Letter to the Editor
Reply to the Letter to the Editor entitled “Acute heart failure from noncompaction requiring emergency heart transplantation”
Resposta à Carta ao Editor intitulada “Insuficiência cardíaca aguda associada a não compactação requerendo transplantação cardíaca emergente”
Rafael Alexandre Meneguz-Moreno
, Marco Aurélio Finger, Carolina Casadei, João Manoel Rossi Neto
Autor para correspondência
Seção Médica de Transplantes, Ambulatório de Disfunção Ventricular e Transplante Cardíaco, Instituto Dante Pazzanese de Cardiologia, Brazil
Lido
4341
Vezesque se leu este artigo
1527
Total PDF
2814
Total HTML
Compartilhar estatísticas
array:26 [ "pii" => "S0870255116301445" "issn" => "08702551" "doi" => "10.1016/j.repc.2016.07.002" "estado" => "S300" "fechaPublicacion" => "2016-09-01" "aid" => "856" "copyright" => "Sociedade Portuguesa de Cardiologia" "copyrightAnyo" => "2016" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Rev Port Cardiol. 2016;35:509-10" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1860 "formatos" => array:3 [ "EPUB" => 183 "HTML" => 1253 "PDF" => 424 ] ] "Traduccion" => array:1 [ "en" => array:20 [ "pii" => "S2174204916301386" "issn" => "21742049" "doi" => "10.1016/j.repce.2016.08.001" "estado" => "S300" "fechaPublicacion" => "2016-09-01" "aid" => "856" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Rev Port Cardiol. 2016;35:509-10" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1861 "formatos" => array:3 [ "EPUB" => 170 "HTML" => 1311 "PDF" => 380 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Reply to the Letter to the Editor entitled “Acute heart failure from noncompaction requiring emergency heart transplantation”" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "509" "paginaFinal" => "510" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Resposta à Carta ao Editor intitulada “Insuficiência cardíaca aguda associada a não compactação requerendo transplantação cardíaca emergente”" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rafael Alexandre Meneguz-Moreno, Marco Aurélio Finger, Carolina Casadei, João Manoel Rossi Neto" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Rafael Alexandre" "apellidos" => "Meneguz-Moreno" ] 1 => array:2 [ "nombre" => "Marco Aurélio" "apellidos" => "Finger" ] 2 => array:2 [ "nombre" => "Carolina" "apellidos" => "Casadei" ] 3 => array:2 [ "nombre" => "João Manoel" "apellidos" => "Rossi Neto" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0870255116301445" "doi" => "10.1016/j.repc.2016.07.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116301445?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916301386?idApp=UINPBA00004E" "url" => "/21742049/0000003500000009/v2_201704020055/S2174204916301386/v2_201704020055/en/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S087025511630141X" "issn" => "08702551" "doi" => "10.1016/j.repc.2016.07.001" "estado" => "S300" "fechaPublicacion" => "2016-09-01" "aid" => "853" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "prv" "cita" => "Rev Port Cardiol. 2016;35:511-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2307 "formatos" => array:3 [ "EPUB" => 131 "HTML" => 1607 "PDF" => 569 ] ] "pt" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artigo Recomendado do Mês</span>" "titulo" => "Comentário a «Redução da pressão arterial e do colesterol em indivíduos sem doença cardiovascular»" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "511" "paginaFinal" => "513" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Comment on “Blood‐Pressure and Cholesterol Lowering in Persons without Cardiovascular Disease”" ] ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rui Baptista" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Rui" "apellidos" => "Baptista" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2174204916301398" "doi" => "10.1016/j.repce.2016.08.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916301398?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511630141X?idApp=UINPBA00004E" "url" => "/08702551/0000003500000009/v1_201608170044/S087025511630141X/v1_201608170044/pt/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S0870255116301433" "issn" => "08702551" "doi" => "10.1016/j.repc.2016.03.007" "estado" => "S300" "fechaPublicacion" => "2016-09-01" "aid" => "855" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Rev Port Cardiol. 2016;35:507-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2074 "formatos" => array:3 [ "EPUB" => 195 "HTML" => 1390 "PDF" => 489 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Acute heart failure from noncompaction requiring emergency heart transplantation" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "507" "paginaFinal" => "508" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Insuficiência cardíaca aguda associada a não compactação requerendo transplantação cardíaca emergente" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Josef Finsterer, Sinda Zarrouk-Mahjoub" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Josef" "apellidos" => "Finsterer" ] 1 => array:2 [ "nombre" => "Sinda" "apellidos" => "Zarrouk-Mahjoub" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2174204916301374" "doi" => "10.1016/j.repce.2016.03.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916301374?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116301433?idApp=UINPBA00004E" "url" => "/08702551/0000003500000009/v1_201608170044/S0870255116301433/v1_201608170044/en/main.assets" ] "asociados" => array:1 [ 0 => array:20 [ "pii" => "S0870255116301433" "issn" => "08702551" "doi" => "10.1016/j.repc.2016.03.007" "estado" => "S300" "fechaPublicacion" => "2016-09-01" "aid" => "855" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Rev Port Cardiol. 2016;35:507-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2074 "formatos" => array:3 [ "EPUB" => 195 "HTML" => 1390 "PDF" => 489 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Acute heart failure from noncompaction requiring emergency heart transplantation" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "507" "paginaFinal" => "508" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Insuficiência cardíaca aguda associada a não compactação requerendo transplantação cardíaca emergente" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Josef Finsterer, Sinda Zarrouk-Mahjoub" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Josef" "apellidos" => "Finsterer" ] 1 => array:2 [ "nombre" => "Sinda" "apellidos" => "Zarrouk-Mahjoub" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2174204916301374" "doi" => "10.1016/j.repce.2016.03.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916301374?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116301433?idApp=UINPBA00004E" "url" => "/08702551/0000003500000009/v1_201608170044/S0870255116301433/v1_201608170044/en/main.assets" ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Reply to the Letter to the Editor entitled “Acute heart failure from noncompaction requiring emergency heart transplantation”" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "509" "paginaFinal" => "510" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Rafael Alexandre Meneguz-Moreno, Marco Aurélio Finger, Carolina Casadei, João Manoel Rossi Neto" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Rafael Alexandre" "apellidos" => "Meneguz-Moreno" "email" => array:1 [ 0 => "rafael.meneguz@yahoo.com.br" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Marco Aurélio" "apellidos" => "Finger" ] 2 => array:2 [ "nombre" => "Carolina" "apellidos" => "Casadei" ] 3 => array:2 [ "nombre" => "João Manoel" "apellidos" => "Rossi Neto" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Seção Médica de Transplantes, Ambulatório de Disfunção Ventricular e Transplante Cardíaco, Instituto Dante Pazzanese de Cardiologia, Brazil" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Resposta à Carta ao Editor intitulada “Insuficiência cardíaca aguda associada a não compactação requerendo transplantação cardíaca emergente”" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We appreciate the interest of Josef Finsterer and Sinda Zarrouk-Mahjoub<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> in our recent original article entitled “Isolated left ventricular noncompaction causing refractory heart failure”,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> and would like to thank them for their pertinent comments.</p><p id="par0010" class="elsevierStylePara elsevierViewall">First of all, with regard to the concern about the patient's father, we agree that it would be important to have information about his echocardiographic exams or even an autopsy study. However, his father had been treated from disease onset in another hospital and we did not have access to these exams. Besides, the family did not keep the father's previous exams, so it was not possible to analyze them. The family had been contacted and insisted he had no episodes of atrial fibrillation, stroke, cardioembolism, arrhythmias or epilepsy.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Second, concerning the index patient's seizures, these occurred during use of high doses of vasoactive drugs, which could have contributed to atrial fibrillation episodes (recorded on ECG). The seizures really occurred, but only once (with no previous episode in the patient's life), and were considered to be a sign of low cardiac output (LCO) causing cerebral hypoxia due to cerebral hypoperfusion. They were tonic-clonic, lasted about two minutes, and ceased after intravenous benzodiazepine administration; at this time, an electroencephalogram was not recorded. She was then treated prophylactically with phenytoin. An intracardiac thrombus 17 mm×14 mm in size was detected in the left atrium, as reported in the main article.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> Thrombocytopenia and hepatopathy developed previous to the seizures and were attributed to the use of prophylactic heparin and systemic inflammatory response syndrome (SIRS), in combination with congestive heart failure and LCO.</p><p id="par0020" class="elsevierStylePara elsevierViewall">It is important to note that after heart transplantation and hospital discharge, the patient presented in outpatient care complaining of loss of consciousness, not sudden, but progressively and constantly. Psychological and physical (cerebral magnetic resonance imaging and EEG) investigation revealed nothing. She then underwent tilt testing; a diagnosis was made of vasovagal syndrome and she was advised to make changes in her behavior in order to prevent syncope episodes.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Furthermore, considering chromosomal defects, we understand the role of genetics in this disease<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">3</span></a> and that it is inherited in at least 30-50% of patients, and several genes that cause left ventricular non-compaction (LVNC) have been identified. These genes seem generally to encode sarcomere (contractile apparatus) or cytoskeletal proteins.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a> However, the patient was not investigated for gene mutations and it was presumed to be a congenital abnormality, as reported.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The rest of her family were investigated by echocardiography and screened for similar myocardial changes but no evidence of myocardial hypertrabeculation/non-compaction was found. There were also no clinical or laboratory indications of neuromuscular disease in the index case or any of her relatives, such as easy fatigability, exercise intolerance, muscle wasting or weakness, myotonia or adverse reactions to general anesthesia. We have not screened for chromosomal defects as this is not a routine procedure. We understand the importance of these disorders particularly in acquired hypertrabeculation, and that up to 80% of patients with LVNC suffer from a neuromuscular disorder.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">5–7</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Concerning anatomopathology, there were non-specific findings of hypertrophy and mild degeneration of myocardial fibers, with no fibrosis or subendocardial fibroelastosis.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The patient currently has no new symptoms of heart failure and has not developed LVNC in the transplanted heart.</p><p id="par0045" class="elsevierStylePara elsevierViewall">To summarize, we believe that the genesis of isolated LVNC is still not completely understood; further investigation of the disease and of patients is required, and genetic studies in particular should be the aim of future research.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</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:7 [ 0 => array:3 [ "identificador" => "bib0040" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute heart failure from noncompaction requiring emergency heart transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Finsterer" 1 => "S. Zarrouk-Mahjoub" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2016" "volumen" => "35" "paginaInicial" => "507" "paginaFinal" => "508" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0045" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Isolated left ventricular noncompaction causing refractory heart failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R.A. Meneguz-Moreno" 1 => "F. Rodrigues da Costa Teixeira" 2 => "J.M. Rossi Neto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.repc.2015.09.015" "Revista" => array:6 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2016" "volumen" => "35" "paginaInicial" => "185.e1" "paginaFinal" => "185.e4" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26928017" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0050" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Considerations about the genetics of left ventricular hypertrabeculation/non-compaction" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Finsterer" 1 => "S. Zarrouk-Mahjoub" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1017/S1047951115000694" "Revista" => array:6 [ "tituloSerie" => "Cardiol Young" "fecha" => "2015" "volumen" => "25" "paginaInicial" => "1435" "paginaFinal" => "1437" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26095215" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0055" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Left ventricular non-compaction cardiomyopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Towbin" 1 => "A. Lorts" 2 => "J.L. Jefferies" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(14)61282-4" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2015" "volumen" => "386" "paginaInicial" => "813" "paginaFinal" => "825" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25865865" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0060" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Non-compaction cardiomyopathy: a genetically and clinically heterogeneous disorder" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "I. Rooms" 1 => "K. Dujardin" 2 => "J. De Sutter" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2143/AC.70.6.3120173" "Revista" => array:7 [ "tituloSerie" => "Acta Cardiol" "fecha" => "2015" "volumen" => "70" "paginaInicial" => "625" "paginaFinal" => "631" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26717209" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109712009242" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0065" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Left ventricular hypertrabeculation/noncompaction and association with additional cardiac abnormalities and neuromuscular disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Stollberger" 1 => "J. Finsterer" 2 => "G. Blazek" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Am J Cardiol" "fecha" => "2002" "volumen" => "90" "paginaInicial" => "899" "paginaFinal" => "902" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12372586" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109713021761" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0070" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Left ventricular hypertrabeculation/noncompaction" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Stollberger" 1 => "J. Finsterer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0894-7317(03)00514-5" "Revista" => array:7 [ "tituloSerie" => "J Am Soc Echocardiogr" "fecha" => "2004" "volumen" => "17" "paginaInicial" => "91" "paginaFinal" => "100" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14712196" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S073510970101806X" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000003500000009/v1_201608170044/S0870255116301445/v1_201608170044/en/main.assets" "Apartado" => array:4 [ "identificador" => "29267" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Cartas ao Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003500000009/v1_201608170044/S0870255116301445/v1_201608170044/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116301445?idApp=UINPBA00004E" ]
| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 6 | 6 | 12 |
| 2024 Outubro | 33 | 25 | 58 |
| 2024 Setembro | 49 | 21 | 70 |
| 2024 Agosto | 51 | 27 | 78 |
| 2024 Julho | 42 | 28 | 70 |
| 2024 Junho | 38 | 21 | 59 |
| 2024 Maio | 30 | 20 | 50 |
| 2024 Abril | 32 | 20 | 52 |
| 2024 Maro | 34 | 18 | 52 |
| 2024 Fevereiro | 28 | 36 | 64 |
| 2024 Janeiro | 30 | 29 | 59 |
| 2023 Dezembro | 33 | 22 | 55 |
| 2023 Novembro | 29 | 18 | 47 |
| 2023 Outubro | 19 | 14 | 33 |
| 2023 Setembro | 25 | 26 | 51 |
| 2023 Agosto | 30 | 22 | 52 |
| 2023 Julho | 22 | 13 | 35 |
| 2023 Junho | 22 | 12 | 34 |
| 2023 Maio | 21 | 23 | 44 |
| 2023 Abril | 12 | 2 | 14 |
| 2023 Maro | 20 | 17 | 37 |
| 2023 Fevereiro | 24 | 22 | 46 |
| 2023 Janeiro | 13 | 5 | 18 |
| 2022 Dezembro | 17 | 11 | 28 |
| 2022 Novembro | 40 | 17 | 57 |
| 2022 Outubro | 19 | 13 | 32 |
| 2022 Setembro | 18 | 25 | 43 |
| 2022 Agosto | 24 | 34 | 58 |
| 2022 Julho | 27 | 32 | 59 |
| 2022 Junho | 18 | 22 | 40 |
| 2022 Maio | 21 | 25 | 46 |
| 2022 Abril | 29 | 33 | 62 |
| 2022 Maro | 19 | 22 | 41 |
| 2022 Fevereiro | 16 | 21 | 37 |
| 2022 Janeiro | 26 | 15 | 41 |
| 2021 Dezembro | 11 | 19 | 30 |
| 2021 Novembro | 26 | 32 | 58 |
| 2021 Outubro | 25 | 34 | 59 |
| 2021 Setembro | 26 | 20 | 46 |
| 2021 Agosto | 28 | 32 | 60 |
| 2021 Julho | 20 | 28 | 48 |
| 2021 Junho | 28 | 21 | 49 |
| 2021 Maio | 31 | 24 | 55 |
| 2021 Abril | 28 | 32 | 60 |
| 2021 Maro | 42 | 18 | 60 |
| 2021 Fevereiro | 43 | 16 | 59 |
| 2021 Janeiro | 31 | 11 | 42 |
| 2020 Dezembro | 28 | 7 | 35 |
| 2020 Novembro | 27 | 16 | 43 |
| 2020 Outubro | 18 | 16 | 34 |
| 2020 Setembro | 55 | 10 | 65 |
| 2020 Agosto | 9 | 8 | 17 |
| 2020 Julho | 44 | 8 | 52 |
| 2020 Junho | 32 | 4 | 36 |
| 2020 Maio | 27 | 5 | 32 |
| 2020 Abril | 35 | 16 | 51 |
| 2020 Maro | 28 | 8 | 36 |
| 2020 Fevereiro | 45 | 18 | 63 |
| 2020 Janeiro | 27 | 7 | 34 |
| 2019 Dezembro | 15 | 5 | 20 |
| 2019 Novembro | 31 | 6 | 37 |
| 2019 Outubro | 31 | 6 | 37 |
| 2019 Setembro | 7 | 4 | 11 |
| 2019 Agosto | 33 | 4 | 37 |
| 2019 Julho | 37 | 9 | 46 |
| 2019 Junho | 24 | 15 | 39 |
| 2019 Maio | 34 | 1 | 35 |
| 2019 Abril | 18 | 15 | 33 |
| 2019 Maro | 25 | 9 | 34 |
| 2019 Fevereiro | 30 | 9 | 39 |
| 2019 Janeiro | 31 | 6 | 37 |
| 2018 Dezembro | 36 | 12 | 48 |
| 2018 Novembro | 40 | 11 | 51 |
| 2018 Outubro | 53 | 5 | 58 |
| 2018 Setembro | 28 | 12 | 40 |
| 2018 Agosto | 17 | 8 | 25 |
| 2018 Julho | 18 | 6 | 24 |
| 2018 Junho | 24 | 7 | 31 |
| 2018 Maio | 31 | 9 | 40 |
| 2018 Abril | 23 | 6 | 29 |
| 2018 Maro | 50 | 11 | 61 |
| 2018 Fevereiro | 25 | 2 | 27 |
| 2018 Janeiro | 33 | 6 | 39 |
| 2017 Dezembro | 56 | 7 | 63 |
| 2017 Novembro | 34 | 11 | 45 |
| 2017 Outubro | 19 | 11 | 30 |
| 2017 Setembro | 21 | 11 | 32 |
| 2017 Agosto | 25 | 14 | 39 |
| 2017 Julho | 20 | 7 | 27 |
| 2017 Junho | 30 | 9 | 39 |
| 2017 Maio | 24 | 8 | 32 |
| 2017 Abril | 9 | 4 | 13 |
| 2017 Maro | 13 | 4 | 17 |
| 2017 Fevereiro | 16 | 3 | 19 |
| 2017 Janeiro | 21 | 11 | 32 |
| 2016 Dezembro | 40 | 15 | 55 |
| 2016 Novembro | 26 | 10 | 36 |
| 2016 Outubro | 43 | 25 | 68 |
| 2016 Setembro | 58 | 33 | 91 |
| 2016 Agosto | 34 | 33 | 67 |
Mostrar tudo
