Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology
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Echocardiography (echo) has gained increasing importance in cardiology as technological developments have enabled progression from one-dimensional to two-dimensional imaging and the inclusion of physiological information with the Doppler principle. Although three-dimensional (3D) echo is not a new concept, its use has been limited by image artifacts and the need for time-consuming offline processing. Despite several improvements since its introduction in the 1990s, real-time 3D echo was until 2007 limited to transthoracic studies, but a real-time 3D transesophageal (TE) echo probe has recently become commercially available. The objective of this article is to describe our initial experience with this probe, to assess its ability to visualize different cardiac structures and to discuss its advantages and shortcomings. ⋯ After a relatively short training period and without prolonging the study time significantly, we were able to visualize the various components of the mitral valve clearly and identify its anatomical relations; in our initial experience, this was the major advantage of the technique, which will probably become the gold standard for preoperative evaluation of mitral valve disease. Programming and guiding ASD closure is another promising area for 3D TE echo. On the other hand, imaging of anterior cardiac structures is poor and needs refinement.
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Hypertension (HT) is the most common modifiable risk factor for cardiovascular disease, and HT management and control is of major importance in preventive strategies. However, patterns of antihypertensive (AHT) treatment have never been evaluated in Portugal. ⋯ There is considerable regional variation in treatment patterns. The proportion of hypertensive patients under monotherapy is still very high. Increasing the use of combination antihypertensive therapy would probably improve HT control in the population. Furthermore, increased use of CCBs would probably also be useful, as they are used less than would be expected, compared to other European countries.
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Prognostic impact of hemoglobin drop during hospital stay in patients with acute coronary syndromes.
Bleeding is currently the most common non-cardiac complication of therapy in patients with acute coronary syndromes (ACS), and may itself be associated with adverse outcomes. The aim of this study was to determine the effect of hemoglobin drop during hospital stay on outcome among patients with ACS. ⋯ A decrease in hemoglobin frequently occurs during hospitalization for ACS and is independently associated with adverse outcomes.
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Multicenter Study Clinical Trial
Effectiveness and safety of levosimendan in clinical practice.
In previous randomized studies levosimendan improved hemodynamics and clinical course, with a still unclear effect on prognosis. There are, however, few data regarding its effects when used in daily practice. ⋯ In daily practice, levosimendan was clinically effective and safe in 80.6% and 79.7% of patients with acute SHF at 24 hours and 5 days respectively after the beginning of treatment. A marked reduction in the number of days of hospitalization for heart failure was also seen during the subsequent six months.