Browsing by Author "Cyrne-Carvalho, H."
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- Coronary artery fistula presenting as unstable anginaPublication . Silva-Vieira, M.; Antunes, M.; Anjo, D.; Palma, P.; Cyrne-Carvalho, H.; Torres, S.
- ENCERRAMENTO PERCUTÂNEO DE COMUNICAÇÃO INTERAURICULAR E FORAMEN OVALE PATENTE EM ADULTOS – A EXPERIÊNCIA DE UM CENTROPublication . Vieira, M.; Dias, V.; Meireles, A.; Gomes, C.; Antunes, N.; Anjo, D.; Guedes, R.; Oliveira, F.; Cabral, S.; Pereira, L.; Braga, P.; Cyrne-Carvalho, H.; Torres, S.
- High Sensitivity Troponin T: A Biomarker of Ventricular Wall Stress in Acutely Decompensated Heart FailurePublication . Ferreira, J.; Santos, M.; Almeida, S.; Marques, I.; Bettencourt, P.; Cyrne-Carvalho, H.
- High-Sensitivity Troponin T: A Biomarker for Diuretic Response in Decompensated Heart Failure PatientsPublication . Ferreira, J.; Santos, M.; Almeida, S.; Marques, I; Bettencourt, P.; Cyrne-Carvalho, H.Background. Patients presenting with acutely decompensated heart failure (ADHF) and positive circulating cardiac troponins were found to be a high-risk cohort. The advent of high-sensitive troponins resulted in a detection of positive troponins in a great proportion of heart failure patients. However, the pathophysiological significance of this phenomenon is not completely clear. Objectives. The aim of this study is to determine the early evolution and clinical significance of high-sensitivity troponin T (hsTnT) in ADHF. Methods. Retrospective, secondary analysis of a prospective study including 100 patients with ADHF. Results. Globally, high-sensitivity troponin T decreased from day 1 to day 3 (P = 0,039). However, in the subgroup of patients who remained decompensated no significant differences in hsTnT from day 1 to day 3 were observed (P = 0,955), whereas in successfully compensated patients a significant reduction in hsTnT levels was observed (P = 0,025). High-sensitivity troponin T decrease was correlated with NTproBNP reduction (P = 0,007). Patients with hsTnT increase had longer length of stay (P = 0,033). Conclusions. Episodes of ADHF are associated with transient increases in the blood levels of hsTnT that are reduced with effective acute episode treatment. The decrease in hsTnT can translate less myocardial damage along with favourable ADHF treatment.
- HOME MONITORING SYSTEM EM DOENTES COM POLINEUROPATIA AMILOIDÓTICA FAMILIARPublication . Vieira, M.; Dias, V.; Meireles, A.; Gomes, C.; Antunes, N.; Anjo, D.; Roque, C.; Reis, H.; Lagarto, V.; Cyrne-Carvalho, H.; Torres, S.
- Influence of spironolactone on matrix metalloproteinase-2 in acute decompensated heart failurePublication . Ferreira, J.; Santos, M.; Oliveira, J.; Marques, I.; Bettencourt, P.; Cyrne-Carvalho, H.Matrix metalloproteinases (MMPs) are a family of enzymes important for the resorption of extracellular matrices, control of vascular remodeling and repair. Increased activity of MMP2 has been demonstrated in heart failure, and in acutely decompensated heart failure (ADHF) a decrease in circulating MMPs has been demonstrated along with successful treatment.
- Mineralocorticoid Receptor Antagonism in Acutely Decompensated Chronic Heart FailurePublication . Ferreira, J.; Santos, M.; Almeida, S.; Marques, I.; Bettencourt, P.; Cyrne-Carvalho, H.
- Mineralocorticoid receptor antagonism in acutely decompensated chronic heart failurePublication . Ferreira, J.P.; Santos, M.; Almeida, S.; Marques, I.; Bettencourt, P.; Cyrne-Carvalho, H.
- Mineralocorticoid receptor antagonism in acutely decompensated chronic heart failurePublication . Ferreira, J.; Santos, M.; Almeida, S.; Marques, I.; Bettencourt, P.; Cyrne-Carvalho, H.Spironolactone was likely to provide faster congestion relief. -------------------------------------------------------------------------------- Abstract Background/objectives Mineralocorticoid receptor antagonist (MRA) use in acutely decompensated chronic heart failure (ADCHF) may improve congestion through diuretic effect and prevent neurohormonal activation. We aimed to evaluate the clinical effect and safety of spironolactone in ADCHF. Methods Prospective, experimental, single-center, and single-blinded trial. Patients were treated with: standard ADCHF therapy or oral spironolactone 50–100 mg/d plus standard ADCHF therapy. Results During a 1 year period, 100 patients were enrolled, 50 included in the treatment group. Mean (SD) spironolactone dose (mg) at day 1 was 94.5 ± 23.3 and at day 3 was 62.7 ± 24.3. Worsening renal function (increase in pCr ≥ 0.3 mg/dL from day 1 to day 3) was more likely to occur in control group (20% vs. 4%; p = 0.038), serum potassium did not differ between groups, and plasma NTproBNP had a significant decrease in spironolactone group at day 3 (median [IQR], 2488 [4579] vs. 1555 [1832]; p = 0.05). Furthermore, a greater proportion of patients in the treatment group were free of congestion at day 3: less edema, rales, jugular venous pressure (JVP) and orthopnea (all, p < 0.05). In addition, a significantly higher proportion of patients were on oral furosemide at day 3 (44% vs. 82%; p < 0.001). Conclusions Our study supports the safety of high dose spironolactone in ADCHF and suggests a positive impact in the resolution of congestion. The important findings of our pilot study need to be confirmed in larger trials.
- Mineralocorticoid Receptor Antagonism in Acutely Decompensated Chronic Heart FailurePublication . Ferreira, J.; Santos, M.; Almeida, S.; Marques, I.; Bettencourt, P.; Cyrne-Carvalho, H.
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