Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: Cardiac rehabilitation in cancer patients is a new concept, constituted by an exercise scheme, which aims to reduce cardiovascular risk and improve cardiopulmonary fitness in cancer patients and survivors.Objective: To characterize cardiac rehabilitation and its benefits in cancer patients.Methodology: A documentary review of the literature was carried out through a search in Google Scholar, Science Direct, PubMed, SciELO and Redalyc with the titles cardiac rehabilitation in cancer patients, cardio-oncology rehabilitation, benefits of cardiac rehabilitation in cancer patients, cardiotoxicity and their English translations.Results: Through the analysis of a total of 53 articles, it was identified that exercises linked to cardiac rehabilitation have several benefits in patients receiving cancer treatment, so that several authors agree that this is key to improve survival and quality of life of cancer patients.Conclusions: Cardiac rehabilitation is a strategy that has had an impact on reducing the effects derived from the complications of the cardiotoxic effect of anticancer drugs.

Introduction: External validation is important in investigations of predictive models and scales. Scales without external validation have limited clinical relevance.Objective: To evaluate the external validity of a cardiovascular disease mortality scale in older adults.Methods: The study population consisted of 82 cases and 246 controls. To evaluate the construct validity, it was decided to define the association between the risk categories given by the scale created and the relationship with the condition at discharge. This was evaluated using chi-square and Kendall's Tau for the association of ordinal variables. Criterion validity was assessed by correlating the new scale designed with the EPICARDIAN scale and calculating the Kendall's Tau-b association coefficient and chi-square. Sensitivity, specificity, positive predictive value, negative predictive value, as well as positive and negative likelihood coefficient were determined when applying the scale created to the external validation sample.Results: The designed scale discriminated better than the EPICARDIAN scale in both sexes; 68.8 % of the deceased in the validation group were classified as high risk.Conclusions: The external validation of the risk scale showed a high predictive capacity and high prognostic efficiency parameters, which facilitates its acceptance and use to optimize community and individual interventions aimed at older adults in primary health care.

Introduction: In patients with rheumatoid arthritis there is an increased morbidity and mortality due to atherosclerotic cardiovascular disease.Objective: To determine the prevalence of subclinical atherosclerotic disease in patients with rheumatoid arthritis and to identify independently associated factors.Methods: A cross-sectional study was conducted in 110 patients with a diagnosis of rheumatoid arthritis seen at the International Health Center "La Pradera" in the period from January 2010 to December 2018. The frequency of subclinical atherosclerotic disease was determined, evaluated with carotid Doppler ultrasound. Variables such as time of evolution and disease activity, erythrocyte sedimentation rate, C-reactive protein and rheumatoid factor were also considered.Results: Female patients predominated. The median age of the patients was 41 years. The average time of disease evolution was 8 years. Smoking was the most frequent risk factor in these cases (23.6%), as were arterial hypertension and diabetes mellitus. The prevalence of subclinical atherosclerotic disease was 53.5%. The existence of positive rheumatoid factor was independently associated with the presence of subclinical atherosclerotic disease in patients with rheumatoid arthritis, as was active disease (DAS28 > 2.6) and the coexistence of HDLc > 1.38 mmol/L in those patients with negative rheumatoid factor.Conclusions: The marked presence of subclinical atherosclerotic disease in patients with rheumatoid arthritis was associated with markers of inflammation.

Peripartum cardiomyopathy is the alteration of the cardiac muscle that manifests as heart failure and appears in the last month of pregnancy or in the first five months postpartum. The aim of the article was to describe the case of a 15-year-old adolescent with a history of peripartum dilated cardiomyopathy and a pregnancy. The patient came to the Intensive Care Unit because she presented with decay and slurred speech. Deviation of the labial commissure on the left side and decreased muscle strength of the right hemibody were noted. Among the family pathologic antecedents, he referred to the mother with arterial hypertension and the maternal grandmother who died of ischemic heart disease. The association between cardioembolic ischemic stroke and peripartum dilated cardiomyopathy has a poor prognosis, requiring surveillance of risk factors and patient follow-up, as well as intensive and early treatment.

Introduction: Heart failure is an important public health problem that has shown some sex differences in clinical, echocardiographic patterns and treatment modalities.Objectives: To evaluate the influence of sex on the clinical presentation and prognosis of heart failure in hospitalized patients.Methods: A retrospective study was conducted, including 153 patients with a diagnosis of heart failure admitted to the Institute of Cardiology and Cardiovascular Surgery of Havana, Cuba, in the period from January 2017 to December 2021.Results: The history of heart failure and the acute chronic clinical form predominated in men, while in women the acute form and orthopnea were more frequent. Electrocardiographic and laboratory parameters were similar in both sexes. Heart failure with preserved ejection fraction prevailed in women, while left ventricular dilation was more frequent in men. Women underwent coronary angiography less frequently and there was no difference with respect to pharmacological treatment. Men had a greater number of rehospitalizations for heart failure, although women presented a tendency towards greater in-hospital mortality for this cause.Conclusions: In those hospitalized for heart failure, women with preserved ejection fraction and high left ventricular filling pressures had a worse prognosis on admission with a tendency to higher in-hospital mortality.

Constrictive pericarditis is a rare disease. Often idiopathic, it may also be secondary to cardiovascular surgery, radiation therapy, and tuberculosis, mainly in developed countries. The stiff, non-elastic pericardium leads to impaired ventricular diastolic filling with exaggerated interdependence and dissociation between intracardiac and intrathoracic pressures during respiration. Pericarditis presents insidiously, with signs and symptoms of systemic venous congestion. The aim of the case presentation is to show the effectiveness and importance of imaging diagnosis of constrictive pericarditis, as well as the advantages of surgical management. We describe the case of a 14-year-old adolescent with this diagnosis as a result of an insect bite, who underwent pericardiectomy. The evolution was satisfactory. Improvement in inspiratory collapse of the inferior vena cava was observed. Severe mitral and moderate tricuspid insufficiencies decreased to moderate and mild respectively, with definitive reabsorption of ascites.

Introduction: Cardiovascular diseases are multicausal and preventable; therefore, they become the object of public health attentionObjective: To design a predictive model of cardiovascular disease mortality risk for the older adult population, based on the social determinants of health identified.Methods: An observational, retrospective, analytical, retrospective, case-control study was carried out in elderly patients belonging to three health areas of the municipality of Santiago de Cuba during the year 2021. The sample consisted of patients who died of atherosclerotic cardiovascular disease (cases) and living older adults without the disease (controls). The cross-product ratio, confidence interval and chi-squared test were used to identify the social determinants associated with mortality.Results: The predictors that were part of the model were: low economic income, no continuous care, low accessibility to healthy food, no family support, no control of identified risk factors, poor material living conditions and family dysfunction. The area under the curve was 0.808 and the Hosmer-Lemeshow test was greater than 0.05 (p = 0.39).Conclusions: The social determinants of health selected in the study could predict mortality from cardiovascular disease in the elderly and facilitate the orientation of preventive interventions in this population group. Likewise, the predictive model obtained showed very good discrimination and calibration capacity.

Introduction: Patients with myocardial infarction in the presence of atrial fibrillation have an indication for incorporation into cardiac rehabilitation programmes. However, there is no consensus on the type, duration and intensity of exercise and there is a fear of complications.Objective: To evaluate the effect of physical training in patients after acute myocardial infarction with atrial fibrillation.Methods: Quasi-experimental, longitudinal, prospective study of morphofunctional variables and the presence of complications in 15 patients with atrial fibrillation and a non-equivalent control group of 15 patients without atrial fibrillation, who underwent 12 weeks of supervised physical training in the convalescence phase of myocardial infarction.Results: We found a predominance of male sex, persistent atrial fibrillation, anterior topography infarction, revascularization by percutaneous coronary intervention and cardiovascular risk factors such as hypertension and smoking. Morphofunctional variables body mass index, left ventricular ejection fraction and peak oxygen consumption experienced significant results (p< 0.05) at the end of intervention in the absence of complications.Conclusions: Supervised physical training for 12 weeks in patients with myocardial infarction in the presence of atrial fibrillation improves functional capacity, body mass index and left ventricular ejection fraction.

Circular shunt is a rare situation where there is a short circuit, in which blood reaches the cardiac chamber itself without passing through the pulmonary or systemic capillary bed. Different variables, mainly anatomical, are involved in its development, which allow the existence of this intracardiac circulation. However, it seems that right ventricular dysfunction may be one of the most decisive variables. In order to recognize the deleterious impact of circular shunt physiology and the importance of echocardiography for its diagnosis, we describe the case of a newborn infant diagnosed with pulmonary atresia with an intact interventricular septum, a right ventricle with dysplastic inflow and a severely hypertrophic right ventricle. Atrioseptectomy, modified Blalock-Taussig fistula and pulmonary commissurotomy were performed. Postoperative evolution was torpid with manifestations of systemic hypoperfusion, generalized o edema, oligoanuria, metabolic acidosis, hyperlactatemia and progressive hypoxemia. Echocardiographic evaluation demonstrated circular shunt physiology. The resulting multi-organ failure ended the patient's life.

Tetralogy of Fallot is the most common cyanotic heart disease in adulthood and one of the most serious repercussions during pregnancy when uncorrected. We present the case of a 21-year-old pregnant woman, carrier of unrepaired Tetralogy of Fallot, who began pregnancy with mild cyanosis and acceptable haemogasometric values, but with the onset of haemodynamic changes in pregnancy and the physiological increase in utero-placental demands, she began to present fetal growth restriction. She delivered preterm at 32 weeks and gave birth to a 1900 g male newborn with a favorable outcome. In the immediate puerperium it was necessary to transfer her to the Intensive Care Unit due to maternal decompensation, secondary to bleeding from uterine atony; an event that was effectively treated without significant intercurrences. Follow-up by a multidisciplinary team was crucial for dealing with complications and obtaining good maternal and perinatal outcomes.