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Ferreira AF, Azevedo MJ, Morais J, Almeida-Coelho J, Leite-Moreira AM, Lourenço AP, Saraiva F, Diaz SO, Amador AF, Sousa C, Machado AP, Sampaio-Maia B, Ramalho C, Leite-Moreira A, Barros AS, Falcão-Pires I. Stretch-induced compliance mechanism in pregnancy-induced cardiac hypertrophy and the impact of cardiovascular risk factors. Am J Physiol Heart Circ Physiol 2024; 326:H1193-H1203. [PMID: 38334973 DOI: 10.1152/ajpheart.00701.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/10/2024]
Abstract
Pressure overload-induced hypertrophy compromises cardiac stretch-induced compliance (SIC) after acute volume overload (AVO). We hypothesized that SIC could be enhanced by physiological hypertrophy induced by pregnancy's chronic volume overload. This study evaluated SIC-cardiac adaptation in pregnant women with or without cardiovascular risk (CVR) factors. Thirty-seven women (1st trimester, 1stT) and a separate group of 31 (3rd trimester, 3rdT) women [healthy or with CVR factors (obesity and/or hypertension and/or with gestational diabetes)] underwent echocardiography determination of left ventricular end-diastolic volume (LVEDV) and E/e' before (T0), immediately after (T1), and 15 min after (T2; SIC) AVO induced by passive leg elevation. Blood samples for NT-proBNP quantification were collected before and after the AVO. Acute leg elevation significantly increased inferior vena cava diameter and stroke volume from T0 to T1 in both 1stT and 3rdT, confirming AVO. LVEDV and E/e' also increased immediately after AVO (T1) in both 1stT and 3rdT. SIC adaptation (T2, 15 min after AVO) significantly decreased E/e' in both trimesters, with additional expansion of LVEDV only in the 1stT. NT-pro-BNP increased slightly after AVO but only in the 1stT. CVR factors, but not parity or age, significantly impacted SIC cardiac adaptation. A distinct functional response to SIC was observed between 1stT and 3rdT, which was influenced by CVR factors. The LV of 3rdT pregnant women was hypertrophied, showing a structural limitation to dilate with AVO, whereas the lower LV filling pressure values suggest increased diastolic compliance.NEW & NOTEWORTHY The sudden increase of volume overload triggers an acute myocardial stretch characterized by an immediate rise in contractility by the Frank-Starling mechanism, followed by a progressive increase known as the slow force response. The present study is the first to characterize echocardiographically the stretch-induced compliance (SIC) mechanism in the context of physiological hypertrophy induced by pregnancy. A distinct functional adaptation to SIC was observed between first and third trimesters, which was influenced by cardiovascular risk factors.
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Affiliation(s)
- Ana Filipa Ferreira
- Cardiovascular Research and Development Unit, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Maria João Azevedo
- Faculdade de Medicina Dentária, Universidade do Porto, Porto, Portugal
- Instituto Nacional de Engenharia Biomédica, Porto, Portugal
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- Academic Center for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Juliana Morais
- Cardiovascular Research and Development Unit, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - João Almeida-Coelho
- Cardiovascular Research and Development Unit, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - André M Leite-Moreira
- Cardiovascular Research and Development Unit, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
- Anesthesiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - André P Lourenço
- Cardiovascular Research and Development Unit, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
- Anesthesiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Francisca Saraiva
- Cardiovascular Research and Development Unit, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sílvia O Diaz
- Cardiovascular Research and Development Unit, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ana Filipa Amador
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Carla Sousa
- Cardiovascular Research and Development Unit, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Ana Paula Machado
- Obstetrics Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Benedita Sampaio-Maia
- Faculdade de Medicina Dentária, Universidade do Porto, Porto, Portugal
- Instituto Nacional de Engenharia Biomédica, Porto, Portugal
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Carla Ramalho
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- Obstetrics Department, Centro Hospitalar Universitário de São João, Porto, Portugal
- Obstetrics, Gynaecology and Pediatrics Department, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Adelino Leite-Moreira
- Cardiovascular Research and Development Unit, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
- Cardiothoracic Surgery Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - António S Barros
- Cardiovascular Research and Development Unit, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Inês Falcão-Pires
- Cardiovascular Research and Development Unit, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
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Valente IM, Monteiro A, Sousa C, Miranda C, Maia MRG, Castro C, Cabrita ARJ, Trindade H, Fonseca AJM. Agronomic, Nutritional Traits, and Alkaloids of Lupinus albus, Lupinus angustifolius and Lupinus luteus Genotypes: Effect of Sowing Dates and Locations. ACS Agric Sci Technol 2024; 4:450-462. [PMID: 38638685 PMCID: PMC11022392 DOI: 10.1021/acsagscitech.3c00581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/11/2024] [Accepted: 03/19/2024] [Indexed: 04/20/2024]
Abstract
Lupins (Lupinus spp.) are legumes with high relevance for the sustainability of agricultural systems as they improve the soil quality, namely, through the fixation of atmospheric nitrogen, and have good adaptability to different climates and soil conditions. Besides, they possess high nutritive value, especially due to the high protein content of the seeds. Nevertheless, the plants' productivity and metabolism can be influenced by the genotype, the edaphoclimatic conditions, and the sowing practices. In this work, the effect of edaphoclimatic conditions and sowing dates on the productivity, nutritional factors, and alkaloids of the seeds of L. albus cv. Estoril, L. angustifolius cv. Tango, and L. luteus cv. Cardiga was evaluated. High variability in the seeds and protein productions, nutritional traits, and alkaloid content related to the species was observed, along with a significant effect of the location. Lupinus albus cv. Estoril showed a good compromise between productivity and low alkaloid content, being an interesting genotype for food and feed use in the conditions of this trial.
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Affiliation(s)
- Inês M. Valente
- REQUIMTE,
LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
- REQUIMTE,
LAQV, Departament of Chemistry and Biochemistry, Faculty of Sciences, University of Porto, Rua do Campo Alegre 687, 4169-007 Porto, Portugal
| | - André Monteiro
- Centre
for the Research and Technology of Agro-Environmental and Biological
Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801 Vila Real, Portugal
| | - Carla Sousa
- REQUIMTE,
LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Carla Miranda
- Centre
for the Research and Technology of Agro-Environmental and Biological
Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801 Vila Real, Portugal
| | - Margarida R. G. Maia
- REQUIMTE,
LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Carlos Castro
- Centre
for the Research and Technology of Agro-Environmental and Biological
Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801 Vila Real, Portugal
| | - Ana R. J. Cabrita
- REQUIMTE,
LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Henrique Trindade
- Centre
for the Research and Technology of Agro-Environmental and Biological
Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801 Vila Real, Portugal
| | - António J. M. Fonseca
- REQUIMTE,
LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
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Cabrita AR, Valente IM, Monteiro A, Sousa C, Miranda C, Almeida A, Cortez PP, Castro C, Maia MR, Trindade H, Fonseca AJ. Environmental conditions affect the nutritive value and alkaloid profiles of Lupinus forage: Opportunities and threats for sustainable ruminant systems. Heliyon 2024; 10:e28790. [PMID: 38596022 PMCID: PMC11002601 DOI: 10.1016/j.heliyon.2024.e28790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/13/2024] [Accepted: 03/25/2024] [Indexed: 04/11/2024] Open
Abstract
The identification of crops that simultaneously contribute to the global protein supply and mitigate the effects of climate change is an urgent matter. Lupins are well adapted to nutrient-poor or contaminated soils, tolerate various abiotic stresses, and present relevant traits for acting as ecosystem engineers. Lupins are best studied for their seeds, but their full foraging potential needs further evaluation. This study evaluated the effects of location and sowing date on forage production, proximate composition, and the detailed mineral and alkaloid profiles of three species of Lupinus (L. albus cv. Estoril, L. angustifolius cv. Tango, and L. luteus cv. Cardiga). Sowing date and location and their interaction with the plant species significantly affected the vast majority of measured parameters, emphasizing the effects of climate and soil conditions on these crops. The relatively high crude protein and in vitro digestibility support the potential of the lupin species studied as sustainable forage protein sources in diets for ruminant animals. The content of individual essential macro and trace elements was below the maximum tolerable levels for cattle and sheep. Lupanine, smipine, and sparteine were the most abundant quinolizidine alkaloids in L. albus cv. Estoril, lupanine, and sparteine in L. angustifolius cv. Tango, and lupinine, gramine, ammodendrine, and sparteine in L. luteus cv. Cardiga. Based on the maximum tolerable levels of total quinolizidine alkaloid intake, the dietary inclusion of forages of L. albus cv. Estoril and L. angustifolius cv. Tango does not pose a risk to the animals, but the high alkaloid content of L. luteus cv. Cardiga may compromise its utilization at high levels in the diet. Overall, the results reveal a high potential for lupins as protein forage sources well adapted to temperate regions and soils with lower fertility, with a relevant impact on livestock sustainability in a climate change era.
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Affiliation(s)
- Ana R.J. Cabrita
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
| | - Inês M. Valente
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
- REQUIMTE, LAQV, Department of Chemistry and Biochemistry, Faculty of Sciences, University of Porto, Rua do Campo Alegre 687, 4169-007, Porto, Portugal
| | - André Monteiro
- Center for the Research and Technology Agro-Environmental and Biological Sciences (CITAB), Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal
| | - Carla Sousa
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
| | - Carla Miranda
- Center for the Research and Technology Agro-Environmental and Biological Sciences (CITAB), Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal
| | - Agostinho Almeida
- REQUIMTE, LAQV, Department of Chemical Sciences, Laboratory of Applied Chemistry, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
| | - Paulo P. Cortez
- CECA/ICETA, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
| | - Carlos Castro
- Center for the Research and Technology Agro-Environmental and Biological Sciences (CITAB), Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal
| | - Margarida R.G. Maia
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
| | - Henrique Trindade
- Center for the Research and Technology Agro-Environmental and Biological Sciences (CITAB), Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal
| | - António J.M. Fonseca
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
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Vinha AF, Costa ASG, Espírito Santo L, Ferreira DM, Sousa C, Pinto E, Almeida A, Oliveira MBPP. High-Value Compounds in Papaya By-Products ( Carica papaya L. var. Formosa and Aliança): Potential Sustainable Use and Exploitation. Plants (Basel) 2024; 13:1009. [PMID: 38611538 PMCID: PMC11013330 DOI: 10.3390/plants13071009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Food waste is a global and growing problem that is gaining traction due to its environmental, ethical, social, and economic repercussions. Between 2022 and 2027, the worldwide papaya market is expected to have a huge increase, meaning a growth in organic waste, including peels and seeds. Thus, this study evaluated the potential use of peels and seeds of two mature papaya fruits as a source of bioactive compounds, converting these by-products into value-added products. Proximate analysis (AOAC methods), mineral content (ICP-MS), free sugars (HPLC-ELSD), fatty acid composition (GC-FID), vitamin E profile (HPLC-DAD-FLD), and antioxidant activity (DPPH and FRAP assays) were evaluated. RESULTS Both by-products showed high total protein (20-27%), and dietary fiber (32-38%) contents. Papaya peels presented a high ash content (14-16%), indicating a potential application as a mineral source. 14 fatty acids were detected, with α-linolenic acid (30%) as the most abundant in the peels and oleic acid (74%) in the seeds. Both by-products showed high antioxidant activity. CONCLUSION Papaya by-products display great potential for industrial recovery and application, such as formulation of new functional food ingredients.
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Affiliation(s)
- Ana F. Vinha
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal; (A.F.V.); (A.S.G.C.); (L.E.S.); (C.S.); (A.A.)
- FP-I3ID, Research Institute, Innovation and Development Fernando Pessoa, Faculty of Health Sciences, Fernando Pessoa University, Praça 9 Abril 349, 4249-004 Porto, Portugal
| | - Anabela S. G. Costa
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal; (A.F.V.); (A.S.G.C.); (L.E.S.); (C.S.); (A.A.)
- Nutrition and Bromatology Group, Department of Analytical Chemistry and Food Science, Faculty of Science, University of Vigo, E-32004 Ourense, Spain
| | - Liliana Espírito Santo
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal; (A.F.V.); (A.S.G.C.); (L.E.S.); (C.S.); (A.A.)
- Nutrition and Bromatology Group, Department of Analytical Chemistry and Food Science, Faculty of Science, University of Vigo, E-32004 Ourense, Spain
| | - Diana M. Ferreira
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal; (A.F.V.); (A.S.G.C.); (L.E.S.); (C.S.); (A.A.)
| | - Carla Sousa
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal; (A.F.V.); (A.S.G.C.); (L.E.S.); (C.S.); (A.A.)
- FP-I3ID, Research Institute, Innovation and Development Fernando Pessoa, Faculty of Health Sciences, Fernando Pessoa University, Praça 9 Abril 349, 4249-004 Porto, Portugal
| | - Edgar Pinto
- REQUIMTE/LAQV, ESS, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;
| | - Agostinho Almeida
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal; (A.F.V.); (A.S.G.C.); (L.E.S.); (C.S.); (A.A.)
| | - Maria Beatriz P. P. Oliveira
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal; (A.F.V.); (A.S.G.C.); (L.E.S.); (C.S.); (A.A.)
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Ferreira AF, Saraiva F, Diaz SO, Azevedo MJ, Sousa C, Leite-Moreira A, Sampaio-Maia B, Ramalho C, Barros AS, Falcão-Pires I. The impact of echocardiographic indexation to evaluate cardiac reverse remodeling throughout pregnancy and postpartum. Rev Port Cardiol 2024; 43:107-127. [PMID: 37495102 DOI: 10.1016/j.repc.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/17/2023] [Accepted: 04/29/2023] [Indexed: 07/28/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Echocardiography guidelines suggest normalizing left ventricular (LV) volumes and mass (LVM) to body size. During pregnancy, continuous weight variation impacts on body surface area (BSA) calculation, limiting the longitudinal analysis of cardiac remodeling (CR) and reverse remodeling (RR) variables. Our aim was to identify the most common indexing methodologies in the literature on pregnant populations through a systematic review; and, to compare four scaling methods: (i) none (absolute values); (ii) indexing to the BSA before pregnancy; (iii) allomeric indexing; and (iv) indexing to BSA measured at the same day of cardiac assessment, using an illustrative example. METHODS We performed a systematic review of CR and RR during pregnancy and post-partum, using two databases. We included studies reporting longitudinal echocardiographic analysis of cardiac chamber volumes in humans. We used a prospective cohort study of healthy pregnant women who underwent four echocardiographic evaluations during pregnancy and postpartum, as an illustrative example. RESULTS Twenty-seven studies were included, most studies indexed to BSA measured at each evaluation moment (n=21). Within-subjects design was the most reported to analyse longitudinal data (n=17). Indexation to the pre-pregnancy BSA or application of allometric indexes revealed a higher effect than BSA measured at each evaluation and an equal effect to not indexing using within-subjects design. The within-subjects designs also revealed a higher effect size value than the between-subjects design for longitudinal analysis of LVM adaptations during pregnancy and postpartum. CONCLUSION(S) This study concludes that indexation methods do not impact the clinical interpretation of longitudinal echocardiographic assessment but highlights the need to harmonize normalization procedures during pregnancy.
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Affiliation(s)
- Ana Filipa Ferreira
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal; Cardiothoracic Surgery Department, Centro Hospitalar de São João, Porto, Portugal
| | - Francisca Saraiva
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Sílvia Oliveira Diaz
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Maria João Azevedo
- Faculdade de Medicina Dentária, Universidade do Porto, Portugal; INEB - Instituto Nacional de Engenharia Biomédica, Portugal; i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal; Academic Center for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Carla Sousa
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal; Cardiology Department, Centro Hospitalar de São João, Porto, Portugal
| | - Adelino Leite-Moreira
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal; Cardiothoracic Surgery Department, Centro Hospitalar de São João, Porto, Portugal
| | - Benedita Sampaio-Maia
- Faculdade de Medicina Dentária, Universidade do Porto, Portugal; INEB - Instituto Nacional de Engenharia Biomédica, Portugal; i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal
| | - Carla Ramalho
- Center of Prenatal Diagnosis, Obstetrics Department, Centro Hospitalar de São João, Porto, Portugal; Obstetrics, Gynecology and Pediatrics Department, Faculty of Medicine of the University of Porto, Portugal
| | - António Sousa Barros
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Inês Falcão-Pires
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal.
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Marques CA, Cabrita A, Sousa C, Resende CX, Salgueiro É, Cruz C, Rodrigues RA. An Unexpected Diagnosis in a Young Male Presenting With Tricuspid Valve Dysfunction: The Ever-Increasing Key Role of 3D Echocardiogram. Heart Lung Circ 2024; 33:e19-e20. [PMID: 38143194 DOI: 10.1016/j.hlc.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/26/2023] [Accepted: 10/29/2023] [Indexed: 12/26/2023]
Affiliation(s)
| | - André Cabrita
- Department of Cardiology, São João Hospital Centre, Porto, Portugal
| | - Carla Sousa
- Department of Cardiology, São João Hospital Centre, Porto, Portugal
| | | | - Élson Salgueiro
- Department of Cardiothoracic Surgery, São João Hospital Centre, Porto, Portugal
| | - Cristina Cruz
- Department of Cardiology, São João Hospital Centre, Porto, Portugal
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Pinho AI, Oliveira C, Santos LD, Marques C, Cabrita A, Dias P, Pestana G, Sousa C, Rodrigues RA. Authors' Response. Monaldi Arch Chest Dis 2024. [PMID: 38358048 DOI: 10.4081/monaldi.2024.2934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
Dear Editor, We would like to thank Dr. Madias for his valuable comment on our original article entitled "QT interval prolongation in Takotsubo Syndrome: a frightening feature with no major prognostic impact" published in Monaldi Archives for Chest Disease on December 6, 2023...
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Affiliation(s)
- Ana Isabel Pinho
- Department of Cardiology, University Hospital Center of São João, Porto.
| | - Cátia Oliveira
- Department of Cardiology, University Hospital Center of São João, Porto.
| | - Luís Daniel Santos
- Department of Cardiology, University Hospital Center of São João, Porto.
| | - Catarina Marques
- Department of Cardiology, University Hospital Center of São João, Porto.
| | - André Cabrita
- Department of Cardiology, University Hospital Center of São João, Porto.
| | - Paula Dias
- Department of Cardiology, University Hospital Center of São João, Porto.
| | - Gonçalo Pestana
- Department of Cardiology, University Hospital Center of São João, Porto.
| | - Carla Sousa
- Department of Cardiology, University Hospital Center of São João, Porto; Cardiovascular Research and Development Center, Faculty of Medicine, University of Porto.
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Valente IM, Sousa C, Almeida M, Miranda C, Pinheiro V, Garcia-Santos S, Ferreira LMM, Guedes CM, Maia MRG, Cabrita ARJ, Fonseca AJM, Trindade H. Insights from the yield, protein production, and detailed alkaloid composition of white ( Lupinus albus), narrow-leafed ( Lupinus angustifolius), and yellow ( Lupinus luteus) lupin cultivars in the Mediterranean region. Front Plant Sci 2023; 14:1231777. [PMID: 38162308 PMCID: PMC10755673 DOI: 10.3389/fpls.2023.1231777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/22/2023] [Indexed: 01/03/2024]
Abstract
Introduction Lupins and other legumes have been considered as alternative plant-based protein sources to soybeans for both humans and livestock. Furthermore, they can contribute to more sustainable agricultural systems. The productivity and chemical composition of legumes is highly variable between species, cultivars, and with the edaphoclimatic conditions. Methods This work evaluated the adaptability of seven Lupinus cultivars in two different sowing locations, during two consecutive years, through the characterization of their seed, as a means of investigating their suitability to be used as a source of food and/or feed. Results and discussion Lupinus angustifolius cv. Tango and Lupinus luteus cv. Acos were the most stable genotypes across the environments when considering the seed and protein production, while L. luteus cv. Alburquerque and L. luteus cv. Mister showed less variation in the total alkaloid content across the environments. The edaphoclimatic conditions affected seed and protein yields, as higher rainfall resulted in high productivity. The lower temperatures observed in the first year at both locations caused a reduction in the production of alkaloids in L. luteus cv. Acos and Cardiga. Due to the high alkaloid content of some of the studied cultivars their use as food or feed can pose some safety concerns. However, these cultivars can have high levels of resistance to herbivore and insect attacks, which can be of the utmost importance for the use of these crops for recovering poor or exhausted soils.
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Affiliation(s)
- Inês M. Valente
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
- REQUIMTE, LAQV, Departament of Chemistry and Biochemistry, Faculty of Sciences, University of Porto, Porto, Portugal
| | - Carla Sousa
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Mariana Almeida
- Veterinary and Animal Research Centre (CECAV) and Associate Laboratory for Veterinary and Animal Science (AL4AnimalS), Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, Vila Real, Portugal
| | - Carla Miranda
- Centre for the Research and Technology Agro-Environmental and Biological Sciences (CITAB), Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Victor Pinheiro
- Veterinary and Animal Research Centre (CECAV) and Associate Laboratory for Veterinary and Animal Science (AL4AnimalS), Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, Vila Real, Portugal
| | - Sofia Garcia-Santos
- Centre for the Research and Technology Agro-Environmental and Biological Sciences (CITAB), Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Luís M. M. Ferreira
- Centre for the Research and Technology Agro-Environmental and Biological Sciences (CITAB), Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Cristina M. Guedes
- Veterinary and Animal Research Centre (CECAV) and Associate Laboratory for Veterinary and Animal Science (AL4AnimalS), Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, Vila Real, Portugal
| | - Margarida R. G. Maia
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Ana R. J. Cabrita
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - António J. M. Fonseca
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Henrique Trindade
- Centre for the Research and Technology Agro-Environmental and Biological Sciences (CITAB), Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
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Pinho AI, Oliveira C, Santos LD, Marques C, Cabrita A, Dias P, Pestana G, Sousa C, Rodrigues RA. QT interval prolongation in Takotsubo syndrome: a frightening feature with no major prognostic impact. Monaldi Arch Chest Dis 2023. [PMID: 38058291 DOI: 10.4081/monaldi.2023.2834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/04/2023] [Indexed: 12/08/2023] Open
Abstract
Despite the frequent and often severe repolarization abnormalities seen in Takotsubo syndrome (TTS), the underlying mechanism of life-threatening arrhythmias is incompletely understood, and the risk remains uncertain. TTS is considered a potential cause of acquired long QT syndrome; however, there is no robust evidence that QT prolongation has a major prognostic impact on these patients' outcomes. Our aim was to assess the prevalence and clinical implications of acquired long QT during TTS events and compare in-hospital and long-term outcomes between patients with and without corrected QT interval (QTc) prolongation. This is a retrospective cohort study that included 113 patients admitted to our tertiary care hospital with a diagnosis of TTS. The cohort was divided into two groups: a long QTc group (QTc≥460 milliseconds in any electrocardiogram at admission or during hospitalization) and a normal QTc group. Baseline characteristics, occurrences during hospitalization, and outcome data were obtained from the revision of medical registries and hospital visits. Of the 113 patients, 107 (94.7%) were female. The mean age was 67.6±11.7 years. QTc prolongation was found in 38%. Demographic characteristics, relevant chronic medication, prevalence of cardiovascular risk factors, and other comorbidities were similar between the groups, except for history of atrial fibrillation, which was more common in the long QTc group. Syncope was more prevalent in the long QTc group. In-hospital complications were not statistically different between patients with long and normal QTc (48.8% versus 44.2%, p=0.637), including ventricular arrhythmias and complete atrioventricular block (both 4.7% versus 1.4%, p=0.556). In-hospital mortality was 0.9%, corresponding to one patient in the long QTc group. The mean follow-up time was 4.8±3.8 years. 5-year all-cause mortality and the occurrence of the composite endpoint of major adverse cardiac and cerebrovascular events did not differ between the groups (p=0.511 and p=0.538, respectively). Our study found no association between prolonged QTc interval during TTS events and adverse prognosis, since in-hospital and long-term outcomes were similar between the groups. Our findings suggest that, although QT prolongation is usually a frightening feature on ECG, this repolarization abnormality during the acute phase has no major prognostic implications in the TTS population.
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Affiliation(s)
- Ana Isabel Pinho
- Department of Cardiology, University Hospital Center of São João, Porto.
| | - Cátia Oliveira
- Department of Cardiology, University Hospital Center of São João, Porto.
| | - Luís Daniel Santos
- Department of Cardiology, University Hospital Center of São João, Porto.
| | - Catarina Marques
- Department of Cardiology, University Hospital Center of São João, Porto.
| | - André Cabrita
- Department of Cardiology, University Hospital Center of São João, Porto.
| | - Paula Dias
- Department of Cardiology, University Hospital Center of São João, Porto.
| | - Gonçalo Pestana
- Department of Cardiology, University Hospital Center of São João, Porto.
| | - Carla Sousa
- Department of Cardiology, University Hospital Center of São João, Porto; Cardiovascular Research and Development Center, Faculty of Medicine, University of Porto.
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10
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Sousa C, Carton I, Jaillard S, Cospain A, Lavillaureix A, Nyangoh Timoh K, Juricic M, Lavoué V, Dion L. Mayer-Rokitansky-Küster-Hauser syndrome patients' interest, expectations and demands concerning uterus transplantation. J Gynecol Obstet Hum Reprod 2023; 52:102674. [PMID: 37805077 DOI: 10.1016/j.jogoh.2023.102674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/01/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVE To better understand patients' conditions and expectations before starting a uterus transplantation (UTx) program for women suffering from Mayer-Rokitansky-Küster-Hauser syndrome (MRKH syndrome). METHOD A web-based survey was conducted among MRKH patients via the French national association network from March to August 2020. The questionnaire comprised twenty-eight questions about their desire for parenthood, their condition's characteristics and previous reconstructive procedures, opinions and knowledge about UTx. RESULTS Among the 148 participants, 88 % reported a desire for parenthood, and 61 % opted for UTx as their first choice to reach this aim. The possibility of bearing a child and having the same genetic heritage were the main motivations. Once informed about the usual course of an UTx protocol, only 13 % of the participants changed their mind and 3 out of 4 of them opted for UT. CONCLUSION Uterus transplantation seems to be the first option to reach motherhood in patients suffering from MRKH syndrome. The development of UTx programs could meet the demands of this already well-informed population.
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Affiliation(s)
- C Sousa
- Service de Gynécologie, Centre hospitalo-Universitaire de Rennes, Rennes, France; Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) Rennes, France
| | - I Carton
- Service de Gynécologie, Centre hospitalo-Universitaire de Rennes, Rennes, France
| | - S Jaillard
- Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) Rennes, France; Service de Cytogénétique et Biologie Cellulaire, Rennes F-35033, France
| | - A Cospain
- Service de Génétique Clinique, CHU Rennes, CLAD Ouest, Rennes, France; ERN ITHACA, Hôpital Sud Rennes France, Université de Rennes, CNRS, IGDR, UMR 6290, Rennes F-35000, France
| | - A Lavillaureix
- Service de Génétique Clinique, CHU Rennes, CLAD Ouest, Rennes, France; ERN ITHACA, Hôpital Sud Rennes France, Université de Rennes, CNRS, IGDR, UMR 6290, Rennes F-35000, France
| | - K Nyangoh Timoh
- Service de Gynécologie, Centre hospitalo-Universitaire de Rennes, Rennes, France
| | - M Juricic
- Service de chirurgie pédiatrique, Centre hospitalo-Universitaire de Rennes, Rennes, France
| | - V Lavoué
- Service de Gynécologie, Centre hospitalo-Universitaire de Rennes, Rennes, France; Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) Rennes, France.
| | - L Dion
- Service de Gynécologie, Centre hospitalo-Universitaire de Rennes, Rennes, France; Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) Rennes, France
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11
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Pinho J, Carvalho M, Paiva M, Teixeira-Tavares N, Costa-Santos C, Sousa C. Is dyslipidemia a risk factor for trastuzumab-induced cardiotoxicity in breast cancer patients? A systematic review and meta-analysis. Rev Port Cardiol 2023; 42:961-984. [PMID: 37399885 DOI: 10.1016/j.repc.2022.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/11/2022] [Indexed: 07/05/2023] Open
Abstract
INTRODUCTION Breast cancer patients undergoing trastuzumab therapy have greater risk of cardiovascular disease. Risk factors for this effect have been proposed. However, the role of dyslipidemia is not completely understood. This systematic review aimed to explore the role of dyslipidemia in trastuzumab-induced cardiotoxicity. METHODS The investigators searched MEDLINE, Scopus, and Web of Science up to October 25, 2020. A random-effects model was used to determine pooled estimates of the results. The primary endpoint was trastuzumab-induced cardiotoxicity in patients with and without dyslipidemia. RESULTS A total of 39 studies were selected for inclusion in our systematic review assessing 21079 patients. One study demonstrated a statistically significant association between dyslipidemia and cardiotoxicity (OR=2.28, 95% CI 1.22-4.26, p=0.01). In all other studies, no such association was observed. Twenty-one studies including 6135 patients were eligible for meta-analysis. In this meta-analysis of unadjusted data, dyslipidemia was significantly associated with cardiotoxicity (OR=1.25, 95% CI 1.01-1.53, p=0.04, I2=0%), however, a subgroup analysis of studies reporting adjusted measures did not demonstrate a significant association (OR=0.89, 95% CI 0.73-1.10, p=0.28, I2=0%). CONCLUSION This systematic review and meta-analysis did not demonstrate a significant association between dyslipidemia alone and the development of cardiotoxicity. In the absence of other relevant cardiovascular risk factors, review of lipid profile may not be obligatory, and management of patients could be performed without referral for cardio-oncology assessment. Further investigation of risk factors for trastuzumab-induced cardiotoxicity is required to confirm these results.
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Affiliation(s)
- Jaime Pinho
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
| | - Miguel Carvalho
- Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - Mariana Paiva
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Centro Hospitalar e Universitário de São João, Porto, Portugal
| | | | | | - Carla Sousa
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Centro Hospitalar e Universitário de São João, Porto, Portugal
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12
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Dion L, Sousa C, Boudjema K, Val-Laillet D, Jaillard S, Rioux-Leclercq N, Flecher E, Lavoue V. Hypothermic machine perfusion for uterus transplantation. Fertil Steril 2023; 120:1259-1261. [PMID: 37660880 DOI: 10.1016/j.fertnstert.2023.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE To describe the feasibility of hypothermic machine perfusion (HMP) in uterus transplantation (UT) to potentially improve the preservation of the uterus and enhance graft preservation in the donation after brainstem death (DBD) context. Uterus transplantation is a new surgical approach to treating absolute uterine infertility; it can be performed after living donation or after DBD. In the DBD context, the uterus is typically the last organ removed after other vital organs, with the exception of the Baylor team, which removes the uterus first. This key aspect imposes an unavoidable mild temperature ischemia for >1 hour on the uterus during the removal of the vital abdominal and chest organs. In renal transplantation, the perfusion machine reduces the risk of delayed graft function; thus, we hypothesized that machine perfusion could result in a reduction of uterus graft dysfunction. The uterus graft dysfunction could be expressed by a low embryo implantation rate, pregnancy loss, or vascular pregnancy diseases such as preeclampsia or fetal growth restriction." To date, static cold storage of the uterus is the only standard method for preservation before transplantation. HMP is an emerging method that could potentially improve the preservation of the uterus to enhance graft preservation in the DBD context. DESIGN This video article shows all the technical details of using the HMP for uterine transplantation. SETTING University. ANIMALS Porcine model. INTERVENTION Porcine uterus was retrieved from a DBD domestic animal model and flushed with KPS MP (Bridge To Life Ltd in UK) at 4 °C. After vascular preparation on the back table, the uterus was perfused using KPS MP through a cannula in the aorta using the VitaSmart device (Bridge To Life Ltd in UK) for 18 hours. Then, the uterus was transplanted to the porcine recipient. MAIN OUTCOME MEASURES The macroscopic appearance of the uterus at the end of HMP and the assessment of the uterus vascularization after transplantation in the recipient compared with the native uterus. RESULTS This video shows the cannulation of the iliac vessels, cooling and removal of the uterus on a porcine model, uterus preservation using HMP during 18 hours, and then UT in a new recipient pig with the reperfusion of the transplanted uterus next to the native, intact uterus of the recipient. The macroscopic appearance of the uterus at the end of HMP appeared viable and was perfectly flushed. The assessment of the uterus vascularization after transplantation in the recipient was similar to that of the native uterus. To our knowledge, we describe here for the first time the UT procedure in DBD context on an animal model and the use of HMP for uterus preservation in UT programs; this could increase the number of uterine grafts available for a greater number of female recipients. CONCLUSION Hypothermic machine perfusion could allow the duration of cold ischemia to be prolonged without altering the uterine graft. Nevertheless, this assertion has to be validated in a human context.
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Affiliation(s)
- Ludivine Dion
- Department of Gynecology, Rennes University Hospital, Hôpital Sud, France; Irset - Inserm UMR_S 1085, Rennes, France.
| | - Carla Sousa
- Department of Gynecology, Rennes University Hospital, Hôpital Sud, France
| | - Karim Boudjema
- Department of Hepatobiliary Surgery and Liver Transplantation, Rennes University Hospital, Pontchaillou, France
| | - David Val-Laillet
- Nutrition Metabolisms and Cancer (NuMeCan), INRAE, INSERM, Univ Rennes, St Gilles, France
| | - Sylvie Jaillard
- Irset - Inserm UMR_S 1085, Rennes, France; Department of Cytogenetics and Cell Biology, Rennes University Hospital, Pontchaillou, France
| | - Nathalie Rioux-Leclercq
- Irset - Inserm UMR_S 1085, Rennes, France; Department of Pathology, Rennes University Hospital, Pontchaillou, France
| | - Erwan Flecher
- Department of Thoracic and Cardiovascular Surgery, Rennes University Hospital, Pontchaillou, France; Signal and Image Treatment Laboratory (LTSI), Inserm U1099, Rennes, France
| | - Vincent Lavoue
- Department of Gynecology, Rennes University Hospital, Hôpital Sud, France; Irset - Inserm UMR_S 1085, Rennes, France
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13
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Sousa C, Sánchez-Mansilla A, Broer R, Straatsma TP, de Graaf C. A Nonorthogonal Configuration Interaction Approach to Singlet Fission in Perylenediimide Compounds. J Phys Chem A 2023; 127:9944-9958. [PMID: 37964533 PMCID: PMC10694806 DOI: 10.1021/acs.jpca.3c04975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/07/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023]
Abstract
Perylenediimide molecules constitute a family of chromophores that undergo singlet fission, a process in which an excited singlet state converts into lower energy triplets on two neighboring molecules, potentially increasing the efficiency of organic solar cells. Here, the nonorthogonal configuration interaction method is applied to study the effect of the different crystal packing of various perylenediimide derivatives on the relative energies of the singlet and triplet states, the intermolecular electronic couplings, and the relative rates for singlet fission. The analysis of the wave functions and electronic couplings reveals that charge transfer states play an important role in the singlet fission mechanism. Dimer conformations where the PDI molecules are at large displacements along the long axis and short on the short axis are posed as the most favorable for singlet fission. The role of the substituent at the imide group has been inspected concluding that, although it has no effect in the energies, for some conformations it significantly influences the electronic couplings, and therefore, replacing this substituent with hydrogen may introduce artifacts in the computational modeling of the PDI molecules.
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Affiliation(s)
- C. Sousa
- Departament
de Ciència de Materials i Química Física and
Institut de Química Teòrica i Computacional, Universitat de Barcelona, 08028 Barcelona, Spain
| | - A. Sánchez-Mansilla
- Departament
de Química Física i Inorgànica, Universitat Rovira i Virgili, 43007 Tarragona, Spain
| | - R. Broer
- Zernike
Institute of Advanced Materials, University
of Groningen, 9747 AG Groningen, The Netherlands
| | - T. P. Straatsma
- National
Center for Computational Sciences, Oak Ridge
National Laboratory, Oak Ridge, Tennessee 37831-6373, United States
- Department
of Chemistry and Biochemistry, University
of Alabama, Tuscaloosa, Alabama 35487-0336, United States
| | - C. de Graaf
- Departament
de Química Física i Inorgànica, Universitat Rovira i Virgili, 43007 Tarragona, Spain
- ICREA, Pg. Lluís Companys 23, 08010 Barcelona, Spain
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14
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Luz D, Sousa C, Silva M, Pais P, Ferreira VC. Surgical Strategies for Tuberculous Spondylodiscitis With Severe Osteoporosis: A Case Illustrating the Challenges of Delayed Intervention. Cureus 2023; 15:e49021. [PMID: 38111399 PMCID: PMC10727488 DOI: 10.7759/cureus.49021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 12/20/2023] Open
Abstract
Tuberculous spondylodiscitis (Pott's spine) is a complex extrapulmonary manifestation of tuberculosis (TB) that poses significant medical challenges, characterized by vertebral destruction affecting approximately 2% of all TB cases. The management of this condition involves a multidisciplinary approach, with surgical intervention indicated for specific cases, including those with neurological complications, spinal instability, and kyphosis. We report a case of a 49-year-old female with a confirmed diagnosis of tuberculous spondylodiscitis who had undergone eight months of tuberculostatic therapy. She was referred for neurosurgical consultation due to uncontrollable axial pain, despite favorable clinical and imaging responses, which had rendered her immobile for six months. Imaging revealed a complete collapse of the L5 vertebral body, and a complementary dual x-ray absorptiometry (DEXA) scan demonstrated severe osteoporosis. A two-stage surgical approach was chosen to address her condition, involving corpectomy through an anterior approach, followed by lumbopelvic stabilization. Postoperative recovery was uneventful, with progressive improvement in pain and mobility. This case highlights the challenges of managing tuberculous spondylodiscitis and underscores the significance of early detection to prevent complications like severe osteoporosis. In this case, delayed referral for surgery following an extended period of immobility added complexity to an already difficult case. The severe osteoporosis, with a t-score of -5.7, had a substantial impact on surgical planning, leading to a more robust approach to arthrodesis with substantial lumbopelvic instrumentation in order to mitigate the risks associated with implant failure. This case shows that timely intervention and a comprehensive multidisciplinary approach are essential for the effective management of tuberculous spondylodiscitis, especially in cases complicated by severe osteoporosis.
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Affiliation(s)
- Diogo Luz
- Neurosurgery, Hospital Garcia de Orta, Almada, PRT
| | - Carla Sousa
- Neurosurgery, Hospital Garcia de Orta, Almada, PRT
| | | | - Pedro Pais
- Neurosurgery, Hospital Garcia de Orta, Almada, PRT
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15
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Ferreira AF, Azevedo MJ, Morais J, Trindade F, Saraiva F, Diaz SO, Alves IN, Fragão-Marques M, Sousa C, Machado AP, Leite-Moreira A, Sampaio-Maia B, Ramalho C, Barros AS, Falcão-Marques I. Cardiovascular risk factors during pregnancy impact the postpartum cardiac and vascular reverse remodeling. Am J Physiol Heart Circ Physiol 2023; 325:H774-H789. [PMID: 37477690 DOI: 10.1152/ajpheart.00200.2023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/06/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023]
Abstract
Pregnant women with cardiovascular risk (CVR) factors are highly prone to develop cardiovascular disease later in life. Thus, recent guidelines suggest extending the follow-up period to 1 yr after delivery. We aimed to evaluate cardiovascular remodeling during pregnancy and determine which CVR factors and potential biomarkers predict postpartum cardiac and vascular reverse remodeling (RR). Our study included a prospective cohort of 76 healthy and 54 obese and/or hypertensive and/or with gestational diabetes pregnant women who underwent transthoracic echocardiography, pulse-wave velocity (PWV), and blood collection at the 1st trimester (1T) and 3rd trimester (3T) of pregnancy as well as at the 1st/6th/12th mo after delivery. Generalized linear mixed-effects models was used to evaluate the extent of RR and its potential predictors. Pregnant women develop cardiac hypertrophy, as confirmed by a significant increase in left ventricular mass (LVM). Moreover, ventricular filling pressure (E/e') and atrial volume increased significantly during gestation. Significant regression of left ventricular (LV) volume, LVM, and filling pressures was observed as soon as 1 mo postpartum. The LV global longitudinal strain worsened slightly and recovered at 6 mo postpartum. PWV decreased significantly from 1T to 3T and normalized at 1 mo postpartum. We found that arterial hypertension, smoking habits, and obesity were independent predictors of increased LVM during pregnancy and postpartum. High C-reactive protein (CRP) and low ST2/IL33-receptor levels are potential circulatory biomarkers of worse LVM regression. Arterial hypertension, age, and gestational diabetes positively correlated with PWV. Altogether, our findings pinpoint arterial hypertension as a critical risk factor for worse RR and CRP, and ST2/IL33 receptors as potential biomarkers of postpartum hypertrophy reversal.NEW & NOTEWORTHY This study describes the impact of cardiovascular risk factors (CVR) in pregnancy-induced remodeling and postpartum reverse remodeling (up to 1 yr) by applying advanced statistic methods (multivariate generalized linear mixed-effects models) to a prospective cohort of pregnant women. Aiming to extrapolate to pathological conditions, this invaluable "human model" allowed us to demonstrate that arterial hypertension is a critical CVR for worse RR and that ST2/IL33-receptors and CRP are potential biomarkers of postpartum hypertrophy reversal.
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Affiliation(s)
- Ana Filipa Ferreira
- Department of Surgery and Physiology, Cardiovascular R&D Centre-UnIC@RISE, Faculdade de Medicina, University of Porto, Porto, Portugal
| | - Maria João Azevedo
- Faculdade de Medicina Dentária, Universidade do Porto, Porto, Portugal
- INEB-Instituto Nacional de Engenharia Biomédica, Porto, Portugal
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- Academic Center for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Juliana Morais
- Department of Surgery and Physiology, Cardiovascular R&D Centre-UnIC@RISE, Faculdade de Medicina, University of Porto, Porto, Portugal
| | - Fábio Trindade
- Department of Surgery and Physiology, Cardiovascular R&D Centre-UnIC@RISE, Faculdade de Medicina, University of Porto, Porto, Portugal
| | - Francisca Saraiva
- Department of Surgery and Physiology, Cardiovascular R&D Centre-UnIC@RISE, Faculdade de Medicina, University of Porto, Porto, Portugal
| | - Sílvia Oliveira Diaz
- Department of Surgery and Physiology, Cardiovascular R&D Centre-UnIC@RISE, Faculdade de Medicina, University of Porto, Porto, Portugal
| | - Inês Nuno Alves
- Department of Surgery and Physiology, Cardiovascular R&D Centre-UnIC@RISE, Faculdade de Medicina, University of Porto, Porto, Portugal
| | - Mariana Fragão-Marques
- Department of Surgery and Physiology, Cardiovascular R&D Centre-UnIC@RISE, Faculdade de Medicina, University of Porto, Porto, Portugal
- Department of Clinical Pathology, Centro Hospitalar de São João, Porto, Portugal
| | - Carla Sousa
- Department of Surgery and Physiology, Cardiovascular R&D Centre-UnIC@RISE, Faculdade de Medicina, University of Porto, Porto, Portugal
- Department of Cardiology, Centro Hospitalar de São João, Porto, Portugal
| | - Ana Paula Machado
- Center of Prenatal Diagnosis, Department of Obstetrics, Centro Hospitalar de São João, Porto, Portugal
| | - Adelino Leite-Moreira
- Department of Surgery and Physiology, Cardiovascular R&D Centre-UnIC@RISE, Faculdade de Medicina, University of Porto, Porto, Portugal
- Department of Cardiothoracic Surgery, Centro Hospitalar de São João, Porto, Portugal
| | - Benedita Sampaio-Maia
- Faculdade de Medicina Dentária, Universidade do Porto, Porto, Portugal
- INEB-Instituto Nacional de Engenharia Biomédica, Porto, Portugal
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Carla Ramalho
- Center of Prenatal Diagnosis, Department of Obstetrics, Centro Hospitalar de São João, Porto, Portugal
- Department of Obstetrics, Gynaecology and Pediatrics, Faculty of Medicine, University of Porto, Porto, Portugal
| | - António Sousa Barros
- Department of Surgery and Physiology, Cardiovascular R&D Centre-UnIC@RISE, Faculdade de Medicina, University of Porto, Porto, Portugal
| | - Inês Falcão-Marques
- Department of Surgery and Physiology, Cardiovascular R&D Centre-UnIC@RISE, Faculdade de Medicina, University of Porto, Porto, Portugal
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Martins de Carvalho M, Alves Pinto R, Proença T, Paiva M, Sousa C, Silva JC, Macedo F. Percutaneous implantation of a Sapiens 3 valve-in-valve in mitral position: A case report involving correction of prosthetic mitral valve regurgitation. Rev Port Cardiol 2023; 42:813-814. [PMID: 37019283 DOI: 10.1016/j.repc.2022.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/07/2022] [Accepted: 12/12/2022] [Indexed: 04/05/2023] Open
Affiliation(s)
- Miguel Martins de Carvalho
- Department of Cardiology, Centro Hospitalar Universitário de São João, Porto, Portugal; Cardiovascular R&D Center, Faculty of Medicine of the University of Porto São João, Porto, Portugal.
| | - Ricardo Alves Pinto
- Department of Cardiology, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Tânia Proença
- Department of Cardiology, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Mariana Paiva
- Department of Cardiology, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Carla Sousa
- Department of Cardiology, Centro Hospitalar Universitário de São João, Porto, Portugal; Cardiovascular R&D Center, Faculty of Medicine of the University of Porto São João, Porto, Portugal
| | - João Carlos Silva
- Department of Cardiology, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Filipe Macedo
- Department of Cardiology, Centro Hospitalar Universitário de São João, Porto, Portugal; Cardiovascular R&D Center, Faculty of Medicine of the University of Porto São João, Porto, Portugal
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Maia MRG, Monteiro A, Valente IM, Sousa C, Miranda C, Castro C, Cortez PP, Cabrita ARJ, Trindade H, Fonseca AJM. Upcycling post-harvest biomass residues from native European Lupinus species: from straws and pod shells production to nutritive value and alkaloids content for ruminant animals. Front Nutr 2023; 10:1195015. [PMID: 37521412 PMCID: PMC10374839 DOI: 10.3389/fnut.2023.1195015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/23/2023] [Indexed: 08/01/2023] Open
Abstract
The production of Lupinus seeds for food and feed is increasing worldwide, which results in large amounts of post-harvest biomass residues, considered of low value and left in the field to be burned or incorporated in the soil. To valorize these agricultural wastes, this work aimed to assess their potential as an alternative feed for ruminants. Thus, the production yield, nutritive value, and alkaloid content of straws and pod shells from three native European Lupinus species, L. albus 'Estoril' (white), L. angustifolius 'Tango' (narrow-leafed), and L. luteus 'Cardiga' (yellow), cultivated in two locations, were evaluated. The dry matter (DM) yield of straws and pod shells were the highest for L. albus 'Estoril' (4.10 t ha-1) and the lowest for L. angustifolius 'Tango' (1.78 t ha-1), suggesting a poor adaptation of narrow-leafed lupin to the particularly dry and warm agronomic year. Despite species-specific differences, lupin biomass residues presented higher crude protein (53.0-68.9 g kg-1 DM) and lignin (103-111 g kg-1 DM) content than cereal straws usually used in ruminant feeding, thus resulting in higher metabolizable energy (6.43-6.58 MJ kg-1 DM) content. In vitro digestibility was similar among lupin species (47.7-50.6%) and higher in pod shells (53.7%) than in straws (44.6%). Lupinus albus 'Estoril' and L. luteus 'Cardiga' presented considerable amounts of alkaloids in straws (23.9 and 119 mg kg-1 DM) and pod shells (20.5 and 298 mg kg-1 DM), while no alkaloids were detected in L. angustifolius 'Tango' biomass residues. Considering the combined production of straw and pod shells per lupin species, it is anticipated that lupin biomass residues produced per ha can fulfill 85% of the energy and nearly 50% of protein requirements of a flock of 4 to 9 dry and mid-pregnancy sheep with 50 kg body weight for one year. No negative effects on small (ovine) and large (bovine) ruminant species due to alkaloids are expected, even if biomass residues are consumed at up to 85% DM intake. The large production yield along with its nutritive value unveils the potential of lupin biomass residues valorization as alternative fodder for ruminants, promoting sustainability under a circular economy approach.
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Affiliation(s)
- Margarida R. G. Maia
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - André Monteiro
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - Inês M. Valente
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
- REQUIMTE, LAQV, Department of Chemistry and Biochemistry, Faculty of Sciences, University of Porto, Porto, Portugal
| | - Carla Sousa
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Carla Miranda
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - Carlos Castro
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - Paulo P. Cortez
- ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Ana R. J. Cabrita
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Henrique Trindade
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - António J. M. Fonseca
- REQUIMTE, LAQV, ICBAS, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
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Sousa C, Rye S, Sousa M, Torres PJ, Perim C, Mansuklal SA, Ennami F. Playing at the school table: Systematic literature review of board, tabletop, and other analog game-based learning approaches. Front Psychol 2023; 14:1160591. [PMID: 37333606 PMCID: PMC10273683 DOI: 10.3389/fpsyg.2023.1160591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/10/2023] [Indexed: 06/20/2023] Open
Abstract
The unique characteristics of games have led scientific research to increasingly focus on their potential role in learning processes. Currently, their effectiveness in fostering experiential learning and skill acquisition in several areas is already supported by the existing evidence, mainly about the potential of digital games. Paradoxically, the current post-digital era seems to have led to a growing popularity of analog games. The present Systematic Literature Review aimed to map the existing literature on the potential of board, tabletop, or other analog games in learning processes. It intended to systematize the contemporary state of the art (2012-2022) around the pedagogical role of these games, their effectiveness, the promoted learning outcomes, the methodological aspects of the interventions, the used games-including mechanics and other characteristics-and the current discussions around inclusion and accessibility in analog game-based learning. Adopting the PRISMA methodology, we searched ACM Digital Library, EBSCO, ERIC, Scopus-Elsevier, and Web of Science databases, as well as other peer-reviewed "grey literature" sources. The search resulted in an initial sample of 2,741 articles that was then screened by inclusion and exclusion criteria previously defined according to the research objectives. We obtained a final sample of 45 articles. To formulate the mapping of existing research, these studies were analyzed using a combination of statistical, content, and critical analysis procedures. The obtained results support the role of board, tabletop, and other analog games in educational contexts-based on their educational potential-with a broad range of knowledge, cognitive, and psychological outcomes. The study also emphasized the relevance of these games in the promotion of soft skills and other aspects typically associated with meaningful learning, such as engagement, satisfaction, flexibility, and freedom of experimentation. However, important limitations were found in a fair amount of the pedagogical approaches studied, which can be mostly attributed to the low prevalence of modern board games that relate what is intended to be learned to aspects of game design and have little to no consideration of accessibility and inclusion aspects in these studies.
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Affiliation(s)
- Carla Sousa
- Lusófona University, CICANT, Lisbon, Portugal
| | - Sara Rye
- LSBU, London Center for Business and Entrepreneurship Research, London, United Kingdom
- Department of Peace Studies and International Development, University of Bradford, Bradford, United Kingdom
| | - Micael Sousa
- CITTA, Departamento de Engenharia Civil, Universidade de Coimbra, Coimbra, Portugal
| | | | | | | | - Firdaous Ennami
- LSBU, London Center for Business and Entrepreneurship Research, London, United Kingdom
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Dion L, Sousa C, Legendre G, Nyangoh-Timoh K, Le Lous M, Morel O, Lavoue V, Descamps P. Assessment of the self-confidence of obstetrics & gynecology fellows to perform a postpartum hemostasis hysterectomy. J Gynecol Obstet Hum Reprod 2023; 52:102548. [PMID: 36781074 DOI: 10.1016/j.jogoh.2023.102548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 02/13/2023]
Abstract
INTRODUCTION Hemostasis Hysterectomy (HH) is a last resort surgical procedure performed in situations of uncontrolled post-partum hemorrhage in maternity wards. The chances of being confronted with this situation are scarce during residency, and the situation is not well suited for teaching. Nevertheless, every obstetrician-gynecologist can be confronted with this stressful situation, and should therefore possess the surgical competence required, regardless of his routine practice. The aim of the present study is to evaluate clinical exposure and self-awareness concerning HH amongst obstetrics and gynecology residents and fellows. MATERIEL AND METHODS We performed a survey amongst French obstetrics and gynecology fellows. An anonymous survey was sent by email between December 1, 2020 to July 1, 2021. RESULTS Half of the interrogated fellows had practiced (as operator) an HH during residency with a senior and only 22,6% in post-residency. During the last year of residency 70% of them had performed less than 10 scheduled hysterectomies as primary operator. The laparoscopic approach was the most frequently practiced. Very few hysterectomies were performed as primary operator. Fellows with a surgical or mixed activity (both gynecological surgery and obstetrical activity in current practice) felt significantly more capable of performing HH compared to those with exclusive obstetrical or reproductive medicine activity; respectively 60% vs 36%, p = 0.008; Odds Ratio: 2.629 (95% CI 1.2214; 5.8094). CONCLUSION The number of scheduled hysterectomies or HH performed as primary operator is very low during residency or fellowship. It remains largely inferior to the number deemed necessary in previous publications about the learning curve for scheduled hysterectomy, which varies from 18 to 80 interventions. Nowadays, the increasing number of residents, added to the decrease of hemostasis hysterectomies through better management of post-partum hemorrhage, pushes towards the development of specific training, such as "damage control simulation".
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Affiliation(s)
- Ludivine Dion
- Rennes University Hospital, Department of Gynecology, Hôpital Sud, France; Irset - Inserm UMR_S 1085, Rennes, France.
| | - Carla Sousa
- Rennes University Hospital, Department of Gynecology, Hôpital Sud, France; Irset - Inserm UMR_S 1085, Rennes, France
| | | | | | - Maëla Le Lous
- Rennes University Hospital, Department of Gynecology, Hôpital Sud, France
| | - Olivier Morel
- Nancy University Hospital, Department of Obstetrics, France
| | - Vincent Lavoue
- Rennes University Hospital, Department of Gynecology, Hôpital Sud, France; Irset - Inserm UMR_S 1085, Rennes, France
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Martins Carvalho M, Alves Pinto R, Proença T, Costa I, Tavares N, Paiva M, Sousa C, Macedo F. Cardiovascular toxicity in breast cancer patients - contributors and role of cardioprotective drugs. Monaldi Arch Chest Dis 2023; 93. [PMID: 37009760 DOI: 10.4081/monaldi.2023.2514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 01/30/2023] [Indexed: 03/30/2023] Open
Abstract
Breast cancer (BC) patients treated with anthracyclines and/or anti-HER2-targeted therapies (AHT) are highly associated with cardiovascular toxicity (CVT). Our objective was to evaluate the risk of CVT secondary to cancer treatment and the role of cardioprotective-drugs (CPD) in BC patients. We collected a retrospective cohort of females with BC treated with chemotherapy and/or AHT from 2017 to 2019. CVT was defined as LVEF<50% or decline ≥10% during follow-up. As CPD, we considered renin-angiotensin-aldosterone-system inhibitors and beta-blockers. A subgroup analysis of the AHT patients was also performed. A total of 203 women were enrolled. The majority had high or very-high CVT risk score and normal cardiac function at presentation. As for CPD, 35.5% were medicated pre-chemotherapy. All patients were submitted to chemotherapy; AHT were applied to 41.7%. During a 16 months follow-up, 8.5% developed CVT. There was a significant decrease of GLS and LVEF at 12-months (decrease of 1.1% and 2.2%, p<0.001). AHT and combined therapy were significantly associated with CVT. In the AHT sub-group analysis (n=85), 15.7% developed CVT. Patients previously medicated with CPD had a significative lower incidence of CVT (2.9% vs 25.0%, p=0.006). Patients already on CPD presented a higher LVEF at 6-months follow-up (62.5% vs 59.2%, p=0.017). Patients submitted to AHT and anthracycline therapy had higher risk of developing CVT. In the AHT sub-group, pre-treatment with CPD was significantly associated with a lower prevalence of CVT. These results highlight the importance of cardio-oncology evaluation and strengthen the value of primary prevention.
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Affiliation(s)
- Miguel Martins Carvalho
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto; Cardiovascular R&D Center, Faculty of Medicine, University of Porto.
| | | | - Tânia Proença
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto.
| | - Inês Costa
- Oncology Department, Centro Hospitalar Universitário de São João, Porto.
| | - Nuno Tavares
- Oncology Department, Centro Hospitalar Universitário de São João, Porto.
| | - Mariana Paiva
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto.
| | - Carla Sousa
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto; Cardiovascular R&D Center, Faculty of Medicine, University of Porto.
| | - Filipe Macedo
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto; Cardiovascular R&D Center, Faculty of Medicine, University of Porto.
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Ferreira AF, Azevedo MJ, Saraiva FA, Trindade F, Barros A, Leite S, Proença T, Sousa C, Machado AP, Leite-Moreira A, Sampaio-Maia B, Ramalho C, Falcão-Pires I. The PERInatal MYocardial Remodeling (PERIMYR) cohort study protocol: A prospective study of cardiac remodeling and "recovery" in pregnancy as a model to understand the impact of comorbidities in cardiac remodeling and reverse remodeling. Rev Port Cardiol 2023:S0870-2551(23)00173-7. [PMID: 36958578 DOI: 10.1016/j.repc.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 03/25/2023] Open
Abstract
INTRODUCTION Heart failure (HF) is among the leading causes of morbidity and mortality worldwide. Several conditions trigger left ventricular chronic pressure or volume overload, hypertrophy, systolic and diastolic dysfunction, leading to cardiac remodeling and a rapid progression toward HF. Therapeutic interventions elicit reverse remodeling (RR), a highly variable myocardial response that ranges from none to total ventricular structural/functional recovery. However, HF patients present several comorbidities and medications that mask a comprehensive molecular knowledge of RR and hinder the identification of potential biomarkers of its progression or prognosis. Therefore, instead of using this heterogeneous population or even animal models to understand myocardial remodeling, we propose studying pregnancy-induced cardiovascular remodeling and postpartum-induced RR. OBJECTIVES To assess cardiovascular functional and structural adaptations during pregnancy and in postpartum, characterizing the associated molecular changes; as well as to explore the impact of hypertension, obesity and diabetes on these processes. METHODS We will perform echocardiography and assess endothelial function and arterial stiffness (EndoPAT® and pulse wave velocity, respectively) and assess potential markers of remodeling and RR using plasma and urine samples from pregnant women. To translate to a HF context, we will determine the impact of risk factors (hypertension, obesity and diabetes) by studying subgroups of pregnant women with these comorbidities. RESULTS Not applicable Conclusion: We are convinced that understanding the impact of these comorbidities in such a homogeneous population, such as pregnant women, provides a valuable model to unveil the most relevant pathologic and often masked signaling pathways underlying cardiac remodeling and incomplete RR in a heterogeneous population, such as HF patients. Moreover, we expect to identify potential novel biomarkers of RR progression/prognosis more easily.
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Affiliation(s)
- A F Ferreira
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - M J Azevedo
- Faculdade de Medicina Dentária, Universidade do Porto, Portugal; INEB - Instituto Nacional de Engenharia Biomédica, Portugal; i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal; Academic Center for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - F A Saraiva
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - F Trindade
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - A Barros
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - S Leite
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal; Anta Family Health Unit, Espinho/Gaia Healthcare Center, Espinho, Portugal
| | - T Proença
- Cardiology Department, Centro Hospitalar de São João, Porto, Portugal
| | - C Sousa
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal; Cardiology Department, Centro Hospitalar de São João, Porto, Portugal
| | - A P Machado
- Center of Prenatal Diagnosis, Obstetrics Department, São João Hospital, Porto, Portugal
| | - A Leite-Moreira
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal; Cardiothoracic Surgery Department, Centro Hospitalar de São João, Porto, Portugal
| | - B Sampaio-Maia
- Faculdade de Medicina Dentária, Universidade do Porto, Portugal; INEB - Instituto Nacional de Engenharia Biomédica, Portugal; i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal
| | - C Ramalho
- Center of Prenatal Diagnosis, Obstetrics Department, São João Hospital, Porto, Portugal; Obstetrics, Gynecology and Pediatrics Department, Faculty of Medicine of the University of Porto, Portugal
| | - I Falcão-Pires
- Cardiovascular R&D Center - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal.
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Duchon M, Sousa C, Ludivine D, Lavoué V. How I do Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in ovarian cancer: a 10 steps video ? J Gynecol Obstet Hum Reprod 2023; 52:102563. [PMID: 36858197 DOI: 10.1016/j.jogoh.2023.102563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/23/2023] [Accepted: 02/26/2023] [Indexed: 03/03/2023]
Abstract
Hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment that combining chemotherapy and surgery. This treatment is performed in one go, at the end of the surgery, after performing the usual cytoreduction procedure recommended in ovarian cancer, therefore removing all cancerous lesions visible to the naked eye. The chemotherapy drugs (Cisplatin) are diluted in a saline solution and heated to 42°C for one hour in order to increase its cytotoxic effect on cancerous tissues. They are then introduced into the peritoneal cavity where they circulate before being drained by a pump. In the open HIPEC technique, the procedure ends with the abdominal wall closure. This surgical technique is part of the therapeutic options in advanced ovarian cancer, it has showed a survival benefit and has been validated by the INCA and HAS in the latest guidelines. According to the clinical studies, the indications for this surgery are a primary debulking surgery and/or interval debulking surgery. Even though this technique is increasingly applied in France, its use remains controversial among practicioners/centers; its implementation requires coordination and investment from a multidisciplinary team. The objective of this video is to detail in 10 steps the indication, the implementation and the course of the surgery. Regarding the HIPEC protocol implemented, it is based on the one of Van Driel et al. published in 2018 in the NEJM. The drug protocol systematically used in our center was the one recommended by the French recommendations, based on the protocol of Van Driel et al, which is the only prospective, randomized, large-scale study: Cisplatin 100 mg/m2 distributed at a rate of 50 mg/m2 at the beginning of the procedure, 25 mg/m2 at 30 min, and 25 mg/m2 at 60 min for a total duration of 90 min at 40-41°C as well as hyperhydration and nephroprotection by IV sodium thiosulfate in a bolus of 9 g/m2 at the beginning of HIPEC then 12 g/m2 over 6 h. Ref: van Driel WJ, Koole SN, Sonke GS. Hyperthermic intraperitoneal chemotherapy in ovarian cancer. N Engl J Med 2018;378(14):1363-4.
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Affiliation(s)
- Mathilde Duchon
- Service de Gynécologie, CHU Rennes, Université de Rennes, F-35000 Rennes, France.
| | - Carla Sousa
- Service de Gynécologie, CHU Rennes, Université de Rennes, F-35000 Rennes, France
| | - Dion Ludivine
- Service de Gynécologie, CHU Rennes, Université de Rennes, F-35000 Rennes, France
| | - Vincent Lavoué
- Service de Gynécologie, CHU Rennes, Université de Rennes, F-35000 Rennes, France
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23
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando JIL, Bosch X, Sinha A, Vidal P, Izquierdo M, Marin F, Esteve-Pastor MA, Tello-Montoliu A, Lopez-Garcia C, Rivera-Caravaca JM, Gil-Pérez P, Nicolas-Franco S, Keituqwa I, Farhan HA, Silva L, Blasco A, Escudier JM, Ortega J, Zamorano JL, Sanmartin M, Pereda DC, Rincon LM, Gonzalez P, Casado T, Sadeghipour P, Lopez-Sendon JL, Manjavacas AMI, Marin LAM, Sotelo LR, Rodriguez SOR, Bueno H, Martin R, Maruri R, Moreno G, Moris C, Gudmundsdottir I, Avanzas P, Ayesta A, Junco-Vicente A, Cubero-Gallego H, Pascual I, Sola NB, Rodriguez OA, Malagon L, Martinez-Basterra J, Arizcuren AM, Indolfi C, Romero J, Calleja AG, Fuertes DG, Crespín Crespín M, Bernal FJC, Ojeda FB, Padron AL, Cabeza MM, Vargas CM, Yanes G, Kitai T, Gonzalez MJG, Gonzalez Gonzalez J, Jorge P, De La Fuente B, Bermúdez MG, Perez-Lopez CMB, Basiero AB, Ruiz AC, Pamias RF, Chamero PS, Mirrakhimov E, Hidalgo-Urbano R, Garcia-Rubira JC, Seoane-Garcia T, Arroyo-Monino DF, Ruiz AB, Sanz-Girgas E, Bonet G, Rodríguez-López J, Scardino C, De Sousa D, Gustiene O, Elbasheer E, Humida A, Mahmoud H, Mohamed A, Hamid E, Hussein S, Abdelhameed M, Ali T, Ali Y, Eltayeb M, Philippe F, Ali M, Almubarak E, Badri M, Altaher S, Alla MD, Dellborg M, Dellborg H, Hultsberg-Olsson G, Marjeh YB, Abdin A, Erglis A, Alhussein F, Mgazeel F, Hammami R, Abid L, Bahloul A, Charfeddine S, Ellouze T, Canpolat U, Oksul M, Muderrisoglu H, Popovici M, Karacaglar E, Akgun A, Ari H, Ari S, Can V, Tuncay B, Kaya H, Dursun L, Kalenderoglu K, Tasar O, Kalpak O, Kilic S, Kucukosmanoglu M, Aytekin V, Baydar O, Demirci Y, Gürsoy E, Kilic A, Yildiz Ö, Arat-Ozkan A, Sinan UY, Dagva M, Gungor B, Sekerci SS, Zeren G, Erturk M, Demir AR, Yildirim C, Can C, Kayikcioglu M, Yagmur B, Oney S, Xuereb RG, Sabanoglu C, Inanc IH, Ziyrek M, Sen T, Astarcioglu MA, Kahraman F, Utku O, Celik A, Surmeli AO, Basaran O, Ahmad WAW, Demirbag R, Besli F, Gungoren F, Ingabire P, Mondo C, Ssemanda S, Semu T, Mulla AA, Atos JS, Wajid I, Appelman Y, Al Mahmeed WAR, Atallah B, Bakr K, Garrod R, Makia F, Eldeeb F, Abdekader R, Gomaa A, Kandasamy S, Maruthanayagam R, Nadar SK, Nakad G, Nair R, Mota P, Prior P, Mcdonald S, Rand J, Schumacher N, Abraheem A, Clark M, Coulding M, Qamar N, Turner V, Negahban AQ, Crew A, Hope S, Howson J, Jones S, Lancaster N, Nicholson A, Wray G, Donnelly P, Gierlotka M, Hammond L, Hammond S, Regan S, Watkin R, Papadopoulos C, Ludman P, Hutton K, Macdonald S, Nilsson A, Roberts S, Monteiro S, Garg S, Balachandran K, Mcdonald J, Singh R, Marsden K, Davies K, Desai H, Goddard W, Iqbal N, Chalil S, Dan GA, Galasko G, Assaf O, Benham L, Brown J, Collins S, Fleming C, Glen J, Mitchell M, Preston S, Uttley A, Radovanovic M, Lindsay S, Akhtar N, Atkinson C, Vinod M, Wilson A, Clifford P, Firoozan S, Yashoman M, Bowers N, Chaplin J, Reznik EV, Harvey S, Kononen M, Lopesdesousa G, Saraiva F, Sharma S, Cruddas E, Law J, Young E, Hoye A, Harper P, Balghith M, Rowe K, Been M, Cummins H, French E, Gibson C, Abraham JA, Hobson S, Kay A, Kent M, Wilkinson A, Mohamed A, Clark S, Duncan L, Ahmed IM, Khatiwada D, Mccarrick A, Wanda I, Read P, Afsar A, Rivers V, Theobald T, Cercek M, Bell S, Buckman C, Francis R, Peters G, Stables R, Morgan M, Noorzadeh M, Taylor B, Twiss S, Widdows P, Brozmannová D, Wilkinson V, Black M, Clark A, Clarkson N, Currie J, George L, Mcgee C, Izzat L, Lewis T, Omar Z, Aytekin V, Phillips S, Ahmed F, Mackie S, Oommen A, Phillips H, Sherwood M, Aleti S, Charles T, Jose M, Kolakaluri L, Ingabire P, Karoudi RA, Deery J, Hazelton T, Knight A, Price C, Turney S, Kardos A, Williams F, Wren L, Bega G, Alyavi B, Scaletta D, Kunadian V, Cullen K, Jones S, Kirkup E, Ripley DP, Matthews IG, Mcleod A, Runnett C, Thomas HE, Cartasegna L, Gunarathne A, Burton J, King R, Quinn J, Sobolewska J, Munt S, Porter J, Christenssen V, Leng K, Peachey T, Gomez VN, Temple N, Wells K, Viswanathan G, Taneja A, Cann E, Eglinton C, Hyams B, Jones E, Reed F, Smith J, Beltrano C, Affleck DC, Turner A, Ward T, Wilmshurst N, Stirrup J, Brunton M, Whyte A, Smith S, Murray V, Walker R, Novas V, Weston C, Brown C, Collier D, Curtis K, Dixon K, Wells T, Trim F, Ghosh J, Mavuri M, Barman L, Dumont C, Elliott K, Harrison R, Mallinson J, Neale T, Smith J, Toohie J, Turnbull A, Parker E, Hossain R, Cheeseman M, Balparda H, Hill J, Hood M, Hutchinson D, Mellows K, Pendlebury C, Storey RF, Barker J, Birchall K, Denney H, Housley K, Cardona M, Middle J, Kukreja N, Gati S, Kirk P, Lynch M, Srinivasan M, Szygula J, Baker P, Cruz C, Derigay J, Cigalini C, Lamb K, Nembhard S, Price A, Mamas M, Massey I, Wain J, Delaney J, Junejo S, Martin K, Obaid D, Hoyle V, Brinkworth E, Davies C, Evans D, Richards S, Thomas C, Williams M, Dayer M, Mills H, Roberts K, Goodchild F, Dámaso ES, Greig N, Kundu S, Donaldson D, Tonks L, Beekes M, Button H, Hurford F, Motherwell N, Summers-Wall J, Felmeden D, Tapia V, Keeling P, Sheikh U, Yonis A, Felmeden L, Hughes D, Micklewright L, Summerhayes A, Sutton J, Panoulas V, Prendergast C, Poghosyan K, Rogers P, Barker LN, Batin P, Conway D, Exley D, Fletcher A, Wright J, Nageh T, Hadebe B, Kunhunny S, Mkhitaryan S, Mshengu E, Karthikeyan VJ, Hamdan H, Cooper J, Dandy C, Parkinson V, Paterson P, Reddington S, Taylor T, Tierney C, Adamyan M, Jones KV, Broadley A, Beesley K, Buckley C, Hellyer C, Pippard L, Pitt-Kerby T, Azam J, Hayes C, Freshwater K, Boyadjian S, Johnson L, Mcgill Y, Redfearn H, Russell M, Alyavi A, Alyavi B, Uzokov J, Hayrapetyan H, Azaryan K, Tadevosyan M, Poghosyan H, Kzhdryan H, Vardanyan A, Huber K, Geppert A, Ahmed A, Weidinger F, Derntl M, Hasun M, Schuh-Eiring T, Riegler L, Haq MM, Cader FA, Dewan MAM, Fatema ME, Hasan AS, Islam MM, Khandoker F, Mayedah R, Nizam SU, Azam MG, Arefin MM, Jahan J, Schelfaut D, De Raedt H, Wouters S, Aerts S, Batjoens H, Beauloye C, Dechamps M, Pierard S, Van Caenegem O, Sinnaeve F, Claeys MJ, Snepvangers M, Somers V, Gevaert S, Schaubroek H, Vervaet P, Buysse M, Renders F, Dumoulein M, Hiltrop N, De Coninck M, Naessens S, Senesael I, Hoffer E, Pourbaix S, Beckers J, Dugauquier C, Jacquet S, Malmendier D, Massoz M, Evrard P, Collard L, Brunner P, Carlier S, Blockmans M, Mayne D, Timiras E, Guédès A, Demeure F, Hanet C, Domange J, Jourdan K, Begic E, Custovic F, Dozic A, Hrvat E, Kurbasic I, Mackic D, Subo A, Durak-Nalbantic A, Dzubur A, Rebic D, Hamzic-Mehmedbasic A, Redzepovic A, Djokic-Vejzovic A, Hodzic E, Hujdur M, Musija E, Gljiva-Gogic Z, Serdarevic N, Bajramovic NS, Brigic L, Halilcevic M, Cibo M, Hadžibegic N, Kukavica N, Begic A, Iglica A, Osmanagic A, Resic N, Grgurevic MV, Zvizdic F, Pojskic B, Mujaric E, Selimovic H, Ejubovic M, Pojskic L, Stimjanin E, Sut M, Zapata PS, Munoz CG, Andrade LAF, Upegui MPT, Perez LE, Chavarria J, Quesada D, Alvarado K, Zaputovic L, Tomulic V, Gobic D, Jakljevic T, Lulic D, Bacic G, Bastiancic L, Avraamides P, Eftychiou C, Eteocleous N, Ioannou A, Lambrianidi C, Drakomathioulakis M, Groch L, Hlinomaz O, Rezek M, Semenka J, Sitar J, Beranova M, Kramarikova P, Pesl L, Sindelarova S, Tousek F, Warda HM, Ghaly I, Habiba S, Habib A, Gergis MN, Bahaa H, Samir A, Taha HSE, Adel M, Algamal HM, Mamdouh M, Shaker AF, Shokry K, Konsoah A, Mostafa AM, Ibrahim A, Imam A, Hafez B, Zahran A, Abdelhamid M, Mahmoud K, Mostafa A, Samir A, Abdrabou M, Kamal A, Sallam S, Ali A, Maghraby K, Atta AR, Saad A, Ali M, Lotman EM, Lubi R, Kaljumäe H, Uuetoa T, Kiitam U, Durier C, Ressencourt O, El Din AA, Guiatni A, Bras ML, Mougenot E, Labeque JN, Banos JL, Capendeguy O, Mansourati J, Fofana A, Augagneur M, Bahon L, Pape AL, Batias-Moreau L, Fluttaz A, Good F, Prieur F, Boiffard E, Derien AS, Drapeau I, Roy N, Perret T, Dubreuil O, Ranc S, Rio S, Bonnet JL, Bonnet G, Cuisset T, Deharo P, Mouret JP, Spychaj JC, Blondelon A, Delarche N, Decalf V, Guillard N, Hakme A, Roger MP, Biron Y, Druelles P, Loubeyre C, Lucon A, Hery P, Nejjari M, Digne F, Huchet F, Neykova A, Tzvetkov B, Larrieu M, Quaino G, Armangau P, Sauguet A, Bonfils L, Dumonteil N, Fajadet J, Farah B, Honton B, Monteil B, Philippart R, Tchetche D, Cottin M, Petit F, Piquart A, Popovic B, Varlot J, Maisuradze D, Sagirashvili E, Kereselidze Z, Totladze L, Ginturi T, Lagvilava D, Hamm C, Liebetrau C, Haas M, Hamm C, Koerschgen T, Weferling M, Wolter JS, Maier K, Nickenig G, Sedaghat A, Zachoval C, Lampropoulos K, Mpatsouli A, Sakellaropoulou A, Tyrovolas K, Zibounoumi N, Argyropoulos K, Toulgaridis F, Kolyviras A, Tzanis G, Tzifos V, Milkas A, Papaioannou S, Kyriazopoulos K, Pylarinou V, Kontonassakis I, Kotakos C, Kourgiannidis G, Ntoliou P, Parzakonis N, Pipertzi A, Sakalidis A, Ververeli CL, Kafkala K, Sinanis T, Diakakis G, Grammatikopoulos K, Papoutsaki E, Patialiatos T, Mamaloukaki M, Papadaki ST, Kanellos IE, Antoniou A, Tsinopoulos G, Goudis C, Giannadaki M, Daios S, Petridou M, Skantzis P, Koukis P, Dimitriadis F, Savvidis M, Styliadis I, Sachpekidis V, Pilalidou A, Stamatiadis N, Fotoglidis A, Karakanas A, Ruzsa Z, Becker D, Nowotta F, Gudmundsdottir I, Libungan B, Skuladottir FB, Halldorsdottir H, Shetty R, Iyengar S, Bs C, G S, Lakshmana S, S R, Tripathy N, Sinha A, Choudhary B, Kumar A, Kumar A, Raj R, Roy RS, Dharma S, Siswanto BB, Farhan HA, Yaseen IF, Al-Zaidi M, Dakhil Z, Amen S, Rasool B, Rajeeb A, Amber K, Ali HH, Al-Kinani T, Almyahi MH, Al-Obaidi F, Masoumi G, Sadeghi M, Heshmat-Ghahdarijani K, Roohafza H, Sarrafzadegan N, Shafeie M, Teimouri-Jervekani Z, Noori F, Kyavar M, Sadeghipour P, Firouzi A, Alemzadeh-Ansari MJ, Ghadrdoost B, Golpira R, Ghorbani A, Ahangari F, Salarifar M, Jenab Y, Biria A, Haghighi S, Mansouri P, Yadangi S, Kornowski R, Orvin K, Eisen A, Oginetz N, Vizel R, Kfir H, Pasquale GD, Casella G, Cardelli LS, Filippini E, Zagnoni S, Donazzan L, Ermacora D, Indolfi C, Polimeni A, Curcio A, Mongiardo A, De Rosa S, Sorrentino S, Spaccarotella C, Landolina M, Marino M, Cacucci M, Vailati L, Bernabò P, Montisci R, Meloni L, Marchetti MF, Biddau M, Garau E, Barbato E, Morisco C, Strisciuglio T, Canciello G, Lorenzoni G, Casu G, Merella P, Novo G, D'Agostino A, Di Lisi D, Di Palermo A, Evola S, Immordino F, Rossetto L, Spica G, Pavan D, Mattia AD, Belfiore R, Grandis U, Vendrametto F, Spagnolo C, Carniel L, Sonego E, Gaudio C, Barillà F, Biccire FG, Bruno N, Ferrari I, Paravati V, Torromeo C, Galasso G, Peluso A, Prota C, Radano I, Benvenga RM, Ferraioli D, Anselmi M, Frigo GM, Sinagra G, Merlo M, Perkan A, Ramani F, Altinier A, Fabris E, Rinaldi M, Usmiani T, Checco L, Frea S, Mussida M, Matsukawa R, Sugi K, Kitai T, Furukawa Y, Masumoto A, Miyoshi Y, Nishino S, Assembekov B, Amirov B, Chernokurova Y, Ibragimova F, Mirrakhimov E, Ibraimova A, Murataliev T, Radzhapova Z, Uulu ES, Zhanyshbekova N, Zventsova V, Erglis A, Bondare L, Zaliunas R, Gustiene O, Dirsiene R, Marcinkeviciene J, Sakalyte G, Virbickiene A, Baksyte G, Bardauskiene L, Gelmaniene R, Salkauskaite A, Ziubryte G, Kupstyte-Kristapone N, Badariene J, Balciute S, Kapleriene L, Lizaitis M, Marinskiene J, Navickaite A, Pilkiene A, Ramanauskaite D, Serpytis R, Silinskiene D, Simbelyte T, Staigyte J, Philippe F, Degrell P, Camus E, Ahmad WAW, Kassim ZA, Xuereb RG, Buttigieg LL, Camilleri W, Pllaha E, Xuereb S, Popovici M, Ivanov V, Plugaru A, Moscalu V, Popovici I, Abras M, Ciobanu L, Litvinenco N, Fuior S, Dumanschi C, Ivanov M, Danila T, Grib L, Filimon S, Cardaniuc L, Batrinac A, Tasnic M, Cozma C, Revenco V, Sorici G, Dagva M, Choijiljav G, Dandar E, Khurelbaatar MU, Tsognemekh B, Appelman Y, Den Hartog A, Kolste HJT, Van Den Buijs D, Van'T Hof A, Pustjens T, Houben V, Kasperski I, Ten Berg J, Azzahhafi J, Bor W, Yin DCP, Mbakwem A, Amadi C, Kushimo O, Kilasho M, Oronsaye E, Bakracheski N, Bashuroska EK, Mojsovska V, Tupare S, Dejan M, Jovanoska J, Razmoski D, Marinoski T, Antovski A, Jovanovski Z, Kocho S, Markovski R, Ristovski V, Samir AB, Biserka S, Kalpak O, Peovska IM, Taleska BZ, Pejkov H, Busljetik O, Zimbakov Z, Grueva E, Bojovski I, Tutic M, Poposka L, Vavlukis M, Al-Riyami A, Nadar SK, Abdelmottaleb W, Ahmed S, Mujtaba MS, Al-Mashari S, Al-Riyami H, Laghari AH, Faheem O, Ahmed SW, Qamar N, Furnaz S, Kazmi K, Saghir T, Aneel A, Asim A, Madiha F, Sobkowicz B, Tycinska A, Kazimierczyk E, Szyszkowska A, Mizia-Stec K, Wybraniec M, Bednarek A, Glowacki K, Prokopczuk J, Babinski W, Blachut A, Kosiak M, Kusinska A, Samborski S, Stachura J, Szastok H, Wester A, Bartoszewska D, Sosnowska-Pasiarska B, Krzysiek M, Legutko J, Nawrotek B, Kasprzak JD, Klosinska M, Wiklo K, Kurpesa M, Rechcinski T, Cieslik-Guerra U, Gierlotka M, Bugajski J, Feusette P, Sacha J, Przybylo P, Krzesinski P, Ryczek R, Karasek A, Kazmierczak-Dziuk A, Mielniczuk M, Betkier-Lipinska K, Roik M, Labyk A, Krakowian M, Machowski M, Paczynska M, Potepa M, Pruszczyk P, Budaj A, Ambroziak M, Omelanczuk-Wiech E, Torun A, Opolski G, Glowczynska R, Fojt A, Kowalik R, Huczek Z, Jedrzejczyk S, Roleder T, Brust K, Gasior M, Desperak P, Hawranek M, Farto-Abreu P, Santos M, Baptista S, Brizida L, Faria D, Loureiro J, Magno P, Monteiro C, Nédio M, Tavares J, Sousa C, Almeida I, Almeida S, Miranda H, Santos H, Santos AP, Goncalves L, Monteiro S, Baptista R, Ferreira C, Ferreira J, Goncalves F, Lourenço C, Monteiro P, Picarra B, Santos AR, Guerreiro RA, Carias M, Carrington M, Pais J, de Figueiredo MP, Rocha AR, Mimoso J, De Jesus I, Fernandes R, Guedes J, Mota T, Mendes M, Ferreira J, Tralhão A, Aguiar CT, Strong C, Da Gama FF, Pais G, Timóteo AT, Rosa SAO, Mano T, Reis J, Selas M, Mendes DE, Satendra M, Pinto P, Queirós C, Oliveira I, Reis L, Cruz I, Fernandes R, Torres S, Luz A, Campinas A, Costa R, Frias A, Oliveira M, Martins V, Castilho B, Coelho C, Moura AR, Cotrim N, Dos Santos RC, Custodio P, Duarte R, Gomes R, Matias F, Mendonca C, Neiva J, Rabacal C, Almeida AR, Caeiro D, Queiroz P, Silva G, Pop-Moldovan AL, Darabantiu D, Mercea S, Dan GA, Dan AR, Dobranici M, Popescu RA, Adam C, Sinescu CJ, Andrei CL, Brezeanu R, Samoila N, Baluta MM, Pop D, Tomoaia R, Istratoaie O, Donoiu I, Cojocaru A, Oprita OC, Rocsoreanu A, Grecu M, Ailoaei S, Popescu MI, Cozma A, Babes EE, Rus M, Ardelean A, Larisa R, Moisi M, Ban E, Buzle A, Filimon G, Dobreanu D, Lupu S, Mitre A, Rudzik R, Sus I, Opris D, Somkereki C, Mornos C, Petrescu L, Betiu A, Volcescu A, Ioan O, Luca C, Maximov D, Mosteoru S, Pascalau L, Roman C, Brie D, Crisan S, Erimescu C, Falnita L, Gaita D, Gheorghiu M, Levashov S, Redkina M, Novitskii N, Dementiev E, Baglikov A, Zateyshchikov D, Zubova E, Rogozhina A, Salikov A, Nikitin I, Reznik EV, Komissarova MS, Shebzukhova M, Shitaya K, Stolbova S, Larina V, Akhmatova F, Chuvarayan G, Arefyev MN, Averkov OV, Volkova AL, Sepkhanyan MS, Vecherko VI, Meray I, Babaeva L, Goreva L, Pisaryuk A, Potapov P, Teterina M, Ageev F, Silvestrova G, Fedulaev Y, Pinchuk T, Staroverov I, Kalimullin D, Sukhinina T, Zhukova N, Ryabov V, Kruchinkina E, Vorobeva D, Shevchenko I, Budyak V, Elistratova O, Fetisova E, Islamov R, Ponomareva E, Khalaf H, Shaimaa AA, Kamal W, Alrahimi J, Elshiekh A, Balghith M, Ahmed A, Attia N, Jamiel AA, Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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Carvalho M, Sousa C. Cardio-oncology: The future is now! Rev Port Cardiol 2022; 41:985-986. [PMID: 36369220 DOI: 10.1016/j.repc.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Miguel Carvalho
- Serviço de Cardiologia, Centro Hospitalar e Universitário de São João, Porto, Portugal; Cardiovascular R&D Center (UnIC@RISE), Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Carla Sousa
- Serviço de Cardiologia, Centro Hospitalar e Universitário de São João, Porto, Portugal; Cardiovascular R&D Center (UnIC@RISE), Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
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Kislaya I, Peralta-Santos A, Vieira L, Sousa C, Ferreira B, Pelerito A, Gomes JP, Pinto Leite P, Nunes B. Case-case study on comparative vaccine effectiveness against Delta and Omicron SARS-CoV-2 infections. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Vaccination is the primary pharmacological measure to reduce SARS-CoV-2 transmission and its complications. Timely information on vaccines effectiveness in a context of novel variants of concern (VOC) emergence is essential for public health policies. This study aimed to provide a measure of comparative vaccine effectiveness between Omicron (BA.1) and Delta (B.1.627.2) VOC according to vaccination exposure (complete primary regimen or booster dose) for Portuguese population aged 12 or more years old using routinely collected data from electronic health records.
Methods
We used a case-case study design linking national electronic vaccination registry and surveillance data on 13,134 SARS-CoV-2 RT-PCR laboratory-confirmed cases notified in Portugal during weeks 49-51 of 2021. Notified cases were classified as Omicron or Delta based on whole-genome sequencing or S-gene Target Failure (SGTF) status using the RT-PCR TaqPath™ Covid 19 CE IVD Kit (Thermo Scientific™) assay. The odds of vaccination was compared between Omicron cases and Delta cases using logistic regression adjusted for age group, sex, region and week of diagnosis and laboratory of origin.
Results
The odds of vaccination were higher in laboratory-confirmed cases infected by Omicron (BA.1) VOC compared to Delta (B.1.627.2) VOC for both complete primary vaccination (Odds ratio (OR)=2.1; 95% Confidence Interval (95%CI): 1.8 - 2.4) and booster dose (OR = 5.2; 95%CI: 3.1 - 8.8), indicating vaccine effectiveness reduction against Omicron.
Conclusions
We found significantly higher odds of vaccination in Omicron cases compared to Delta, suggesting lower effectiveness of the primary vaccination and the booster dose in preventing infections by Omicron. Case-case study design has proven to be feasible approach to rapidly compare vaccine effectiveness between VOC in context of novel VOC emergence to timely inform public health stakeholders.
Key messages
• Reduction of vaccine-induced protection against SARS-COV-2 infection with the Omicron compared to Delta after primary and booster vaccination.
• Continuous monitoring of COVID-19 vaccine effectiveness is essential to support public health policies in context of novel VOC emergence.
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Affiliation(s)
- I Kislaya
- Departamento de Epidemiologia, National Institute of Health Doutor Ricardo Jorge , Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - A Peralta-Santos
- Public Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
- Direção de Serviços de Informação e Análise, Direção-Geral da Saúde , Lisbon, Portugal
| | - L Vieira
- Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge , Lisbon, Portugal
| | | | - B Ferreira
- Algarve Biomedical Center Research Institute , Faro, Portugal
- Faculty of Medicine and Biomedical Sciences, University of Algarve , Faro, Portugal
| | - A Pelerito
- Portuguese Red Cross Laboratory , Lisbon, Portugal
| | - JP Gomes
- Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge , Lisbon, Portugal
| | - P Pinto Leite
- Direção de Serviços de Informação e Análise, Direção-Geral da Saúde , Lisbon, Portugal
| | - B Nunes
- Departamento de Epidemiologia, National Institute of Health Doutor Ricardo Jorge , Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Centre, Universidade NOVA de Lisboa , Lisbon, Portugal
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Amador A, Martins Da Costa C, Calvao J, Carvalho JM, Proenca T, Pinto R, Marques C, Cabrita A, Santos L, Oliveira C, Pinho A, Palma P, Rocha M, Sousa C, Macedo F. Aortic valve calcium score: does it correlate with mean transaortic gradient? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Aortic valvular calcium score (AVCS) is useful in patients with aortic stenosis for whom echocardiography was not conclusive in grading its severity. Transcatheter aortic valve implantation (TAVI) is an established procedure of treatment in symptomatic severe AS. The burden of aortic valve calcification has been associated with some TAVI related complications (as perivalvular leaks), but at the same time it is well accepted that some degree of calcification is needed to ensure stable anchoring of the prosthesis to the aortic annulus.
Purpose
To assess if there is a correlation between aortic valve calcium score and mean transvalvular gradient 6 months after TAVI – is a higher AVCS correlated with lower mean transaortic gradient after TAVI?
Methods
We performed a single-center, retrospective cohort study including patients who underwent TAVI with a preoperative standardized contrast enhanced MSCT with AVCS available. Clinical and echocardiographic data were collected previously to TAVI (pre-TAVI) and at 6 months follow up (6M-FUP).
Results
A total of 187 patients were included, with 54% female and a mean age of 79.4±9.0 years old. Most patients had tricuspid aortic valve (95.7%); 5 patients had aortic bicuspidy and 3 had aortic valve bioprothesis. Concerning the valve type, 73.3% had new generation prosthesis and the main valve used was the CoreValve Evolut Pro (33.7%). Also, 38,5% needed balloon pre-dilation before TAVI. The mean pre-TAVI aortic transvalvular maximum and mean gradients were 76.5±23.2 mmHg and 48.3±15.5 mmHg, respectively; mean aortic valve area was 0.75±0.16 cm2. The mean AVCS was 2851±1524 AU (Agaston Units); 81.2% of women had AVCS>1300 AU and 74.4% men had AVCS >2000 AU. Comparing transvalvular aortic gradients previously and 6M-FUP after TAVI, there was an average differential of maximum gradient of 61±22 mmHg and of mean gradient of 40±15 mmHg. A negative and weak correlation was found between the AVCS and the maximum gradient (pearson coefficient of −0.181, p=0.02) and between mean gradient at 6M-FUP (pearson coefficient of −0.191, p=0.014).
Discussion and conclusion
AVCS is a significant predictor for death, stroke and perivalvular leaks after TAVI. On the other hand, high AVCS is associated with better seating in the native annulus during deployment. Nevertheless, high AVCS did not strongly correlated with mean transaortic gradient 6 months after TAVI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Amador
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | | | - J Calvao
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - J M Carvalho
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - T Proenca
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - R Pinto
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - C Marques
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - A Cabrita
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - L Santos
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - C Oliveira
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - A Pinho
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - P Palma
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - M Rocha
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - C Sousa
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - F Macedo
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
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Amador A, Martins Da Costa C, Calvao J, Pinto R, Proenca T, Carvalho JM, Cabrita A, Marques C, Pinho A, Santos L, Oliveira C, Moreira H, Palma P, Sousa C, Macedo F. Reduced 3D-left atrium ejection fraction predicts development of atrial fibrillation in patients with hypertrophic cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Atrial fibrillation (AF) is the most common sustained arrhythmia in hypertrophic cardiomyopathy (HCM), occurring in approximately 25% of patients, related to left atrial (LA) dilatation and remodeling. HCM patients who develop AF have increased risk of HCM-related death, functional impairment, and stroke. Accurate risk stratification for AF in this population is crucial as contemporary treatments are highly successful.
Purpose
To assess if new echocardiographic parameters can predict the development of AF in HCM patients.
Methods
HCM patients who underwent comprehensive echocardiographic examination during 2011 were followed and checked for “de novo” AF until November 2021. We searched for associations between AF development and novel echocardiographic parameters such as LA Volume index, Left Atrioventricular Coupling Index (LACI, as LAVI/a'), 3D LA volumes and 3D LA ejection fraction (3D-LAEF).
Results
A total of 43 patients were included, with 62.8% male and mean age 56,1±6,2 years old. 55.8% had the septal asymmetric HCM type and mean LV mass was 326±127g. Mean LA diameter and biplane 2D volume was 46±7 mm and 78±37 mL, respectively. 11.6% of patients already had AF. During a median follow-up of 9.4 years, the incidence of “de novo” AF was 31,6%. Within the total 17 patients with AF, 35,2% took warfarin and the remaining direct oral anti-coagulation. No stroke was documented. There were 3 deaths (mortality rate of 7,0%), none from cardiac causes.
No association was found between AF development and LAVI, LACI or 3D LA volumes. We only found a statistically significant difference regarding 3D-LAEF, which was lower in patients who developed AF compared with those without AF (26±12% VS 39±19%, p=0.04).
Binary logistic regression analysis found that reduced 3D-LAEF predicts the development of AF (p=0.019, odds ratio [OR] 2.6, 95% confidence interval [CI] 1.0 to 1.1). The area under a receiver operating characteristic curve using 3D-LAEF as a predictive marker for AF development in HCM patients was 0.743 (p=0.004). When the cut-off value of 3D-LAEF was set at 34,5%, the sensitivity and specificity for AF diagnosis were 66% and 86%, respectively.
Conclusion
In our study, 3D LAEF predicted the development of AF in HCM patients – this may be a useful tool to identify patients at high risk of future AF who may benefit from more intensive rhythm monitoring and a lower threshold for oral anticoagulation.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Amador
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | | | - J Calvao
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - R Pinto
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - T Proenca
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - J M Carvalho
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - A Cabrita
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - C Marques
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - A Pinho
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - L Santos
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - C Oliveira
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - H Moreira
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - P Palma
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - C Sousa
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
| | - F Macedo
- Centro Hospitalar Universitario Sao Joao, Cardiology , Porto , Portugal
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Martins De Carvalho M, Alves Pinto R, Proenca T, Calvao J, Martins Da Costa C, Amador AF, Amaral Marques C, Cabrita A, Santos L, Oliveira C, Pinho A, Sousa C, Paiva M, Silva JC, Macedo F. Long-term success in percutaneous valve commissurotomy – is Wilkins score over 9 a definitive limit? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Percutaneous valve commissurotomy (PMC) is an established treatment in patients with significative mitral stenosis (MS). Although rheumatic MS incidence has decreased in the last century, it remains a prevalent pathology worldwide. The Wilkins score (WS) is a reference in echocardiographic assessment of MS; a score ≤8 is considered a predictor of treatment success and score between 9 and 11 is a “grey zone” (WGZ) in which doubts persists regarding PMC success.
Purpose
To evaluate the early and long-term results of PMC in patients with rheumatic MS and to compare long-term events between patients with WS ≤8 and patients in WGZ.
Methods
We retrospectively analysed all patients between 1991 and 2008 with significative rheumatic MS undergoing PMC. Data were collected at baseline and during long-term follow-up. M ACE was defined as a composite of all-cause mortality, mitral valve re-intervention or cardiovascular hospitalization.
Results
In our cohort, 124 patients were included. Most were female (87%), mean age at the time of repair was 46±11 year-old and mean follow-up was 20±6 years. Before the procedure, 81% had WS ≤8 and 19% were in WGZ. Both groups had similar baseline characteristics, namely age at first intervention, NYHA class and follow-up time. All patients had preserved biventricular systolic function, 83% presented PH, mean transvalvular gradient (TVG) and mitral valve area (MVA) were 12.8 mmHg and 1.0 cm2, respectively. Most of the procedures were successful (91%) and without complications (94%). Mean MVA improvement was similar in both groups [0.9 cm2 in WS ≤8 and 0.8 cm2 in WGZ, t(102)=0.173, p=0.863]; there was also no significative difference in TVG and PASP reduction after PMC. During long-term follow-up, re-intervention and mortality occurred in 40% and 23% in WS ≤8 and in 50% and 29% in WGZ, respectively, and none of these differences was statistically significant (p=0.389 and p=0.544, respectively). Concerning time-to-event analysis, approximately 80% of patients kept uneventful and >90% alive after 10 years in both groups and no significant difference in M ACE events and all-cause mortality between WS ≤8 and WGZ was observed (Log Rank, p=0,419 and p=0.950, respectively).
Conclusion
PMC was safe and effective in clinically significant rheumatic MS in both WS ≤8 and WS 9–11, with similar MVA improvement. After 10 years, approximately 80% of patients were MACE-free and >90% alive in both groups. There was no difference in all-cause mortality and in a composite of all-cause death, mitral valve re-intervention or cardiovascular hospitalization concerning WS groups.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | | | - T Proenca
- Sao Joao Hospital , Porto , Portugal
| | - J Calvao
- Sao Joao Hospital , Porto , Portugal
| | | | | | | | - A Cabrita
- Sao Joao Hospital , Porto , Portugal
| | - L Santos
- Sao Joao Hospital , Porto , Portugal
| | | | - A Pinho
- Sao Joao Hospital , Porto , Portugal
| | - C Sousa
- Sao Joao Hospital , Porto , Portugal
| | - M Paiva
- Sao Joao Hospital , Porto , Portugal
| | - J C Silva
- Sao Joao Hospital , Porto , Portugal
| | - F Macedo
- Sao Joao Hospital , Porto , Portugal
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Trindade F, Ferreira AF, Saraiva F, Martins D, Mendes VM, Sousa C, Gavina C, Leite-Moreira A, Manadas B, Falcão-Pires I, Vitorino R. Optimization of a Protocol for Protein Extraction from Calcified Aortic Valves for Proteomics Applications: Development of a Standard Operating Procedure. Proteomes 2022; 10:proteomes10030030. [PMID: 36136308 PMCID: PMC9505568 DOI: 10.3390/proteomes10030030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/02/2022] [Accepted: 08/11/2022] [Indexed: 11/28/2022] Open
Abstract
The comprehension of the pathophysiological mechanisms, the identification of druggable targets, and putative biomarkers for aortic valve stenosis can be pursued through holistic approaches such as proteomics. However, tissue homogenization and protein extraction are made difficult by tissue calcification. The reproducibility of proteome studies is key in clinical translation of the findings. Thus, we aimed to optimize a protocol for aortic valve homogenization and protein extraction and to develop a standard operating procedure (SOP), which researchers can use to maximize protein yield while reducing inter-laboratory variability. We have compared the protein yield between conventional tissue grinding in nitrogen followed by homogenization with a Potter apparatus with a more advanced bead-beating system. Once we confirmed the superiority of the latter, we further optimized it by testing the effect of beads size, the number of homogenization cycles, tube capacity, lysis buffer/tissue mass ratio, and two different lysis buffers. Optimal protein extraction was achieved with 2.8 mm zirconium dioxide beads, in two homogenization cycles, in the presence of 20 µL RIPA buffer/mg tissue, using 2 mL O-ring cryotubes. As a proof of concept of the usefulness of this SOP for proteomics, the AV proteome of men and women with aortic stenosis was characterized, resulting in the quantification of proteins across six orders of magnitude and uncovering some putative proteins dysregulated by sex.
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Affiliation(s)
- Fábio Trindade
- Cardiovascular R&D Centre—UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Correspondence:
| | - Ana F. Ferreira
- Cardiovascular R&D Centre—UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Francisca Saraiva
- Cardiovascular R&D Centre—UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Diana Martins
- Cardiovascular R&D Centre—UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Vera M. Mendes
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
| | - Carla Sousa
- Cardiovascular R&D Centre—UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Cardiology Department, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal
| | - Cristina Gavina
- Cardiovascular R&D Centre—UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Cardiology Department, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, 4464-513 Matosinhos, Portugal
| | - Adelino Leite-Moreira
- Cardiovascular R&D Centre—UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Department of Cardiothoracic Surgery, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal
| | - Bruno Manadas
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
- Institute for Interdisciplinary Research, University of Coimbra, 3030-789 Coimbra, Portugal
| | - Inês Falcão-Pires
- Cardiovascular R&D Centre—UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Rui Vitorino
- Cardiovascular R&D Centre—UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- iBiMED—Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
- LAQV/REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
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Proença T, Pinto RA, Carvalho MMD, Sousa C, Dias P, Campelo M, Macedo F. Predictors of Atrial Fibrillation in Holter Monitoring after Stroke - A Ten Year Flashback. Arq Bras Cardiol 2022; 119:346-348. [PMID: 35946697 PMCID: PMC9363065 DOI: 10.36660/abc.20210660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 03/09/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Tânia Proença
- Centro Hospitalar Universitário de São João, Porto - Portugal
| | | | | | - Carla Sousa
- Centro Hospitalar Universitário de São João, Porto - Portugal
| | - Paula Dias
- Centro Hospitalar Universitário de São João, Porto - Portugal
| | - Manuel Campelo
- Centro Hospitalar Universitário de São João, Porto - Portugal.,Universidade do Porto Faculdade de Medicina, Porto - Portugal
| | - Filipe Macedo
- Centro Hospitalar Universitário de São João, Porto - Portugal.,Universidade do Porto Faculdade de Medicina, Porto - Portugal
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Carvalho dos Santos P, Costa P, Carvalho I, Sousa C. Complicaciones de la rinosinusitis aguda. Una revisión clínica radiológica. Radiología 2022. [DOI: 10.1016/j.rx.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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32
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Straatsma TP, Broer R, Sánchez-Mansilla A, Sousa C, de Graaf C. GronOR: Scalable and Accelerated Nonorthogonal Configuration Interaction for Molecular Fragment Wave Functions. J Chem Theory Comput 2022; 18:3549-3565. [PMID: 35640094 DOI: 10.1021/acs.jctc.2c00266] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
GronOR is a program package for nonorthogonal configuration interaction calculations. Electronic wave functions are constructed in terms of antisymmetrized products of multiconfiguration molecular fragment wave functions. The computational complexity of the nonorthogonal methodologies implemented in GronOR applied to large molecular assemblies requires a design that takes full advantage of massively parallel supercomputer architectures and accelerator technologies. This work describes the implementation strategy and resulting performance characteristics. In addition to parallelization and acceleration, the software development strategy includes aspects of fault resiliency and heterogeneous computing. The program was designed for large-scale supercomputers but also runs effectively on small clusters and workstations for small molecular systems. GronOR is available as open source to the scientific community.
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Affiliation(s)
- T P Straatsma
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831-6373, United States.,Department of Chemistry and Biochemistry, University of Alabama, Tuscaloosa, Alabama 35487-0336, United States
| | - R Broer
- Theoretical Chemistry Group, Zernike Institute for Advanced Materials, University of Groningen, 9747 AG Groningen, The Netherlands
| | - A Sánchez-Mansilla
- Department of Physical and Inorganic Chemistry, Universitat Rovira i Virgili, C. Marcel·lí Domingo 1, 43007 Tarragona, Spain
| | - C Sousa
- Department of Physical Chemistry and Institut de Química Teòrica i Computacional, Universitat de Barcelona, 08028 Barcelona, Spain
| | - C de Graaf
- Theoretical Chemistry Group, Zernike Institute for Advanced Materials, University of Groningen, 9747 AG Groningen, The Netherlands.,Department of Physical and Inorganic Chemistry, Universitat Rovira i Virgili, C. Marcel·lí Domingo 1, 43007 Tarragona, Spain.,ICREA, Pg. Lluís Companys 23, 08010 Barcelona, Spain
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Sánchez-Mansilla A, Sousa C, Kathir RK, Broer R, Straatsma TP, de Graaf C. On the role of dynamic electron correlation in non-orthogonal configuration interaction with fragments. Phys Chem Chem Phys 2022; 24:11931-11944. [PMID: 35521680 DOI: 10.1039/d2cp00772j] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Two different approaches have been implemented to include the effect of dynamic electron correlation in the Non-Orthogonal Configuration Interaction for Fragments (NOCI-F) method. The first is based on shifting the diagonal matrix elements of the NOCI matrix, while the second incorporates the dynamic correlation explicitly in the fragment wave functions used to construct the many-electron basis functions of the NOCI. The two approaches are illustrated for the calculation of the electronic coupling relevant in singlet fission and the coupling of spin moments in organic radicals. Comparison of the calculated diabatic couplings, the NOCI energies and wave functions shows that dynamic electron correlation is not only efficiently but also effectively incorporated by the shifting approach and can largely affect the coupling between electronic states. Also, it brings the NOCI coupling of the spin moments in close agreement with benchmark calculations.
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Affiliation(s)
- A Sánchez-Mansilla
- Departament de Química Física i Inorgànica, Universitat Rovira i Virgili, Tarragona, Spain
| | - C Sousa
- Departament de Ciència de Materials i Química Física and Institut de Química Teòrica i Computacional, Universitat de Barcelona, Spain.
| | - R K Kathir
- Zernike Institute of Advanced Materials, University of Groningen, The Netherlands
| | - R Broer
- Zernike Institute of Advanced Materials, University of Groningen, The Netherlands
| | - T P Straatsma
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37831-6373, USA.,Department of Chemistry and Biochemistry, University of Alabama, Tuscaloosa, AL 35487-0336, USA
| | - C de Graaf
- Departament de Química Física i Inorgànica, Universitat Rovira i Virgili, Tarragona, Spain.,Zernike Institute of Advanced Materials, University of Groningen, The Netherlands.,ICREA, Pg. Lluís Companys 23, Barcelona, Spain.
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Favareto S, Sousa C, Pinto P, Ramos H, Neto E, Abrahao C, Chen M, Pellizzon A, Silva M, Gondim G, Castro D, Fogaroli R. PO-1294 clinical prognostic factors for esophageal cancer treated with definitive chemo-radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03258-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Martins De Carvalho M, Proenca T, Pinto RA, Costa I, Torres S, Resende CX, Grilo PD, Amador AF, Costa C, Calvao J, Cabrita A, Marques C, Sousa C, Paiva M, Macedo F. Breast cancer patients presenting with cardiotoxicity - risk factors and role of cardioprotective drugs. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Recent advances in cancer treatment have led to improved survival, albeit with cardiovascular adverse effects being some of the most frequent and feared consequences. Patient’s risk stratification, prevention and treatment are still to be fully elucidated. Our aim was to evaluate the risk and therapy of cardiotoxicity (CT) secondary to cancer treatment in a subset of patients with breast cancer (BC).
Methods
We collected a retrospective cohort of female with BC treated with conventional chemotherapy (CHT) and/or anti-HER2-targeted therapies (AHT) referred to Cardio-oncology consultation from January 2017 to March 2020. All patients were evaluated before CHT and at least at 3, 6 and 12-months with echocardiogram and cardiac biomarkers, namely high sensitivity troponin I (hs-cTnI) and brain natriuretic peptide (BNP). CT was defined as left ventricle ejection fraction (LVEF) under 50% or decline of at least 10% in LVEF during follow-up. As cardioprotective drugs (CPD) we considered renin-angiotensin-aldosterone system inhibitors and beta-blockers.
Results
A total of 203 women were enrolled, with mean age 50.9 ± 10.9 year-old. As for the cardiovascular risk factors, 23.5% had hypertension, 32.4% dyslipidaemia, 9.8% diabetes and 33.0% were smokers or previous smokers. The majority of patients had a high or very-high CT risk score (98.5% with score ≥ 5) and 35.5% were already on CPD before CHT. All patients were submitted to CHT: anthracyclines (AC) and AHT were applied to 83.8% and 41.7% of patients, respectively, with 27.9% of patients on both therapies; 81.4% were submitted to radiotherapy (RT). At presentation, all patients had normal cardiac function with mean LVEF of 62.9% and mean global longitudinal strain (GLS) of -19.4; mean hs-cTnI and BNP were 3.3 ng/L and 33.4 pg/mL, respectively. During a median follow-up of 16 months, 8.5% of patients developed CT, leading to initiation or titration of CPD in 76.9% and treatment interruption in 23.5%; most of them recovered (88.2%). During treatment there was a significantly increase of hs-cTnI (mean 19.7 ng/L at 3 months, p < 0.001) and a decrease of GLS and LVEF at 12 months (decrease of 1.1 and 2.2%, respectively, both p < 0.001). Both AHT and AHT plus AC were significantly associated with CT (p = 0.002 and p < 0.001, respectively), with an extremely high prevalence in the latter group (19.6%). Nor CVRF neither RT raised the risk of CT. Although patients on CPD did not had lower prevalence of CT (5.6% vs 10.2%, p = 0.268), its initiation was associated with a higher rate of cardiac function recovery (100.0% vs 66.7%, p = 0.057).
Conclusion
Patients submitted to AHT or AHT plus AC were at higher risk of developing CT. This and the significant LVEF decline during follow-up highlight the importance of long-term-monitoring of these patients. CPD seemed to be associated with cardiac recovery, although this finding needs further validation.
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Affiliation(s)
| | | | - RA Pinto
- Sao Joao Hospital, Porto, Portugal
| | - I Costa
- Sao Joao Hospital, Porto, Portugal
| | - S Torres
- Sao Joao Hospital, Porto, Portugal
| | | | - PD Grilo
- Sao Joao Hospital, Porto, Portugal
| | | | - C Costa
- Sao Joao Hospital, Porto, Portugal
| | - J Calvao
- Sao Joao Hospital, Porto, Portugal
| | | | | | - C Sousa
- Sao Joao Hospital, Porto, Portugal
| | - M Paiva
- Sao Joao Hospital, Porto, Portugal
| | - F Macedo
- Sao Joao Hospital, Porto, Portugal
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Amador A, Martins Da Costa C, Calvao J, Alves Pinto R, Proenca T, Carvalho JM, Cabrita A, Marques C, Grilo PD, Sousa C, Macedo F. Aortic valve calcium score and peri-prothesis leaks after transcatheter aortic valve implantation: a hint? Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
The first-line evaluation of aortic stenosis (AS) severity is Doppler echocardiography. Aortic valvular calcium score (AVCS) measured by tomography scans (TS) is useful in patients for whom echocardiography is not conclusive. For high-risk patients with symptomatic severe AS, transcatheter aortic valve implantation (TAVI) is an established procedure of treatment. The burden of aortic valve calcification has been associated with some TAVI related complications. Peri-prothesis leaks (PPL) are an important complication that may compromise TAVI net results and further refinements are required to predict high-risk patients. Purpose: To access if there is an association between aortic valve calcium score and moderate to severe (mod-sev) peri-prothesis leaks immediately and 6 month after TAVI. Methods: We performed a single-center, retrospective cohort study including patients who underwent TAVI with a preoperative standardised TS with AVCS available. Clinical and echocardiographic data were collected previously to TAVI (pre-TAVI) and at 6 months follow up (6M-FUP). Results: A total of 187 patients were included, with 54% female and a mean age of 79.37± 9.029 year-old. Most patients had tricuspid aortic valve (95.7%); 5 patients had aortic bicuspidy and 3 had aortic valve bioprothesis. Considering left ventricular systolic function, the majority had conserved function (73.0%), the remaining had mild (9.7%), moderate (11.4%) or severe (5.9%) dysfunction. Concerning the valve type, 73.3% had new generation prosthesis and the main valve used was the CoreValve Evolut Pro (33.7%). Also, 38.5% patients underwent balloon valve pre-dilation before implantation. In-hospital mortality was 2.7%. At 6M-FUP, 8 of 182 patients had dead. The mean AVCS was 2851 ± 1524 AU (Agaston Units); 81.2% of women had AVCS > 1300 AU and 74.4% men had AVCS >2000 AU. Comparing AVCS with the presence or absence of moderate to severe peri-prothesis leaks, no statistically significant difference was found immediately (no vs mod-sev leak, AS: 2758 ± 2308 vs 3621 ± 1376, p= 0,13) and 6 months after the procedure (no vs mod-sev leak, AS: 2892 ± 2366 vs 3621 ± 1424, p = 0.15). Considering earlier (Portico, CoreValve Evolut R) vs newer valves (CoreValve Evolut Pro; Edward Sapiens 3; Accurate Neo), there was no statistically significant difference relating AVCS and PPL; however, in patients who had newer valves there was a trend to higher AVCS and moderate to severe leaks, both on the immediate (no vs mod-sev leak, AS: 2777 ± 2507 vs 3601 ± 1385, p = 0.07) and at 6 months (no vs mod-sev leak, AS: 2782 ± 2506 vs 3984 ± 1138, p = 0.06). No statistically significant difference was found when comparing pre-ballooning dilatation. Conclusion: Aortic calcium measured by Agatston score did not show an association with new moderate to severe peri-valvular leaks after TAVI. Nevertheless, it seems to be a trend for higher AS and moderate to severe peri-prothesis leaks when newer valves are implanted.
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Affiliation(s)
- A Amador
- Centro Hospitalar Universitario Sao Joao, Porto, Portugal
| | | | - J Calvao
- Centro Hospitalar Universitario Sao Joao, Cardiology, Porto, Portugal
| | - R Alves Pinto
- Centro Hospitalar Universitario Sao Joao, Cardiology, Porto, Portugal
| | - T Proenca
- Centro Hospitalar Universitario Sao Joao, Cardiology, Porto, Portugal
| | - JM Carvalho
- Centro Hospitalar Universitario Sao Joao, Cardiology, Porto, Portugal
| | - A Cabrita
- Centro Hospitalar Universitario Sao Joao, Cardiology, Porto, Portugal
| | - C Marques
- Centro Hospitalar Universitario Sao Joao, Cardiology, Porto, Portugal
| | - PD Grilo
- Centro Hospitalar Universitario Sao Joao, Cardiology, Porto, Portugal
| | - C Sousa
- Centro Hospitalar Universitario Sao Joao, Cardiology, Porto, Portugal
| | - F Macedo
- Centro Hospitalar Universitario Sao Joao, Cardiology, Porto, Portugal
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Calvao J, Costa C, Amador A, Pinto R, Carvalho M, Proenca T, Marques C, Cabrita A, Grilo P, Resende C, Torres S, Sousa C, Macedo F. Impact of severe mitral annular calcification on mitral regurgitation after transcatheter aortic valve implantation. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Transcatheter aortic valve implantation (TAVI) has become the standard of care treatment in patients with severe aortic stenosis who are at intermediate or high risk for surgical aortic valve replacement. Mitral annular calcification (MAC) is frequent in patients with aortic stenosis, and its presence is associated with increased cardiovascular morbidity and mortality. Not infrequently, it is associated with significant morphologic and functional abnormalities of the mitral valve apparatus.
Purpose
The aim of this work is to evaluate the relationship between severe MAC and the presence and development of significant mitral regurgitation after TAVI.
Methods
We retrospectively analyzed all patients who underwent TAVI at a tertiary center from October 2014 to November 2019. Clinical, echocardiographic and procedure-related data were collected until a follow-up of 6 months. Statistical analysis was conducted on IBM SPSS® Statistics software. Descriptive statistics were calculated for all variables. Sample T-test, Chi-square and Wilcoxon sign test were used. A p-value < 0.05 was considered significant. The presence and severity of MAC was defined according to echocardiographic data. Severe MAC was defined by the presence of calcification of more than half of the mitral annular circumference.
Results
A total of 343 patients were enrolled in the study. The mean age of the population was 80 ± 8 years, 45% were male. Mean functional area was 0.75 ± 0.18 cm2, mean transvalvular pressure gradient was 48 ± 15 mmHg and the mean left ventricular ejection fraction (LVEF) was 54 ± 14%. MAC was detected in 231 (67%) patients. In 44 (19%) of these patients, MAC was graded as severe. Patients with severe MAC tended to have higher prevalence of moderate (27.3 vs 20.4%, p = 0.30) as well as severe (4.5 vs 1.8%, p = 0.24) mitral regurgitation at baseline. After TAVI, the prevalence of moderate mitral regurgitation at 6 months was similar between both groups (22.5 vs 20.4%, p = 0.76). Although not reaching statistical significance, patients with severe MAC had higher prevalence of severe mitral regurgitation at 6 months post-procedure (12.2 VS 5.0%, p = 0.07) as well as higher incidence of worsening of mitral regurgitation (34.2 vs 23.7%, p = 0.16). The proportion of patients that had improvement (13.2 vs 15.0%, p = 0.76) or no change (52.6 vs 61.3%, p = 0.31) in the degree of mitral regurgitation was similar in both groups.
Conclusion
The presence of severe MAC at baseline echocardiography in patients undergoing TAVI may be associated with worsening of mitral regurgitation after the procedure. These patients tend to have higher prevalence of severe mitral regurgitation post-TAVI. Further studies are needed in order to further elucidate this association.
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Affiliation(s)
- J Calvao
- Sao Joao Hospital, Porto, Portugal
| | - C Costa
- Sao Joao Hospital, Porto, Portugal
| | - A Amador
- Sao Joao Hospital, Porto, Portugal
| | - R Pinto
- Sao Joao Hospital, Porto, Portugal
| | | | | | | | | | - P Grilo
- Sao Joao Hospital, Porto, Portugal
| | | | - S Torres
- Sao Joao Hospital, Porto, Portugal
| | - C Sousa
- Sao Joao Hospital, Porto, Portugal
| | - F Macedo
- Sao Joao Hospital, Porto, Portugal
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Costa C, Calvao J, Amador A, Proenca T, Carvalho M, Pinto R, Marques C, Cabrita A, Grilo PD, Resende CX, Torres S, Sousa C, Macedo F. Can aortic calcium score predict new conduction disturbances in pos-transcatheter aortic valve implantation? Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Transcatheter aortic valve implantation (TAVI) may be the first line treatment for severe aortic stenosis according to overall patient characteristics. Semi-quantitative Agatston score (AS), which quantifies aortic calcium by cardiac computed tomography (CCT), has knowledgeable practical and clinical implications, and is performed in TAVI diagnostic workup. Since conduction disturbances continue to be the most frequent complication, further refinements are required to predict high-risk patients.
Purpose
To access if aortic AS relates with new conduction disturbances and permanent pacemaker (PPM) implantation in patients undergoing TAVI.
Methods
We retrospectively analyzed all patients who underwent TAVI at a tertiary center from October 2014 to November 2019; patients with previous permanent pacemaker (PPM) or had no aortic AS were excluded. Clinical and electrocardiogram (ECG) data were collected at admission and after the procedure. All categorical variables are reported as numbers and percentages. Continuous variables were analyzed using the two-tailed unpaired Student’s t-test and are reported as mean values and the standard deviation. Statistical analysis was performed using the IBM SPSS.
Results
172 patients with a mean age 79 ± 9.1 years old were included (see table 1 for baseline characteristics). AS was on average 3008 ± 2262 (see table 2 for remaining diagnostic workup and procedure characteristics).
Comparing AS with new conduction disturbances, no statistically significant difference was found for new complete left branch block (LBBB) (no vs new LBBB, AS: 3179 ± 2555 vs 2637 ± 1388, p= 0,15) and with new complete atrioventricular block (AVB) (no vs new AVB, AS: 2834 ± 1520 vs 4485 ± 5285, p = 0.2). Considering PPM implantation after TAVI, there was a tendency for higher AS and PPM implantation (no vs PPM implantation, AS: 2756 ± 1451 vs 4242 ± 4310, p = 0.07).
In patients who had pre-ballooning, there was no difference relating to AS; however, in patients who had no pre-ballooning there was a trend to higher AS and PPM implantation (no vs PPM implantation, AS: 2417 ± 1301 vs 4616 ± 4969, p = 0.06). No statistically significant difference was found when comparing earlier (Portico, CoreValve Evolut R) vs newer valves (CoreValve Evolut Pro; Edward Sapiens 3; Accurate Neo).
Conclusion
Aortic calcium measured by Agatston score did not show a correlation with new LBBB or new AVB after TAVI. Nevertheless, it seems to be a trend for higher AS and PPM implantation; this was more noticeable when pre-ballooning was not performed. Further studies are needed in order to further elucidate this association. Abstract Figure. Patients baseline characteristics Abstract Figure. TAVI diagnostic workup and procedure
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Affiliation(s)
- C Costa
- Sao Joao Hospital, Porto, Portugal
| | - J Calvao
- Sao Joao Hospital, Porto, Portugal
| | - A Amador
- Sao Joao Hospital, Porto, Portugal
| | | | | | - R Pinto
- Sao Joao Hospital, Porto, Portugal
| | | | | | - PD Grilo
- Sao Joao Hospital, Porto, Portugal
| | | | - S Torres
- Sao Joao Hospital, Porto, Portugal
| | - C Sousa
- Sao Joao Hospital, Porto, Portugal
| | - F Macedo
- Sao Joao Hospital, Porto, Portugal
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BEIRÃO B, Freitas M, Francisco J, Sousa C, Pereira P, Prata C, Castro R, Morgado T. POS-928 EFFICACY OF THE PFIZER/ BNT162b2 COVID-19 VACCINE IN PERITONEAL DIALYSIS PATIENTS. Kidney Int Rep 2022. [PMCID: PMC8854947 DOI: 10.1016/j.ekir.2022.01.968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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FRANCISCO J, Beirão B, Freitas M, Sousa C, Pereira P, Castro R, Morgado T. POS-939 EFFICACY OF BNT162b2 VACCINE IN PATIENTS UNDERGOING HEMODIALYSIS IN NORTH OF PORTUGAL. Kidney Int Rep 2022. [PMCID: PMC8854880 DOI: 10.1016/j.ekir.2022.01.979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Arieira C, Dias de Castro F, Boal Carvalho P, Magalhães J, Xavier S, Sousa C, Rosa B, Cotter J. Bowel cleansing efficacy for colonoscopy: prospective, randomized comparative study of same-day dosing with 1-L and 2-L PEG + ascorbate. Endosc Int Open 2021; 9:E1602-E1610. [PMID: 34790521 PMCID: PMC8589540 DOI: 10.1055/a-1520-4596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 05/10/2021] [Indexed: 12/23/2022] Open
Abstract
Background and study aims Polyethylene glycol (PEG) bowel preparations are effective but associated with high ingestion volume. In this study, 1-L PEG and 2-L PEG preparations were compared in a randomized, colonoscopist-blinded, single-center trial. Patients and methods Patients were aged > 18 years, required colonoscopy, and provided informed consent. Randomization was 1:1 to 1-L PEG or 2-L PEG, based on hospital identification number (odd or even). Preparations were administered using same-day dosing adjusted for colonoscopy start time. The primary endpoint was successful bowel preparation on the Boston Bowel Preparation Scale (BBPS) (no segment scored < 2). Results A total of 852 patients were randomized. In the intention-to-treat (ITT) population, significantly more patients had diabetes in the 2-L PEG arm, resulting in the creation of the modified-ITT population (mITT) that excluded diabetic patients to correct the imbalance (1-L PEG, n = 239; 2-L PEG, n = 238). In the mITT, there was no significant difference in successful cleansing between 1-L PEG and 2-L PEG (88.3 % vs. 82.4 %; P = 0.067). Excellent cleansing (BBPS 7-9; no segment < 2) was significantly improved with 1-L PEG (60.7 % vs. 50.4 %; P < 0.024), as were mean scores in the right and left colon (right: 2.47 vs. 2.30; P < 0.008; left: 2.55 vs. 2.39; P = 0.008). Adverse events were mild to moderate in intensity and none resulted in discontinuation. Rates of nausea and vomiting were significantly higher with 1-L PEG, but that did not affect successful cleansing. Conclusions The lower-volume 1-L PEG was associated with higher levels of excellent bowel cleansing and greater mean segmental scores on the BBPS than 2-L PEG.
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Affiliation(s)
- Cátia Arieira
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal,Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga/Guimarães, Portugal,Life and Health Sciences Research Institute (ICVS)/3B’s Research Group, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Francisca Dias de Castro
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal,Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga/Guimarães, Portugal,Life and Health Sciences Research Institute (ICVS)/3B’s Research Group, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Pedro Boal Carvalho
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal,Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga/Guimarães, Portugal,Life and Health Sciences Research Institute (ICVS)/3B’s Research Group, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Joana Magalhães
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal,Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga/Guimarães, Portugal,Life and Health Sciences Research Institute (ICVS)/3B’s Research Group, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Sofia Xavier
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal,Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga/Guimarães, Portugal,Life and Health Sciences Research Institute (ICVS)/3B’s Research Group, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Carla Sousa
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - Bruno Rosa
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal,Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga/Guimarães, Portugal,Life and Health Sciences Research Institute (ICVS)/3B’s Research Group, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - José Cotter
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal,Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga/Guimarães, Portugal,Life and Health Sciences Research Institute (ICVS)/3B’s Research Group, PT Government Associate Laboratory, Braga/Guimarães, Portugal
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Sousa C, Varela P, Baptista A. Acrodermatitis continua de Hallopeau y el fenómeno de Koebner. Actas Dermo-Sifiliográficas 2021. [DOI: 10.1016/j.ad.2020.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Ferreira AF, Azevedo MJ, Proenca T, Saraiva FA, Machado AP, Sousa C, Sampaio Maia B, Leite-Moreira A, Ramalho C, Fa I. Cardiac remodelling and reverse remodelling in pregnant women: what can be expected? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Hemodynamic overload during pregnancy induces cardiac remodelling which is characterized by left ventricle (LV) eccentric hypertrophy and left-atrium enlargement.After delivery,the woman's heart undergoes reverse remodelling and myocardial performance normalize to their pre-gravid structure and function.
Aim
To characterize cardiac remodelling and reverse remodelling during pregnancy and postpartum, respectively, as well as to investigate the impact of cardiovascular (CV) risk factors in these processes.
Methods
This prospective cohort study included volunteer pregnant women recruited in a tertiary centre between 2019 and 2020.Women were evaluated by transthoracic echocardiography and pulse wave velocity at the 1st trimester [1T, baseline], 3rd trimester [3T, peak of CV remodelling] of pregnancy as well as at the 1st month and 6th month after delivery (reverse remodelling). Mann-whitney,wilcoxon and Ffriedman test were used as appropriate to between and within groups comparisons. Bonferroni correction was applied. Spearman correlation was performed to determine the relationship between pulse wave velocity (PWV) and echocardiographic variables.
Results
We included 32 pregnant women with a median age of 34 [26; 41] years, 50% being hypertensive and/or obese. The pregnant women tended to develop eccentric hypertrophy pattern during pregnancy, characterized by significant increase of cardiac mass index (CMi) from 1T to 3T (table 1, p=0.006) and slight modification of relative wall thickness (RWT, table 1, p=0.339). During postpartum, hypertrophy regression became significant only at 6 months after delivery (CMi: table 1, p<0.001; RWT: table 1, p<0.001). In contrast, a fastest recovery of indexed left atrial (3T to 1 month postpartum:table 1,p=0.033) and ventricular volumes (table 1, p<0.001) was observed after delivery, despite its slight enlargement during pregnancy (atrium-table 1, p=0.55; LV-table 1, p=0.084). RWT correlated positively with PWV at 3T (r=0.447, p=0.012). Compared to the healthy pregnant women,CV risk factors group showed higher RWT in all time points of follow-up period,without any differences in CMi and cardiac volumes indexed. Filling pressures increased during gestation (table 1, p=0.002),normalizing as soon as 1 month after delivery (table 1, p=0.001) and maintained at the 6th month (table 1, p<0.001). Pregnant women with CV risk factors revealed a significant higher value of E/e' in comparison with the healthy group, but only at the 6th month of postpartum (5.6 [5.2; 8.2] vs 5.4 [4.4; 7.7], p=0.036).
Conclusion
In our cohort, complete reverse remodelling occurs as soon as one month after delivery, with the exception of hypertrophy.The positive correlation between relative wall thickness and pulse wave velocity highlighted arterial-ventricular coupling relevance for the cardiac remodelling process during pregnancy. Pregnant women with CV risk factors showed higher relative wall thickness when compared with healthy women at all time points of the follow-up.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Universidade do Porto/FMUP and FSE-Fundo Social Europeu; FCT - Foundation for Science and Technology
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Affiliation(s)
- A F Ferreira
- Faculty of Medicine University of Porto, Surgery and Physiology Department, Porto, Portugal
| | - M J Azevedo
- I3s (Institute for Research and Innovation in Health), Porto, Portugal
| | - T Proenca
- Sao Joao Hospital, Cardiology Department, Porto, Portugal
| | - F A Saraiva
- Faculty of Medicine University of Porto, Surgery and Physiology, Cardiovascular R&D Unit, Porto, Portugal
| | - A P Machado
- Sao Joao Hospital, Obstetrics Department, Porto, Portugal
| | - C Sousa
- Sao Joao Hospital, Cardiology Department, Porto, Portugal
| | - B Sampaio Maia
- I3s (Institute for Research and Innovation in Health), Porto, Portugal
| | - A Leite-Moreira
- Faculty of Medicine University of Porto, Surgery and Physiology, Cardiovascular R&D Unit, Porto, Portugal
| | - C Ramalho
- Faculty of Medicine University of Porto, Gynecology-Obstetrics and Pediatrics Department, Porto, Portugal
| | - I Fa
- Faculty of Medicine University of Porto, Surgery and Physiology, Cardiovascular R&D Unit, Porto, Portugal
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Almeida I, Santos H, Santos M, Miranda H, Chin J, Sa C, Almeida S, Sousa C, Almeida L. Antithrombotic strategy in patients with atrial fibrillation and acute coronary syndrome. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is frequent in patients admitted with acute coronary syndromes (ACS). The development of this arrhythmia occurs in 2–21% of patients with non ST-elevation ACS and 21% of ST-elevation ACS. According with the most recent European guidelines, a short period up to 1 week of triple antithrombotic therapy (TAT) is recommended, followed by dual antithrombotic therapy (DAT) using a NOAC and a single antiplatelet agent, preferably clopidogrel.
Objective
To compare the antithrombotic strategy (DAT vs TAT) used and its prognostic value in patients with AF and ACS.
Methods
Retrospective analysis of patients' data admitted with ACS in a multicentric registry between 10/2010–09/2019. TAT was defined as the prescription of dual antiplatelet therapy and one anticoagulant and DAT as one antiplatelet and one anticoagulant. Survival and rehospitalization were evaluated through Kaplan-Meier curve.
Results
1067 patients were included, mean age 67±14 years, 72.3% male. Patients who developed de novo AF during hospitalization due to ACS were older (75±12 vs 66±14 years, p<0.001) and with higher prevalence of cardiovascular risk factors and cardiovascular disease. AF was more often in patients with ST elevation ACS (53.4%). During hospitalization, AF patients were more often medicated with aspirin, glycoprotein inhibitor, heparin, fondaparinux and vitamin K antagonists. No difference was found regarding P2Y12 inhibitors. AF patients presented more often obstructive coronary disease (normal coronaries 5.4 vs 8.5%, p<0.001) so they were more often submitted to PCI (79.5 vs 70.9%, p<0.001). AF patients presented with higher rates of adverse in-hospital events as re-infarction, heart failure, shock, ventricular arrhythmias, cardiac arrest, stroke, major bleeding and death (p<0.001). At discharge, AF patients were less prescribed with aspirin or ticagrelor, but the rate of clopidogrel prescription was higher, such as vitamin K antagonists or any of the new anticoagulants. In the AF group, 21.5% patients were discharged with TAT and 30.3% with DAT. Concerning patients discharged with TAT, 1-year follow-up revealed no significant differences in mortality (p=0.578), re-admission for cardiovascular causes (p=0.301) and total re-admission rates (p=0.291). Patients discharged with DAT had similar mortality (p=0.623) and re-admission for cardiovascular causes rates (p=0.138), but significant differences were identified regarding total re-admissions (p=0.024).
Conclusions
In patients with ACS and de novo AF, a low percentage of patients was discharged with oral anticoagulation (51.8%). In those whose anticoagulation was initiated, DAT was the preferred strategy. 1-year outcomes were not different between the antithrombotic strategy, except for all cause re-admission.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- I Almeida
- Hospital N.S. Rosario, Barreiro, Portugal
| | - H Santos
- Hospital N.S. Rosario, Barreiro, Portugal
| | - M Santos
- Hospital N.S. Rosario, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Barreiro, Portugal
| | - L Almeida
- Hospital N.S. Rosario, Barreiro, Portugal
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Martins De Carvalho M, Pinto RA, Proenca T, Costa I, Torres S, Resende CX, Grilo PD, Amador AF, Costa C, Calvao J, Sousa C, Paiva M, Macedo F, Marques C, Cabrita A. HER2 positive breast cancer: is there a preventive role of cardioprotective drugs? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
In patients with breast cancer, anti-HER2-targeted therapies (AHT) are highly associated with cardiotoxicity (CT), being the main reason for treatment interruption in patients receiving adjuvant trastuzumab. Guidelines recommend regular left ventricular ejection fraction (LVEF) assessments and CT's management with cardioprotective drugs (CPD). However, while secondary prevention has already entered clinical practice, primary prevention is still in the research domain. Our aim was to evaluate risk of CT and the role of CPD in a subset of breast cancer patients treated with AHT.
Methods
We retrospectively analyzed a population of breast cancer female patients treated with AHT referred to Cardio-oncology consultation at a tertiary center from January 2017 to March 2020. All patients were evaluated with echocardiogram before treatment initiation and at least at 3, 6, 9 and 12-months. CT was defined as LVEF under 50% or decline of at least 10% in LVEF during follow-up. As CPD we considered renin-angiotensin-aldosterone system inhibitors and beta-blockers.
Results
A total of 85 patients were included with mean age of 52.4±10.2 year-old. Concerning cardiovascular risk factors 11.8% had diabetes, 32.9% dyslipidaemia, 29.4% hypertension and 22.4% were smokers or previous smokers; most patients had a high or very-high CT risk score (98.8% with score ≥5). Besides AHT, 68.2% and 80% were also on anthracyclines and radiotherapy, respectively. Patients were followed for a median follow-up of 16 months. At baseline, mean high sensitivity troponin I was 3.9 ng/L, mean LVEF was 63.1% and mean global longitudinal strain was −19.7, with all patients having normal cardiac function. During follow-up, 15.7% developed CT with a higher prevalence in patients concomitantly on anthracyclines (19.6% vs 7.4%, p=0.151). CPD was initiated or titrated in 84.6% of patients and 30.8% needed to suspend AHT; overall 92.3% of CT patients recovered. Unlike AHT suspension, CPD initiation after CT was associated with a higher rate of cardiac function recovery (100.0% vs 50.0%, p=0.020). When comparing patients already medicated with CPD before cancer treatment (41.7%) to those naïve of CPD, the first group presented a significative lower incidence of CT [2.9% vs 25.0%, p=0.006, OR=0.09 (95% CI 0.01 – 0.72)]. When analysed all sample (with or without CT), patients already on CPD also presented a higher LVEF at 6 months follow-up (62.5% vs 59.2%, t(69)=−2.4, p=0.017 at 6 months), despite a non-significative lower LVEF at baseline (62.3% vs 63.6%, p=0.139). Medication with statins before chemotherapy didn't reduce the risk of CT.
Conclusion
Pre-treatment with CPD was significantly associated with a lower prevalence of CT and a higher LVEF at 6-months follow-up. CPD initiation after CT was associated with cardiac function recovery. These results highlights the importance of cardiac evaluation in HER2+ patients and strengthen the primary prevention field in these patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | | | | | - I Costa
- Sao Joao Hospital, Porto, Portugal
| | - S Torres
- Sao Joao Hospital, Porto, Portugal
| | | | | | | | - C Costa
- Sao Joao Hospital, Porto, Portugal
| | - J Calvao
- Sao Joao Hospital, Porto, Portugal
| | - C Sousa
- Sao Joao Hospital, Porto, Portugal
| | - M Paiva
- Sao Joao Hospital, Porto, Portugal
| | - F Macedo
- Sao Joao Hospital, Porto, Portugal
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Proença T, Sousa C, Alves Pinto R, Macedo F. Dissection of anterior mitral valve leaflet masking severe mitral regurgitation - an unusual case of infective endocarditis. Acta Cardiol 2021; 77:456-458. [PMID: 34254881 DOI: 10.1080/00015385.2021.1950370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Tânia Proença
- Serviço de Cardiologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Carla Sousa
- Serviço de Cardiologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Ricardo Alves Pinto
- Serviço de Cardiologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Filipe Macedo
- Serviço de Cardiologia, Centro Hospitalar Universitário de São João, Porto, Portugal
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Santos H, Almeida I, Miranda H, Santos M, Sa C, Chin J, Almeida S, Sousa C, Almeida L. Sustained ventricular tachycardia as a predictor of major adverse cardiac events in acute coronary syndrome patients. Europace 2021. [DOI: 10.1093/europace/euab116.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
Portuguese Registry of Acute Coronary Syndromes
Background
Sustained ventricular tachycardia (VT) is a frequent rhythm disturbance during an ischemic event like acute coronary syndrome (ACS). VT was frequently associated with worse prognosis, then is expected, that its presence is related to a higher incidence of major adverse cardiac events (MACE).
Objective
Evaluate if sustained VT was a predictor of MACE in ACS hospitalized patients.
Methods
Multicenter retrospective study, based on the Portuguese Registry of ACS between 1/10/2010-4/09/2019. Patients were divided into two groups: A – patients without VT, and B – patients that presented VT on the hospitalization. VT was defined as a register or more of the VT with at least 30 seconds. Were excluded patients without a previous cardiovascular history or clinical data. MACE was defined as re-infarction, congestive heart failure, cardiogenic shock, a mechanical complication of myocardial infarction, completed atrioventricular block, sustained ventricular tachycardia, cardiac arrest, stroke and hospitalization death. Univariate logistic regression was performed to assess if VT in ACS patients was a predictor of MACE.
Results
A total of 29851 patients was analyze and 25725 had information regarding VT. From the group of patients that presented VT, 177 (1.1%) had re-infarction, 2415 (14.1%) had congestive heart failure, 816 (5.0%) had atrial fibrillation, 108 (0.7%) had a mechanical complication of myocardial infarction, 442 (2.7%) had completed atrioventricular block, 458 (2.8%) had cardiac arrest, 101 (0.6%) had stroke and 535 (3.3%) died. VT did not predict re-infarction (p = 0.071), mechanical complication of myocardial infarction (p = 0.979) and stroke (p = 0.500) in ACS hospitalized patients. Logistic regression revealed that VT in ACS patients was a predictor of congestive heart failure (odds ratio (OR) 2.304, p < 0.001, confidence interval (CI) 1.742-3.047), atrial fibrillation (OR 2.078, p < 0.001, CI 1.453-2.973), completed atrioventricular block (OR 1.831, p = 0.012, CI 1.145-2.928), cardiac arrest (OR 15.434, p < 0.001, CI 11.429-20.843) and hospitalization death (OR 6.472, p < 0.001, CI 4.484-9.342).
Conclusions
VT in ACS patients predict MACE, namely congestive heart failure, atrial fibrillation, completed atrioventricular block, cardiac rest and hospitalization death.
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Affiliation(s)
- H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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Santos H, Santos M, Almeida I, Miranda H, Sa C, Almeida S, Chin J, Sousa C, Almeida L. Was the atrioventricular block similar in anterior and inferior ST-elevation myocardial infarction? Europace 2021. [DOI: 10.1093/europace/euab116.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
Portuguese Registry of Acute Coronary Syndromes
Background
The presence of atrioventricular block (AVB) in ST-elevation myocardial infarction (STEMI) is more frequently registered when is identified in the inferior leads. However, AVB maybe occurs in anterior STEMI, yet the AVB and STEMI localization maybe had different implications.
Objective
Evaluate the impact and prognosis of AVB according to the STEMI localization.
Methods
Multicenter retrospective study, based on the Portuguese Registry of Acute Coronary Syndrome between 1/10/2010-3/05/2020. Patients were divided into two groups: A – patients with anterior STEMI, and B – patients with inferior STEMI. Were excluded patients without a previous cardiovascular history or clinical data regarding AVB occurrence. Logistic regression was performed to assess AVB as a prognostic marker in STEMI patients.
Results
From 32157 patients, was identified 462 with AVB, 72 in group A (15.6%) and 390 in group B (84.4%). Both groups were similar regarding gender (p = 0.710), age (p = 0.068), body mass index (p = 0.535), admitly directly to cat lab (p = 0.635), initial symptons until first medical contact (p = 0.561), smoker status (p = 0.483), diabetes mellitus (p = 0.331), coronary artery disease (p = 0.053), previous stroke (p = 0.332), peripheral artery disease (p = 0.348), chronic kidney disease (p = 0.425), systolic blood pressure (p = 0.057), multivessel diasease (p = 0.235), new-onset of atrial fibrillation (p = 0.582), cardiac arrest (p = 0.062) and stroke complication (p = 0.685). Group B had higher left ventricular ejection fraction (LVEF) >50% (16.9 vs 60.7%, p < 0.001). On the other hand, group A had more arterial hypertension (79.7 vs 66.2%, p = 0.027), dislipidaemia (58.2 vs 54.4%, p = 0.038), heart rate at admission (81 ± 20 vs 59 ± 23, p < 0.001), Killip-Kimball class > I (45.7 vs 29.6%, p = 0.008), sinus rhythm at admission (84.5 vs 72.6%, p = 0.035), heart failure complication (65.3 vs 37.1%, p < 0.001), cardiogenic shock complication (42.3 vs 24.7%, p < 0.001), ACS mechanical complication (8.3 vs 3.1%, p = 0.047), sustained ventricular tachycardia during ACS hospitalization (19.4 vs 8.5%, p = 0.005) and hospitalization death (52.9 vs 44.7%, p < 0.001). Logistic regression revealed that AVB in inferior STEMI was a predictor of new-onset of atrial fibrillation (odds ratio (OR) 3.817, p = 0.038, confidence interval (CI) 1.123-12.975), with a R2 Nagelkerke 24.4. Also, revealed that AVB in anterior STEMI was a predictor of death (OR 0.111, p < 0.001, CI 0.034-0.366), with a R2 Nagelkerke 55.2.
Conclusions
AVB in inferior STEMI was a predictor of new-onset of atrial fibrillation and AVB in anterior STEMI was a predictor of death.
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Affiliation(s)
- H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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Santos H, Miranda H, Almeida I, Santos M, Sa C, Chin J, Almeida S, Sousa C, Almeida L. Sustained ventricular tachycardia in acute coronary syndromes the Portuguese experience. Europace 2021. [DOI: 10.1093/europace/euab116.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
Portuguese Registry of Acute Coronary Syndromes
Background
Acute coronary syndromes (ACS) are frequent and are associated with high levels of comorbidities and complications. Ventricular tachycardia (VT) is one of the most danger and stressful situations in ACS.
Objective
Evaluate predictors of ventricular tachycardia in ACS.
Methods
Multicenter retrospective study, based on the Portuguese Registry of ACS between 1/10/2010-4/09/2019. Patients were divided in two groups: A – patients without VT, and B – patients that presented VT on the hospitalization. VT was defined as a register or more of the VT with at least 30 seconds. Logistic regression was performed to assess predictors of VT in ACS patients.
Results
25361 in group A (98.6%) and 364 in group B (1.4%). Both groups were similar regarding gender, cardiovascular risk factors, except for dyslipidemia (61.7 vs 51.9%, p < 0.001) and ST-segment elevation myocardial infarction (STEMI) location. Group B was elderly (67 ± 14 vs 70 ± 14, p < 0.001), was admitted directly to the cat lab (10.6 vs 20.4%, p < 0.001), had less time since the onset of symptoms until the admission (383 ± 157 vs 349 ± 121, p = 0.003), but presented higher previous history of heart failure (5.9 vs 10.6%, p < 0.001), peripheral vascular disease (5.5 vs 8.4%, p = 0.015), chronic obstructive pulmonary disease (COPD) (4.4 vs 7.9%, p = 0.001) and dementia (1.7 vs 3.2%, p = 0.038). At admission presented higher levels of STEMI (42 vs 67%, p < 0.001), dyspnea (29 vs 18.1%, p < 0.001), syncope (1.3 vs 6.6%, p < 0.001), cardiac arrest (0.4 vs 4.4%, p < 0.001), Killip-Kimball classification > I (14.8 vs 40.5%, p < 0.001) and atrial fibrillation at admission (AF) (7.1 vs 15.3%, p < 0.001). Ivabradine (3.7 vs 7.6%, p < 0.001), aldosterone receptor antagonists (10.2 vs 24%, p < 0.001), diuretic (28 vs 57.2%, p < 0.001), amiodarone (5.6 vs 53.5%, p < 0.001), digoxin (1.4 vs 4.7%, p < 0.001) were more prevalent used in the admission. Group B exhibited higher multivessel disease (MVD) (51.5 vs 61.5%, p < 0.001), culprit as common coronary trunk (CT) (1.7 vs 4.2%, p = 0.024), hybrid revascularization (0.8 vs 2%, p = 0.032) and left ventricular ejection fraction (LVEF)<50% (38.7 vs 71%, p < 0.001). On the other hand, the used of beta block (81.4 vs 62.3%, p < 0.001), angiotensin-converting-enzyme inhibitor (85.5 vs 74.4%, p < 0.001) and calcium channel blockers (10.1 vs 24%, p < 0.001) since had a protect effect. Regarding reinfarction (0.9 vs 2.5%, p = 0.007), de novo heart failure (15.1 vs 50.3%, p < 0.001), atrioventricular block (2.2 vs 17%, p < 0.001), stroke (1.4 vs 4.9%, p < 0.001) and death (3.4 vs 26.9%, p < 0.001), all were higher in Group B. Logistic regression revealed COPD (odds ratio (OR) 1.9, p = 0.010, confidence interval (CI) 1.17-3.10), STEMI (OR 2.73, p < 0.001, CI 2.00-3.73), AF (OR 2.30, p < 0.001, CI 1.52-3.49), MVD (OR 1.44, p = 0.012, CI 1.08-1.92), CT (OR 2.87, p = 0.003, CI 1.45-5.69) and LVEF < 50% (OR 3.44, p < 0.001, CI 2.52-4.71) as predictors of VT in ACS.
Conclusions
COPD, STEMI, AF, MVD, CT and LVEF < 50% were predictors of VT in ACS.
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Affiliation(s)
- H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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Santos M, Santos H, Almeida I, Miranda H, Sa C, Chin J, Almeida S, Sousa C, Tavares J, Santos L, Almeida ML. Atrial Fibrillation in Acute Coronary Syndrome - early onset impact on MACE. Europace 2021. [DOI: 10.1093/europace/euab116.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
on behalf of the Investigators of " Portuguese Registry of ACS "
Introduction
Atrial Fibrillation (AF) complicates approximately 10% of acute coronary syndromes (ACS) and it is, therefore, important to access its impact on ACS patients’ (pts) prognosis.
Objective
To evaluate early onset (≤48h) de novo atrial fibrillation (AF) as predictor of major adverse cardiovascular events (MACE) and in-hospital complications.
Methods
Based on a multicenter retrospective study, data collected from admissions between 1/10/2010 and 8/01/2019. Pts were divided in two groups: A – early onset de novo AF (EOAF), and B – late onset de novo AF (LOAF). Patients without data on previous cardiovascular history or uncompleted clinical data were excluded. Univariate logistic regression was performed to assess if LOAF in ACS was a predictor of MACE or complications.
Results
29851 pts had ACS. EOAF occurred in 584 pts (2.0%) and LOAF in 360 pts (1.2%). EOAF were younger (73 ± 13 vs 77 ± 10, p < 0.001) and smokers (21.3% vs 12.1%, p < 0.001). LOAF had higher rates of diabetes mellitus (40.1% vs 30.2%, p < 0.001), angina (30.8% vs 21.4%, p < 0.001), previous ACS (22.5% vs 15.4%, p = 0.006), previous revascularization (percutaneous coronary intervention 14% vs 9.5%, p = 0.032; coronary artery bypass surgery 8.4% vs 3.9%, p = 0.004). ST-segment elevation myocardial infarction (MI) rates were higher in EOAF (56.8% vs 46.9%, p = 0.003) and were admitted directly to the cath lab more often (21.7% vs 13.4%, p = 0.001). Non-ST elevation MI rates were higher in LOAF (44.2% vs 37.7%, p = 0.048). LOAF times from first symptoms to admission were longer (420min vs 183%, p < 0.001), mean brain natriuretic peptide levels were higher (579 vs 447, p = 0.009) and diuretics usage was more frequent (72.8% vs 54.3%, p < 0.001). EOAF had higher rates of heart failure (32.1% vs 17.2%, p < 0.001), atrioventricular block (10.5% vs 7.8%, p = 0.006) and sustained ventricular tachycardia (8.1% vs 3.1%, p = 0.001). LOAF had higher in-hospital mortality (14.2% vs 9.6%, p = 0.031) and longer hospital stay (12 days vs 7 days, p < 0.001). Logistic regression confirmed that EOAF was predictive of in-hospital heart failure (p < 0.001, OR 2.15) and atrioventricular block (p = 0.008, OR 7.46). Regarding 1 year-follow-up, EOAF had poorer prognosis comparing to LOAF (59.3% vs 73.0%, p = 0.018, OR 1.62, CI 1.09-2.42)
Conclusion
EOAF is predictive of MACE, namely heart failure and atrioventricular block, and is associated to poorer prognosis comparing to LOAF.
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Affiliation(s)
- M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Tavares
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - ML Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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