Humans – ABC CARDIOL

IJCS

Editorial

Sex and Gender Equity in Research and Publishing: International Journal of Cardiovascular Sciences endorses SAGER Guidelines

Claudio Tinoco Mesquita et al. Aline Goneli de Lacerda

According to the recently published “Cardiovascular Statistics – Brazil 2020”, mortality from cardiovascular diseases (CVD) is proportionally higher in women compared to men. The INTERHEART study demonstrated that the population attributable risk for myocardial infarction associated with modifiable risk factors of smoking, alcohol use, high-risk diet, and physical inactivity, was significantly higher among women than men. Evidence from the VIRGO study (Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction [AMI] Patients) indicates that both health professionals and women are unaware or neglect the development of cardiovascular heart disease (CHD) and the presence of cardiovascular risk factors in women.

Women are underrepresented in cardiovascular disease trials despite known sex differences across a broad range of risk, prevention, treatment, and outcome parameters. Gender influences many aspects of disease like its pathophysiology and clinical presentation, response to treatment, clinicians’ behavior, and access to health care,^, and now it is clear that research must consider this to promote better diagnosis and treatment, and gender equity in health care.

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IJCS

Original Article

Diagnostic and Prognostic Role of Liver Elastography in Heart Failure

Diane Xavier Ávila et al. Priscila Abreu Matos Gabriel Quintino Wolney de Andrade Martins … Dalmo Machado Claudio Tinoco Mesquita Humberto Villacorta Junior

Abstract

Background:

Hepatic congestion is a frequent finding in patients with heart failure (HF). Physical examination has limitations in quantifying systemic congestion and requires correlation with echocardiographic and laboratory data (usually B-type natriuretic peptide, BNP, or N-terminal pro-B type natriuretic peptide, NT-proBNP). Hepatic elastography evaluates liver stiffness using a transducer that transmits low-frequency vibrations (50 Hz), and the speed of shear waves propagating through the tissues is measured by ultrasound. The faster the vibrations propagate in the hepatic parenchyma, the stiffer the liver, which, in case of HF, can be correlated with hepatic congestion.

Objective:

In this systematic review, case-controls, cohort studies, and randomized clinical trials were searched in MEDLINE, LILACS and Cochrane Database of Systematic Review, to evaluate the use of elastography in the detection of hepatic congestion in patients with HF.

Methods:

From the 49 articles retrieved, seven were selected for review, according to the inclusion and exclusion criteria. The most used methods for the diagnosis and evaluation of HF were echocardiography combined with BNP and NT-proBNP measurements.

Results:

Elastography performed at bedside was able to establish a significant correlation between increased liver stiffness and increased venous capillary pressure. In addition, liver elastography performed at hospital discharge was able to predict rehospitalization and mortality.

Conclusion:

Liver elastography is a non-invasive method that can be useful in predicting prognosis and mortality of individuals with HF, contributing to the clinical management of these patients.