Escore de Cálcio ou Espessura das carótidas: Quem vê Cálcio não vê Coração 3

Carotid artery intima-media thickness, but not coronary artery calcium, predicts coronary vascular resistance in patients evaluated for coronary artery disease
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AQUI
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We evaluated 120 patients (mean age 56 ± 9 years, 58 men) without a documented history of CAD in whom obstructive CAD was excluded by means of invasive coronary angiography (ICA) or computed tomography coronary angiography (CTCA). All patients underwent C-IMT measurements, CAC scoring, and vasodilator stress 15O-water PET/CT, during which the coronary flow reserve (CFR) and minimal CVR were analyzed.
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Multivariable regression analysis revealed that C-IMT (p = 0.03), male gender (p < 0.001), age (p < 0.01), and BMI (p < 0.01) were independently associated with minimal CVR. . C-IMT, but not CAC score, independently predicts minimal CVR in patients with multiple cardiovascular risk factors and suspected of CAD.
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Ressincronização: Clínica x Eco ou Clínica + Eco?


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Aqui
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The clinical and echocardiographic responses to CRT were defined based on clinical improvement (≥1 NYHA class) and LV reverse remodelling (reduction in LV end-systolic volume ≥15%) at 6-month follow-up, respectively.
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only echocardiographic response to CRT was independently associated with superior survival (hazard ratio: 0.38; 95% CI: 0.27–0.50; P < 0.001).
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A complete two-dimensional and colour Doppler echocardiographic examination was performed. LV end-diastolic (LVEDV) and LVESV were calculated using Simpson’s biplane method of discs. The LV ejection fraction was calculated and expressed as a percentage.
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Conclusion In a large population of heart failure patients treated with CRT, the reduction in LV end-systolic volume at the mid-term follow-up demonstrated to be a better predictor of long-term survival than improvement in the clinical status.
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Frequentemente criticamos a metodologia de Simpson para avaliar vantagens da ressincronização. Aqui usaram o volume sistólico final para encontrar benefício. Ainda aguardamos estudos com 3D e volume verdadeiro para acreditarmos.

Rodrigo, a onda a´serve para alguma coisa!!!!!

Estimation of left atrial blood stasis using diastolic late mitral annular velocity
Eur Heart J Cardiovasc Imaging (2012)
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Diastolic late mitral annular velocity (a′) measured by transthoracic echocardiography (TTE) is reported to represent left atrial (LA) pump function and the severity of LA remodelling. The purpose of this study is to investigate the association between a′ and LA blood stasis in patients with non-valvular paroxysmal atrial fibrillation.
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Receiver-operating characteristic curve analysis showed that the best cut-off value of a′ was 7.0 cm/s for the prediction of SEC with a sensitivity of 80%, specificity of 81%, and predictive accuracy of 80%. Multivariate analysis revealed that decreased a′ (OR = 0.61, P = 0.0026) was independently associated with SEC.
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Conclusion Decreased a′ may be a useful parameter for the estimation of LA blood stasis in patients with paroxysmal atrial fibrillation.
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Um aluno do ecocardiograma da UNICAMP fez prova prática com o Rodrigo em SP. Como sempre, foi muito bem recebido e conduzido. Durante o exame, ele perguntou ao aluno qual seria a utilidade de medir a onda a´?
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Gostei muito da pergunta, apesar de não saber responder. O estudo acima prova que temos sim, uso racional para a medida da onda tecidual a´.

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