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  1 / 42223 MEDLINE  
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[PMID]:29223273
[Au] Autor:van der Veer T; In 't Veen JCCM; den Dekker WK; Miedema J
[Ad] Endereço:Department of Pulmonology, Franciscus Gasthuis & Vlietland, Erasmus Medical Center, Rotterdam, the Netherlands. Electronic address: t.vanderveer@franciscus.nl.
[Ti] Título:A 79-Year-Old Woman With Dyspnea and Hypoxemia That Worsened in an Upright Position.
[So] Source:Chest;152(6):e139-e142, 2017 12.
[Is] ISSN:1931-3543
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CASE PRESENTATION: A 79-year-old woman presented to the ED with complaints of gradually worsening exertional dyspnea, dizziness, and chest discomfort. For several weeks she had not been able to perform light household work. The patient's medical history mentioned pulmonary embolism following immobilization (2012), several fractures after trauma, an ischemic cerebral vascular accident (2014), and curative treatment for breast cancer (1995). Her current medication included esomeprazole, clopidogrel, simvastatin, calcium/vitamin D, amitriptyline, and acetaminophen.
[Mh] Termos MeSH primário: Anormalidades Múltiplas
Aneurisma da Aorta Torácica/complicações
Dispneia/etiologia
Forame Oval Patente/complicações
Hipóxia/etiologia
[Mh] Termos MeSH secundário: Idoso
Aneurisma da Aorta Torácica/diagnóstico
Cateterismo Cardíaco
Procedimentos Cirúrgicos Cardíacos/métodos
Diagnóstico Diferencial
Dispneia/diagnóstico
Ecocardiografia
Feminino
Forame Oval Patente/diagnóstico
Forame Oval Patente/cirurgia
Seres Humanos
Hipóxia/diagnóstico
Dispositivo para Oclusão Septal
Síndrome
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171211
[St] Status:MEDLINE


  2 / 42223 MEDLINE  
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[PMID]:29390347
[Au] Autor:Yang Y; Li X; Chen M; Feng Y
[Ad] Endereço:Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
[Ti] Título:Transcatheter closure of a huge iatrogenic atrial septal defect: A case report.
[So] Source:Medicine (Baltimore);96(50):e9216, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Iatrogenic atrial septal defects caused by cardiac surgery are rare complications that are traditionally repaired through reoperations; unfortunately, reoperations are accompanied by high risk and trauma. PATIENT CONCERNS: Herein, we report a rare case of a huge atrial septal defect after mitral and aortic mechanical valve replacement. DIAGNOSES: Transesophageal echocardiography revealed a 20 × 33 mm atrial septal defect with a mainly left-to-right shunt and bidirectional shunt. INTERVENTIONS: The defect was successfully occluded using a Shape Memory septal occlude with a waist diameter of 42 mm. OUTCOMES: At follow-up 6 months after, the patient's symptoms were remarkably relieved and chest radiograph showed obvious improvement of the pulmonary congestion. LESSONS: Percutaneous device treatment can be used as an alternative to surgery in iatrogenic atrial septal defects if the anatomical condition of the septal defect is appropriate for transcatheter closure.
[Mh] Termos MeSH primário: Cateterismo Cardíaco
Comunicação Interatrial/cirurgia
Implante de Prótese de Valva Cardíaca/efeitos adversos
Dispositivo para Oclusão Septal
[Mh] Termos MeSH secundário: Ecocardiografia Transesofagiana
Comunicação Interatrial/etiologia
Seres Humanos
Doença Iatrogênica
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009216


  3 / 42223 MEDLINE  
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[PMID]:28460768
[Au] Autor:Nanjappa V; Sadanand KS; Santhosh K; Basappa H; Manjunath CN; Nayak MH
[Ad] Endereço:Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore, India. Electronic address: veenananjappa@yahoo.co.in.
[Ti] Título:Case series: Difficult PTMC using novel technique of veno-arterial looping.
[So] Source:Indian Heart J;69(2):207-210, 2017 Mar - Apr.
[Is] ISSN:0019-4832
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:Percutaneous transvenous mitral commissurotomy (PTMC) using Inoue/Accura balloon is an effective procedure for management of patients with rheumatic mitral stenosis. Inability to cross the mitral valve is one of the pertinent reasons for procedural failure. We describe a series of three patients who were tackled with successful PTMC using a novel technique of veno-arterial looping and in the fourth patient we used double loop entry into left ventricle with veno-arterial rail and peripheral balloon dilatation for completing the PTMC. This is first such reported case series in literature to our knowledge.
[Mh] Termos MeSH primário: Valvuloplastia com Balão/métodos
Cateterismo Cardíaco/métodos
Cateterismo Periférico/métodos
Estenose da Valva Mitral/cirurgia
Valva Mitral/cirurgia
Cirurgia Assistida por Computador/métodos
[Mh] Termos MeSH secundário: Adulto
Artérias
Feminino
Fluoroscopia
Seres Humanos
Meia-Idade
Estenose da Valva Mitral/diagnóstico
Veias
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


  4 / 42223 MEDLINE  
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[PMID]:28460765
[Au] Autor:Lanjewar C; Phadke M; Singh A; Sabnis G; Jare M; Kerkar P
[Ad] Endereço:Department of Cardiology, Seth G.S. Medical College & King Edward VII Memorial Hospital, Mumbai, India.
[Ti] Título:Percutaneous balloon valvuloplasty with Inoue balloon catheter technique for pulmonary valve stenosis in adolescents and adults.
[So] Source:Indian Heart J;69(2):176-181, 2017 Mar - Apr.
[Is] ISSN:0019-4832
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Percutaneous balloon pulmonary valvuloplasty is the procedure of choice for uncomplicated severe or symptomatic pulmonary stenosis. The present study describes our experience in balloon pulmonary valvuloplasty using the Inoue balloon catheter in adolescent and adult patients. AIMS: To assess the immediate and mid-term outcomes of percutaneous balloon valvuloplasty with Inoue balloon catheter in adolescent and adult patients. METHODS AND RESULTS: Between June 2010 and July 2015, we performed percutaneous balloon pulmonary valvuloplasty with Inoue balloon catheter in 32 patients (59.37% females) aged 8 to 54 years (mean 23.6±11.5). Following the procedure, the mean right ventricular systolic pressure and the pulmonary valvular peak-to-peak systolic gradient decreased from (121.6±42.4 to 61.19±24.5mmHg, p=0.001) and (100.9±43.3 to 36.4±22.5mmHg, p=0.001), respectively. Twenty patients (Group A) showed immediate optimal results with post-procedure peak systolic gradient <36mmHg while 12 patients (Group B) had suboptimal results. An increase in pulmonary regurgitation by one grade was detected in 17 patients (53.2%). Twenty-three patients available for follow-up (mean duration, 2.75 years [range 0.25-5 years]) had a mean residual peak gradient of 23.6±2.51mmHg on Doppler echocardiography with attenuation of reactive RVOT stenosis in all Group B patients. There was no further increase in grade of pulmonary regurgitation or restenosis on mid-term follow-up. CONCLUSION: Percutaneous Inoue balloon technique is an attractive alternative with excellent mid-term results for adolescents and adults with isolated pulmonary stenosis.
[Mh] Termos MeSH primário: Valvuloplastia com Balão/métodos
Cateterismo Cardíaco/métodos
Estenose da Valva Pulmonar/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Ecocardiografia Doppler
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Estenose da Valva Pulmonar/diagnóstico
Estenose da Valva Pulmonar/fisiopatologia
Sístole
Fatores de Tempo
Resultado do Tratamento
Função Ventricular Direita/fisiologia
Pressão Ventricular
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


  5 / 42223 MEDLINE  
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[PMID]:28460764
[Au] Autor:Pandian J; Kaur D; Yalagudri S; Devidutta S; Sundar G; Chennapragada S; Narasimhan C
[Ad] Endereço:CARE Hospital, Road No.1, Banjara Hills, Hyderabad 500 034, India.
[Ti] Título:Safety and efficacy of epicardial approach to catheter ablation of ventricular tachycardia - An institutional experience.
[So] Source:Indian Heart J;69(2):170-175, 2017 Mar - Apr.
[Is] ISSN:0019-4832
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIM: Epicardial approach to VT ablation increases the success rate of ablation but is not without complications. We studied the safety and efficacy of epicardial VT ablations performed at our institute. METHODS: All patients who underwent epicardial VT ablation at our institute were studied retrospectively. The outcome of VT ablation was among three groups: ischaemic cardiomyopathy (ICM), non-ischaemic cardiomyopathy (NICM) and granulomatous myocarditis (GM). Safety outcomes assessed included all complications considered to be due to pericardial access or epicardial mapping/ablation. RESULTS: A total of 54 patients (total 119 VTs, mean 2.2 (0.9)) were taken up for ablation procedure through epicardial access. Mean age: 47 (10) years, males: 83%. All patients had drug resistant recurrent VTs. The epicardial procedure was abandoned in three patients due to access issues; percutaneous sub-xiphoid access was employed in 48 and surgical approach in four patients. Complete success was achieved in 59% and partial success in 76%. The outcomes were poor in ICM patients as compared to those with GM and NICM. Overall success rates for all clinical VTs were 89% in GM, 90% in NICM and 67% in ICM. Success rates for epicardial VT ablation were 94%, 85% and 78% respectively for GM, NICM and ICM. Procedure related complications occurred in six patients. CONCLUSION: Epicardial ablation for VT offers good immediate outcomes with acceptable safety profile.
[Mh] Termos MeSH primário: Cateterismo Cardíaco/métodos
Ablação por Cateter/métodos
Sistema de Condução Cardíaco/cirurgia
Pericárdio/cirurgia
Taquicardia Ventricular/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Ecocardiografia
Técnicas Eletrofisiológicas Cardíacas/métodos
Feminino
Seguimentos
Sistema de Condução Cardíaco/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Taquicardia Ventricular/diagnóstico
Taquicardia Ventricular/fisiopatologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


  6 / 42223 MEDLINE  
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[PMID]:29173356
[Au] Autor:Sedhai YR; Golamari R; Timalsina S; Basnyat S; Koirala A; Asija A; Choksi T; Kushwah A; Geovorgyan D; Dar T; Borikar M; Ahangar W; Alukal J; Zia S; Missri J
[Ad] Endereço:Department of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania. Electronic address: dr.sedhai@gmail.com.
[Ti] Título:Contrast-Induced Nephropathy After Cardiac Catheterization: Culprits, Consequences and Predictors.
[So] Source:Am J Med Sci;354(5):462-466, 2017 11.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Contrast-induced nephropathy (CIN) is a common complication after radiocontrast exposure. METHODS: A retrospective medical record review of 513 hospitalized patients who underwent cardiac catheterization from June-December 2014 was done, of which 38 patients with end-stage renal disease and 57 patients without preprocedural creatinine were excluded. Serum creatinine concentration before the procedure and each day for 3 days after the procedure was recorded. CIN was defined as an increase in serum creatinine concentration by ≥25% or ≥0.5mg/dL from the preprocedural value within 72hours of contrast exposure. RESULTS: A total of 418 patients (mean age: 69.1 ± 13.8 years, 55% males) were included in the study. Mean incidence of CIN was 3.7% (n = 16). CIN accounted for longer duration of hospitalization, lengthier intensive care unit admission, requirement of hemodialysis and higher mortality. Incidence of CIN was higher in the presence of preexisting atrial fibrillation (AF), congestive heart failure (CHF) and chronic kidney disease (CKD). When tested by univariate analysis, incidence of CIN was 13.8% in the AF group (P < 0.001), 8.6% in CHF group (P < 0.01) and 8.9% in CKD group (P < 0.002), compared with 2.3%, 1.9% and 2.4% in the absence of preexisting AF, CHF and CKD, respectively. On further testing using multivariate logistic regression model using AF, CHF and CKD as independent variables, development of CIN was strongly associated with preexisting AF with an odds ratio of 4.11, 95% CI: 1.40-12.07, P = 0.01. CONCLUSION: Identifying patients at risk is an important step in preventing CIN. Preexisting AF, independent of traditional risk factors, may increase the risk for CIN.
[Mh] Termos MeSH primário: Meios de Contraste/efeitos adversos
Nefropatias/induzido quimicamente
Nefropatias/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Cateterismo Cardíaco/estatística & dados numéricos
Creatinina/sangue
Feminino
Seres Humanos
Incidência
Nefropatias/prevenção & controle
Nefropatias/terapia
Modelos Logísticos
Masculino
Meia-Idade
Razão de Chances
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media); AYI8EX34EU (Creatinine)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


  7 / 42223 MEDLINE  
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[PMID]:29351312
[Au] Autor:Greiner S; Jud A; Aurich M; Geisenberger C; Uhlmann L; Hilbel T; Kieser M; Katus HA; Mereles D
[Ad] Endereço:Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany.
[Ti] Título:Prognostic relevance of elevated pulmonary arterial pressure assessed non-invasively: Analysis in a large patient cohort with invasive measurements in near temporal proximity.
[So] Source:PLoS One;13(1):e0191206, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The clinical relevance of non-invasively derived pulmonary arterial pressure (PAP) by Doppler echocardiography (DE) has been questioned in the past. However, transthoracic echocardiography is used as a cornerstone examination for patients with dyspnea and suspected pulmonary hypertension (PH). This study aimed to evaluate the prognostic value of non-invasive assessed PAP in a large population of patients with known or suspected cardiopulmonary disease. METHODS: The analyses are based on data of patients of a tertiary cardiology center that received right heart catheterization (RHC) as well as non-invasively assessed PAP by DE within five days, and includes serological and clinical parameters in a retrospective follow-up for up to eight years. RESULTS: Of 1,237 patients, clinical follow-up was possible in 1,038 patients who were included in the statistical analysis. The mean-follow up time was 1,002 days. The composite endpoint of heart transplantation (HTx) or death occurred in n = 308 patients. Elevated PAP measured non-invasively as well as invasively had significant prognostic impact (hazard ratio (HR) 2.32; 95% confidence interval (CI) 1.78-3.04; χ2 = 37.9; p<0.001 versus HR 2.84; 95%CI 2.11-3.82; χ2 = 51.9; p<0.001, respectively). By multivariate analysis, NYHA functional class, N-terminal pro-brain natriuretic peptide, cardiac troponin T, left ventricular ejection fraction, and right ventricular dysfunction remained independently predictive. Incremental prognostic information in a multimodal approach was highly relevant. CONCLUSIONS: In this comprehensive study, elevated pulmonary arterial pressure measured by DE offers similar prognostic information on survival or need for HTx as right heart catheterization. Furthermore, the addition of functional capacity and serological biomarkers delivered incremental prognostic information.
[Mh] Termos MeSH primário: Pressão Arterial
Hipertensão Pulmonar/diagnóstico
Hipertensão Pulmonar/fisiopatologia
Artéria Pulmonar
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Determinação da Pressão Arterial/métodos
Cateterismo Cardíaco
Estudos de Coortes
Ecocardiografia
Ecocardiografia Doppler
Feminino
Seguimentos
Seres Humanos
Hipertensão Pulmonar/mortalidade
Masculino
Meia-Idade
Prognóstico
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Análise de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191206


  8 / 42223 MEDLINE  
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[PMID]:29419696
[Au] Autor:Clement ME; Lin L; Navar AM; Okeke NL; Naggie S; Douglas PS
[Ad] Endereço:Division of Infectious Diseases.
[Ti] Título:Lower likelihood of cardiac procedures after acute coronary syndrome in patients with human immunodeficiency virus/acquired immunodeficiency syndrome.
[So] Source:Medicine (Baltimore);97(6):e9849, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cardiovascular disease (CVD) is an increasing cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected adults; however, this population may be less likely to receive interventions during hospitalization for acute coronary syndrome (ACS). The degree to which this disparity can be attributed to poorly controlled HIV infection is unknown.In this large cohort study, we used the National Inpatient Sample (NIS) to compare rates of cardiac procedures among patients with asymptomatic HIV-infection, symptomatic acquired immunodeficiency syndrome (AIDS), and uninfected adults hospitalized with ACS from 2009 to 2012. Multivariable analysis was used to compare procedure rates by HIV status, with appropriate weighting to account for NIS sampling design including stratification and hospital clustering.The dataset included 1,091,759 ACS hospitalizations, 0.35% of which (n = 3783) were in HIV-infected patients. Patients with symptomatic AIDS, asymptomatic HIV, and uninfected patients differed by sex, race, and income status. Overall rates of cardiac catheterization and revascularization were 53.3% and 37.4%, respectively. In multivariable regression, we found that relative to uninfected patients, those with symptomatic AIDS were less likely to undergo catheterization (odds ratio [OR] 0.48, confidence interval [CI] 0.43-0.55), percutaneous coronary intervention (OR 0.69, CI 0.59-0.79), and coronary artery bypass grafting (0.75, CI 0.61-0.93). No difference was seen for those with asymptomatic HIV relative to uninfected patients (OR 0.93, CI 0.81-1.07; OR 1.06, CI 0.93-1.21; OR 0.88, CI 0.72-1.06, respectively).We found that lower rates of cardiovascular procedures in HIV-infected patients were primarily driven by less frequent procedures in those with AIDS.
[Mh] Termos MeSH primário: Síndrome de Imunodeficiência Adquirida
Síndrome Coronariana Aguda
Cateterismo Cardíaco/estatística & dados numéricos
Ponte de Artéria Coronária/estatística & dados numéricos
Infecções por HIV/epidemiologia
Intervenção Coronária Percutânea/estatística & dados numéricos
[Mh] Termos MeSH secundário: Síndrome de Imunodeficiência Adquirida/diagnóstico
Síndrome de Imunodeficiência Adquirida/epidemiologia
Síndrome Coronariana Aguda/diagnóstico
Síndrome Coronariana Aguda/epidemiologia
Síndrome Coronariana Aguda/cirurgia
Idoso
Infecções Assintomáticas/epidemiologia
Cateterismo Cardíaco/métodos
Estudos de Coortes
Ponte de Artéria Coronária/métodos
Feminino
Hospitalização/estatística & dados numéricos
Seres Humanos
Funções Verossimilhança
Masculino
Meia-Idade
Seleção de Pacientes
Intervenção Coronária Percutânea/métodos
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009849


  9 / 42223 MEDLINE  
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[PMID]:28747203
[Au] Autor:Shi YJ; Lv J; Han XT; Luo GG
[Ad] Endereço:Department of Neurology, Xi'an Jiaotong University, Xi'an, China.
[Ti] Título:Migraine and percutaneous patent foramen ovale closure: a systematic review and meta-analysis.
[So] Source:BMC Cardiovasc Disord;17(1):203, 2017 07 26.
[Is] ISSN:1471-2261
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The association between patent foramen ovale (PFO) and migraine with aura (MA) is well established. However, the benefits of PFO closure are less certain in patients with migraine without aura (MwoA). METHODS: We systematically searched Pubmed for pertinent clinical studies published from January 2000 to July 2015. The primary end-point was the elimination or significant improvement of migraine symptoms after PFO closure. RESULTS: Upon screening an initial list of 315 publications, we identified eight studies that included 546 patients. Overall, our analysis indicated a significant improvement of migraine in 81% of MA cases compared to only 63% of MwoA cases. The summary odds ratio was 2.5 (95% confidence interval 1.09-5.73), and the benefits of PFO closure were significantly greater for patients with MA compared to patients with MwoA (P = 0.03). CONCLUSIONS: The presence of aura provides a reference standard for the clinical selection of patients with migraine for PFO closure intervention.
[Mh] Termos MeSH primário: Cateterismo Cardíaco
Forame Oval Patente/terapia
Enxaqueca com Aura/prevenção & controle
Enxaqueca sem Aura/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Distribuição de Qui-Quadrado
Feminino
Forame Oval Patente/complicações
Forame Oval Patente/diagnóstico
Forame Oval Patente/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Enxaqueca com Aura/diagnóstico
Enxaqueca com Aura/etiologia
Enxaqueca sem Aura/diagnóstico
Enxaqueca sem Aura/etiologia
Razão de Chances
Seleção de Pacientes
Fatores de Risco
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1186/s12872-017-0644-9


  10 / 42223 MEDLINE  
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Registro de Ensaios Clínicos
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[PMID]:29191325
[Au] Autor:Tobis JM; Charles A; Silberstein SD; Sorensen S; Maini B; Horwitz PA; Gurley JC
[Ad] Endereço:David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California. Electronic address: jtobis@mednet.ucla.edu.
[Ti] Título:Percutaneous Closure of Patent Foramen Ovale in Patients With Migraine: The PREMIUM Trial.
[So] Source:J Am Coll Cardiol;70(22):2766-2774, 2017 Dec 05.
[Is] ISSN:1558-3597
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Migraine is a prevalent and disabling disorder. Patent foramen ovale (PFO) has been associated with migraine, but its role in the disorder remains poorly understood. OBJECTIVES: This study examined the efficacy of percutaneous PFO closure as a therapy for migraine with or without aura. METHODS: The PREMIUM (Prospective, Randomized Investigation to Evaluate Incidence of Headache Reduction in Subjects With Migraine and PFO Using the AMPLATZER PFO Occluder to Medical Management) was a double-blind study investigating migraine characteristics over 1 year in subjects randomized to medical therapy with a sham procedure (right heart catheterization) versus medical therapy and PFO closure with the Amplatzer PFO Occluder device (St. Jude Medical, St. Paul, Minnesota). Subjects had 6 to 14 days of migraine per month, had failed at least 3 migraine preventive medications, and had significant right-to-left shunt defined by transcranial Doppler. Primary endpoints were responder rate defined as 50% reduction in migraine attacks and adverse events. Secondary endpoints included reduction in migraine days and efficacy in patients with versus without aura. RESULTS: Of 1,653 subjects consented, 230 were enrolled. There was no difference in responder rate in the PFO closure (45 of 117) versus control (33 of 103) groups. One serious adverse event (transient atrial fibrillation) occurred in 205 subjects who underwent PFO closure. Subjects in the PFO closure group had a significantly greater reduction in headache days (-3.4 vs. -2.0 days/month, p = 0.025). Complete migraine remission for 1 year occurred in 10 patients (8.5%) in the treatment group versus 1 (1%) in the control group (p = 0.01). CONCLUSIONS: PFO closure did not meet the primary endpoint of reduction in responder rate in patients with frequent migraine. (Prospective, Randomized Investigation to Evaluate Incidence of Headache Reduction in Subjects With Migraine and PFO Using the AMPLATZER PFO Occluder to Medical Management [PREMIUM]; NCT00355056).
[Mh] Termos MeSH primário: Cateterismo Cardíaco/métodos
Forame Oval Patente
Transtornos de Enxaqueca
Implante de Prótese
Dispositivo para Oclusão Septal
[Mh] Termos MeSH secundário: Adulto
Método Duplo-Cego
Ecocardiografia Doppler/métodos
Feminino
Forame Oval Patente/complicações
Forame Oval Patente/diagnóstico
Forame Oval Patente/cirurgia
Seres Humanos
Masculino
Meia-Idade
Transtornos de Enxaqueca/complicações
Transtornos de Enxaqueca/diagnóstico
Transtornos de Enxaqueca/fisiopatologia
Transtornos de Enxaqueca/terapia
Manejo da Dor/métodos
Medição da Dor/métodos
Implante de Prótese/efeitos adversos
Implante de Prótese/instrumentação
Implante de Prótese/métodos
Índice de Gravidade de Doença
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171202
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE



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