Determinants and clinical outcomes of patients who refused anticoagulation: findings from the global GARFIELD-AF registry.

Objective: There is a substantial incidence of stroke in patients with atrial fibrillation (AF) not receiving anticoagulation. The reasons for not receiving anticoagulation are generally attributed to clinician's choice, however, a proportion of AF patients refuse anticoagulation. The aim of our study was to investigate factors associated with patient refusal of anticoagulation and the clinical outcomes in these patients.

Sacubitril/valsartan versus enalapril on exercise capacity in patients with heart failure with reduced ejection fraction: A randomized, double-blind, active-controlled study.

Unlabelled: Sacubitril/valsartan reduces mortality in patients with heart failure with reduced ejection fraction (HFrEF) when compared with enalapril. However, it is unknown the effect of both treatments on exercise capacity. We compared sacubitril/valsartan versus enalapril in patients with HFrEF based on peak oxygen consumption (VO) and 6-minute walk test (6-MWT).

Is Current Drug Therapy for Heart Failure Sufficient to Control Heart Rate of Patients?

Background: Studies have shown that heart failure (HF) patients with heart rate (HR) < 70 bpm have had a better clinical outcome and lower morbidity and mortality compared with those with HR > 70 bpm. However, many HF patients maintain an elevated HR.

Objective: To evaluate HR and the prescription of medications known to reduce mortality in HF patients attending an outpatient cardiology clinic.

Android to gynoid fat ratio and its association with functional capacity in male patients with heart failure.

Aims: We studied the association between android (A) to gynoid (G) fat ratio and functional capacity (peak VO ) in male patients with heart failure with reduced ejection fraction (HFrEF).

Methods And Results: We enrolled 118 male patients with HFrEF with left ventricular ejection fraction (LVEF) <40%. Body composition (by using dual x-ray absorptiometry) and peak VO (by cardiopulmonary exercise testing) were measured.

Biomarkers for prediction of mortality in left-sided infective endocarditis.

Background: Evidence regarding biomarkers for risk prediction in patients with infective endocarditis (IE) is limited. We aimed to investigate the value of a panel of biomarkers for the prediction of in-hospital mortality in patients with IE.

Methods: Between 2016 and 2018, consecutive IE patients admitted to the emergency department were prospectively included.

Stroke prevention in patients from Latin American countries with non-valvular atrial fibrillation: Insights from the GARFIELD-AF registry.

Background: Atrial fibrillation (AF) is an important preventable cause of stroke. Anticoagulation (AC) therapy can reduce this risk. However, prescribing patterns and outcomes in patients with non-valvular AF (NVAF) from Latin American countries are poorly described.

Infection in Patients with Decompensated Heart Failure: In-Hospital Mortality and Outcome.

Background: Heart failure (HF) is a syndrome, whose advanced forms have a poor prognosis, which is aggravated by the presence of comorbidities.

Objective: We assessed the impact of infection in patients with decompensated HF admitted to a tertiary university-affiliated hospital in the city of São Paulo.

Methods: This study assessed 260 patients consecutively admitted to our unit because of decompensated HF.

Effect of Exercise Training and Testosterone Replacement on Skeletal Muscle Wasting in Patients With Heart Failure With Testosterone Deficiency.

Objective: To examine whether combined testosterone replacement and exercise training (ET) therapies would potentiate the beneficial effects of isolated therapies on neurovascular control and muscle wasting in patients with heart failure (HF) with testosterone deficiency.

Patients And Methods: From January 10, 2010, through July 25, 2013, 39 male patients with HF, New York Heart Association functional class III, total testosterone level less than 249 ng/dL (to convert to nmol/L, multiply by .03467), and free testosterone level less than 131 pmol/L were randomized to training (4-month cycloergometer training), testosterone (intramuscular injection of testosterone undecylate for 4 months), and training + testosterone groups.

Testosterone deficiency increases hospital readmission and mortality rates in male patients with heart failure.

Background: Testosterone deficiency in patients with heart failure (HF) is associated with decreased exercise capacity and mortality; however, its impact on hospital readmission rate is uncertain. Furthermore, the relationship between testosterone deficiency and sympathetic activation is unknown.

Objective: We investigated the role of testosterone level on hospital readmission and mortality rates as well as sympathetic nerve activity in patients with HF.

Heart failure care in low- and middle-income countries: a systematic review and meta-analysis.

Background: Heart failure places a significant burden on patients and health systems in high-income countries. However, information about its burden in low- and middle-income countries (LMICs) is scant. We thus set out to review both published and unpublished information on the presentation, causes, management, and outcomes of heart failure in LMICs.

Thermal vasodilation using a portable infrared thermal blanket in decompensated heart failure.

Adjunctive and non-pharmacological therapies, such as heat, for the treatment of heart failure patients have been proposed. Positive results have been obtained in clinically stable patients, but no studies of the use of thermal therapy in patients with decompensated heart failure (DHF) have been reported. An open randomized clinical trial was designed in patients with DHF and controls.

Short-term add-on therapy with angiotensin receptor blocker for end-stage inotrope-dependent heart failure patients: B-type natriuretic peptide reduction in a randomized clinical trial.

Objective: We aimed to evaluate angiotensin receptor blocker add-on therapy in patients with low cardiac output during decompensated heart failure.

Methods: We selected patients with decompensated heart failure, low cardiac output, dobutamine dependence, and an ejection fraction <0.45 who were receiving an angiotensin-converting enzyme inhibitor.

Continuous noninvasive hemodynamic monitoring in decompensated heart failure.

Background: The clinical and hemodynamic assessment at the bedside and the use of pulmonary artery catheter for the estimation of hemodynamic data have been used in decompensated heart failure. However, there are no data on the use of continuous noninvasive hemodynamic monitoring.

Objective: To compare the data obtained through noninvasive hemodynamic monitoring with invasive ones in patients with decompensated heart failure and refractory to treatment.

Haemodynamic effects of aliskiren in decompensated severe heart failure.

Aim: The renin-angiotensin-aldosterone system (RAAS) has dual pathways to angiotensin II production; therefore, multiple blockages may be useful in heart failure. In this study, we evaluated the short-term haemodynamic effects of aliskiren, a direct renin inhibitor, in patients with decompensated severe heart failure who were also taking angiotensin-converting enzyme (ACE) inhibitors.

Materials And Methods: A total of 16 patients (14 men, two women, mean age: 60.

Exercise training improves neurovascular control and functional capacity in heart failure patients regardless of age.

Background: Exercise training is a non-pharmacological strategy for treatment of heart failure. Exercise training improves functional capacity and quality of life in patients. Moreover, exercise training reduces muscle sympathetic nerve activity (MSNA) and peripheral vasoconstriction.

Predictors of low cardiac output in decompensated severe heart failure.

Objective: To identify predictors of low cardiac output and mortality in decompensated heart failure.

Introduction: Introduction: Patients with decompensated heart failure have a high mortality rate, especially those patients with low cardiac output. However, this clinical presentation is uncommon, and its management is controversial.

Constrictive pericarditis with extensive calcification.

A patient with signs and symptoms of right heart failure of unknown etiology was referred to a referral hospital in the eastern area of the city of São Paulo with a diagnosis of calcified constrictive pericarditis and was treated by surgery. This pathology is characterized by an irreversible process of pericardium calcification, and surgery is the only alternative to control the symptoms and improve patients' quality of life. This case drew special attention due to the extensive calcification involving the interventricular septum.

Study of pro-thrombotic and pro-inflammatory factors in Chagas cardiomyopathy.

Background: The relationship between inflammatory and prothrombotic activity in chagas cardiomyopathy and in other etiologies is unclear.

Objective: To study the profile of pro-thrombotic and pro-inflammatory markers in patients with Chagas' heart failure and compare them with patients of non-chagas etiology.

Methods: Cross-sectional cohort.

The effect of Sao Paulo's smoke-free legislation on carbon monoxide concentration in hospitality venues and their workers.

Background: Studies have shown that there is no safe level of secondhand smoke (SHS) exposure and there is a close link between SHS and the risk of coronary heart disease and stroke. Carbon monoxide (CO) is one of the most important components present in SHS.

Objective: To evaluate the impact of the smoking ban law in the city of Sao Paulo, Brazil, on the CO concentration in restaurants, bars, night clubs and similar venues and in their workers.

[Chagas cardiomyopathy: prognosis in clinical and hemodynamic profile C].

Background: patients with heart failure (HF) who are admitted showing poor perfusion and congestion (clinical-hemodynamic profile C) are the group that evolves with the worst prognosis in decompensated heart failure. However, there is little information in literature on the etiology of cardiopathy influences the outcome of patients in advanced stage.

Objective: to assess the outcome of patients admitted with clinical and hemodynamic profile C and verify the role of the etiology in this phase.

[Anemia in patients with advanced heart failure].

Background: anemia is linked with worsening of progress in patients with heart failure (HF). However, there are few studies of anemia in patients with advanced HF.

Objective: to evaluate the characteristics of anemia in HF at an advanced stage.