Editorial comment
Frailty, age and heart failure
Fragilidade, idade e insuficiência cardíaca
Lido
1356
Vezesque se leu este artigo
565
Total PDF
791
Total HTML
Compartilhar estatísticas
array:25 [ "pii" => "S0870255123000574" "issn" => "08702551" "doi" => "10.1016/j.repc.2023.01.008" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "2107" "copyright" => "Sociedade Portuguesa de Cardiologia" "copyrightAnyo" => "2023" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "dis" "cita" => "Rev Port Cardiol. 2023;42:235-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0870255123000458" "issn" => "08702551" "doi" => "10.1016/j.repc.2022.02.010" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "2095" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Port Cardiol. 2023;42:237-46" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Long-term prognostic impact of beta-blockers in patients with Takotsubo syndrome: Results from the RETAKO Registry" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "237" "paginaFinal" => "246" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Impacto prognóstico a longo prazo do uso de beta-bloqueantes em doentes com síndrome de Takotsubo: resultados do Registo RETAKO" ] ] "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" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1133 "Ancho" => 1508 "Tamanyo" => 116157 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Kaplan-Meier curves adjusted by inverse probability weighting (IPW) propensity score analysis.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sergio Raposeiras-Roubín, Iván J. Núñez-Gil, Karim Jamhour, Emad Abu-Assi, David Aritza Conty, Oscar Vedia, Manuel Almendro-Delia, Alessandro Sionis, Agustin C. Martin-Garcia, Miguel Corbí-Pascual, Manuel Martínez-Sellés, Aitor Uribarri, Marta Guillén, José María García Acuña, Javier Lopez País, Emilia Blanco, José A. Linares Vicente, Alejandro Sánchez Grande Flecha, Mireia Andrés, Alberto Pérez-Castellanos, Joaquín Alonso, Xavier Rosselló, Andrés Iñiguez Romo, Gisela Feltes" "autores" => array:25 [ 0 => array:2 [ "nombre" => "Sergio" "apellidos" => "Raposeiras-Roubín" ] 1 => array:2 [ "nombre" => "Iván J." "apellidos" => "Núñez-Gil" ] 2 => array:2 [ "nombre" => "Karim" "apellidos" => "Jamhour" ] 3 => array:2 [ "nombre" => "Emad" "apellidos" => "Abu-Assi" ] 4 => array:2 [ "nombre" => "David Aritza" "apellidos" => "Conty" ] 5 => array:2 [ "nombre" => "Oscar" "apellidos" => "Vedia" ] 6 => array:2 [ "nombre" => "Manuel" "apellidos" => "Almendro-Delia" ] 7 => array:2 [ "nombre" => "Alessandro" "apellidos" => "Sionis" ] 8 => array:2 [ "nombre" => "Agustin C." "apellidos" => "Martin-Garcia" ] 9 => array:2 [ "nombre" => "Miguel" "apellidos" => "Corbí-Pascual" ] 10 => array:2 [ "nombre" => "Manuel" "apellidos" => "Martínez-Sellés" ] 11 => array:2 [ "nombre" => "Aitor" "apellidos" => "Uribarri" ] 12 => array:2 [ "nombre" => "Marta" "apellidos" => "Guillén" ] 13 => array:2 [ "nombre" => "José María García" "apellidos" => "Acuña" ] 14 => array:2 [ "nombre" => "Javier Lopez" "apellidos" => "País" ] 15 => array:2 [ "nombre" => "Emilia" "apellidos" => "Blanco" ] 16 => array:2 [ "nombre" => "José A." "apellidos" => "Linares Vicente" ] 17 => array:2 [ "nombre" => "Alejandro Sánchez Grande" "apellidos" => "Flecha" ] 18 => array:2 [ "nombre" => "Mireia" "apellidos" => "Andrés" ] 19 => array:2 [ "nombre" => "Alberto" "apellidos" => "Pérez-Castellanos" ] 20 => array:2 [ "nombre" => "Joaquín" "apellidos" => "Alonso" ] 21 => array:2 [ "nombre" => "Xavier" "apellidos" => "Rosselló" ] 22 => array:2 [ "nombre" => "Andrés Iñiguez" "apellidos" => "Romo" ] 23 => array:2 [ "nombre" => "Gisela" "apellidos" => "Feltes" ] 24 => array:1 [ "colaborador" => "on behalf of RETAKO Investigators" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255123000458?idApp=UINPBA00004E" "url" => "/08702551/0000004200000003/v1_202303051609/S0870255123000458/v1_202303051609/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0870255123000446" "issn" => "08702551" "doi" => "10.1016/j.repc.2022.02.009" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "2094" "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. 2023;42:225-34" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Frailty phenotype in heart failure: A condition that transcends age" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "225" "paginaFinal" => "234" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "O fenótipo de fragilidade na insuficiência cardíaca: uma condição que transcende idades" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rui Valdiviesso, Emília Moreira, Sónia Martins, Luís Filipe Azevedo, Rosário Ataíde, Lia Fernandes, José Silva-Cardoso, Nuno Borges" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Rui" "apellidos" => "Valdiviesso" ] 1 => array:2 [ "nombre" => "Emília" "apellidos" => "Moreira" ] 2 => array:2 [ "nombre" => "Sónia" "apellidos" => "Martins" ] 3 => array:2 [ "nombre" => "Luís Filipe" "apellidos" => "Azevedo" ] 4 => array:2 [ "nombre" => "Rosário" "apellidos" => "Ataíde" ] 5 => array:2 [ "nombre" => "Lia" "apellidos" => "Fernandes" ] 6 => array:2 [ "nombre" => "José" "apellidos" => "Silva-Cardoso" ] 7 => array:2 [ "nombre" => "Nuno" "apellidos" => "Borges" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255123000446?idApp=UINPBA00004E" "url" => "/08702551/0000004200000003/v1_202303051609/S0870255123000446/v1_202303051609/en/main.assets" ] "asociados" => array:1 [ 0 => array:19 [ "pii" => "S0870255123000446" "issn" => "08702551" "doi" => "10.1016/j.repc.2022.02.009" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "2094" "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. 2023;42:225-34" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Frailty phenotype in heart failure: A condition that transcends age" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "225" "paginaFinal" => "234" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "O fenótipo de fragilidade na insuficiência cardíaca: uma condição que transcende idades" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rui Valdiviesso, Emília Moreira, Sónia Martins, Luís Filipe Azevedo, Rosário Ataíde, Lia Fernandes, José Silva-Cardoso, Nuno Borges" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Rui" "apellidos" => "Valdiviesso" ] 1 => array:2 [ "nombre" => "Emília" "apellidos" => "Moreira" ] 2 => array:2 [ "nombre" => "Sónia" "apellidos" => "Martins" ] 3 => array:2 [ "nombre" => "Luís Filipe" "apellidos" => "Azevedo" ] 4 => array:2 [ "nombre" => "Rosário" "apellidos" => "Ataíde" ] 5 => array:2 [ "nombre" => "Lia" "apellidos" => "Fernandes" ] 6 => array:2 [ "nombre" => "José" "apellidos" => "Silva-Cardoso" ] 7 => array:2 [ "nombre" => "Nuno" "apellidos" => "Borges" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255123000446?idApp=UINPBA00004E" "url" => "/08702551/0000004200000003/v1_202303051609/S0870255123000446/v1_202303051609/en/main.assets" ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>" "titulo" => "Frailty, age and heart failure" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "235" "paginaFinal" => "236" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Maria Mónica Mendes Pedro" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Maria Mónica" "apellidos" => "Mendes Pedro" "email" => array:1 [ 0 => "monicapedro01@gmail.com" ] "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Serviço de Cardiologia, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Centro Académico de Medicina de Lisboa, Lisboa, Portugal" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Centro Cardiovascular da Universidade de Lisboa, Lisboa, Portugal" "etiqueta" => "d" "identificador" => "aff0020" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Fragilidade, idade e insuficiência cardíaca" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Frailty has traditionally been associated with aging, reflecting a state of physiological decline with decreased physical fitness, weight loss, sarcopenia and progressive reduction of autonomy. There is also a marked vulnerability to adverse health events and diminished capacity to tolerate and adapt to stressors such as acute illness, and surgical or medical interventions.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Fried et al. were the first to describe the pathophysiology of the frailty process in detail, signaling the path toward functional decline.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">2</span></a> They proposed a frailty index by measuring the phenotype, including muscle strength, muscle mass, walking speed, energy expenditure and nutritional status/weight loss. This index remains the most influential frailty tool.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Since then, several screening tools have been proposed to assess frailty, which can be divided in two main groups: ones that address physical frailty, that is, signs and symptoms associated with higher vulnerability to adverse health outcomes (weakness, fatigue, weight loss, slow gait, low activity), and deficit accumulation frailty or index frailty, that considers co-morbidities and cumulative illnesses.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Whichever tool is used to measure frailty, it seems to be unanimous that advanced frailty is associated with increased mortality, disability, hospitalization and procedural complications.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The prevalence of frailty depends on the frailty scale used and, on the population, studied, and varies among studies.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">So far, most of the studies addressing frailty have been conducted in old people. Studies that comprise or are directed toward younger people are usually in the context of critically ill patients in different settings, heart failure including advanced heart failure (HF).<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The frailty phenotype is very common in heart failure<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a> and frailty itself is not a syndrome exclusive to old people or only associated with aging. It can affect patients at any time of life and, when present, can negatively influence morbidity and mortality. As such, the aim of the study “Frailty phenotype in heart failure: A condition that transcends age”<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a> raises the pertinent question of whether there are differences between younger and older pre-frail and frail HF outpatients using Fried's criteria, although no substantial differences were found by the authors between the two groups (only in hand grip strength, gait speed and in the prevalence of type 2 diabetes). That is not surprising given the limitations stated by the authors (cross-sectional study; small sample size; use of estimated and indirect measures of body composition), but also perhaps because only two wide groups were considered (<65 years and ≥65 years). The patients were broadly in the same stage of syndrome impact, and older people with substantial age-related co-morbidities had most probably already died and were not “healthy” enough to endure HF.</p><p id="par0040" class="elsevierStylePara elsevierViewall">It would be interesting in the future to perform longitudinal studies, controlled with non-frail patients, with more discriminated age groups, to define age-specific cut-offs for frailty criteria, including, as stated by the authors, hand grip strength and gait speed; to evaluate other frailty tools and determine which are the best to assess HF patients, whether there are advantages to using different criteria in different age groups to refine the diagnosis and, eventually, to come to a consensus concerning definition and the tools to be used.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Finally, if diagnosing and measuring is important, there is also a need to agree on the best strategies for preventing, treating and/or mitigating frailty and its impact on the quality of life, morbidity and mortality of HF patients.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</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.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Frailty in elderly people" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A. Clegg" 1 => "J. Young" 2 => "S. Iliffe" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Lancet" "fecha" => "2013" "volumen" => "381" "paginaInicial" => "752" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0055" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Frailty in older adults: evidence for a phenotype" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "L.P. Fried" 1 => "C.M. Tangen" 2 => "J. Walston" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/gerona/56.3.m146" "Revista" => array:6 [ "tituloSerie" => "J Gerontol A Biol Sci Med Sci" "fecha" => "2001" "volumen" => "56" "paginaInicial" => "M146" "paginaFinal" => "M156" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11253156" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0060" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Frailty: a tale of two concepts" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.D. Walston" 1 => "K. Bandeen-Roche" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12916-015-0420-6" "Revista" => array:5 [ "tituloSerie" => "BMC Med" "fecha" => "2015" "volumen" => "13" "paginaInicial" => "185" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26265077" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0065" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Agreement between 35 published frailty scores in the general population" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "G.A. Aquayo" 1 => "A.F. Donneau" 2 => "M.T. Vaillant" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/aje/kwx061" "Revista" => array:5 [ "tituloSerie" => "Am J Epidemiol" "fecha" => "2017" "volumen" => "186" "paginaInicial" => "420" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28633404" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0070" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Operationalization of frailty using eight commonly used scales and comparison of their ability to predict all-cause mortality" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "O. Theou" 1 => "T.D. Brothers" 2 => "A. Mitnitski" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jgs.12420" "Revista" => array:5 [ "tituloSerie" => "J Am Geriatr Soc" "fecha" => "2013" "volumen" => "61" "paginaInicial" => "1537" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24028357" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0075" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The prevalence and prognostic significance of frailty in patients with advanced heart failure referred for heart transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S.R. Jha" 1 => "M.K. Hannu" 2 => "S. Chang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/TP.0000000000000991" "Revista" => array:6 [ "tituloSerie" => "Transplantation" "fecha" => "2016" "volumen" => "100" "paginaInicial" => "429" "paginaFinal" => "436" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26516676" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0080" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The prevalence of frailty in heart failure: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "Q.E. Denfeld" 1 => "K. Winters-Stone" 2 => "J.O. Mudd" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijcard.2017.01.153" "Revista" => array:6 [ "tituloSerie" => "Int J Cardiol" "fecha" => "2017" "volumen" => "236" "paginaInicial" => "283" "paginaFinal" => "289" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28215466" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0085" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Frailty phenotype in heart failure: a condition that transcends age" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R. Valdiviesso" 1 => "E. Moreira" 2 => "S. Martins" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2023" "volumen" => "42" "paginaInicial" => "225" "paginaFinal" => "234" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0090" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effectiveness of interventions to prevent pre-frailty and frailty progression in older adults: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Apóstolo" 1 => "R. Cooke" 2 => "E. Bobrowicz-Campos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "JBI Database System Ver Implement Rep" "fecha" => "2018" "volumen" => "16" "paginaInicial" => "140" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000004200000003/v1_202303051609/S0870255123000574/v1_202303051609/en/main.assets" "Apartado" => array:4 [ "identificador" => "93359" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000004200000003/v1_202303051609/S0870255123000574/v1_202303051609/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255123000574?idApp=UINPBA00004E" ]
| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 9 | 7 | 16 |
| 2024 Outubro | 43 | 26 | 69 |
| 2024 Setembro | 38 | 23 | 61 |
| 2024 Agosto | 35 | 33 | 68 |
| 2024 Julho | 49 | 25 | 74 |
| 2024 Junho | 20 | 17 | 37 |
| 2024 Maio | 32 | 19 | 51 |
| 2024 Abril | 37 | 27 | 64 |
| 2024 Maro | 36 | 26 | 62 |
| 2024 Fevereiro | 25 | 26 | 51 |
| 2024 Janeiro | 20 | 14 | 34 |
| 2023 Dezembro | 25 | 19 | 44 |
| 2023 Novembro | 50 | 36 | 86 |
| 2023 Outubro | 21 | 23 | 44 |
| 2023 Setembro | 28 | 15 | 43 |
| 2023 Agosto | 25 | 19 | 44 |
| 2023 Julho | 23 | 8 | 31 |
| 2023 Junho | 25 | 8 | 33 |
| 2023 Maio | 46 | 36 | 82 |
| 2023 Abril | 31 | 19 | 50 |
| 2023 Maro | 130 | 91 | 221 |
| 2023 Fevereiro | 24 | 22 | 46 |
| 2023 Janeiro | 19 | 26 | 45 |
Mostrar tudo
