Sickle cell anemia is the most prevalent hereditary hematological disease with high morbidity and mortality rates worldwide. Cardiac involvement and cardiomyopathy are frequent manifestations of ...sickle cell anemia. Echocardiographic analysis using tissue Doppler and speckle tracking is an important tool for assessing cardiac functions.
This study aimed to determine cardiac function alterations in patients with sickle cell anemia and sickle cell traits to assess the usefulness of new echocardiographic techniques for the early detection of myocardial dysfunction in this disease. A systematic review was carried out using PubMed, Scientific Electronic Library Online, and Latin American and Caribbean Health Sciences Literature databases based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology and Population, Intervention, Control, and Outcomes criteria. Original cohort, case-control, cross-sectional, and case series articles published between December 1999 and March 2023 were analyzed.
Echocardiographic studies have focused on identifying the impact of ventricular systolic and diastolic performance on this disease. The studies analyzed in the current systematic review suggest intrinsic myocardial abnormalities in patients with sickle cell anemia, which may indicate early signs of cardiac involvement in young individuals.
•New technologies are extremely useful in the preclinical detection of cardiac involvement in systemic diseases.
Introduction: The knowledge on High-Output Cardiac Failure (HOCF) has greatly improvedin the last two decades. One of the advances was the identification of a new phenotype ofHOCF, characterized by ...the absence of ventricular dilation, already associated with liver disease,Arteriovenous Fistulas (AVF), lung disease, myelodysplastic syndromes, and obesity. However, ithas been noted that any aetiology can present with one of the two phenotypes, depending on theevolution. Objective: The study aims to describe, through an integrative review, the physiopathology and aetiologiesof HOCF and to discuss phenotypes associated with this condition. Methods: Revisions, guidelines, case-controls, cohort studies and clinical studies were searched inMEDLINE and LILACS, using the connectives in the “cardiac output, high” database (MeSHTerms) OR “high cardiac output” (All Fields). Discussion: Two distinct phenotypes are currently described in the HOCF, regardless of the aetiology:1) one with enlarged cardiac chambers; and 2) with normal heart chambers. The mechanisms relatedto HOCF are vasodilation, arteriovenous shunts that cause increased microvascular density,Reduced Systemic Vascular Resistance (RSVR), and high metabolism. These mechanisms lead toactivation of the renin-angiotensin-aldosterone system, sodium and water retention, activation ofneprilysin, of the sodium-glucose-2 transporter, which promote interstitial fibrosis, ventricular remodelingand a consequent increase in cardiac output >8L/min. Conclusion: Many aetiologies of HOCF have been described, and some of them are potentially curable.Prompt recognition of this condition and proper treatment may lead to better outcomes.
Hypertension in patients with cancer Souza, Vinicius Barbosa de; Silva, Eduardo Nani; Ribeiro, Mario Luiz ...
Arquivos Brasileiros de Cardiologia,
03/2015, Volume:
104, Issue:
3
Journal Article
Peer reviewed
Open access
There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this ...association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality.
Population aging is a worldwide phenomenon associated with physiological and metabolic changes that contribute to the increased prevalence of risk factors for cardiovascular disease. The phase angle ...(PA) is a variable calculated by bioelectrical impedance analysis, interpreted as a direct measure of cell stability. The objective of the present study was to investigate the correlation of PA with the anthropometric measures, metabolic profile and the cardiovascular risk estimated by the Global Cardiovascular Risk Score in the elderly population.
A cross-sectional study was carried out with 402 patients aged >60 years (70.4 ± 6.9 years, 74% female) treated in primary care. Patients were evaluated by blood pressure, anthropometric measurements and body composition. The score of the risk and the stratification of the cardiovascular risk were calculated using the criteria from the Framingham Heart Study.
Age, systolic blood pressure, neck circumference and fat-free mass correlated with PA in female patients. In men, age and systolic blood pressure were the variables that correlated with the PA in the bivariate analysis. In the multiple linear regression, for the female group the risk score presented an independent variation with PA (P = 0.051) and age (P < 0.0001). The same correlation was observed for the male group both for PA (P = 0.042) and age (P < 0.0001).
The present data show an independent association of PA with overall cardiovascular risk in the elderly population. Geriatr Gerontol Int 2018; 18: 732-737.
Introduction
Breast Cancer (BC) is a neoplasm with the highest prevalence in women in Brazil and worldwide. Pregnancy-associated with BC is defined as that which occurs during pregnancy or within 1 ...to 2 years postpartum. The objective is to present a clinical case of a young patient with a history of familial BC who had cancer during pregnancy. The patient had cardiotoxicity after using doxorubicin and trastuzumab.
Case report
She was a young patient within infiltrating ductal carcinoma in the right breast She was diagnosed within nine weeks of gestation and submitted to neoadjuvant chemotherapy with AC protocol (doxorubicina and cyclophosphamide) and mastectomy. Developed left atrial overload after treatment and still responding to hypersensitivity to trastuzumab.
Management and outcome
The patient presented an alteration in the electrocardiogram (ECG) after the use of doxorubicin. The exam was repeated and the ECG was normal. Trastuzumab was started after delivery and the patient had a hypersensitivity reaction. Administration of trastuzumab was stopped and hydrocortisone was administered. The patient showed improvement in symptoms with cessation of trastuzumab.
Discussion
Although anthracycline-induced cardiotoxicity and hypersensitivity reactions to trastuzumab are common reactions, there are few studies on the effects of these drugs in patients with Gestational breast cancer (GBC). Monitoring cardiotoxicity in breast cancer treatment in pregnant patients is essential to avoid two complications: for the pregnant woman and the fetus.
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