CONTENTS

EDITORIAL
Sergio V. Perrone
Insuf Card 2010;5(3):103.
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ALGORITHM
Acute decompensated heart failure treatment
Insuf Card 2010;5(3):104.
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ORIGINAL ARTICLES
Role of peritoneal dialysis in the treatment of heart failure
Emilio Sánchez, Carmen Rodríguez, Teresa Ortega, Beatriz Díaz Molina, Carmen García Cueto
Heart failure (HF) is a progressive disorder even with adequate treatment. Fluid removal may aid in the management of these patients. Authors evaluated the efficacy of peritoneal dialysis (PD) in the treatment of refractory HF, concluding that it is a good option since it improves functional status and quality of life, reduces morbidity, mortality and health care costs.
Keywords: Heart failure - Peritoneal dialysis - Diuretics - Ultrafiltration - Quality of life - Cost-utility
Insuf Card 2010;5(3):105-112.
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Evaluation of left ventricular systolic function in young and its variation according to ventricular geometry
Jorge Luis Bocián, Irene Ennis, Oscar A. Pinilla, Eduardo Escudero
Changes in left ventricular (LV) geometry in younger patients and if these, even if subclinical produce alterations in systolic function (SF), have not been evaluated. This study enrolled students from the Department of Physiology and Biological Physics, Faculty of Medical Sciences of the Universidad Nacional de La Plata (UNLP). Its results allow to conclude that the deterioration of systolic function that occurs in the progress of LVH would be detected much earlier by the Slat wave than by the VMWS/STRESS, reflecting this early involvement of the longitudinal fibers when compared with the transverse fibers.
Keywords: Left ventricular hypertrophy - Echocardiography - Tissue Doppler - Systolic function - Concentric remodeling - Left ventricular geometry
Insuf Card 2010;5(3):113-119.
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Is evidence-based treatment in patients with heart failure due to systolic dysfunction used?
Raúl Capece, Beatriz Santoro, Silvia Mosca, José Borgo
This study was designed to assess pharmacological evidence-based-treatment before admission in patients with heart failure (HF) due to systolic dysfunction, New York Heart Association functional class (FC) III/IV who are hospitalized at Coronary Unit. Comparisons within admission group and treatment group at discharge only showed statistically significant differences about beta blocker indication. Based on evidence, HF outpatients pharmacological treatment is less optimal, and tolerability to a mayor use of drugs with high impact in morbidity and mortality does not constitute a limitation to its use.
Keywords: Heart failure - Pharmacological treatment - Systolic dysfunction
Insuf Card 2010;5(3):120-125.
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PULMONARY HYPERTENSION - TRIAL PROTOCOL
Design of the HINPULSAR Registry (HIpertensióN PULmonar y aSociaciones en la ARgentina)
Pulmonary hypertension and associations in Argentina
Comité de Insuficiencia Cardíaca e Hipertensión Pulmonar. Federación Argentina de Cardiología.
Pulmonary arterial hypertension (PAH) is a disease with low prevalence, but with a poor prognosis. The Argentinean Federation of Cardiology provides the adequate support to developing a national survey to attempt answering relevant questions related to PH in our country: epidemiology, clinical profile, diagnostic and management strategies, referral pattern, treatment and prognosis.
Keywords: Pulmonary arterial hypertension - Pulmonary hypertension - Registry
Insuf Card 2010;5(3):126-131.
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PHARMACOLOGICAL UPDATE
SHIFT trial. A SHIFT in the treatment of heart failure
Sergio V. Perrone
Despite the progress made in the treatment of heart failure, it remains associated with high morbidity and mortality. Several studies link elevated heart rate to cardiac remodeling and increased morbidity and mortality with a higher incidence of cardiovascular events. The study SHIFT (Systolic Heart failure Treatment with the I_f inhibitor ivabradine Trial) allowed us to evaluate the effects of ivabradine versus placebo in patients with heart failure due to left ventricular dysfunction with a baseline heart rate> 70 beats/minute in functional class II to IV of the New York Heart Association. This study showed that the addition of ivabradine in patients with low ejection fraction, heart rate ≥ 70 beats per minute and sinus rhythm is associated with a significant reduction in mortality. SHIFT study contributed to a shift in the way we see the heart failure.
Keywords: Study SHIFT - Ivabradine - Heart failure - Left ventricular dysfunction - Heart rate
Insuf Card 2010;5(3):132-136.
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CARDIOMETABOLISM
Metabolic syndrome: what should we know about metabolic syndrome in our daily practice?
Gustavo H. Cerezo
Metabolic syndrome (MS) or insulin resistance syndrome is a clinical setting characterized by a constellation of risk factors for cardiovascular disease and the development of diabetes mellitus type two, and has a high prevalence worldwide and it is growing. This synthetic review aims to bring essential knowledge to practitioners about a clinical setting with a great epidemiological and individual importance, in order to assist our patients to break the vicious circle that represents the MS, because if this does not happen, our patients sooner or later result in severe complications that compromise their quality and quantity of life.
Keywords: Metabolic syndrome - Insulin resistance syndrome - Risk factors - Cardiovascular disease - Diabetes mellitus type 2
Insuf Card 2010;5(3):137-143.
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HEART FAILURE INTERCONSULT
What to do when anemia stands in chronic heart failure?
Marcos J. Alvarez
Anemia is an independent risk factor of mortality and morbidity in chronic heart failure, so its correction improves survival in these patients. It is often presented as mixed aetiological forms which makes difficult our reach to a diagnosis and then find the specific treatment. While we can now define some guidelines like: rule out common causes of anemia (gastrointestinal losses), evaluate iron deposits and use erythropoietin in a select group of patients, there is still no consensus on the heart failure guidelines.
Keywords: Heart failure - Anemic syndrome - Erythropoietin
Insuf Card 2010;5(3):144-149.
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CLINICAL CASE
High output cardiac failure by congenital arteriovenous fistula. Parkes Weber Syndrome
Agustín Picolini, Adrián Carlessi, Guillermo Heredia, Víctor Moles, Hernán Molinas, Emilio Alaguibe
Report of a case of a young patient with congenital arteriovenous fistula in the right upper limb, which evolves with elephantiasis of the affected limb, dilated cardiomyopathy and high output heart failure. With the surgical treatment failure (fistula ligation), we decided the fistulas embolization.
Keywords: High output cardiac failure - Arteriovenous fistula - Parkes Weber syndrome
Insuf Card 2010;5(3):150-153.
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