Valvopatia aórtica crônica grave sintomática: estudo comparado da ressonância magnética cardíaca e ecocardiografia

Nigri, Marcelo; Rochitte, Carlos Eduardo; Tarasoutchi, Flávio; Spina, Guilherme Sobreira; Parga, José R.; Ávila, Luiz Francisco; Sampaio, Roney Orismar; Ramires, José Antônio Franchini; Grinberg, Max

doi:10.1590/s0066-782x2006000200011

Cited by 1 publication

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“…And what would be the optimal time for surgical correction of aortic regurgitation? This is a subject of enormous interest, for which morphological indexes would be very useful 13,14 .…”

Section: Study Associationmentioning

confidence: 99%

Situação atual do tratamento da insuficiência cardíaca no Brasil

Mady¹

2007

Arq. Bras. Cardiol.

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Heart failure has been addressed with increasingly frequency in symposia, congresses and researches because of its very high incidence, morbidity and mortality. The number of individuals with heart failure is about 23 million worldwide, with two million new cases each year. In Brazil, according to the IBGE (Instituto Brasileiro de Geografia e Estatística -Brazilian Institute of Geography and Statistics), the population in 2007 will be of almost 190 million, seven million of which with this syndrome 1 . The number of new patients has been growing despite the increasingly greater advances in treatment. And what would be the causes to explain this fact? There are attempts to explain it by the increase in population survival, as well as by the increase in industrialization and urbanization of countries in constant development. As a consequence, there is a deterioration of eating habits and an increase in the incidence of sedentary lifestyle, stress and smoking, thus leading to an increased incidence of artery diseases, diabetes mellitus and hypertension, which are potential causes of heart failure. To make this situation even worse, high rates of individuals with Chagas disease and rheumatic disease are still seen in our country. In parallel, there is a decrease in the number of hospital admissions and an increase in in-hospital deaths, facts that are explained by a decrease in hospital bed supply and increased severity of cases hospitalized [2][3][4] . For decades, researchers have struggled to diminish morbidity, mortality and costs of this syndrome. New agents, surgical therapeutic approaches, devices, and multiprofessional clinics have been introduced in the clinical practice. What are the results of this huge endeavor, and what is the cost-benefit ratio for society?When the impact of the use of medications on mortality is analyzed, the conclusion is not favorable. The new agents available in the market had positive results on death rates, albeit modest. This was predictable. For instance, the analysis of the original graphs of the CONSENSUS study (Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study 5 ), published two decades ago, shows an evident drop in mortality in the group treated; however, when we pay attention to the values and compare the treatment group with the placebo group, the numerical difference is small.The use of angiotensin converting enzyme inhibitors brought an unquestionable benefit, but unfortunately the cost-benefit ratio was not as favorable.We addressed this issue at that time in several symposia and lectures, and the discussions were always heated; there was great resistance to accept this argument. It was the beginning of a new stage in the treatment of heart failure, in which the neurohormonal axis was being directly approached. Studies conducted later corroborated these results. The RALES 6 study, which showed a drop in mortality of patients with heart failure receiving spironolactone, was also q...

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“…And what would be the optimal time for surgical correction of aortic regurgitation? This is a subject of enormous interest, for which morphological indexes would be very useful 13,14 .…”

Section: Study Associationmentioning

confidence: 99%

Situação atual do tratamento da insuficiência cardíaca no Brasil

Mady¹

2007

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

show abstract

Valvopatia aórtica crônica grave sintomática: estudo comparado da ressonância magnética cardíaca e ecocardiografia

Abstract: CMRI data were in agreement with ECHO data regarding the assessment of left ventricular volume and ejection fraction, and with the clinical presentation of patients with chronic aortic valve disease.

Cited by 1 publication

References 20 publications

Situação atual do tratamento da insuficiência cardíaca no Brasil

Situação atual do tratamento da insuficiência cardíaca no Brasil

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