Editorial comment
Heart failure care: The time has come to tackle the cardiovascular “epidemic” of the XXI century
Cuidados na Insuficiência Cardíaca: chegou a hora de enfrentar a «epidemia» cardiovascular do século XXI
Lido
1162
Vezesque se leu este artigo
466
Total PDF
696
Total HTML
Compartilhar estatísticas
array:23 [ "pii" => "S0870255123004031" "issn" => "08702551" "doi" => "10.1016/j.repc.2023.09.002" "estado" => "S300" "fechaPublicacion" => "2023-11-01" "aid" => "2254" "copyrightAnyo" => "2023" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "dis" "cita" => "Rev Port Cardiol. 2023;42:893-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0870255123003517" "issn" => "08702551" "doi" => "10.1016/j.repc.2023.03.018" "estado" => "S300" "fechaPublicacion" => "2023-11-01" "aid" => "2224" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Port Cardiol. 2023;42:895-903" "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" => "Irbesartan has a curative effect on lipopolysaccharide-induced cardiotoxicity by antioxidant and antiapoptotic pathways" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "895" "paginaFinal" => "903" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "O irbesartan tem um efeito curativo na cardiotoxicidade induzida por lipopolissacarídeos por vias antioxidantes e antiapoptóticas" ] ] "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" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 2671 "Ancho" => 2508 "Tamanyo" => 443853 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Relative mRNA expression results and statistical comparison between groups. <span class="elsevierStyleItalic">BAX</span>: Bcl-2-associated X protein; <span class="elsevierStyleItalic">BCL2</span>: B-cell lymphoma 2; IRB: irbesartan; LPS: lipopolysaccharide; <span class="elsevierStyleItalic">SIRT1</span>: sirtuin 1. Values are presented as means<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>standard deviation. *p<0.05, **p<0.001.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Muhammet Yusuf Tepebaşi, Halil Aşci, Samet Coşan, Mehmet Abdülkadir Sevük, Nasıf Fatih Karakuyu, Özlem Özmen" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Muhammet Yusuf" "apellidos" => "Tepebaşi" ] 1 => array:2 [ "nombre" => "Halil" "apellidos" => "Aşci" ] 2 => array:2 [ "nombre" => "Samet" "apellidos" => "Coşan" ] 3 => array:2 [ "nombre" => "Mehmet Abdülkadir" "apellidos" => "Sevük" ] 4 => array:2 [ "nombre" => "Nasıf Fatih" "apellidos" => "Karakuyu" ] 5 => array:2 [ "nombre" => "Özlem" "apellidos" => "Özmen" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255123003517?idApp=UINPBA00004E" "url" => "/08702551/0000004200000011/v1_202311030625/S0870255123003517/v1_202311030625/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0870255123002755" "issn" => "08702551" "doi" => "10.1016/j.repc.2023.01.027" "estado" => "S300" "fechaPublicacion" => "2023-11-01" "aid" => "2210" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Port Cardiol. 2023;42:885-91" "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" => "Expert perspectives on strategic factors for the management and prevention of heart failure in Portugal" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "885" "paginaFinal" => "891" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Perspetivas de peritos sobre fatores estratégicos para a gestão e prevenção da insuficiência cardíaca em Portugal" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1904 "Ancho" => 3000 "Tamanyo" => 286582 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Overview of the ATHENA-PT project.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Daniel Caldeira, Dulce Brito, Carlos Aguiar, José Silva Cardoso, Cândida Fonseca, Fátima Franco, Filipe Macedo, Brenda Moura, Fausto J. Pinto, António Vaz-Carneiro" "autores" => array:10 [ 0 => array:2 [ "nombre" => "Daniel" "apellidos" => "Caldeira" ] 1 => array:2 [ "nombre" => "Dulce" "apellidos" => "Brito" ] 2 => array:2 [ "nombre" => "Carlos" "apellidos" => "Aguiar" ] 3 => array:2 [ "nombre" => "José" "apellidos" => "Silva Cardoso" ] 4 => array:2 [ "nombre" => "Cândida" "apellidos" => "Fonseca" ] 5 => array:2 [ "nombre" => "Fátima" "apellidos" => "Franco" ] 6 => array:2 [ "nombre" => "Filipe" "apellidos" => "Macedo" ] 7 => array:2 [ "nombre" => "Brenda" "apellidos" => "Moura" ] 8 => array:2 [ "nombre" => "Fausto J." "apellidos" => "Pinto" ] 9 => array:2 [ "nombre" => "António" "apellidos" => "Vaz-Carneiro" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255123002755?idApp=UINPBA00004E" "url" => "/08702551/0000004200000011/v1_202311030625/S0870255123002755/v1_202311030625/en/main.assets" ] "asociados" => array:1 [ 0 => array:18 [ "pii" => "S0870255123002755" "issn" => "08702551" "doi" => "10.1016/j.repc.2023.01.027" "estado" => "S300" "fechaPublicacion" => "2023-11-01" "aid" => "2210" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Port Cardiol. 2023;42:885-91" "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" => "Expert perspectives on strategic factors for the management and prevention of heart failure in Portugal" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "885" "paginaFinal" => "891" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Perspetivas de peritos sobre fatores estratégicos para a gestão e prevenção da insuficiência cardíaca em Portugal" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1904 "Ancho" => 3000 "Tamanyo" => 286582 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Overview of the ATHENA-PT project.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Daniel Caldeira, Dulce Brito, Carlos Aguiar, José Silva Cardoso, Cândida Fonseca, Fátima Franco, Filipe Macedo, Brenda Moura, Fausto J. Pinto, António Vaz-Carneiro" "autores" => array:10 [ 0 => array:2 [ "nombre" => "Daniel" "apellidos" => "Caldeira" ] 1 => array:2 [ "nombre" => "Dulce" "apellidos" => "Brito" ] 2 => array:2 [ "nombre" => "Carlos" "apellidos" => "Aguiar" ] 3 => array:2 [ "nombre" => "José" "apellidos" => "Silva Cardoso" ] 4 => array:2 [ "nombre" => "Cândida" "apellidos" => "Fonseca" ] 5 => array:2 [ "nombre" => "Fátima" "apellidos" => "Franco" ] 6 => array:2 [ "nombre" => "Filipe" "apellidos" => "Macedo" ] 7 => array:2 [ "nombre" => "Brenda" "apellidos" => "Moura" ] 8 => array:2 [ "nombre" => "Fausto J." "apellidos" => "Pinto" ] 9 => array:2 [ "nombre" => "António" "apellidos" => "Vaz-Carneiro" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255123002755?idApp=UINPBA00004E" "url" => "/08702551/0000004200000011/v1_202311030625/S0870255123002755/v1_202311030625/en/main.assets" ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>" "titulo" => "Heart failure care: The time has come to tackle the cardiovascular “epidemic” of the XXI century" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "893" "paginaFinal" => "894" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Diogo Santos-Ferreira, Ricardo Fontes-Carvalho" "autores" => array:2 [ 0 => array:3 [ "nombre" => "Diogo" "apellidos" => "Santos-Ferreira" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 1 => array:4 [ "nombre" => "Ricardo" "apellidos" => "Fontes-Carvalho" "email" => array:1 [ 0 => "fontes.carvalho@gmail.com" ] "referencia" => array:3 [ 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">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Serviço de Cardiologia, Centro Hospitalar Vila Nova Gaia/Espinho, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Cardiovascular Research and Development Center – UnIC@RISE, Faculty of Medicine, University of Porto, Porto, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Cuidados na Insuficiência Cardíaca: chegou a hora de enfrentar a «epidemia» cardiovascular do século XXI" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Heart failure (HF) is an increasingly prevalent condition, with a very high personal and socioeconomical burden. It is estimated that HF affects 5.2% of the adult Portuguese population (more than 400<span class="elsevierStyleHsp" style=""></span>000 individuals),<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> a prevalence which will likely increase over the next decades, due to the ageing population, to the growing prevalence of risk factors (especially obesity and diabetes) and to the increasing availability of disease-modifying drugs. HF will likely become the most significant cardiovascular “epidemic” of the 21st century. The economic and societal impact of this syndrome will also, although it represents 0.2% of the national gross domestic product and 2.6% of all health-related costs (over €400 million per year).<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The challenge ahead will be enormous for doctors, the healthcare system but especially for the society.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Progressively, this issue has begun to be addressed.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3–5</span></a> To better “understand our enemy” the Portuguese Society of Cardiology is currently conducting the PORTHOS study. In this landmark epidemiological study, the investigators are going prospectively to understand the real burden of the disease, and the epidemiology of HF in Portugal, using state-of-the arte diagnostic tools using state-of-the-art diagnostic tools.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Regarding HF treatment, in recent decades, there has been an exponential growth in the number of available therapies – both pharmacological and device-related – that increase survival and quality of life in these patients. Recent data analysis has shown that optimal medical treatment can have a major impact on life-expectancy and extend survival to up to 8.3 additional years of life for a 55-year-old patient with HF with reduced ejection fraction (HFrEF).<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Few therapies in medicine have such an impact on patient prognosis.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Despite all these advances in HF treatment, the use of many of these therapies in routine practice is remarkably low. The time has come for every stakeholder to concentrate on applying the principles of “implementation science” in HF care i.e., develop new methods and strategies that facilitate the uptake of evidence-based practice by practitioners and policymakers, as we did several decades ago in the organization of acute myocardial infarction care across the country.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In this issue, a group of HF specialists report the results of the ATHENA project<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> which tried to identify the most impactful strategies to improve HF care in Portugal from HF prevention, diagnosis, and treatment. Starting with prevention, we need to improve the promotion of healthy lifestyle habits, address and directly combat the “diabesity” epidemic in Portugal and promote an early(ier) diagnosis to prevent disease progression, keep patients in a less-advanced disease state, and facilitate intrinsic networks between care in all health settings. It is also important to broaden the access to the use of natriuretic peptide levels in primary care because this measurement has been recommended as a screening tool for patients at risk of developing HF<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">7-9</span></a> and to improve the early diagnosis of HF, especially in the always challenging diagnosis of HF with preserved ejection fraction (HFpEF).</p><p id="par0030" class="elsevierStylePara elsevierViewall">Regarding disease management, another component which is frequently overlooked is the importance of cardiac rehabilitation. Although this is a class IA recommendation in the guidelines,<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> its utilization in real-life practice is extremely poor and Caldeira et. al. have also accurately identified this as a source of inequality in HF care nationwide.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> In fact, equity in HF management should be viewed as a priority, and establishing a close network between both tertiary and peripheral hospitals, and also between them and with primary care, would be a major step toward delivering evidence-based treatment for every patient.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In summary, this relevant article addresses several organizational issues which, if corrected, can significantly improve HF care in Portugal. Now the discussion must be wider and involve the active contribution of many more doctors, healthcare professionals and involve scientific societies, the government, policymakers and, most importantly, the real patients.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The time has come to tackle the cardiovascular “epidemic” of the 21st century.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">Ricardo Fontes-Carvalho has received consulting/speaker fees from Novartis, Bial, Servier, AstraZeneca, Boehringer-Ingelheim.</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:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Os custos da insuficiência cardíaca em Portugal e a sua evolução previsível com o envelhecimento da população" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M.R.A. Gouveia" 1 => "R.M.S.S. Ascenção" 2 => "F. Fiorentino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.repc.2019.09.006" "Revista" => array:6 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2020" "volumen" => "39" "paginaInicial" => "3" "paginaFinal" => "11" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31973946" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estimating lifetime benefits of comprehensive disease-modifying pharmacological therapies in patients with heart failure with reduced ejection fraction: a comparative analysis of three randomised controlled trials" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M. Vaduganathan" 1 => "B.L. Claggett" 2 => "P.S. Jhund" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Lancet (London, England)" "fecha" => "2020" "volumen" => "396" "paginaInicial" => "121" "paginaFinal" => "128" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of chronic heart failure in Southwestern Europe: the EPICA study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "F. Ceia" 1 => "C. Fonseca" 2 => "T. Mota" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur J Heart Fail" "fecha" => "2002" "volumen" => "4" "paginaInicial" => "531" "paginaFinal" => "539" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Current costs of heart failure in Portugal and expected increases due to population aging" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M.R.A. Gouveia" 1 => "R. Ascenção" 2 => "F. Fiorentino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.repc.2019.09.006" "Revista" => array:6 [ "tituloSerie" => "Rev Port Cardiol (Engl Ed)" "fecha" => "2020" "volumen" => "39" "paginaInicial" => "3" "paginaFinal" => "11" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31973946" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The current and future burden of heart failure in Portugal" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M. Gouveia" 1 => "R. Ascenção" 2 => "F. Fiorentino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ehf2.12399" "Revista" => array:6 [ "tituloSerie" => "ESC Heart Fail" "fecha" => "2019" "volumen" => "6" "paginaInicial" => "254" "paginaFinal" => "261" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30620150" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Expert perspectives on strategic factors for the management and prevention of heart failure in Portugal" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "D. Caldeira" 1 => "D.z Brito" 2 => "C. Aguiar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2023" "volumen" => "42" "paginaInicial" => "885" "paginaFinal" => "891" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Biomarkers for the diagnosis and management of heart failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "V. Castiglione" 1 => "A. Aimo" 2 => "G. Vergaro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10741-021-10105-w" "Revista" => array:6 [ "tituloSerie" => "Heart Fail Rev" "fecha" => "2022" "volumen" => "27" "paginaInicial" => "625" "paginaFinal" => "643" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33852110" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "C.W. Yancy" 1 => "M. Jessup" 2 => "B. Bozkurt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIR.0000000000000509" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2017" "volumen" => "136" "paginaInicial" => "e137" "paginaFinal" => "e161" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28455343" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Heart Failure Association of the European Society of Cardiology practical guidance on the use of natriuretic peptide concentrations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "C. Mueller" 1 => "K. McDonald" 2 => "R.A. de Boer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ejhf.1494" "Revista" => array:6 [ "tituloSerie" => "Eur J Heart Fail" "fecha" => "2019" "volumen" => "21" "paginaInicial" => "715" "paginaFinal" => "731" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31222929" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "T.A. McDonagh" 1 => "M. Metra" 2 => "M. Adamo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur Heart J" "fecha" => "2021" "volumen" => "42" "paginaInicial" => "3599" "paginaFinal" => "3726" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000004200000011/v1_202311030625/S0870255123004031/v1_202311030625/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/08702551/0000004200000011/v1_202311030625/S0870255123004031/v1_202311030625/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255123004031?idApp=UINPBA00004E" ]
| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 11 | 8 | 19 |
| 2024 Outubro | 51 | 31 | 82 |
| 2024 Setembro | 41 | 20 | 61 |
| 2024 Agosto | 55 | 32 | 87 |
| 2024 Julho | 53 | 29 | 82 |
| 2024 Junho | 37 | 30 | 67 |
| 2024 Maio | 48 | 24 | 72 |
| 2024 Abril | 31 | 19 | 50 |
| 2024 Maro | 41 | 21 | 62 |
| 2024 Fevereiro | 32 | 28 | 60 |
| 2024 Janeiro | 26 | 21 | 47 |
| 2023 Dezembro | 38 | 28 | 66 |
| 2023 Novembro | 175 | 115 | 290 |
| 2023 Outubro | 51 | 44 | 95 |
| 2023 Setembro | 6 | 16 | 22 |
Mostrar tudo
