0.001 and 0.002 respectively.Conclusion
In patients with CAD and normal EF, borderline E/e′ ratio and normal atrial size, there are decreased LA and RA systolic S and SR parameters with no effect on atrial volumes or distensibility. Accordingly, this could prove that atrial wall deformation occurs early in CAD even before any changes in atrial volumes or dimensions. 相似文献7.
Guilherme Pessoa-Amorim Jennifer Mancio Luís Vouga José Ribeiro Vasco Gama Nuno Bettencourt Ricardo Fontes-Carvalho 《Revista espa?ola de cardiología》2018,71(6):466-476
Introduction and objectives
Left atrial dysfunction in aortic stenosis may precede atrial enlargement and predict the occurrence of atrial fibrillation (AF). To test this hypothesis, we assessed left atrial function and determined its impact on the incidence of AF after aortic valve replacement.Methods
A total of 149 severe aortic stenosis patients (74 ± 8.6 years, 51% men) with no prior AF were assessed using speckle-tracking echocardiography. Left atrial function was evaluated using peak atrial longitudinal strain (PALS), peak atrial contraction strain (PACS), and phasic left atrial volumes. The occurrence of AF was monitored in 114 patients from surgery until hospital discharge.Results
In multiple linear regression, PALS and PACS were inversely correlated with left atrial dilation, left ventricular hypertrophy, and diastolic function. Atrial fibrillation occurred in 36 patients within a median time of 3 days [interquartile range, 1-4] after aortic valve replacement. In multiple Cox regression, PALS and PACS were independently associated with the incidence of AF (HR, 0.946; 95%CI, 0.910-0.983; P = .005 and HR, 0.932; 95%CI, 0.883-0.984; P = .011, respectively), even after further adjustment for left atrial dimensions. Both reduced PALS and PACS were associated with the incidence of AF in patients with nondilated left atria (P value for the interaction of PALS with left atrial dimensions = .013).Conclusions
In severe aortic stenosis, left atrial dysfunction predicted the incidence of postoperative AF independently of left atrial dilation, suggesting that speckle-tracking echocardiography before surgery may help in risk stratification, particularly in patients with nondilated left atria.Full English text available from: www.revespcardiol.org/en 相似文献8.
Hugo Marques Pedro de Araújo Gonçalves António Miguel Ferreira Rita Cruz João Lopes Rosana dos Santos Lucian Radu Francisco Costa João Mesquita Pedro Carmo Diogo Cavaco Leonor Parreira João Pisco João Goyri O’Neill Pedro Adragão 《Revista portuguesa de cardiologia》2018,37(11):873-883
Background
Cardiac computed tomography (CT) can provide a precise tridimentional anatomic map and exclude intra‐cardiac thrombus. We aimed to access the impact of CT protocol optimization and technological evolution on the contrast and radiation dose as well as on image quality previous to atrial fibrillation (AF) ablation.Methods
From a prospective registry of consecutive patients who underwent cardiac CT in a single center, we selected 270 patients in whom the CT was done for evaluation prior to AF ablation and they were distributed in 3 groups: Group1: the first 150 patients included; Group2: the last 60 patients performed with the same CT scanner; Group3: the first 60 exams performed with the new CT scanner. Quality of the protocol was access based on radiation dose, contrast volume used, the use of a second (delayed) acquisition, and on quantitative image quality analisis (signal to noise and contrast to noise ratios; density homogeneity racio between LA and LAA).Results
We found a significant radiation dose as well as contrast dose reduction between the first and last subgroups (G1: 5,6 mSv and 100 ml; G2: 1,3 mSv and 90 ml; G3: 0,6 mSv and 65 ml). Even though group 3 had less radiation and contrast used it still had better quantitative image quality (signal/noise of 13,5; contrast/noise 14,8; density homogeneity racio of 0,92).Conclusion
Protocol optimization and technology both contributed to significant lower radiation dose and contrast volume used on cardiac CTs prior to AF ablation, without compromising image quality. 相似文献9.
Cristiane Travensolo Karla Goessler Roberto Poton Roberta Ramos Pinto Marcos Doederlein Polito 《Revista portuguesa de cardiologia》2018,37(6):525-537
Introduction
The literature concerning the effects of cardiac rehabilitation (CR) on field tests results is inconsistent.Purpose
To perform a systematic review with meta‐analysis on field tests results after programs of CR.Methods
Studies published in PubMed and Web of Science databases until May 2016 were analyzed. The standard difference in means correct by bias (Hedges’ g) was used as effect size (g) to measure que amount of modifications in performance of field tests after CR period. Potential differences between subgroups were analyzed by Q‐test based on ANOVA.Results
Fifteen studies published between 1996 e 2016 were included in the review, 932 patients and age ranged 54,4 ‐ 75,3 years old. Fourteen studies used the six‐minutes walking test to evaluate the exercise capacity and one study used the Shuttle Walk Test. The random Hedges's g was 0.617 (P<0.001), representing a drop of 20% in the performance of field test after CR. The meta‐regression showed significantly association (P=0.01) to aerobic exercise duration, i.e., for each 1‐min increase in aerobic exercise duration, there is a 0.02 increase in effect size for performance in the field test.Conclusion
Field tests can detect physical modification after CR, and the large duration of aerobic exercise during CR was associated with a better result. 相似文献10.
Brian D. Hoit 《Current cardiology reports》2018,20(10):96
Purpose of Review
To review the current status of measuring left atrial functions with echocardiography and the ability of atrial functional analysis to predict cardiovascular outcomes.Recent Findings
An increasing body of data suggests that left atrium (LA) function assessed with echocardiography provides incremental prognostic information in general and referral populations, and in patients with atrial fibrillation, stroke, heart failure, and ischemic and valvular heart disease. In addition to volumetric analysis and spectral and tissue Doppler, deformational (strain and strain rate) imaging has most recently been used to assess LA reservoir, conduit, and booster pump functions and predict cardiovascular events.Summary
Studies of LA function provide new insights into the contribution of LA performance to cardiovascular disease and are promising tools for predicting cardiovascular events in healthy subjects and patients with heart disease. However, robust clinical outcome data from large prospective outcome trials are needed to confirm the incremental predictive ability of these LA functional measures before they are widely accepted.11.
Ana T. Timóteo Luísa M. Branco Sílvia A. Rosa Ana Galrinho Lídia Sousa José A. Oliveira Maria F. Pinto Ana F. Agapito Rui C. Ferreira 《Revista portuguesa de cardiologia》2018,37(9):739-745
Introduction
Transposition of the great arteries (TGA) is a rare form of congenital heart disease in which most patients reach adulthood. Right ventricular dysfunction is the most severe residual complication in long-term follow-up, both in patients treated by atrial switch and in those with congenitally corrected TGA. New echocardiographic tools such as longitudinal strain by two-dimensional (2D) speckle tracking may improve assessment of ventricular function in these patients.Methods and Results
We performed a retrospective analysis of echocardiograms in adult patients with TGA (26 patients with dextro-TGA – 15 treated by atrial switch and six by arterial switch – and five with congenitally corrected TGA) and in a control group of 14 healthy individuals. Right ventricular strain was significantly worse (p<0.001), as was the corresponding annular plane systolic excursion (p=0.010) in atrial switch patients, in comparison to arterial switch patients, while no differences were found in left ventricular parameters. In the overall population, systemic right ventricular parameters were significantly less negative than pulmonary right ventricular parameters, and these were less negative than in controls. Left ventricular parameters were similar across groups, except for pulmonary left ventricular strain, which was worse than in controls (p=0.008) as well as pulmonary right ventricular strain.Conclusions
Assessment of ventricular function in patients with TGA by 2D speckle tracking longitudinal strain is easy and feasible and may be a useful tool for serial follow-up. Of particular note, we found that there is also some degree of ventricular dysfunction even after re-establishment of normal connections. 相似文献12.
Khaled Mohamed Said Ahmed Ibrahim Nassar Ahmed Fouad Ali A. Ramzy Mustafa Fayed Fadle Abd Allah 《The Egyptian Heart Journal》2018,70(4):353-359
Background
Two-dimensional (2D) speckle-tracking strain imaging is a novel method for assessment of regional myocardial deformation that uses tracking of acoustic speckles or kernels rather than Doppler myocardial velocities. It has been suggested that Left atrial (LA) strain as measured by 2D speckle tracking can be used to evaluate dynamic LA function.Objective
To study the relation between left atrial deformation and the severity of coronary artery stenosis in patients with stable coronary artery disease (CAD).Study design
30 patients with stable coronary artery disease (SCAD) with coronary artery stenosis (>50%) who were admitted for elective coronary angiography at Ain Shams University hospitals and AlAzhar University hospitals were included in the study. Measurements of conventional echocardiographic parameters as well as LA strain and strain rate parameters were obtained, Syntax (SX) score was calculated for all patients.Results
Patients were categorized into 3 groups: low Syntax score of <23 (Group I), moderate syntax score 23–32 (Group II) and high syntax score of ≥33 (Group III). Peak atrial longitudinal strain (PALS) (Group I: 29.80?±?4.48, Group II: 22.44?±?1.42, Group III: 19.53?±?4.46; p?<?0.001) and Peak atrial contraction strain (PACS) (Group I: 13.43?±?4.05, Group II: 10.84?±?2.47, Group III: 7.19?±?0.71; p?<?0.022) were significantly lower in high syntax group. Significant negative correlation was found between SX score level and LA strain parameters (PALS and PACS) (r?=?0.861; p?<?0.001).Conclusion
Left atrial deformation analysis by 2D Speckle tracking Doppler Echocardiography can predict the severity of coronary affection in patients with stable CAD. 相似文献13.
Bassam Hennawy Wael El Kilany Haitham Galal Ahmed Mamdouh 《The Egyptian Heart Journal》2018,70(3):217-223
Background
Arterial hypertension adversely affects left atrial (LA) size and function, effect on function may precede effect on size. Many techniques were used to assess LA function but with pitfalls.Objectives
Early detection of left atrial dysfunction with speckle tracking echocardiography in hypertensive patients with normal left atrial size.Patients and methods
The study was conducted on 50 hypertensive patients and 50 age matched normotensive controls, all with normal LA volume index and free from any other cardiovascular disease that may affect the LA size or function. They were all subjected to history taking, clinical examination and echocardiographic study with assessment of LA functions [total LA stroke volume, LA expansion index by conventional 2D echocardiography and Global peak atrial longitudinal strain by speckle tracking (PALS)], left ventricular (LV) systolic and diastolic functions, and LV mass.Results
Different indices of LA dysfunction (Total LA stroke volume, LA expansion index and global PALS) were significantly lower in the hypertensive group despite the normal LA volume index in all the studied subjects. The presence of diabetes mellitus (DM) and higher grade of LV diastolic dysfunction were significantly associated with lower global PALS. The higher age, systolic blood pressure (BP), body mass index (BMI), LA volume index, and LV mass index and the lower LA expansion index were associated with lower global PALS.Conclusion
Speckle tracking echocardiography is a useful novel technique in detecting LA dysfunction in hypertension even before LA enlargement occurs. 相似文献14.
Liliana Reis Luís Paiva Marco Costa Joana Silva Rogério Teixeira Ana Botelho Paulo Dinis Marta Madeira Joana Ribeiro José Nascimento Lino Gonçalves 《Revista portuguesa de cardiologia》2018,37(9):763-772
Introduction
Percutaneous closure of the left atrial appendage (LAA) is a promising therapy in patients with atrial fibrillation with high risk for stroke and contraindication for oral anticoagulation (OAC). Intracardiac echocardiography (ICE) may make this percutaneous procedure feasible in patients in whom transesophageal echocardiography (TEE) is inadvisable. Our aim was to assess the efficacy and safety of LAA closure and the feasibility of ICE compared to TEE to guide the procedure.Methods
In this cohort study of patients who underwent LAA closure between May 2010 and January 2017, clinical and imaging assessment was performed before and after the procedure.Results
In 82 patients (mean age 74±8 years, 64.4% male) the contraindications for OAC were severe bleeding or anemia (65%), high bleeding risk (14%), labile INR (16%), or recurrent embolic events (5%). The procedural success rate was 96.3%. The procedure was guided by TEE or ICE, and no statistically significant differences were observed between the two techniques. During follow‐up, one patient had an ischemic stroke at 12 months, two had bleeding complications at six months, and there were four non‐cardiovascular deaths. Embolic and bleeding events were less frequent than expected from the observed CHA2DS2VASc (0.6% vs. 6.3%; p<0.001) and HAS‐BLED (1.2% vs. 4.1%; p<0.001) risk scores.Conclusions
In this population percutaneous LAA closure was shown to be safe and effective given the lower frequency of events than estimated by the CHA2DS2VASc and HAS‐BLED scores. The clinical and imaging results of procedures guided by ICE in the left atrium were not inferior to those guided by TEE. 相似文献15.
Dulce Brito Nuno Cardim Luís Rocha Lopes Adriana Belo Jorge Mimoso Lino Gonçalves Hugo Madeira 《Revista portuguesa de cardiologia》2018,37(6):457-466
Introduction
In adults, unexplained left ventricular hypertrophy is usually due to sarcomeric hypertrophic cardiomyopathy (HCM). Fabry disease (FD) is rare but may mimic sarcomeric HCM, and has an adverse prognosis in the absence of specific treatment. We aimed to assess cardiologists’ awareness of FD based on data from the Portuguese Registry of Hypertrophic Cardiomyopathy.Methods
A total of 811 index patients, aged 55 ± 16 years, 486 (59.9%) male, were included. Three groups were characterized: A – 128 patients, 74 (57.8%) male, with pathogenic or likely pathogenic mutation(s) in sarcomeric genes; B – 234 patients, 146 (62.4%) male, with negative genetic testing; and C – 449 patients, 266 (59.2%) male, no genetic testing performed. The groups were compared in terms of whether FD was excluded in the registry. Potential red flags for FD were also analyzed and compared between groups.Results
Patients in group A were younger and more frequently had familial HCM (A – 53.9% vs. B – 20.1% vs. C – 18.3%; p <0.001). FD was recorded as excluded in 217 (26.8%), similar in all groups; GLA gene testing was performed in only 50/217 patients (A – 48.6%, B – 25.7%, p = 0.019; C – 13.4%, p = 0.036 for B vs. C), mostly in women (p <0.001) in groups B and C. Alpha-galactosidase A (α-Gal A) activity was assessed in 39/217 (18%) patients, with no difference between groups, but more often in men (p = 0.005). Among patients with potential red flags for FD, only 46.7% underwent specific tests (GLA gene testing and/or α-Gal A activity). When GLA genotyping was performed no mutations were identified.Conclusions
There is a need to improve cardiologists’ alertness for the identification of FD among the Portuguese HCM population. 相似文献16.
Gabriel Vázquez-Oliva Alberto Zamora Rafel Ramos Isaac Subirana María Grau Irene R. Dégano Daniel Muñoz Montserrat Fitó Roberto Elosua Jaume Marrugat 《Revista espa?ola de cardiología》2018,71(11):910-916
Introduction and objectives
New biomarkers could improve the predictive capacity of classic risk functions. The aims of this study were to determine the association between circulating levels of apolipoprotein A1 (apoA1), apolipoprotein B (apoB), albumin, and 25-OH-vitamin D and coronary events and to analyze whether these biomarkers improve the predictive capacity of the Framingham-REGICOR risk function.Methods
A case-cohort study was designed. From an initial cohort of 5404 individuals aged 35 to 74 years with a 5-year follow-up, all the participants who had a coronary event (n = 117) and a random group of the cohort (subcohort; n = 667) were selected. Finally, 105 cases and 651 individuals representative of the cohort with an available biological sample were included. The events of interest were angina, fatal and nonfatal myocardial infarction and coronary deaths.Results
Case participants were older, had a higher proportion of men and cardiovascular risk factors, and showed higher levels of apoB and lower levels of apoA1, apoA1/apoB ratio, 25-OH-vitamin D and albumin than the subcohort. In multivariate analyses, plasma albumin concentration was the only biomarker independently associated with coronary events (HR, 0.73; P = .002). The inclusion of albumin in the risk function properly reclassified a significant proportion of individuals, especially in the intermediate risk group (net reclassification improvement, 32.3; P = .048).Conclusions
Plasma albumin levels are inversely associated with coronary risk and improve the predictive capacity of classic risk functions. 相似文献17.
Nuno Cardim Dulce Brito Luís Rocha Lopes António Freitas Carla Araújo Adriana Belo Lino Gonçalves Jorge Mimoso Iacopo Olivotto Perry Elliott Hugo Madeira 《Revista portuguesa de cardiologia》2018,37(1):1-10
Introduction
We report the results of the Portuguese Registry of Hypertrophic Cardiomyopathy, an initiative that reflects the current spectrum of cardiology centers throughout the territory of Portugal.Methods
A direct invitation to participate was sent to cardiology departments. Baseline and outcome data were collected.Results
A total of 29 centers participated and 1042 patients were recruited. Four centers recruited 49% of the patients, of whom 59% were male, and mean age at diagnosis was 53±16 years. Hypertrophic cardiomyopathy (HCM) was identified as familial in 33%. The major reason for diagnosis was symptoms (53%). HCM was obstructive in 35% of cases and genetic testing was performed in 51%. Invasive septal reduction therapy was offered to 8% (23% of obstructive patients). Most patients (84%) had an estimated five-year risk of sudden death of <6%. Thirteen percent received an implantable cardioverter-defibrillator. After a median follow-up of 3.3 years (interquartile range [P25-P75] 1.3-6.5 years), 31% were asymptomatic. All-cause mortality was 1.19%/year and cardiovascular mortality 0.65%/year. The incidence of heart failure-related death was 0.25%/year, of sudden cardiac death 0.22%/year and of stroke-related death 0.04%/year. Heart failure-related death plus heart transplantation occurred in 0.27%/year and sudden cardiac death plus equivalents occurred in 0.53%/year.Conclusions
Contemporary HCM in Portugal is characterized by relatively advanced age at diagnosis, and a high proportion of invasive treatment of obstructive forms. Long-term mortality is low; heart failure is the most common cause of death followed by sudden cardiac death. However, the burden of morbidity remains considerable, emphasizing the need for disease-specific treatments that impact the natural history of the disease. 相似文献18.
A.O. Grøn E.-M. Dalsgaard A.R. Ribe S. Seidu G. Mora A.M. Cebrián-Cuenca M. Charles 《Primary Care Diabetes》2018,12(4):289-304
Background and aim
Individuals with severe mental illness (SMI) who suffer from type 2 diabetes (T2DM) are likely to be sub-optimally treated for their physical condition. This study aimed to review the effect of interventions in this population.Methods
A systematic search in five databases was conducted in July 2017.Results
Seven studies on multi-faced interventions were included. These comprised nutrition and exercise counselling, behavioural modelling and increased disease awareness aiming to reduce HbA1c, fasting plasma glucose, body mass index and weight.Conclusion
Non-pharmacologic interventions in individuals with SMI and T2DM could possibly improve measures of diabetes care, although with limited clinical impact. 相似文献19.
《Clinical cardiology》2017,40(12):1323-1327
Background
Previous studies demonstrated that left atrium (LA) size is associated with mortality in an elderly population. It remains unclear whether indices of LA function including reservoir, conduit, or booster elements of LA function provide incremental prognostic information.Hypothesis
Echocardiographic measures of the various parameters of LA function would predict 5‐year mortality in a community‐dwelling population of 85 to 86 year olds independently of LA volume.Methods
Subjects ages 85 to 86 years old underwent home echocardiography. LA volumes were assessed by the biplane Simpson's method from apical views using measurements of phasic volumes and functions of the LA, including LA expansion index. LA passive and active emptying fractions were assessed. Survival status at 5‐year follow‐up was assessed.Results
Two hundred eighty‐two subjects were included, of whom 87 (31%) had died at follow‐up. Survival of the subjects in the lowest quartile of the LA expansion index as well as LA active filling index was significantly lower. When measurements of LA volume index were added to the model, the relationship between survival and indices of LA function remained significant.Conclusions
This study demonstrated that elderly subjects aged 85 to 86 years with significantly impaired LA function had increased 5‐year mortality independently of indices of LA volume.20.
João de Sousa Pedro Marques Vítor Martins António Hipólito-Reis Luís Duarte Inês Joaquim Diogo Monteiro Giuseppe Boriani Claudia Wolff Andrea Grammatico Luigi Padeletti 《Revista portuguesa de cardiologia》2018,37(12):973-978