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Oliveira M, Fernandes C, Barbosa F, Ferreira-Santos F. The impact of fear and psychopathological symptoms on neural responses to naturalistic stimuli in adolescents. Neuropsychologia 2024; 194:108781. [PMID: 38154591 DOI: 10.1016/j.neuropsychologia.2023.108781] [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: 04/05/2023] [Revised: 12/10/2023] [Accepted: 12/23/2023] [Indexed: 12/30/2023]
Abstract
The presentation of real-world images can swiftly engage processing mechanisms within specific brain regions and neural pathways. In this study, we explore the effects of fear and psychopathological symptoms on neural processing of realistic stimuli during a free viewing naturalistic task in a sample of adolescents (11-16y). Thirty-one participants performed an experimental task consisting of the visualization of animal pictures according to three conditions - Snakes, Spiders, and Dogs - during EEG recordings. Dimensions of fear and psychopathological symptoms were previously assessed through The Fear Survey Schedule for Children- Revised and the Brief Symptom Inventory. Earlier and later visual processing was analyzed through ERP components' peak amplitudes. The results show a robust effect of psychopathology-related dimensions in the visual processing of naturalistic images, suggesting an increase of neural activity at later stages of visual processing (at the N200 time window) in symptomatic adolescents, corroborating the role of psychopathological symptoms in modulating neural responses to naturalistic images, and also guiding clinicians by providing additional data on how symptomatic adolescents perceive and process reality.
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Affiliation(s)
- M Oliveira
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.
| | - C Fernandes
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal; Faculty of Human and Social Sciences, University Fernando Pessoa, Portugal; Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP) & RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC), Portugal
| | - F Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - F Ferreira-Santos
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Oliveira M, Fernandes C, Barbosa F, Ferreira-Santos F. Differential correlates of fear and anxiety in salience perception: A behavioral and ERP study with adolescents. Cogn Affect Behav Neurosci 2024; 24:143-155. [PMID: 38267798 PMCID: PMC10827851 DOI: 10.3758/s13415-024-01159-y] [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] [Subscribe] [Scholar Register] [Accepted: 01/07/2024] [Indexed: 01/26/2024]
Abstract
Anxiety disorders are the most common psychopathologies among adolescents. Their diagnostic criteria include both fear and anxiety symptomatology, although according to the literature, we can find evidence for some distinction between these two emotions. The present study contribute to this distinction, exploring the effects of trait fear and trait anxiety on behavioral and neural correlates. Thirty-two participants (aged 11-16 years) performed two experimental tasks of salient target detection, including visual stimuli that were manipulated to become salient, while reaction times and EEG were recorded. Results of both tasks revealed differential effects of trait fear and trait anxiety assessed through the Fear Survey Schedule for Children-Revised and the Youth Anxiety Measure for DSM-5 on reaction times and ERP components amplitudes. Specifically, higher symptoms from Separation Anxiety Disorder increased early neural visual processing and decreased reaction times for more salient stimuli. Also, trait fear reduced later neural visual processing of salient stimuli. These findings may provide a significant contribution to guiding psychological interventions, especially with adolescents presenting higher levels of anxiety-related symptomatology.
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Affiliation(s)
- M Oliveira
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, R. Alfredo Allen, 4200-135, Porto, Portugal.
| | - C Fernandes
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, R. Alfredo Allen, 4200-135, Porto, Portugal
- Faculty of Human and Social Sciences, University Fernando Pessoa, Porto, Portugal
- Research Center of IPO Porto (CI-IPOP, RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC), Molecular Oncology and Viral Pathology Group, Porto, Portugal
| | - F Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, R. Alfredo Allen, 4200-135, Porto, Portugal
| | - F Ferreira-Santos
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, R. Alfredo Allen, 4200-135, Porto, Portugal
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Brown W, Oliveira M, Reis Silva R, Woodruff K, Bisha B, Demetrio D, Block J. Effects of mycobacterium cell wall fraction on embryo development following in vitro embryo production and pregnancy rates following embryo transfer in virgin dairy heifers. Theriogenology 2024; 215:334-342. [PMID: 38134681 DOI: 10.1016/j.theriogenology.2023.12.019] [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: 08/10/2023] [Revised: 11/28/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023]
Abstract
An experiment was conducted to determine whether administration of mycobacterium cell wall fraction (MCWF; Amplimune, NovaVive) could enhance embryo developmental competence following in vitro embryo production (IVP) and pregnancy establishment after embryo transfer (ET). Nulliparous, Holstein heifers (n = 40; age 8-15 months) were submitted to two rounds of ovum pick-up (OPU) and IVP in a crossover design. Thirty-six h after follicle wave synchronization, treatments (saline or MCWF, 5 mL, im) were administered in conjunction with a single dose of follicle stimulating hormone (175 IU) and OPU was performed 48-52 h later. Recovered cumulus-oocyte complexes were used for IVP to assess embryo development. For ET, nulliparous, Holstein heifers (n = 225; age 12-18 months) were used as recipients. At 12-24 h after detection of spontaneous estrus, recipients were randomly treated with either saline or MCWF (5 mL, im). The effect of MCWF on pregnancy per ET (P/ET) was assessed in a 2 × 2 factorial design with recipients treated with or without MCWF receiving a fresh IVP embryo from a donor treated with or without MCWF at day 7 or 8 after detected estrus. Blood samples were collected from a subset of donors (n = 8) and recipients (n = 26 to 33 per treatment) prior to treatment and at 6 and 24 h post-treatment to determine serum concentration of interleukin (IL)-1β, IL-6, tumor necrosis factor-α, and interferon-γ. Blood samples were also collected from a group of recipients (n = 31 to 39 per treatment) to assess serum concentration of progesterone at days 4, 7, and 16 post-treatment. Pregnancy status was determined at days 40 and 100 of gestation. Donor treatment with MCWF tended (P < 0.07) to increase the proportion of oocytes that developed into transferable embryos, but there was no effect of MCWF on other parameters of embryo development. The P/ET at days 40 and 100 of gestation and pregnancy loss were not affected by donor treatment or recipient treatment with MCWF and there was no interaction. Serum concentration of proinflammatory cytokines among donors and recipients and serum concentration of progesterone among recipients were not increased by treatment with MCWF. Results of the present study indicate that treatment of donors with MCWF has minimal impact on subsequent embryo development following IVP. Moreover, regardless of whether donors or recipients were treated with MCWF, there was no effect on P/ET following transfer of IVP embryos.
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Affiliation(s)
- W Brown
- Department of Animal Science, University of Wyoming, Laramie, WY, USA
| | | | - R Reis Silva
- EVZ, Federal University of Goias, Goiania, GO, Brazil
| | - K Woodruff
- Department of Animal Science, University of Wyoming, Laramie, WY, USA
| | - B Bisha
- Department of Animal Science, University of Wyoming, Laramie, WY, USA
| | | | - J Block
- Department of Animal Science, University of Wyoming, Laramie, WY, USA.
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da Silva M, Souza K, Bezerra T, Silva T, Fernades D, Silva F, Araújo L, Almeida A, Oliveira M. Unlocking the molecular realm: advanced approaches for identifying clinically and environmentally relevant bacteria. Braz J Med Biol Res 2023; 56:e12894. [PMID: 37851790 PMCID: PMC10578128 DOI: 10.1590/1414-431x2023e12894] [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: 07/05/2023] [Accepted: 08/10/2023] [Indexed: 10/20/2023] Open
Abstract
Rapid, effective, and specific identification of clinical and environmental bacterial pathogens is of major importance for their control. Traditionally, bacteria have been identified by phenotypic methods based on morphological, biochemical, and metabolic properties. While these methods are very useful in clinical practice, they have limitations including a poor ability to differentiate within and between species and time-consuming workflows. Newly developed molecular methods can greatly improve the accuracy of taxonomic characterization, identifying specific strains of medical or environmental importance. However, due to high costs and the need for trained professionals, these methods are not yet routine in diagnostic laboratories. Thus, disseminating knowledge on advances in molecular identification techniques is pivotal to make these methodologies accessible. The objective of this work was to review and discuss current molecular techniques for bacteria identification aiming to track and monitor microbial agents in clinical and environmental samples.
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Affiliation(s)
- M.R.F. da Silva
- Departamento de Bioquímica, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - K. Souza
- Departamento de Bioquímica, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - T. Bezerra
- Departamento de Microbiologia, Instituto Aggeu Magalhães, FIOCRUZ PE, Recife, PE, Brasil
| | - T. Silva
- Departamento de Bioquímica, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - D. Fernades
- Departamento de Microbiologia, Instituto Aggeu Magalhães, FIOCRUZ PE, Recife, PE, Brasil
| | - F. Silva
- Departamento de Tecnologia Bioquímico-Farmacêutica, Universidade de São Paulo, São Paulo, SP, Brasil
| | - L. Araújo
- Departamento de Bioquímica, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - A. Almeida
- Departamento de Microbiologia, Instituto Aggeu Magalhães, FIOCRUZ PE, Recife, PE, Brasil
| | - M. Oliveira
- Departamento de Bioquímica, Universidade Federal de Pernambuco, Recife, PE, Brasil
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Oliveira M, Falato C, Cejalvo JM, Vila MM, Tolosa P, Salvador-Bofill FJ, Cruz J, Arumi M, Luna AM, Guerra JA, Vidal M, Martínez-Sáez O, Paré L, González-Farré B, Sanfeliu E, Ciruelos E, Espinosa-Bravo M, Pernas S, Izarzugaza Y, Esker S, Fan PD, Parul P, Santhanagopal A, Sellami D, Villacampa G, Ferrero-Cafiero JM, Pascual T, Prat A. Patritumab Deruxtecan in Untreated Hormone Receptor-Positive/HER2-Negative Early Breast Cancer: Final Results from Part A of the Window-of-Opportunity SOLTI TOT-HER3 Pre-Operative Study. Ann Oncol 2023:S0923-7534(23)00685-3. [PMID: 37211044 DOI: 10.1016/j.annonc.2023.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 04/04/2023] [Revised: 04/27/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Patritumab deruxtecan (HER3-DXd) is a HER3-directed antibody-drug conjugate composed of a fully human anti-HER3 monoclonal antibody (patritumab) covalently linked to a topoisomerase I inhibitor payload via a stable, tumor-selective, tetrapeptide-based cleavable linker. TOT-HER3 is a window-of-opportunity study designed to assess the biological activity, measured by CelTIL score [ = -.8 × tumor cellularity (in %) + 1.3 × TILs (in %)], and clinical activity of HER3-DXd during short-term (21 days) pre-operative treatment in patients with primary operable HER2-negative early breast cancer. PATIENTS AND METHODS Patients with previously untreated hormone receptor (HR)-positive/HER2-negative tumors were allocated to one of four cohorts according to baseline ERBB3 mRNA expression. All patients received one dose of HER3-DXd 6.4 mg/kg. The primary objective was to evaluate change from baseline in CelTIL score. RESULTS Seventy-seven patients were evaluated for efficacy. A significant change in CelTIL score was observed, with a median increase from baseline of 3.5 (interquartile range, -3.8 to 12.7; P=.003). Among patients evaluable for clinical response (n=62), an overall response rate of 45% was observed (tumor measurement by caliper), with a trend toward an increase in CelTIL score among responders compared with non-responders (mean difference, +11.9 vs +1.9). Change in CelTIL score was independent of baseline ERBB3 mRNA and HER3 protein levels. Genomic changes occurred, including switching toward a less proliferative tumor phenotype based on PAM50 subtypes, suppression of cell proliferation genes, and induction of genes associated with immunity. Treatment-emergent adverse events were observed in 96% of patients (14% grade ≥3); most common were nausea, fatigue, alopecia, diarrhea, vomiting, abdominal pain, and neutrophil count decrease. CONCLUSIONS A single dose of HER3-DXd was associated with clinical response, increased immune infiltration, suppression of proliferation in HR-positive/HER2-negative early breast cancer, and a tolerable safety profile consistent with previously reported results. These findings support further study of HER3-DXd in early breast cancer.
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Affiliation(s)
- M Oliveira
- Medical Oncology Department, Vall d'Hebron University Hospital, and Breast Cancer Group, Vall D'Hebron Institute of Oncology (VHIO), Barcelona, Spain;; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - C Falato
- SOLTI Breast Cancer Research Group, August Pi Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain, and Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden
| | - J M Cejalvo
- SOLTI Breast Cancer Research Group, Department of Medical Oncology, Hospital Clinico Universitario de Valencia, Valencia, Spain
| | - M Margelí Vila
- SOLTI Breast Cancer Research Group, Medical Oncology Department, ICO - Institut Català d'Oncologia Badalona (Hospital Universitario Germans Trias i Pujol), Badalona, Spain
| | - P Tolosa
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital 12 de Octubre, Madrid, Spain
| | - F J Salvador-Bofill
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - J Cruz
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - M Arumi
- Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - A M Luna
- Centro Integral Oncológico Clara Campal HM (CIOCC), Madrid, Spain
| | - J A Guerra
- Medical Oncology Department, Hospital de Fuenlabrada, Fuenlabrada, Spain
| | - M Vidal
- Medical Oncology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - O Martínez-Sáez
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapies in Solid Tumors, August Pi Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - L Paré
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - B González-Farré
- SOLTI Breast Cancer Research Group, Pathology Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - E Sanfeliu
- SOLTI Breast Cancer Research Group, Pathology Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - E Ciruelos
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital 12 de Octubre, Centro Integral Oncológico Clara Campal HM (CIOCC), Madrid, Spain
| | - M Espinosa-Bravo
- SOLTI Breast Cancer Research Group, Breast Cancer Surgical Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - S Pernas
- SOLTI Breast Cancer Research Group, Department of Medical Oncology, Catalan Institute of Oncology - ICO, Breast Cancer Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Y Izarzugaza
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Fundación Jimenez Díaz, Madrid, Spain
| | - S Esker
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - P-D Fan
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - P Parul
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - A Santhanagopal
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - D Sellami
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - G Villacampa
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | | | - T Pascual
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapies in Solid Tumors, August Pi Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - A Prat
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapies in Solid Tumors, August Pi Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain;.
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Horovistiz A, Oliveira M, Araújo H. Computer vision-based solutions to overcome the limitations of wireless capsule endoscopy. J Med Eng Technol 2023; 47:242-261. [PMID: 38231042 DOI: 10.1080/03091902.2024.2302025] [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: 09/09/2022] [Accepted: 12/28/2023] [Indexed: 01/18/2024]
Abstract
Endoscopic investigation plays a critical role in the diagnosis of gastrointestinal (GI) diseases. Since 2001, Wireless Capsule Endoscopy (WCE) has been available for small bowel exploration and is in continuous development. Over the last decade, WCE has achieved impressive improvements in areas such as miniaturisation, image quality and battery life. As a result, WCE is currently a very useful alternative to wired enteroscopy in the investigation of various small bowel abnormalities and has the potential to become the leading screening technique for the entire gastrointestinal tract. However, commercial solutions still have several limitations, namely incomplete examination and limited diagnostic capacity. These deficiencies are related to technical issues, such as image quality, motion estimation and power consumption management. Computational methods, based on image processing and analysis, can help to overcome these challenges and reduce both the time required by reviewers and human interpretation errors. Research groups have proposed a series of methods including algorithms for locating the capsule or lesion, assessing intestinal motility and improving image quality.In this work, we provide a critical review of computational vision-based methods for WCE image analysis aimed at overcoming the technological challenges of capsules. This article also reviews several representative public datasets used to evaluate the performance of WCE techniques and methods. Finally, some promising solutions of computational methods based on the analysis of multiple-camera endoscopic images are presented.
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Affiliation(s)
- Ana Horovistiz
- Institute of Systems and Robotics, University of Coimbra, Coimbra, Portugal
| | - Marina Oliveira
- Institute of Systems and Robotics, University of Coimbra, Coimbra, Portugal
- Department of Electrical and Computer Engineering (DEEC), Faculty of Sciences and Technology, University of Coimbra, Coimbra, Portugal
| | - Helder Araújo
- Institute of Systems and Robotics, University of Coimbra, Coimbra, Portugal
- Department of Electrical and Computer Engineering (DEEC), Faculty of Sciences and Technology, University of Coimbra, Coimbra, Portugal
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Rojas Laimito K, Vieito Villar M, Fullana Grimalt B, Berché R, Hierro Carbo C, Saavedra Santa Gadea O, Braña I, Alonso Casal G, Galvao de Aguiar V, Lostes Bardaji M, Oliveira M, Verdaguer H, Morales Barrera R, Garcia Duran C, Zamora E, Carles Galceran J, Macarulla T, Tabernero J, Garralda Cabanas E. 51P Toxicity profile in early clinical trials with fibroblast growth factor receptor (FGFR) inhibitors (FGFRi): 10-years experience of a drug development unit. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.100909] [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: 04/05/2023] Open
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Oliveira M, Pinto M, Simões H, Gomes JP, Veríssimo C, Sabino R. Molecular detection of Aspergillus in respiratory samples collected from patients at higher risk of chronic pulmonary aspergillosis. Infect Dis Now 2023; 53:104633. [PMID: 36375764 DOI: 10.1016/j.idnow.2022.11.002] [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: 09/25/2022] [Revised: 10/12/2022] [Accepted: 11/04/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Aspergillosis diagnosis depends on the detection of Aspergillus in biological samples ─ usually using cultural and immunoenzyme techniques ─ but their sensitivity and specificity varies. We aimed to study the prevalence of Aspergillus in patients at higher risk of chronic pulmonary aspergillosis (i.e., HIV-infected patients and individuals with active or previous tuberculosis), and to determine the potential role of molecular approaches to increase detection of Aspergillus in respiratory samples. METHODS The DNA extracted from 43 respiratory samples that had been previously analyzed by immunoenzyme and/or cultural techniques was amplified by real-time multiplex PCR, and the results of these methods were compared. We also sequenced the ITS1 region and the calmodulin gene in 10 respiratory samples to perform a pilot metagenomic study to understand the ability of this methodology to detect potential pathogenic fungi in the lung mycobiome. RESULTS Real-time Aspergillus PCR test exhibited a higher positivity rate than the conventional techniques used for aspergillosis diagnosis, particularly in individuals at risk for chronic pulmonary aspergillosis. The metagenomic analysis allowed for the detection of various potentially pathogenic fungi. CONCLUSIONS Molecular techniques, including metagenomics, have great ability to detect potentially pathogenic fungi rapidly and efficiently in human biological samples.
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Affiliation(s)
- M Oliveira
- Animal Biology Department, Faculty of Sciences of the University of Lisbon, 1749-016 Lisbon, Portugal; Reference Unit for Parasitic and Fungal Infections, Department of Infectious Diseases, National Institute of Health, Dr. Ricardo Jorge, 1649-016 Lisbon, Portugal.
| | - M Pinto
- Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health, Dr. Ricardo Jorge, 1649-016 Lisbon, Portugal.
| | - H Simões
- Reference Unit for Parasitic and Fungal Infections, Department of Infectious Diseases, National Institute of Health, Dr. Ricardo Jorge, 1649-016 Lisbon, Portugal.
| | - J P Gomes
- Reference Unit for Parasitic and Fungal Infections, Department of Infectious Diseases, National Institute of Health, Dr. Ricardo Jorge, 1649-016 Lisbon, Portugal.
| | - C Veríssimo
- Reference Unit for Parasitic and Fungal Infections, Department of Infectious Diseases, National Institute of Health, Dr. Ricardo Jorge, 1649-016 Lisbon, Portugal.
| | - R Sabino
- Reference Unit for Parasitic and Fungal Infections, Department of Infectious Diseases, National Institute of Health, Dr. Ricardo Jorge, 1649-016 Lisbon, Portugal; Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal.
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9
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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, 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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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| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 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Oliveira M, Reis Silva R, Fonseca J, Santos R, Demetrio D. 11 The impact of multiple ovum pickups on reproductive and productive performance of Holstein heifers. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab11] [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: 12/11/2022] Open
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Demetrio D, Oliveira M, Reis Silva R, Amorim D, Demetrio C, Santos R. 12 Relationship between Angus oocyte quality and embryo production. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab12] [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: 12/12/2022] Open
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Reis Silva R, Demetrio D, Walhof C, Oliveira M, Spricigo J, Santos R. 13 Is pregnancy failure still a major concern for bovine. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab13] [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: 12/12/2022] Open
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Bevilaqua J, Vergani G, Fonseca J, Oliveira M, Bartlewski P. 246 Luteal function, biometrics, and echotextural attributes in Santa Ines ewes superovulated with three different doses of porcine follicle stimulating hormone. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab246] [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: 12/12/2022] Open
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Lagares M, Anselmo F, Oliveira M, Wenceslau R, Stahlberg R. 40 L-carnitine protects membrane functionality of boar spermatozoa. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab40] [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: 12/12/2022] Open
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Ribeiro Silva M, Ribeiro Queiros P, Santos Silva G, Teixeira R, Fernandes S, Almeida J, Fonseca P, Oliveira M, Goncalves H, Rodrigues A, Primo J, Fontes-Carvalho R. Predictors of AF recurrence in patients with paroxysmal AF undergoing catheter ablation: new predictors coming? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.591] [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
Recurrence of atrial fibrillation (AF) after catheter ablation (CA) is estimated to be between 20% and 45% and the prediction of recurrence AF in patients (pts) with paroxysmal AF undergoing CA remains challenging.
Purpose
To determine the clinical and procedural predictors of recurrence AF after CA in pts with paroxysmal AF.
Methods
Single-centre retrospective study that included all pts with paroxysmal AF who underwent AF CA between 2017 and 2019. Ablation procedures included radiofrequency and second-generation cryoballoon CA. All pts underwent cardiac computed tomography prior the procedure. AF recurrence was defined as any recurrence of AF, atrial flutter or atrial tachycardia >30 seconds (recorded in 12-lead electrocardiogram or Holter) after 90 days of CA. The independent association between clinical and procedural variables and AF recurrence was evaluated with Cox regression analysis.
Results
We included 351 pts, 63,5% male and with a mean age of 57,1±11,4 years. CHADSVASCscore ≥2 points were present in 43,7% of the pts, median duration of AF prior the intervention was 3 years (IQR 1–6) and most pts were treated with some antiarrhythmic drug at the time of CA (56,9%). Overall, median follow-up was 27 months (IQR 19–39).
AF recurrence was present in 96 pts (27,4%), on average, 15,2±10,4 months after CA.
Univariate logistic regression identified female gender, thyroid disease, left atrium (LA) enlargement (defined as LA indexed volume >34 mL/m2 or LA diameter >38mm for female or >40mm for male), coronary calcium score >100, epicardial adipose tissue volume, number of previous electric cardioversions, treatment with antiarrhythmic drugs prior CA and the extent of CA (only pulmonary vein isolation (PVI) or PVI and ablation of other lesions) as predictors of recurrence AF after CA in pts with paroxysmal AF (p<0,05 for all).
Cox regression analysis identified female gender (OR 1,615, 95% CI 1,005–2,597; p=0,008), LA enlargement (OR 2,084, 95% CI 1,207–3,596; p=0,008) and coronary calcium score >100 (OR 1,958, 95% CI 1,133–3,385; p=0,016) as independent predictors of AF recurrence.
Conclusions
In our cohort, AF recurrence was significantly higher in pts with LA enlargement, with coronary calcium score >100 and female gender pts.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Ribeiro Silva
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - P Ribeiro Queiros
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - G Santos Silva
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - R Teixeira
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - S Fernandes
- Leiria Hospital Centre, Cardiology , Leiria , Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - P Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - H Goncalves
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - A Rodrigues
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
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Schwarzer A, Oliveira M, Kleppa M, Liesa M, Kostura M. Pharmacological activation of the mitochondrial stress protease OMA1 reveals a therapeutic liability in Diffuse Large B-Cell Lymphoma. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00908-x] [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: 11/03/2022]
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Ubeda C, Vano E, Perez MD, Jímenez P, Ramirez R, Nader A, Miranda P, Azcurra P, Damsky J, Capdevila S, Oliveira M, Albuquerque J, Bocamino R, Schelin H, Yagui A, Aguirre D, Riquelme N, Cardenas L, Álvarez A, Mosquera W, Arias F, Gutierrez R, De la Mora R, Rivera T, Zapata J, Araujo P, Chiesa P. Setting up regional diagnostic reference levels for pediatric interventional cardiology in Latin America and the Caribbean countries: preliminary results and identified challenges. J Radiol Prot 2022; 42:031513. [PMID: 35940166 DOI: 10.1088/1361-6498/ac87b7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
The goal of the present study was to propose a set of preliminary regional diagnostic reference levels (DRLs) for pediatric interventional cardiology (IC) procedures in Latin America and the Caribbean countries, classified by age and weight groups. The study was conducted in the framework of the Optimization of Protection in Pediatric Interventional Radiology in Latin America and the Caribbean program coordinated by the World Health Organization and the Pan American Health Organization in cooperation with the International Atomic Energy Agency. The first step of the program was focused on pediatric IC. Dose data from diagnostic and therapeutic procedures were collected between December 2020 and December 2021. Regional DRLs were set as the third quartile of patient dose data (kerma area product) collected in 18 hospitals from 10 countries in an initial sample of 968 procedures. DRLs were set for four age bands and five weight ranges. The values obtained for the four age bands (<1 yr, 1 to <5 yr, 5 to <10 yr and 10 to <16 yr) were 2.9, 6.1, 8.8 and 14.4 Gy cm2for diagnostic procedures, and 4.0, 5.0, 10.0 and 38.1 Gy cm2for therapeutic procedures, respectively. The values obtained for the five weight bands (<5 kg, 5 to <15 kg, 15 to <30 kg, 30 to <50 kg and 50 to <80 kg) were 3.0, 4.5, 8.1, 9.2 and 26.8 Gy cm2for diagnostic procedures and 3.7, 4,3, 7.3, 16.1 and 53.4 Gy cm2for therapeutic procedures, respectively. While initial data were collected manually as patient dose management systems (DMSs) were not available in most of the hospitals involved in the program, a centralized automatic DMS for the collection and management of patient dose indicators has now been introduced and is envisaged to increase the sample size. The possibility of alerting on high dose values and introducing corrective actions will help in optimization.
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Affiliation(s)
- C Ubeda
- Departamento de Tecnología Médica, Facultad de Ciencias de la Salud, Universidad de Tarapacá, Arica, Chile
| | - E Vano
- Radiology Department, Faculty of Medicine, Complutense University and IdIS, San Carlos Hospital, 28040 Madrid, Spain
| | - M D Perez
- World Health Organization (WHO), Geneva, Switzerland
| | - P Jímenez
- Pan American Health Organization (PAHO), Washington, DC, United States of America
| | - R Ramirez
- International Atomic Energy Agency (IAEA), Vienna, Austria
| | - A Nader
- International Atomic Energy Agency (IAEA), Vienna, Austria
| | - P Miranda
- Luis Calvo Mackenna's Hospital, AntonioVaras 360, Santiago, Chile
| | - P Azcurra
- Hemodynamic Service, Italian Hospital, Buenos Aires, Argentina
| | - J Damsky
- Hemodynamic Service, Pedro de Elizalde Children's Hospital, Buenos Aires, Argentina
| | - S Capdevila
- Hemodynamic Service, Santísima Trinidad Children's Hospital, Córdova, Argentina
| | - M Oliveira
- Department of Health Technology and Biology, Federal Institute of Bahia, Salvador, Brazil
| | - J Albuquerque
- University Hospital of the Federal University of Maranhão, San Luis, Brasil
| | - R Bocamino
- Clinical Hospital of the Federal University of Paraná, Curitiba, Brasil
| | - H Schelin
- Pequeno Príncipe Hospital, Curitiba, Brasil
| | - A Yagui
- Pequeno Príncipe Hospital, Curitiba, Brasil
| | - D Aguirre
- Hemodynamic Service, Roberto del Rio Children's, Santiago, Chile
| | - N Riquelme
- Hemodynamic Service, Roberto del Rio Children's, Santiago, Chile
| | - L Cardenas
- Hemodynamic Service, Santa Maria Clinic, Santiago, Chile
| | - A Álvarez
- Hemodynamic Service, Santa Maria Clinic, Santiago, Chile
| | - W Mosquera
- Valle del Lili Foundation University Hospital ICESI, Cali, Colombia
| | - F Arias
- National Children's Hospital, San José, Costa Rica
| | - R Gutierrez
- National Children's Hospital, San José, Costa Rica
| | - R De la Mora
- National Directorate of Environmental Health, Ministry of Public Health, Havana, Cuba
| | - T Rivera
- Center for Research in Applied Sciences and Advanced Technology Legaria, IPN, Ciudad de México, Mexico
| | - J Zapata
- National Institute of Child Health St. Borja, Lima, Peru
| | - P Araujo
- National Cardiovascular Institute, Lima, Peru
| | - P Chiesa
- Children's Cardiology Institute, Montevideo, Uruguay
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Oliveira M, Cejalvo Andujar J, Margeli Vila M, Tolosa Ortega P, Martinez Saez O, Salvador Bofill F, Cruz Jurado J, Luna Barrera A, Arumi de Dios M, Vidal Losada M, Guerra J, Pernas Simon S, Villacampa Javierre G, Gonzalez-farre B, Sanfeliu Torres E, Santhanagopal A, Falato C, Ferrero Cafiero J, Pascual T, Prat A. 202TiP SOLTI-1805 TOT-HER3 trial: A window-of-opportunity trial of patritumab deruxtecan (HER3-DXd) in patients with treatment-naïve, early breast cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.237] [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: 11/01/2022] Open
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Teixeira J, Sousa G, Delerue-Matos C, Morais S, Oliveira M. P19-13 Levels of fine and ultrafine particles in firefighters’ personal protective equipment storage rooms. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.662] [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: 10/14/2022]
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Leao I, Zamora E, Cayuela R, Villacampa Javierre G, Gomez Pardo P, Arumi de Dios M, Pimentel I, Escriva de Romani S, Ortiz Velez C, Cruellas Lapena M, Sanz L, Borrell Puy M, De La Torre J, Espinosa-bravo M, Gorria T, Oliveira M, Saura Manich C, Peg V, Vidal Losada M, Bellet Ezquerra M. 165P EPclin, OncotypeDx and Prosigna in lobular breast cancer (ILC): Is there an association with Ki67? Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.200] [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: 11/15/2022] Open
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Schmid P, Cortés J, Marmé F, Rugo H, Tolaney S, Oliveira M, Loirat D, Jhaveri K, Yoon O, Motwani M, Wang H, Delaney R, Bardia A. 214MO Sacituzumab govitecan (SG) efficacy in hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2–) metastatic breast cancer (MBC) by HER2 immunohistochemistry (IHC) status in the phase III TROPiCS-02 study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.253] [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: 11/01/2022] Open
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Silva G, Cardoso F, Almeida J, Fonseca P, Ribeiro S, Oliveira M, Sanfins V, Goncalves H, Primo J, Lourenco A, Fontes-Carvalho R. Cardioneuroablation of severe neurally mediated reflex syncope: the experience of two Portuguese centres. Europace 2022. [DOI: 10.1093/europace/euac053.326] [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.
Background
Neurocardiogenic syncope (NCS) is the most frequent aetiology of syncope in young people. Cardioinhibition with asystole and/or transitory atrio-ventricular block induced by a massive vagal reflex is commonly observed in severe cases. According to the current guidelines, cardiac pacing is indicated in patients > 40 years old with severe, recurrent syncope and documented cardioinhibitory reflex. In younger patients there is no recommendation. Although pacing therapy could be effective, complications after pacemaker implantation are commonly seen. Recently, cardioneuroablation (CNA), a technique based on radiofrequency ablation of vagal ganglia, was developed to treat NCS as an alternative to pacemaker implantation in younger patients. However, this method is still evolving, and existing data refer to a small number of patients in a limited number of centres.
Purpose
The aim of our study was to evaluate the efficacy and safety of CNA in patients with highly symptomatic neurocardiogenic syncope.
Methods and Results
A total of 15 patients (11 male; aged 40.0 ± 13.3 years) who underwent CNA in two Portuguese centres between January 2019 and September 2021 were included. All had recurrent syncope with documented pauses at head-up tilt test, Holter or implantable loop recorder. Radiofrequency energy was applied in ganglionated plexi (GP) 1 (between the right upper pulmonary vein and the right atrium) in 14 patients, GP2 (between the superior vena cava and aortic root just above the right upper pulmonary vein) in 9 patients, GP3 (between the inferior vena cava and the right and left atrium) in 5 patients and GP4 (at the insertion of the left pulmonary veins) in 9 patients. The end point of procedure was the inhibition of the vagal response at target sites. Ablation was successfully performed in all patients. One patient had a convulsive episode after the procedure, requiring admission to intensive care but without neurological sequelae. No other major complications occurred. At a mean follow-up of 17.1 ± 12.6 months (range 3-35 months), 13 patients remained free of syncope. Other 2 patients had spontaneous recurrence of syncope (both 9 months after CNA) and underwent a new procedure. These 2 patients had a new symptomatic recurrence and a pacemaker was implanted.
Conclusion
CNA appears to be an effective and safe treatment option for patients with refractory neurocardiogenic syncope and provide a new potential approach without pacemaker implantation.
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Affiliation(s)
- G Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - F Cardoso
- Hospital Senhora da Oliveira - Guimaraes, Guimaraes, Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - S Ribeiro
- Hospital Senhora da Oliveira - Guimaraes, Guimaraes, Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - V Sanfins
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - H Goncalves
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Lourenco
- Hospital Senhora da Oliveira - Guimaraes, Guimaraes, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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23
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Fernandes S, Cruz I, Ladeiras-Lopes R, Diaz S, Silva M, Barros A, Saraiva F, Faria R, Almeida J, Fonseca P, Goncalves H, Oliveira M, Ferreira N, Primo J, Fontes-Carvalho R. Role of epicardial adipose tissue volume as predictor of atrial fibrillation recurrence. Europace 2022. [DOI: 10.1093/europace/euac053.146] [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.
Background
Several studies have demonstrated the relation between general obesity and atrial fibrillation (AF). Epicardial adipose tissue (EAT), due to its local paracrine effect and the intimate relation with the atrium, could influence AF recurrence rates, but very few studies have explored this association.
Purpose
In this study we aimed to evaluate if EAT could be a predictor of AF recurrence after an AF ablation procedure.
Methods
We included all consecutive patients submitted to AF ablation (2017-2019) who performed a computed tomography scan prior to the procedure. EAT volume was semi-automatically reconstructed by manually tracing the pericardium. Adipose tissue was defined in the range between -150 and -50 Hounsfield units. Recurrence was defined as any documented (ECG/Holter) episode of AF, atrial flutter or atrial tachycardia after 3 months of the procedure. Logistic regression with a restricted cubic polynomial transformation was used to model the non-linear relationship between recurrence and EAT volumes. Inspection of the partial effect curves suggested that a cutoff for EAT volume ≥80mL could stratify patients at risk of recurrence and a Time-to-event analysis was carried.
Results
A total of 354 patients (66% male, median age 57 years [IQR 48–65] and 21% persistent AF) were included. During a median follow-up of 34 months [IQR 24-43], 117 patients (33%) had AF recurrence. These patients had a significantly greater EAT volume (76 mL [IQR 55-111] vs 72 mL [IQR 48-95], p=0.03) when compared to those without recurrence. Also, patients with higher EAT volume (≥ 80mL) had a higher risk of recurrence compared to patients with lower volume (Figure 1, log-rank test p=0.007). After adjusting for clinical risk factors (age, gender, hypertension, diabetes mellitus, obesity, thyroid disease, AF type and left atrial enlargement), higher EAT volume did not remain an independent predictor of AF recurrence (Figure 2, HR 1.25 [95% CI, 0.83-1.86] p=0.3).
Conclusion
In this cohort of patients with AF submitted to catheter ablation, EAT volume ≥80mL was associated with increased risk of AF recurrence. However, it was not an independent predictor of AF recurrence after adjustment to clinical risk factors.
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Affiliation(s)
| | - I Cruz
- Faculty of Medicine University of Porto, Porto, Portugal
| | - R Ladeiras-Lopes
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - S Diaz
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - M Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Barros
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - F Saraiva
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - R Faria
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - H Goncalves
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - N Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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24
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Fernandes S, Ladeiras-Lopes R, Cruz I, Silva G, Diaz S, Barros A, Saraiva F, Faria R, Almeida J, Fonseca P, Goncalves H, Oliveira M, Ferreira N, Primo J, Fontes-Carvalho R. Higher coronary calcium score is associated with increased risk of atrial fibrillation recurrence. Europace 2022. [DOI: 10.1093/europace/euac053.140] [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.
Introduction
Patients with atrial fibrillation (AF) referred for catheter ablation routinely undergo cardiac computed tomography (CCT) for procedure planning. An opportunistic evaluation of coronary artery calcium score (CACS) can be an important tool to improve clinical care. It is already known that CACS is associated with a high risk of AF development, particularly if values are above 100, but few data are available regarding the impact of CACS in AF recurrence after ablation.
Purpose
To assess the impact of CACS on atrial fibrillation recurrence following catheter ablation.
Methods
Retrospective, single-centre cohort study of consecutive patients with AF undergoing CCT for ablation procedure planning, from 2017 to 2019. Baseline clinical and demographical data were collected. Patients with known history of coronary artery disease (CAD) and moderate to severe valvular heart disease were excluded. CACS was assessed using the Agatston method. Recurrence was defined as any documented episode of AF, atrial flutter or atrial tachycardia after 3 months from procedure. Patients were stratified in CACS<100 and CACS≥100. Explorative analysis incorporated Kaplan-Meier survival curves and Cox regression.
Results
A total of 354 patients were included, with a mean age of 56 ± 12 years, 66% male and 21% with persistent AF. More than half of the patients had a CACS>0 (n=185, 52%) and 63 patients (18%) had a CACS≥100. Patients with CACS≥100 were older (63 ± 7 vs 54 ± 12 years, p<0.001), had higher prevalence of hypertension (68% vs 43%, p<0.001) and diabetes mellitus (21% vs 10%, p=0.012) and higher left atrial volume (39 ± 9 vs 35 ± 9 ml/m2, p=0.018). After a median observation time of 34 months (IQR 24-43), 117 patients (33%) had AF recurrence.
CACS≥100 was associated with increased risk of AF recurrence (unadjusted Cox regression: hazard ratio [HR] 1.85; 95% confidence interval [CI], 1.23-2.79, p=0.003) (Fig. 1). After covariate adjustment (age, gender, hypertension, diabetes mellitus, obesity, thyroid disease, AF type and left atria enlargement) CACS≥100 remained an independent predictor of the risk of AF recurrence (HR, 1.68; 95% CI, 1.05-2.70, p=0.03) as well as persistent AF (HR, 1.91; 95% CI, 1.23-3.00, p=0.004) (Fig. 2).
Conclusion
In patients with AF undergoing catheter ablation, without previous history of CAD, a CACS≥100 was independently associated with a 68% increase in the risk of AF recurrence.
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Affiliation(s)
| | - R Ladeiras-Lopes
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - I Cruz
- Faculty of Medicine University of Porto, Porto, Portugal
| | - G Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - S Diaz
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - A Barros
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - F Saraiva
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - R Faria
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - H Goncalves
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - N Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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25
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Freire Barbas De Albuquerque F, Portugal G, Silva Cunha P, Valente B, Lousinha A, Delgado AS, Paulo M, Rosa T, Bras M, Cruz Ferreira R, Oliveira M. Long-term impact of activation circuit-based ventricular tachycardia ablation on ventricular arrhythmia burden. Europace 2022. [DOI: 10.1093/europace/euac053.350] [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.
Background
Ventricular arrhythmias (VA) are a major cause of morbidity and mortality in heart failure patients. Ventricular tachycardia (VT) ablation is an established treatment for the reduction of recurrent implantable cardioverter-defibrillator (ICD) therapies in this population. In patients with substrate-related VT, mapping of the entire tachycardia circuit, when feasible, may allow for more accurate targeting of the clinical VT.
Purpose
To assess the long-term impact of catheter ablation based on activation mapping of substrate-related VT on VA burden.
Methods
Consecutive patients submitted to VT ablation between January 2013 and October 2021 were included. A comprehensive review of clinical records and device monitoring was performed to assess VA burden, defined as all ICD therapies and clinically documented VTs, before and after ablation. The primary outcome was reduction in the overall burden of VA after ablation. The impact of ablation on VA burden was assessed by fixed-effects Poisson regression; comparison at fixed time intervals was performed with a paired-sample Wilcoxon signed-rank test (STATA 12, JASP).
Results
A total of 134 VT ablation procedures were performed during the study period. Of these, there were 21 procedures where complete mapping of the VT activation circuit was achieved, corresponding to 18 patients. Mean age was 56.7 years, 88% male sex, mean left ventricular ejection fraction 39 ± 13%, BNP 540 ± 627 pg/mL. Etiology was ischemic in 44%, non-ischemic dilated cardiomyopathy in 39%, arrhythmogenic right ventricular dysplasia in 11% and hypertrophic cardiomyopathy in 6%. Mechanical support was in situ in 3 patients (two with temporary VA ECMO and one with LVAD as destination therapy); all but one patient had an ICD. Procedural duration was 209 ± 61 minutes. One patient developed complete AV block; no other peri-procedural complications were observed. During follow-up two patients died due to heart failure, one patient died from refractory cardiogenic shock with refractory incessant VT and one patient underwent orthotopic heart transplant. The mean follow-up time after ablation was 2.2 ± 1.9 years. A significant reduction in VA burden was observed (Figure 1) at 3 months (92.5% reduction, p=0.002) and 6 months after ablation (83.3% reduction, p=0.041). After fixed-effects Poisson regression, there was an estimated long-term reduction of 75% (CI 12-93%, p=0.031) of VA burden after VT circuit ablation.
Conclusion
Targeted circuit ablation is feasible in a subset of patients referred to VT ablation and leads to a significant sustained decrease in VA burden and device therapies.
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Affiliation(s)
| | - G Portugal
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Lousinha
- Hospital de Santa Marta, Lisbon, Portugal
| | - AS Delgado
- Hospital de Santa Marta, Lisbon, Portugal
| | - M Paulo
- Hospital de Santa Marta, Lisbon, Portugal
| | - T Rosa
- Hospital de Santa Marta, Lisbon, Portugal
| | - M Bras
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - M Oliveira
- Hospital de Santa Marta, Lisbon, Portugal
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26
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Dias Ferreira Reis JP, Valente B, Portugal G, Lousinha A, Silva Cunha P, Oliveira M, Cruz Ferreira R. Lead extraction with the "pisa technique" - experience of a portuguese tertiary care center. Europace 2022. [DOI: 10.1093/europace/euac053.518] [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
Funding Acknowledgements
Type of funding sources: None.
Background
The "Pisa Technique" (PT) is an increasingly used method of lead extraction (LE) that has shown excellent results in terms of clinical (Cs) and radiological success (Rs) associated with the lowest rate of complications reported in ELECTRa Registry.
Purpose
To characterize the adult population submitted to LE with the PT and evaluate its short-term results.
Methods
A single-center prospective study of consecutive procedures (P) of LE using the PT between February 2013 and October 2019. Demographic, clinical, and P related variables, mortality (M) and reimplantation (R) data were assessed.
Results
320 electrodes (E) were removed in a total of 171 Ps and 159 patients (pts). 80.7% of these P’s were due to CIED infection (55.1% due to pocket site infection, 18.8% to occult bacteremia with probable CIED infection and 26.1% due to both local and systemic infection, with 44% of pts presenting with valvular/ lead vegetation) and the remainder due to E dysfunction or venous occlusion. Pts averaged 67.7 years of age, 71.9% were male with a mean left ventricular ejection fraction of 47.8%.
19.3% presented coronary artery disease, 42.1% overt heart failure and 43.9% atrial fibrillation. 29 pts had cardiac resynchronization devices, 20 pts implantable cardioverter-defibrillator devices and 110 pts pacemaker systems (mostly DDD). The mean "age" of the extracted E’s was 83.2 months, 244 of which were atrial or ventricular pacing, 26 pacing E’s via the coronary sinus and 50 shock E’s. In 31.0% of the cases, the E’s were of active fixation, with 42.7% of the pts being pacing dependent. 14% of pts had a previous attempt of LE, 37.4% had already been submitted to generator replacement and a third to CIED upgrade. In 66.7% of pts, a new contralateral CIED was implanted during the hospital stay - H -(mean time for R of 6 days) and in 19% of R’s an antibacterial envelope was used. The Rs and Cs rates were 91.2% and 98.3%, respectively. There was 1 case of cardiac tamponade during LE, which was stabilized by pericardiocentesis and 2 pocket site hematomas requiring surgical drainage. There were no deaths during the P. During a mean follow-up (FU) of 33 months, 11 pts had to undergo a new P, 5 of them due to pocket reinfections. The M rate during FU was 24.2% (37 pts), with 8 pts (5.0%) dying during H, mostly due to septic shock, and 19 pts during the first year post-P.
Conclusion
Our center’s experience with the PT confirms the method’s high efficacy and safety in the percutaneous extraction of E’s in pts with CIED.
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Affiliation(s)
| | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | - G Portugal
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Lousinha
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - M Oliveira
- Hospital de Santa Marta, Lisbon, Portugal
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27
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Dias Ferreira Reis JP, Mendonca T, Castelo A, Rodrigues I, Fiarresga A, Ramos R, Cacela D, Oliveira M, Ferreira R. Predictors of pacemaker dependency after transcatheter aortic valve replacement. Europace 2022. [DOI: 10.1093/europace/euac053.401] [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.
Background
Conduction disturbances after transcatheter aortic valve replacement (TAVR) are common with a variable risk of long-term pacemaker dependency (PD), being influenced by patient- and procedure-specific factors. As pacemaker (PM) implantation is associated with potential complications, our aim was to assess predictors of PD requirement after TAVR.
Methods
Retrospective analysis of consecutive patients (P) who underwent TAVR with a self-expanding valve from 2009 to 2020 at our institution. All P had pre-procedural clinical evaluation, cardiac computed tomographic angiography, transthoracic echocardiography and electrocardiography performed. Cumulative percentage of ventricular pacing (%Vp) was determined from stored PM data. P with a PM implanted previous to TAVR were excluded. PM implantation post-TAVR was defined as a device implant performed during hospital stay in the context of TAVR or during the first month after discharge. PD was defined as a %Vp > 80% at one-year follow-up. Multivariate analysis for the prediction of PD was done using Cox regression.
Results
A total of 474 P (57% male, age 81.7±6.5 years, left ventricular ejection fraction 51.5±14.6%) were analysed. Mean follow-up was 18.7 months. Mean baseline gradient was 51.7 mmHg with a mean aortic valve area of 0.71 cm2. One hundred and four P (21.9%) required PM implantation after TAVR, with a mean %Vp of 65.3±43.4%, presenting PD in 60% of the cases at one-year follow-up. A glomerular filtration rate > 60 ml/min (OR 0.87, CI 95% 0.74-0.96, p=0.021) and mean aortic annulus perimeter (OR 0.89, CI 95% 0.80-0.98, p=0.029) were independent predictors of a PD < 5%. Arterial hypertension (OR 7.00, CI 95% 1.31-37.40, p=0.023), baseline right bundle branch block (OR 10.2, CI 95% 1.21-18.45, p=0.033), and the EUROSCORE II (OR 1.05, CI 95% 1.01-1.10, p=0.044) were predictors of PD > 80%. Baseline left bundle branch block, implantation depth and aortic valve calcium score were not predictors of PD.
Conclusion
Predictors of PD after TAVR may influence PM implantation, as well as device selection and programming. P with a higher aortic annulus perimeter and preserved kidney function may undergo a more expectant management, as PD rates are low after 1 year follow-up.
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Affiliation(s)
| | - T Mendonca
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Castelo
- Hospital de Santa Marta, Lisbon, Portugal
| | | | | | - R Ramos
- Hospital de Santa Marta, Lisbon, Portugal
| | - D Cacela
- Hospital de Santa Marta, Lisbon, Portugal
| | - M Oliveira
- Hospital de Santa Marta, Lisbon, Portugal
| | - R Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
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28
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Dias Ferreira Reis JP, Valente B, Portugal G, Lousinha A, Silva Cunha P, Oliveira M, Cruz Ferreira R. Impact of anticoagulation therapy on outcomes in patients undergoing transvenous lead extraction. Europace 2022. [DOI: 10.1093/europace/euac053.519] [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
Funding Acknowledgements
Type of funding sources: None.
Background
Oral anticoagulation (OAC) is essential for patients (pts) at high risk for thromboembolism. However,uninterrupted anticoagulation and bridging with enoxaparin increases the risk of pocket hematoma (PH) andinfection (I).
Aim
To evaluate the impact of OAC in the rate of PH and outcomes in pts undergoing lead extraction (LE) usingthe Pisa Technique (PT).
Methods
A single centre prospective study of consecutive procedures (Pr) of LE using the PT between February2013 and October 2019. Demographic, clinical, device and procedure related variables, morbidity and mortality(M) data were compared between pts without OAC (O0) and pts with AC (O1).
Results
320 electrodes (E) were removed in a total 171 Pr in 159 pts (mean age - 67.7 years, mean LVEF - 48%,male - 72%). The LE were from the following implanted systems: pacemaker – 110 pts, cardiac resynchronizationtherapy – 29 pts, cardioverter-defibrillator – 20 pts. The radiological success rate was 91.2% and the clinicalsuccess rate was 98.3%. There were 14 cases of PH. During a mean follow-up (FU) of 33 months, 11 pts had toundergo a new Pr, 5 of them due to pocket I. 8 pts (5.0%) died during hospital stay, and 19 pts during the firstyear post-Pr. There were no deaths during the Pr. O1 included 56 pts (35.4%), of which 51.9% were under vitaminK antagonists (AVK) and 48.1% under direct oral anticoagulants (DOAC). 11 pts were receiving OAC due toprosthetic mechanical valve, and the remainder due to atrial fibrillation (AF). Pts in O1 were significantly older(p=0.026), presented a lower LVEF (p=0.001), a higher prevalence of valvular heart disease - VHD -(p=0.002),overt heart failure (p=0.006), AF (p<0.001) and previous cardiac surgery - CS - (p<0.001). OAC was associatedwith a higher rate of PH (OR 2,44, IC 95% 1.02-5,84, p=0.046) and pts with PH presented a significantlyprolonged hospital stay (22.7 vs 9.8 days, p=0.031). These pts also presented a higher hospitalization rate duringthe first year post-Pr (OR 2,48, IC95% 1.27-4.88, p=0.009). There was no difference in all-cause hospital M(p=0.522), all-cause M during first year of follow-up (p=0.551) or need for reintervention (p=0.375). Among pts inO1, pts under AVK presented a significantly higher rate of PH (OR 18,67, IC95% 2,23-156,17, p=0.007).
Conclusion
Pts receiving OAC, particularly pts under AVK, presented a higher rate of PH after LE. PerioperativeOAC management is crucial to reduce the morbidity rate in this population.
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Affiliation(s)
| | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | - G Portugal
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Lousinha
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - M Oliveira
- Hospital de Santa Marta, Lisbon, Portugal
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29
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Grazina A, Aguiar Rosa S, Fiarresga A, Garcia Bras P, Ferreira V, Cardoso I, Viegas JM, Ramos R, De Sousa L, Oliveira M, Cacela D, Cruz Ferreira R. Permanent pacemaker implantation after Alcoholic Septal Ablation: long-term outcomes. Europace 2022. [DOI: 10.1093/europace/euac053.439] [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.
Introduction
Patients with hypertrophic obstructive cardiomyopathy (HOCM) that remain symptomatic despite optimized medical therapy are often submitted to alcohol septal ablation (ASA). One of the most frequent complications is the complete heart block (CHB), requiring permanent pacemaker (PPM) in variable rates, up to 20% of the patients. The long-term impact of PPM implantation in these patients remains unclear.
Objectives
This study aims to evaluate the long-term pacemaker dependency in patients with PPM after ASA and to assess the long-term impact of PPM in these patients.
Methods
In a tertiary center, patients who underwent ASA were retrospectively analyzed. Patients with previous PPM or implantable cardio-defibrillator were excluded. The groups with and without PPM implantation after ASA were compared regarding baseline characteristics, procedure data and outcomes. In the group who implanted PPM, the long-term pacing rates were evaluated.
Results
Between 2009 and 2020, 109 patients underwent ASA. 97 patients were included in this analysis (68% female, mean age 65.2 years-old). 16 patients (16.5%) required PPM implantation for CHB. In those, no vascular access, pacemaker pocket or pulmonary parenchyma complications were noted. The baseline characteristics regarding co-morbidities, symptoms, echocardiographic and electrocardiographic findings were identical in the two groups, with statistically significant differences in the mean age (70.6y/o in the PPM group versus 64.1y/o) and in the beta-blocker therapy rates previously to the intervention (56% in the PPM group versus 84%). Procedure-related data showed higher creatine kinase (CK) peaks in the PPM group (1692U/L versus 1243U/L, p0.05), without significant differences in the alcohol dose (2.1ml in both groups, p0.33). In the PPM group, the mean pacing rates at 1 month, 1 year and 2 years were 66.6±38.0, 50.4±44.1 and 50.8±42.5, respectively, with 2 patients (12.5%) having 1-5% pacing and none having pacing <1% at 2 years. In the group without PPM, 5 patients (6.2%) required posteriorly PPM implantation during the follow-up. There were no statistically significant differences in the two groups regarding in-hospital mortality, 1 year mortality or 1 year re-hospitalization. Despite a lower mean follow-up period in the PPM group (2.3±1.5 years versus 3.5±2.2 years, p0.05), there were no differences in the groups regarding all-cause mortality, cardiac cause mortality and cardiac cause re-hospitalization, with a statistical tendency to a lower all cause re-hospitalization in the PPM group (19% versus 43%, p0.07).
Conclusions
The registered pacing rates shows that all devices were adequately implanted. The long-term impact analysis suggests that the outcomes in patients who implant PPM after ASA are non-inferior to those who do not, with a tendency to reduce all cause re-hospitalizations.
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Affiliation(s)
- A Grazina
- Hospital de Santa Marta, Lisbon, Portugal
| | | | | | | | - V Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
| | - I Cardoso
- Hospital de Santa Marta, Lisbon, Portugal
| | - JM Viegas
- Hospital de Santa Marta, Lisbon, Portugal
| | - R Ramos
- Hospital de Santa Marta, Lisbon, Portugal
| | - L De Sousa
- Hospital de Santa Marta, Lisbon, Portugal
| | - M Oliveira
- Hospital de Santa Marta, Lisbon, Portugal
| | - D Cacela
- Hospital de Santa Marta, Lisbon, Portugal
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30
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Pascual T, Bermejo De Las Heras B, Martinez N, Oliveira M, Pernas Simon S, Lopez Lopez R, Ruiz Cabrero I, Alarcon J, Martinez De Dueñas E, Malon Gimenez D, Gonzalez Cao M, Manso Sanchez L, Morales Murillo S, Lopez de Ceballos H, Cortés J, Llombart Cussac A, Prat A. 95P PAM50 HER2-enriched phenotype as a predictor of early response to neoadjuvant lapatinib plus trastuzumab HER2-positive breast cancer: Survival results of the SOLTI-PAMELA study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.111] [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: 11/01/2022] Open
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31
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Leao I, Zamora E, Gomez Pardo P, Arumi de Dios M, Pimentel I, Escriva de Romani S, Ortiz Velez C, Cruellas Lapena M, Sanz L, Borrell M, Vega Cano K, Gómez-Puerto D, De La Torre J, Espinosa-Bravo M, Oliveira M, Fasani R, Nuciforo P, Saura C, Peg V, Bellet M. 87P EPClin vs OncotypeDx in invasive lobular cancer (ILC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.102] [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] Open
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32
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Prat A, Falato C, Pare Brunet L, Martinez Saez O, Cejalvo Andujar J, Margeli Vila M, Tolosa P, Salvador Bofill F, Cruz Jurado J, Gonzalez-Farre B, Sanfeliu Torres E, Ciruelos E, Espinosa-Bravo M, Izarzugaza Peron Y, Pernas Simon S, Esker S, Fan PD, Ferrero Cafiero J, Pascual T, Oliveira M. LBA3 Patritumab deruxtecan (HER3-DXd) in early-stage HR+/HER2- breast cancer: Final results of the SOLTI TOT-HER3 window of opportunity trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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33
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Oliveira M, Scanavino M. Gender differences in internet use for sexual purposes in individuals aged 55 years and over. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.491] [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: 11/28/2022]
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34
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Greil R, Lin NU, Murthy RK, Abramson V, Anders C, Bachelot T, Bedard PL, Borges V, Cameron D, Carey L, Chien AJ, Curigliano G, DiGiovanna MP, Gelmon K, Hortobagyi G, Hurvitz S, Krop I, Loi S, Loibl S, Mueller V, Oliveira M, Paplomata E, Pegram M, Slamon D, Zelnak A, Ramos J, Feng W, Winer E. Aktualisierte Ergebnisse von Tucatinib versus Placebo in Kombination
mit Trastuzumab und Capecitabin bei Patienten mit vorbehandeltem, metastasierten
HER2-positiven Brustkrebs mit ZNS-Metastasen (HER2CLIMB). Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1746156] [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: 10/18/2022] Open
Affiliation(s)
- R Greil
- Dritte medizinische Abteilung, Paracelsus Medizinische
Universität Salzburg, Salzburger Krebsforschungsinstitut –
Zentrum für Klinische Krebs- und Immunologiestudien und Cancer Cluster
Salzburg, Salzburg. Österreich
| | - N U Lin
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - R K Murthy
- MD Anderson Cancer Center, Houston, Texas, USA
| | - V Abramson
- Vanderbilt University Medical Center, Nashville, Tennessee,
USA
| | - C Anders
- Duke Cancer Institute, Durham, North Carolina, USA
| | | | - P L Bedard
- University Health Network, Princess Margaret Cancer Centre, Toronto,
Ontario, Kanada
| | - V Borges
- University of Colorado Cancer Center, Aurora, Colorado,
USA
| | - D Cameron
- Edinburgh Cancer Research Centre, Edinburgh, Vereinigtes
Königreich
| | - L Carey
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North
Carolina, USA
| | - A J Chien
- University of California at San Francisco, San Francisco, Kalifornien,
USA
| | - G Curigliano
- Istituto Europeo di Oncologia, IRCCS, University of Milano, Mailand,
Italien
| | | | - K Gelmon
- British Columbia Cancer – Vancouver Centre, British Columbia,
Kanada
| | | | - S Hurvitz
- UCLA Medical Center/Jonsson Comprehensive Cancer Center, Los
Angeles, Kalifornien, USA
| | - I Krop
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - S Loi
- Peter MacCallum Cancer Centre, Melbourne, Australien
| | - S Loibl
- Deutsche Brust-Gruppe, Neu-Isenburg. Deutschland
| | - V Mueller
- Universitätsklinikum Hamburg-Eppendorf, Hamburg,
Deutschland
| | - M Oliveira
- Hospital Universitario Vall D‘Hebron, Barcelona,
Spanien
| | - E Paplomata
- Carbone Cancer Center University of Wisconsin, Madison, Wisconsin,
USA
| | - M Pegram
- Stanford Comprehensive Cancer Institute Palo Alto, Kalifornien,
USA
| | - D Slamon
- UCLA Medical Center/Jonsson Comprehensive Cancer Center, Los
Angeles, Kalifornien, USA
| | - A Zelnak
- Northside Hospital, Sandy Springs, Georgia, USA
| | - J Ramos
- Seagen Inc., Bothell, Washington, USA
| | - W Feng
- Seagen Inc., Bothell, Washington, USA
| | - E. Winer
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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35
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Venâncio C, Melnic I, Tamayo-Belda M, Oliveira M, Martins MA, Lopes I. Polymethylmethacrylate nanoplastics can cause developmental malformations in early life stages of Xenopus laevis. Sci Total Environ 2022; 806:150491. [PMID: 34844312 DOI: 10.1016/j.scitotenv.2021.150491] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/06/2021] [Accepted: 09/17/2021] [Indexed: 06/13/2023]
Abstract
Polymethylmethacrylate (PMMA) production has increased almost 20% over the last years. With its release into the aquatic environment, its breakdown or degradation to nano dimensions (nanoplastics-NPLs) due to biological and physical/mechanical action is, theoretically, anticipated. The occurrence of PMMA-NPLs in aquatic ecosystems may thus cause adverse effects particularly to early life stages of amphibians, which may be in contact with PMMA-NPLs suspended in the water column or deposited in upper layers of the sediments. Accordingly, this work aimed at assessing the effects of PMMA-NPLs to aquatic early life stages of the model anuran species Xenopus laevis. To attain this objective, two types of toxicity assays were carried out by exposing embryos [Nieuwkoop and Faber (NF) stage 8-11] or tadpoles (NF 45) to three concentrations of PMMA-NPLs (1, 100 and 1000 μg/L): i) 96-h embryo teratogenicity assay, where survival, malformation, and total body length (BL) of embryos were assessed; and ii) 48-h feeding rate assay, where survival, feeding (FR), malformations and growth rates (body weight-BW and BL) of tadpoles were evaluated. PMMA-NPLs exposure had no significant effects on mortality, malformations of X. laevis embryos but BL was lower at 1000 μg PMMA-NPLs/L. In tadpoles, no effects on survival or FR were observed after exposure to PMMA-NPLs, but significant changes occured in BW and BL. Moreover, anatomical changes in the abdominal region (externalization of the gut) were observed in 62.5% of the tadpoles exposed to 1000 μg PMMA-NPLs/L. Despite the lack of knowledge regarding the environmental levels of NPLs, it is expected that sediments constitute a sink for these contaminants, where they can become available for organisms that, like tadpoles, feed on the organic matter at the surface of sediments. Considering the continuous release and subsequent accumulation of PMMA, the malformations obtained in the feeding assays suggest that, in the future, these nano-polymers may constitute a risk for aquatic life stages of amphibians.
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Affiliation(s)
- C Venâncio
- Centre for Functional Ecology (CFE), Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - I Melnic
- Faculty of Biology Alexandru Ioan Cuza, University of Iași, Romania
| | - M Tamayo-Belda
- Department of Biology, Faculty of Science, Universidad Autónoma de Madrid, Madrid, Spain
| | - M Oliveira
- Centre for Environmental and Marine Studies (CESAM), Department of Biology, University of Aveiro, 3810-193 Aveiro, Portugal
| | - M A Martins
- CICECO-Aveiro Institute of Materials, Department of Materials and Ceramic Engineering, University of Aveiro, 3810-193 Aveiro, Portugal
| | - I Lopes
- Centre for Environmental and Marine Studies (CESAM), Department of Biology, University of Aveiro, 3810-193 Aveiro, Portugal.
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36
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Torres T, Paiva-Lopes MJ, Gonçalo M, Claro C, Oliveira M, Gomes J, Vieira AP, Amoedo P, Alpalhão M, Nogueira M, Santiago F, Henrique M, Amaro C, Esteves T, Alves J, Cerejeira D, Mendes-Bastos P, Pestana M, Ramos L, Rocha J, Carvalho R, Teixeira L, Selores M, Mota A, Filipe P. Dupilumab for atopic dermatitis: a real-world portuguese multicenter retrospective study. J DERMATOL TREAT 2022; 33:2554-2559. [PMID: 35083945 DOI: 10.1080/09546634.2022.2035309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction: Atopic dermatitis (AD) is a difficult-to-treat inflammatory skin disease with a high impact on patients' quality of life. Dupilumab, an IL-4 and IL-13 inhibitor, was the first monoclonal antibody approved for the treatment of moderate-to-severe AD and is currently approved in patients aged 6 or older.Methods: This is a nationwide, multicenter, retrospective, 48-week study designed by the Portuguese Group of AD to assess real-world efficacy and safety of dupilumab for the treatment of AD.Results: A total of 169 patients were enrolled, with a mean disease duration of 22.75 (±11.98) years. The percentage of patients achieving an improvement of at least 75% in Eczema Area and Severity Index (EASI) compared to baseline (EASI75 response) at weeks 12 and 48 was 67.6% and 74.1%, respectively. In the same timepoints, 25.0% and 44.1% achieved an EASI90 response. Patient-reported outcome measures also improved throughout the study period. Regarding safety, 32.0% of the patients developed adverse events, with conjunctivitis (26.6%), persistent facial erythema (4.7%), and arthritis/arthralgia (3.6%) as the more frequently reported.Conclusion: Data from real-world populations are crucial to guide clinicians in their daily decisions. This study provides data demonstrating that dupilumab is an effective and safe therapeutic option for AD.
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Affiliation(s)
- T Torres
- Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - M J Paiva-Lopes
- Department of Dermatology, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal.,CEDOC, Nova Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - M Gonçalo
- Department of Dermatology, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.,Clinic of Dermatology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - C Claro
- Department of Dermatology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
| | - M Oliveira
- Department of Dermatology, Centro Hospitalar Tondela Viseu, Viseu, Portugal
| | - J Gomes
- Department of Dermatology, Hospital de Braga, Braga, Portugal
| | - A P Vieira
- Department of Dermatology, Hospital de Braga, Braga, Portugal
| | - P Amoedo
- Department of Dermatology, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - M Alpalhão
- Department of Dermatology, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal.,Dermatology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Dermatology Research Unit, IMM João Lobo Antunes, University of Lisbon, Lisbon, Portugal
| | - M Nogueira
- Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - F Santiago
- Department of Dermatology, Centro Hospitalar Leiria-Pombal, Leiria, Portugal
| | - M Henrique
- Department of Dermatology, Centro Hospitalar Leiria-Pombal, Leiria, Portugal
| | - C Amaro
- Department of Dermatology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
| | - T Esteves
- Department of Dermatology, Hospital Central do Funchal, Madeira, Portugal
| | - J Alves
- Department of Dermatology, Hospital Garcia de Orta, Almada, Portugal
| | - D Cerejeira
- Department of Dermatology, Hospital Garcia de Orta, Almada, Portugal
| | - P Mendes-Bastos
- Dermatology Center, Hospital CUF Descobertas, Lisboa, Portugal
| | - M Pestana
- Department of Dermatology, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal
| | - L Ramos
- Department of Dermatology, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - J Rocha
- Department of Dermatology, Hospital de Pedro Hispano, Matosinhos, Portugal
| | - R Carvalho
- Department of Dermatology, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal.,Nova Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - L Teixeira
- Center for Health Technology and Services Research (CINTESIS), Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS.UP), Porto, Portugal
| | - M Selores
- Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - A Mota
- Department of Dermatology, Centro Hospitalar Universitário de São João EPE, Porto, Portugal.,Faculty of Medicine, University of Porto, CINTESIS, Porto, Portugal
| | - P Filipe
- Department of Dermatology, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal.,Dermatology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Dermatology Research Unit, IMM João Lobo Antunes, University of Lisbon, Lisbon, Portugal
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37
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Freitas BLS, Terin UC, Fava NMN, Maciel PMF, Garcia LAT, Medeiros RC, Oliveira M, Fernandez-Ibañez P, Byrne JA, Sabogal-Paz LP. A critical overview of household slow sand filters for water treatment. Water Res 2022; 208:117870. [PMID: 34823084 DOI: 10.1016/j.watres.2021.117870] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/26/2021] [Accepted: 11/13/2021] [Indexed: 06/13/2023]
Abstract
Household, or point-of-use (POU), water treatments are effective alternatives to provide safe drinking water in locations isolated from a water treatment and distribution network. The household slow sand filter (HSSF) is amongst the most effective and promising POU alternatives available today. Since the development of the patented biosand filter in the early 1990s, the HSSF has undergone a number of modifications and adaptations to improve its performance, making it easier to operate and increase users' acceptability. Consequently, several HSSF models are currently available, including those with alternative designs and constant operation, in addition to the patented ones. In this scenario, the present paper aims to provide a comprehensive overview from the earliest to the most recent publications on the HSSF design, operational parameters, removal mechanisms, efficiency, and field experiences. Based on a critical discussion, this paper will contribute to expanding the knowledge of HSSF in the peer-reviewed literature.
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Affiliation(s)
- B L S Freitas
- Department of Hydraulics and Sanitation, São Carlos School of Engineering, University of São Paulo, Avenida Trabalhador São-Carlense, 400, São Carlos, São Paulo, 13566-590, Brazil
| | - U C Terin
- Department of Hydraulics and Sanitation, São Carlos School of Engineering, University of São Paulo, Avenida Trabalhador São-Carlense, 400, São Carlos, São Paulo, 13566-590, Brazil
| | - N M N Fava
- Department of Hydraulics and Sanitation, São Carlos School of Engineering, University of São Paulo, Avenida Trabalhador São-Carlense, 400, São Carlos, São Paulo, 13566-590, Brazil
| | - P M F Maciel
- Department of Hydraulics and Sanitation, São Carlos School of Engineering, University of São Paulo, Avenida Trabalhador São-Carlense, 400, São Carlos, São Paulo, 13566-590, Brazil
| | - L A T Garcia
- Department of Hydraulics and Sanitation, São Carlos School of Engineering, University of São Paulo, Avenida Trabalhador São-Carlense, 400, São Carlos, São Paulo, 13566-590, Brazil
| | - R C Medeiros
- Department of Engineering and Environmental Technology, Federal University of Santa Maria, Linha 7 de Setembro, BR 386, Km 40, Frederico Westphalen, Rio Grande do Sul, 98400-000, Brazil
| | - M Oliveira
- Department of Hydraulics and Sanitation, São Carlos School of Engineering, University of São Paulo, Avenida Trabalhador São-Carlense, 400, São Carlos, São Paulo, 13566-590, Brazil
| | - P Fernandez-Ibañez
- Nanotechnology and Integrated Bioengineering Centre, School of Engineering, Ulster University, Jordanstown, BT37 0QB, Northern Ireland, United Kingdom
| | - J A Byrne
- Nanotechnology and Integrated Bioengineering Centre, School of Engineering, Ulster University, Jordanstown, BT37 0QB, Northern Ireland, United Kingdom
| | - L P Sabogal-Paz
- Department of Hydraulics and Sanitation, São Carlos School of Engineering, University of São Paulo, Avenida Trabalhador São-Carlense, 400, São Carlos, São Paulo, 13566-590, Brazil.
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38
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Oliveira M, Zucaro A, Santagata R, Ulgiati S. Environmental assessment of milk production from local to regional scales. Ecol Modell 2022. [DOI: 10.1016/j.ecolmodel.2021.109795] [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: 11/03/2022]
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39
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Demetrio D, Oliveira M, Baumgartner T, Demetrio C, Santos R. 8 Jersey in vitro embryo production data. Reprod Fertil Dev 2021; 34:237-238. [PMID: 35231208 DOI: 10.1071/rdv34n2ab8] [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: 11/23/2022] Open
Affiliation(s)
| | | | | | - C Demetrio
- Universidade de São Paulo, Piracicaba, SP, Brazil
| | - R Santos
- Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
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40
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Brandts I, Solà R, Martins MA, Tvarijonaviciute A, Barreto A, Teles M, Oliveira M. A baseline study on the impact of nanoplastics on the portals of entry of xenobiotics in fish. Mar Pollut Bull 2021; 173:113018. [PMID: 34653883 DOI: 10.1016/j.marpolbul.2021.113018] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/23/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
Mediterranean waters are particularly vulnerable to plastic pollution, with plastic particles concentrations comparable to those found in oceanic gyres. This work aimed to assess the impact of polymethylmethacrylate nanoplastics (PMMA-NPs) on the most important mucosal barriers of the gilthead seabream (Sparus aurata), a highly consumed fish species in the Mediterranean area. Fish were waterborne exposed to NPs (0.001-10 mg/L) for 24 and 96 h, and biochemical parameters associated with oxidative status (total oxidative status and total antioxidant capacity) and immune function (adenosine deaminase, ADA, acetylcholinesterase activity, AChE, and esterase activity, EA) were assessed in gills, intestine, and skin. In intestine, PMMA-NPs led to oxidative status alterations and decreased ADA and EA. In gills, PMMA-NPs induced EA decrease and AChE activity increase. Total protein values were significantly increased in skin. Overall, more alterations were observed in intestine, suggesting it may be one of the most affected tissues by exposure to NPs.
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Affiliation(s)
- I Brandts
- Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; Institute of Biotechnology and Biomedicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - R Solà
- Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; Institute of Biotechnology and Biomedicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - M A Martins
- Department of Physics & CICECO, University of Aveiro, 3810-193 Aveiro, Portugal
| | - A Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Analysis INTERLAB-UMU, Regional Campus of International Excellence Mare Nostrum, University of Murcia, Espinardo, Murcia 30100, Spain
| | - A Barreto
- Centre for Environmental and Marine Studies (CESAM), Department of Biology, University of Aveiro, 3810-193 Aveiro, Portugal
| | - M Teles
- Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; Institute of Biotechnology and Biomedicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain.
| | - M Oliveira
- Centre for Environmental and Marine Studies (CESAM), Department of Biology, University of Aveiro, 3810-193 Aveiro, Portugal
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41
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Oliveira M, Demetrio C, Baumgartner T, Santos R, Demetrio D. 12 Factors affecting Jersey in vitro embryo pregnancy rates. Reprod Fertil Dev 2021; 34:240. [PMID: 35231257 DOI: 10.1071/rdv34n2ab12] [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: 11/23/2022] Open
Affiliation(s)
| | - C Demetrio
- Universidade de São Paulo, Piracicaba, SP, Brazil
| | | | - R Santos
- Universidade de Uberlândia, Uberlândia, MG, Brazil
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42
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Balasch JC, Brandts I, Barría C, Martins MA, Tvarijonaviciute A, Tort L, Oliveira M, Teles M. Short-term exposure to polymethylmethacrylate nanoplastics alters muscle antioxidant response, development and growth in Sparus aurata. Mar Pollut Bull 2021; 172:112918. [PMID: 34526262 DOI: 10.1016/j.marpolbul.2021.112918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 08/03/2021] [Accepted: 08/27/2021] [Indexed: 05/27/2023]
Abstract
Polymethylmethacrylate (PMMA) plastic fragments have been found abundant in the environment, but the knowledge regarding its effects on the physiology of aquatic animals is still poorly studied. Here the short-term (96 h) effects of waterborne exposure to PMMA nanoplastics (PMMA-NPs) on the muscle of gilthead sea bream (Sparus aurata) fingerlings was evaluated at a concentration range that includes 0.001 up to 10 mg/L. The expression of key transcripts related to cell stress, tissue repair, immune response, antioxidant status and muscle development, together with several biochemical endpoints and metabolic parameters. Results indicate that exposure to PMMA-NPs elicit mildly antioxidant responses, enhanced the acetylcholinesterase (AChE) activity, and inhibited key regulators of muscle development (growth hormone receptors ghr-1/ghr-2 and myostatin, mstn-1 transcripts). However, no effects on pro-inflammatory cytokines (interleukin 1β, il1β and tumor necrosis factor α, tnfα) expression nor on the levels of energetic substrates (glucose, triglycerides and cholesterol) were found.
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Affiliation(s)
- J C Balasch
- Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - I Brandts
- Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; Institute of Biotechnology and Biomedicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - C Barría
- Programa de doctorado en Ciencias de la Acuicultura, Universidad Austral de Chile, Puerto Montt, Chile; Centro de Investigación y Gestión de Recursos Naturales (CIGREN), Instituto de Biología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
| | - M A Martins
- Department of Physics & CICECO, University of Aveiro, 3810-193 Aveiro, Portugal
| | - A Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Analysis INTERLAB-UMU, Regional Campus of International Excellence Mare Nostrum, University of Murcia, Espinardo, Murcia 30100, Spain
| | - L Tort
- Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - M Oliveira
- Centre for Environmental and Marine Studies (CESAM), Department of Biology, University of Aveiro, 3810-193 Aveiro, Portugal
| | - M Teles
- Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; Institute of Biotechnology and Biomedicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain.
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43
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Cardoso A, Faria B, Von Hafe P, Dias G, Pereira T, Ribeiro S, Calvo L, Oliveira M, Fernandes M, Sanfins V, Lourenco A. Family screening in brugada syndrome patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Brugada syndrome (BS) is a rare inherited channelopathy associated with sudden cardiac death (SCD) and family screening (FS) of index patients (pts) is recommended. However, data about pts identified through FS is lacking.
Aim
To compare index pts to non-index pts identified through systematic FS.
Methods
Single-center retrospective study of BS pts followed by the Arrhythmology Department. FS was offered to 1st degree relatives of all index pts through primary care services and a once-weekly voluntary open appointment. Genetic counselling was performed when indicated. Index and non-index pts were compared regarding baseline characteristics and events during the follow-up (syncope of probable arrhythmic origin, ventricular tachycardia/ventricular fibrillation (VT/VF) and SCD).
Results
We included 165 pts (61% males, mean age 47±15 years) and 72 (44%) were identified through FS. Non-index pts were diagnosed at a younger age (42±14 vs 51±14 years, p <.001), were more often female (57% vs 25%, p<.001), were diagnosed predominantly through provocative test with ajmaline/flecainide (88% vs 47%, p<.001) and had less documented spontaneous type 1 ECG pattern (17% vs 59%, p<.001). A type 2 pattern was identified in 18 (25%) non-index pts.
Genetic testing was performed in 38 (53%) non-index pts: 6 had a pathogenic SCN5A mutation, 18 a likely pathogenic SCN5A mutation and 12 a mutation of uncertain significance.
At diagnosis, 24 (33%) non-index pts had history of syncope, 3 (4%) had nocturnal agonal respiration and 11 (15%) had palpitations with no differences between both groups (p=.119). Non-index pts were less likely to implant a cardioverterdefibrillator (14% vs 38%, p=.001).
During a median follow-up of 28 (IQR 16–41) months, 10 (6%) pts had an event - 2 (3%) in the non-index group (2 syncope) and 8 (9%) in the index group (1 syncope; 7 VT/VF) - with no significative differences between groups (p=.432). There were nocardiovascular deaths.
Conclusions
FS identified a considerable proportion of BS pts. Non-index pts were younger at the time of the diagnosis and had less spontaneous type 1 pattern. No differences were found in events between index and non-index pts, however, the event rate was low. Systematic FS can identify individuals at risk of SCD earlier, allowing close monitoring and, when indicated, appropriate treatment.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Cardoso
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - B Faria
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - P Von Hafe
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - G Dias
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - T Pereira
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - S Ribeiro
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - L Calvo
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Oliveira
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Fernandes
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - V Sanfins
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - A Lourenco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
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Garcia Bras P, Silva Cunha P, Galrinho A, Portugal G, Valente B, Rio P, Timoteo A, Coutinho Cruz M, Paulo M, Delgado A, Bras M, Ferreira R, Moura Branco L, Oliveira M. Left atrial strain imaging and integrated backscatter: predictors of recurrence in patients with paroxysmal, persistent and long-standing persistent atrial fibrillation undergoing catheter ablation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0531] [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
Left atrial (LA) strain imaging by echocardiography (TTE) is a promising tool in the evaluation of LA mechanical function. The aim of this study was to compare LA longitudinal strain and integrated backscatter (IBS) between paroxysmal (PAF), persistent (PersAF) and long-standing persistent AF (LsAF) and evaluate its association with AF recurrence post-index catheter ablation.
Methods
Analysis of consecutive patients (P) with symptomatic PAF and PersAF who underwent index AF catheter ablation and had performed TTE in our centre prior to AF ablation. LA reservoir phase longitudinal strain (LASr) and strain rate was assessed by 2D speckle-tracking at baseline. LA volume index (LAVi) and IBS were analysed. AF recurrence was documented with 12-lead ECG, 24h Holter monitoring, external loop recorder or pacemaker analysis in a 12-month follow-up period.
Results
78 P, 69% PAF vs 31% PersAF (46% LsAF), 65% male, 40% with structural heart disease, who underwent pulmonary vein isolation were studied (cryoballoon ablation in 53% and radiofrequency ablation in 47%). P with PersAF had a higher LAVi (46±15 mL/m2 vs 36±13 mL/m2 p=0.004), particularly LsAF P (55±17 mL/m2) and impaired LASr (9.2±4.9% vs 23.9±9.3%, p<0.001) (especially LsAF 5.61±3.08% vs 12.20±4.04%, p<0.001) as well as strain rate (0.58±0.25 s–1 vs 1.08±0.40 s–1, p<0.001). There was no significant difference between groups regarding IBS (116.6±36.1 dB vs 106.6±21.5 dB, p=0.134), including LsAF (128.8±21.5 dB vs 102.1±45.1 dB, p=0.071). During follow-up there was a 28% (22P) AF recurrence rate, higher in PersAF (50% vs PAF 20%, adjusted HR 3.44 [95% CI 1.44–7.69], p=0.005), particularly in LsAF (72% vs 31%, adjusted HR 3.24 [95% CI 0.98–10.9], p=0.048). P with AF recurrence showed significantly impaired baseline LASr both in PersAF (6.44±3.26% vs 11.93±4.79%, p=0.003), as well as PAF (13.86±5.65% vs 26.29±8.47%, p<0.001). LsAF P with AF recurrence demonstrated a considerably impaired LASr (4.99±2.93% vs 9.34±1.40%, p=0.006) vs PersAF. Multivariate analysis showed that impaired baseline LASr was an independent predictor of AF recurrence both in PersAF (adjusted HR 0.82 [95% CI 0.68–0.98], p=0.028) and PAF (adjusted HR 0.78 [95% CI 0.68–0.88], p<0.001). Kaplan-Meier analysis (Fig. 1) showed that both PAF and PersAF P with baseline LASr below the 18% cut-off had a significantly higher rate of AF recurrence, with earlier recurrence in PersAF. PAF P with AF recurrence had a higher baseline IBS (109.3±22.1 dB vs 94.7±14 dB, p=0.016) vs non-recurring P, in contrast to PersAF P (117.8±31.1 dB vs 115.4±42.1 dB, p=0.876), however IBS was not a significant predictor of AF recurrence in PAF (HR 1.03 [95% CI 0.99–1.07], p=0.060) or PersAF.
Conclusion
P with PersAF (and particularly LsAF) showed significantly impaired LASr, and PAF P with AF recurrence had superior baseline IBS vs non-recurring P. Reduced baseline LASr was an independent predictor of AF recurrence both in PAF and in PersAF P.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
| | | | - A Galrinho
- Hospital de Santa Marta, Lisbon, Portugal
| | - G Portugal
- Hospital de Santa Marta, Lisbon, Portugal
| | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | - P Rio
- Hospital de Santa Marta, Lisbon, Portugal
| | | | | | - M Paulo
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - M Bras
- Hospital de Santa Marta, Lisbon, Portugal
| | - R Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - M Oliveira
- Hospital de Santa Marta, Lisbon, Portugal
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Faia Carvalho Dias G, Oliveira M, Faria B, Von Hafe P, Cardoso F, Pereira T, Tinoco M, Ribeiro S, Sanfins V, Almeida F, Lourenco A. Electrophysiologic study for risk stratification in Brugada Syndrome: does it still matters? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0643] [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
The value of eletrophisiologic study (EPS) with programmed ventricular stimulation for risk stratification in patients with Brugada Syndrome (BS) remains controversial.
Purpose
The aim of this study is to determine the clinical and electrocardiographic predictors of positive EPS and to evaluate whether the induction of malignant ventricular dysrhythmias in the EPS is a predictor of events
Methods
A retrospective study was carried out of patients with spontaneous type 1 Brugada pattern followed up in Arrhythmology consultation at our Hospital. From this population, patients who underwent EPS for stratification of dysrhythmic risk were selected. Clinical and electrocardiographic variables were analyzed. Hospital records and monitoring data from cardiac devices were consulted. Statistical analysis was performed using SPSS 20.0.
Results
Fourty nine patients were included, with a mean age at the beginning of follow-up of 45±14 years, 40 (82%) of whom were male. In 16 individuals (33%) the EPS was positive with induction of malignant ventricular dysrhythmias. All patients with positive EPS implanted an implantable cardioverter-defibrillator and of the 32 patients with negative EPS, 10 implanted an implantable event recorder. The group of patients with positive EPS had a higher proportion of male patients (88% vs 78%). The median follow-up time was 31 months.
The family history of sudden death, family history of BS, or identification of a genetic variant classified as pathogenic or probably pathogenic did not present any relationship with EPS positivity. Of the analyzed electrocardiographic markers, PR interval (178±29 vs 171±27) and QRS duration (119±24 vs 113±15) tended to be longer in patients with positive EPS. Additionally, it was found that 74% of patients with a QRS of less than 120 ms had a negative EPS.
In the analysis of the value of EPS in the stratification of dysrhythmic risk, it was found that of all the patients who suffered events (4), 75% had positive EPS. Of the patients with negative EPS, only 3% (1) presented events in the follow-up. However, there was no significant association between these variables.
Conclusion
In this population, the analysed clinical elements did not correlate with the EPS result. Although there was no statistical significance, there was a tendency for patients with narrower QRS to be more likely to have negative EPS. Accordingly with published data, it was found that the EPS result was not a predictor of events during the follow-up period, which highlights the difficulty of risk stratification in patients with BS.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | | | - B Faria
- Hospital Guimaraes, Guimaraes, Portugal
| | | | - F Cardoso
- Hospital Guimaraes, Guimaraes, Portugal
| | - T Pereira
- Hospital Guimaraes, Guimaraes, Portugal
| | - M Tinoco
- Hospital Guimaraes, Guimaraes, Portugal
| | - S Ribeiro
- Hospital Guimaraes, Guimaraes, Portugal
| | - V Sanfins
- Hospital Guimaraes, Guimaraes, Portugal
| | - F Almeida
- Hospital Guimaraes, Guimaraes, Portugal
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Ribeiro Da Silva M, Santos Silva G, Ribeiro Queiros P, Teixeira R, Almeida J, Fonseca P, Oliveira M, Goncalves H, Rodrigues A, Primo J, Fontes-Carvalho R. Predictors of early and late recurrence of atrial fibrillation after catheter ablation: two sides of the same coin? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0527] [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
Recurrence of atrial fibrillation (AF) after catheter ablation (CA) is estimated to be between 20% and 45%. Recurrent AF early after ablation is generally classified as benign as a part of a blanking period, but recently has been associated with later recurrent AF. The prediction of early and late AF recurrence after CA remains challenging as well as the predictive value of early AF recurrence in the blanking period.
Purpose
We aimed to determine the clinical and procedural factors associated with early and late recurrence of AF after CA.
Methods
Single-centre retrospective study that included all patients who underwent AF CA between January 2017 and October 2019. Ablation procedures included radiofrequency and second-generation cryoballoon CA. Early recurrence of AF (ERAF) was defined as any recurrence of AF >30 seconds within 90 days after CA and late recurrence (LR) was defined as any recurrence of AF >30 seconds after 90 days of CA. The independent association between clinical and procedural variables and AF recurrence was evaluated with logistic regression analysis.
Results
We included 399 patients, 64,7% male, with a mean age of 56,8±11,6 years, most of them had paroxysmal AF with a mean duration until CA of 3,5±3,4 years.
Early recurrence of AF occurred in 51 patients (12,8%). After multivariate logistic regression, we identify left atrium (LA) diameter [odds ratio (OR) 1,1, 95% confidence interval (CI) 1,03–1,18; p=0,007] as the only independent predictor associated with recurrent AF.
Late recurrence of AF was observed in 104 patients (26,1%), on average, 12,8±8,7 months after CA. After multivariable adjustment, LA diameter (OR 1,1, 95% CI 1,01–1,12; p=0,032) and intraprocedural electric cardioversion (OR 1,8, 95% CI 1,03–3,12; p=0,040) were independently associated with recurrent AF.
Regarding patients with ERAF, most of them also had late recurrent AF (64,7%), whereas in patients without ERAF, only 20,4% had LR (p<0,001). After including ERAF in the multivariate logistic regression, we identify ERAF as the only independent predictor of late recurrence of AF (OR 5,23, 95% CI 2,56–10,72; p<0,001).
Conclusions
In our cohort, late recurrence of AF after catheter ablation was significantly higher in patients with recurrence within the blanking period, which was the only independent predictor of AF late recurrence.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Ribeiro Da Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - G Santos Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Ribeiro Queiros
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Teixeira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - H Goncalves
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Rodrigues
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Cardoso A, Faria B, Von Hafe P, Dias G, Pereira T, Ribeiro S, Calvo L, Oliveira M, Fernandes M, Sanfins V, Lourenco A. Gender related differences in brugada syndrome. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0636] [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
Brugada syndrome (BS) is a heritable channelopathy with male predominance. Males (M) seem to have a higher risk of arrhythmic events, although, there is limited data regarding gender differences in BS.
Aim
To compare the differences between genders in a Portuguese sample of BS patients (pts).
Methods
Single-center retrospective study of BS pts followed by the Arrhythmology Department. Pts were divided according to gender and compared regarding baseline characteristics and electrocardiographic (ECG) parameters that possibly predict the arrhythmic risk (significative S wave in DI, R wave sign, Tpeak-Tend interval and fragmented QRS). The events during follow-up were syncope of probable arrhythmic origin, ventricular tachycardia/ventricular fibrillation (VT/VF) and sudden cardiac death (SCD).
Results
A total of 165 pts were included; 64 (39%) were female (F) and the mean age at diagnosis was 47±15 years. The diagnosis was made by family screening (FS) in 72 (44%) pts. Sixty-seven pts (41%) had spontaneous type 1 pattern, 59 (36%) had history of syncope and 5 (3%) had history of aborted SCD. A positive genetic test was identified in 41 (25%) pts. Sixty-three (38%) pts were referred for an electrophysiological study (EEF) which was positive in 17 (27%) pts. A cardioverter-defibrillator was implanted in 45 (27%) pts. Females were more often diagnosed by FS (64% vs 31%, p <.001), had less type 1 spontaneous pattern (22% vs 53%, p<.001) and had no atrial fibrillation (0% vs 7%, p=.043). They performed EEF less frequently (22% vs 49%, p<.001) and had less spontaneous pattern during treadmill stress test (8% vs 33%, p=.004).
Regarding ECG parameters, females had shorter QRS interval (104±12 vs 115±18 ms, p<0.001), less frequent aVR sign (3% vs 27%, p<0.001), less significative S wave in DI (31% vs 55%, p=0.004), and a tendency for a shorter Tp-Te interval (80 vs 100 ms, p=0.051). Corrected QT interval was longer in females (396 vs 392ms, p=0.044). During a median follow-up of 28 (IQR 16–41) months, 7 pts had VT/VF (2F, 5M) and 3 had syncope (3M), with no differences between gender (p=0.287). There were no cardiovascular deaths.
Conclusion
In BS, female pts are more often diagnosed by FS and have less spontaneous type 1 pattern. Gender appears to affect basal ECG characteristics in BS, namely in parameters that may predict arrhythmic risk. Further studies are important to clarify the role of gender in prognosis and risk stratification of BS pts.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Cardoso
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - B Faria
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - P Von Hafe
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - G Dias
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - T Pereira
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - S Ribeiro
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - L Calvo
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Oliveira
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Fernandes
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - V Sanfins
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - A Lourenco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
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Fernandes S, Ladeiras-Lopes R, Faria R, Ferreira W, Carvalho M, Almeida J, Fonseca P, Oliveira M, Goncalves H, Ferreira N, Primo J, Fontes-Carvalho R. Coronary calcification by computed tomography in patients with paroxysmal and persistent atrial fibrillation undergoing catheter ablation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0425] [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
Cardiac computed tomography (CCT) is routinely performed for pulmonary vein isolation (PVI) planning in patients with paroxysmal or persistent atrial fibrillation (AF). This imaging method can also identify coronary artery calcium (CAC).
Purpose
To evaluate the prevalence of CAC in patients with paroxysmal and persistent AF undergoing catheter ablation.
Methods
Cross-sectional study including patients with AF/atrial flutter (AFL) undergoing CCT for ablation procedure planning from 2017 to 2019. Baseline clinical and demographic data were collected and CAC score was assessed using the Agatston method. Patients with paroxysmal and persistent AF/AFL (defined according to 2020 European Society of Cardiology guidelines for the diagnosis and management of AF) were compared.
Results
A total of 474 patients were included (441 with AF and 33 with AFL), with a mean age of 57±12 years, of which 295 (62%) were males. CHA2DS2-VASc score was ≥1 (male) or ≥2 (female) in 278 (64%) patients and most patients had a low to moderate cardiovascular risk (259, 80%). CAC was identified in 254 (54%) patients. AF/AFL was paroxysmal in 348 (75%) patients and persistent in 116 (25%). Baseline characteristics and cardiovascular risk factors were similar between groups except for diabetes mellitus (33 [10%] vs 22 [20%], p=0.012) and valvular heart disease (13 [4%] vs 18 [16%], p<0.001) that were more prevalent in patients with persistent AF/AFL. Patients with persistent AF/AFL had higher left atrial volume and left ventricle mass (36±8 vs 43±12 ml/m2, p<0.001 and 90±22 vs 96±22 g/m2, p=0.041). CAC was more frequently present in patients with persistent AF/AFL (175 [50%] vs 72 [62%], p=0.028), especially CAC score >100 (58 [17%] vs 35 [30%], p=0.002). After multivariate analysis, CAC score>100 remained an independent predictor of persistent AF/AFL (OR 2.12, 95% CI 1.18–3.82, p=0.013) along with higher left atrial volume (OR 1.06, 95% CI 1.03–1.08, p<0.001).
Conclusion
In this study, coronary artery calcium was present in more than half of AF/FLA patients undergoing catheter ablation. Patients with persistent AF/AFL showed higher calcium scores and this could derive from chronic, more advanced disease. Especially in those patients, opportunistic CV risk screening and CAC-guided clinical management might be clinically useful.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - R Ladeiras-Lopes
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Faria
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - W Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - H Goncalves
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - N Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Ribeiro Queiros P, Fonseca P, Almeida J, Silva G, Silva M, Teixeira R, Oliveira M, Goncalves H, Dias Ferreira N, Primo J, Fontes-Carvalho R. Cryoballoon versus radiofrequency guided by ablation index for atrial fibrillation ablation: a retrospective propensity-matched study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0376] [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/Introduction
Radiofrequency (RF) and cryoballoon (CB) ablation are established techniques for the treatment of atrial fibrillation (AF). Randomized trials comparing both techniques show similar levels of success; however, studies comparing CB with RF guided by ablation index (AI) are lacking.
Purpose
To compare the treatment success of CB with RF guided by AI, in patients with paroxysmal or persistent AF undergoing their first ablation procedure.
Methods
Patients undergoing AF ablation between 2017 and 2019 were retrospectively analysed. Primary success outcome was freedom from recurrence (defined as any episode of AF, atrial flutter or atrial tachycardia lasting >30 seconds and occurring after 91 days from ablation, or need for antiarrhythmic drugs (AAD), cardioversion or redo procedure). Secondary end-point was a composite of adverse cardiovascular outcomes (stroke/TIA, emergency room visit for AF, hospitalization for AF or cardiovascular death). Analysis was done before and after propensity score matching.
Results
A total of 316 patients were included. Mean age was 56.9±11.7 years. Sixty-two percent were male (n=196). Paroxysmal AF was present in 80.7% (n=255), with no difference between groups. RF was used in 57.9% (n=183) and CB in 42.1% (n=133), with isolation of all pulmonary veins accomplished in 95.9% (n=302), without differences between groups. Mean CHA2DS2-VASc score was 1.5±1.3, being higher in the RF group (1.7±1.3 vs 1.2±1.1; p=0.03); these patients were also older (mean age 58.1±12.0 vs. 55.17±11.0 years; p=0.007) and more likely to be in AF at the ablation (26.7% vs. 16.5%; p=0.006), have chronic kidney disease (40.2% vs. 23.2%; p=0.002), anaemia (11.8% vs. 2.7%; p<0.001), moderate/severe mitral disease (17.5% vs. 7.4%; p=0.012) or history of atrial flutter (17.7% vs. 3.1%; p<0.001). Patients in the CB group had a longer history of AF (3.8±3.5 vs. 3.0±2.9 years; p=0.041), received treatment with AAD more often (60.9% vs. 55.9%; p=0.049) and had longer follow-up time (889±397 vs. 601±239 days; p<0.001). Mean freedom from recurrence was not significantly different between groups (1106 days for CB vs. 889 days for RF; p=0.793), and recurrence rates were also similar (27.8% for CB vs. 23.5% for RF; p=0.291); however, patients treated with CB were more likely to need a redo procedure (38.3% vs. 17.4%; p=0.025). There were no differences in the composite of adverse cardiovascular events or in individual outcomes. Propensity score matching was done, and 154 patients were matched 1:1 for each treatment group. Survival free from recurrence showed no differences (1060 days for CB vs. 864 days for RF; p=0.912), and neither did the recurrence rate. CB patients with recurrence were still more likely to need a redo procedure (37.9% vs. 11.1%; p=0.021).
Conclusion
RF and CB result in similar survival free from AF and AF recurrence; however, recurrence in CB seems more significant, leading to higher rates of redo procedures.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Centro Hospitalar de Vila Nova de Gaia/Espinho
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Affiliation(s)
- P Ribeiro Queiros
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - G Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Teixeira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - H Goncalves
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - N Dias Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Fernandes S, Ladeiras-Lopes R, Faria R, Ferreira W, Carvalho M, Almeida J, Fonseca P, Oliveira M, Goncalves H, Ferreira N, Primo J, Fontes-Carvalho R. Coronary artery calcium in patients with atrial fibrillation undergoing catheter ablation – an opportunity to personalize cardiovascular and thromboembolic risk management. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2470] [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
There is a well-established association between atrial fibrillation (AF) and coronary artery disease (CAD). Coronary artery calcium score (CACS) is a helpful tool to refine cardiovascular risk stratification and guide strategies of cardiovascular (CV) primary prevention.
Purpose
To evaluate the prevalence and clinical implications of CACS in terms of CV and thromboembolic risk stratification and preventive therapies, in patients with AF and atrial flutter (AFL) undergoing catheter ablation.
Methods
Cross-sectional study including patients with AF/AFL undergoing multidetector computed tomography (MDCT) for ablation procedure planning from 2017 to 2019. Baseline clinical and demographical data were collected. CV and thromboembolic risks were evaluated based on the SCORE (Systematic Coronary Risk Evaluation) system and CHA2DS2-VASc score. CACS was assessed in patients without history of coronary artery disease using the Agatston method.
Results
A total of 474 patients were included (441 with AF and 33 with AFL, mean age of 58±10 years, 62% male). Excluding those over 70 years of age (n=50, 11%), most patients had low (n=69, 22%) or moderate (n=188, 60%) CV risk and 277 (64%) patients had a CHA2DS2-VASc score ≥1 (male) or ≥2 (female). Overall, 265 patients (65%) were under chronic anticoagulation and 157 (39%) were under statin therapy. CAC was present in 254 (54%) patients and showed a multivessel distribution in 62% of the cases. The left main stem was affected in 81 (17%) patients and the left anterior descending artery in 211 (45%). Incorporating CACS>100 as a variable in CHA2DS2-VASc score (vascular disease parameter in patients without history of vascular disease) would have resulted in a significant score reclassification (n=87, 20%) and identification of new potential candidates for anticoagulation (n=12, 3%). Additional, anticoagulation would be indicated as a class IA recommendation in more 26 (6%) patients. Twenty three percent of patients with zero calcium were taking statins, and only 7% of patients with a CACS >300 were on high-intensity statin therapy. According to the recommendations and based on their CACS and current therapy, 103 (25%) patients would be candidates for statin therapy and 69 (17%) patients would be candidates for changes in the current statin therapy intensity (Table 1).
Conclusion
In our study, more than half of the patients undergoing MDCT before AF/AFL catheter ablation had coronary calcium above zero. Our findings suggest that an opportunistic evaluation of CACS can be clinically valuable in thromboembolic risk stratification and management of preventive pharmacological strategies such as anticoagulation and statins.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - R Ladeiras-Lopes
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Faria
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - W Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - H Goncalves
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - N Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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