Diagnostic Equipment – ABC CARDIOL

ABCIC

Review Article

My approach to optimize my equipment for the use of ultrasound contrast agents

Abstract

Contrast echocardiography, based on ultrasound contrast agents composed of microbubbles, has been increasingly incorporated into echocardiography labs. It involves the infusion of compounds that enhance the visualization of various cardiac and vascular structures. The multiple adjustments required are usually included in pre-configured packages (presets) installed by manufacturers on the equipment. However, it is possible – and sometimes necessary – to make modifications to optimize image generation and, guided by the objective of the echocardiographic study, to achieve the full potential this technique can offer.

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ABC

Original Article

Subclinical Atrial Fibrillation Screening in Dialytic Chronic Kidney Disease Patients Using Portable Device

Adson Patrik Vieira Carvalho et al. Gabriel Assis Lopes do Carmo Cassia Aparecida Silva Ana Cecília Oliveira … Lucas Giandoni Perez Lilian Pires de Freitas do Carmo Antonio L. Ribeiro

Abstract

Background

Cardiovascular morbidity and mortality rates are higher in hemodialysis (HD) patients, with an increased prevalence of arrhythmias. Atrial fibrillation (AF) is an independent risk factor for mortality and thromboembolic events in dialysis patients. For a better understanding and management of AF in these patients, it is important to know its prevalence. The use of a portable device would be pioneering for this group of patients.

Objective

To screen HD patients for AF using a portable gadget and evaluate the device’s diagnostic performance.

Methods

HD patients at a tertiary hospital underwent AF screening during HD sessions using MyDiagnostick^® (Applied Biomedical Systems). Multiple data were collected to evaluate potential associations. Statistical significance was defined as p < 0.05.

Results

388 patients were evaluated (female, 40.7%; mean age of 56.8 years old, SD ± 14.7; and HD time of 27 months, 10-57). Screening was positive in 16 (4.1%) patients. AF was confirmed by electrocardiogram in 7 (1.8%) patients. Male sex (p = 0.019), older age (p = 0.007), altered baseline electrocardiogram (p < 0.001), increased serum potassium (p = 0.021), reduced systolic blood pressure at the beginning of dialysis (p = 0.007), and stable angina (0.011) were associated with positive screening for AF. The device presented a 91.74% specificity (95% CI, 86.65% to 96.91%) and 100% sensitivity (95% CI, 100% to 100%), with a negative predictive value of 100% (95% CI, 100% to 100%) for AF screening.

Conclusion

The use of this device proved to be practical, with high sensitivity and excellent negative predictive value. Subclinical AF has a high prevalence and may be underestimated in this population.

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ABC

Editorial

Short Editorial: Distinct Prognostic Competence between the Clinical and Anatomical Models in Acute Coronary Syndromes: Comparison by Type of Outcome

Roberto Coury Pedrosa

Cardiovascular events, especially acute myocardial infarction, are the main causes of death in Brazil. In some European countries (e.g., France, Portugal, Italy), the 30-day mortality rates due to infarction have declined in recent decades to as low as 3% to 5%. This reflects the organization of healthcare logistics, including pre-hospital care, unified protocols, training, central regulation, and commitment to care. In Brazil, the 30-day mortality rates vary from 3% to 5% in advanced centers and 30% in those where care does not apply the recommended guidelines. This disparity usually reflects a still deficient public healthcare system that lacks diagnostic flowcharts, institutional protocols, central regulation, or professionals who are able to interpret the diagnosis for infarction using an electrocardiogram (ECG). Unfortunately, we still find that many centers lack equipment in emergency sectors (defibrillator, intubation materials, ventilators, electrocardiographs, vasoactive drugs, cardiac monitors, temporary pacemakers, and fibrinolytic drugs) and coronary units, as well as the lack of qualified professionals to provide the best treatment.

The recognition that acute coronary syndromes (ACS) constitute a heterogeneous disease in relation to prognosis was fundamental for the correct identification of individuals at higher risk, who require more intensive intervention. It has been shown that not all patients with ACS belong to high or very high risk categories; there is a considerable percentage consisting of young patients without classic risk factors that can be adequately classified into intermediate or even low risk categories. Thus, it is important to identify those patients at higher risk who need more intensive treatment. Important clinical studies have contributed to the evolution of the approach to patients with ACS.^– Currently, the emerging focus on the involvement of socioeconomic factors in cardiovascular risk has been constantly reported.

[…]

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My approach to optimize my equipment for the use of ultrasound contrast agents

Abstract

Subclinical Atrial Fibrillation Screening in Dialytic Chronic Kidney Disease Patients Using Portable Device

Abstract

Background

Objective

Methods

Results

Conclusion

Short Editorial: Distinct Prognostic Competence between the Clinical and Anatomical Models in Acute Coronary Syndromes: Comparison by Type of Outcome

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)