SC - Artigos publicados em revistas indexadas na Pubmed/Medline
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- Study on COgnition and Prognosis in the Elderly (SCOPE): baseline characteristicsPublication . HANSSON, L.; LITHELL, H.; SKOOG, I.; BARO, F.; BANKI, C.M.; BRETELER, M.; CASTAIGNE, A.; CORREIA, M.; DEGAUTE, J.P.; ELMFELDT, D.; ENGEDAL, K.; FARSANG, C.; FERRO, J.; HACHINSKI, V.; HOFMAN, A.; JAMES, O.F.; KRISIN, E.; LEEMAN, M.; DE LEEUW, P.W.; LEYS, D.; LOBO, A.; NORDBY, G.; OLOFSSON, B.; OPOLSKI, G.; PRINCE, M.; REISCHIES, F.M.Blood Press. 2000;9(2-3):146-51. Study on COgnition and Prognosis in the Elderly (SCOPE): baseline characteristics. Hansson L, Lithell H, Skoog I, Baro F, Bánki CM, Breteler M, Castaigne A, Correia M, Degaute JP, Elmfeldt D, Engedal K, Farsang C, Ferro J, Hachinski V, Hofman A, James OF, Krisin E, Leeman M, de Leeuw PW, Leys D, Lobo A, Nordby G, Olofsson B, Opolski G, Prince M, Reischies FM. University of Uppsala, Department of Public Health, Clinical Hypertension Research, Sweden. Abstract The Study on COgnition and Prognosis in the Elderly (SCOPE) is a multi-centre, prospective, randomized, double-blind, parallel-group study. The primary objective of SCOPE is to assess the effect of the angiotensin II type 1 (AT1) receptor blocker, candesartan cilexetil 8-16 mg once daily, on major cardiovascular events in elderly patients (70-89 years of age) with mild hypertension (DBP 90-99 and/or SBP 160-179 mmHg). The secondary objectives of the study are to test the hypothesis that antihypertensive therapy can prevent cognitive decline (as measured by the Mini Mental State Examination, MMSE) and dementia, and to assess the effect of therapy on total mortality, myocardial infarction (MI), stroke, renal function, and hospitalization. A total of 4964 patients from 15 participating countries were recruited during the randomization phase of SCOPE, exceeding the target population of 4000. The mean age of the patients at enrolment was 76 years, the ratio of male to female patients was approximately 1:2, and 52% of patients were already being treated with an antihypertensive agent at enrolment. The majority of patients (88%) were educated to at least primary school level. At randomization, mean sitting blood pressure values were SBP 166 mmHg and DBP 90 mmHg, and the mean MMSE score was 28. Previous cardiovascular disease in the study population included myocardial infarction (4%), stroke (4%) and atrial fibrillation (4%). Men, more often than women, had a history of previous MI, stroke and atrial fibrillation. A greater percentage of men were smokers (13% vs 6% in women) and had attended university (11% vs 3% of women). Of the randomized patients, 21% were 80 years of age. In this age group smoking was less common (4% vs 10% for 70-79-year-olds) and fewer had attended university (4% vs 7% for 70-79-year-olds). The incidence of MI was similar in both age groups. However, stroke and atrial fibrillation had occurred approximately twice as frequently in the older patients. The patients' mean age at baseline was similar in the participating countries, and most countries showed the approximate 1:2 ratio for male to female patients. There was also little inter-country variation in terms of mean SBP, DBP or MMSE score. However, there was considerable regional variation in the percentage of patients on therapy prior to enrolment. PMID: 10855739 [PubMed - indexed for MEDLINE]
- Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of CardiologyPublication . NIEMINEN MS.; BOHM M.; COWIE M.; DREXLER H.; FILIPPATOS G.; JONDEAU G.; HASIN Y.; LOPEZSENDON J.; MEBAZAA A.; METRA M.; RHODES A.; SWEDBERG K.; PRIORI S.; GARCIA M.; BLANC J.; BUDAJ A.; COWIE M.; DEAN V.; DECKERS J.; BURGOS E.; LEKAKIS J.; LINDAHL B.; MAZZOTTA G.; MORAIS J.; OTO A.; SMISETH O.; GARCIA M.; DICKSTEIN K.; ALBUQUERQUE A.; CONTHE P.; CRESPO‐LEIRO M.; FERRARI R.; FOLLATH F.; GAVAZZI A.; JANSSENS U.; KOMAJDA M.; MORAIS J.; MORENO R.; SINGER M.; SINGH S.; TENDERA M.; THYGESEN K.; ESC COMMITTE FOR PRACTICE GUIDELINE (CPG)We found 1 article: Eur Heart J. 2005 Feb;26(4):384-416. Epub 2005 Jan 28. Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology. Nieminen MS, Böhm M, Cowie MR, Drexler H, Filippatos GS, Jondeau G, Hasin Y, Lopez-Sendon J, Mebazaa A, Metra M, Rhodes A, Swedberg K, Priori SG, Garcia MA, Blanc JJ, Budaj A, Cowie MR, Dean V, Deckers J, Burgos EF, Lekakis J, Lindahl B, Mazzotta G, Morais J, Oto A, Smiseth OA, Garcia MA, Dickstein K, Albuquerque A, Conthe P, Crespo-Leiro M, Ferrari R, Follath F, Gavazzi A, Janssens U, Komajda M, Morais J, Moreno R, Singer M, Singh S, Tendera M, Thygesen K; ESC Committe for Practice Guideline (CPG). Division of Cardiology, Helsinki University Central Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland. markku.nieminen@hus.fi PMID: 15681577 [PubMed - indexed for MEDLINE]Free Article
- Deaths from ischemic disease, anthropometry and cardiac biometryPublication . LEAL, A.; OLIVEIRA, J.; AMADO, J.; GOMES, L.; MAGALHAES, T.Rev Port Cardiol. 2005 Apr;24(4):521-30. Deaths from ischemic disease, anthropometry and cardiac biometry. [Article in English, Portuguese] Leal A, Oliveira J, Amado J, Gomes L, Magalhães T. Instituto de Ciencias Biomédicas Abel Salazar-Saúde Comunitária, Porto, Portugal. antl@clix.pt Abstract INTRODUCTION: The relation between body mass index (BMI)/obesity and left ventricular hypertrophy (LVH) in ischemic heart disease (IHD) has not been completely established, based on postmortem studies. OBJECTIVE: To study necropsy data of deaths from cardiac ischemia and its relation to macroscopic data of the heart and anthropometry. METHOD: Retrospective study of necropsies conducted by the medical legal services of Porto in 2002-03, with a final diagnosis of "myocardial infarction" or "chronic ischemic heart disease" or with more than 50% obstructive coronary disease. An observation grid was compiled from the necropsy data, with emphasis on anthropometry and cardiac exam. Descriptive and inferential methods (Pearson's correlation, the chi-square test and stepwise multiple regression) were used for the statistical analysis (alpha = 0.05). RESULTS: Of the 231 selected cases, 75.3% were men, of whom 53.7% were diagnosed with myocardial infarction and 46.3% with IHD, with BMI of 26.9 +/- 5.1, body weight of 74.7 +/- 19.9 kg, left ventricular thickness of 16.9 +/- 4.7 mm, and cardiac weight of 517 +/- 163 g. Significant negative correlations (p < 0.001) were found between age, body weight (-0.33), height (-0.33), and BMI (-0.21) and positive correlations between cardiac weight, body weight (0.35), height (0.24), BMI (0.26), and LVH (0.29). Significant differences were found between genders with regard to age, weight, height and heart weight, but no differences in terms of years of education, BMI or left ventricular thickness. Stepwise regression found two predictive variables for heart weight: body weight, accounting for 12.1%, with age increasing this to 15.4%. CONCLUSION: These results seem to confirm objectively by postmortem examination that high values of BMI and body weight, left ventricular hypertrophy and cardiac weight correlate with IHD, with important gender differences to be taken into consideration. Body weight and age are major predictive variables for heart weight. These findings have important public health implications in the prevention of overweight and ischemic heart disease. PMID: 15977776 [PubMed - indexed for MEDLINE]Free Article
- Evaluative and discriminative properties of the Portuguese MacNew Heart Disease Health‐related Quality of Life Questionnaire.Publication . LEAL, A.; PAIVA, C.; HOFER, S.; AMADO, J.; GOMES, L.; OLDRIDGE, N.Qual Life Res. 2005 Dec;14(10):2335-41. Evaluative and discriminative properties of the Portuguese MacNew Heart Disease Health-related Quality of Life Questionnaire. Leal A, Paiva C, Höfer S, Amado J, Gomes L, Oldridge N. Cardiac Rehabilitation Unit, Hospital Sto António Porto, Largo Prof Abel Salazar 400, Portugal. antl@clix.pt Abstract The aim of this study was to validate the Portuguese version of the self-administered MacNew Heart Disease Health-related Quality of Life (MacNew) questionnaire in patients after diagnosis of acute coronary syndrome. The MacNew, with a Global score and physical, emotional and social subscales, the Short Form SF-36 (SF-36) and the Hospital Anxiety and Depression Scale (HADS) were completed at baseline by 150 patients and again by 48 clinically stable patients 2-3 weeks later. A cohort of 50 different patients completed the same questionnaires before and after a cardiac rehabilitation program in order to examine responsiveness. Acceptance of the MacNew by the patients was good and the three factor model was substantiated and explained 52.2% of the variance. Internal consistency, intra-class-correlation, and test-retest reliability each exceeded 0.72. The predicted construct validity hypotheses were partially confirmed. The discriminative validity of the MacNew was confirmed with significantly higher MacNew scores for patients with normal left ventricular function, with improved health status, and who were not anxious or depressed. Even though MacNew scores improved significantly following cardiac rehabilitation, the evaluative validity of the MacNew was less robust with small responsiveness statistics. The Portuguese version of the MacNew HRQL questionnaire appears to be a reliable, valid, and moderately responsive instrument to evaluate health-related quality of life after diagnosis of acute coronary syndrome. PMID: 16328913 [PubMed - indexed for MEDLINE]
- Myocardial bridging: retrospective analysis and scintigraphic testing of patients with no angiographically significant atherosclerotic coronary disease.Publication . Luz, A.C.; Silveira, J.; Palma, P.; Cyrne-Carvalho, H.; Albuquerque, A.; Amorim, I.; Gomes, L.Rev Port Cardiol. 2006 Apr;25(4):397-406. Myocardial bridging: retrospective analysis and scintigraphic testing of patients with no angiographically significant atherosclerotic coronary disease. [Article in English, Portuguese] Luz A, Silveira J, Palma P, Carvalho HC, Albuquerque A, Amorim I, Gomes L. SourceServiço de Cardiologia, Hospital Geral de Santo António, Porto, Portugal. andre_luz@sapo.pt Abstract INTRODUCTION AND OBJECTIVE: The clinical relevance of myocardial bridging (MB) is a matter of debate. The objective of this work was to examine its prevalence, clinical presentation, prognosis, and functional features on scintigraphy in a group of patients with no significant atherosclerotic coronary disease. METHODS: We retrospectively examined 7039 consecutive cardiac angiograms performed between January 1994 and December 2004, selecting cases in which MB was not accompanied by significant coronary disease (defined as luminal stenosis > 50%), valvular heart disease or cardiomyopathy. Patient characteristics such as age, gender, vascular risk factors and clinical presentation were recorded. We then contacted these patients by telephone to determine cardiovascular events since diagnosis (hospitalization, infarction, death) or symptoms of angina, and to invite them for myocardial perfusion scintigraphy (MPS) with stress testing. RESULTS: The prevalence of MB was 0.97% (68 patients). The study population without significant coronary disease, valvular heart disease or cardiomyopathy was composed of 31 subjects, mean age 51.45 +/- 13.77 years, 94% (29 patients) male. Clinical presentations were: non-ST elevation acute coronary syndromes with or without biomarkers of necrosis 34% (14 patients), stable angina 23% (7 patients), atypical chest pain 16% (5 patients), ST-elevation myocardial infarction 13% (4 patients), other 3% (1 patient). Left ventricular function was normal in all patients, and angiography showed MB of the left anterior descending artery, 63% (19 patients) in the mid portion, and 33% (12 patients) in the distal portion. All subjects were treated medically. We were able to contact 24 (77%) of the 31 patients, all of whom underwent MPS; mean time since angiography was 61.25 months, with no cardiovascular events (hospitalization, infarction, death) or symptomatic angina. MPS only identified three patients with findings consistent with anterior wall ischemia. CONCLUSIONS: In this series, 58% of the patients with MB and no significant atherosclerotic coronary disease presented with acute coronary syndromes. In all the subjects contacted, the prognosis had been good during the time since diagnosis. In the majority of them, no signs of ischemia were detected on MPS. PMID: 16869205 [PubMed - indexed for MEDLINE]
- Right coronary artery aneurysmPublication . Luz, A.; Silveira, J.; Cyrne-Carvalho, H.; Gomes, L.Int J Cardiol. 2007 Jan 18;114(3):e122-3. Epub 2006 Oct 16. Right coronary artery aneurysm. Luz A, Silveira J, Carvalho H, Gomes L. Abstract Coronary artery aneurysms, characterized by abnormal dilatations of a localized portion of the coronary artery, are an uncommon finding during angiography. We present a case where a giant right coronary aneurysm was detected during angiography, in a patient admitted with a inferior wall myocardial infarction. PMID: 17049395 [PubMed - indexed for MEDLINE]
- Successful management of Listeria monocytogenes pericarditis: case report and review of the literature.Publication . Dias, V.; Cabral, S.; Anjo, D.; Vieira, M.; Antunes, N.; Carvalheiras, G.; Gomes, C.; Meireles, A.; Mendonça, T.; Torres, S.Listeria monocytogenes, although an uncommon cause of illness in the general population, is feared principally because of the morbidity and mortality associated with CNS infections. Cardiovascular involvement with L. monocytogenes is very rare, and has been limited to endocarditis. We describe a case of Listeria pericarditis, which occurred in a 60-year-old man with Child-Pugh B cirrhosis who presented to the emergency department with asthenia, anorexia, and respiratory distress. The echocardiogram showed severe pericardial effusion and after pericardiocentesis, L. monocytogenes was isolated in the culture of pericardial fluid. After surgical pericardiectomy with draining of the pericardial effusion and antibiotic treatment with ampicillin, the patient experienced a slow, but full recovery. Documentation of L. monocytogenes pericarditis is an extremely rare entity with very scarce reports in medical literature, and is usually associated with a very poor prognosis. A case report is presented together with a review of the literature.
- Recurrent orthodeoxia and patent foramen ovale.Publication . Magalhães, L.; Pinto, R.; Oliveira, J.; Oliveira, F.; Reis, E.Introdução: Foramen ovale patente (FOP) ocorre em até 25% dos adultos saudáveis. Pode favorecer embolização paradoxal, enxaqueca e insuficiência respiratória (IR). Apresenta-se caso de IR e ortodeoxia por shunt direito-esquerdo via FOP sem evidência prévia de aumento da pressão intra-auricular direita. Encerramento do FOP resolveu eficazmente IR. Caso clínico: Homem, 52 anos. Mieloma múltiplo IgA/k diagnosticado um ano antes. Internado por IR hipoxémica grave com ortodeoxia e má resposta à oxigenoterapia, após colocação de cateter venoso central (CVC) na subclávia direita. Referia parestesias e alterações visuais inespecíficas, após manipulações do CVC. Características da IR sugeriam shunt entre circulação pulmonar e sistémica. Sem evidência clínica ou imagiológica de shunt intra-pulmonar. Ecocardiograma transtorácico com contraste: shunt direito- -esquerdo. Ecocardiograma transesofágico: FOP. Cateterismo cardíaco (após resolução espontânea da IR): sem shunt. Uma semana depois recorreu IR grave, que resolveu (bem como queixas neurológicas) com encerramento do FOP. Discussão: IR por shunt intra-cardíaco sem aumento da pressão nas cavidades direitas é de difícil interpretação hemodinâmica. Raros relatos (em adultos) associam esta entidade a anomalias anatómicas, que favorecerão shunt por orientação preferencial do fluxo sanguíneo para o FOP. São exemplos parésia diafragmática direita e ectasia da aorta ascendente, identificadas no doente apresentado. O papel do CVC, colocado imediatamente antes da IR, é especulativo. O completo sucesso terapêutico após encerramento do FOP apoia o diagnóstico. Conclusão: Avaliar correctamente IR (pesquisar ortodeoxia e resposta à oxigenoterapia) permite suspeitar de shunt, que se diagnostica utilizando meios acessíveis, seguros e rentáveis. Shunt intra-cardíaco sem aumento da pressão à direita deve ser considerado porque tem tratamento eficaz. Background: Patent foramen ovale (PFO) occurs in 25% of healthy adults. It can lead to paradoxical embolization, migraine and respiratory failure (RF). The authors present a case of RF and orthodeoxia due to a rightto- left shunt via a PFO without previous elevation of right atrial pressure. Closure of the PFO effectively resolved the RF. Case report: A 52-year-old man, with IgA-k multiple myeloma diagnosed one year before, was admitted for severe hypoxemic RF, with orthodeoxia and poor response to oxygen supplementation, after placement of a central venous catheter (CVC) in the right subclavian vein. The patient reported paresthesia and nonspecific visual changes after manipulation of the CVC. The RF suggested a shunt between the pulmonary and systemic circulations. There was no clinical or radiological evidence of an intrapulmonary shunt. Contrast echocardiography showed a right-to-left shunt and transesophageal echocardiography revealed a PFO. Cardiac catheterization, after spontaneous resolution of the RF, showed no shunt. A week later, severe RF recurred. Complete resolution of respiratory dysfunction and neurological symptoms was seen after PFO closure. Discussion: RF due to an intracardiac shunt without increased right-sided pressure is hemodynamically difficult to interpret. A few reports (in adults) relate this entity to anatomical anomalies, which can lead to a shunt by directing blood flow preferentially to the PFO. Examples include right diaphragmatic paresis and ectasia of the ascending aorta, which were observed in this patient. The role of the CVC, which was placed immediately before the RF, is uncertain. Complete therapeutic success after closure of the PFO supports the diagnosis. Conclusion: Correct evaluation of RF (by investigating orthodeoxia and response to oxygen therapy) enables the suspicion of a shunt, which can be confirmed through simple, safe and cost-effective exams. Intracardiac shunt without increased rightsided pressure should be considered because it can be successfully treatment.
- Renal cell carcinoma presentingas a stress cardiomyopathyPublication . Vieira, MS; Cyrne-Carvalho, H.; Torres, S.; Antunes, N.
- Pulmonary embolism with thromboembolus in transitPublication . Silva-Vieira, M.; Anjo, D.; Antunes, N.; Cyrne-Carvalho, H.; Torres, S.