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  2. Keyword: Cerebral Infarction
Figure 1
ABC
Case Report

Could Acute Myeloid Leukemia Have Presented Even Worse? “Uncommon Cause of Concurrently Multivessel Thrombosis”

Kutluhan Eren Hazir et al. Ersin Cagri Simsek Esra Baldan Hakan Gökalp Uzun … Hale Bulbul Bengisu Yarci Elif Busra Ozcan

Abstract

Acute promyelocytic leukemia (APL) is a subgroup of acute myeloid leukemia (AML). Although it is known that hemorrhagic complications are common, thrombotic complications are not as rare as thought. However, myocardial infarction and ischemic stroke incidence are very rare during AML. Here, we present the astonishing case of APL diagnosed with pancytopenia in its presentation with acute myocardial infarction and ischemic stroke.

  • Cerebral Infarction
  • Leukemia, Promyelocytic, Acute
  • Myocardial Infarction
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Creative Commons Attribution (CC BY) Creative Commons license
11/08/2023 DOI: 10.36660/abc.20220808
ABC
Original Article

Atrial High-Rate Episodes and Their Association with Cerebral Ischemic Events in Chagasic Patients

Emanoela Lima Freitas et al. Elieusa e Silva Sampaio Márcia Maria Carneiro Oliveira Lucas Hollanda Oliveira … Marcos Sergio da Silva Guimarães Jussara de Oliveira Pinheiro Luís Pereira de Magalhães Guisela Steffen Bonadie Albuquerque Cristiano Macedo Roque Aras

Abstract

Background

Atrial high-rate episodes (AHREs) are associated with an increased risk of cerebral ischemic events; however, there are no studies related to the presence of AHREs and cerebral ischemic events in Chagasic patients.

Objective

To investigate the association between the presence of AHREs ≥ 6 minutes and cerebral ischemic events in Chagasic patients.

Methods

Cohort study with Chagasic patients with implantable electronic cardiac devices (IECDs), followed at the Arrhythmia Outpatient Clinic of a University Hospital, in the city of Salvador, state of Bahia, Brazil, between May 2016 and June 2017.. Patients diagnosed with atrial flutter / atrial fibrillation, with unicameral IECD and using oral anticoagulation were excluded. AHREs with atrial frequency ≥ 190 beats per minute and duration ≥ 6 minutes (min) were considered, and cerebral ischemic events were identified by computed tomography (CT) of the skull.

Results

The 67 research participants (67.2% females, mean age 63.6 ± 9.2 years) were followed for 98 ± 28.8 days and 11.9% of the patients had AHREs ≥ 6 min. Skull CT showed silent cerebral ischemic events in 16.4% of the patients, 63.6% of whom had AHREs ≥ 6 min in the analysis of IECDs. Advanced age [OR 1.12 (95% CI 1.03-1.21; p=0.009] and the presence of AHREs ≥ 6 minutes [OR 96.2 (95% CI 9.4-987.4; p <0.001)] were independent predictors for ischemic events.

Conclusion

AHREs detected by IECDs were associated with the presence of silent cerebral ischemic events in Chagasic patients. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

  • Atrial flutter
  • Brain Ischemia
  • Cerebral Infarction
  • Chagas Disease/complications
  • Pacemaker, Artificial
  • Tomography, Computed/methods
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Creative Commons Attribution (CC BY) Creative Commons license
11/09/2020 DOI: 10.36660/abc.20190647 Views 3
ABC
Brief Communication

Silent Cerebral Infarctions with Reduced, Mid-Range and Preserved Ejection Fraction in Patients with Heart Failure

Márcia Maria Carneiro Oliveira et al. Elieusa e Silva Sampaio Jun Ramos Kawaoka Maria Amélia Bulhões Hatem … Edmundo José Nassri Câmara André Maurício Souza Fernandes Jamary Oliveira-Filho Roque Aras

Abstract

Heart failure predisposes to an increased risk of silent cerebral infarction, and data related to left ventricular ejection fraction are still limited. Our objective was to describe the clinical and echocardiographic characteristics and factors associated with silent cerebral infarction in patients with heart failure, according to the left ventricular ejection fraction groups. A prospective cohort was performed at a referral hospital in Cardiology between December 2015 and July 2017. The left ventricular ejection fraction groups were: reduced (≤ 40%), mid-range (41-49%) and preserved (≥ 50%). All patients underwent cranial tomography, transthoracic and transesophageal echocardiography. Seventy-five patients were studied. Silent cerebral infarction was observed in 14.7% of the study population (45.5% lacunar and 54.5% territorial) and was more frequent in patients in the reduced left ventricular ejection fraction group (29%) compared with the mid-range one (15.4%, p = 0.005). There were no cases of silent cerebral infarction in the group of preserved left ventricular ejection fraction. In the univariate analysis, an association was identified between silent cerebral infarction and reduced (OR = 8.59; 95%CI: 1.71 – 43.27; p = 0.009) and preserved (OR = 0.05; 95%CI: 0.003-0.817, p = 0.003) left ventricular ejection fraction and diabetes mellitus (OR = 4.28, 95%CI: 1.14-16.15, p = 0.031). In patients with heart failure and without a clinical diagnosis of stroke, reduced and mid-range left ventricular ejection fractions contributed to the occurrence of territorial and lacunar silent cerebral infarction, respectively. The lower the left ventricular ejection fraction, the higher the prevalence of silent cerebral infarction.

  • Cerebral Infarction
  • Heart Failure
  • Stroke
  • Stroke Volume
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Creative Commons Attribution (CC BY) Creative Commons license
01/09/2018 DOI: 10.5935/abc.20180140
ABC
Original Article

Cerebral infarction in autopsies of chagasic patients with heart failure

Roque Aras et al. José Alberto M. da Matta Gildo Mota Irênio Gomes Ailton Melo

OBJECTIVE: To determine the frequency of encephalic infarction and its contribution to lethality in patients with Chagas’ disease and heart failure. METHODS: Medical records and autopsy reports of patients with Chagas’ disease complicated by heart failure, who died at the Professor Edgar Santos Hospital of the Federal University of Bahia in the past 45 years were retrospectively analyzed. Data comprised information regarding the clinical history on hospital admission, complementary and anatomicopathological examinations, including the presence of encephalic infarction, the impaired region, and the cause of death. RESULTS: Of the 5,447 autopsies performed, 524 were in patients with heart failure due to Chagas’ disease. The mean age was 45.7 years, and 51 (63%) patients were of the male sex. The frequency of encephalic infarction was 17.5%, corresponding to 92 events in 92 individuals, 82 (15.8%) of which involved the brain, 8 (1.5%) involved the cerebellum, and 2 (0.4%) involved the hypophysis. CONCLUSION: Cerebral infarction has been a frequent finding in autopsies of chagasic patients with heart failure, and it has been an important cause of death in our region. The presence of cerebral infarction and its complications have been associated with death in 52% of the cases studied.

  • autopsies
  • Cerebral Infarction
  • Chagas disease
  • frequency
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Creative Commons Attribution (CC BY) Creative Commons license
06/11/2003 DOI: 10.1590/S0066-782X2003001200008

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Hazir KE, Simsek EC, Baldan E, Uzun HG, Bulbul H, Yarci B, Ozcan EB, et al. Could Acute Myeloid Leukemia Have Presented Even Worse? “Uncommon Cause of Concurrently Multivessel Thrombosis”. Arquivos Brasileiros de Cardiologia 2023;120(8):20220808.

Electronic Document Format (ABNT)

Hazir, Kutluhan Eren; Simsek, Ersin Cagri; Baldan, Esra; Uzun, Hakan Gökalp; Bulbul, Hale; Yarci, Bengisu; Ozcan, Elif Busra. Could Acute Myeloid Leukemia Have Presented Even Worse? “Uncommon Cause of Concurrently Multivessel Thrombosis”. Arquivos Brasileiros de Cardiologia, v. 120, n. 8, 20220808, Aug. 2023.

Electronic Document Format (APA)

Hazir, K. E., Simsek, E. C., Baldan, E., Uzun, H. G., Bulbul, H., Yarci, B., & Ozcan, E. B. (2023). Could Acute Myeloid Leukemia Have Presented Even Worse? “Uncommon Cause of Concurrently Multivessel Thrombosis”. Arquivos Brasileiros de Cardiologia, 120(8), 20220808.

Electronic Document Format (ISO)

Hazir, Kutluhan Eren and Simsek, Ersin Cagri and Baldan, Esra and Uzun, Hakan Gökalp and Bulbul, Hale and Yarci, Bengisu and Ozcan, Elif Busra. Could Acute Myeloid Leukemia Have Presented Even Worse? “Uncommon Cause of Concurrently Multivessel Thrombosis”. Arquivos Brasileiros de Cardiologia [online]. 2023, vol. 120, n. 8, [cited 2026-10-14], 20220808. Available from: <https://journals.cardiol.br/en/article/could-acute-myeloid-leukemia-have-presented-even-worse-uncommon-cause-of-concurrently-multivessel-thrombosis/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Freitas EL, Sampaio ES, Oliveira MMC, Oliveira LH, Guimarães MSS, Pinheiro JO, Magalhães LP, et al. Atrial High-Rate Episodes and Their Association with Cerebral Ischemic Events in Chagasic Patients. Arquivos Brasileiros de Cardiologia 2020;115(6):1072-9.

Electronic Document Format (ABNT)

Freitas, Emanoela Lima; Sampaio, Elieusa e Silva; Oliveira, Márcia Maria Carneiro; Oliveira, Lucas Hollanda; Guimarães, Marcos Sergio da Silva; Pinheiro, Jussara de Oliveira; Magalhães, Luís Pereira de; Albuquerque, Guisela Steffen Bonadie; Macedo, Cristiano; Aras, Roque. Atrial High-Rate Episodes and Their Association with Cerebral Ischemic Events in Chagasic Patients. Arquivos Brasileiros de Cardiologia, v. 115, n. 6, p. 1072-1079, Sep. 2020.

Electronic Document Format (APA)

Freitas, E. L., Sampaio, E. S., Oliveira, M. M. C., Oliveira, L. H., Guimarães, M. S. S., Pinheiro, J. O., Magalhães, L. P. , Albuquerque, G. S. B., Macedo, C., & Aras, R. (2020). Atrial High-Rate Episodes and Their Association with Cerebral Ischemic Events in Chagasic Patients. Arquivos Brasileiros de Cardiologia, 115(6), 1072-1079.

Electronic Document Format (ISO)

Freitas, Emanoela Lima and Sampaio, Elieusa e Silva and Oliveira, Márcia Maria Carneiro and Oliveira, Lucas Hollanda and Guimarães, Marcos Sergio da Silva and Pinheiro, Jussara de Oliveira and Magalhães, Luís Pereira de and Albuquerque, Guisela Steffen Bonadie and Macedo, Cristiano and Aras, Roque. Atrial High-Rate Episodes and Their Association with Cerebral Ischemic Events in Chagasic Patients. Arquivos Brasileiros de Cardiologia [online]. 2020, vol. 115, n. 6, [cited 2026-10-14], pp. 1072-1079. Available from: <https://journals.cardiol.br/en/article/atrial-high-rate-episodes-and-their-association-with-cerebral-ischemic-events-in-chagasic-patients/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Oliveira MMC, Sampaio ES, Kawaoka JR, Hatem MAB, Câmara EJN, Fernandes AMS, Oliveira-Filho J, et al. Silent Cerebral Infarctions with Reduced, Mid-Range and Preserved Ejection Fraction in Patients with Heart Failure. Arquivos Brasileiros de Cardiologia 2018;111(3):419-22.

Electronic Document Format (ABNT)

Oliveira, Márcia Maria Carneiro; Sampaio, Elieusa e Silva; Kawaoka, Jun Ramos; Hatem, Maria Amélia Bulhões; Câmara, Edmundo José Nassri; Fernandes, André Maurício Souza; Oliveira-Filho, Jamary; Aras, Roque. Silent Cerebral Infarctions with Reduced, Mid-Range and Preserved Ejection Fraction in Patients with Heart Failure. Arquivos Brasileiros de Cardiologia, v. 111, n. 3, p. 419-422, Aug. 2018.

Electronic Document Format (APA)

Oliveira, M. M. C., Sampaio, E. S., Kawaoka, J. R., Hatem, M. A. B., Câmara, E. J. N., Fernandes, A. M. S., Oliveira-Filho, J., & Aras, R. (2018). Silent Cerebral Infarctions with Reduced, Mid-Range and Preserved Ejection Fraction in Patients with Heart Failure. Arquivos Brasileiros de Cardiologia, 111(3), 419-422.

Electronic Document Format (ISO)

Oliveira, Márcia Maria Carneiro and Sampaio, Elieusa e Silva and Kawaoka, Jun Ramos and Hatem, Maria Amélia Bulhões and Câmara, Edmundo José Nassri and Fernandes, André Maurício Souza and Oliveira-Filho, Jamary and Aras, Roque. Silent Cerebral Infarctions with Reduced, Mid-Range and Preserved Ejection Fraction in Patients with Heart Failure. Arquivos Brasileiros de Cardiologia [online]. 2018, vol. 111, n. 3, [cited 2026-10-14], pp. 419-422. Available from: <https://journals.cardiol.br/en/article/silent-cerebral-infarctions-with-reduced-mid-range-and-preserved-ejection-fraction-in-patients-with-heart-failure/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Aras R, Matta JAM, Mota G, Gomes I, Melo A. Cerebral infarction in autopsies of chagasic patients with heart failure. Arquivos Brasileiros de Cardiologia 2003;81(4):414-6.

Electronic Document Format (ABNT)

Aras, Roque; Matta, José Alberto M. da; Mota, Gildo; Gomes, Irênio; Melo, Ailton. Cerebral infarction in autopsies of chagasic patients with heart failure. Arquivos Brasileiros de Cardiologia, v. 81, n. 4, p. 414-416, Nov. 2003.

Electronic Document Format (APA)

Aras, R., Matta, J. A. M. , Mota, G., Gomes, I., & Melo, A. (2003). Cerebral infarction in autopsies of chagasic patients with heart failure. Arquivos Brasileiros de Cardiologia, 81(4), 414-416.

Electronic Document Format (ISO)

Aras, Roque and Matta, José Alberto M. da and Mota, Gildo and Gomes, Irênio and Melo, Ailton. Cerebral infarction in autopsies of chagasic patients with heart failure. Arquivos Brasileiros de Cardiologia [online]. 2003, vol. 81, n. 4, [cited 2026-10-14], pp. 414-416. Available from: <https://journals.cardiol.br/en/article/cerebral-infarction-in-autopsies-of-chagasic-patients-with-heart-failure/>. ISSN 0066-782X

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