Myocardial stretch-induced compliance is abrogated under ischemic conditions and restored by cGMP/PKG-related pathways

Introduction: Management of acute myocardial infarction (MI) mandates careful optimization of volemia, which can be challenging due to the inherent risk of congestion. Increased myocardial compliance in response to stretching, known as stretch-induced compliance (SIC), has been recently characterized and partly ascribed to cGMP/cGMP-dependent protein kinase (PKG)-related pathways. We hypothesized that SIC would be impaired in MI but restored by activation of PKG, thereby enabling a better response to volume loading in MI.Methods: We conducted experiments in ex vivo rabbit right ventricular papillary muscles under ischemic and non-ischemic conditions as well as pressure–volume hemodynamic evaluations in experimental in vivo MI induced by left anterior descending artery ligation in rats.Results: Acutely stretching muscles ex vivo yielded increased compliance over the next 15 min, but not under ischemic conditions. PKG agonists, but not PKC agonists, were able to partially restore SIC in ischemic muscles. A similar effect was observed with phosphodiesterase-5 inhibitor (PDE5i) sildenafil, which was amplified by joint B-type natriuretic peptide or nitric oxide donor administration. In vivo translation revealed that volume loading after MI only increased cardiac output in rats infused with PDE5i. Contrarily to vehicle, sildenafil-treated rats showed a clear increase in myocardial compliance upon volume loading.Discussion: Our results suggest that ischemia impairs the adaptive myocardial response to acute stretching and that this may be partly prevented by pharmacological manipulation of the cGMP/PKG pathway, namely, with PDE5i. Further studies are warranted to further elucidate the potential of this intervention in the clinical setting of acute myocardial ischemia

Modulação aguda da função cardíaca diastólica e suas implicações fisiopatológicas

Mestrado Integrado em MedicinaMaster Degree in Medicin

Experience from an evidence-based journey with digital automation for heart failure outpatient management in a Portuguese hospital

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O sistema apelinérgico: papel na fisiologia e patologia humanas e potenciais aplicações terapêuticas

A apelina é um peptídeo recentemente descoberto e identificado como o ligando endógeno do receptor APJ. A apelina e o receptor APJ são expressos numa grande variedade de tecidos, tais como coração, cérebro, rins e pulmões, onde a sua interação pode ter importantes efeitos fisiopatológicos. Com efeito, a última década foi fértil no esclarecimento de possíveis papéis desempenhados pela apelina na fisiologia humana, nomeadamente como peptídeo regulador dos sistemas cardiovascular, hipotálamo-hipófisário, gastrointestinal e imunitário. Um possível envolvimento da apelina na patogênese de doenças com elevada prevalência e co-morbilidades, como a hipertensão arterial, a insuficiência cardíaca e o diabete melito tipo 2, perspectivam-na como um possível alvo terapêutico a explorar no futuro. Este trabalho fornece uma visão geral dos efeitos fisiológicos da apelina e apresenta o possível papel desse peptídeo na patogênese de várias doenças, associado a implicações terapêuticas que poderão vir a ser, assim, exploradas

Social media use by cardiovascular healthcare professionals in Portugal

Introduction and objectives: Social media (SoMe) has a flourishing role in cardiovascular (CV) medicine as a facilitator of academic communication not only during conferences and congresses, but also by scientific societies and journals. However, there is no solid data illustrating the use of SoMe by CV healthcare professionals (CVHP) in Portugal.Hence, the main goal of this national cross-sectional survey was to accurately characterize SoMe use by Portuguese CVHPs. Methods: A 35-item questionnaire was specifically developed for this study, approved by the Digital Health Study Group of the Portuguese Society of Cardiology (SPC), and sent, by e-mail, to the mailing list of the SPC (including 1293 potential recipients). Results and conclusion: There were 206 valid answers. Fifty-two percent of respondents were female and 58% were younger than 44 years of age with almost two out of three participants being physicians. Ninety-two percent of the survey participants reported that they are currently using SoMe; LinkedIn was the most common platform used for professional purposes. Sixty-four percent believed SoMe had had a positive impact on their clinical practice; 77% and 49% had used SoMe for acquiring and sharing information related to COVID-19, respectively.In conclusion, the majority of Portuguese CVHPs that participated in this survey are actively using SoMe, with a greater participation of those <45 years of age; its clinical impact is positive, with a leading role in the dissemination of evidence during the COVID pandemic. Resumo: Introdução e objetivos: As redes sociais desempenham um papel cada vez mais importante na medicina cardiovascular como facilitador da comunicação não só durante congressos científicos, mas também entre sociedades e revistas científicas. Contudo, não foi ainda caracterizado o uso das redes sociais pelos profissionais de saúde cardiovascular em Portugal. Assim, o objetivo deste inquérito de âmbito nacional foi caracterizar o uso das redes sociais pelos profissionais de saúde cardiovascular em Portugal. Métodos: Foi construído um questionário com 35 perguntas dirigido aos profissionais de saúde, que foi aprovado pelo Grupo de Estudo de Saúde Digital da Sociedade Portuguesa de Cardiologia. Esse questionário foi enviado por e-mail para a mailing list da Sociedade Portuguesa de Cardiologia, com 1293 destinatários potenciais. Resultados e conclusão: Foram obtidas 206 respostas válidas. Dos respondedores, 52% eram do sexo feminino e 58% e tinham menos de 44 anos, praticamente dois em cada três eram médicos. Dos respondedores, 92% admitiram usar redes sociais e o LinkedIn foi a plataforma mais usada no âmbito profissional. As redes sociais tiveram um papel positivo na prática clínica de 64% dos respondedores. Em relação à pandemia de Covid-19, 77% admitiram ter obtido informação pelas redes sociais e 49% partilharam informação sobre esse tópico. A maioria dos profissionais de saúde cardiovascular de Portugal que participou neste inquérito é usuária ativa das redes sociais, com uma participação preponderante dos indivíduos com menos de 45 anos; o seu impacto global sobre a prática clínica é positivo, com um papel de destaque na disseminação de evidência científica durante a pandemia de Covid-19

Twitter promotion predicts citation rates of cardiovascular articles: a preliminary analysis from the ESC Journals Randomized Study

AIMS The association between the dissemination of scientific articles on Twitter and online visibility (including Altmetric score) is still controversial and the impact on citation rates has never been addressed for cardiovascular medicine journals. METHODS AND RESULTS The ESC Journals Study randomized 696 papers published in the ESC Journals family (March 2018-May 2019) for promotion on Twitter or to a control arm (with no active tweeting from ESC channels) and aimed to assess if Twitter promotion was associated with an increase in citation rate (primary endpoint) and Altmetric score. This is a preliminary analysis of 536 articles (77% of total) published until December 2018 (therefore, papers published at least 6 months before collecting citation and Altmetrics data). In the analysis of the primary endpoint, Twitter promotion of articles was associated with a 1.43 (95% confidence interval 1.29-1.58) higher rate of citations, and this effect was independent of the type of article. Both Altmetric score and number of users tweeting were positively associated with the number of citations in both arms, with evidence of a stronger association (interaction) in the Twitter arm. CONCLUSION Therefore, a social media strategy of Twitter promotion for cardiovascular medicine papers seems to be associated with increased online visibility and higher number of citations. The final analysis will include 696 papers and 2-year scientific citation rate and is estimated to be concluded in March 2021