array:25 [
  "pii" => "S0870255118303536"
  "issn" => "08702551"
  "doi" => "10.1016/j.repc.2018.05.011"
  "estado" => "S300"
  "fechaPublicacion" => "2018-07-01"
  "aid" => "1249"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2018"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "dis"
  "cita" => "Rev Port Cardiol. 2018;37:603-5"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1469
    "formatos" => array:3 [
      "EPUB" => 116
      "HTML" => 1038
      "PDF" => 315
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S0870255117301142"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2017.08.008"
    "estado" => "S300"
    "fechaPublicacion" => "2018-07-01"
    "aid" => "1230"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "rev"
    "cita" => "Rev Port Cardiol. 2018;37:607-21"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1949
      "formatos" => array:3 [
        "EPUB" => 146
        "HTML" => 1366
        "PDF" => 437
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review Article</span>"
      "titulo" => "Cardiovascular risk in Turner syndrome"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "607"
          "paginaFinal" => "621"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Risco cardiovascular na s&#237;ndrome de Turner"
        ]
      ]
      "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" => "fig0020"
          "etiqueta" => "Figure 4"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr4.jpeg"
              "Alto" => 757
              "Ancho" => 800
              "Tamanyo" => 25441
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Long-axis three-chamber-view CMR of a 24-year-old patient with TS&#44; showing dilatation of the ascending aorta&#44; with ASI &#62;2&#46;5 cm&#47;m<span class="elsevierStyleSup">2</span> indicating a high risk of dissection&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Beatriz Donato, Maria Jo&#227;o Ferreira"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Beatriz"
              "apellidos" => "Donato"
            ]
            1 => array:2 [
              "nombre" => "Maria Jo&#227;o"
              "apellidos" => "Ferreira"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2174204918302502"
        "doi" => "10.1016/j.repce.2017.08.008"
        "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/S2174204918302502?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117301142?idApp=UINPBA00004E"
    "url" => "/08702551/0000003700000007/v3_201808080407/S0870255117301142/v3_201808080407/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S087025511730389X"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2017.10.015"
    "estado" => "S300"
    "fechaPublicacion" => "2018-07-01"
    "aid" => "1248"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2018;37:595-602"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2112
      "formatos" => array:3 [
        "EPUB" => 117
        "HTML" => 1580
        "PDF" => 415
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Worsening or &#8216;pseudo-worsening&#8217; renal function&#63; The prognostic value of hemoconcentration in patients admitted with acute heart failure"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "595"
          "paginaFinal" => "602"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Agravamento da fun&#231;&#227;o renal ou &#171;pseudo-agravamento da fun&#231;&#227;o renal&#63;&#187;&#46; O impacto progn&#243;stico da hemoconcentra&#231;&#227;o em doentes admitidos com insufici&#234;ncia card&#237;aca aguda"
        ]
      ]
      "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" => "fig0025"
          "etiqueta" => "Figure 5"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr5.jpeg"
              "Alto" => 1262
              "Ancho" => 1589
              "Tamanyo" => 112092
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Survival curves grouped by presence or absence of hemoconcentration &#40;HC&#41; according to KDIGO criteria among patients without chronic kidney disease with worsening renal function &#40;WRF&#41;&#46; Log rank&#59; p&#61;0&#46;02&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jos&#233; Lu&#237;s Martins, Lu&#237;s Santos, Ana Faustino, Jesus Viana, Jos&#233; Santos"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Jos&#233; Lu&#237;s"
              "apellidos" => "Martins"
            ]
            1 => array:2 [
              "nombre" => "Lu&#237;s"
              "apellidos" => "Santos"
            ]
            2 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Faustino"
            ]
            3 => array:2 [
              "nombre" => "Jesus"
              "apellidos" => "Viana"
            ]
            4 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Santos"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511730389X?idApp=UINPBA00004E"
    "url" => "/08702551/0000003700000007/v3_201808080407/S087025511730389X/v3_201808080407/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:19 [
      "pii" => "S087025511730389X"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2017.10.015"
      "estado" => "S300"
      "fechaPublicacion" => "2018-07-01"
      "aid" => "1248"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "Rev Port Cardiol. 2018;37:595-602"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 2112
        "formatos" => array:3 [
          "EPUB" => 117
          "HTML" => 1580
          "PDF" => 415
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
        "titulo" => "Worsening or &#8216;pseudo-worsening&#8217; renal function&#63; The prognostic value of hemoconcentration in patients admitted with acute heart failure"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "595"
            "paginaFinal" => "602"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Agravamento da fun&#231;&#227;o renal ou &#171;pseudo-agravamento da fun&#231;&#227;o renal&#63;&#187;&#46; O impacto progn&#243;stico da hemoconcentra&#231;&#227;o em doentes admitidos com insufici&#234;ncia card&#237;aca aguda"
          ]
        ]
        "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" => "fig0025"
            "etiqueta" => "Figure 5"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr5.jpeg"
                "Alto" => 1262
                "Ancho" => 1589
                "Tamanyo" => 112092
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Survival curves grouped by presence or absence of hemoconcentration &#40;HC&#41; according to KDIGO criteria among patients without chronic kidney disease with worsening renal function &#40;WRF&#41;&#46; Log rank&#59; p&#61;0&#46;02&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Jos&#233; Lu&#237;s Martins, Lu&#237;s Santos, Ana Faustino, Jesus Viana, Jos&#233; Santos"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "Jos&#233; Lu&#237;s"
                "apellidos" => "Martins"
              ]
              1 => array:2 [
                "nombre" => "Lu&#237;s"
                "apellidos" => "Santos"
              ]
              2 => array:2 [
                "nombre" => "Ana"
                "apellidos" => "Faustino"
              ]
              3 => array:2 [
                "nombre" => "Jesus"
                "apellidos" => "Viana"
              ]
              4 => array:2 [
                "nombre" => "Jos&#233;"
                "apellidos" => "Santos"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511730389X?idApp=UINPBA00004E"
      "url" => "/08702551/0000003700000007/v3_201808080407/S087025511730389X/v3_201808080407/en/main.assets"
    ]
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
    "titulo" => "Putting creatinine and hemoconcentration in their place as prognostic predictors in the conundrum of acute heart failure"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "603"
        "paginaFinal" => "605"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Pedro Marques da Silva"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Pedro Marques"
            "apellidos" => "da Silva"
            "email" => array:1 [
              0 => "pmarques&#46;silva&#64;sapo&#46;pt"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "N&#250;cleo de Investiga&#231;&#227;o Arterial&#44; Medicina 4&#44; Hospital de Santa Marta&#44; Centro Hospitalar de Lisboa Central&#44; EPE&#44; Lisboa&#44; Portugal"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Assentar a creatinina e a hemoconcentra&#231;&#227;o no lugar correto enquanto preditores progn&#243;sticos na insufici&#234;ncia card&#237;aca aguda"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleDisplayedQuote" id="dsq0005"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#8220;Homage to thee&#44; O my heart&#33; Homage to you&#44; O my kidneys&#33;&#8221;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The Egyptian Book of the Dead<a class="elsevierStyleCrossRef" href="#fn0005"><span class="elsevierStyleSup">a</span></a></p></span></p><p id="par0010" class="elsevierStylePara elsevierViewall">Many centuries ago&#44; traditional Chinese medicine &#8211; today&#44; quite rightly&#44; a subject of some controversy in the Portuguese medical community &#8211; described a disorder termed &#8220;heart and kidney failing to link&#44;&#8221; suggesting a close connection between dysfunction of the kidneys and of the heart&#46; These may have been the first references to what is now known as cardiorenal syndrome &#40;CRS&#41;&#44; a complex &#8220;disorder of the heart and the kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other&#8221;&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">1&#8211;3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Five subtypes of CRS are now recognized&#44; but in all of them&#44; both organs &#40;heart and kidneys&#41; show or develop structural and&#47;or functional alterations&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">4&#44;5</span></a> Type 1 &#40;acute CRS&#41; &#8211; the subject of this editorial &#8211; refers to acute worsening of heart function leading to acute kidney injury &#40;AKI&#41; and&#47;or dysfunction&#44;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">1&#8211;3</span></a> and can be found in 19-45&#37; of patients with acute decompensated heart failure &#40;ADHF&#41; presenting with AKI&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">4</span></a> AKI mostly occurs early&#44; within 3-5 days of hospitalization&#44; and appears to be a predictor of even worse prognosis&#44; associated with higher short- and long-term all-cause and cardiovascular mortality and prolonged hospitalization&#46; The well-documented risk factors for AKI in the context of AHF are a history of diabetes&#44; severity of cardiac dysfunction on admission&#44; use of high-dose diuretics &#40;particularly loop diuretics&#44; but also thiazides&#41;&#44; vasodilator therapy&#44; and use of larger radiocontrast volumes&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The clinical presentation of type 1 CRS usually includes rapid worsening renal function &#40;WRF&#41; &#40;suggestive of altered renal perfusion&#44; unless proven otherwise&#41;&#44; resulting in volume overload with signs and symptoms of fluid retention&#44; pulmonary rales and systemic congestion&#44; less frequently in low cardiac output with peripheral hypoperfusion&#44; and in poor response to diuretics&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">2&#44;4&#44;5</span></a> It should be borne in mind that in the context of AHF diuretic resistance is multifactorial and includes&#44; in varying degrees&#44; impaired renal blood flow&#44; altered drug reabsorption&#44; reduced glomerular filtration&#44; low albumin concentrations&#44; and increased levels of urea nitrogen and other organic acids competitively impeding diuretic availability at the site of action&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">6&#44;7</span></a> Ideally&#44; in order to recognize renal dysfunction and to stratify the severity of AKI&#44; the risk&#44; injury&#44; failure&#44; loss of kidney function&#44; and end-stage kidney disease &#40;RIFLE&#41; and Acute Kidney Injury Network &#40;AKIN&#41; classifications should be applied&#46; The former is based on changes in serum creatinine &#40;SCr&#41; or glomerular filtration rate &#40;GFR&#41; and&#47;or urine output&#44; and is a good predictor of AKI severity and outcome&#46; The AKIN classification is a modified adaptation of RIFLE&#44; and can increase the sensitivity and specificity of AKI diagnosis&#46; Although clinically available biomarkers are sometimes inadequate for a diagnosis of CRS and detection of AKI in ADHF&#44; in clinical practice the suspicion of type 1 CRS derives from an increase in SCr and blood urea nitrogen &#40;BUN&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">BUN is a serum by-product of protein metabolism and is probably one of the oldest short- as well as long-term prognostic markers in patients with heart failure&#46; In the Acute Decompensated Heart Failure National Registry &#40;ADHERE&#41; database&#44; BUN &#8805;43 mg&#47;dl was the single best predictor&#44; followed by systolic blood pressure &#60;115 mmHg on admission and SCr &#8805;2&#46;75 mg&#47;dl &#40;243&#46;1 &#956;mol&#47;l&#41;&#44; of in-hospital mortality among 65<span class="elsevierStyleHsp" style=""></span>275 AHF admissions&#46; These findings have been replicated in other studies and BUN levels should be measured in routine prognostic assessment of ADHF&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a> Creatinine is a breakdown product of creatine phosphate in muscle tissue&#44; and increases in the blood when GFR decreases&#44; an indication of renal dysfunction&#46; Increases in SCr elevations are also associated with worse outcomes in heart failure patients&#44; and are a strong independent predictor of both one- and five-year mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">However&#44; as Martins et al&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> note in this issue of the <span class="elsevierStyleItalic">Journal</span>&#44; an increase of SCr in AHF patients does not always imply renal dysfunction or worse prognosis&#46; As the authors point out&#44; AHF patients with mild creatinine elevation but without established renal failure have a better prognosis&#44; since these changes are due to hemoconcentration &#40;HC&#41; rather than to true WRF&#46; It should be noted that in this case&#44; HC arises from an absolute or relative loss of water from blood plasma &#40;deshydremia&#41;&#46; In Martins et al&#46;&#8217;s paper&#44; HC was defined as an increase in hemoglobin during hospital stay&#44; estimated by subtracting hemoglobin at discharge from hemoglobin at admission&#59; a similar definition has been used by other investigators&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">10&#8211;14</span></a> In their study&#44; as in others&#44; HC was associated with a better prognosis in patients with or without WRF&#44; acting as a surrogate for anticongestive therapy&#44; and had prognostic value in AHF patients without CKD but with elevated SCr&#46; It would therefore be a mistake to argue that a simple increase in SCr indicates AKI&#44; and in fact when associated with HC<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">3</span></a> &#8211; with no renal failure or chronic kidney disease &#8211; it is associated with better prognosis and survival&#46; Such cases should be reclassified as &#8216;pseudo-WRF&#8217;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">On the whole&#44; the article by Martins et al&#46; is clear&#44; credible and well researched&#44; with an accurate and judicious description of its limitations&#58; its single-center and retrospective nature&#44; the importance of missing data such as SCr and left ventricular ejection fraction&#44; and the fact that pharmacological therapy at discharge was not recorded &#40;with possible effects on prognosis&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Diuretics &#40;mainly&#44; but not only&#44; loop diuretics&#41; are the cornerstone of ADHF and CRS treatment&#46; They relieve renal venous congestion and fluid overload and improve patients&#8217; symptoms and comfort&#44; and their early use in severe ADHF can reduce mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">5&#44;6</span></a> However&#44; they are a double-edged sword&#58; they may worsen kidney function and trigger even more neurohormonal systems&#46; The use and effects of diuretic therapy must therefore be carefully monitored&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">5&#44;6</span></a> HC may be linked with increased risk of WRF during hospitalization&#44; increased diuretic doses&#44; and greater weight loss&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> However&#44; in multivariate analysis&#44; HC is not linked with mortality&#44; and an early increase &#40;in the first week&#41; in hemoglobin is independently associated with a favorable outcome&#44; despite a slight worsening of renal function&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Future research needs to focus on the differences between and determinants of late and early HC in AHF and to determine the cutoffs between them &#8211; because&#44; apparently&#44; only late HC is associated with improved survival<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> &#8211; and&#44; bearing in mind that HC can be a surrogate for successful decongestion in AHF&#44; to clarify why in some patients there is a conflict between HC and clinical assessment of venous congestion&#44; with persistent congestion at discharge linked with increased mortality that is not HC-dependent&#46; Finally&#44; as Martins et al&#46; suggest&#44; HC is associated with better outcomes but cannot replace clinical assessment in the initial diagnosis of AHF and a proper diagnostic workup that includes specific biomarkers&#44; as well as BUN&#44; SCr&#44; hemoglobin and hematocrit&#46; In the meantime&#44; all patients with AHF should promptly start pharmacological and non-pharmacological treatment in parallel&#44; as recommended in the most recent guidelines&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">5&#44;6</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The author has 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
    "NotaPie" => array:1 [
      0 => array:3 [
        "etiqueta" => "a"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Eknoyan G&#46; The kidneys in the Bible&#58; what happened&#63; J Am Soc Nephrol&#46; 2005&#59;16&#40;12&#41;&#58;3464-71&#46;</p>"
        "identificador" => "fn0005"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:16 [
            0 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiorenal syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Ronco"
                            1 => "M&#46; Haapio"
                            2 => "A&#46;A&#46; House"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2008.07.051"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2008"
                        "volumen" => "52"
                        "paginaInicial" => "1527"
                        "paginaFinal" => "1539"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19007588"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardio-renal syndromes&#58; report from the consensus conference of the Acute Dialysis Quality Initiative"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Acute Dialysis Quality Initiative &#40;ADQI&#41; Consensus Group"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Ronco"
                            1 => "P&#46; McCullough"
                            2 => "S&#46;D&#46; Anker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehp507"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2010"
                        "volumen" => "31"
                        "paginaInicial" => "703"
                        "paginaFinal" => "711"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20037146"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The acute cardiorenal syndrome type I&#58; considerations on physiology&#44; epidemiology&#44; and therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;A&#46; Valika"
                            1 => "M&#46;R&#46; Costanzo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11897-014-0224-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Heart Fail Rep"
                        "fecha" => "2014"
                        "volumen" => "11"
                        "paginaInicial" => "382"
                        "paginaFinal" => "392"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25224320"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute heart failure&#46; Putting the puzzle of pathophysiology and evidence together in daily practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "W&#46; Kr&#252;ger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:6 [
                        "edicion" => "2nd ed&#46;"
                        "fecha" => "2017"
                        "paginaInicial" => "371"
                        "paginaFinal" => "400"
                        "editorial" => "Springer International Publishing AG"
                        "editorialLocalizacion" => "Switzerland"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2017 comprehensive update of the Canadian Cardiovascular Society guidelines for the management of heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;A&#46; Ezekowitz"
                            1 => "E&#46; O&#8217;Meara"
                            2 => "M&#46;A&#46; McDonald"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cjca.2017.08.022"
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Cardiol"
                        "fecha" => "2017"
                        "volumen" => "33"
                        "paginaInicial" => "1342"
                        "paginaFinal" => "1433"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29111106"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Erratum in&#58; Eur Heart J&#46; 2016 Dec 30"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure&#58; The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology &#40;ESC&#41; Developed with the special contribution of the Heart Failure Association &#40;HFA&#41; of the ESC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46; Ponikowski"
                            1 => "A&#46;A&#46; Voors"
                            2 => "S&#46;D&#46; Anker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehw128"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2016"
                        "volumen" => "37"
                        "paginaInicial" => "2129"
                        "paginaFinal" => "2200"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27206819"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Edema mechanisms in the heart failure patient and treatment options"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;A&#46; Sica"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Managing the kidney when the heart is failing"
                        "paginaInicial" => "73"
                        "paginaFinal" => "89"
                        "serieFecha" => "2012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "&#91;Contemporary Cardiology&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute decompensated heart failure in the observation unit&#58; treatment protocols"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Pease"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Short stay management of acute heart failure"
                        "paginaInicial" => "197"
                        "paginaFinal" => "210"
                        "edicion" => "3rd ed&#46;"
                        "serieFecha" => "2017"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Worsening or &#8216;pseudo-worsening&#8217; renal function&#63; The prognostic value of hemoconcentration in patients admitted with acute heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;L&#46; Martins"
                            1 => "L&#46; Santos"
                            2 => "A&#46; Faustino"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2017.10.015"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2018"
                        "volumen" => "37"
                        "paginaInicial" => "595"
                        "paginaFinal" => "602"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29934213"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Timing of hemoconcentration during treatment of acute decompensated heart failure and subsequent survival&#58; importance of sustained decongestion"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;M&#46; Testani"
                            1 => "M&#46;A&#46; Brisco"
                            2 => "J&#46; Chen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2013.05.027"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2013"
                        "volumen" => "62"
                        "paginaInicial" => "516"
                        "paginaFinal" => "524"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23747773"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hemoconcentration is a good prognostic predictor for clinical outcomes in acute heart failure&#58; data from the Korean Heart Failure &#40;KorHF&#41; Registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; Oh"
                            1 => "S&#46;M&#46; Kang"
                            2 => "N&#46; Hong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2013.07.241"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cardiol"
                        "fecha" => "2013"
                        "volumen" => "168"
                        "paginaInicial" => "4739"
                        "paginaFinal" => "4743"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23958420"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hemoconcentration-guided diuresis in heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Vaduganathan"
                            1 => "S&#46;J&#46; Greene"
                            2 => "G&#46;C&#46; Fonarow"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjmed.2014.06.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Med"
                        "fecha" => "2014"
                        "volumen" => "127"
                        "paginaInicial" => "1154"
                        "paginaFinal" => "1159"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24937157"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Discordance between hemoconcentration and clinical assessment of decongestion in acute heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "W&#46; Darawsha"
                            1 => "S&#46; Chirmicci"
                            2 => "A&#46; Solomonica"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cardfail.2016.04.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Card Fail"
                        "fecha" => "2016"
                        "volumen" => "22"
                        "paginaInicial" => "680"
                        "paginaFinal" => "688"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27079674"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The top tertile of hematocrit change during hospitalization is associated with lower risk of mortality in acute heart failure patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "H&#46; Zhou"
                            1 => "T&#46; Xu"
                            2 => "Y&#46; Huang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12872-017-0669-0"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Cardiovasc Disord"
                        "fecha" => "2017"
                        "volumen" => "17"
                        "paginaInicial" => "235"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28865437"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical correlates of hemoconcentration during hospitalization for acute decompensated heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Davila"
                            1 => "A&#46; Reyentovich"
                            2 => "S&#46;D&#46; Katz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cardfail.2011.08.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Card Fail"
                        "fecha" => "2011"
                        "volumen" => "17"
                        "paginaInicial" => "1018"
                        "paginaFinal" => "1022"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22123365"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The predictive value of short-term changes in hemoglobin concentration in patients presenting with acute decompensated heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46; van der Meer"
                            1 => "D&#46; Postmus"
                            2 => "P&#46; Ponikowski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2012.12.050"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2013"
                        "volumen" => "61"
                        "paginaInicial" => "1973"
                        "paginaFinal" => "1981"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23500313"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/08702551/0000003700000007/v3_201808080407/S0870255118303536/v3_201808080407/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "29261"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Artigos Originais"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003700000007/v3_201808080407/S0870255118303536/v3_201808080407/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255118303536?idApp=UINPBA00004E"
]
Partilhar
Informação da revista

Estatísticas

Siga este link para acessar o texto completo do artigo

Editorial comment
Putting creatinine and hemoconcentration in their place as prognostic predictors in the conundrum of acute heart failure
Assentar a creatinina e a hemoconcentração no lugar correto enquanto preditores prognósticos na insuficiência cardíaca aguda
Pedro Marques da Silva
Núcleo de Investigação Arterial, Medicina 4, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal
Lido
4972
Vezes
que se leu este artigo
1663
Total PDF
3309
Total HTML
Compartilhar estatísticas
 array:25 [
  "pii" => "S0870255118303536"
  "issn" => "08702551"
  "doi" => "10.1016/j.repc.2018.05.011"
  "estado" => "S300"
  "fechaPublicacion" => "2018-07-01"
  "aid" => "1249"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2018"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "dis"
  "cita" => "Rev Port Cardiol. 2018;37:603-5"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1469
    "formatos" => array:3 [
      "EPUB" => 116
      "HTML" => 1038
      "PDF" => 315
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S0870255117301142"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2017.08.008"
    "estado" => "S300"
    "fechaPublicacion" => "2018-07-01"
    "aid" => "1230"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "rev"
    "cita" => "Rev Port Cardiol. 2018;37:607-21"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1949
      "formatos" => array:3 [
        "EPUB" => 146
        "HTML" => 1366
        "PDF" => 437
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review Article</span>"
      "titulo" => "Cardiovascular risk in Turner syndrome"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "607"
          "paginaFinal" => "621"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Risco cardiovascular na s&#237;ndrome de Turner"
        ]
      ]
      "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" => "fig0020"
          "etiqueta" => "Figure 4"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr4.jpeg"
              "Alto" => 757
              "Ancho" => 800
              "Tamanyo" => 25441
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Long-axis three-chamber-view CMR of a 24-year-old patient with TS&#44; showing dilatation of the ascending aorta&#44; with ASI &#62;2&#46;5 cm&#47;m<span class="elsevierStyleSup">2</span> indicating a high risk of dissection&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Beatriz Donato, Maria Jo&#227;o Ferreira"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Beatriz"
              "apellidos" => "Donato"
            ]
            1 => array:2 [
              "nombre" => "Maria Jo&#227;o"
              "apellidos" => "Ferreira"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2174204918302502"
        "doi" => "10.1016/j.repce.2017.08.008"
        "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/S2174204918302502?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117301142?idApp=UINPBA00004E"
    "url" => "/08702551/0000003700000007/v3_201808080407/S0870255117301142/v3_201808080407/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S087025511730389X"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2017.10.015"
    "estado" => "S300"
    "fechaPublicacion" => "2018-07-01"
    "aid" => "1248"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2018;37:595-602"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2112
      "formatos" => array:3 [
        "EPUB" => 117
        "HTML" => 1580
        "PDF" => 415
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Worsening or &#8216;pseudo-worsening&#8217; renal function&#63; The prognostic value of hemoconcentration in patients admitted with acute heart failure"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "595"
          "paginaFinal" => "602"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Agravamento da fun&#231;&#227;o renal ou &#171;pseudo-agravamento da fun&#231;&#227;o renal&#63;&#187;&#46; O impacto progn&#243;stico da hemoconcentra&#231;&#227;o em doentes admitidos com insufici&#234;ncia card&#237;aca aguda"
        ]
      ]
      "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" => "fig0025"
          "etiqueta" => "Figure 5"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr5.jpeg"
              "Alto" => 1262
              "Ancho" => 1589
              "Tamanyo" => 112092
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Survival curves grouped by presence or absence of hemoconcentration &#40;HC&#41; according to KDIGO criteria among patients without chronic kidney disease with worsening renal function &#40;WRF&#41;&#46; Log rank&#59; p&#61;0&#46;02&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jos&#233; Lu&#237;s Martins, Lu&#237;s Santos, Ana Faustino, Jesus Viana, Jos&#233; Santos"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Jos&#233; Lu&#237;s"
              "apellidos" => "Martins"
            ]
            1 => array:2 [
              "nombre" => "Lu&#237;s"
              "apellidos" => "Santos"
            ]
            2 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Faustino"
            ]
            3 => array:2 [
              "nombre" => "Jesus"
              "apellidos" => "Viana"
            ]
            4 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Santos"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511730389X?idApp=UINPBA00004E"
    "url" => "/08702551/0000003700000007/v3_201808080407/S087025511730389X/v3_201808080407/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:19 [
      "pii" => "S087025511730389X"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2017.10.015"
      "estado" => "S300"
      "fechaPublicacion" => "2018-07-01"
      "aid" => "1248"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "Rev Port Cardiol. 2018;37:595-602"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 2112
        "formatos" => array:3 [
          "EPUB" => 117
          "HTML" => 1580
          "PDF" => 415
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
        "titulo" => "Worsening or &#8216;pseudo-worsening&#8217; renal function&#63; The prognostic value of hemoconcentration in patients admitted with acute heart failure"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "595"
            "paginaFinal" => "602"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Agravamento da fun&#231;&#227;o renal ou &#171;pseudo-agravamento da fun&#231;&#227;o renal&#63;&#187;&#46; O impacto progn&#243;stico da hemoconcentra&#231;&#227;o em doentes admitidos com insufici&#234;ncia card&#237;aca aguda"
          ]
        ]
        "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" => "fig0025"
            "etiqueta" => "Figure 5"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr5.jpeg"
                "Alto" => 1262
                "Ancho" => 1589
                "Tamanyo" => 112092
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Survival curves grouped by presence or absence of hemoconcentration &#40;HC&#41; according to KDIGO criteria among patients without chronic kidney disease with worsening renal function &#40;WRF&#41;&#46; Log rank&#59; p&#61;0&#46;02&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Jos&#233; Lu&#237;s Martins, Lu&#237;s Santos, Ana Faustino, Jesus Viana, Jos&#233; Santos"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "Jos&#233; Lu&#237;s"
                "apellidos" => "Martins"
              ]
              1 => array:2 [
                "nombre" => "Lu&#237;s"
                "apellidos" => "Santos"
              ]
              2 => array:2 [
                "nombre" => "Ana"
                "apellidos" => "Faustino"
              ]
              3 => array:2 [
                "nombre" => "Jesus"
                "apellidos" => "Viana"
              ]
              4 => array:2 [
                "nombre" => "Jos&#233;"
                "apellidos" => "Santos"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511730389X?idApp=UINPBA00004E"
      "url" => "/08702551/0000003700000007/v3_201808080407/S087025511730389X/v3_201808080407/en/main.assets"
    ]
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
    "titulo" => "Putting creatinine and hemoconcentration in their place as prognostic predictors in the conundrum of acute heart failure"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "603"
        "paginaFinal" => "605"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Pedro Marques da Silva"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Pedro Marques"
            "apellidos" => "da Silva"
            "email" => array:1 [
              0 => "pmarques&#46;silva&#64;sapo&#46;pt"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "N&#250;cleo de Investiga&#231;&#227;o Arterial&#44; Medicina 4&#44; Hospital de Santa Marta&#44; Centro Hospitalar de Lisboa Central&#44; EPE&#44; Lisboa&#44; Portugal"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Assentar a creatinina e a hemoconcentra&#231;&#227;o no lugar correto enquanto preditores progn&#243;sticos na insufici&#234;ncia card&#237;aca aguda"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleDisplayedQuote" id="dsq0005"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#8220;Homage to thee&#44; O my heart&#33; Homage to you&#44; O my kidneys&#33;&#8221;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The Egyptian Book of the Dead<a class="elsevierStyleCrossRef" href="#fn0005"><span class="elsevierStyleSup">a</span></a></p></span></p><p id="par0010" class="elsevierStylePara elsevierViewall">Many centuries ago&#44; traditional Chinese medicine &#8211; today&#44; quite rightly&#44; a subject of some controversy in the Portuguese medical community &#8211; described a disorder termed &#8220;heart and kidney failing to link&#44;&#8221; suggesting a close connection between dysfunction of the kidneys and of the heart&#46; These may have been the first references to what is now known as cardiorenal syndrome &#40;CRS&#41;&#44; a complex &#8220;disorder of the heart and the kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other&#8221;&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">1&#8211;3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Five subtypes of CRS are now recognized&#44; but in all of them&#44; both organs &#40;heart and kidneys&#41; show or develop structural and&#47;or functional alterations&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">4&#44;5</span></a> Type 1 &#40;acute CRS&#41; &#8211; the subject of this editorial &#8211; refers to acute worsening of heart function leading to acute kidney injury &#40;AKI&#41; and&#47;or dysfunction&#44;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">1&#8211;3</span></a> and can be found in 19-45&#37; of patients with acute decompensated heart failure &#40;ADHF&#41; presenting with AKI&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">4</span></a> AKI mostly occurs early&#44; within 3-5 days of hospitalization&#44; and appears to be a predictor of even worse prognosis&#44; associated with higher short- and long-term all-cause and cardiovascular mortality and prolonged hospitalization&#46; The well-documented risk factors for AKI in the context of AHF are a history of diabetes&#44; severity of cardiac dysfunction on admission&#44; use of high-dose diuretics &#40;particularly loop diuretics&#44; but also thiazides&#41;&#44; vasodilator therapy&#44; and use of larger radiocontrast volumes&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The clinical presentation of type 1 CRS usually includes rapid worsening renal function &#40;WRF&#41; &#40;suggestive of altered renal perfusion&#44; unless proven otherwise&#41;&#44; resulting in volume overload with signs and symptoms of fluid retention&#44; pulmonary rales and systemic congestion&#44; less frequently in low cardiac output with peripheral hypoperfusion&#44; and in poor response to diuretics&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">2&#44;4&#44;5</span></a> It should be borne in mind that in the context of AHF diuretic resistance is multifactorial and includes&#44; in varying degrees&#44; impaired renal blood flow&#44; altered drug reabsorption&#44; reduced glomerular filtration&#44; low albumin concentrations&#44; and increased levels of urea nitrogen and other organic acids competitively impeding diuretic availability at the site of action&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">6&#44;7</span></a> Ideally&#44; in order to recognize renal dysfunction and to stratify the severity of AKI&#44; the risk&#44; injury&#44; failure&#44; loss of kidney function&#44; and end-stage kidney disease &#40;RIFLE&#41; and Acute Kidney Injury Network &#40;AKIN&#41; classifications should be applied&#46; The former is based on changes in serum creatinine &#40;SCr&#41; or glomerular filtration rate &#40;GFR&#41; and&#47;or urine output&#44; and is a good predictor of AKI severity and outcome&#46; The AKIN classification is a modified adaptation of RIFLE&#44; and can increase the sensitivity and specificity of AKI diagnosis&#46; Although clinically available biomarkers are sometimes inadequate for a diagnosis of CRS and detection of AKI in ADHF&#44; in clinical practice the suspicion of type 1 CRS derives from an increase in SCr and blood urea nitrogen &#40;BUN&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">BUN is a serum by-product of protein metabolism and is probably one of the oldest short- as well as long-term prognostic markers in patients with heart failure&#46; In the Acute Decompensated Heart Failure National Registry &#40;ADHERE&#41; database&#44; BUN &#8805;43 mg&#47;dl was the single best predictor&#44; followed by systolic blood pressure &#60;115 mmHg on admission and SCr &#8805;2&#46;75 mg&#47;dl &#40;243&#46;1 &#956;mol&#47;l&#41;&#44; of in-hospital mortality among 65<span class="elsevierStyleHsp" style=""></span>275 AHF admissions&#46; These findings have been replicated in other studies and BUN levels should be measured in routine prognostic assessment of ADHF&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a> Creatinine is a breakdown product of creatine phosphate in muscle tissue&#44; and increases in the blood when GFR decreases&#44; an indication of renal dysfunction&#46; Increases in SCr elevations are also associated with worse outcomes in heart failure patients&#44; and are a strong independent predictor of both one- and five-year mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">However&#44; as Martins et al&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> note in this issue of the <span class="elsevierStyleItalic">Journal</span>&#44; an increase of SCr in AHF patients does not always imply renal dysfunction or worse prognosis&#46; As the authors point out&#44; AHF patients with mild creatinine elevation but without established renal failure have a better prognosis&#44; since these changes are due to hemoconcentration &#40;HC&#41; rather than to true WRF&#46; It should be noted that in this case&#44; HC arises from an absolute or relative loss of water from blood plasma &#40;deshydremia&#41;&#46; In Martins et al&#46;&#8217;s paper&#44; HC was defined as an increase in hemoglobin during hospital stay&#44; estimated by subtracting hemoglobin at discharge from hemoglobin at admission&#59; a similar definition has been used by other investigators&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">10&#8211;14</span></a> In their study&#44; as in others&#44; HC was associated with a better prognosis in patients with or without WRF&#44; acting as a surrogate for anticongestive therapy&#44; and had prognostic value in AHF patients without CKD but with elevated SCr&#46; It would therefore be a mistake to argue that a simple increase in SCr indicates AKI&#44; and in fact when associated with HC<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">3</span></a> &#8211; with no renal failure or chronic kidney disease &#8211; it is associated with better prognosis and survival&#46; Such cases should be reclassified as &#8216;pseudo-WRF&#8217;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">On the whole&#44; the article by Martins et al&#46; is clear&#44; credible and well researched&#44; with an accurate and judicious description of its limitations&#58; its single-center and retrospective nature&#44; the importance of missing data such as SCr and left ventricular ejection fraction&#44; and the fact that pharmacological therapy at discharge was not recorded &#40;with possible effects on prognosis&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Diuretics &#40;mainly&#44; but not only&#44; loop diuretics&#41; are the cornerstone of ADHF and CRS treatment&#46; They relieve renal venous congestion and fluid overload and improve patients&#8217; symptoms and comfort&#44; and their early use in severe ADHF can reduce mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">5&#44;6</span></a> However&#44; they are a double-edged sword&#58; they may worsen kidney function and trigger even more neurohormonal systems&#46; The use and effects of diuretic therapy must therefore be carefully monitored&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">5&#44;6</span></a> HC may be linked with increased risk of WRF during hospitalization&#44; increased diuretic doses&#44; and greater weight loss&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> However&#44; in multivariate analysis&#44; HC is not linked with mortality&#44; and an early increase &#40;in the first week&#41; in hemoglobin is independently associated with a favorable outcome&#44; despite a slight worsening of renal function&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Future research needs to focus on the differences between and determinants of late and early HC in AHF and to determine the cutoffs between them &#8211; because&#44; apparently&#44; only late HC is associated with improved survival<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> &#8211; and&#44; bearing in mind that HC can be a surrogate for successful decongestion in AHF&#44; to clarify why in some patients there is a conflict between HC and clinical assessment of venous congestion&#44; with persistent congestion at discharge linked with increased mortality that is not HC-dependent&#46; Finally&#44; as Martins et al&#46; suggest&#44; HC is associated with better outcomes but cannot replace clinical assessment in the initial diagnosis of AHF and a proper diagnostic workup that includes specific biomarkers&#44; as well as BUN&#44; SCr&#44; hemoglobin and hematocrit&#46; In the meantime&#44; all patients with AHF should promptly start pharmacological and non-pharmacological treatment in parallel&#44; as recommended in the most recent guidelines&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">5&#44;6</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The author has 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
    "NotaPie" => array:1 [
      0 => array:3 [
        "etiqueta" => "a"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Eknoyan G&#46; The kidneys in the Bible&#58; what happened&#63; J Am Soc Nephrol&#46; 2005&#59;16&#40;12&#41;&#58;3464-71&#46;</p>"
        "identificador" => "fn0005"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:16 [
            0 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiorenal syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Ronco"
                            1 => "M&#46; Haapio"
                            2 => "A&#46;A&#46; House"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2008.07.051"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2008"
                        "volumen" => "52"
                        "paginaInicial" => "1527"
                        "paginaFinal" => "1539"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19007588"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardio-renal syndromes&#58; report from the consensus conference of the Acute Dialysis Quality Initiative"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Acute Dialysis Quality Initiative &#40;ADQI&#41; Consensus Group"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Ronco"
                            1 => "P&#46; McCullough"
                            2 => "S&#46;D&#46; Anker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehp507"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2010"
                        "volumen" => "31"
                        "paginaInicial" => "703"
                        "paginaFinal" => "711"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20037146"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The acute cardiorenal syndrome type I&#58; considerations on physiology&#44; epidemiology&#44; and therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;A&#46; Valika"
                            1 => "M&#46;R&#46; Costanzo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11897-014-0224-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Heart Fail Rep"
                        "fecha" => "2014"
                        "volumen" => "11"
                        "paginaInicial" => "382"
                        "paginaFinal" => "392"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25224320"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute heart failure&#46; Putting the puzzle of pathophysiology and evidence together in daily practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "W&#46; Kr&#252;ger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:6 [
                        "edicion" => "2nd ed&#46;"
                        "fecha" => "2017"
                        "paginaInicial" => "371"
                        "paginaFinal" => "400"
                        "editorial" => "Springer International Publishing AG"
                        "editorialLocalizacion" => "Switzerland"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2017 comprehensive update of the Canadian Cardiovascular Society guidelines for the management of heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;A&#46; Ezekowitz"
                            1 => "E&#46; O&#8217;Meara"
                            2 => "M&#46;A&#46; McDonald"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cjca.2017.08.022"
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Cardiol"
                        "fecha" => "2017"
                        "volumen" => "33"
                        "paginaInicial" => "1342"
                        "paginaFinal" => "1433"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29111106"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Erratum in&#58; Eur Heart J&#46; 2016 Dec 30"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure&#58; The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology &#40;ESC&#41; Developed with the special contribution of the Heart Failure Association &#40;HFA&#41; of the ESC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46; Ponikowski"
                            1 => "A&#46;A&#46; Voors"
                            2 => "S&#46;D&#46; Anker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehw128"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2016"
                        "volumen" => "37"
                        "paginaInicial" => "2129"
                        "paginaFinal" => "2200"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27206819"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Edema mechanisms in the heart failure patient and treatment options"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;A&#46; Sica"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Managing the kidney when the heart is failing"
                        "paginaInicial" => "73"
                        "paginaFinal" => "89"
                        "serieFecha" => "2012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "&#91;Contemporary Cardiology&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute decompensated heart failure in the observation unit&#58; treatment protocols"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Pease"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Short stay management of acute heart failure"
                        "paginaInicial" => "197"
                        "paginaFinal" => "210"
                        "edicion" => "3rd ed&#46;"
                        "serieFecha" => "2017"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Worsening or &#8216;pseudo-worsening&#8217; renal function&#63; The prognostic value of hemoconcentration in patients admitted with acute heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;L&#46; Martins"
                            1 => "L&#46; Santos"
                            2 => "A&#46; Faustino"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2017.10.015"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2018"
                        "volumen" => "37"
                        "paginaInicial" => "595"
                        "paginaFinal" => "602"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29934213"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Timing of hemoconcentration during treatment of acute decompensated heart failure and subsequent survival&#58; importance of sustained decongestion"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;M&#46; Testani"
                            1 => "M&#46;A&#46; Brisco"
                            2 => "J&#46; Chen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2013.05.027"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2013"
                        "volumen" => "62"
                        "paginaInicial" => "516"
                        "paginaFinal" => "524"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23747773"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hemoconcentration is a good prognostic predictor for clinical outcomes in acute heart failure&#58; data from the Korean Heart Failure &#40;KorHF&#41; Registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; Oh"
                            1 => "S&#46;M&#46; Kang"
                            2 => "N&#46; Hong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2013.07.241"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cardiol"
                        "fecha" => "2013"
                        "volumen" => "168"
                        "paginaInicial" => "4739"
                        "paginaFinal" => "4743"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23958420"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hemoconcentration-guided diuresis in heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Vaduganathan"
                            1 => "S&#46;J&#46; Greene"
                            2 => "G&#46;C&#46; Fonarow"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjmed.2014.06.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Med"
                        "fecha" => "2014"
                        "volumen" => "127"
                        "paginaInicial" => "1154"
                        "paginaFinal" => "1159"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24937157"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Discordance between hemoconcentration and clinical assessment of decongestion in acute heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "W&#46; Darawsha"
                            1 => "S&#46; Chirmicci"
                            2 => "A&#46; Solomonica"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cardfail.2016.04.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Card Fail"
                        "fecha" => "2016"
                        "volumen" => "22"
                        "paginaInicial" => "680"
                        "paginaFinal" => "688"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27079674"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The top tertile of hematocrit change during hospitalization is associated with lower risk of mortality in acute heart failure patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "H&#46; Zhou"
                            1 => "T&#46; Xu"
                            2 => "Y&#46; Huang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12872-017-0669-0"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Cardiovasc Disord"
                        "fecha" => "2017"
                        "volumen" => "17"
                        "paginaInicial" => "235"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28865437"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical correlates of hemoconcentration during hospitalization for acute decompensated heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Davila"
                            1 => "A&#46; Reyentovich"
                            2 => "S&#46;D&#46; Katz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cardfail.2011.08.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Card Fail"
                        "fecha" => "2011"
                        "volumen" => "17"
                        "paginaInicial" => "1018"
                        "paginaFinal" => "1022"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22123365"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The predictive value of short-term changes in hemoglobin concentration in patients presenting with acute decompensated heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46; van der Meer"
                            1 => "D&#46; Postmus"
                            2 => "P&#46; Ponikowski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2012.12.050"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2013"
                        "volumen" => "61"
                        "paginaInicial" => "1973"
                        "paginaFinal" => "1981"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23500313"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/08702551/0000003700000007/v3_201808080407/S0870255118303536/v3_201808080407/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "29261"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Artigos Originais"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003700000007/v3_201808080407/S0870255118303536/v3_201808080407/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255118303536?idApp=UINPBA00004E"
]
Informação do artigo
ISSN: 08702551
Idioma original: Inglês
Dados atualizados diariamente
Ano/Mês Html Pdf Total
2024 Outubro 18 12 30
2024 Setembro 68 25 93
2024 Agosto 65 28 93
2024 Julho 55 38 93
2024 Junho 59 34 93
2024 Maio 42 26 68
2024 Abril 44 32 76
2024 Maro 31 19 50
2024 Fevereiro 30 26 56
2024 Janeiro 27 31 58
2023 Dezembro 49 32 81
2023 Novembro 48 26 74
2023 Outubro 33 22 55
2023 Setembro 59 23 82
2023 Agosto 38 15 53
2023 Julho 62 9 71
2023 Junho 51 10 61
2023 Maio 31 30 61
2023 Abril 29 3 32
2023 Maro 64 26 90
2023 Fevereiro 51 21 72
2023 Janeiro 24 17 41
2022 Dezembro 38 28 66
2022 Novembro 57 24 81
2022 Outubro 44 31 75
2022 Setembro 19 28 47
2022 Agosto 31 23 54
2022 Julho 34 45 79
2022 Junho 22 36 58
2022 Maio 18 30 48
2022 Abril 40 37 77
2022 Maro 30 45 75
2022 Fevereiro 30 36 66
2022 Janeiro 32 21 53
2021 Dezembro 35 34 69
2021 Novembro 33 25 58
2021 Outubro 29 47 76
2021 Setembro 24 26 50
2021 Agosto 26 28 54
2021 Julho 25 17 42
2021 Junho 22 18 40
2021 Maio 46 35 81
2021 Abril 24 34 58
2021 Maro 56 27 83
2021 Fevereiro 52 16 68
2021 Janeiro 30 16 46
2020 Dezembro 24 21 45
2020 Novembro 37 14 51
2020 Outubro 32 17 49
2020 Setembro 47 15 62
2020 Agosto 22 6 28
2020 Julho 123 17 140
2020 Junho 44 6 50
2020 Maio 57 11 68
2020 Abril 64 18 82
2020 Maro 40 8 48
2020 Fevereiro 77 41 118
2020 Janeiro 26 9 35
2019 Dezembro 31 10 41
2019 Novembro 42 12 54
2019 Outubro 31 8 39
2019 Setembro 18 7 25
2019 Agosto 21 13 34
2019 Julho 32 9 41
2019 Junho 35 13 48
2019 Maio 51 11 62
2019 Abril 16 15 31
2019 Maro 40 7 47
2019 Fevereiro 81 6 87
2019 Janeiro 98 11 109
2018 Dezembro 113 14 127
2018 Novembro 51 13 64
2018 Outubro 72 23 95
2018 Setembro 50 18 68
2018 Agosto 90 22 112
2018 Julho 57 40 97
2018 Junho 12 16 28
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.