array:25 [
  "pii" => "S0870255113001261"
  "issn" => "08702551"
  "doi" => "10.1016/j.repc.2013.05.001"
  "estado" => "S300"
  "fechaPublicacion" => "2013-07-01"
  "aid" => "297"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2013"
  "documento" => "simple-article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "dis"
  "cita" => "Rev Port Cardiol. 2013;32:577-9"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 4585
    "formatos" => array:3 [
      "EPUB" => 171
      "HTML" => 3432
      "PDF" => 982
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0870255113000401"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2012.10.012"
    "estado" => "S300"
    "fechaPublicacion" => "2013-07-01"
    "aid" => "256"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2013;32:581-91"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 7866
      "formatos" => array:3 [
        "EPUB" => 164
        "HTML" => 5708
        "PDF" => 1994
      ]
    ]
    "pt" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original</span>"
      "titulo" => "Unidade de S&#237;ncope &#8211; Experi&#234;ncia de um centro com base em organigramas de decis&#227;o para s&#237;ncope de etiologia incerta ap&#243;s a avalia&#231;&#227;o inicial"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "581"
          "paginaFinal" => "591"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Syncope unit&#58; Experience of a center using diagnostic flowcharts for syncope of uncertain etiology after initial assessment"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0035"
          "etiqueta" => "Figura 7"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr7.jpeg"
              "Alto" => 917
              "Ancho" => 1368
              "Tamanyo" => 100164
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Faixas et&#225;rias dos doentes avaliados na Unidade de S&#237;ncope&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Pedro Sousa, Nuno Marques, Ricardo Faria, Joana Trigo, Joana Chin, Jos&#233; Amado, Salom&#233; Pereira, Rui Candeias, Il&#237;dio de Jesus"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "Sousa"
            ]
            1 => array:2 [
              "nombre" => "Nuno"
              "apellidos" => "Marques"
            ]
            2 => array:2 [
              "nombre" => "Ricardo"
              "apellidos" => "Faria"
            ]
            3 => array:2 [
              "nombre" => "Joana"
              "apellidos" => "Trigo"
            ]
            4 => array:2 [
              "nombre" => "Joana"
              "apellidos" => "Chin"
            ]
            5 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Amado"
            ]
            6 => array:2 [
              "nombre" => "Salom&#233;"
              "apellidos" => "Pereira"
            ]
            7 => array:2 [
              "nombre" => "Rui"
              "apellidos" => "Candeias"
            ]
            8 => array:2 [
              "nombre" => "Il&#237;dio"
              "apellidos" => "de Jesus"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255113000401?idApp=UINPBA00004E"
    "url" => "/08702551/0000003200000078/v1_201308220036/S0870255113000401/v1_201308220036/pt/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0870255113001236"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2012.10.018"
    "estado" => "S300"
    "fechaPublicacion" => "2013-07-01"
    "aid" => "294"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2013;32:567-75"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 5712
      "formatos" => array:3 [
        "EPUB" => 181
        "HTML" => 4357
        "PDF" => 1174
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Characterization of acute heart failure hospitalizations in a Portuguese cardiology department"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "567"
          "paginaFinal" => "575"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Caracteriza&#231;&#227;o das hospitaliza&#231;&#245;es por insufici&#234;ncia card&#237;aca aguda num servi&#231;o de cardiologia portugu&#234;s"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1271
              "Ancho" => 2014
              "Tamanyo" => 173244
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Oral medication on admission and at discharge for acute heart failure patients&#46; McNemar test for related samples&#46; ACEI&#58; angiotensin-converting enzyme inhibitor&#59; ARB&#58; angiotensin receptor blocker&#59; BB&#58; beta-adrenergic receptor blocker&#59; CCB&#58; calcium channel blocker&#59; MRA&#58; mineralocorticoid receptor antagonist&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana Catarina Pinho-Gomes, Jos&#233; Silva Cardoso, Lu&#237;s Filipe Azevedo, Rui Almeida, Teresa Pinho, Maria J&#250;lia Maciel"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Ana Catarina"
              "apellidos" => "Pinho-Gomes"
            ]
            1 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Silva Cardoso"
            ]
            2 => array:2 [
              "nombre" => "Lu&#237;s Filipe"
              "apellidos" => "Azevedo"
            ]
            3 => array:2 [
              "nombre" => "Rui"
              "apellidos" => "Almeida"
            ]
            4 => array:2 [
              "nombre" => "Teresa"
              "apellidos" => "Pinho"
            ]
            5 => array:2 [
              "nombre" => "Maria J&#250;lia"
              "apellidos" => "Maciel"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255113001236?idApp=UINPBA00004E"
    "url" => "/08702551/0000003200000078/v1_201308220036/S0870255113001236/v1_201308220036/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:19 [
      "pii" => "S0870255113001236"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2012.10.018"
      "estado" => "S300"
      "fechaPublicacion" => "2013-07-01"
      "aid" => "294"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "article"
      "crossmark" => 0
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "Rev Port Cardiol. 2013;32:567-75"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 5712
        "formatos" => array:3 [
          "EPUB" => 181
          "HTML" => 4357
          "PDF" => 1174
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
        "titulo" => "Characterization of acute heart failure hospitalizations in a Portuguese cardiology department"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "567"
            "paginaFinal" => "575"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Caracteriza&#231;&#227;o das hospitaliza&#231;&#245;es por insufici&#234;ncia card&#237;aca aguda num servi&#231;o de cardiologia portugu&#234;s"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "pt" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1271
                "Ancho" => 2014
                "Tamanyo" => 173244
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Oral medication on admission and at discharge for acute heart failure patients&#46; McNemar test for related samples&#46; ACEI&#58; angiotensin-converting enzyme inhibitor&#59; ARB&#58; angiotensin receptor blocker&#59; BB&#58; beta-adrenergic receptor blocker&#59; CCB&#58; calcium channel blocker&#59; MRA&#58; mineralocorticoid receptor antagonist&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Ana Catarina Pinho-Gomes, Jos&#233; Silva Cardoso, Lu&#237;s Filipe Azevedo, Rui Almeida, Teresa Pinho, Maria J&#250;lia Maciel"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "Ana Catarina"
                "apellidos" => "Pinho-Gomes"
              ]
              1 => array:2 [
                "nombre" => "Jos&#233;"
                "apellidos" => "Silva Cardoso"
              ]
              2 => array:2 [
                "nombre" => "Lu&#237;s Filipe"
                "apellidos" => "Azevedo"
              ]
              3 => array:2 [
                "nombre" => "Rui"
                "apellidos" => "Almeida"
              ]
              4 => array:2 [
                "nombre" => "Teresa"
                "apellidos" => "Pinho"
              ]
              5 => array:2 [
                "nombre" => "Maria J&#250;lia"
                "apellidos" => "Maciel"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255113001236?idApp=UINPBA00004E"
      "url" => "/08702551/0000003200000078/v1_201308220036/S0870255113001236/v1_201308220036/en/main.assets"
    ]
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
    "titulo" => "Profile of the acute heart failure patient in Portugal"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "577"
        "paginaFinal" => "579"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Dulce Brito"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Dulce"
            "apellidos" => "Brito"
            "email" => array:1 [
              0 => "dulcebrito59&#64;gmail&#46;com"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Cardiology Department&#44; Santa Maria University Hospital&#44; Lisbon&#59; CCUL &#40;Cardiology Centre&#44; Lisbon University&#44; Portugal"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Perfil do doente com insufici&#234;ncia card&#237;aca aguda em Portugal"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">This editorial refers to &#8220;Characterization of acute heart failure hospitalizations in a Portuguese cardiology department&#8221; by A&#46;C&#46; Pinho-Gomes et al&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Acute heart failure &#40;AHF&#41; is a highly prevalent condition&#44; a common cause of hospitalization associated with significant in-hospital mortality and poor short- and longer-term outcomes&#44; and represents a significant burden on overall healthcare costs&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The condition is difficult to define and classify&#46; The latest ESC guidelines on acute and chronic heart failure &#40;HF&#41; refer to AHF as &#8220;the term used to describe the rapid onset of&#44; or change in&#44; symptoms and signs of heart failure&#46; It is a life-threatening condition that requires immediate medical attention and usually leads to urgent admission to hospital&#46;&#8221;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> The assumptions included in this apparently undefined &#8220;definition&#8221; of AHF in fact apply to all forms of acute heart failure&#44; a complex clinical syndrome that varies widely in terms of underlying pathophysiologic mechanisms&#44; clinical presentations and targeted therapies&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Most AHF patients presenting to an emergency department are admitted to hospital<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a> and it is the most common diagnosis at discharge in patients aged &#62;65 years&#46; The syndrome&#39;s high in-hospital mortality of 3-12&#37; and short-term readmission rate of 25-30&#37;&#44; with the associated costs&#44; are critical issues worldwide&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;6&#44;13&#44;14</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The heterogeneity of AHF syndrome&#40;s&#41; hinders any attempt at classification or application of a single-algorithm approach&#46; AHF may present either as new-onset HF or worsening of pre-existing HF&#44; and these two forms may differ in causes&#44; precipitating factors&#44; associated comorbidities&#44; therapeutic options&#44; in-hospital mortality and post-discharge prognosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;4&#44;13&#44;15</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Regarding clinical presentations&#44; data from the EuroHeart Failure Survey &#40;EHFS&#41; II &#40;3580 patients with AHF enrolled&#41; showed that 65&#46;4&#37; of patients presented with decompensated HF&#44; 11&#46;4&#37; with hypertensive HF&#44; 16&#46;2&#37; with pulmonary edema&#44; 3&#46;9&#37; with cardiogenic shock&#44; and 3&#46;2&#37; with isolated right HF&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Cardiac dysfunction may be due to different causes&#44; including acute coronary syndromes&#44; valve dysfunction&#44; arrhythmias&#44; pericardial disease&#44; and increased left ventricular afterload&#46; These different causes &#40;which can also act as precipitating factors for the syndrome&#41; may coexist and interact in the same patient&#44; modulating clinical presentation and influencing management options and outcomes&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Data on AHF studies and registries provide valuable information regarding the pathophysiologic&#44; therapeutic&#44; and prognostic issues related to different clinical scenarios&#59; they are useful for assessing the extent of compliance with heart failure management guidelines and can help improve clinical assessment and both short- and long-term outcome&#46; Also&#44; analysis of similarities and differences in patient characteristics and management in different centers and countries&#44; in various settings&#44; may help to determine the most useful independent predictors of a worse prognosis and to define better strategies to obtain more favorable outcomes&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The paper by Pinho-Gomes et al&#46; in this issue of the <span class="elsevierStyleItalic">Journal</span><a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">16</span></a> presents the results of a hospital-based&#44; observational&#44; retrospective cohort study conducted in a single large Portuguese center &#40;a teaching hospital&#41;&#44; focusing on acute heart failure admissions to the cardiology department during 2010&#46; Patients enrolled met the ESC criteria for HF<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> and were selected by review of the medical records of patients discharged with a diagnosis of AHF &#40;either primary or secondary to another acute cardiac event&#41;&#46; Acute coronary syndromes &#40;ACS&#41; patients were included&#46; All patients were followed for at least 12 months after discharge&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The study aimed to clarify the overall clinical characteristics of patients with AHF and their hospital management and outcomes&#44; and also to identify predictors of rehospitalization or death at six and 12 months after discharge&#46; Importantly&#44; patients admitted in two different AHF clinical contexts &#8722; ACS vs&#46; non-ACS &#8722; were compared&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">AHF accounted for 21&#37; of all admissions &#40;201&#47;924&#41; over the one-year inclusion period&#46; Most were men &#40;61&#37;&#41; and the mean age was 69 years&#46; AHF was new-onset in 53&#37; and most admissions &#40;63&#37;&#41; were in the context of ACS&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The prevalence of new-onset AHF as well as of ACS as the precipitating factor were both higher than in the EHFSII<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and ALARM-HF<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> studies that included patients of a mixed provenance &#40;internal medicine and cardiology wards&#41;&#46; However&#44; new-onset AHF was lower than in ATTEND&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> an epidemiological study of AHF in the Asia Pacific region that excluded patients with ACS&#46; Acute decompensated chronic heart failure &#40;DCHF&#41; was the clinical presentation in 46&#46;8&#37; of patients and pulmonary edema in 21&#46;4&#37;&#44; similar to other studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;14</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Comparison of AHF patients presenting with or without ACS showed significant differences&#44; on the basis of which two different clinical profiles can be defined&#46; Patients presenting with ACS as the precipitating event were younger&#44; less often men&#44; and more commonly had a history of chronic hypertension &#40;72&#46;4&#37; vs&#46; 55&#46;4&#37;&#41; and coronary artery disease &#40;45&#37; vs&#46; 27&#37;&#41;&#46; New-onset HF was the rule &#40;74&#37; vs&#46; 17&#46;6&#37;&#41; and pulmonary edema was a common clinical presentation &#40;26&#37; vs&#46; 13&#46;5&#37;&#41;&#46; In contrast&#44; patients with non-ACS AHF were older and more often men&#44; the cause of cardiac dysfunction was more frequently valve disease &#40;31&#37; vs&#46; 5&#46;5&#37;&#41; or dilated cardiomyopathy &#40;17&#46;6 vs&#46; 1&#46;6&#37;&#41;&#44; and a history of previous HF hospitalizations was more common &#40;25&#46;7&#37; vs&#46; 8&#46;7&#37;&#41;&#44; as was atrial fibrillation &#40;46&#37; vs&#46; 22&#37;&#41;&#46; The factor triggering AHF in this population was frequently arrhythmia &#40;39&#46;2&#37;&#41; and DCHF was the dominant acute clinical presentation &#40;82&#46;4&#37;&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The prevalence of cardiovascular diseases &#8722; hypertension and coronary artery disease being the most common &#8722; and of non-cardiovascular morbidities was comparable to those in previous larger surveys&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#44;13&#44;14</span></a> Echocardiographic examination and plasma brain natriuretic peptide &#40;BNP&#41; measurement were performed on admission &#40;or within a few days&#41; in 96&#46;5&#37; and 90&#37; of patients&#44; respectively&#44; showing good adherence to the ESC guidelines&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Most patients &#40;73&#46;2&#37;&#41; had reduced ejection fraction &#40;77&#46;6&#37; of ACS patients and 65&#37; of non-ACS patients&#41;&#46; However&#44; in proportion&#44; more non-ACS patients showed either more severe systolic dysfunction than ACS patients &#40;42&#37; vs&#46; 32&#46;8&#37;&#44; p&#61;0&#46;01&#41; or preserved systolic function &#40;34&#46;8&#37; vs&#46; 22&#46;4&#37;&#44; p&#61;0&#46;01&#41;&#44; these dissimilar functional phenotypes being in line with the heterogeneity of AHF syndromes&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">On admission&#44; blood pressure&#44; heart rate&#44; oxygen levels&#44; serum hemoglobin&#44; sodium and potassium&#44; and creatinine clearance were similar in patients presenting with ACS to those with non-ACS presentation&#46; Acute coronary syndrome patients&#44; as expected&#44; were admitted more often to the intensive cardiac care unit &#40;ICCU&#41;&#44; more frequently underwent coronary angiography and percutaneous interventions&#44; and were more often treated with intravenous vasodilators&#44; non-invasive ventilation and intra-aortic balloon pump&#46; However&#44; invasive ventilation was needed to a similar degree in both populations&#44; as were therapy with intravenous diuretics and inotropes&#44; renal filtration&#44; and ICD implantation&#46; Overall&#44; acute care management was similar to previous studies&#44; although intravenous inotropes were used less often<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#44;14</span></a> and percutaneous coronary interventions were performed more frequently<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3</span></a> due to the high proportion of ST-segment elevation ACS patients in this study&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">16</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Rates of prescription of major oral HF medications increased from admission to discharge&#44; a common observation in several previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#44;13</span></a> One possible reason in the study by Pinho-Gomes et al&#46; may be the low &#40;15&#37;&#41; rate of previous HF-related admissions&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The mean total hospital stay was 11 days and in-hospital mortality was 5&#46;5&#37;&#44; similar in patients with or without ACS presentation&#46; A shorter in-hospital stay &#40;4&#46;3&#8211;9 days&#41; was reported in ADHERE&#44;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> EHFS II<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and ALARM-HF&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> while in ATTEND a surprising long in-hospital stay &#40;21 days&#41; was observed&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> In-hospital mortality also varied significantly between different studies&#44; being 3&#46;8&#37; in ADHERE<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and OPTIMIZE-HF&#44;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> 6&#46;7&#37; in EHFS II&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> 7&#46;7&#37; in ATTEND&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> and 12&#37; in ALARM-HF&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> Lower in-hospital mortality may be related to shorter in-hospital stay&#44; although this may not necessarily translate into better short- or long-term prognosis in HF patients&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> Several factors may be expected to be associated with longer in-hospital stay in AHF patients&#44; particularly high BNP on admission and need for ICCU admission&#44; both signs of worse clinical status&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The HF rehospitalization rate and all-cause mortality in this study were respectively 20&#46;9&#37; and 10&#46;9&#37; at six months and 23&#46;9&#37; and 15&#46;9&#37; at 12 months&#44; and did not differ in patients with or without ACS at index presentation&#46; However&#44; HF mortality at six months was significantly higher in patients outside the setting of ACS presentation at index admission &#40;12&#46;2&#37; vs&#46; 4&#46;7&#37;&#44; p&#61;0&#46;053&#41;&#44; a population that presented mostly with DCHF&#46; In fact&#44; post-discharge prognosis appears in general to be better in patients with new-onset AHF&#46; Data from the Italian registries showed that post-discharge mortality at both six months and one year was lower in new-onset AHF patients than in those with pre-existing chronic HF&#44; and the rehospitalization rate was also lower in the former group&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;8</span></a> In other studies<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;7&#44;15</span></a> the results were also consistent with a better clinical course in patients with new-onset HF&#44; whereas a previous history of worsening HF was shown to be an independent predictor of mortality&#46; There also appears to be a cumulative risk with increasing duration and number of HF hospitalizations&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">In the study by Pinho-Gomes et al&#46;&#44; a previous history of HF hospitalization was an important predictor of rehospitalization or death during one-year follow-up after first hospital discharge &#40;threefold increase in risk&#41;&#46; Low sodium on admission and the presence of atrial fibrillation were the other predictors of higher risk&#44; while reduced LVEF on admission conferred a decreased risk of rehospitalization or death&#46; The reason for this latter finding is not clear&#44; as reduced LVEF was similarly present on admission in patients with or without ACS&#44; the former presenting mostly with new-onset AHF and having better associated long-term prognosis than the latter&#46; Reduced LVEF on admission may have been modified after percutaneous coronary revascularization procedures &#40;performed in half of ACS patients&#41;&#44; or left ventricular remodeling may have occurred during follow-up after the ACS and be a confounding factor regarding the effect of initially measured LVEF on long-term prognosis&#46; Also&#44; patients with reduced or preserved ejection fraction on admission were not compared head-to-head&#46; Comparison was mainly between AHF patients with and without ACS on presentation&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">When comparing AHF studies&#44; several issues need to be clarified&#44; particularly the criteria for syndrome definition on admission&#44; the admission setting &#40;emergency department&#44; intensive care unit&#44; cardiology ward or internal medicine ward&#41; and types of patients included &#40;ACS patients often require different and specific management&#41;&#46; Also&#44; HF with reduced and with preserved ejection fraction are to some extent different entities with distinct risk factors&#44; management and prognosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;19</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Each of these variables contributes to different results because the populations are dissimilar&#44; are managed differently&#44; and may have also different prognosis in both the short and long term&#46; Despite the limitations pointed by the authors&#44; the study by Pinho-Gomes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">16</span></a> contributes significantly to our knowledge of the situation in Portugal concerning acute heart failure admissions and helps to identify a subset of high-risk patients most in need of close surveillance&#44; ideally to be included in an HF management program&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0105" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of interest"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:19 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characteristics and outcomes of patients hospitalized for heart failure in the United States&#58; rationale&#44; design&#44; and preliminary observations from the first 100&#44;000 cases in the Acute Decompensated Heart Failure National Registry &#40;ADHERE&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "K&#46;F&#46; Adams Jr&#46;"
                            1 => "G&#46;C&#46; Fonarow"
                            2 => "C&#46;L&#46; Emerman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ahj.2004.08.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Heart J"
                        "fecha" => "2005"
                        "volumen" => "149"
                        "paginaInicial" => "209"
                        "paginaFinal" => "216"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15846257"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nationwide survey on acute heart failure in cardiology ward services in Italy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46; Tavazzi"
                            1 => "A&#46;P&#46; Maggioni"
                            2 => "D&#46; Lucci"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehi845"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2006"
                        "volumen" => "27"
                        "paginaInicial" => "1207"
                        "paginaFinal" => "1215"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16603579"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "EuroHeart Failure Survey II &#40;EHFS II&#41;&#58; a survey on hospitalized acute heart failure patients&#58; description of population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;S&#46; Nieminen"
                            1 => "D&#46; Brutsaert"
                            2 => "K&#46; Dickstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehl193"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2006"
                        "volumen" => "27"
                        "paginaInicial" => "2725"
                        "paginaFinal" => "2736"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17000631"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical profile&#44; contemporary management and one-year mortality in patients with severe acute heart failure syndromes&#58; The EFICA study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46; Zannad"
                            1 => "A&#46; Mebazaa"
                            2 => "Y&#46; Juilli&#232;re"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejheart.2006.01.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Heart Fail"
                        "fecha" => "2006"
                        "volumen" => "8"
                        "paginaInicial" => "697"
                        "paginaFinal" => "705"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16516552"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute heart failure syndromes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Gheorghiade"
                            1 => "P&#46;S&#46; Pang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2008.10.041"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2009"
                        "volumen" => "53"
                        "paginaInicial" => "557"
                        "paginaFinal" => "573"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19215829"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The economic burden of heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;B&#46; O&#8217;Connell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Cardiol"
                        "fecha" => "2000"
                        "volumen" => "23"
                        "paginaInicial" => "6"
                        "paginaFinal" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of nonfatal hospitalization for heart failure on subsequent mortality in patients with chronic heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46;D&#46; Solomon"
                            1 => "J&#46; Dobson"
                            2 => "S&#46; Pocock"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.107.696906"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2007"
                        "volumen" => "116"
                        "paginaInicial" => "1482"
                        "paginaFinal" => "1487"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17724259"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multicenter prospective observational study on acute and chronic heart failure&#58; the one-year follow-up results of IN-HF Outcome Registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46; Tavazzi"
                            1 => "M&#46; Senni"
                            2 => "M&#46; Metra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Circ Heart Fail"
                        "fecha" => "2013"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012&#58; The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology&#46; Developed in collaboration with the Heart Failure Association &#40;HFA&#41; of the ESC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;J&#46; McMurray"
                            1 => "S&#46; Adamopoulos"
                            2 => "S&#46;D&#46; Anker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurjhf/hfs105"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Heart Fail"
                        "fecha" => "2012"
                        "volumen" => "14"
                        "paginaInicial" => "803"
                        "paginaFinal" => "869"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22828712"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Correlation of the Agency for Health Care Policy and Research congestive heart failure admission guideline with mortality&#58; peer review organization voluntary hospital association initiative to decrease events &#40;PROVIDE&#41; for congestive heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46; Graff"
                            1 => "J&#46; Orledge"
                            2 => "M&#46;J&#46; Radford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Emerg Med"
                        "fecha" => "1999"
                        "volumen" => "34"
                        "paginaInicial" => "429"
                        "paginaFinal" => "437"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10499942"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "AHA&#46; Heart Disease and Stroke statistics-2007 update&#46; Dallas&#44; Tx&#59; 2006&#46;"
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparison of criterion standard methods to diagnose acute heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46;P&#46; Collins"
                            1 => "C&#46;J&#46; Lindsell"
                            2 => "D&#46;M&#46; Yealy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1751-7133.2012.00288.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Congest Heart Fail"
                        "fecha" => "2012"
                        "volumen" => "18"
                        "paginaInicial" => "262"
                        "paginaFinal" => "271"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22994440"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute decompensated heart failure syndromes &#40;ATTEND&#41; registry&#46; A prospective observational multicenter cohort study&#58; rationale&#44; design&#44; and preliminary data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "N&#46; Sato"
                            1 => "K&#46; Kajimoto"
                            2 => "K&#46; Asai"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ahj.2010.03.019"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Heart J"
                        "fecha" => "2010"
                        "volumen" => "159"
                        "paginaInicial" => "949"
                        "paginaFinal" => "955"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20569705"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical presentation&#44; management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment &#40;ALARM-HF&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46; Follath"
                            1 => "M&#46;B&#46; Yilmaz"
                            2 => "J&#46;F&#46; Delgado"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-010-2113-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2011"
                        "volumen" => "37"
                        "paginaInicial" => "619"
                        "paginaFinal" => "626"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21210078"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute heart failure&#58; multiple clinical profiles and mechanisms require tailored therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Metra"
                            1 => "M&#46; Felker"
                            2 => "V&#46; Zac&#224;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2010.04.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cardiol"
                        "fecha" => "2010"
                        "volumen" => "144"
                        "paginaInicial" => "175"
                        "paginaFinal" => "179"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20537739"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characterization of acute heart failure hospitalizations in a Portuguese cardiology department"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;C&#46; Pinho-Gomes"
                            1 => "J&#46; Silva Cardoso"
                            2 => "L&#46;F&#46; Azevedo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2013"
                        "volumen" => "32"
                        "paginaInicial" => "567"
                        "paginaFinal" => "575"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characteristics&#44; treatments and outcomes of patients with preserved systolic function hospitalized for heart failure&#58; a report from the OPTIMIZE-HF Registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "G&#46;C&#46; Fonarow"
                            1 => "W&#46;G&#46; Stough"
                            2 => "W&#46;T&#46; Abraham"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2007.04.064"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2007"
                        "volumen" => "50"
                        "paginaInicial" => "768"
                        "paginaFinal" => "777"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17707182"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relation of disease etiology and risk factors to heart failure with preserved or reduced ejection fraction&#58; insights from the National Heart&#44; Lung and Blood Institute&#39;s Framingham Heart Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46;S&#46; Lee"
                            1 => "P&#46; Gona"
                            2 => "R&#46;S&#46; Vasan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.108.815944"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2009"
                        "volumen" => "119"
                        "paginaInicial" => "3070"
                        "paginaFinal" => "3077"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19506115"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparing new onset heart failure with reduced ejection fraction and new onset heart failure with preserved ejection fraction&#58; an epidemiologic perspective"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46;P&#46; Brouwers"
                            1 => "H&#46;L&#46; Hilleg"
                            2 => "W&#46;H&#46; van Gilst"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11897-012-0115-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Heart Fail Rep"
                        "fecha" => "2012"
                        "volumen" => "9"
                        "paginaInicial" => "363"
                        "paginaFinal" => "368"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22968403"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/08702551/0000003200000078/v1_201308220036/S0870255113001261/v1_201308220036/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "358"
    "tipo" => "SECCION"
    "pt" => array:2 [
      "titulo" => "Artigos originais"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "pt"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003200000078/v1_201308220036/S0870255113001261/v1_201308220036/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255113001261?idApp=UINPBA00004E"
]
Partilhar
Informação da revista

Estatísticas

Siga este link para acessar o texto completo do artigo

Editorial comment
Profile of the acute heart failure patient in Portugal
Perfil do doente com insuficiência cardíaca aguda em Portugal
Dulce Brito
Cardiology Department, Santa Maria University Hospital, Lisbon; CCUL (Cardiology Centre, Lisbon University, Portugal
Lido
7701
Vezes
que se leu este artigo
2300
Total PDF
5401
Total HTML
Compartilhar estatísticas
 array:25 [
  "pii" => "S0870255113001261"
  "issn" => "08702551"
  "doi" => "10.1016/j.repc.2013.05.001"
  "estado" => "S300"
  "fechaPublicacion" => "2013-07-01"
  "aid" => "297"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2013"
  "documento" => "simple-article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "dis"
  "cita" => "Rev Port Cardiol. 2013;32:577-9"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 4585
    "formatos" => array:3 [
      "EPUB" => 171
      "HTML" => 3432
      "PDF" => 982
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0870255113000401"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2012.10.012"
    "estado" => "S300"
    "fechaPublicacion" => "2013-07-01"
    "aid" => "256"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2013;32:581-91"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 7866
      "formatos" => array:3 [
        "EPUB" => 164
        "HTML" => 5708
        "PDF" => 1994
      ]
    ]
    "pt" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original</span>"
      "titulo" => "Unidade de S&#237;ncope &#8211; Experi&#234;ncia de um centro com base em organigramas de decis&#227;o para s&#237;ncope de etiologia incerta ap&#243;s a avalia&#231;&#227;o inicial"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "581"
          "paginaFinal" => "591"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Syncope unit&#58; Experience of a center using diagnostic flowcharts for syncope of uncertain etiology after initial assessment"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0035"
          "etiqueta" => "Figura 7"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr7.jpeg"
              "Alto" => 917
              "Ancho" => 1368
              "Tamanyo" => 100164
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Faixas et&#225;rias dos doentes avaliados na Unidade de S&#237;ncope&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Pedro Sousa, Nuno Marques, Ricardo Faria, Joana Trigo, Joana Chin, Jos&#233; Amado, Salom&#233; Pereira, Rui Candeias, Il&#237;dio de Jesus"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "Sousa"
            ]
            1 => array:2 [
              "nombre" => "Nuno"
              "apellidos" => "Marques"
            ]
            2 => array:2 [
              "nombre" => "Ricardo"
              "apellidos" => "Faria"
            ]
            3 => array:2 [
              "nombre" => "Joana"
              "apellidos" => "Trigo"
            ]
            4 => array:2 [
              "nombre" => "Joana"
              "apellidos" => "Chin"
            ]
            5 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Amado"
            ]
            6 => array:2 [
              "nombre" => "Salom&#233;"
              "apellidos" => "Pereira"
            ]
            7 => array:2 [
              "nombre" => "Rui"
              "apellidos" => "Candeias"
            ]
            8 => array:2 [
              "nombre" => "Il&#237;dio"
              "apellidos" => "de Jesus"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255113000401?idApp=UINPBA00004E"
    "url" => "/08702551/0000003200000078/v1_201308220036/S0870255113000401/v1_201308220036/pt/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0870255113001236"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2012.10.018"
    "estado" => "S300"
    "fechaPublicacion" => "2013-07-01"
    "aid" => "294"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2013;32:567-75"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 5712
      "formatos" => array:3 [
        "EPUB" => 181
        "HTML" => 4357
        "PDF" => 1174
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Characterization of acute heart failure hospitalizations in a Portuguese cardiology department"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "567"
          "paginaFinal" => "575"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Caracteriza&#231;&#227;o das hospitaliza&#231;&#245;es por insufici&#234;ncia card&#237;aca aguda num servi&#231;o de cardiologia portugu&#234;s"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1271
              "Ancho" => 2014
              "Tamanyo" => 173244
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Oral medication on admission and at discharge for acute heart failure patients&#46; McNemar test for related samples&#46; ACEI&#58; angiotensin-converting enzyme inhibitor&#59; ARB&#58; angiotensin receptor blocker&#59; BB&#58; beta-adrenergic receptor blocker&#59; CCB&#58; calcium channel blocker&#59; MRA&#58; mineralocorticoid receptor antagonist&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana Catarina Pinho-Gomes, Jos&#233; Silva Cardoso, Lu&#237;s Filipe Azevedo, Rui Almeida, Teresa Pinho, Maria J&#250;lia Maciel"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Ana Catarina"
              "apellidos" => "Pinho-Gomes"
            ]
            1 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Silva Cardoso"
            ]
            2 => array:2 [
              "nombre" => "Lu&#237;s Filipe"
              "apellidos" => "Azevedo"
            ]
            3 => array:2 [
              "nombre" => "Rui"
              "apellidos" => "Almeida"
            ]
            4 => array:2 [
              "nombre" => "Teresa"
              "apellidos" => "Pinho"
            ]
            5 => array:2 [
              "nombre" => "Maria J&#250;lia"
              "apellidos" => "Maciel"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255113001236?idApp=UINPBA00004E"
    "url" => "/08702551/0000003200000078/v1_201308220036/S0870255113001236/v1_201308220036/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:19 [
      "pii" => "S0870255113001236"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2012.10.018"
      "estado" => "S300"
      "fechaPublicacion" => "2013-07-01"
      "aid" => "294"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "article"
      "crossmark" => 0
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "Rev Port Cardiol. 2013;32:567-75"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 5712
        "formatos" => array:3 [
          "EPUB" => 181
          "HTML" => 4357
          "PDF" => 1174
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
        "titulo" => "Characterization of acute heart failure hospitalizations in a Portuguese cardiology department"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "567"
            "paginaFinal" => "575"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Caracteriza&#231;&#227;o das hospitaliza&#231;&#245;es por insufici&#234;ncia card&#237;aca aguda num servi&#231;o de cardiologia portugu&#234;s"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "pt" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1271
                "Ancho" => 2014
                "Tamanyo" => 173244
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Oral medication on admission and at discharge for acute heart failure patients&#46; McNemar test for related samples&#46; ACEI&#58; angiotensin-converting enzyme inhibitor&#59; ARB&#58; angiotensin receptor blocker&#59; BB&#58; beta-adrenergic receptor blocker&#59; CCB&#58; calcium channel blocker&#59; MRA&#58; mineralocorticoid receptor antagonist&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Ana Catarina Pinho-Gomes, Jos&#233; Silva Cardoso, Lu&#237;s Filipe Azevedo, Rui Almeida, Teresa Pinho, Maria J&#250;lia Maciel"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "Ana Catarina"
                "apellidos" => "Pinho-Gomes"
              ]
              1 => array:2 [
                "nombre" => "Jos&#233;"
                "apellidos" => "Silva Cardoso"
              ]
              2 => array:2 [
                "nombre" => "Lu&#237;s Filipe"
                "apellidos" => "Azevedo"
              ]
              3 => array:2 [
                "nombre" => "Rui"
                "apellidos" => "Almeida"
              ]
              4 => array:2 [
                "nombre" => "Teresa"
                "apellidos" => "Pinho"
              ]
              5 => array:2 [
                "nombre" => "Maria J&#250;lia"
                "apellidos" => "Maciel"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255113001236?idApp=UINPBA00004E"
      "url" => "/08702551/0000003200000078/v1_201308220036/S0870255113001236/v1_201308220036/en/main.assets"
    ]
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
    "titulo" => "Profile of the acute heart failure patient in Portugal"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "577"
        "paginaFinal" => "579"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Dulce Brito"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Dulce"
            "apellidos" => "Brito"
            "email" => array:1 [
              0 => "dulcebrito59&#64;gmail&#46;com"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Cardiology Department&#44; Santa Maria University Hospital&#44; Lisbon&#59; CCUL &#40;Cardiology Centre&#44; Lisbon University&#44; Portugal"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Perfil do doente com insufici&#234;ncia card&#237;aca aguda em Portugal"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">This editorial refers to &#8220;Characterization of acute heart failure hospitalizations in a Portuguese cardiology department&#8221; by A&#46;C&#46; Pinho-Gomes et al&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Acute heart failure &#40;AHF&#41; is a highly prevalent condition&#44; a common cause of hospitalization associated with significant in-hospital mortality and poor short- and longer-term outcomes&#44; and represents a significant burden on overall healthcare costs&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The condition is difficult to define and classify&#46; The latest ESC guidelines on acute and chronic heart failure &#40;HF&#41; refer to AHF as &#8220;the term used to describe the rapid onset of&#44; or change in&#44; symptoms and signs of heart failure&#46; It is a life-threatening condition that requires immediate medical attention and usually leads to urgent admission to hospital&#46;&#8221;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> The assumptions included in this apparently undefined &#8220;definition&#8221; of AHF in fact apply to all forms of acute heart failure&#44; a complex clinical syndrome that varies widely in terms of underlying pathophysiologic mechanisms&#44; clinical presentations and targeted therapies&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Most AHF patients presenting to an emergency department are admitted to hospital<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a> and it is the most common diagnosis at discharge in patients aged &#62;65 years&#46; The syndrome&#39;s high in-hospital mortality of 3-12&#37; and short-term readmission rate of 25-30&#37;&#44; with the associated costs&#44; are critical issues worldwide&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;6&#44;13&#44;14</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The heterogeneity of AHF syndrome&#40;s&#41; hinders any attempt at classification or application of a single-algorithm approach&#46; AHF may present either as new-onset HF or worsening of pre-existing HF&#44; and these two forms may differ in causes&#44; precipitating factors&#44; associated comorbidities&#44; therapeutic options&#44; in-hospital mortality and post-discharge prognosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;4&#44;13&#44;15</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Regarding clinical presentations&#44; data from the EuroHeart Failure Survey &#40;EHFS&#41; II &#40;3580 patients with AHF enrolled&#41; showed that 65&#46;4&#37; of patients presented with decompensated HF&#44; 11&#46;4&#37; with hypertensive HF&#44; 16&#46;2&#37; with pulmonary edema&#44; 3&#46;9&#37; with cardiogenic shock&#44; and 3&#46;2&#37; with isolated right HF&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Cardiac dysfunction may be due to different causes&#44; including acute coronary syndromes&#44; valve dysfunction&#44; arrhythmias&#44; pericardial disease&#44; and increased left ventricular afterload&#46; These different causes &#40;which can also act as precipitating factors for the syndrome&#41; may coexist and interact in the same patient&#44; modulating clinical presentation and influencing management options and outcomes&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Data on AHF studies and registries provide valuable information regarding the pathophysiologic&#44; therapeutic&#44; and prognostic issues related to different clinical scenarios&#59; they are useful for assessing the extent of compliance with heart failure management guidelines and can help improve clinical assessment and both short- and long-term outcome&#46; Also&#44; analysis of similarities and differences in patient characteristics and management in different centers and countries&#44; in various settings&#44; may help to determine the most useful independent predictors of a worse prognosis and to define better strategies to obtain more favorable outcomes&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The paper by Pinho-Gomes et al&#46; in this issue of the <span class="elsevierStyleItalic">Journal</span><a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">16</span></a> presents the results of a hospital-based&#44; observational&#44; retrospective cohort study conducted in a single large Portuguese center &#40;a teaching hospital&#41;&#44; focusing on acute heart failure admissions to the cardiology department during 2010&#46; Patients enrolled met the ESC criteria for HF<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> and were selected by review of the medical records of patients discharged with a diagnosis of AHF &#40;either primary or secondary to another acute cardiac event&#41;&#46; Acute coronary syndromes &#40;ACS&#41; patients were included&#46; All patients were followed for at least 12 months after discharge&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The study aimed to clarify the overall clinical characteristics of patients with AHF and their hospital management and outcomes&#44; and also to identify predictors of rehospitalization or death at six and 12 months after discharge&#46; Importantly&#44; patients admitted in two different AHF clinical contexts &#8722; ACS vs&#46; non-ACS &#8722; were compared&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">AHF accounted for 21&#37; of all admissions &#40;201&#47;924&#41; over the one-year inclusion period&#46; Most were men &#40;61&#37;&#41; and the mean age was 69 years&#46; AHF was new-onset in 53&#37; and most admissions &#40;63&#37;&#41; were in the context of ACS&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The prevalence of new-onset AHF as well as of ACS as the precipitating factor were both higher than in the EHFSII<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and ALARM-HF<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> studies that included patients of a mixed provenance &#40;internal medicine and cardiology wards&#41;&#46; However&#44; new-onset AHF was lower than in ATTEND&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> an epidemiological study of AHF in the Asia Pacific region that excluded patients with ACS&#46; Acute decompensated chronic heart failure &#40;DCHF&#41; was the clinical presentation in 46&#46;8&#37; of patients and pulmonary edema in 21&#46;4&#37;&#44; similar to other studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;14</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Comparison of AHF patients presenting with or without ACS showed significant differences&#44; on the basis of which two different clinical profiles can be defined&#46; Patients presenting with ACS as the precipitating event were younger&#44; less often men&#44; and more commonly had a history of chronic hypertension &#40;72&#46;4&#37; vs&#46; 55&#46;4&#37;&#41; and coronary artery disease &#40;45&#37; vs&#46; 27&#37;&#41;&#46; New-onset HF was the rule &#40;74&#37; vs&#46; 17&#46;6&#37;&#41; and pulmonary edema was a common clinical presentation &#40;26&#37; vs&#46; 13&#46;5&#37;&#41;&#46; In contrast&#44; patients with non-ACS AHF were older and more often men&#44; the cause of cardiac dysfunction was more frequently valve disease &#40;31&#37; vs&#46; 5&#46;5&#37;&#41; or dilated cardiomyopathy &#40;17&#46;6 vs&#46; 1&#46;6&#37;&#41;&#44; and a history of previous HF hospitalizations was more common &#40;25&#46;7&#37; vs&#46; 8&#46;7&#37;&#41;&#44; as was atrial fibrillation &#40;46&#37; vs&#46; 22&#37;&#41;&#46; The factor triggering AHF in this population was frequently arrhythmia &#40;39&#46;2&#37;&#41; and DCHF was the dominant acute clinical presentation &#40;82&#46;4&#37;&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The prevalence of cardiovascular diseases &#8722; hypertension and coronary artery disease being the most common &#8722; and of non-cardiovascular morbidities was comparable to those in previous larger surveys&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#44;13&#44;14</span></a> Echocardiographic examination and plasma brain natriuretic peptide &#40;BNP&#41; measurement were performed on admission &#40;or within a few days&#41; in 96&#46;5&#37; and 90&#37; of patients&#44; respectively&#44; showing good adherence to the ESC guidelines&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Most patients &#40;73&#46;2&#37;&#41; had reduced ejection fraction &#40;77&#46;6&#37; of ACS patients and 65&#37; of non-ACS patients&#41;&#46; However&#44; in proportion&#44; more non-ACS patients showed either more severe systolic dysfunction than ACS patients &#40;42&#37; vs&#46; 32&#46;8&#37;&#44; p&#61;0&#46;01&#41; or preserved systolic function &#40;34&#46;8&#37; vs&#46; 22&#46;4&#37;&#44; p&#61;0&#46;01&#41;&#44; these dissimilar functional phenotypes being in line with the heterogeneity of AHF syndromes&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">On admission&#44; blood pressure&#44; heart rate&#44; oxygen levels&#44; serum hemoglobin&#44; sodium and potassium&#44; and creatinine clearance were similar in patients presenting with ACS to those with non-ACS presentation&#46; Acute coronary syndrome patients&#44; as expected&#44; were admitted more often to the intensive cardiac care unit &#40;ICCU&#41;&#44; more frequently underwent coronary angiography and percutaneous interventions&#44; and were more often treated with intravenous vasodilators&#44; non-invasive ventilation and intra-aortic balloon pump&#46; However&#44; invasive ventilation was needed to a similar degree in both populations&#44; as were therapy with intravenous diuretics and inotropes&#44; renal filtration&#44; and ICD implantation&#46; Overall&#44; acute care management was similar to previous studies&#44; although intravenous inotropes were used less often<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#44;14</span></a> and percutaneous coronary interventions were performed more frequently<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3</span></a> due to the high proportion of ST-segment elevation ACS patients in this study&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">16</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Rates of prescription of major oral HF medications increased from admission to discharge&#44; a common observation in several previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#44;13</span></a> One possible reason in the study by Pinho-Gomes et al&#46; may be the low &#40;15&#37;&#41; rate of previous HF-related admissions&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The mean total hospital stay was 11 days and in-hospital mortality was 5&#46;5&#37;&#44; similar in patients with or without ACS presentation&#46; A shorter in-hospital stay &#40;4&#46;3&#8211;9 days&#41; was reported in ADHERE&#44;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> EHFS II<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and ALARM-HF&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> while in ATTEND a surprising long in-hospital stay &#40;21 days&#41; was observed&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> In-hospital mortality also varied significantly between different studies&#44; being 3&#46;8&#37; in ADHERE<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and OPTIMIZE-HF&#44;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> 6&#46;7&#37; in EHFS II&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> 7&#46;7&#37; in ATTEND&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> and 12&#37; in ALARM-HF&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> Lower in-hospital mortality may be related to shorter in-hospital stay&#44; although this may not necessarily translate into better short- or long-term prognosis in HF patients&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> Several factors may be expected to be associated with longer in-hospital stay in AHF patients&#44; particularly high BNP on admission and need for ICCU admission&#44; both signs of worse clinical status&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The HF rehospitalization rate and all-cause mortality in this study were respectively 20&#46;9&#37; and 10&#46;9&#37; at six months and 23&#46;9&#37; and 15&#46;9&#37; at 12 months&#44; and did not differ in patients with or without ACS at index presentation&#46; However&#44; HF mortality at six months was significantly higher in patients outside the setting of ACS presentation at index admission &#40;12&#46;2&#37; vs&#46; 4&#46;7&#37;&#44; p&#61;0&#46;053&#41;&#44; a population that presented mostly with DCHF&#46; In fact&#44; post-discharge prognosis appears in general to be better in patients with new-onset AHF&#46; Data from the Italian registries showed that post-discharge mortality at both six months and one year was lower in new-onset AHF patients than in those with pre-existing chronic HF&#44; and the rehospitalization rate was also lower in the former group&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;8</span></a> In other studies<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;7&#44;15</span></a> the results were also consistent with a better clinical course in patients with new-onset HF&#44; whereas a previous history of worsening HF was shown to be an independent predictor of mortality&#46; There also appears to be a cumulative risk with increasing duration and number of HF hospitalizations&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">In the study by Pinho-Gomes et al&#46;&#44; a previous history of HF hospitalization was an important predictor of rehospitalization or death during one-year follow-up after first hospital discharge &#40;threefold increase in risk&#41;&#46; Low sodium on admission and the presence of atrial fibrillation were the other predictors of higher risk&#44; while reduced LVEF on admission conferred a decreased risk of rehospitalization or death&#46; The reason for this latter finding is not clear&#44; as reduced LVEF was similarly present on admission in patients with or without ACS&#44; the former presenting mostly with new-onset AHF and having better associated long-term prognosis than the latter&#46; Reduced LVEF on admission may have been modified after percutaneous coronary revascularization procedures &#40;performed in half of ACS patients&#41;&#44; or left ventricular remodeling may have occurred during follow-up after the ACS and be a confounding factor regarding the effect of initially measured LVEF on long-term prognosis&#46; Also&#44; patients with reduced or preserved ejection fraction on admission were not compared head-to-head&#46; Comparison was mainly between AHF patients with and without ACS on presentation&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">When comparing AHF studies&#44; several issues need to be clarified&#44; particularly the criteria for syndrome definition on admission&#44; the admission setting &#40;emergency department&#44; intensive care unit&#44; cardiology ward or internal medicine ward&#41; and types of patients included &#40;ACS patients often require different and specific management&#41;&#46; Also&#44; HF with reduced and with preserved ejection fraction are to some extent different entities with distinct risk factors&#44; management and prognosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;19</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Each of these variables contributes to different results because the populations are dissimilar&#44; are managed differently&#44; and may have also different prognosis in both the short and long term&#46; Despite the limitations pointed by the authors&#44; the study by Pinho-Gomes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">16</span></a> contributes significantly to our knowledge of the situation in Portugal concerning acute heart failure admissions and helps to identify a subset of high-risk patients most in need of close surveillance&#44; ideally to be included in an HF management program&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0105" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of interest"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:19 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characteristics and outcomes of patients hospitalized for heart failure in the United States&#58; rationale&#44; design&#44; and preliminary observations from the first 100&#44;000 cases in the Acute Decompensated Heart Failure National Registry &#40;ADHERE&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "K&#46;F&#46; Adams Jr&#46;"
                            1 => "G&#46;C&#46; Fonarow"
                            2 => "C&#46;L&#46; Emerman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ahj.2004.08.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Heart J"
                        "fecha" => "2005"
                        "volumen" => "149"
                        "paginaInicial" => "209"
                        "paginaFinal" => "216"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15846257"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nationwide survey on acute heart failure in cardiology ward services in Italy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46; Tavazzi"
                            1 => "A&#46;P&#46; Maggioni"
                            2 => "D&#46; Lucci"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehi845"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2006"
                        "volumen" => "27"
                        "paginaInicial" => "1207"
                        "paginaFinal" => "1215"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16603579"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "EuroHeart Failure Survey II &#40;EHFS II&#41;&#58; a survey on hospitalized acute heart failure patients&#58; description of population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;S&#46; Nieminen"
                            1 => "D&#46; Brutsaert"
                            2 => "K&#46; Dickstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehl193"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2006"
                        "volumen" => "27"
                        "paginaInicial" => "2725"
                        "paginaFinal" => "2736"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17000631"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical profile&#44; contemporary management and one-year mortality in patients with severe acute heart failure syndromes&#58; The EFICA study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46; Zannad"
                            1 => "A&#46; Mebazaa"
                            2 => "Y&#46; Juilli&#232;re"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejheart.2006.01.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Heart Fail"
                        "fecha" => "2006"
                        "volumen" => "8"
                        "paginaInicial" => "697"
                        "paginaFinal" => "705"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16516552"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute heart failure syndromes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Gheorghiade"
                            1 => "P&#46;S&#46; Pang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2008.10.041"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2009"
                        "volumen" => "53"
                        "paginaInicial" => "557"
                        "paginaFinal" => "573"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19215829"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The economic burden of heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;B&#46; O&#8217;Connell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Cardiol"
                        "fecha" => "2000"
                        "volumen" => "23"
                        "paginaInicial" => "6"
                        "paginaFinal" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of nonfatal hospitalization for heart failure on subsequent mortality in patients with chronic heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46;D&#46; Solomon"
                            1 => "J&#46; Dobson"
                            2 => "S&#46; Pocock"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.107.696906"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2007"
                        "volumen" => "116"
                        "paginaInicial" => "1482"
                        "paginaFinal" => "1487"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17724259"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multicenter prospective observational study on acute and chronic heart failure&#58; the one-year follow-up results of IN-HF Outcome Registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46; Tavazzi"
                            1 => "M&#46; Senni"
                            2 => "M&#46; Metra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Circ Heart Fail"
                        "fecha" => "2013"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012&#58; The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology&#46; Developed in collaboration with the Heart Failure Association &#40;HFA&#41; of the ESC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;J&#46; McMurray"
                            1 => "S&#46; Adamopoulos"
                            2 => "S&#46;D&#46; Anker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurjhf/hfs105"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Heart Fail"
                        "fecha" => "2012"
                        "volumen" => "14"
                        "paginaInicial" => "803"
                        "paginaFinal" => "869"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22828712"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Correlation of the Agency for Health Care Policy and Research congestive heart failure admission guideline with mortality&#58; peer review organization voluntary hospital association initiative to decrease events &#40;PROVIDE&#41; for congestive heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46; Graff"
                            1 => "J&#46; Orledge"
                            2 => "M&#46;J&#46; Radford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Emerg Med"
                        "fecha" => "1999"
                        "volumen" => "34"
                        "paginaInicial" => "429"
                        "paginaFinal" => "437"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10499942"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "AHA&#46; Heart Disease and Stroke statistics-2007 update&#46; Dallas&#44; Tx&#59; 2006&#46;"
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparison of criterion standard methods to diagnose acute heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46;P&#46; Collins"
                            1 => "C&#46;J&#46; Lindsell"
                            2 => "D&#46;M&#46; Yealy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1751-7133.2012.00288.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Congest Heart Fail"
                        "fecha" => "2012"
                        "volumen" => "18"
                        "paginaInicial" => "262"
                        "paginaFinal" => "271"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22994440"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute decompensated heart failure syndromes &#40;ATTEND&#41; registry&#46; A prospective observational multicenter cohort study&#58; rationale&#44; design&#44; and preliminary data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "N&#46; Sato"
                            1 => "K&#46; Kajimoto"
                            2 => "K&#46; Asai"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ahj.2010.03.019"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Heart J"
                        "fecha" => "2010"
                        "volumen" => "159"
                        "paginaInicial" => "949"
                        "paginaFinal" => "955"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20569705"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical presentation&#44; management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment &#40;ALARM-HF&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46; Follath"
                            1 => "M&#46;B&#46; Yilmaz"
                            2 => "J&#46;F&#46; Delgado"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-010-2113-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2011"
                        "volumen" => "37"
                        "paginaInicial" => "619"
                        "paginaFinal" => "626"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21210078"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute heart failure&#58; multiple clinical profiles and mechanisms require tailored therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Metra"
                            1 => "M&#46; Felker"
                            2 => "V&#46; Zac&#224;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2010.04.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cardiol"
                        "fecha" => "2010"
                        "volumen" => "144"
                        "paginaInicial" => "175"
                        "paginaFinal" => "179"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20537739"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characterization of acute heart failure hospitalizations in a Portuguese cardiology department"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;C&#46; Pinho-Gomes"
                            1 => "J&#46; Silva Cardoso"
                            2 => "L&#46;F&#46; Azevedo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2013"
                        "volumen" => "32"
                        "paginaInicial" => "567"
                        "paginaFinal" => "575"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characteristics&#44; treatments and outcomes of patients with preserved systolic function hospitalized for heart failure&#58; a report from the OPTIMIZE-HF Registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "G&#46;C&#46; Fonarow"
                            1 => "W&#46;G&#46; Stough"
                            2 => "W&#46;T&#46; Abraham"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2007.04.064"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2007"
                        "volumen" => "50"
                        "paginaInicial" => "768"
                        "paginaFinal" => "777"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17707182"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relation of disease etiology and risk factors to heart failure with preserved or reduced ejection fraction&#58; insights from the National Heart&#44; Lung and Blood Institute&#39;s Framingham Heart Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46;S&#46; Lee"
                            1 => "P&#46; Gona"
                            2 => "R&#46;S&#46; Vasan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.108.815944"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2009"
                        "volumen" => "119"
                        "paginaInicial" => "3070"
                        "paginaFinal" => "3077"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19506115"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparing new onset heart failure with reduced ejection fraction and new onset heart failure with preserved ejection fraction&#58; an epidemiologic perspective"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46;P&#46; Brouwers"
                            1 => "H&#46;L&#46; Hilleg"
                            2 => "W&#46;H&#46; van Gilst"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11897-012-0115-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Heart Fail Rep"
                        "fecha" => "2012"
                        "volumen" => "9"
                        "paginaInicial" => "363"
                        "paginaFinal" => "368"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22968403"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/08702551/0000003200000078/v1_201308220036/S0870255113001261/v1_201308220036/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "358"
    "tipo" => "SECCION"
    "pt" => array:2 [
      "titulo" => "Artigos originais"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "pt"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003200000078/v1_201308220036/S0870255113001261/v1_201308220036/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255113001261?idApp=UINPBA00004E"
]
Informação do artigo
ISSN: 08702551
Idioma original: Inglês
Dados atualizados diariamente
Ano/Mês Html Pdf Total
2024 Novembro 7 6 13
2024 Outubro 38 26 64
2024 Setembro 44 27 71
2024 Agosto 53 31 84
2024 Julho 38 31 69
2024 Junho 33 26 59
2024 Maio 42 33 75
2024 Abril 37 37 74
2024 Maro 43 24 67
2024 Fevereiro 36 17 53
2024 Janeiro 42 33 75
2023 Dezembro 33 33 66
2023 Novembro 35 41 76
2023 Outubro 23 11 34
2023 Setembro 40 27 67
2023 Agosto 28 22 50
2023 Julho 26 16 42
2023 Junho 42 15 57
2023 Maio 34 34 68
2023 Abril 25 6 31
2023 Maro 27 25 52
2023 Fevereiro 30 19 49
2023 Janeiro 26 24 50
2022 Dezembro 27 15 42
2022 Novembro 51 32 83
2022 Outubro 31 25 56
2022 Setembro 38 42 80
2022 Agosto 34 23 57
2022 Julho 51 39 90
2022 Junho 35 27 62
2022 Maio 31 40 71
2022 Abril 37 27 64
2022 Maro 47 38 85
2022 Fevereiro 25 18 43
2022 Janeiro 34 23 57
2021 Dezembro 30 40 70
2021 Novembro 45 34 79
2021 Outubro 28 35 63
2021 Setembro 21 20 41
2021 Agosto 35 40 75
2021 Julho 27 29 56
2021 Junho 26 18 44
2021 Maio 44 20 64
2021 Abril 31 31 62
2021 Maro 60 12 72
2021 Fevereiro 78 14 92
2021 Janeiro 31 11 42
2020 Dezembro 24 4 28
2020 Novembro 30 12 42
2020 Outubro 32 16 48
2020 Setembro 31 12 43
2020 Agosto 14 11 25
2020 Julho 36 9 45
2020 Junho 26 5 31
2020 Maio 31 4 35
2020 Abril 28 9 37
2020 Maro 35 13 48
2020 Fevereiro 47 52 99
2020 Janeiro 34 11 45
2019 Dezembro 22 13 35
2019 Novembro 26 10 36
2019 Outubro 36 8 44
2019 Setembro 20 10 30
2019 Agosto 23 7 30
2019 Julho 37 13 50
2019 Junho 29 16 45
2019 Maio 39 42 81
2019 Abril 18 25 43
2019 Maro 17 21 38
2019 Fevereiro 32 14 46
2019 Janeiro 66 6 72
2018 Dezembro 107 15 122
2018 Novembro 80 7 87
2018 Outubro 100 24 124
2018 Setembro 41 11 52
2018 Agosto 32 15 47
2018 Julho 22 9 31
2018 Junho 41 13 54
2018 Maio 46 8 54
2018 Abril 28 5 33
2018 Maro 33 10 43
2018 Fevereiro 19 11 30
2018 Janeiro 21 8 29
2017 Dezembro 41 7 48
2017 Novembro 40 8 48
2017 Outubro 17 13 30
2017 Setembro 38 10 48
2017 Agosto 34 9 43
2017 Julho 27 7 34
2017 Junho 54 16 70
2017 Maio 35 15 50
2017 Abril 25 7 32
2017 Maro 30 5 35
2017 Fevereiro 23 7 30
2017 Janeiro 27 3 30
2016 Dezembro 34 11 45
2016 Novembro 26 12 38
2016 Outubro 32 8 40
2016 Setembro 24 5 29
2016 Agosto 16 3 19
2016 Julho 11 5 16
2016 Junho 12 8 20
2016 Maio 4 6 10
2016 Abril 31 9 40
2016 Maro 56 11 67
2016 Fevereiro 73 24 97
2016 Janeiro 67 15 82
2015 Dezembro 64 15 79
2015 Novembro 58 16 74
2015 Outubro 50 13 63
2015 Setembro 48 13 61
2015 Agosto 77 12 89
2015 Julho 61 11 72
2015 Junho 48 3 51
2015 Maio 48 6 54
2015 Abril 56 15 71
2015 Maro 50 5 55
2015 Fevereiro 45 4 49
2015 Janeiro 54 8 62
2014 Dezembro 62 8 70
2014 Novembro 50 7 57
2014 Outubro 52 8 60
2014 Setembro 34 10 44
2014 Agosto 33 7 40
2014 Julho 52 11 63
2014 Junho 56 8 64
2014 Maio 50 12 62
2014 Abril 49 12 61
2014 Maro 60 14 74
2014 Fevereiro 61 15 76
2014 Janeiro 64 19 83
2013 Dezembro 56 10 66
2013 Novembro 81 25 106
2013 Outubro 71 29 100
2013 Setembro 133 49 182
2013 Agosto 19 15 34
Mostrar tudo

Siga este link para acessar o texto completo do artigo

Idiomas
Revista Portuguesa de Cardiologia
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

Ao assinalar que é «Profissional de Saúde», declara conhecer e aceitar que a responsável pelo tratamento dos dados pessoais dos utilizadores da página de internet da Revista Portuguesa de Cardiologia (RPC), é esta entidade, com sede no Campo Grande, n.º 28, 13.º, 1700-093 Lisboa, com os telefones 217 970 685 e 217 817 630, fax 217 931 095 e com o endereço de correio eletrónico revista@spc.pt. Declaro para todos os fins, que assumo inteira responsabilidade pela veracidade e exatidão da afirmação aqui fornecida.