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  2. Keyword: Cardiac Conduction System Disease
Figure 1
ABC
Research Letter

Late-Onset Fabry Disease: Diagnostic Challenges and Clinical Evolution

Hernán Patricio García Mejía et al. Heleuterio da Conceição Nicolau Madogolele Manuela Cristina Ribeiro Dias Barroso Matheus Carvalho Alves Nogueira … Kevin Rafael de Paula Morales Cristhian Espinoza Romero Luciano Nastari Fábio Fernandes

Introduction

Simultaneous cardiac and renal involvement can result from various systemic conditions, such as hypertension, autoimmune diseases, infiltrative diseases, and hereditary syndromes. Fabry disease (FD) is an X-linked genetic disorder caused by a deficiency or absence of the enzyme α-galactosidase A, leading to the progressive accumulation of glycosphingolipids, especially globotriaosylceramide (Gb3), in various tissues. This accumulation of Gb3 promotes multisystemic dysfunctions, with heterogeneous clinical manifestations that vary according to sex, the degree of residual enzymatic activity, and the form of presentation, classic or non-classic.,

The estimated incidence of FD ranges from 1 in 40,000 to 1 in 117,000 individuals worldwide. In Brazil, the epidemiology of FD remains poorly defined due to the rarity of the condition and underreporting of cases, which reinforces the value of clinical reports such as this one.

[…]

  • Cardiac Conduction System Disease
  • Cardiomyopathies
  • Fabry Disease
  • Left Ventricular Hypertrophy
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Creative Commons Attribution (CC BY) Creative Commons license
17/04/2026 DOI: 10.36660/abc.20250554i Views 3
Figure 1
ABC
Research Letter

Left Anterior Fascicular Block Associated with Atrioventricular Block during Exercise Stress Test

Andréa Marinho Falcão et al. Vagner L. Suares William A. Chalela

Introduction

The exercise stress test (EST) has been indicated in various clinical situations. Despite the robust evidence about the clinical significance of ST-T abnormalities during exercise, little attention has been paid to the development of exercise-induced intraventricular conduction disorders.

Conduction disorders and fascicular blocks induced during EST are rare. The prevalence of stress-induced left bundle-branch blocks (LBBB) ranges from 0.3%-0.5%, and frequently, the prognosis is more adverse (greater CAD and heart failure prevalence).

[…]

  • Cardiac Conduction System Disease
  • Coronary Artery Disease
  • Exercise Test
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Creative Commons Attribution (CC BY) Creative Commons license
20/11/2023 DOI: 10.36660/abc.20230200
Figure 2
ABC
Original Article

Long-Term Ventricular Pacing Dependency and Pacemaker Implantation Predictors after Transcatheter Aortic Valve Replacement – A 1-Year Follow-Up

Ricardo Alves Pinto et al. Tânia Proença Miguel Martins Carvalho Gonçalo Pestana … Ana Lebreiro Luis Adão Filipe Macedo

Abstract

Background

Conduction disturbances (CD) are the most frequent complication after transcatheter aortic valve replacement (TAVR), and there continues to be a lack of consensus on their management.

Objective

To assess new CD and permanent pacemaker (PPM) implantation after TAVR and to evaluate the ventricular pacing percentage (VP) up to 1 year of follow-up.

Methods

Patients who underwent TAVR from October 2014 to November 2019 were enrolled; patients with previous PPM were excluded. Clinical, procedure, ECG, and PPM data were collected up to 1 year after implantation. The significance level adopted in the statistical analysis was 0.05.

Results

A total of 340 patients underwent TAVR. The most frequent CD was the new left bundle branch block (LBBB; 32.2%), which 56% resolved after 6 months. Right bundle branch block (RBBB) was the biggest risk factor for advanced atrioventricular block (AVB) [OR=8.46; p<0.001] and PPM implantation [OR=5.18, p<0.001], followed by previous low-grade AVB [OR=2.25; p=0.016 for PPM implantation]. Regarding procedure characteristics, newer generation valves and valve-in-valve procedures were associated with fewer CDs. Overall, 18.5% of patients had a PPM implanted post-TAVR. At first PPM evaluation, patients with advanced AVB had a median percentage of VP of 80% and 83% at one year. Regarding patients with LBBB plus low-grade AVB, median VP was lower (6% at first assessment, p=0.036; 2% at one year, p = 0.065).

Conclusion

LBBB was the most frequent CD after TAVR, with more than half being resolved in the first six months. RBBB was the major risk factor for advanced AVB and PPM implantation. Advanced AVB was associated with a higher percentage of VP at 1 year of follow-up.

  • Aortic Valve Stenosis
  • Atrioventriclar Block
  • Cardiac Conduction System Disease
  • Heart Valve Prosthesis Implantation
  • Pacemaker,Artificial
  • Transcatheter Aortic Valve Replacement
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Creative Commons Attribution (CC BY) Creative Commons license
18/07/2022 DOI: 10.36660/abc.20210613 Views 2
ABC
Original Article

Assessment of Subclinical Cardiac Alterations and Atrial Electromechanical Delay by Tissue Doppler Echocardiography in Patients with Nonfunctioning Adrenal Incidentaloma

Gulizar Sokmen et al. Murat Sahin Dilek Tuzun Abdullah Sokmen … Hanife Bolat Ayten Oguz Adem Doganer Huseyin Nacar Kamile Gul

Abstract

Background:

Majority of the incidentally discovered adrenal masses, called adrenal incidentaloma (AI), are nonfunctioning adrenal adenomas. The appropriate management of AI is still a matter debate, so it is necessary to investigate their associated morbidity. However, data regarding morphological and functional cardiac alterations are limited in this group.

Objective:

In this study, we aimed to assess cardiac structural and functional characteristics and atrial conduction properties in patients with nonfunctioning AI.

Methods:

Thirty patients with nonfunctioning AI and 46 properly matched control subjects were included in the study. After hormonal and biochemical analysis, all participants underwent transthoracic echocardiography to obtain systolic and diastolic parameters of both ventricles, in addition to atrial conduction times by tissue Doppler echocardiography. Data were analyzed with Statistical Package for the Social Sciences (SPSS, Chicago, IL, United States) statistics, version 17.0 for Windows. P < 0.05 was considered statistically significant.

Results:

Left ventricular (LV) mass index and LV myocardial performance index were significantly increased in AI group. Among atrial conduction times, both intra- and interatrial electromechanical delays were significantly prolonged in patients with nonfunctioning AI. Other laboratory and echocardiographic findings were similar between groups.

Conclusion:

Our study revealed that intra- and inter-atrial conduction times were prolonged, and LV mass index was increased in patients with nonfunctioning AI. These findings may be markers of subclinical cardiac involvement and tendency to cardiovascular complications. Close follow-up is necessary for individuals with nonfunctioning AI for their increased cardiovascular risk.

  • Adrenocortical Adenoma
  • Cardiac Conduction System Disease
  • Diagnostic Imaging
  • Diastole/function
  • Incidental Findings
  • Metabolic Syndrome
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Creative Commons Attribution (CC BY) Creative Commons license
11/10/2018 DOI: 10.5935/abc.20180188 Views 1

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Mejía HPG, Madogolele HCN, Barroso MCRD, Nogueira MCA, Morales KRP, Romero CE, Nastari L, et al. Late-Onset Fabry Disease: Diagnostic Challenges and Clinical Evolution. Arquivos Brasileiros de Cardiologia 2026;123(2):e20250554.

Electronic Document Format (ABNT)

Mejía, Hernán Patricio García; Madogolele, Heleuterio da Conceição Nicolau; Barroso, Manuela Cristina Ribeiro Dias; Nogueira, Matheus Carvalho Alves; Morales, Kevin Rafael de Paula; Romero, Cristhian Espinoza; Nastari, Luciano; Fernandes, Fábio. Late-Onset Fabry Disease: Diagnostic Challenges and Clinical Evolution. Arquivos Brasileiros de Cardiologia, v. 123, n. 2, e20250554, Apr. 2026.

Electronic Document Format (APA)

Mejía, H. P. G., Madogolele, H. C. N., Barroso, M. C. R. D., Nogueira, M. C. A., Morales, K. R. P., Romero, C. E., Nastari, L., & Fernandes, F. (2026). Late-Onset Fabry Disease: Diagnostic Challenges and Clinical Evolution. Arquivos Brasileiros de Cardiologia, 123(2), e20250554.

Electronic Document Format (ISO)

Mejía, Hernán Patricio García and Madogolele, Heleuterio da Conceição Nicolau and Barroso, Manuela Cristina Ribeiro Dias and Nogueira, Matheus Carvalho Alves and Morales, Kevin Rafael de Paula and Romero, Cristhian Espinoza and Nastari, Luciano and Fernandes, Fábio. Late-Onset Fabry Disease: Diagnostic Challenges and Clinical Evolution. Arquivos Brasileiros de Cardiologia [online]. 2026, vol. 123, n. 2, [cited 2026-10-14], e20250554. Available from: <https://journals.cardiol.br/en/article/late-onset-fabry-disease-diagnostic-challenges-and-clinical-evolution/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Falcão AM, Suares VL, Chalela WA. Left Anterior Fascicular Block Associated with Atrioventricular Block during Exercise Stress Test. Arquivos Brasileiros de Cardiologia 2023;120(11):e20230200.

Electronic Document Format (ABNT)

Falcão, Andréa Marinho; Suares, Vagner L.; Chalela, William A.. Left Anterior Fascicular Block Associated with Atrioventricular Block during Exercise Stress Test. Arquivos Brasileiros de Cardiologia, v. 120, n. 11, e20230200, Nov. 2023.

Electronic Document Format (APA)

Falcão, A. M., Suares, V. L., & Chalela, W. A. (2023). Left Anterior Fascicular Block Associated with Atrioventricular Block during Exercise Stress Test. Arquivos Brasileiros de Cardiologia, 120(11), e20230200.

Electronic Document Format (ISO)

Falcão, Andréa Marinho and Suares, Vagner L. and Chalela, William A.. Left Anterior Fascicular Block Associated with Atrioventricular Block during Exercise Stress Test. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 11, [cited 2026-10-14], e20230200. Available from: <https://journals.cardiol.br/en/article/left-anterior-fascicular-block-associated-with-atrioventricular-block-during-exercise-stress-test/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Pinto RA, Proença T, Carvalho MM, Pestana G, Lebreiro A, Adão L, Macedo F, et al. Long-Term Ventricular Pacing Dependency and Pacemaker Implantation Predictors after Transcatheter Aortic Valve Replacement – A 1-Year Follow-Up. Arquivos Brasileiros de Cardiologia 2022;119(4):522-30.

Electronic Document Format (ABNT)

Pinto, Ricardo Alves; Proença, Tânia; Carvalho, Miguel Martins; Pestana, Gonçalo; Lebreiro, Ana; Adão, Luis; Macedo, Filipe. Long-Term Ventricular Pacing Dependency and Pacemaker Implantation Predictors after Transcatheter Aortic Valve Replacement – A 1-Year Follow-Up. Arquivos Brasileiros de Cardiologia, v. 119, n. 4, p. 522-530, Jul. 2022.

Electronic Document Format (APA)

Pinto, R. A., Proença, T., Carvalho, M. M., Pestana, G., Lebreiro, A., Adão, L., & Macedo, F. (2022). Long-Term Ventricular Pacing Dependency and Pacemaker Implantation Predictors after Transcatheter Aortic Valve Replacement – A 1-Year Follow-Up. Arquivos Brasileiros de Cardiologia, 119(4), 522-530.

Electronic Document Format (ISO)

Pinto, Ricardo Alves and Proença, Tânia and Carvalho, Miguel Martins and Pestana, Gonçalo and Lebreiro, Ana and Adão, Luis and Macedo, Filipe. Long-Term Ventricular Pacing Dependency and Pacemaker Implantation Predictors after Transcatheter Aortic Valve Replacement – A 1-Year Follow-Up. Arquivos Brasileiros de Cardiologia [online]. 2022, vol. 119, n. 4, [cited 2026-10-14], pp. 522-530. Available from: <https://journals.cardiol.br/en/article/long-term-ventricular-pacing-dependency-and-pacemaker-implantation-predictors-after-transcatheter-aortic-valve-replacement-a-1-year-follow-up/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Sokmen G, Sahin M, Tuzun D, Sokmen A, Bolat H, Oguz A, Doganer A, et al. Assessment of Subclinical Cardiac Alterations and Atrial Electromechanical Delay by Tissue Doppler Echocardiography in Patients with Nonfunctioning Adrenal Incidentaloma. Arquivos Brasileiros de Cardiologia 2018;111(5):656-63.

Electronic Document Format (ABNT)

Sokmen, Gulizar; Sahin, Murat; Tuzun, Dilek; Sokmen, Abdullah; Bolat, Hanife; Oguz, Ayten; Doganer, Adem; Nacar, Huseyin; Gul, Kamile. Assessment of Subclinical Cardiac Alterations and Atrial Electromechanical Delay by Tissue Doppler Echocardiography in Patients with Nonfunctioning Adrenal Incidentaloma. Arquivos Brasileiros de Cardiologia, v. 111, n. 5, p. 656-663, Oct. 2018.

Electronic Document Format (APA)

Sokmen, G., Sahin, M., Tuzun, D., Sokmen, A., Bolat, H., Oguz, A., Doganer, A., Nacar, H., & Gul, K. (2018). Assessment of Subclinical Cardiac Alterations and Atrial Electromechanical Delay by Tissue Doppler Echocardiography in Patients with Nonfunctioning Adrenal Incidentaloma. Arquivos Brasileiros de Cardiologia, 111(5), 656-663.

Electronic Document Format (ISO)

Sokmen, Gulizar and Sahin, Murat and Tuzun, Dilek and Sokmen, Abdullah and Bolat, Hanife and Oguz, Ayten and Doganer, Adem and Nacar, Huseyin and Gul, Kamile. Assessment of Subclinical Cardiac Alterations and Atrial Electromechanical Delay by Tissue Doppler Echocardiography in Patients with Nonfunctioning Adrenal Incidentaloma. Arquivos Brasileiros de Cardiologia [online]. 2018, vol. 111, n. 5, [cited 2026-10-14], pp. 656-663. Available from: <https://journals.cardiol.br/en/article/assessment-of-subclinical-cardiac-alterations-and-atrial-electromechanical-delay-by-tissue-doppler-echocardiography-in-patients-with-nonfunctioning-adrenal-incidentaloma/>. ISSN 0066-782X

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