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Repositório do Hospital Prof. Doutor Fernando Fonseca (3.582 recursos)

The Hospital Prof. Dr. Fernando Fonseca E.P.E. (HFF) institutional repository collects, preserves and disseminates the intellectual output of its professionals in digital format. Its aims are to increase the HFF’s investigation visibility and citation impact, to foster scientific communication and to preserve the HFF’s intellectual memory.

CAR - Artigos

Mostrando recursos 1 - 20 de 41

  1. The Index of Microcirculatory Resistance as a Predictor of Echocardiographic Left Ventricular Performance Recovery in Patients With ST-Elevation Acute Myocardial Infarction Undergoing Successful Primary Angioplasty.

    Faustino, M; Baptista, S; Freitas, A; Monteiro, C; Leal, P; Nédio, M; Antunes, C; Abreu, PF; Gil, V; Morais, C
    BACKGROUND: This study aims to evaluate the relationship between IMR (Index of Microcirculatory Resistance) and the echocardiographic evolution of left ventricular (LV) systolic and diastolic performance after ST-elevation acute myocardial infarction (STEMI), undergoing primary angioplasty (P-PCI). METHODS: IMR was evaluated immediately after P-PCI. Echocardiograms were performed within the first 24 hours (Echo1) and at 3 months (Echo2): LV volumes, ejection fraction (LVEF), wall motion score index (WMSI), E/é ratio, global longitudinal strain (GLS), and left atrial volume were measured. RESULTS: Forty STEMI patients were divided in 2 groups according to median IMR: Group 1 (IMR < 26), with less microvascular dysfunction, and Group 2 (IMR > = 26), with more...

  2. Continuum of Vasodilator Stress From Rest to Contrast Medium to Adenosine Hyperemia for Fractional Flow Reserve Assessment.

    Johnson, N; Jeremias, A; Zimmermann, F; Adjedj, J; Witt, N; Hennigan, B; Koo, B; Maehara, A; Matsumura, M; Barbato, E; Esposito, G; Trimarco, B; Rioufol, G; Park, S; Yang, H; Baptista, S; Chrysant, G; Leone, A; Berry, C; De Bruyne, B; Gould, K; Kirkeeide, R; Oldroyd, K; Pijls, N; Fearon, W
    OBJECTIVES: This study compared the diagnostic performance with adenosine-derived fractional flow reserve (FFR) ≤0.8 of contrast-based FFR (cFFR), resting distal pressure (Pd)/aortic pressure (Pa), and the instantaneous wave-free ratio (iFR). BACKGROUND: FFR objectively identifies lesions that benefit from medical therapy versus revascularization. However, FFR requires maximal vasodilation, usually achieved with adenosine. Radiographic contrast injection causes submaximal coronary hyperemia. Therefore, intracoronary contrast could provide an easy and inexpensive tool for predicting FFR. METHODS: We recruited patients undergoing routine FFR assessment and made paired, repeated measurements of all physiology metrics (Pd/Pa, iFR, cFFR, and FFR). Contrast medium and dose were per local practice, as was the dose...

  3. Arterial tonometry-derived subendocardial viability ratio in coronary artery disease patients: the jury is still out.

    Baptista, S

  4. Endothelial dysfunction evaluated by peripheral arterial tonometry is related with peak TnI values in patients with ST elevation myocardial infarction treated with primary angioplasty

    Baptista, S; Faustino, M; Simões, J; Nédio, M; Monteiro, C; Lourenço, E; Leal, P; Abreu, PF; Gil, V
    PURPOSE: The role of endothelial-dependent function in patients with acute ST elevation myocardial infarction (STEMI) is not clear. Endothelial dysfunction may contribute to the pathophysiological processes occurring after STEMI and influence the extension of myocardial necrosis. Endothelial-dependent dysfunction evaluated by peripheral arterial tonometry (PAT) has already showed to be correlated with microvascular coronary endothelial dysfunction. Our purpose was to evaluate the impact of endothelial dysfunction on peak Troponin I (TnI) values, as a surrogate for the extension of myocardial infarction, in patients with STEMI treated with primary angioplasty (P-PCI). METHODS: 58 patients with STEMI treated with P-PCI (mean age 59.0 ± 14.0 years,...

  5. Percutaneous epicardial access as an alternative approach for catheter ablation of a posteroseptal accessory pathway related to the coronary venous system.

    Faustino, M; Bellotti, H; Hardy, C; Scanavacca, M

  6. Left ventricular pseudoaneurysm: a challenging diagnosis.

    Faustino, M; Ranchordás, S; Abecasis, J; Freitas, A; Ferreira, M; Gil, V; Morais, C; Neves, JP
    Left ventricular pseudoaneurysm is a rare complication of acute myocardial infarction, associated with high mortality. However, it can present in a non-specific manner, complicating and delaying the diagnosis. The authors present the case of a 65-year-old patient, hypertensive, with no other known relevant medical history, who presented with chest pain, cough and left pleural effusion, initially attributed to a pulmonary process. However, these were in fact the result of a left ventricular pseudoaneurysm following silent acute myocardial infarction. The diagnosis was suspected on echocardiography and confirmed by cardiac magnetic resonance imaging, and the patient underwent successful surgical pseudoaneurysm repair. This...

  7. Trends in primary angioplasty in Portugal from 2002 to 2013 according to the Portuguese National Registry of Interventional Cardiology

    Pereira, H; Teles, R; Costa, M; Silva, P; Ribeiro, V; Brandão, V; Martins, D; Matias, F; Pereira-Machado, F; Baptista, J; Abreu, PF; Santos, R; Drummond, A; Carvalho, H; Calisto, J; Silva, J; Pipa, J; Marques, J; Sousa, P; Fernandes, R; Ferreira, R; Ramos, S; Oliveira, E; Almeida, M
    Introduction and Objectives: The aim of the present paper was to report trends in coronary angioplasty for the treatment of ST-elevation myocardial infarction (STEMI) in Portugal. Methods: Prospective multicenter data from the Portuguese National Registry of Interventional Cardiology (RNCI) and official data from the Directorate-General for Health (DGS) were studied to analyze percutaneous coronary intervention (PCI) procedures for STEMI from 2002 to 2013. Results: In 2013, 3524 primary percutaneous coronary intervention (p-PCI) procedures were performed (25% of all procedures), an increase of 315% in comparison to 2002 (16% of all interventions). Between 2002 and 2013 the rate increased from 106 to 338 p-PCIs per mil- lion population per...

  8. Impact of Routine Fractional Flow Reserve Evaluation During Coronary Angiography on Management Strategy and Clinical Outcome: One-Year Results of the POST-IT.

    Baptista, S; Raposo, L; Santos, L; Ramos, R; Calé, R; Jorge, E; Machado, C; Costa, M; Oliveira, E; Costa, J; Pipa, J; Fonseca, N; Guardado, J; Silva, B; Sousa, MJ; Silva, JC; Rodrigues, A; Seca, L; Fernandes, R
    Penetration of fractional flow reserve (FFR) in clinical practice varies extensively, and the applicability of results from randomized trials is understudied. We describe the extent to which the information gained from routine FFR affects patient management strategy and clinical outcome. METHODS AND RESULTS: Nonselected patients undergoing coronary angiography, in which at least 1 lesion was interrogated by FFR, were prospectively enrolled in a multicenter registry. FFR-driven change in management strategy (medical therapy, revascularization, or additional stress imaging) was assessed per-lesion and per-patient, and the agreement between final and initial strategies was recorded. Cardiovascular death, myocardial infarction, or unplanned revascularization (MACE) at 1...

  9. Angioplastia primária em Portugal entre 2002-2013. Atividade segundo o Registo Nacional de Cardiologia de Intervenção

    Pereira, H; Teles, R; Costa, M; Silva, P; Ribeiro, V; Brandão, V; Martins, D; Matias, F; Pereira-Machado, F; Baptista, J; Abreu, PF; Santos, R; Drummond, A; Carvalho, H; Calisto, J; Silva, JC; Pipa, JL; Marques, J; Sousa, P; Fernandes, R; Ferreira, R; Ramos, S; Oliveira, E; Almeida, M; Registo Nacional de Cardiologia de Intervenção
    Introdução e objectivos: Foi nosso objectivo reportar a evolução da angioplastia coronária no tratamento do enfarte agudo do miocárdio com supradesnivelamento do segmento ST (EAMCST), entre 2002-2013. Métodos: Os dados prospectivos multicêntricos do Registo Nacional de Cardiologia de Intervenção (RNCI) e os dados oficiais da Direção Geral de Saúde (DGS) foram conjugados para estudar os procedimentos no EAMCST entre 2002 e 2013. Resultados: Em 2013 realizaram-se 3524 angioplastias primárias (ICP-P), representando um crescimento de 315% relativamente ao ano 2002. Em 2002 a ICP-P representava 16% do total de angioplastias coronárias, passando a representar 25% nos anos de 2012-2013. Entre 2002-2013 o número...

  10. O papel do eletrocardiograma no diagnóstico da Miocardiopatia Takotsubo

    Crespo, R; Paulino, R; Bernardo, R; Raposo, N
    A Miocardiopatia Takotsubo (MT) ocorre maioritariamente em doentes idosos do género feminino, com associação causal a fatores de stress emocional ou físico. O stress poderá provocar elevações nos níveis de catecolaminas e hiperexpressividade do sistema nervoso simpático, resultando num quadro semelhante a stunning miocárdico neurogénico, onde ocorre “balonamento” dos segmentos meso‐apicais do ventrículo esquerdo (VE). Este traduz‐se em alterações da cinética das paredes do VE e é identificado por ecocardiografia ou ventriculografia. A coronariografia, tipicamente, revela ausência de estenose superior a 50%, oclusões do lúmen ou rutura de placa, mas a apresentação clínica na fase aguda é sugestiva de Síndrome Coronário Agudo (SCA) e o eletrocardiograma (ECG)...

  11. Satisfação dos doentes portadores de CDI e CRT­‐D com seguimento remoto  

    Pereira, R; Morujo, N; Raposo, N
    Introdução: A monitorização remota (MR) apresenta diversas vantagens sendo uma delas o aumento do nível de satisfação dos doentes, utilizada como medida par avaliar os programas de seguimento remoto. Objetivo: Avaliar a satisfação dos doentes portadores de CDI ou CRT-D que realizem consulta de monitorização/seguimento remoto. Metodologia: Estudo observacional, descritivo e analítico com componente transversal. A recolha dos dados foi realizada telefonicamente, através da implementação de um questionário validado e adaptado aos objectivos do presente estudo durante o período compreendido entre 11 de março e 4 de abril de 2014. As questões foram essencialmente de resposta fechada, recaindo sobre a...

  12. Evolução da intervenção coronária percutânea entre 2004-2013. Atividade em Portugal segundo o Registo Nacional de Cardiologia de Intervenção

    Pereira, H; Teles, R; Costac, M; Silva, P; Ferreira, R; Ribeiro, V; Santos, R; Abreu, PF, et al.
    Introducção e objetivos: Foi nosso objetivo estudar as tendências da intervencção coronária percutânea entre 2004-2013 e comparar Portugal com outros países europeus. Métodos: Análise dos procedimentos coronários efetuados entre 2004-2013 com base num registo prospetivo, multicêntrico, voluntário, doente a doente --- Registo Nacional de Cardiologia de Intervenc¸ão (RNCI) da Associac¸ão Portuguesa de Intervenc¸ão Cardiovascular da Sociedade Portuguesa de Cardiologia (APIC-SPC) --- e dos dados oficiais publicados pela Direc¸ão Geral de Saúde (DGS). Resultados: Em 2013 realizaram-se 36 810 cateterismos diagnósticos (3529 coronariografias por milhão de habitantes), representando um aumento significativo de 34% relativamente ao ano de 2007 (p < 0,001). As intervenc¸ões coronárias percutâneas (ICP) cresceram 64% desde 2004, atingindo...

  13. Evolução da intervenção coronária percutânea entre 2004‐2013. Atividade em Portugal segundo o Registo Nacional de Cardiologia de Intervenção

    Pereira, H; Teles, R; Costa, M; Silva, P; Ferreira, R; Ribeiro, V; Santos, R; Abreu, PF; Carvalho, H; Marques, J; Fernandes, R; Brandão, V; Martins, D; Drummond, A; Pipa, J; Seca, L; Calisto, J; Baptista, J; Matias, F; Ramos, J; Pereira-Machado, F; Silva, J; Almeida, M; Registo Nacional de Cardiologia de Intervenção
    INTRODUCTION AND OBJECTIVES: The aim of the present paper is to report trends in Portuguese interventional cardiology from 2004 to 2013 and to compare them with other European countries. METHODS: Based on the Portuguese National Registry of Interventional Cardiology and on official data from the Directorate-General of Health, we give an overview of developments in coronary interventions from 2004 to 2013. RESULTS: In 2013, 36 810 diagnostic catheterization procedures were performed, representing an increase of 34% compared to 2007 and a rate of 3529 coronary angiograms per million population. Coronary interventions increased by 65% in the decade from 2004 to 2013, with a total of...

  14. The multi-modality cardiac imaging approach to the Athlete's heart: an expert consensus of the European Association of Cardiovascular Imaging.

    Galderisi, M; Cardim, N; D'Andrea, A; Bruder, O; Cosyns, B; Davin, L; Donal, E; Edvardsen, T; Freitas, A; Habib, G, e outros
    The term 'athlete's heart' refers to a clinical picture characterized by a slow heart rate and enlargement of the heart. A multi-modality imaging approach to the athlete's heart aims to differentiate physiological changes due to intensive training in the athlete's heart from serious cardiac diseases with similar morphological features. Imaging assessment of the athlete's heart should begin with a thorough echocardiographic examination.Left ventricular (LV) wall thickness by echocardiography can contribute to the distinction between athlete's LV hypertrophy and hypertrophic cardiomyopathy (HCM). LV end-diastolic diameter becomes larger (>55 mm) than the normal limits only in end-stage HCM patients when the LV...

  15. Symptomatic charcoal heart

    Faustino, M; Abecasis, J; Freitas, A; Gouveia, R; Gil, V

  16. Role of multimodality cardiac imaging in the management of patients with hypertrophic cardiomyopathy: an expert consensus of the European Association of Cardiovascular Imaging Endorsed by the Saudi Heart Association.

    Cardim, N; Galderisi, M; Edvardsen, T; Plein, S; Popescu, BA; D'Andrea, A; Bruder O, O; Cosyns, B; Davin, L; Donal, E; Freitas, A; Habib, G, e outros
    Taking into account the complexity and limitations of clinical assessment in hypertrophic cardiomyopathy (HCM), imaging techniques play an essential role in the evaluation of patients with this disease. Thus, in HCM patients, imaging provides solutions for most clinical needs, from diagnosis to prognosis and risk stratification, from anatomical and functional assessment to ischaemia detection, from metabolic evaluation to monitoring of treatment modalities, from staging and clinical profiles to follow-up, and from family screening and preclinical diagnosis to differential diagnosis. Accordingly, a multimodality imaging (MMI) approach (including echocardiography, cardiac magnetic resonance, cardiac computed tomography, and cardiac nuclear imaging) is encouraged in...

  17. Constrictive Pericarditis: A Challenging Diagnosis in Paediatrics

    Faustino, M; Mendes, I; Anjos, R
    Constrictive pericarditis is an uncommon disease in children, usually difficult to diagnose. We present the case of a 14-year-old boy with a previous history of tuberculosis and right heart failure, in whom constrictive pericarditis was diagnosed. The case highlights the need to integrate all information, including clinical data, noninvasive cardiac imaging, and even invasive hemodynamic evaluation when required, in order to establish the correct diagnosis and proceed to surgical treatment.

  18. An inappropriate defibrillator shock during ventricular tachycardia.

    Faustino, M; Madeira, F; Morais, C
    Ventricular oversensing in patients with defibrillators is an infrequent but deleterious condition. We report a patient with a cardiac resynchronization-defibrillation device that presented with hyperkalemia and syncope. Device interrogation revealed ventricular double-counting within the QRS of a slow ventricular tachycardia, resulting detection of the slow ventricular tachycardia in the ventricular fibrillation zone, and delivery of an effective therapy, below device programmed detection rate. This case of defibrillator inappropriate detection emphasizes the relevance of device electrogram interrogation in order to minimize inappropriate therapies.

  19. Saúde para todos: especialidades: cooperação portuguesa com São Tomé e Príncipe na área da cardiologia

    Loureiro, J; Freitas, A; Antunes, C
    A estrutura e o trabalho desenvolvido pelo Instituto Marquês de Valle Flõr (IMVF) no campo da cooperação na área da saúde em São Tomé e Príncipe foi descrita em número anterior da Revista Clínica do Hospital Prof. Doutor Fernando Fonseca. Neste artigo, pretende-se descrever o contributo da cardiologia no âmbito do programa Saúde para Todos – Especialidades, lançado pelo IMVF em 2010.

  20. Ecocardiografia de sobrecarga no enfarte do miocárdio

    Mota, P
    Nos doentes com enfarte do miocárdio recente, os principais determinantes de prognóstico são: a extensão da necrose transmural, o estado da artéria relacionada com o enfarte e a presença e extensão de miocárdio em risco. A utilização da ecocardiografia de sobrecarga pressupõe que a sobrecarga farmacológica induz isquemia miocárdica a qual provoca alteração da motilidade segmentar. Esta dissinergia é um marcador precoce, sensível e específico de isquemia miocárdi ca. A infusão de dobutamina permite avaliar a resposta contráctil do miocárdio. Em baixas doses dá-nos informação sobre a reserva contráctil e, inerentemente, viabilidade. Sob doses elevadas de dobutamina a função sistólica torna-se dependente da capacidade da árvore coronária...

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