CONTENTS

EDITORIAL
Raúl J. Bevacqua
Insuf Card 2010;5(1):1.
Full text - PDF

ALGORITHM
Pulmonary hypertension - Diagnosis
Insuf Card 2010;5(1):2.
Full text - PDF

UPDATE ARTICLE
What is the role of neurohormonal system in heart failure with preserved ejection fraction?
Enrique Alonso, Enrique Alonso (h)
The role of neurohormonal system (NHS) in the pathophysiology of systolic heart failure (SHF) is transcendental. However, their participation in heart failure with preserved ejection fraction (HFpEF) is not fully clear, since the data is provided from observational studies in patients with SHF. Small studies have shown that the degree of activation of SNH in the HFpEF is lower than in the SHF. Experimental models of hypertensive heart disease showed the active involvement of NHS in the progression of cardiac hypertrophy to SHF.
Keywords: Heart failure with preserved ejection fraction - Sympathetic nervous system - Neurohormonal system - Renin-angiotensin-aldosterone system - Natriuretic peptide
Insuf Card 2010;5(1):3-10.
Full text - PDF

ORIGINAL ARTICLE
Left ventricular hypertrophy not always reverts with the decrease in blood pressure
Daniel Piskorz, Alicia Tommasi
In hypertensive patients it is considered that a fall in blood pressure values is necessary to achieve the regression of target organ damage. The aim of this study is to determine the effect obtained with decreasing blood pressure in hypertensive patients on left ventricular hypertrophy in a specialized clinic. Concluding that 36.6% of patients who normalized blood pressure did not reach a normal left ventricular mass index in 2 years of follow up; 50% of patients who did not normalize their blood pressure reached a normal left ventricular mass, and that variables different from blood pressure levels achieved by the treatment may be involved in the regression of target organ damage.
Keywords: Arterial hypertension - Therapeutic goals - Regression - Ventricular hypertrophy
Insuf Card 2010;5(1):11-16.
Full text - PDF

EXPERTS’ REVIEW
Sudden death in sport. Legal aspects on prevention
América Pérez, Miguel Resnik, Jorge González Zuelgaray
Prevention of sudden death during sports promotes only transient concern in the majority of countries when an athlete dies in the field. Currently, it is difficult to accept the absence of a consensus-based systematic approach which balances the need to prevent these dramatic deaths with the availability of resources. Authors analyzes legal aspects and takes the Italian regulation (the only one endorsed by long-term results) as a model for a local proposal.
Keywords: Sudden death - Sports - Legal aspects
Insuf Card 2010;5(1):17-24.
Full text -PDF

OPINION ARTICLE
The "Continuum" of heart failure
Lilia Luz Lobo Márquez
The different phenotypes of heart failure are not only the result of the interplay neurohormonal, hemodynamics and inflammation, but chronic or acute activation of these systems on substrates ventricular defined (purely failures or purely systolic diastolic) determine a particular type of clinical and pathophysiological presentation. In addition, external factors modifiable and not modifiable could determine a particular phenotype. Each type of heart failure is the result of a combination of factors ranging from a certain genotype to phenotype, influenced by these new circumstances that may be modulating this scenario. Advances in physiopathology have no doubt, a great therapeutic impact.
Keywords: Heart failure - Genotype - Phenotype - Hemodynamics - Neurohormonal - Inflammation
Insuf Card 2010;5(1):25-31.
Full text - PDF

PULMONARY HYPERTENSION
Sildenafil for everyone?
Rodolfo Juan Sarjanovich, Luis Lema
Throughout history progress has been made in understanding the pathophysiological mechanisms that cause pulmonary hypertension. However, all applied pharmacology to improve the quality of life and survival of these patients has only been tested in patients in group I with the exclusion of other patients. Epidemiological data tell us that the vast majority of patients with pulmonary arterial hypertension belong to groups II, III and IV, where these drugs have not been tested. Even though authors ground that Sildenafil is a mainstay treatment for their performance and for being easily accessible for patients and physicians.
Keywords: Pulmonary hypertension - Sildenafil - Chronic obstructive pulmonary disease - Heart failure - Chronic thromboembolism
Insuf Card 2010;5(1):32-41.
Full text - PDF

CLINICAL CASE
Cor triatriatum sinister. Report of a case
Federico Gerardo Barbaglia, Martín José Casanova, Ramón Adrián Araujo, Jorge Isaac Tazar
Cor triatriaum sinister is a very rare cause of pulmonary venous hypertension and congestive heart failure, with a reported incidence of 0.1% of children with congenital heart defects. Authors report the case of a 43 year old hypertensive woman with a history of direct closure of ASD 8 months ago. During the execution of a transesophageal echocardiography, consistent findings with cor triatriatum were observed.
Keywords: Cor triatriatum sinister - Atrial septal defect - Atrial flutter - Transesophageal echocardiogram - Surgical resolution
Insuf Card 2010;5(1):42-47.
Full text - PDF

IN MEMORIAM
Florencio Garófalo, MD
Juan Carlos Linares Casas
Insuf Card 2010;5(1):48.
Full text - PDF