Sergio V. Perrone
Insuf Card 2009;4(4):151.
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Converting enzyme inhibitors and antagonists of angiotensin II receptors in chronic heart failure
Marcos J. Alvarez
The group of drugs consisting of angiotensin converting enzyme inhibitors and angiotensin II receptors antagonists represent a cornerstone in the therapeutic arsenal to overcome the great challenges of chronic heart failure. Some of these challenges are to improve quality of life, slow the progression of the disease and increase survival.
Keywords: Angiotensin receptor antagonists - Converting enzyme inhibitors - Chronic heart failure - Ventricular remodeling
Insuf Card 2009;4(4):152-156.
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Is the presence of wide QRS mandatory for cardiac resynchronization therapy?
Carina Cantale
Heart failure (HF) is the final stage of numerous cardiovascular diseases and is currently a major socio-medical problem. Although drugs and surgical alternatives have achieved an improvement in symptoms and survival, many patients continue to have a low quality of life and a high mortality rate. A substantial proportion of patients with IC (30%) had significant disruptions in inter and intraventricular electrical conduction, leading to asynchronous ventricular contraction, a negative influence on prognosis. Cardiac resynchronization therapy that tries to counteract the effects of conduction disorder is taking a great interest in recent years.
Keywords: Ventricular mechanical asymmetry - Cardioverter - Heart Failure - Wide QRS - Cardiac resynchronization
Insuf Card 2009;4(4): 157-160.
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Digitals and y diuretics in the treatment of chronic heart failure
María Soledad Alvarez
In recent decades, the treatment of heart failure (HF) showed great progress due to a greater understanding of its pathophysiology. Change was such that medical treatment is currently one of the cornerstones of the management of heart failure in addition to surgical and electrical treatments, with increasingly sophisticated devices. Although digitals and diuretics are the older drugs in the treatment of HF, they are still used as a part of the therapeutic arsenal in the era of technological breakthroughs.
Keywords: Digital - Diuretics - Heart Failure
Insuf Card 2009;4(4):161-167.
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Electrical therapy in heart failure
Valentina M. Bichara
Chronic heart failure (CHF) is one of the most prevalent diseases in Western countries, being the third leading cause of death for cardiovascular disease. Proper treatment to prevent structural heart disease, knowledge of neurohormoral-inflammatory mechanism and electrical therapy (cardiac resynchronization therapy -CRT- and implantable cardioverter defibrillator -ICD) in association with optimal medical treatment, are useful tools in this disease. Electrical therapy involves one of the most important advances in the treatment of CHF. The author writes about this theme emphasizing that patients responding to CRT improve quality of life and increase survival. As well as ICD reduces sudden death risk. Taking into account that we need to know better ways to indicate both therapies together, future studies may give us answers about which patients will benefit, achieving a proper cost-benefit to patients and society.
Keywords: Implantable cardioverter defibrillator - Chronic heart failure - Cardiac resynchronization therapy
Insuf Card 2009;4(4):168-176.
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Peripartum cardiomyopathy
Diego Felipe Polanía Ardila, Solón Navarrete Hurtado, Edgar Mariano Acuña Osorio, Rafael Alberto Álvarez Rosero
Peripartum cardiomyopathy is a rare disease. However it presents a high mortality rate, rising even more when diagnosis and treatment are not made early. In 1937 it is described that the cause of heart failure in patients with these characteristics are due to a dilated cardiomyopathy, unlike heart disease caused by the stress of pregnancy. Since then, peripartum cardiomyopathy is recognized as a distinct entity from the rest of cardiomyopathies. The authors aim to make a description of the mechanisms involved in the pathophysiology, clinical manifestations, diagnosis and treatment of this disease.
Keywords: Dilated cardiomiopathy - Epidemiology - Cardiac failure - Genome - Peripartum cardiomiopathy - Virus
Insuf Card 2009;4(4):177-183.
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Peripartum cardiomyopathy
Héctor H. Tacchi
The author gives his opinion on peripartum cardiomyopathy, being a rare or under-diagnosed entity which’s etiology and pathophysiology are still unknown. He also highlights the importance and great update article written by Polanía Ardila et al.
Keywords: Dilated cardiomiopathy - Cardiac failure - Peripartum cardiomiopathy
Insuf Card 2009;4(4):184-185.
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Heart failure and systemic inflammatory response
Alfredo Navigante, Alfredo D’Ortencio
The systemic inflammatory response (SIR) is currently considered as one of the cornerstones of the pathophysiological mechanisms of maintenance of a number of morbid conditions. The authors develop this theme and its relationship with heart failure, considering that although the clinical relevance may be limited, as there are specific treatments for its control, there are subgroups that might benefit by reducing the emerging SIR hipercatabolism through implementation of mixed amino acids nutrition and drugs that are currently on trial.
Palabras clave: Heart failure - Systemic inflammatory response - Systemic immune-metabolic syndrome
Insuf Card 2009;4(4):186-189.
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Cardiac amyloidosis. Findings in cardiovascular magnetic resonance
Bettina Yaman, Mario Embón, Hernán Cohen Arazi, Sergio V. Perrone
Authors present images of cardiac magnetic resonance (CMR) of a 38 years old patient carrying a cardiac amyloidosis with clinic of congestive heart failure. CMR should be considered before the suspected diagnosis of cardiac amyloidosis and may be useful to monitor treatment response.
Keywords: Cardiac amyloidosis - Cardiovascular magnetic resonance - Congestive heart failure - Restrictive cardiomyopathy
Insuf Card 2009;4(4):190-193.
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The importance of the detection of myocardial viability in decision making in advanced dilated isquemic myocadiopathies
Luis Castro, Juan Erriest, Jorge Camilletti
Detection of myocardial viability in patients who have coronary artery disease (CAD) and left ventricular (LV) systolic dysfunction (with either MPI or FDG imaging) is generally regarded as a class I recommendation (level B evidence). LV dysfunction in ischemic heart disease may be due to prior infarct and scar or viable tissue that can be stunned, hibernating, or normal remodeled myocardium. Approximately 70% of CHF is secondary to CAD and a significant number of these patients have myocardial hibernation. Authors present the case of a 51-year-old, hypertensive, dyslipidemic, sedentary, overweight, smoker patient, who exemplifies these concepts.
Keywords: Coronary artery disease - Positron emission tomography - Myocardial viability - SPECT
Insuf Card 2009;4(4):194-200.
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