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Impact of the Brazilian scientific publications on the recent scientific developments in cardiology

EDITORIAL

Mailing address

Key words: Cardiology / trends; scientific and technical publications.

The Brazilian research, in the clinical and surgical areas as well as in the basic areas, has developed greatly in recent years. Cardiology, in turn, has effectively contributed for this development. Currently, the Brazilian Archives of Cardiology (Arquivos Brasileiros de Cardiologia), an ISI-indexed journal, joins other important national and also indexed journals, offering the national and international researchers good options for the publication of their studies.

This Editorial will discuss the impact of the recent Brazilian scientific publications from the clinical and surgical areas in Cardiology.

The atherosclerotic disease has been the target of constant research in the last years. More recently, the analysis of peripheral artery disease, both concerning its diagnosis as well as its prognostic impact, has been carried out, including epidemiological studies1,2. The occurrence of an earlier onset of atherosclerotic disease, affecting even children and adolescents, as well as the influence of smoking and arterial hypertension in this population, which influences the lipoprotein profile, is a warning to the authorities seeking a more effective and earlier prevention3,4. Another important population study, carried out in Rio de Janeiro, confirmed the importance of smoking as a public health problem, increasing the number of cases of disability, chronic obstructive pulmonary disease, cerebrovascular disease and cardiovascular disease5. Another aspect that has been broadly discussed was the cardiovascular risk in non-cardiac surgeries, as well as methods of intraoperative monitoring and the importance of the cardiologic assessment in the context of this interdisciplinary evaluation6-8.

The discussion of multiprofessional collaboration has also been represented in clinical studies. The correlation between periodontal disease and cardiovascular risk, as well as the possibility of safe dental treatment, using anesthetic agents with vasoconstrictors, even in patients with coronary artery disease and the presence of ventricular arrhythmia, were the subject of recent publications9,10. The impact of physical activity in the context of cardiovascular event prevention, improvement of the endothelial function and control of arterial pressure have been broadly discussed, including in specific subpopulations, such as adolescents, the elderly and the female sex11-13.

In the field of heart failure and ventricular dysfunction, we have observed important original contributions. The discussion on the importance of physical activity in patients with FCII, with impact on the quality of life, functional classes and characteristic features of respiratory variables and heart rate, even in patients undergoing treatment with beta-blockers, have represented advances in this area14-17 . The criteria for diagnostic confirmation of myocardial noncompaction, as well as therapeutic strategies in this newly discovered novel classification of cardiomyopathies have also aroused the interest of researchers 18-20. Other forms of clinical presentation and the etiology of cardiomyopathies have also been studied. As it remains quite prevalent, considering its high mortality rate at the more advanced phases, the Chagasic cardiomyopathy offers great opportunities for original researches, as its physiopathological mechanism is yet to be fully elucidated21. Similarly, the hypertrophic cardiomyopathy and myocardial damage due to amyloid deposits, as differential diagnoses of cardiac hypertrophies and heart failure with restrictive patterns have also been broadly studied in the last years22-25. A study that evaluated pregnant women with ventricular dysfunction during the perinatal period also brought important concepts and analyses of the maternal risk during this period, a question that has been scarcely studied in the international literature26.

In the field of cardiovascular surgery, several advances have been presented regarding the treatment of valvulopathies, coronary failure, thoracic aorta disorders and the use of mechanical circulatory assistance devices in our country. These advances include the standardization of the use of video-assisted surgery in the treatment of heart valve disorders27,28, as well as the consolidation of reconstruction techniques in the treatment of mitral valve disorders29,30 and the performance of Ross surgery with decellularized pulmonary grafts in aortic valve substitutions31.

In the treatment of ischemic cardiomyopathy, the evaluation of the safety of employing intramyocardial injections of hematopoietic stem cells as a therapy associated to coronary artery bypass graft (CABG) surgery was the object of two clinical protocols32,33 that defined the safety of its use. Other important studies were those on the best preservation of venous grafts34,35, the use of arterial grafts36,37 and the comparison between the on- or off-pump CABG surgery38.

The proposal of employing hybrid procedures in the treatment of acute aortic dissections39 and the study of the use of evoked potentials in the monitoring of medullary distress during the surgical approach of the descending aorta40 have opened up new perspectives in the treatment of thoracic aorta disorders. On the other hand, the Brazilian experience regarding the use of mechanical circulatory assistance devices includes only initial series with extracorporeal membrane oxygenation (ECMO)41,42 and paracorporeal artificial ventricles in the treatment of cardiogenic shock or as bridge to heart transplant43.

The better control of the quality and outcomes of cardiac surgery has also been the subject of studies in the national literature44, especially analyses of preoperative risk factors for the development of kidney failure in the postoperative period45 and in the surgical approach of elderly patients46.

References

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  • 2. Makdisse M, Pereira AC, Brasil DP, Borges JL, Machado-Coelho GL, Krieger JE, et al. Prevalence and risk factors associated with peripheral arterial disease in the Hearts of Brazil Project: Hearts of Brazil Study and Peripheral Arterial Disease Committee of the Brazilian Society of Cardiology/Funcor. Arq Bras Cardiol. 2008; 91 (6): 370-82.
  • 3. Guedes DP, Guedes JE, Barbosa DS, de Oliveira JA. Tobacco use and plasma lipid-lipoprotein profile in adolescents. Rev Assoc Med Bras. 2007; 53 (1): 59-63.
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  • 5. Oliveira AF, Valente JG, Leite IC. The disease burden attributable to smoking in the state of Rio de Janeiro, Brazil in 2000. Clinics. 2008; 63 (2): 215-22.
  • 6. Smania MC, Piva JP, Garcia PC. Dexmetomidine in anesthesia of children submitted to videolaparoscopic appendectomy: a double-blind randomized and placebo-controled study. Rev Assoc Med Bras. 2008; 54 (4): 308-13.
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  • 18. Miranda EP, Albuquerque LA, Menezes RA Jr, Silva AW, Belém LS, Ramos FP. Isolated noncompacted myocardium in na elderly patient. Clinics. 2008; 63 (4): 567-70.
  • 19. Barbosa ND, Azeka E, Aielo VD, Viana F, Jatene M, Tanamati C, et al. Isolated left ventricular noncompaction: unusual cause of decompensated heart failure and indication of heart transplantation in the early infancy-case report and literature review. Clinics. 2008; 63 (1): 136-9.
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  • 24. Gutierrez PS, Fernandes F, Mady C, Higuchi ML. Clinical, electrocardiographic and echocardiographic findings in significant cardiac amyloidosis detected only at necropsy: comparison with cases diagnosed in life. Arq Bras Cardiol. 2008; 90 (3): 191-6.
  • 25. Souza HCD, Penteado DMD, Martin-Pinge MC, Barbosa Neto O, Teixeira VPA, Blanco JHD. Nitric oxide synthesis blockade increases hypertrophy and cardiac fibrosis in rats submitted to aerobic training. Arq Bras Cardiol. 2007; 89: 99-104.
  • 26. Custódio MG, Yamakami LY, Bortolotto MR, Waissman AL, Zugaib M. Maternal and perinatal outcome in patients with severe systolic dysfunction. Rev Assoc Med Bras. 2008; 54 (6): 500-5.
  • 27. Fortunato Jr JA, Branco Filho AA, Branco A, Martins AL, Pereira ML, Ferraz JG, et al. Padronização da técnica para cirurgia cardíaca videoassistida: experiência inicial. Rev Bras Cir Cardiovasc. 2008; 23 (2): 183-9.
  • 28. Poffo R, Bonin M, Selbach RA, Pilatti M. Vídeo-assisted minimally invasive mitral valve replacement. Rev Bras Cir Cardiovasc. 2007; 22 (4): 491-4.
  • 29. Brandão CM, Guedes MA, Silva MF, Vieira ML, Pomerantzeff PM, Stolf NA. Plastia da valva mitral com a técnica do "Duplo Teflon": resultados de 10 anos Rev Bras Cir Cardiovasc. 2007; 22 (4): 448-53.
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  • 32. Dallan LAO, Gowdak LH, Lisboa LAF, Schetter I, Krieger JE, César LAM, et al. Terapia celular associada à revascularização transmiocárdica laser como proposta no tratamento da angina refratária. Rev Bras Cir Cardiovasc. 2008; 23 (1): 46-52.
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  • 41. Atik FA, Castro RS, Succi FM, Barros MR, Afiune C, Succi GM, et al. Emprego do suporte cardiopulmonar com bomba centrífuga e oxigenador de membrana em cirurgia cardiovascular pediátrica. Arq Bras Cardiol. 2008; 90 (4): 216-20.
  • 42. Colafranceschi AS, Monteiro AJ, Canale LS, Campos LA, Montera MW, Silva PR, et al. Assistência circulatória com oxigenação por membrana extracorpórea (ECMO) no adulto: um conceito falido ou esquecido? Arq Bras Cardiol. 2008; 91 (1): 34-41.
  • 43. Galantier J, Moreira LFP, Benício A, Leirner AA, Cestari I, Bocchi EA, et al. Desempenho hemodinâmico e resposta inflamatória durante o uso do DAV-InCor como ponte para o transplante. Arq Bras Cardiol. 2008; 91 (5): 301-8.
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  • 45. Kochi AC, Martins AS, Lima MC, Martin LC, Balbi Al. Fatores pré-operatórios para o desenvolvimento de insuficiência renal aguda após cirurgia cardíaca: estudo prospectivo. Rev Assoc Med Bras. 2008; 54 (3): 208-13
  • 46. Alves Jr L, Rodrigues AJ, Evora PR, Basseto S, Scorzoni Filho A, Luciano PM, et al. Fatores de risco em septuagenários ou mais idosos submetidos à revascularização do miocárdio e ou operações valvares. Rev Bras Cir Cardiovasc. 2008; 23 (4): 550-5.
  • Impact of the Brazilian Scientific Publications on the recent scientific developments in cardiology

    Fernando Bacal
  • Publication Dates

    • Publication in this collection
      05 May 2010
    • Date of issue
      Dec 2009
    Sociedade Brasileira de Cardiologia - SBC Avenida Marechal Câmara, 160, sala: 330, Centro, CEP: 20020-907, (21) 3478-2700 - Rio de Janeiro - RJ - Brazil, Fax: +55 21 3478-2770 - São Paulo - SP - Brazil
    E-mail: revista@cardiol.br