Mailing address: Luiz Felipe P. Moreira • Av. Dr. Enéas Carvalho Aguiar, 44 2o andar, Bloco 2, Sala 13 Cerqueira César 05403-000 São Paulo, SP Brazil E-mail: lfelipe@cardiol.br The Arquivos Brasileiros de Cardiologia (Brazilian Archives of Cardiology) have been, for more than 60 years, one of the main means of dissemination of scientific research in the area of cardiovascular diseases in our country. Included in all main international databases and published in three language providing free access to its entire content through the Scientific Electronic Library Online (Scielo), the journal currently offers wide distribution and visibility to the scientific articles that it publishes.

/pdf/the-archives-and-the-publication-of-its-first-impact-factor-5bjj4d2wro.pdf

The Archives and the publication of its first impact factor.

/pdf/3a-diretriz-brasileira-de-transplante-cardiaco-bp79tczfoh.pdf

3ª Diretriz Brasileira de Transplante Cardíaco

Adherence to medication regimes is crucial for transplant patients. Addressing methodological limitations and gaps in the literature, we studied: (i) the prevalence of nonadherence (NA) with immunosuppression (IS) using various measurement methods, (ii) NA prevalence regarding intake and timing, (iii) changes in NA over time, (iv) differences in NA across organ transplant populations, (v) NA regarding co-medication. Using a descriptive, prospective, comparative design over 3 months, we included convenience samples of adult heart (n=79), liver (n=55), and lung (n=104) transplant patients. NA with IS was measured using self-report, collateral report, blood assay, electronic monitoring (Helping Hand™ , Bang and Olufsen Medicom, Denmark), and their combinations. In the overall sample, depending on the method used, IS NA ranged from 23.9% to 70.0%. For co-medication, the overall NA rate was 30.1% using self-report. Nonadherence rates remained stable over time. At inclusion, significant NA differences between organ groups were reported via self- and collateral report; lung transplant patients were less adherent than heart or liver transplant recipients, both to IS and to co-medication.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1432-2277.2011.01296.x

The spectrum of nonadherence with medication in heart, liver, and lung transplant patients assessed in various ways

Crucial for healthcare and biomedical applications, respiration monitoring often employs wearable sensors in practice, causing inconvenience due to their direct contact with human bodies. Therefore, researchers have been constantly searching for contact-free alternatives. Nonetheless, existing contact-free designs mostly require human subjects to remain static, largely confining their adoptions in everyday environments where body movements are inevitable. Fortunately, radio-frequency (RF) enabled contact-free sensing, though suffering motion interference inseparable by conventional filtering, may offer a potential to distill respiratory waveform with the help of deep learning. To realize this potential, we introduce MoRe-Fi to conduct fine-grained respiration monitoring under body movements. MoRe-Fi leverages an IR-UWB radar to achieve contact-free sensing, and it fully exploits the complex radar signal for data augmentation. The core of MoRe-Fi is a novel variational encoder-decoder network; it aims to single out the respiratory waveforms that are modulated by body movements in a non-linear manner. Our experiments with 12 subjects and 66-hour data demonstrate that MoRe-Fi accurately recovers respiratory waveform despite the interference caused by body movements. We also discuss potential applications of MoRe-Fi for pulmonary disease diagnoses.

MoRe-Fi: Motion-robust and Fine-grained Respiration Monitoring via Deep-Learning UWB Radar

pdf/more-fi-motion-robust-and-fine-grained-respiration-tn6zc0hvzp.pdf

MoRe-Fi: Motion-robust and Fine-grained Respiration Monitoring via Deep-Learning UWB Radar.

Purpose of review The prevention and treatment of rejection have been the major focus of clinical and research studies since the inception of heart transplantation. Recent improvement in survival after transplant has been in large part due to continued advancement in antirejection therapies. Recent findings The combination of steroids/cyclosporine/azathioprine has been widely used since the early 1980s. The last decade has seen the increasing use of the drugs mycophenolate mofetil and tacrolimus. Newer agents such as target of rapamycin protein inhibitors and anti-interleukin-2 inhibitors have come under intense research recently, and may play a significant role in heart transplantation. Further study is required for agents such as rituximab. With the recent introduction of a new grading of cardiac allograft rejection, controversy remains over when rejection should be treated and which agents should be used. Summary Use of newer proven antirejection drugs has reduced rejection and improved survival after heart transplantation. Rejection and side effects from these drugs are still major problems, however; therefore continued research in this area is required.

New advances in antirejection therapy.

Purpose of reviewHeart failure is very common in the elderly and there are numerous challenges in diagnosis, prognostication, and treatment.Recent findingsRecent studies have provided useful tools to help with the diagnosis and treatment of heart failure in the elderly. Recent studies also show that

Heart failure in the elderly.

Purpose of review Diabetes is a well-recognized risk factor for the development of cardiovascular disease. In recent years, several new glucose-lowering drugs (GLD) have shown improvements in cardiovascular outcomes, renewing interest of cardiovascular specialists in diabetes management. Recent findings Individual studies in the last 5 years have demonstrated the cardiovascular safety of certain dipeptidyl peptidase-4 inhibitors, glucagon-like peptide 1 agonists, and sodium glucose cotransporter 2 inhibitors. Recent meta-analyses have attempted to demonstrate class effects of these medications, but remain driven by several large studies. Other studies have used registry data to show improvements in cardiovascular outcomes in patients receiving new GLD compared with insulin therapy. The cardiovascular benefits of GLD are so attractive that these agents have been applied to patients without diabetes, though these studies have not borne a net clinical benefit in nondiabetic patients. Summary An evolving body of literature now supports the safety profile of many new GLDs in patients at risk for cardiovascular disease. Several new agents have demonstrated improvements in cardiovascular outcomes and are now recommended as second-line agents after metformin in patients with cardiovascular disease. VIDEO ABSTRACT.

Treatment of diabetes and heart failure: a paradigm shift for cardiologists?

Background Dyspnea is a common symptom that has many causes, including obstructive airway disorders. We sought to examine previous diagnosis of obstructive airway disorders and other conditions in patients receiving treatment with inhaled medications for shortness of breath in a community setting. Methods This cross-sectional study included consecutive patients aged 18 years and older receiving treatment for shortness of breath with inhaled medications for a minimum of 6 months. Study participants were recruited through community pharmacies in Edmonton and Saskatoon, Canada, between February 2009 and February 2012. Previous diagnosis of obstructive airway disorders by a primary care provider was assessed by patient self-report and review of health records. We conducted an assessment (as per guidelines from the American Thoracic Society and the European Respiratory Society), including pulmonary function tests; diagnoses were adjudicated by an expert physician panel (2 respirologists and 1 emergency physician). The agreement between diagnoses derived from pulmonary function tests and diagnoses from primary care providers was evaluated. Results A total of 328 patients (median age 50 yr, 57.3% female) underwent assessment; 134 (40.9%) of patients reported ever having a pulmonary function test performed. After adjudication, 138 (42.1%) were diagnosed with asthma only, 86 (26.2%) with chronic obstructive pulmonary disease only and 11 (3.4%) with both. Some patients (93, 28.4%) had no evidence of obstructive airway disorders and 20 (6.1%) had evidence of other conditions that cause shortness of breath, such as heart failure and pulmonary hypertension. Overall, 62 (18.9%) patients could not be assigned a diagnosis. Interpretation In a group of community-based patients with shortness of breath being treated with inhalers, less than half ever had pulmonary function tests performed, and a considerable proportion had no evidence of lung disease or other conditions. These findings highlight the need for confirmatory testing, including pulmonary function tests, before prescribing inhalers for patients with presumed obstructive airway disorders.

Diagnostic practices for patients with shortness of breath and presumed obstructive airway disorders: a cross-sectional analysis.

Accelerated atherosclerosis is a well-known complication of diabetes, and recently the importance of heart failure independent of coronary artery disease has become a focus of research and innovation. A number of recent cardiovascular outcome trials have demonstrated cardiovascular and renal benefits with two novel classes of glucose-lowering drugs: SGLT2 inhibitors and GLP-1 agonists. Work is ongoing to define the underlying mechanisms of these benefits. Interest in demonstrating the cardiovascular safety of older glucose-lowering drugs has also been rekindled. In addition, in the very near future, it is likely that SGLT2 inhibitors will be administered to new patient populations, including those with type 1 diabetes or without diabetes altogether. Efforts in lifestyle management and preventive health continue to be well spent, due to their potential effectiveness and the growing global burden of disease.

Treatment of Diabetes and Heart Failure

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