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Marti HP, Pavía López AA, Schwartzmann P. Safety and tolerability of β-blockers: importance of cardioselectivity. Curr Med Res Opin 2024; 40:55-62. [PMID: 38597063 DOI: 10.1080/03007995.2024.2317433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/02/2024] [Indexed: 04/11/2024]
Abstract
Cardioselective β-blockade is generally well tolerated in practice and contraindications to this therapy are uncommon. β-blockers are a diverse therapeutic class, and their individual tolerability profiles are influenced strongly by their pharmacodynamic effects across different adrenergic receptors. Bisoprolol, probably the β-blocker with the highest selectivity for blockade of β1- vs. β2-adrenoceptors, does not block β2-adrenoceptors to an appreciable extent at doses in therapeutic use. Side-effects often attributed to β-blockers, such as erectile dysfunction and adverse metabolic effects are uncommon with bisoprolol and other β-blockers used at doses which only block β1-adrenoceptors. Cautious use of a cardioselective β-blocker is not contraindicated in people with chronic obstructive pulmonary disease or asthma and the outcomes benefits of β-blockers in patients with coronary heart disease or heart failure are also apparent in patients with concurrent COPD. Starting with a low dose and titrating upwards carefully is important for optimising the tolerability of a β-blocker. Most people with hypertension will receive combination antihypertensive therapy in practice, and the low-dose combination therapy approach provides a useful strategy for optimising the efficacy and tolerability of a regimen that includes a β-blocker, compared with up-titrating an existing monotherapy.
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Affiliation(s)
- Hans-Peter Marti
- Nephrology Section, Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | | | - Pedro Schwartzmann
- Advanced Research Center - CAPED, Cardiology Unit, Unimed Hospital, Ribeirão Preto, Brazil
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Rohde LE, Rover MM, Hoffmann Filho CR, Rabelo-Silva ER, Silvestre OM, Martins SM, Passos LCS, de Figueiredo Neto JA, Danzmann LC, Silveira FS, Mesas CE, Hernandes ME, Moura LZ, Simões MV, Ritt LEF, Nishijuka FA, Bertoldi EG, Dall Orto FTC, Magedanz EH, Mourilhe-Rocha R, Fernandes-Silva MM, Ferraz AS, Schwartzmann P, de Castilho FM, Pereira Barretto AC, dos Santos Júnior EG, Nogueira PR, Canesin M, Beck-da-Silva L, de Carvalho Silva M, Adolfi Júnior MS, Santos RHN, Ferreira A, Pereira D, López Pedraza L, Kojima FCS, Campos V, de Barros e Silva PGM, Blacher M, Cavalcanti AB, Ramires F. Multifaceted Strategy Based on Automated Text Messaging After a Recent Heart Failure Admission: The MESSAGE-HF Randomized Clinical Trial. JAMA Cardiol 2024; 9:105-113. [PMID: 38055237 PMCID: PMC10701668 DOI: 10.1001/jamacardio.2023.4501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/27/2023] [Indexed: 12/07/2023]
Abstract
Importance Readmissions after an index heart failure (HF) hospitalization are a major contemporary health care problem. Objective To evaluate the feasibility and efficacy of an intensive telemonitoring strategy in the vulnerable period after an HF hospitalization. Design, Setting, and Participants This randomized clinical trial was conducted in 30 HF clinics in Brazil. Patients with left ventricular ejection fraction less than 40% and access to mobile phones were enrolled up to 30 days after an HF admission. Data were collected from July 2019 to July 2022. Intervention Participants were randomly assigned to a telemonitoring strategy or standard care. The telemonitoring group received 4 daily short message service text messages to optimize self-care, active engagement, and early intervention. Red flags based on feedback messages triggered automatic diuretic adjustment and/or a telephone call from the health care team. Main Outcomes and Measures The primary end point was change in N-terminal pro-brain natriuretic peptide (NT-proBNP) from baseline to 180 days. A hierarchical win-ratio analysis incorporating blindly adjudicated clinical events (cardiovascular deaths and HF hospitalization) and variation in NT-proBNP was also performed. Results Of 699 included patients, 460 (65.8%) were male, and the mean (SD) age was 61.2 (14.5) years. A total of 352 patients were randomly assigned to the telemonitoring strategy and 347 to standard care. Satisfaction with the telemonitoring strategy was excellent (net promoting score at 180 days, 78.5). HF self-care increased significantly in the telemonitoring group compared with the standard care group (score difference at 30 days, -2.21; 95% CI, -3.67 to -0.74; P = .001; score difference at 180 days, -2.08; 95% CI, -3.59 to -0.57; P = .004). Variation of NT-proBNP was similar in the telemonitoring group compared with the standard care group (telemonitoring: baseline, 2593 pg/mL; 95% CI, 2314-2923; 180 days, 1313 pg/mL; 95% CI, 1117-1543; standard care: baseline, 2396 pg/mL; 95% CI, 2122-2721; 180 days, 1319 pg/mL; 95% CI, 1114-1564; ratio of change, 0.92; 95% CI, 0.77-1.11; P = .39). Hierarchical analysis of the composite outcome demonstrated a similar number of wins in both groups (telemonitoring, 49 883 of 122 144 comparisons [40.8%]; standard care, 48 034 of 122 144 comparisons [39.3%]; win ratio, 1.04; 95% CI, 0.86-1.26). Conclusions and Relevance An intensive telemonitoring strategy applied in the vulnerable period after an HF admission was feasible, well-accepted, and increased scores of HF self-care but did not translate to reductions in NT-proBNP levels nor improvement in a composite hierarchical clinical outcome. Trial Registration ClinicalTrials.gov Identifier: NCT04062461.
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Affiliation(s)
- Luis E. Rohde
- Cardiovascular Division, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | | | | | | | | | | | | | | | - Luiz C. Danzmann
- Hospital Universitário de Canoas e Universidade Luterana do Brasil, Canoas, Brazil
| | | | | | | | | | - Marcus V. Simões
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Luiz E. F. Ritt
- Instituto D’Or de Pesquisa e Ensino, Hospital Cárdio Pulmonar, Salvador, Brazil
| | | | | | | | | | - Ricardo Mourilhe-Rocha
- Hospital Universitário Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Pedro Schwartzmann
- Centro Avançado de Pesquisa e Ensino e Hospital Unimed de Ribeirão Preto, Ribeirão Preto, Brazil
| | - Fábio M. de Castilho
- Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | - Manoel Canesin
- Hospital Universitário Regional do Norte do Paraná, Londrina, Brazil
| | - Luis Beck-da-Silva
- Cardiovascular Division, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | | | | | | | - Amanda Ferreira
- Cardiovascular Division, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Danielle Pereira
- Cardiovascular Division, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | | | | | | | | | - Mariana Blacher
- Cardiovascular Division, Hospital Moinhos de Vento, Porto Alegre, Brazil
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Speranza M, López-López JD, Schwartzmann P, Morr I, Rodríguez-González MJ, Buitrago A, Pow-Chon-Long F, Passos LC, Rossel V, Perna ER, Escalante M, Romero A, Arteaga-Tobar AA, Quesada D, Alarco W, Gómez-Mesa JE. Cardiovascular Complications in Patients with Heart Failure and COVID-19: CARDIO COVID 19-20 Registry. J Cardiovasc Dev Dis 2024; 11:34. [PMID: 38392248 PMCID: PMC10889647 DOI: 10.3390/jcdd11020034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 02/24/2024] Open
Abstract
Since early 2020, different studies have shown an increased prevalence of COVID-19 and poorer prognosis in older adults with cardiovascular comorbidities. This study aimed to assess the impact of heart failure (HF) on cardiovascular complications, intensive care unit (ICU) admissions, and in-hospital mortality in patients hospitalized with COVID-19. The CARDIO COVID 19-20 registry includes 3260 hospitalized patients with a COVID-19 serological diagnosis between May 2020 and June 2021 from Latin American countries. A history of HF was identified in 182 patients (5.6%). In patients with and without previous HF, the incidence of supraventricular arrhythmia was 16.5% vs. 6.3%, respectively (p = 0.001), and that of acute coronary syndrome was 7.1% vs. 2.7%, respectively (p = 0.001). Patients with a history of HF had higher rates of ICU admission (61.5% vs. 53.1%, respectively; p = 0.031) and in-hospital mortality (41.8% vs. 24.5%, respectively; p = 0.001) than patients without HF. Cardiovascular mortality at discharge (42.1% vs. 18.5%, respectively; p < 0.001) and at 30 days post-discharge (66.7% vs. 18.0%, respectively) was higher for patients with a history of HF than for patients without HF. In patients hospitalized with COVID-19, previous history of HF was associated with a more severe cardiovascular profile, with increased risk of cardiovascular complications, and poor in-hospital and 30-day outcomes.
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Affiliation(s)
- Mario Speranza
- Department of Cardiology, Hospital Clínica Bíblica, San José 10104, Costa Rica
- Consejo Interamericano de Falla Cardiaca e Hipertensión Pulmonar (CIFACAH) de la Sociedad Interamericana de Cardiología (SIAC), Mexico City 01000, Mexico
| | - Juan D López-López
- Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali 760026, Colombia
- Department of Health Sciences, Universidad Icesi, Cali 760031, Colombia
| | - Pedro Schwartzmann
- Department of Cardiology, CAPED-Advanced Research Center and Hospital Unimed, Ribeirão Preto 14000-000, Brazil
| | - Igor Morr
- Department of Tropical Cardiology, Sociedad Venezolana de Cardiología, Caracas 1060, Venezuela
| | | | - Andrés Buitrago
- Department of Cardiology, Fundación Santa Fe, Bogotá D.C. 110111, Colombia
| | - Freddy Pow-Chon-Long
- Consejo Interamericano de Falla Cardiaca e Hipertensión Pulmonar (CIFACAH) de la Sociedad Interamericana de Cardiología (SIAC), Mexico City 01000, Mexico
- Department of Cardiology, Hospital Luis Vernaza, Guayaquil 090313, Ecuador
- Department of Cardiology, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
| | | | - Víctor Rossel
- Consejo Interamericano de Falla Cardiaca e Hipertensión Pulmonar (CIFACAH) de la Sociedad Interamericana de Cardiología (SIAC), Mexico City 01000, Mexico
- Instituto Nacional del Tórax, Heart Transplant Program, Santiago de Chile 8320000, Chile
| | - Eduardo Roque Perna
- Consejo Interamericano de Falla Cardiaca e Hipertensión Pulmonar (CIFACAH) de la Sociedad Interamericana de Cardiología (SIAC), Mexico City 01000, Mexico
- Division of Heart Failure and Pulmonary Hypertension, Instituto de Cardiología J.F. Cabral, Corrientes 3400, Argentina
| | - Manuela Escalante
- Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali 760026, Colombia
| | - Alexander Romero
- Consejo Interamericano de Falla Cardiaca e Hipertensión Pulmonar (CIFACAH) de la Sociedad Interamericana de Cardiología (SIAC), Mexico City 01000, Mexico
- Department of Cardiology, Hospital Santo Tomás, Panama City 07093, Panama
| | - Andrea Alejandra Arteaga-Tobar
- Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali 760026, Colombia
- Department of Cardiology, Fundación Valle del Lili, Cali 760026, Colombia
| | - Daniel Quesada
- Consejo Interamericano de Falla Cardiaca e Hipertensión Pulmonar (CIFACAH) de la Sociedad Interamericana de Cardiología (SIAC), Mexico City 01000, Mexico
- Department of Cardiology, Hospital San Vicente de Paúl, Heredia 40101, Costa Rica
| | - Walter Alarco
- Consejo Interamericano de Falla Cardiaca e Hipertensión Pulmonar (CIFACAH) de la Sociedad Interamericana de Cardiología (SIAC), Mexico City 01000, Mexico
- Department of Cardiology, Instituto Nacional Cardiovascular, Lima 15072, Peru
| | - Juan Esteban Gómez-Mesa
- Consejo Interamericano de Falla Cardiaca e Hipertensión Pulmonar (CIFACAH) de la Sociedad Interamericana de Cardiología (SIAC), Mexico City 01000, Mexico
- Department of Health Sciences, Universidad Icesi, Cali 760031, Colombia
- Department of Cardiology, Fundación Valle del Lili, Cali 760026, Colombia
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Cowie MR, Mourilhe-Rocha R, Chang HY, Volterrani M, Ban HN, de Albuquerque DC, Chung E, Fonseca C, Lopatin Y, Serrano JAM, Mircheva L, Moncada-Paz GA, Pagava Z, Reyes EB, Saldarriaga C, Schwartzmann P, Leng DSK, Trivi M, Yotov YT, Zieroth S. The impact of the COVID-19 pandemic on heart failure management: Global experience of the OPTIMIZE heart failure care network. Int J Cardiol 2022; 363:240-246. [PMID: 35750302 PMCID: PMC9217066 DOI: 10.1016/j.ijcard.2022.06.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/18/2022] [Accepted: 06/10/2022] [Indexed: 11/05/2022]
Abstract
During the COVID-19 pandemic, reductions in heart failure (HF) hospitalizations have been widely reported, and there is an urgent need to understand how HF care has been reorganized in countries with different infection levels, vaccination rates and healthcare services. The OPTIMIZE Heart Failure Care program has a global network of investigators in 42 countries, with first-hand experience of the impact of the pandemic on HF management in different care settings. The national coordinators were surveyed to assess: 1) the challenges of the COVID-19 pandemic for continuity of HF care, from both a hospital and patient perspective; 2) the organizational changes enacted to ensure continued HF care; and 3) lessons learned for the future of HF care. Contributions were obtained from 37 national coordinators in 29 countries. We summarize their input, highlighting the issues raised and using the example of three very different settings (Italy, Brazil, and Taiwan) to illustrate the similarities and differences across the OPTIMIZE program.
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Affiliation(s)
- Martin R Cowie
- Royal Brompton Hospital, Guy's & St Thomas' NHS Foundation Trust, and School of Cardiovascular Medicine and Sciences, Faculty of Lifesciences & Medicine, King's College London, London, UK.
| | - Ricardo Mourilhe-Rocha
- Pedro Ernesto University Hospital, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Hung-Yu Chang
- Heart Center, Cheng Hsin General Hospital, and Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Maurizio Volterrani
- Department of Cardiovascular and Respiratory Sciences, Scientific Institute for Research, Hospitalization and Health Care (IRCCS) San Raffaele Roma, Rome, Italy
| | - Ha Ngoc Ban
- Ho Chi Minh City Heart Institute, Ho Chi Minh City, Viet Nam
| | | | - Edward Chung
- Department of Medicine, University of the West Indies, Mona, Jamaica
| | - Cândida Fonseca
- Heart Failure Clinic, Department of Internal Medicine, São Francisco Xavier Hospital, and NOVA Medical School, Faculty of Medical Sciences, NOVA University, Lisbon, Portugal
| | - Yuri Lopatin
- Regional Cardiology Centre, Volgograd State Medical University, Volgograd, Russian Federation
| | - José Antonio Magaña Serrano
- Division of Heart Failure and Cardiac Transplantation, Cardiology Hospital, National Medical Center "Siglo XXI", Mexican Social Security Institute, Mexico City, Mexico
| | - Lilyana Mircheva
- Second Cardiology Clinic, University Hospital St. Marina, and First Department of Internal Medicine, Medical University of Varna, Varna, Bulgaria
| | - Gustavo Adolfo Moncada-Paz
- Department of Cardiology, Honduran Social Security Institute, and Faculty of Medical Sciences, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Zurab Pagava
- Bokhua Memorial Cardiovascular Center, Tbilisi, Georgia
| | - Eugenio B Reyes
- Philippine General Hospital and Division of Cardiovascular Medicine, University of the Philippines, Manila, Philippines
| | - Clara Saldarriaga
- Department of Cardiology, Pontifical Bolivarian University and University of Antioquia, Medellín, Colombia
| | - Pedro Schwartzmann
- Unimed Hospital Ribeirão Preto and Advanced Center for Research, Teaching and Diagnosis, Ribeirão Preto, SP, Brazil
| | | | - Marcelo Trivi
- Department of Clinical Cardiology, Buenos Aires Cardiovascular Institute, Buenos Aires, Argentina
| | - Yoto Trifonov Yotov
- Second Cardiology Clinic, University Hospital St. Marina, and First Department of Internal Medicine, Medical University of Varna, Varna, Bulgaria
| | - Shelley Zieroth
- Heart Failure and Transplant Clinics, St. Boniface Hospital, and Section of Cardiology, University of Manitoba, Winnipeg, MB, Canada
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Cintra RM, Nogueira AC, Bonilha I, Luchiari BM, Coelho-Filho OR, Coelho OR, Schwartzmann P, Muscellie E, Nadruz W, Carvalho LSF, Sposito AC. Glucose-lowering Drugs and Hospitalization for Heart Failure: A Systematic Review and Additive-effects Network Meta-analysis With More Than 500 000 Patient-years. J Clin Endocrinol Metab 2021; 106:3060-3067. [PMID: 34125217 DOI: 10.1210/clinem/dgab428] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Sodium glucose co-transporter 2 inhibitors (SGLT2is) prevent hospitalization resulting from heart failure (HHF). However, patients with type 2 diabetes mellitus use multiple antihyperglycemic drugs to achieve glycosylated hemoglobin (HbA1c) targets. In these drug combinations, the risk of HHF is unpredictable and so is the parallel effect of glucose-lowering. PURPOSE To examine the impact of antihyperglycemic drugs and their association on HHF. DATA SOURCES Forty randomized controlled trials (RCTs) reporting HHF. STUDY SELECTION Published RCTs were the data source. DATA EXTRACTION Incidence rates of HHF. DATA SYNTHESIS Random additive-effects network meta-analysis showed that metformin (P = 0.55), sulfonylureas (P = 0.51), glucagon-like peptide-1 receptor-agonist (P = 0.16), and dipeptidyl peptidase 4 inhibitors (DPP4is; P = 0.54) were neutral on the risk of HHF. SGLT2is and SGLT2is + DPP4is reduced the risk of HHF with a hazard ratio (HR) of 0.68 (95% CI, 0.60-0.76; P < 0.0001) and 0.70 (95% CI, 0.60-0.81; P < 0.0001), respectively. Increased risk of HHF was associated with thiazolidinediones (TZDs) as monotherapy or in combination with DPP4is (HR: 1.45; 95% CI, 1.18-1.78; P = 0.0004) and 1.49 (95% CI, 1.18-1.88; P = 0.0008), respectively. Regardless of the therapy, a 1% reduction in HbA1c reduced the risk of HHF by 31.3% (95% CI, 9-48; P = 0.009). LIMITATIONS There are no data to verify drug combinations available for clinical use and to discriminate the effect of drugs within each of the therapeutic classes. CONCLUSIONS The risk of HHF is reduced by SGLT2is as monotherapy or in combination with DPP4is and increased by TZDs as monotherapy or in combination. Glucose-lowering provides an additive effect of reducing HHF.
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Affiliation(s)
- Riobaldo M Cintra
- Atherosclerosis and Vascular Biology Laboratory (Atherolab), Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil
| | - Ana Claudia Nogueira
- Directory of Clinical Research and Innovation, Institute for Strategic Management in Healthcare (IGESDF), Brasília, DF, Brazil
| | - Isabella Bonilha
- Atherosclerosis and Vascular Biology Laboratory (Atherolab), Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil
| | - Beatriz M Luchiari
- Atherosclerosis and Vascular Biology Laboratory (Atherolab), Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil
| | | | - Otavio R Coelho
- Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil
| | - Pedro Schwartzmann
- Atherosclerosis and Vascular Biology Laboratory (Atherolab), Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil
| | - Elza Muscellie
- Atherosclerosis and Vascular Biology Laboratory (Atherolab), Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil
| | - Wilson Nadruz
- Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil
| | - Luiz Sergio F Carvalho
- Atherosclerosis and Vascular Biology Laboratory (Atherolab), Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil
- Directory of Clinical Research and Innovation, Institute for Strategic Management in Healthcare (IGESDF), Brasília, DF, Brazil
| | - Andrei C Sposito
- Atherosclerosis and Vascular Biology Laboratory (Atherolab), Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil
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Schwartzmann P. Sildenafil as an Eligible Heart Transplantation Therapy for Advanced Heart Failure Associated with Fixed Pulmonary Hypertension. Arq Bras Cardiol 2021; 116:227-228. [PMID: 33656069 PMCID: PMC7909971 DOI: 10.36660/abc.20200631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Pedro Schwartzmann
- Hospital Unimed Ribeirão PretoRibeirão PretoSPBrasilHospital Unimed Ribeirão Preto, Ribeirão Preto, SP - Brasil
- Centro de PesquisaCentro Médico RBSRibeirão PretoSPBrasilCentro de Pesquisa (CAPED) - Centro Médico RBS, Ribeirão Preto, SP - Brasil
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Schwartzmann P. Angiotensin Receptor-Neprilysin Inhibition Therapy and Improved Exercise Parameters in Heart Failure with Reduced Ejection Fraction. Arq Bras Cardiol 2020; 115:828-829. [PMID: 33295444 PMCID: PMC8452205 DOI: 10.36660/abc.20200566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Montera MW, Mesquita ET, Colafranceschi AS, Oliveira ACD, Rabischoffsky A, Ianni BM, Rochitte CE, Mady C, Mesquita CT, Azevedo CF, Bocchi EA, Saad EB, Braga FGM, Fernandes F, Ramires FJA, Bacal F, Feitosa GS, Figueira HR, Souza Neto JDD, Moura LAZ, Campos LADA, Bittencourt MI, Barbosa MDM, Moreira MDCV, Higuchi MDL, Schwartzmann P, Rocha RM, Pereira SB, Mangini S, Martins SM, Bordignon S, Salles VA. I Brazilian guidelines on myocarditis and pericarditis. Arq Bras Cardiol 2014; 100:1-36. [PMID: 23765413 DOI: 10.5935/abc.2013s004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Schwartzmann P, Herman J, Magal U. [Self-induced hypoglycemia: a factitious illness]. Harefuah 1985; 108:279-81. [PMID: 3843395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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