Myocardial Stunning – ABC CARDIOL

IJCS

Editorial

What have we Learned about the Different COVID-19 Phenotypes in the Pediatric Population so Far?

Andressa Mussi Soares et al. Bernardo Mussi Soares

The understanding of SARS-CoV-2 related syndromes in the pediatric population needs to grow worldwide. In its severe presentation, COVID-19 is a systemic disease characterized by hyperinflammation, cytokine storm and increased myocardial injury markers. Cardiac involvement in seen in 20-30% of hospitalized adult patients and accounts for about 40% of deaths.

An intriguing aspect of the COVID-19 is the fact that most children and adolescents have mild or asymptomatic forms of the disease, perhaps related to a lower expression of virus receptors, recent exposure to other coronaviruses generating cross-protection, more developed innate immunity, among others. In fact, it is known that 40% of individuals under the age of 18 exposed to the virus get infected and that only 20-30% of children and adolescents infected with SARS-Cov-2 have symptoms.

[…]

Ler artigo completo

IJCS

Review Article

Reperfusion Strategies in Acute Myocardial Infarction: State of the Art

Fernando Oswaldo Dias Rangel

Abstract

ST elevation myocardial infarction (STEMI) is a highly prevalent condition worldwide. Reperfusion therapy is strongly associated with the prognosis of STEMI and must be performed with a high standard of quality and without delay. A systematic review of different reperfusion strategies for STEMI was conducted, including randomized controlled trials that included major cardiovascular events (MACE), and systematic reviews in the last 5 years through the PRISMA ( Preferred Reporting Items for Systematic Reviews and Meta-Analysis) methodology. The research was done in the PubMed and Cochrane Central Register of Controlled Trials databases, in addition to a few manual searches. After the exclusion criteria were applied, 90 articles were selected for this review. Despite the reestablishment of IRA patency in PCI for STEMI, microvascular lesions occur in a significant proportion of these patients, which can compromise ventricular function and clinical course. Several therapeutic strategies – intracoronary administration of nicorandil, nitrates, melatonin, antioxidant drugs (quercetin, glutathione), anti-inflammatory substances (tocilizumab [an inhibitor of interleukin 6], inclacumab, P-selectin inhibitor), immunosuppressants (cyclosporine), erythropoietin and ischemic pre- and post-conditioning and stem cell therapy – have been tested to reduce reperfusion injury, ventricular remodeling and serious cardiovascular events, with heterogeneous results: These therapies need confirmation in larger studies to be implemented in clinical practice

Ler artigo completo

IJCS

Editorial

After a STEMI, is Less Sugar more Protective to Myocardium?

Rafael Willain Lopes et al. Alexandre Hohl

The infarct size reduction in acute myocardial infarction (AMI) has been studied for more than 50 years. Animal experiments were conducted in the 1970s, followed by the first clinical studies to reduce infarct size (IS), with fibrinolytic agents or with mechanical coronary angioplasty (PTCA). The clinical experience of coronary reperfusion indicated that left ventricle function was not normalized in 30% of the patients, and despite unblocking the epicardial vessel, demonstrated hemodynamically, there was no equivalent in myocardial perfusion. New concepts emerged such as reperfusion injury, microvascular dysfunction, “no-reflow” phenomenon, and stunned and hibernating myocardium, which became the focus of basic research and clinical investigation. To improve characterization, different technologies were used, such as contrast echocardiography, isotopic studies, including positron emission tomography, and magnetic resonance.

Cardioprotection (CP) aims to reduce IS and improve clinical outcomes. The translation of CP from preclinical and promising proof-of-concept studies to clinical benefit (CB) for patients has been quite unsatisfactory. Almost all these studies that did not translate into CB had infarct size reduction as the primary endpoint and used protocols selected to achieve IS reduction.

[…]

Ler artigo completo

IJCS

Review Article

Myocardial Viability: From PARR-2 to IMAGE HF – Current Evidence and Future Directions

Fernanda Erthal et al. Christiane Wiefels Steven Promislow Riina Kandolin … Ellamae Stadnick Lisa Mielniczuk Terrence Ruddy Gary Small Rob Beanlands

Abstract

Ischemic heart failure is a growing disease with high morbidity and mortality. Several studies suggest the benefit of viability imaging to assist revascularization decision, but there is controversy. Multiple imaging modalities can be used to accurately define hibernating myocardium; however, the best approach remains uncertain. This review will highlight current evidence and future directions of viability imaging assessment.

Ler artigo completo

What have we Learned about the Different COVID-19 Phenotypes in the Pediatric Population so Far?

Reperfusion Strategies in Acute Myocardial Infarction: State of the Art

Abstract

After a STEMI, is Less Sugar more Protective to Myocardium?

Myocardial Viability: From PARR-2 to IMAGE HF – Current Evidence and Future Directions

Abstract

Formato de Documento Eletrônico (Vancouver)

Formato de Documento Eletrônico (ABNT)

Formato de Documento Eletrônico (APA)

Formato de Documento Eletrônico (ISO)

Formato de Documento Eletrônico (Vancouver)

Formato de Documento Eletrônico (ABNT)

Formato de Documento Eletrônico (APA)

Formato de Documento Eletrônico (ISO)

Formato de Documento Eletrônico (Vancouver)

Formato de Documento Eletrônico (ABNT)

Formato de Documento Eletrônico (APA)

Formato de Documento Eletrônico (ISO)

Formato de Documento Eletrônico (Vancouver)

Formato de Documento Eletrônico (ABNT)

Formato de Documento Eletrônico (APA)

Formato de Documento Eletrônico (ISO)