Pandemic – ABC CARDIOL

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Research Letter

Change of Strategy in Coronary Artery Bypass Graft Surgery Waiting List during the COVID-19 Pandemic: One-Year Follow-Up

Franc Jorge Sampaio Santos Pereira et al. Marília Prudente Menezes Gabriela Carolina Santamaria Naranjo José Henrique Herrmann Delamain … José Ribamar Costa Mario Issa Vivian Lerner Amato Fausto Feres Pedro Silvio Farsky

Introduction

The COVID-19 pandemic led to a significant occupation of intensive care beds, causing the suspension of elective cases of coronary artery bypass grafting (CABG).

At the same time, the evolution of techniques for the percutaneous treatment of coronary artery disease (CAD) has expanded the possibilities for this modality, and published studies have not shown a reduction in outcomes in stable patients with moderate/high ischemic burden under optimized clinical treatment (OCT).

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Editorial

A Biochemical Kaleidoscope Called Troponin

Fabrício Braga

“There is no such thing as new ideas. We just take a bunch of old ideas and put them into a kind of mental kaleidoscope.”

The phrase above attributed to the colossal American writer Mark Twain (1835-1910) brings me a somewhat disturbing provocation. Things are always here. Everything new has always been here and starts to “exist” until someone looks at what is old differently. For example, electrical energy has always been here, but to evolve from mysticism to domestic utility, many had to see this phenomenon differently.

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Research Letter

Heart Failure Mortality during COVID-19 Pandemic: Insights from a Cohort of Public Hospitals in Brazil

Miguel M. Fernandes-Silva et al. Eduardo Leal Adam Sabrina Bernardez-Pereira Suzana Alves Silva … Luiz Guilherme Passaglia Kleber Renato Ponzi Pereira Marco Antônio Vieira Guedes João David de Souza Neto Ângelo Amato Vincenzo de Paola Maria Alayde Mendonça Rivera Elmiro Santos Resende Denilson Campos de Albuquerque Fernando Bacal Antônio Luiz Pinho Ribeiro Louise Morgan Sidney C. Smith Jr Fábio Papa Taniguchi

Introduction

Brazil is one of the most hit countries by the pandemic caused by the novel coronavirus (Coronavirus Disease, COVID-19), with more than half million deaths in June, 2021, the world’s second-highest number of deaths. It has been reported that the COVID-19 outbreak has affected the delivery of care of patients without COVID-19 (non-COVID-19 patients), particularly patients with cardiovascular (CV) diseases, increasing the death toll from the pandemic. Studies have shown a reduction in hospitalizations in tandem with an increase mortality from CV diseases during the outbreak in many countries.^– However, most of these reports focused on patients with acute coronary syndrome (ACS ) in developed countries, with few data on heart failure (HF) admissions, and the reasons for the worse mortality are not well understood. We evaluated the changes in severity, reasons for decompensation and 30-day mortality of patients admitted for HF in public hospitals included in the Best Practices in Cardiology (BPC) program in Brazil during the COVID-19 outbreak and compared with previous periods.

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Letter to the Editor

Previous Chronic Diseases and their Relationship with COVID-19 Infection

Bruna Redivo de Souza et al. Eliane Mazzuco Layse Wiggers Kemper

Dear editor,

Due to the current global pandemic, the subject addressed is of great relevance. It is known that there is a certain urgency in the production and dissemination of scientific and epidemiological data about the new Coronavirus. Therefore, research that helps profile the population most vulnerable to this disease contributes to preventing an even greater number of deaths and sequelae resulting from COVID-19.

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Letter to the Editor

Prevalence and Associated Factors of SARS caused by Covid-19 in Adults and Aged People with Chronic Cardiovascular Disease: A Critical Analysis

Fernanda Gunha Ignácio et al. Fernanda Pinzon Ribeiro Aline Oenning Baggio Chaiana Esmeraldino Mendes Marcon

Dear Editor,

The study by Paiva et al. evaluated the incidence of patients infected with the COVID-19 virus, associated with cardiovascular diseases (CVD), in Brazil. It is concluded that the high prevalence of severe acute respiratory syndrome (SARS) in adults and in the elderly is related to sociodemographic and clinical characteristics, signs and symptoms. In view of that, the importance of primary health care is reiterated – in order to maintain regular medical visits aiming at controlling the disease and symptoms, while the presence of cardiovascular comorbidities increases in severe COVID-19 cases.

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Editorial

Science Gender Gap: Are We in theRight Path?

Gláucia Maria Moraes de Oliveira et al. Marge Tenorio Alessandra de Sá Earp Siqueira

Women are entering the medical and scientific community in growing numbers, reaching and even surpassing their male counterparts in medical schools. However, a settled imbalance between men and women is still a reality in the international cardiology community despite these recent advances. The female presence in Brazilian medical schools was barely noticed until the 1960s; in the following years, there was a gradual increase in the number of women in the medical field, mainly in the first decade of the 21st century (59 % in 2020). In a 2020 demographic analysis of the Brazilian Federal Council of Medicine , men still predominated, accounting for 53.4% of all doctors in the country. Nevertheless, in the age-range below 30-years-old, women are the majority, accounting for 58.5%; the percentage of female doctors is inversely proportional to the increase in the age group, with only 21% of women in the age group above 70 years old.

In the USA, women represent less than 15% of the cardiology workforce and less than 5% of interventional cardiologists, while in Europe, women account for only one-third of cardiologists, and 18% of women are interventionists. Currently, Brazil has nearly 500 thousand doctors, 17,802 thousand cardiologists, of which 31.1% are females, and mostly concentrated in the southeast region. In 2018, only 215 (8.6%) of a total of 2,062 cardiovascular surgeons and 7.5% of 970 interventional cardiologists were women. The Brazilian Society of Cardiology had two female presidents; and the Cardiovascular Surgery Society, the Interventional Cardiology, and the Federation of Portuguese Language Cardiology Societies had one female president. Also, in the last five years, only one fifth of the speakers in the annual congress of the Brazilian Cardiology Society were women.

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Editorial

Exercise Is Medicine! How to Safely Return to Sports after COVID-19? A Meta-Analysis and a Practical Flowchart for Cardiovascular Risk Assessment may Help you

Clea Colombo

Exercise is medicine! Although this premise is well established, how to maintain this “treatment” for various diseases during the COVID-19 pandemic? This has been a concern of all doctors in the world since exercise contributes to the control of cardiovascular diseases and other comorbidities recognized as risk factors for a worse outcome in COVID-19. Moreover, it has already been shown that higher cardiorespiratory fitness is inversely associated with the likelihood of hospitalization due to COVID-19.

In addition to the hygiene and social distancing measures necessary to prevent coronavirus infection, cardiovascular sequelae in individuals recovering from COVID-19 may contribute to the delay in resuming exercise. Cardiovascular complications, including myocarditis, are relatively common in patients affected by SARS-CoV-2. Although the occurrence of myocarditis as a consequence of COVID-19 was initially described in hospitalized patients with severe presentation of the disease, subsequent studies have reported its occurrence in individuals with mild COVID-19 and even in asymptomatic patients.

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Research Letter

Impact of the COVID-19 Pandemic on Cardiac Implantable Electronic Devices Procedures in a Tertiary Referral Center

Roberto Costa et al. Katia Regina da Silva Sarah Caroline Martins Saucedo Laisa Arruda Silva … Elizabeth Sartori Crevelari Wagner Tadeu Jurevicius Nascimento Thiago Gonçalves Silveira Alfredo Fiorelli Martino Martinelli Filho Fabio Biscegli Jatene

Introduction

The COVID-19 pandemic has caused a change in the surgical practice of many medical specialties worldwide.^– Medical societies have supported changes in cardiac pacing services routines and established new recommendations on the definition of case severity and urgency of surgical procedures.^,

The aim of the present study was to evaluate the impact of the measures implemented in surgical procedures performed for artificial cardiac pacing during the pandemic. We compared the number of patients operated, clinical profile of patients, characteristics of procedures, and the rate of confirmed COVID-19 cases in the peak of the pandemic, and compared them with the period immediately before the pandemic.

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Viewpoint

The Athlete's Return in the Post-COVID-19

José Antônio Caldas Teixeira et al. Mateus Freitas Teixeira Pedro Soares Teixeira Juliana Grael Jorge

Specific Complications in the Organs and Influences in Athletes

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Image

Myocardial Injury in COVID-19: a Challenge for Clinical Cardiologists

Roberto Cintra de Azevedo Aragão et al. Mariana Carvalho Alves Hellen Dutra Passos Luiz Flavio Galvão Gonçalves … Leonardo Baumworcel José Augusto Soares Barreto Filho

A 39-year-old male patient, with no previous comorbidities, was admitted to the emergency department presenting intense chest pain, associated with nausea, sweating, and mild respiratory distress. The pain was oppressive, and it radiated to both shoulders. The patient reported onset of asthenia, lack of appetite, and fever (38.9 ºC) 2 days prior, and he presented with polymorphic erythematous skin lesions on his back 1 day after admission.

Physical examination revealed the following: blood pressure = 140/100 mmHg, heart rate = 90 bpm, no fever, SpO₂= 98% in room air, regular cardiac rhythm with 2 beats, no murmurs, clean lungs, good peripheral perfusion, and no edema.

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Review Article

The Effect of Coronavirus Disease 2019 on Cardiovascular Diseases

Lutfu Askin et al. Okan Tanrıverdi Husna Sengul Askin

Abstract

Coronavirus disease 2019 (COVID-19) is a global pandemic affecting the world, seen in more than 1,300,000 patients. COVID-19 acts through the angiotensin-converting enzyme 2 (ACE2) receptor. Cardiovascular comorbidities are more common with COVID-19, and nearly 10% of cases develop myocarditis (22% of critical patients). Further research is needed to continue or discontinue ACE inhibitors and angiotensin receptor blockers, which are essential in hypertension and heart failure in COVID-19. Intensive research is promising for the treatment and prevention of COVID-19.

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