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    • How to Publish an Abstract Supplement?
    • Supplements from the Brazilian Congress of Cardiology

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  4. 2023, Volume 120, Number 5
Editorial

Telecardiology and its Potential in Remote Areas

Simone Farah

Many have been changes that have taken place in recent years in the field of Telemedicine, in Brazil and in the world, to face the COVID-19 pandemic. We made progress in understanding the relevance and impact of Telemedicine and its application in health care, especially in prevention and health promotion. Furthermore, to keep up with all these transformations, it was also necessary to move forward from a legal point of view. During the pandemic, Law No. 13,989 of April 15, 2020 allowed direct patient care through teleconsultation, which was not allowed in Brazil until then. Currently, Telemedicine Resolution No. 2,314 of May 5, 2022, and Law No. 14,510, known as the Telehealth Law, of December 27, 2022, are in effect, which allows teleconsultation throughout the national territory. This allowed areas previously devoid of specialized care access to specialists in real terms (synchronous) to provide care in various specialties.

Medical teleconsultation, defined as non-face-to-face consultation, mediated by Digital Information and Communication Technologies (TDIC), with doctor and patient located in different spaces, is one of the modalities of telemedicine care. In cardiology, this modality becomes even more important since cardiovascular diseases (CVD) are the major cause of morbidity and mortality in Brazil and the world, with increasing importance as population aging occurs, impacting costs for the health system. And in a country the size of Brazil, the presence of specialists in all locations becomes very difficult, demanding a lot of time and high cost to make it available at all points of primary or secondary care.

[…]

  • Cardiovascular Diseases
  • Disease Prevention
  • Remote Areas
  • Telecardiology
  • Teleconsultation
  • Telemedicine
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Creative Commons Attribution (CC BY) Creative Commons license
26/06/2023 DOI: 10.36660/abc.20230281 Views 1
Figure 1
Research Letter

New Technique for Preserving Cephalic Vein Flow in Pacemaker Implantation Ipsilateral to Arteriovenous Fistula

Mafalda Carrington et al. Pedro Silvério António Natacha Rodrigues Afonso Nunes-Ferreira … Ana Bernardes Fausto J. Pinto João de Sousa Pedro Marques

Introduction

Vascular patrimony is a major concern in patients with end-stage renal disease. As patients on chronic hemodialysis programs experience increasing survival rates, they frequently face multiple vascular access failures and may need recurrent central venous catheter insertions and fistula/grafts re-interventions to optimize their arteriovenous accesses. In addition, heart failure and heart rhythm disorders are frequent comorbidities in this population, and pacemaker or implantable cardiac defibrillator (ICD) implantation are frequently indicated. The estimated prevalence of Cardiovascular Electronic Implantable Devices (CIED) implantation in patients on chronic hemodialysis is about 10%. We aimed to describe a new technique for pacemaker implantation, which consisted in preserving cephalic vein ipsilateral to arteriovenous fistula flow, and in evaluating clinical outcomes of this technique over 12 months.

[…]

  • Arteriovenous Fistula, Upper Extremity Deep Vein Thrombosis
  • Pacemaker, Artificial
  • renal dialysis
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Creative Commons Attribution (CC BY) Creative Commons license
23/06/2023 DOI: 10.36660/abc.20220926 Views 1
Editorial

Auricular Vagus Nerve Stimulation in Heart Failure: Critical Analysis and Future Perspectives

Denise Tessariol Hachul

The term VAGUS, from the Latin, was chosen to name the cranial nerve with the most complex diversity of functions and which affects numerous physiological processes, such as autonomic, immunological, cardiovascular, gastrointestinal, respiratory and endocrine regulation.

The vagus nerve is made up of 20% efferent fibers and 80% afferent fibers, which make reciprocal connections between the brain and our organs. Afferent fibers transmit sensory information upward and terminate in four nuclei located in the medulla, including the nucleus tractus solitarius (NTS). Its efferent functions include sending parasympathetic cholinergic signals from brain nuclei to target organs. ,

[…]

  • Auricular Stimulation/methods
  • Epilepsy/prevention and control
  • Heart Failure
  • Transcutaneous Electric Nerve Stimulation/methods
  • Vagus Nerve
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Creative Commons Attribution (CC BY) Creative Commons license
19/06/2023 DOI: 10.36660/abc.20230298 Views 1
Editorial

Improving Outcomes of Patients with Acute Coronary Disease in Real Life: The Case of Applying in Practice What We Already Know from Clinical Studies

Stefano Garzon et al. Pedro A. Lemos

Cardiovascular diseases are one the leading causes of death in the world in both developed and developing countries, and according to the World Health Organization, 75% of these deaths are expected to happen in developing countries. Socioeconomic deprivation is a major determinant of cardiovascular mortality associated with more exposure to risk factors and premature deaths. Cardiovascular diseases also take a great toll on the economy. A recent study conducted in Australia projects a total healthcare cost of cardiovascular diseases from 2020 to 2029 of almost 62 billion Australian dollars, with productivity losses of almost 79 billion, with a total cost surpassing 140 billion over 10 years.

Brazil is a developing country of continental dimensions, with marked regional, racial, and socioeconomic disparities. From the 1960s onwards, the country underwent a fast demographic change, with a rapidly aging population and transitioning from predominantly rural to urban. A large proportion of the Brazilian population is exposed to known risk factors of cardiovascular disease, such as low educational levels, poor living and dietary habits, tobacco use, obesity, air pollution, and poorly-controlled risk factors such as hypertension, diabetes, and hyperlipidemia, all of which are associated with higher cardiovascular mortality. Although Brazil has a Universal Healthcare System (SUS), healthcare access is highly heterogeneous, overcrowded, and underfunded, and frequently fails to provide proper care to the Brazilian population.

[…]

  • Cardiovascular Diseases, mortality
  • Coronary Artery Disease
  • Development Countries
  • Percutaneous Coronary Intervention
  • poverty
  • Risk Factors
  • Unified System Health
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Creative Commons Attribution (CC BY) Creative Commons license
19/06/2023 DOI: 10.36660/abc.20230283
Central Illustration
Review Article

Valvular Heart Disease Emergencies: A Comprehensive Review Focusing on the Initial Approach in the Emergency Department

Tarso Augusto Duenhas Accorsi et al. Milena Ribeiro Paixão José Leão de Souza Júnior Marcus Vinicius Burato Gaz … Ricardo Galesso Cardoso Karen Francine Köhler Karine De Amicis Lima Flavio Tarasoutchi INTEGRATE Investigadores

Abstract

Valvular heart disease (VHD) is an increasing health problem worldwide. Patients with VHD may experience several cardiovascular-related emergencies. The management of these patients is a challenge in the emergency department, especially when the previous heart condition is unknown. Specific recommendations for the initial management are currently poor. This integrative review proposes an evidence-based three-step approach from bedside VHD suspicion to the initial treatment of the emergencies. The first step is the suspicion of underlying valvular condition based on signs and symptoms. The second step comprises the attempt to confirm the diagnosis and assessment of VHD severity with complementary tests. Finally, the third step addresses the diagnosis and treatment options for heart failure, atrial fibrillation, valvular thrombosis, acute rheumatic fever, and infective endocarditis. In addition, several images of complementary tests and summary tables are provided for physician support.

  • emergency medicine
  • Heart Valve Prosthesis
  • Heart valves
  • Valvular heart disease
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Creative Commons Attribution (CC BY) Creative Commons license
19/06/2023 DOI: 10.36660/abc.20220707 Views 1
Figure 1
Research Letter

Marked Concentric Myocardial Hypertrophy with Good Postoperative Evolution in a 4 Years Old Child

Edmar Atik et al. Gabriela Nunes Leal Marcelo B. Jatene

Introduction

Hypertrophic cardiomyopathy (HCM), characterized by hypertrophy of the left ventricle, has no etiological explanation under conditions of the usual diseases that cause cardiac overloads like systemic arterial hypertension, obstructive congenital heart diseases, and other pathologies. – It results from cardiovascular genetic pathology causing a complex disease, from gene diversity (more than 1400 mutations identified in 11 different genes) to phenotypic expression, histological characteristics, and manifested symptoms. Beta myosins (MYH7) genes occur in 35% of the cases, and myosin is linked to protein C (MYBPC3) in 49%, corresponding to three-quarters of the pathogenic mutations. Higher evolutionary risk is observed in the first group of changes, mainly to sudden death. The breakdown of myofibrils with bizarre nuclei and increased extracellular connective tissue characterize the histological findings.

Genetic diagnosis is achieved in 80% of these cases in children, which is important for risk stratification, therapeutic planning, and genetic counseling.

[…]

  • Abnormalities Congenital/surgery
  • Cardiomyopathy, Hypertrophic/surgery
  • Diagnostic Imaging/methods
  • Hypertrophy, Left Ventricular/surgery
  • Risk Factors
  • Sudden Cardiac Death
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Creative Commons Attribution (CC BY) Creative Commons license
19/06/2023 DOI: 10.36660/abc.20220869 Views 1
Figure 1
Editorial

Managing Women’s Cardiovascular Diseases: It’s Everyone’s Job

Gláucia Maria Moraes de Oliveira et al. Nanette Kass Wenger

Cardiovascular diseases (CVDs) remain the leading cause of disease burden in the world. Recent data from the 2021 Global Burden of Diseases project have estimated standardized rates of DALYs of 3568.0 (disability-adjusted life years – one DALY represents the loss of the equivalent of one year of total health) and 162.2 deaths per 100 000 inhabitants, with a standardized prevalence rate of 6905.6 per 100 000 inhabitants, in Brazil. While considerable progress has been made in decreasing CVD deaths in Brazil from the 1980s to the early 2020s, there has been a worrying increase in crude mortality and DALYs in recent years, especially among young women, due to myocardial infarction, among other causes. Therefore, new strategies are needed to improve cardiovascular health. ,

Brazil is a continental country with many inequalities despite a health system with universal coverage. This system is based on the Family Health Program present in 5568 municipalities across all Brazilian geographic regions. From 1990 to 2019 there was a higher number of deaths and DALYs due to stroke in women versus men in all areas, especially in the North and Northeast of Brazil, while the numbers of deaths and DALYs due to ischemic heart disease were similar in the different regions for both sexes. The Organization for Economic Cooperation and Development has recently released a report on primary health care in Brazil, with no mention of CVD in women, but only suggestions for approaching breast and ovarian neoplasms. However, CVDs cause twice as many deaths as all neoplasms combined in Brazilian women.

[…]

  • Cardiovascular Diseases
  • Women
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Creative Commons Attribution (CC BY) Creative Commons license
16/06/2023 DOI: 10.36660/abc.20230250
Editorial

Renin-Angiotensin System Inhibition and Beta Blockade Adrenergic May Be Useful to Attenuate Cardiotoxicity by Anthracyclines

Mario Fritsch Neves

Cardiotoxicity related to the use of anthracyclines is a major concern in oncology, as it can increase the morbidity of many patients receiving chemotherapy for various types of cancer. This toxicity can lead to left ventricular systolic dysfunction and, therefore, a higher incidence of heart failure, which can result in mortality in severe cases. A better understanding of the mechanisms involved and a better definition of diagnostic methods have provided significant advances in detecting this complication. However, there is still no consensus on the most accurate biomarkers for early identification of cardiotoxicity. Despite this, troponin measurement after each chemotherapy cycle can be a valid tool to indicate immediate intervention. ,

Manifestations of cardiotoxicity may remain restricted to myocardial cell damage detectable only by measuring circulating biomarkers or vary between silent ventricular dysfunction and clinically manifest heart failure. Strategies to avoid or at least attenuate anthracycline-induced cardiotoxicity are essential to improve the prognosis of patients using this class. The current recommendations include treating pre-existing cardiovascular risk factors, – choosing less cardiotoxic analogues, and administering low cumulative doses of anthracyclines. ,

[…]

  • Anthracyclines / toxicity
  • Drug Therapy
  • Heart Failure
  • Oncology
  • Ventricular Dysfunction, Left
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Creative Commons Attribution (CC BY) Creative Commons license
16/06/2023 DOI: 10.36660/abc.20230280
Editorial

Blood Pressure Measurement: There’s More Than Meets the Arm

Rodrigo Bezerra et al. Audes D. M. Feitosa Wilson Nadruz

Hypertension is the most important risk factor for cardiovascular events in the population worldwide. – Therefore, the identification of this risk factor is crucial for the assessment of cardiovascular risk. Non-invasive evaluation of blood pressure (BP) using cuffs in the arms is the recommended method for diagnosing and managing hypertension. However, this evaluation must be done properly and accurately to avoid suboptimal BP measurement and inappropriate management decisions.

The selection of cuff size is a fundamental step in evaluating BP and depends on the arm circumference of the examined individual. A smaller-than-required cuff overestimates BP, while a larger-than-required cuff underestimates BP. Some studies have reported average differences in systolic BP of 6 mmHg when inappropriately sized cuffs are used, even though markedly greater discrepancies can be observed in some individuals. In the United States, approximately 51% of adults with hypertension need large or extra-large cuffs, including 84% of those with obesity and 65% of those aged 18-34. Because obesity is highly prevalent worldwide, these American figures highlight the importance of systematic evaluation of arm circumference for accurate BP measurement in clinical practice.

[…]

  • Adipose Tissue
  • Arms
  • blood pressure monitors
  • Hypertension
  • Obesity
  • Risk Factors
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Creative Commons Attribution (CC BY) Creative Commons license
16/06/2023 DOI: 10.36660/abc.20230274 Views 1
Editorial

Intermittent Fasting and Blood Pressure Reduction: Related Mechanisms

Rui Póvoa

Obesity and an inadequate diet are modifiable risk factors that play an important role in the increase of cardiovascular diseases. They have an estimated 13% attributable risk of cardiovascular mortality. Several dietary interventions can improve this risk, most notably calorie restriction, which is linked to weight loss, improved insulin sensitivity, and reduced blood pressure. ,

Intermittent fasting (IF) is a dietary intervention similar to calorie restriction, as it uses the principle of restricting food intake. The two most comprehensive types are alternate daytime fasting (24 hours followed by a 24-hour eating period) and time-restricted fasting (16-20 hour variations).

[…]

  • Caloric Restriction
  • Cardiovascular Diseases, mortality
  • Fasting
  • Hypertension
  • Obesity
  • Weight Loss
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Creative Commons Attribution (CC BY) Creative Commons license
16/06/2023 DOI: 10.36660/abc.20230265
Editorial

The Clinical Impact of Cardiovascular Symptoms on Post-Acute COVID-19 Syndrome

Giovanni Possamai Dutra et al. Bruno Ferraz de Oliveira Gomes

The COVID-19 pandemic has intensely impacted people’s lives worldwide, generating, in addition to high mortality, high late morbidity, and negatively affecting health systems, remaining a significant global challenge today. In February 2023, World Health Organization records point to more than 756 million confirmed cases and approximately 6,845,000 deaths. Until the abovementioned month, approximately 36,961,000 cases were reported in Brazil, with about 698,000 deaths. Considering the substantial challenges related to comorbidity between heart disease and COVID-19, which go beyond the acute phase of the disease, further studies are needed to address the high burden of cardiopulmonary symptoms comprehensively. These investigations must be carefully planned, considering cost-effectiveness and clinical benefits for patients, to minimize inequalities in health care. In addition, it is essential to optimize social and mental care for patients. Cardiopulmonary involvement in COVID-19 continues to pose a major public health challenge. ,

The study by Kalil-Filho et al. included 480 survivors after hospitalization due to COVID-19 and evaluated the characteristics associated with the occurrence of cardiopulmonary symptoms and, especially, post-acute COVID-19 syndrome (PACS). It was a sample with a predominance of men, obese and with comorbidities such as hypertension, diabetes, and dyslipidemia. Almost a quarter of patients required intensive care admission, and only 12.2% required mechanical ventilation support. The prevalence of any of the symptoms was lower (32.1%) than that found in the literature, as well as PACS related to cardiopulmonary symptoms (16.3%). Notably, almost two-thirds of the population that underwent tomography (n=122) did not demonstrate pulmonary involvement. Thus, we observed that the analyzed population had a lower degree of severity related to COVID-19, justifying the lower prevalence of symptoms.

[…]

  • Cardiovascular Diseases
  • Comorbidity
  • COVID-19
  • Pandemics, Mortality
  • Public Health
  • Pulmonary Heart Disease
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Creative Commons Attribution (CC BY) Creative Commons license
16/06/2023 DOI: 10.36660/abc.20230282 Views 1
Editorial

Intracardiac Echocardiography Must Be Used in All Patients Who Underwent AF Ablation?

Cristiano F. Pisani et al. Mauricio Scanavacca

Atrial fibrillation ablation has become a widely used technique in treating patients with atrial fibrillation in the last 20 years due to better knowledge of its pathophysiological mechanisms, evolution in techniques for isolating pulmonary veins, and reduction of complications associated with the procedure. During this period, there have been large investments in new technologies by the industry, mainly in the improvement of images such as electroanatomical mapping systems, development of new catheters and new energies to produce more effective and lasting lesions and also with the use of intracardiac echocardiography (ICE) to add safety in the performance of the procedure to the allow instant visualization of heart structures and their relationships with catheters and sheaths. ,

The ICE is an invasive imaging technique that uses a specialized catheter to deliver ultrasound images from a probe that is located inside the heart. It presents an excellent image definition capable of recognizing in detail the location of the oval fossa and the ostia of the pulmonary veins. Allows monitoring the proper positioning and contact of the catheter tip with the structures of interest during RF application, as well as monitoring the formation of thrombi or microbubbles and alterations in tissue refraction that precede the formation of the so-called “Steam-pops”. Another advantage of the ICE is that it is operated in the field by the electrophysiologist himself, without the need for an echocardiographer.

[…]

  • Ablation Techniques/trends
  • Arrhythmia Cardiac
  • Atrial Fibrillation
  • Echocardiography, Transesophageal/methods
  • Echocardiography/methods, Catheter Ablation/methods
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Creative Commons Attribution (CC BY) Creative Commons license
16/06/2023 DOI: 10.36660/abc.20230290 Views 2
Central Illustration
Original Article

Post-COVID-19 Cardiopulmonary Symptoms: Predictors and Imaging Features in Patients after Hospital Discharge

Kalil-Filho Roberto et al. Roberta Saretta André Franci Luciano M. Baracioli … Filomena R. B. G. Galas Juliana S. Gil Amanda Ferino Camilla Giacovone Isabella Oliveira Johnatan Souza Vanessa Batista Augusto Scalabrini Neto Livia do Valle Costa Amanda Danieleto Ruiz Carla B. Ledo Teresa Cristina D. C. Nascimento Luciano F. Drager

Abstract

Background

Most of the evidence about the impact of the post-acute COVID-19 Syndrome (PACS) reports individual symptoms without correlations with related imaging.

Objectives

To evaluate cardiopulmonary symptoms, their predictors and related images in COVID-19 patients discharged from hospital.

Methods

Consecutive patients who survived COVID-19 were contacted 90 days after discharge. The Clinic Outcome Team structured a questionnaire evaluating symptoms and clinical status (blinded for hospitalization data). A multivariate analysis was performed to address the course of COVID-19, comorbidities, anxiety, depression, and post-traumatic stress during hospitalization, and cardiac rehabilitation after discharge. The significance level was set at 5%.

Results

A total of 480 discharged patients with COVID-19 (age: 59±14 years, 67.5% males) were included; 22.3% required mechanical ventilation. The prevalence of patients with PACS-related cardiopulmonary symptoms (dyspnea, tiredness/fatigue, cough, and chest discomfort) was 16.3%. Several parameters of chest computed tomography and echocardiogram were similar in patients with and without cardiopulmonary symptoms. The multivariate analysis showed that PACS-related cardiopulmonary-symptoms were independently related to female sex (OR 3.023; 95% CI 1.319-6.929), in-hospital deep venous thrombosis (OR 13.689; 95% CI 1.069-175.304), elevated troponin I (OR 1.355; 95% CI 1.048-1.751) and C-reactive protein during hospitalization (OR 1.060; 95% CI 1.023-1.097) and depression (OR 6.110; 95% CI 2.254-16.558).

Conclusion

PACS-related cardiopulmonary symptoms 90 days post-discharge are common and multifactorial. Beyond thrombotic and markers of inflammation/myocardial injury during hospitalization, female sex and depression were independently associated with cardiopulmonary-related PACS. These results highlighted the need for a multifaceted approach targeting susceptible patients.

  • COVID-19
  • Depression
  • Sex
  • Signs and Symptoms
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Creative Commons Attribution (CC BY) Creative Commons license
29/05/2023 DOI: 10.36660/abc.20220642
Figure 1
Research Letter

Cardiac Hydatid Cyst: An Uncommon Cause of Complete Atrioventricular Block

Renata Pibernat de Moraes et al. Mathias Silvestre de Brida Rodrigo Moraes Reis Raphael Santos Silva Camila Bergonsi de Farias

Abstract

Hydatidosis is a zoonosis caused by Echinococcus granulosus, leading to the formation of cysts on involved organs. Cardiac involvement is rare and can cause a wide range of complications secondary to rupture, embolization, or compression. Its diagnosis is challenging, and is generally confirmed through data related to clinical manifestations, environmental exposure, and laboratory and imaging exams. Surgical removal is necessary in most cases, in which an association with antiparasite therapy is recommended. The present article describes a case of a cardiac hydatid cyst associated with a complete atrioventricular block (AVB) in a young adult patient, with the need for a pacemaker implant, an atypical presentation, and scarce reports in the literature.

  • Atrioventricular block
  • Cardiac Tumors
  • Echinococcosis
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Creative Commons Attribution (CC BY) Creative Commons license
26/05/2023 DOI: 10.36660/abc.20220597 Views 1
Letter to the Editor

Analysis of low-density lipoprotein in diabetic patients using the Martin/Hopkins and Sampson equations

Cristian Rodrigues do Nascimento et al. Rodrigo Mendes Carlos Alberto de Lima Botelho Filho Romero Henrique de Almeida Barbosa Pedro Pereira Tenório

Dear Editor,

We read with great interest the article: Comparison of Novel Martin/Hopkins and Sampson Equations for Calculation of Low-Density Lipoprotein Cholesterol in Diabetic Patients. The study compared the Martin/Hopkins (LDL-Cmh), Sampson (LDL-Cs), and Friedewald (LDL-Cf) equations with directly obtained low-density lipoprotein (LDL-Cd). The aim was to analyze which would have a greater agreement with LDL-Cd in diabetic patients and investigate how these new equations could change clinical decision-making compared to LDL-Cf.

[…]

  • Coronary Artery Disease
  • Diabetes Mellitus
  • dyslipidemia
  • Lipoprotein LDL
  • Metabolic Diseases
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Creative Commons Attribution (CC BY) Creative Commons license
26/05/2023 DOI: 10.36660/abc.20220859 Views 1
Figure 1
Original Article

Renin-angiotensin System Antagonists and Beta-blockers in Prevention of Anthracycline Cardiotoxicity: a Systematic Review and Meta-analysis

Monica Samuel Avila et al. Suellen Rodrigues Rangel Siqueira Lucas Waldeck Silvia Moreira Ayub-Ferreira … Richard Takx Marcio Sommer Bittencourt Edimar Alcides Bocchi

Abstract

Background

The evidence supporting the use of renin-angiotensin-aldosterone system (RAAS) inhibitors and beta-blockers for the prevention of anthracycline-induced cardiomyopathy is controversial.

Objective

We performed a meta-analysis to assess the effectiveness of these drugs in preventing cardiotoxicity.

Methods

The meta-analysis included prospective, randomized studies in adults receiving anthracycline chemotherapy and compared the use of RAAS inhibitors or beta-blockers versus placebo with a follow-up of 6 to 18 months. The primary outcome was change in left ventricular ejection fraction (LVEF) during chemotherapy. Secondary outcomes were the incidence of heart failure, all-cause mortality, and changes in end-diastolic measurement. Heterogeneity was assessed by stratification and meta-regression. A significance level of p < 0.05 was adopted.

Results

The search resulted in 17 studies, totaling 1,530 patients. The variation (delta) in LVEF was evaluated in 14 studies. Neurohormonal therapy was associated with a lower delta in pre- versus post-therapy LVEF (weighted mean difference 4.42 [95% confidence interval 2.3 to 6.6]) and higher final LVEF (p < 0.001). Treatment resulted in a lower incidence of heart failure (risk ratio 0.45 [95% confidence interval 0.3 to 0.7]). There was no effect on mortality (p = 0.3). For analysis of LVEF, substantial heterogeneity was documented, which was not explained by the variables explored in the study.

Conclusion

The use of RAAS inhibitors and beta-blockers to prevent anthracycline-induced cardiotoxicity was associated with less pronounced reduction in LVEF, higher final LVEF, and lower incidence of heart failure. No changes in mortality were observed. (CRD PROSPERO 42019133615)

  • Angiotensin-Converting Enzyme Inhibitors
  • Drug Therapy
  • Heart Failure
  • Mineralocorticoid
  • Receptor Antagonists Anthracyclines
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Creative Commons Attribution (CC BY) Creative Commons license
26/05/2023 DOI: 10.36660/abc.20220298 Views 1
Erratum

Erratum

Arq Bras Cardiol. 2023;120(4):e20230203

In the “Brazilian Position Statement for Familial Chylomicronemia Syndrome – 2023”, with DOI: https://doi.org/10.36660/abc.20230203, published in the journal Arquivos Brasileiros de Cardiologia, Arq Bras Cardiol. 2023;120(4):e20230203, on page 1, make the following corrections:

[…]

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26/05/2023 DOI: 10.36660/abc.20230306
Figure 1
Original Article

Auricular Vagal Neuromodulation and its Application in Patients with Heart Failure and Reduced Ejection Fraction

Sergio Menezes Couceiro et al. Lucas Bonacossa Sant’Anna Mariana Bonacossa Sant’Anna Renata S. Matos Menezes … Evandro Tinoco Mesquita Fernando Mendes Sant’Anna

Abstract

Background

The autonomic nervous system (ANS) imbalance in heart failure (HF) creates a vicious cycle, excess sympathetic activity, and decreased vagal activity contributing to the worsening of HF. Low-intensity transcutaneous electrical stimulation of the auricular branch of the vagus nerve (taVNS) is well tolerated and opens new therapeutic possibilities.

Objectives

To hypothesize the applicability and benefit of taVNS in HF through intergroup comparison of echocardiography parameters, 6-minute walk test, Holter heart rate variability (SDNN and rMSSD), Minnesota quality of life questionnaire, and functional class by the New York Heart Association. In comparisons, p values <0.05 were considered significant.

Methods

Prospective, double-blind, randomized clinical study with sham methodology, unicentric. Forty-three patients were evaluated and divided into 2 groups: Group 1 received taVNS (frequencies 2/15 Hz), and Group 2 received sham. In comparisons, p values <0.05 were considered significant.

Results

In the post-intervention phase, it was observed that Group 1 had better rMSSD (31 x 21; p = 0.046) and achieved better SDNN (110 vs. 84, p = 0.033). When comparing intragroup parameters before and after the intervention, it was observed that all of them improved significantly in group 1, and there were no differences in group 2.

Conclusion

taVNS is a safe to perform and easy intervention and suggests a probable benefit in HF by improving heart rate variability, which indicates better autonomic balance. New studies with more patients are needed to answer the questions raised by this study.

  • Heart Failure
  • Parasympathetic Nervous System Diseases
  • Reduced Ejection Fraction
  • Vagus Nerve Stimulation
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Creative Commons Attribution (CC BY) Creative Commons license
15/05/2023 DOI: 10.36660/abc.20220581 Views 1
Central Illustration
Original Article

Atrial Fibrillation Ablation: Impact of Intracardiac Echocardiography in Reducing Procedure Time and Hospitalization

Roberto Tofani Sant`Anna et al. Gustavo Glotz de Lima Marco Aurélio Lumertz Saffi Marcelo Lapa Kruse Tiago Luiz Luz Leiria

Abstract

Background

Intracardiac echocardiography (ICE) allows visualization of cardiac structures and recognition of complications during atrial fibrillation ablation (AFA). Compared to transesophageal echocardiography (TEE), ICE is less sensitive to detecting thrombus in the atrial appendage but requires minimal sedation and fewer operators, making it attractive in a resource-constrained setting.

Objective

To compare 13 cases of AFA using ICE (AFA-ICE group) with 36 cases of AFA using TEE (AFA-TEE group).

Methods

This is a single-center prospective cohort study. The main outcome was procedure time. Secondary outcomes: fluoroscopy time, radiation dose (mGy/cm2), major complications, and length of hospital stay in hours. The clinical profile was compared using the CHA2DS2-VASc score. A p-value <0.05 was considered a statistically significant difference between groups.

Results

The median CHA2DS2-VASc score was 1 (0-3) in the AFA-ICE group and 1 (0-4) in the AFA-TEE group. The total procedure time was 129 ± 27 min in the AFA-ICE group and 189 ± 41 min in the AFA-TEE group (p<0.001); the AFA-ICE group received a lower dose of radiation (mGy/cm2, 51296 ± 24790 vs. 75874 ± 24293; p=0.002), despite the similar fluoroscopy time (27.48 ± 9. 79 vs. 26.4 ± 9.32; p=0.671). The median length of hospital stay did not differ; 48 (36-72) hours (AFA-ICE) and 48 (48-66) hours (AFA-TEE) (p=0.27).

Conclusions

In this cohort, AFA-ICE was related to shorter procedure times and less exposure to radiation without increasing the risk of complications or the length of hospital stay.

  • Atrial Fibrillation/complications
  • Catheter Ablation
  • Echocadiography/methods
  • Hospitalization
  • Pulmonary Veins/diagnostic imaging
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15/05/2023 DOI: 10.36660/abc.20220306 Views 1
Figure 1
Original Article

Prognosis Related to Reperfusion Therapy Post-Acute Coronary Syndrome in Secondary Care: Long-Term Survival Analysis in the ERICO Study

Tatiana C. Bruno et al. Márcio S. Bittencourt Alessandra V. L. Quidim Itamar S. Santos … Paulo A. Lotufo Isabela M. Benseñor Alessandra C. Goulart

Abstract

Background

Relationship between reperfusion therapy post-acute coronary syndrome (ACS) and mortality in secondary care is not well-known.

Objectives

To evaluate the impact of three therapeutic strategies: (1) exclusive medical therapy, (2) percutaneous coronary intervention (PCI) and (3) coronary artery bypass grafting (CABG) on long-term survival of participants in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study.

Methods

Survival analyses for all-cause, cardiovascular (CVD) and coronary artery disease (CAD) mortality were performed according to three therapeutic strategies (exclusive medical therapy, PCI or CABG). Cox regression models were used to estimate the hazard ratio (HR) with respective 95% confidence interval (95%CI) from 180 days to four years of follow-up after ACS. Models are presented as crude, age-sex adjusted and further adjusted for previous CAD, ACS subtype, smoking, hypertension, dyslipidemia, left ventricular ejection fraction and according to the number of obstructed (≥ 50%) major coronary arteries.

Results

Among 800 participants, the lowest crude survival rates were detected among individuals who underwent CABG (all-cause and CVD). CABG was correlated to CAD (HR: 2.19 [95% CI: 1.05-4.55]). However, this risk lost significance in the full model. PCI was associated to lower probability of fatal events during four-year follow-up: all-cause [multivariate HR: 0.42 (95% CI: 0.26-0.70)], CVD [HR: 0.39 (95% CI: 0.20-0.73)] and CAD [multivariate HR: 0.24 (95% CI: 0.09-0.63)] compared to those submitted to exclusive medical therapy.

Conclusion

In the ERICO study, PCI after ACS was associated to better prognosis, particularly CAD survival.

  • Acute coronary syndrome
  • Angioplasty
  • Coronary Artery Bypass
  • Mortality
  • Survival Analysis
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Figure 1
Original Article

Influence of Arm Fat on the Indirect Measurement of Blood Pressure: A Statistical and Machine Learning Approach

Paôla de Oliveira Souza et al. José Maria Parente de Oliveira Letícia Helena Januário

Abstract

Background

The indirect measurement of blood pressure (BP) is known to be influenced by many factors such as the technique, observer, and equipment; however, the influence of arm composition has not been investigated yet.

Objective

To identify the influence of arm fat on the indirect measurement of blood pressure using statistical inference and machine learning models.

Methods

Cross-sectional study, with 489 healthy young adults aged from 18 to 29 years old. Measurements of arm length (AL), arm circumference (AC) and arm fat index (AFI) were taken. BP was measured in both arms simultaneously. Data were processed using Python 3.0 and its specific packages for descriptive analysis, regression and cluster analysis. Significance levels: 5% for all calculations.

Results

BP and anthropometric measurements were different between the hemi-bodies. In the right arm, systolic blood pressure (SBP), AL and AFI were higher, while AC was similar compared with the left arm. AL and AC showed positive correlation with SBP. According to the regression model, for a fixed value of AC and AL, SBP readings could be reduced by a mean of 1.80 mmHg in the right arm, and 1.62 mmHg in the left arm for every 10% increase in AFI. Clustering analysis corroborated the regression results.

Conclusion

There was a significant influence of AFI on BP readings. SBP had a positive correlation with AL and AC, and a negative correlation with AFI, suggesting the need for further investigations on the relationship between BP and percentages of arm muscle and fat.

  • Arm
  • Arterial Pressure
  • Cluster Analysis
  • Regression Analysis
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15/05/2023 DOI: 10.36660/abc.20220484 Views 2
Figure 1
Original Article

Clinical Features and Management of Patients Assessed by Cardiology Teleconsultation in the Brazilian Region with the Highest Number of Isolated Cities

Tarso Augusto Duenhas Accorsi et al. Renato Paladino Nemoto Jairo Tavares Nunes Antônio Fernando Barros de Azevedo Filho … Flavio Tocci Moreira Karen Francine Kohler Karine de Amicis Lima Bruna Dayanne Reges Amaral Renata Albaladejo Morbeck Carlos Henrique Sartorato Pedrotti

Abstract

Background

Cardiovascular diseases are the leading cause of adult mortality. Geographically remote and low-income Brazilian regions lack specialized consultations. The telemedicine management of this population by cardiologists is not fully known.

Objectives

To analyze cardiology teleconsultation in the Brazilian region with the highest number of isolated cities.

Methods

From February 2020 to October 2021, patients from the North Region of Brazil evaluated by local general practitioners were referred for cardiological evaluation by telemedicine. Referral reasons, demographics, clinical history, physical examinations, tests, medications, and prescriptions pre- and post-telemedicine were analyzed (p<0.05 was considered statistically significant).

Results

We analyzed 653 patients. The attendance rate was 85.7% (53.1% female, mean age: 54.2±6.5 years). The main reasons for referral were cardiovascular symptoms (58.1%) and risk factors among asymptomatic patients (13.3%). Only 12.6% had a diagnosed disease. Most patients had regular physical examinations and electrocardiograms. Few had recent complementary tests. The prescription of angiotensin receptor blockers (ARBs), calcium channel blockers and statins was significantly increased, while that of digoxin, noncardiac beta-blockers and acetylsalicylic acid (ASA) was decreased at the first teleconsultation. Most of the tests requested were of low complexity and cost: electrocardiogram (28.2%), chest X-ray (14%), echocardiogram (64.5%) and blood tests (71.8%). For 2.1% of patients, interventions were indicated, and 8% were discharged after the first consultation.

Conclusion

On-demand cardiology teleconsultation contributes to heart disease treatment optimization. Most patients were referred with syndromic diagnoses without previous complementary tests. The specialist workup requested was usually available locally and at a low cost but precluded early discharge. Local training could optimize the referral.

  • referral and consultation
  • Remote Consultation
  • Suburban Population
  • Telecardiology
  • Telemedicine
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08/05/2023 DOI: 10.36660/abc.20220467 Views 1
Figure 1
Original Article

Prognostic Significance of Nutrition-Associated Markers in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis

Ying Meng et al. Zhengyi Zhang Tong Zhao Dekui Zhang

Abstract

Background

The prognostic significance of nutrition indicators in patients with heart failure with preserved ejection fraction (HFpEF) is unclear.

Objectives

This systematic review and meta-analysis aimed to assess the prognostic value of serum albumin (SA), the geriatric nutritional risk index (GNRI), and the prognostic nutritional index (PNI) in patients with HFpEF.

Methods

Databases of PubMed, Embase, The Cochrane Library, and Web of Science were systematically searched for all studies published up to January 2022. The prognostic significance of SA, GNRI, and PNI for HFpEF was explored. Pooled hazard ratio (HR) and 95% confidence interval (CI) were estimated using the STATA 15.0 software. The Quality of Prognosis Studies tool was used to assess the quality of studies.

Results

Nine studies met the inclusion criteria, and 5603 adults with HFpEF were included in the meta-analysis. The analyses showed that a decreased SA or GNRI was significantly related to high all-cause mortality (HR: 1.98; 95% CI: 1.282–3.057; p = 0.002; and HR: 1.812;95% CI: 1.064–3.086; p = 0.029, respectively). Furthermore, a lower SA indicates a bad composite outcome of all-cause mortality and HF rehospitalization (HR: 1.768; 95% CI: 1.483–2.108; p = 0.000), and a lower GNRI was significantly associated with high cardiovascular mortality (HR: 1.922; 95% CI: 1.504–2.457;p = 0.000). However, a lower PNI did not correlate with all-cause mortality (HR: 1.176; 95% CI: 0.858–1.612, p=0.314).

Conclusions

Our meta-analysis indicates that SA and GNRI may be useful indicators to predict the prognosis of patients with HFpEF.

  • Epidemiology
  • Heart Failure
  • malnutrition
  • Mortality
  • Prognosis
  • Strpke Volume
  • Systematic Reviews
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08/05/2023 DOI: 10.36660/abc.20220523
Erratum

Erratum

Arq Bras Cardiol. 2023; 120(2):e20220247

In the Original Article “Cardiovascular Statistics from the Good Practices in Cardiology Program – Data from a Brazilian Tertiary Public Hospital”, with DOI: https://doi.org/10.36660/abc.20220247, published in the journal Arquivos Brasileiros de Cardiologia, Arq Bras Cardiol. 2023; 120(2)e20220247, on page 1, correct the author’s name: Carolina Teixeira Cunha Érika for: Carolina Teixeira Cunha.

[…]

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08/05/2023 DOI: 10.36660/abc.20230178

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Farah S. Telecardiology and its Potential in Remote Areas. Arquivos Brasileiros de Cardiologia 2023;120(5):e20230281.

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Carrington M, António PS, Rodrigues N, Nunes-Ferreira A, Bernardes A, Pinto FJ, Sousa J, et al. New Technique for Preserving Cephalic Vein Flow in Pacemaker Implantation Ipsilateral to Arteriovenous Fistula. Arquivos Brasileiros de Cardiologia 2023;120(5):e20220926.

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Carrington, Mafalda; António, Pedro Silvério; Rodrigues, Natacha; Nunes-Ferreira, Afonso; Bernardes, Ana; Pinto, Fausto J.; Sousa, João de; Marques, Pedro. New Technique for Preserving Cephalic Vein Flow in Pacemaker Implantation Ipsilateral to Arteriovenous Fistula. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20220926, Jun. 2023.

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Carrington, M., António, P. S., Rodrigues, N., Nunes-Ferreira, A., Bernardes, A., Pinto, F. J., Sousa, J. , & Marques, P. (2023). New Technique for Preserving Cephalic Vein Flow in Pacemaker Implantation Ipsilateral to Arteriovenous Fistula. Arquivos Brasileiros de Cardiologia, 120(5), e20220926.

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Carrington, Mafalda and António, Pedro Silvério and Rodrigues, Natacha and Nunes-Ferreira, Afonso and Bernardes, Ana and Pinto, Fausto J. and Sousa, João de and Marques, Pedro. New Technique for Preserving Cephalic Vein Flow in Pacemaker Implantation Ipsilateral to Arteriovenous Fistula. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20220926. Available from: <https://journals.cardiol.br/en/article/new-technique-for-preserving-cephalic-vein-flow-in-pacemaker-implantation-ipsilateral-to-arteriovenous-fistula/>. ISSN 0066-782X

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Hachul DT. Auricular Vagus Nerve Stimulation in Heart Failure: Critical Analysis and Future Perspectives. Arquivos Brasileiros de Cardiologia 2023;120(5):e20230298.

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Hachul, Denise Tessariol. Auricular Vagus Nerve Stimulation in Heart Failure: Critical Analysis and Future Perspectives. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20230298, Jun. 2023.

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Hachul, Denise Tessariol. Auricular Vagus Nerve Stimulation in Heart Failure: Critical Analysis and Future Perspectives. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20230298. Available from: <https://journals.cardiol.br/en/article/auricular-vagus-nerve-stimulation-in-heart-failure-critical-analysis-and-future-perspectives/>. ISSN 0066-782X

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Garzon S, Lemos PA. Improving Outcomes of Patients with Acute Coronary Disease in Real Life: The Case of Applying in Practice What We Already Know from Clinical Studies. Arquivos Brasileiros de Cardiologia 2023;120(5):e20230283.

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Garzon, Stefano; Lemos, Pedro A.. Improving Outcomes of Patients with Acute Coronary Disease in Real Life: The Case of Applying in Practice What We Already Know from Clinical Studies. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20230283, Jun. 2023.

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Garzon, S., & Lemos, P. A. (2023). Improving Outcomes of Patients with Acute Coronary Disease in Real Life: The Case of Applying in Practice What We Already Know from Clinical Studies. Arquivos Brasileiros de Cardiologia, 120(5), e20230283.

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Garzon, Stefano and Lemos, Pedro A.. Improving Outcomes of Patients with Acute Coronary Disease in Real Life: The Case of Applying in Practice What We Already Know from Clinical Studies. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20230283. Available from: <https://journals.cardiol.br/en/article/improving-outcomes-of-patients-with-acute-coronary-disease-in-real-life-the-case-of-applying-in-practice-what-we-already-know-from-clinical-studies/>. ISSN 0066-782X

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Accorsi TAD, Paixão MR, Souza Júnior JL, Gaz MVB, Cardoso RG, Köhler KF, Lima KDA, et al. Valvular Heart Disease Emergencies: A Comprehensive Review Focusing on the Initial Approach in the Emergency Department. Arquivos Brasileiros de Cardiologia 2023;120(5):e20220707.

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Accorsi, Tarso Augusto Duenhas; Paixão, Milena Ribeiro; Souza Júnior, José Leão de; Gaz, Marcus Vinicius Burato; Cardoso, Ricardo Galesso; Köhler, Karen Francine; Lima, Karine De Amicis; Tarasoutchi, Flavio; Investigadores, INTEGRATE. Valvular Heart Disease Emergencies: A Comprehensive Review Focusing on the Initial Approach in the Emergency Department. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20220707, Jun. 2023.

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Accorsi, T. A. D., Paixão, M. R., Souza Júnior, J. L. , Gaz, M. V. B., Cardoso, R. G., Köhler, K. F., Lima, K. D. A., Tarasoutchi, F., & Investigadores, I. (2023). Valvular Heart Disease Emergencies: A Comprehensive Review Focusing on the Initial Approach in the Emergency Department. Arquivos Brasileiros de Cardiologia, 120(5), e20220707.

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Accorsi, Tarso Augusto Duenhas and Paixão, Milena Ribeiro and Souza Júnior, José Leão de and Gaz, Marcus Vinicius Burato and Cardoso, Ricardo Galesso and Köhler, Karen Francine and Lima, Karine De Amicis and Tarasoutchi, Flavio and Investigadores, INTEGRATE. Valvular Heart Disease Emergencies: A Comprehensive Review Focusing on the Initial Approach in the Emergency Department. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20220707. Available from: <https://journals.cardiol.br/en/article/valvular-heart-disease-emergencies-a-comprehensive-review-focusing-on-the-initial-approach-in-the-emergency-department/>. ISSN 0066-782X

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Atik E, Leal GN, Jatene MB. Marked Concentric Myocardial Hypertrophy with Good Postoperative Evolution in a 4 Years Old Child. Arquivos Brasileiros de Cardiologia 2023;120(5):e20220869.

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Atik, Edmar; Leal, Gabriela Nunes; Jatene, Marcelo B.. Marked Concentric Myocardial Hypertrophy with Good Postoperative Evolution in a 4 Years Old Child. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20220869, Jun. 2023.

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Atik, E., Leal, G. N., & Jatene, M. B. (2023). Marked Concentric Myocardial Hypertrophy with Good Postoperative Evolution in a 4 Years Old Child. Arquivos Brasileiros de Cardiologia, 120(5), e20220869.

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Atik, Edmar and Leal, Gabriela Nunes and Jatene, Marcelo B.. Marked Concentric Myocardial Hypertrophy with Good Postoperative Evolution in a 4 Years Old Child. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20220869. Available from: <https://journals.cardiol.br/en/article/marked-concentric-myocardial-hypertrophy-with-good-postoperative-evolution-in-a-4-years-old-child/>. ISSN 0066-782X

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Oliveira GMM, Wenger NK. Managing Women’s Cardiovascular Diseases: It’s Everyone’s Job. Arquivos Brasileiros de Cardiologia 2023;120(5):e20230250.

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Oliveira, Gláucia Maria Moraes de; Wenger, Nanette Kass. Managing Women’s Cardiovascular Diseases: It’s Everyone’s Job. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20230250, Jun. 2023.

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Oliveira, G. M. M. , & Wenger, N. K. (2023). Managing Women’s Cardiovascular Diseases: It’s Everyone’s Job. Arquivos Brasileiros de Cardiologia, 120(5), e20230250.

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Oliveira, Gláucia Maria Moraes de and Wenger, Nanette Kass. Managing Women’s Cardiovascular Diseases: It’s Everyone’s Job. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20230250. Available from: <https://journals.cardiol.br/en/article/managing-womens-cardiovascular-diseases-its-everyones-job/>. ISSN 0066-782X

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Neves MF. Renin-Angiotensin System Inhibition and Beta Blockade Adrenergic May Be Useful to Attenuate Cardiotoxicity by Anthracyclines. Arquivos Brasileiros de Cardiologia 2023;120(5):e20230280.

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Neves, Mario Fritsch. Renin-Angiotensin System Inhibition and Beta Blockade Adrenergic May Be Useful to Attenuate Cardiotoxicity by Anthracyclines. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20230280, Jun. 2023.

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Neves, M. F. (2023). Renin-Angiotensin System Inhibition and Beta Blockade Adrenergic May Be Useful to Attenuate Cardiotoxicity by Anthracyclines. Arquivos Brasileiros de Cardiologia, 120(5), e20230280.

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Neves, Mario Fritsch. Renin-Angiotensin System Inhibition and Beta Blockade Adrenergic May Be Useful to Attenuate Cardiotoxicity by Anthracyclines. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20230280. Available from: <https://journals.cardiol.br/en/article/renin-angiotensin-system-inhibition-and-beta-blockade-adrenergic-may-be-useful-to-attenuate-cardiotoxicity-by-anthracyclines/>. ISSN 0066-782X

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Bezerra R, Feitosa ADM, Nadruz W. Blood Pressure Measurement: There’s More Than Meets the Arm. Arquivos Brasileiros de Cardiologia 2023;120(5):e20230274.

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Bezerra, Rodrigo; Feitosa, Audes D. M.; Nadruz, Wilson. Blood Pressure Measurement: There’s More Than Meets the Arm. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20230274, Jun. 2023.

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Bezerra, R., Feitosa, A. D. M., & Nadruz, W. (2023). Blood Pressure Measurement: There’s More Than Meets the Arm. Arquivos Brasileiros de Cardiologia, 120(5), e20230274.

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Bezerra, Rodrigo and Feitosa, Audes D. M. and Nadruz, Wilson. Blood Pressure Measurement: There’s More Than Meets the Arm. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20230274. Available from: <https://journals.cardiol.br/en/article/blood-pressure-measurement-theres-more-than-meets-the-arm/>. ISSN 0066-782X

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Póvoa R. Intermittent Fasting and Blood Pressure Reduction: Related Mechanisms. Arquivos Brasileiros de Cardiologia 2023;120(5):e20230265.

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Póvoa, Rui. Intermittent Fasting and Blood Pressure Reduction: Related Mechanisms. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20230265, Jun. 2023.

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Póvoa, R. (2023). Intermittent Fasting and Blood Pressure Reduction: Related Mechanisms. Arquivos Brasileiros de Cardiologia, 120(5), e20230265.

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Póvoa, Rui. Intermittent Fasting and Blood Pressure Reduction: Related Mechanisms. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20230265. Available from: <https://journals.cardiol.br/en/article/intermittent-fasting-and-blood-pressure-reduction-related-mechanisms/>. ISSN 0066-782X

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Dutra GP, Gomes BFO. The Clinical Impact of Cardiovascular Symptoms on Post-Acute COVID-19 Syndrome. Arquivos Brasileiros de Cardiologia 2023;120(5):e20230282.

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Dutra, Giovanni Possamai; Gomes, Bruno Ferraz de Oliveira. The Clinical Impact of Cardiovascular Symptoms on Post-Acute COVID-19 Syndrome. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20230282, Jun. 2023.

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Dutra, G. P., & Gomes, B. F. O. (2023). The Clinical Impact of Cardiovascular Symptoms on Post-Acute COVID-19 Syndrome. Arquivos Brasileiros de Cardiologia, 120(5), e20230282.

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Dutra, Giovanni Possamai and Gomes, Bruno Ferraz de Oliveira. The Clinical Impact of Cardiovascular Symptoms on Post-Acute COVID-19 Syndrome. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20230282. Available from: <https://journals.cardiol.br/en/article/the-clinical-impact-of-cardiovascular-symptoms-on-post-acute-covid-19-syndrome/>. ISSN 0066-782X

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Pisani CF, Scanavacca M. Intracardiac Echocardiography Must Be Used in All Patients Who Underwent AF Ablation?. Arquivos Brasileiros de Cardiologia 2023;120(5):e20230290.

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Pisani, Cristiano F.; Scanavacca, Mauricio. Intracardiac Echocardiography Must Be Used in All Patients Who Underwent AF Ablation?. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20230290, Jun. 2023.

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Pisani, C. F., & Scanavacca, M. (2023). Intracardiac Echocardiography Must Be Used in All Patients Who Underwent AF Ablation?. Arquivos Brasileiros de Cardiologia, 120(5), e20230290.

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Pisani, Cristiano F. and Scanavacca, Mauricio. Intracardiac Echocardiography Must Be Used in All Patients Who Underwent AF Ablation?. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20230290. Available from: <https://journals.cardiol.br/en/article/intracardiac-echocardiography-must-be-used-in-all-patients-who-underwent-af-ablation/>. ISSN 0066-782X

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Roberto K, Saretta R, Franci A, Baracioli LM, Galas FRBG, Gil JS, Ferino A, et al. Post-COVID-19 Cardiopulmonary Symptoms: Predictors and Imaging Features in Patients after Hospital Discharge. Arquivos Brasileiros de Cardiologia 2023;120(5):e20220642.

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Roberto, Kalil-Filho; Saretta, Roberta; Franci, André; Baracioli, Luciano M.; Galas, Filomena R. B. G.; Gil, Juliana S.; Ferino, Amanda; Giacovone, Camilla; Oliveira, Isabella; Souza, Johnatan; Batista, Vanessa; Scalabrini Neto, Augusto; Costa, Livia do Valle; Ruiz, Amanda Danieleto; Ledo, Carla B.; Nascimento, Teresa Cristina D. C.; Drager, Luciano F.. Post-COVID-19 Cardiopulmonary Symptoms: Predictors and Imaging Features in Patients after Hospital Discharge. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20220642, May. 2023.

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Roberto, K., Saretta, R., Franci, A., Baracioli, L. M., Galas, F. R. B. G., Gil, J. S., Ferino, A., Giacovone, C., Oliveira, I., Souza, J., Batista, V., Scalabrini Neto, A., Costa, L. V., Ruiz, A. D., Ledo, C. B., Nascimento, T. C. D. C., & Drager, L. F. (2023). Post-COVID-19 Cardiopulmonary Symptoms: Predictors and Imaging Features in Patients after Hospital Discharge. Arquivos Brasileiros de Cardiologia, 120(5), e20220642.

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Roberto, Kalil-Filho and Saretta, Roberta and Franci, André and Baracioli, Luciano M. and Galas, Filomena R. B. G. and Gil, Juliana S. and Ferino, Amanda and Giacovone, Camilla and Oliveira, Isabella and Souza, Johnatan and Batista, Vanessa and Scalabrini Neto, Augusto and Costa, Livia do Valle and Ruiz, Amanda Danieleto and Ledo, Carla B. and Nascimento, Teresa Cristina D. C. and Drager, Luciano F.. Post-COVID-19 Cardiopulmonary Symptoms: Predictors and Imaging Features in Patients after Hospital Discharge. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20220642. Available from: <https://journals.cardiol.br/en/article/post-covid-19-cardiopulmonary-symptoms-predictors-and-imaging-features-in-patients-after-hospital-discharge/>. ISSN 0066-782X

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Moraes RP, Brida MS, Reis RM, Silva RS, Farias CB. Cardiac Hydatid Cyst: An Uncommon Cause of Complete Atrioventricular Block. Arquivos Brasileiros de Cardiologia 2023;120(5):e20220597.

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Moraes, Renata Pibernat de; Brida, Mathias Silvestre de; Reis, Rodrigo Moraes; Silva, Raphael Santos; Farias, Camila Bergonsi de. Cardiac Hydatid Cyst: An Uncommon Cause of Complete Atrioventricular Block. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20220597, May. 2023.

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Moraes, R. P. , Brida, M. S. , Reis, R. M., Silva, R. S., & Farias, C. B. (2023). Cardiac Hydatid Cyst: An Uncommon Cause of Complete Atrioventricular Block. Arquivos Brasileiros de Cardiologia, 120(5), e20220597.

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Moraes, Renata Pibernat de and Brida, Mathias Silvestre de and Reis, Rodrigo Moraes and Silva, Raphael Santos and Farias, Camila Bergonsi de. Cardiac Hydatid Cyst: An Uncommon Cause of Complete Atrioventricular Block. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20220597. Available from: <https://journals.cardiol.br/en/article/cardiac-hydatid-cyst-an-uncommon-cause-of-complete-atrioventricular-block/>. ISSN 0066-782X

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Electronic Document Format (Vancouver)

Nascimento CR, Mendes R, Botelho Filho CAL, Barbosa RHA, Tenório PP. Analysis of low-density lipoprotein in diabetic patients using the Martin/Hopkins and Sampson equations. Arquivos Brasileiros de Cardiologia 2023;120(5):e20220859.

Electronic Document Format (ABNT)

Nascimento, Cristian Rodrigues do; Mendes, Rodrigo; Botelho Filho, Carlos Alberto de Lima; Barbosa, Romero Henrique de Almeida; Tenório, Pedro Pereira. Analysis of low-density lipoprotein in diabetic patients using the Martin/Hopkins and Sampson equations. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20220859, May. 2023.

Electronic Document Format (APA)

Nascimento, C. R. , Mendes, R., Botelho Filho, C. A. L., Barbosa, R. H. A., & Tenório, P. P. (2023). Analysis of low-density lipoprotein in diabetic patients using the Martin/Hopkins and Sampson equations. Arquivos Brasileiros de Cardiologia, 120(5), e20220859.

Electronic Document Format (ISO)

Nascimento, Cristian Rodrigues do and Mendes, Rodrigo and Botelho Filho, Carlos Alberto de Lima and Barbosa, Romero Henrique de Almeida and Tenório, Pedro Pereira. Analysis of low-density lipoprotein in diabetic patients using the Martin/Hopkins and Sampson equations. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20220859. Available from: <https://journals.cardiol.br/en/article/analysis-of-low-density-lipoprotein-in-diabetic-patients-using-the-martin-hopkins-and-sampson-equations/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Avila MS, Siqueira SRR, Waldeck L, Ayub-Ferreira SM, Takx R, Bittencourt MS, Bocchi EA, et al. Renin-angiotensin System Antagonists and Beta-blockers in Prevention of Anthracycline Cardiotoxicity: a Systematic Review and Meta-analysis. Arquivos Brasileiros de Cardiologia 2023;120(5):e20220298.

Electronic Document Format (ABNT)

Avila, Monica Samuel; Siqueira, Suellen Rodrigues Rangel; Waldeck, Lucas; Ayub-Ferreira, Silvia Moreira; Takx, Richard; Bittencourt, Marcio Sommer; Bocchi, Edimar Alcides. Renin-angiotensin System Antagonists and Beta-blockers in Prevention of Anthracycline Cardiotoxicity: a Systematic Review and Meta-analysis. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20220298, May. 2023.

Electronic Document Format (APA)

Avila, M. S., Siqueira, S. R. R., Waldeck, L., Ayub-Ferreira, S. M., Takx, R., Bittencourt, M. S., & Bocchi, E. A. (2023). Renin-angiotensin System Antagonists and Beta-blockers in Prevention of Anthracycline Cardiotoxicity: a Systematic Review and Meta-analysis. Arquivos Brasileiros de Cardiologia, 120(5), e20220298.

Electronic Document Format (ISO)

Avila, Monica Samuel and Siqueira, Suellen Rodrigues Rangel and Waldeck, Lucas and Ayub-Ferreira, Silvia Moreira and Takx, Richard and Bittencourt, Marcio Sommer and Bocchi, Edimar Alcides. Renin-angiotensin System Antagonists and Beta-blockers in Prevention of Anthracycline Cardiotoxicity: a Systematic Review and Meta-analysis. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20220298. Available from: <https://journals.cardiol.br/en/article/renin-angiotensin-system-antagonists-and-beta-blockers-in-prevention-of-anthracycline-cardiotoxicity-a-systematic-review-and-meta-analysis/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

. Erratum. Arquivos Brasileiros de Cardiologia 2023;120(5):e20230306.

Electronic Document Format (ABNT)

. Erratum. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20230306, May. 2023.

Electronic Document Format (APA)

(2023). Erratum. Arquivos Brasileiros de Cardiologia, 120(5), e20230306.

Electronic Document Format (ISO)

. Erratum. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20230306. Available from: <https://journals.cardiol.br/en/article/erratum-40/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Couceiro SM, Sant’Anna LB, Sant’Anna MB, Menezes RSM, Mesquita ET, Sant’Anna FM. Auricular Vagal Neuromodulation and its Application in Patients with Heart Failure and Reduced Ejection Fraction. Arquivos Brasileiros de Cardiologia 2023;120(5):e20220581.

Electronic Document Format (ABNT)

Couceiro, Sergio Menezes; Sant’Anna, Lucas Bonacossa; Sant’Anna, Mariana Bonacossa; Menezes, Renata S. Matos; Mesquita, Evandro Tinoco; Sant’Anna, Fernando Mendes. Auricular Vagal Neuromodulation and its Application in Patients with Heart Failure and Reduced Ejection Fraction. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20220581, May. 2023.

Electronic Document Format (APA)

Couceiro, S. M., Sant’Anna, L. B., Sant’Anna, M. B., Menezes, R. S. M., Mesquita, E. T., & Sant’Anna, F. M. (2023). Auricular Vagal Neuromodulation and its Application in Patients with Heart Failure and Reduced Ejection Fraction. Arquivos Brasileiros de Cardiologia, 120(5), e20220581.

Electronic Document Format (ISO)

Couceiro, Sergio Menezes and Sant’Anna, Lucas Bonacossa and Sant’Anna, Mariana Bonacossa and Menezes, Renata S. Matos and Mesquita, Evandro Tinoco and Sant’Anna, Fernando Mendes. Auricular Vagal Neuromodulation and its Application in Patients with Heart Failure and Reduced Ejection Fraction. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20220581. Available from: <https://journals.cardiol.br/en/article/auricular-vagal-neuromodulation-and-its-application-in-patients-with-heart-failure-and-reduced-ejection-fraction/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Sant`Anna RT, Lima GG, Saffi MAL, Kruse ML, Leiria TLL. Atrial Fibrillation Ablation: Impact of Intracardiac Echocardiography in Reducing Procedure Time and Hospitalization. Arquivos Brasileiros de Cardiologia 2023;120(5):e20220306.

Electronic Document Format (ABNT)

Sant`Anna, Roberto Tofani; Lima, Gustavo Glotz de; Saffi, Marco Aurélio Lumertz; Kruse, Marcelo Lapa; Leiria, Tiago Luiz Luz. Atrial Fibrillation Ablation: Impact of Intracardiac Echocardiography in Reducing Procedure Time and Hospitalization. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20220306, May. 2023.

Electronic Document Format (APA)

Sant`Anna, R. T., Lima, G. G. , Saffi, M. A. L., Kruse, M. L., & Leiria, T. L. L. (2023). Atrial Fibrillation Ablation: Impact of Intracardiac Echocardiography in Reducing Procedure Time and Hospitalization. Arquivos Brasileiros de Cardiologia, 120(5), e20220306.

Electronic Document Format (ISO)

Sant`Anna, Roberto Tofani and Lima, Gustavo Glotz de and Saffi, Marco Aurélio Lumertz and Kruse, Marcelo Lapa and Leiria, Tiago Luiz Luz. Atrial Fibrillation Ablation: Impact of Intracardiac Echocardiography in Reducing Procedure Time and Hospitalization. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20220306. Available from: <https://journals.cardiol.br/en/article/atrial-fibrillation-ablation-impact-of-intracardiac-echocardiography-in-reducing-procedure-time-and-hospitalization/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Bruno TC, Bittencourt MS, Quidim AVL, Santos IS, Lotufo PA, Benseñor IM, Goulart AC, et al. Prognosis Related to Reperfusion Therapy Post-Acute Coronary Syndrome in Secondary Care: Long-Term Survival Analysis in the ERICO Study. Arquivos Brasileiros de Cardiologia 2023;120(5):e20220849.

Electronic Document Format (ABNT)

Bruno, Tatiana C.; Bittencourt, Márcio S.; Quidim, Alessandra V. L.; Santos, Itamar S.; Lotufo, Paulo A.; Benseñor, Isabela M.; Goulart, Alessandra C.. Prognosis Related to Reperfusion Therapy Post-Acute Coronary Syndrome in Secondary Care: Long-Term Survival Analysis in the ERICO Study. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20220849, May. 2023.

Electronic Document Format (APA)

Bruno, T. C., Bittencourt, M. S., Quidim, A. V. L., Santos, I. S., Lotufo, P. A., Benseñor, I. M., & Goulart, A. C. (2023). Prognosis Related to Reperfusion Therapy Post-Acute Coronary Syndrome in Secondary Care: Long-Term Survival Analysis in the ERICO Study. Arquivos Brasileiros de Cardiologia, 120(5), e20220849.

Electronic Document Format (ISO)

Bruno, Tatiana C. and Bittencourt, Márcio S. and Quidim, Alessandra V. L. and Santos, Itamar S. and Lotufo, Paulo A. and Benseñor, Isabela M. and Goulart, Alessandra C.. Prognosis Related to Reperfusion Therapy Post-Acute Coronary Syndrome in Secondary Care: Long-Term Survival Analysis in the ERICO Study. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20220849. Available from: <https://journals.cardiol.br/en/article/prognosis-related-to-reperfusion-therapy-post-acute-coronary-syndrome-in-secondary-care-long-term-survival-analysis-in-the-erico-study/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Souza PO, Oliveira JMP, Januário LH. Influence of Arm Fat on the Indirect Measurement of Blood Pressure: A Statistical and Machine Learning Approach. Arquivos Brasileiros de Cardiologia 2023;120(5):e20220484.

Electronic Document Format (ABNT)

Souza, Paôla de Oliveira; Oliveira, José Maria Parente de; Januário, Letícia Helena. Influence of Arm Fat on the Indirect Measurement of Blood Pressure: A Statistical and Machine Learning Approach. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20220484, May. 2023.

Electronic Document Format (APA)

Souza, P. O., Oliveira, J. M. P. , & Januário, L. H. (2023). Influence of Arm Fat on the Indirect Measurement of Blood Pressure: A Statistical and Machine Learning Approach. Arquivos Brasileiros de Cardiologia, 120(5), e20220484.

Electronic Document Format (ISO)

Souza, Paôla de Oliveira and Oliveira, José Maria Parente de and Januário, Letícia Helena. Influence of Arm Fat on the Indirect Measurement of Blood Pressure: A Statistical and Machine Learning Approach. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20220484. Available from: <https://journals.cardiol.br/en/article/influence-of-arm-fat-on-the-indirect-measurement-of-blood-pressure-a-statistical-and-machine-learning-approach/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Accorsi TAD, Nemoto RP, Nunes JT, Azevedo Filho AFB, Moreira FT, Kohler KF, Lima KA, et al. Clinical Features and Management of Patients Assessed by Cardiology Teleconsultation in the Brazilian Region with the Highest Number of Isolated Cities. Arquivos Brasileiros de Cardiologia 2023;120(5):e20220467.

Electronic Document Format (ABNT)

Accorsi, Tarso Augusto Duenhas; Nemoto, Renato Paladino; Nunes, Jairo Tavares; Azevedo Filho, Antônio Fernando Barros de; Moreira, Flavio Tocci; Kohler, Karen Francine; Lima, Karine de Amicis; Amaral, Bruna Dayanne Reges; Morbeck, Renata Albaladejo; Pedrotti, Carlos Henrique Sartorato. Clinical Features and Management of Patients Assessed by Cardiology Teleconsultation in the Brazilian Region with the Highest Number of Isolated Cities. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20220467, May. 2023.

Electronic Document Format (APA)

Accorsi, T. A. D., Nemoto, R. P., Nunes, J. T., Azevedo Filho, A. F. B. , Moreira, F. T., Kohler, K. F., Lima, K. A., Amaral, B. D. R., Morbeck, R. A., & Pedrotti, C. H. S. (2023). Clinical Features and Management of Patients Assessed by Cardiology Teleconsultation in the Brazilian Region with the Highest Number of Isolated Cities. Arquivos Brasileiros de Cardiologia, 120(5), e20220467.

Electronic Document Format (ISO)

Accorsi, Tarso Augusto Duenhas and Nemoto, Renato Paladino and Nunes, Jairo Tavares and Azevedo Filho, Antônio Fernando Barros de and Moreira, Flavio Tocci and Kohler, Karen Francine and Lima, Karine de Amicis and Amaral, Bruna Dayanne Reges and Morbeck, Renata Albaladejo and Pedrotti, Carlos Henrique Sartorato. Clinical Features and Management of Patients Assessed by Cardiology Teleconsultation in the Brazilian Region with the Highest Number of Isolated Cities. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20220467. Available from: <https://journals.cardiol.br/en/article/clinical-features-and-management-of-patients-assessed-by-cardiology-teleconsultation-in-the-brazilian-region-with-the-highest-number-of-isolated-cities/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Meng Y, Zhang Z, Zhao T, Zhang D. Prognostic Significance of Nutrition-Associated Markers in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis. Arquivos Brasileiros de Cardiologia 2023;120(5):e20220523.

Electronic Document Format (ABNT)

Meng, Ying; Zhang, Zhengyi; Zhao, Tong; Zhang, Dekui. Prognostic Significance of Nutrition-Associated Markers in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20220523, May. 2023.

Electronic Document Format (APA)

Meng, Y., Zhang, Z., Zhao, T., & Zhang, D. (2023). Prognostic Significance of Nutrition-Associated Markers in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis. Arquivos Brasileiros de Cardiologia, 120(5), e20220523.

Electronic Document Format (ISO)

Meng, Ying and Zhang, Zhengyi and Zhao, Tong and Zhang, Dekui. Prognostic Significance of Nutrition-Associated Markers in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20220523. Available from: <https://journals.cardiol.br/en/article/prognostic-significance-of-nutrition-associated-markers-in-heart-failure-with-preserved-ejection-fraction-a-systematic-review-and-meta-analysis/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

. Erratum. Arquivos Brasileiros de Cardiologia 2023;120(5):e20230178.

Electronic Document Format (ABNT)

. Erratum. Arquivos Brasileiros de Cardiologia, v. 120, n. 5, e20230178, May. 2023.

Electronic Document Format (APA)

(2023). Erratum. Arquivos Brasileiros de Cardiologia, 120(5), e20230178.

Electronic Document Format (ISO)

. Erratum. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 5, [cited 2026-10-14], e20230178. Available from: <https://journals.cardiol.br/en/article/erratum-36/>. ISSN 0066-782X

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