Editorial comment
TOGETHER we can overcome barriers for optimal management of heart failure
JUNTOS, podemos ultrapassar as barreiras para uma gestão ótima da insuficiência cardíaca
João Presume, Daniel Gomes, Jorge Ferreira
Autor para correspondência
Department of Cardiology, Hospital de Santa Cruz, CHLO, Carnaxide, Portugal
Lido
1098
Vezesque se leu este artigo
425
Total PDF
673
Total HTML
Compartilhar estatísticas
array:23 [ "pii" => "S0870255124000040" "issn" => "08702551" "doi" => "10.1016/j.repc.2024.01.001" "estado" => "S300" "fechaPublicacion" => "2024-05-01" "aid" => "2293" "copyrightAnyo" => "2024" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "dis" "cita" => "Rev Port Cardiol. 2024;43:237-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0870255123004948" "issn" => "08702551" "doi" => "10.1016/j.repc.2023.08.007" "estado" => "S300" "fechaPublicacion" => "2024-05-01" "aid" => "2281" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Port Cardiol. 2024;43:241-54" "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" => "Quality indicators in atrial fibrillation ablation (RIQAFA). A national registry from the Portuguese Association of Arrhythmology, Pacing and Electrophysiology (APAPE)" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "241" "paginaFinal" => "254" ] ] "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" => 4162 "Ancho" => 3341 "Tamanyo" => 555141 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Electronic questionnaire form used for the survey (part 2: ablation characteristics).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pedro Carmo, Dinis Mesquita, Nuno Cabanelas, Ana Rita Marinheiro, Sílvia Nunes, Duarte Chambel, Francisco Moscoso Costa, Victor Sanfins, Leonor Parreira" "autores" => array:10 [ 0 => array:2 [ "nombre" => "Pedro" "apellidos" => "Carmo" ] 1 => array:2 [ "nombre" => "Dinis" "apellidos" => "Mesquita" ] 2 => array:2 [ "nombre" => "Nuno" "apellidos" => "Cabanelas" ] 3 => array:2 [ "nombre" => "Ana Rita" "apellidos" => "Marinheiro" ] 4 => array:2 [ "nombre" => "Sílvia" "apellidos" => "Nunes" ] 5 => array:2 [ "nombre" => "Duarte" "apellidos" => "Chambel" ] 6 => array:2 [ "nombre" => "Francisco" "apellidos" => "Moscoso Costa" ] 7 => array:2 [ "nombre" => "Victor" "apellidos" => "Sanfins" ] 8 => array:2 [ "nombre" => "Leonor" "apellidos" => "Parreira" ] 9 => array:1 [ "colaborador" => "on behalf of the Portuguese Association of Arrhythmology, Pacing and Electrophysiology (APAPE)" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255123004948?idApp=UINPBA00004E" "url" => "/08702551/0000004300000005/v1_202404230444/S0870255123004948/v1_202404230444/en/main.assets" ] "itemAnterior" => array:17 [ "pii" => "S0870255123004006" "issn" => "08702551" "doi" => "10.1016/j.repc.2023.05.012" "estado" => "S300" "fechaPublicacion" => "2024-05-01" "aid" => "2251" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Port Cardiol. 2024;43:225-35" "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" => "conTemporary reflectiOns regarding heart failure manaGEmenT – How to ovERcome the PorTuguese barriers (TOGETHER-PT)" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "225" "paginaFinal" => "235" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Reflexões contemporâneas sobre a gestão da insuficiência cardíaca – Como ultrapassar as barreiras 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" => 2443 "Ancho" => 2341 "Tamanyo" => 400073 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Questionnaire development method. GEIC-SPC: Heart Failure Study Group of the Portuguese Society of Cardiology; GEsDCard-APMGF: Cardiovascular Study Group of the Portuguese Association of General and Family Medicine; HCP: health care professionals; HF: heart failure; NEIC-SPMI: Heart Failure Study Group of the Portuguese Society of Internal Medicine.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Silva-Cardoso, Jonathan Santos, Inês Araújo, Aurora Andrade, Pedro Morais Sarmento, Paulo Santos, Brenda Moura, Irene Marques, Marisa Peres, João Pedro Ferreira, Joao Agostinho, Joana Pimenta" "autores" => array:12 [ 0 => array:2 [ "nombre" => "José" "apellidos" => "Silva-Cardoso" ] 1 => array:2 [ "nombre" => "Jonathan" "apellidos" => "Santos" ] 2 => array:2 [ "nombre" => "Inês" "apellidos" => "Araújo" ] 3 => array:2 [ "nombre" => "Aurora" "apellidos" => "Andrade" ] 4 => array:2 [ "nombre" => "Pedro" "apellidos" => "Morais Sarmento" ] 5 => array:2 [ "nombre" => "Paulo" "apellidos" => "Santos" ] 6 => array:2 [ "nombre" => "Brenda" "apellidos" => "Moura" ] 7 => array:2 [ "nombre" => "Irene" "apellidos" => "Marques" ] 8 => array:2 [ "nombre" => "Marisa" "apellidos" => "Peres" ] 9 => array:2 [ "nombre" => "João Pedro" "apellidos" => "Ferreira" ] 10 => array:2 [ "nombre" => "Joao" "apellidos" => "Agostinho" ] 11 => array:2 [ "nombre" => "Joana" "apellidos" => "Pimenta" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255123004006?idApp=UINPBA00004E" "url" => "/08702551/0000004300000005/v1_202404230444/S0870255123004006/v1_202404230444/en/main.assets" ] "asociados" => array:1 [ 0 => array:17 [ "pii" => "S0870255123004006" "issn" => "08702551" "doi" => "10.1016/j.repc.2023.05.012" "estado" => "S300" "fechaPublicacion" => "2024-05-01" "aid" => "2251" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Port Cardiol. 2024;43:225-35" "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" => "conTemporary reflectiOns regarding heart failure manaGEmenT – How to ovERcome the PorTuguese barriers (TOGETHER-PT)" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "225" "paginaFinal" => "235" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Reflexões contemporâneas sobre a gestão da insuficiência cardíaca – Como ultrapassar as barreiras 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" => 2443 "Ancho" => 2341 "Tamanyo" => 400073 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Questionnaire development method. GEIC-SPC: Heart Failure Study Group of the Portuguese Society of Cardiology; GEsDCard-APMGF: Cardiovascular Study Group of the Portuguese Association of General and Family Medicine; HCP: health care professionals; HF: heart failure; NEIC-SPMI: Heart Failure Study Group of the Portuguese Society of Internal Medicine.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Silva-Cardoso, Jonathan Santos, Inês Araújo, Aurora Andrade, Pedro Morais Sarmento, Paulo Santos, Brenda Moura, Irene Marques, Marisa Peres, João Pedro Ferreira, Joao Agostinho, Joana Pimenta" "autores" => array:12 [ 0 => array:2 [ "nombre" => "José" "apellidos" => "Silva-Cardoso" ] 1 => array:2 [ "nombre" => "Jonathan" "apellidos" => "Santos" ] 2 => array:2 [ "nombre" => "Inês" "apellidos" => "Araújo" ] 3 => array:2 [ "nombre" => "Aurora" "apellidos" => "Andrade" ] 4 => array:2 [ "nombre" => "Pedro" "apellidos" => "Morais Sarmento" ] 5 => array:2 [ "nombre" => "Paulo" "apellidos" => "Santos" ] 6 => array:2 [ "nombre" => "Brenda" "apellidos" => "Moura" ] 7 => array:2 [ "nombre" => "Irene" "apellidos" => "Marques" ] 8 => array:2 [ "nombre" => "Marisa" "apellidos" => "Peres" ] 9 => array:2 [ "nombre" => "João Pedro" "apellidos" => "Ferreira" ] 10 => array:2 [ "nombre" => "Joao" "apellidos" => "Agostinho" ] 11 => array:2 [ "nombre" => "Joana" "apellidos" => "Pimenta" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255123004006?idApp=UINPBA00004E" "url" => "/08702551/0000004300000005/v1_202404230444/S0870255123004006/v1_202404230444/en/main.assets" ] ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>" "titulo" => "TOGETHER we can overcome barriers for optimal management of heart failure" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "237" "paginaFinal" => "239" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "João Presume, Daniel Gomes, Jorge Ferreira" "autores" => array:3 [ 0 => array:2 [ "nombre" => "João" "apellidos" => "Presume" ] 1 => array:2 [ "nombre" => "Daniel" "apellidos" => "Gomes" ] 2 => array:4 [ "nombre" => "Jorge" "apellidos" => "Ferreira" "email" => array:1 [ 0 => "jorge_ferreira@netcabo.pt" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Cardiology, Hospital de Santa Cruz, CHLO, Carnaxide, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "JUNTOS, podemos ultrapassar as barreiras para uma gestão ótima da insuficiência cardíaca" ] ] "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" => 1761 "Ancho" => 2925 "Tamanyo" => 432685 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Barriers and facilitators of knowledge translation in heart failure.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">4,12</span></a></p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Heart failure (HF) is a progressive and multifactorial clinical syndrome that can be viewed as the final path of heart disease. It affects more than 15 million people living in Europe and this number is expected to increase significantly as the population ages.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> As the final common pathway of heart disease, HF is associated with high mortality, at least 50% at 5 years. HF contributes to more than two million hospital stays per year in Europe, and is the most common cause of hospitalizations over the age of 65 years and is associated with low quality of life.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Notwithstanding these facts, the awareness of the syndrome among the general population, health professionals, and decision-makers is poor. This is reflected in suboptimal prevention and clinical management, inappropriate adherence to therapy, low treatment reimbursements and scarce research funding.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In this issue of the <span class="elsevierStyleItalic">Journal</span>, Silva-Cardoso et al.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">4</span></a> describe 16 statements belonging to four major HF domains, defined by a group of Portuguese HF experts and designed to improve HF care in Portugal (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>). These statements were validated by a large Delphi-like panel encompassing cardiologists, internists, general practitioners, and nurses interested in or dedicated to HF.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The authors establish four critical statements to raise HF patient literacy and awareness of the syndrome. Most HF features including morbidity and impact on survival are unknown to the general population and even among patients.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">2</span></a> The prognostic impact of HF is similar to more common forms of cancer concerning hospitalizations and five-year case mortality, which supports the concept that HF is as malignant as cancer.<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">5,6</span></a> Moreover, a large proportion of patients with cancer will die of cardiovascular disease including HF. However, public perception and investment are still mainly focused on oncology, with HF still falling behind when it comes to the true perception of the associated prognosis and funding invested in research.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">3</span></a> Despite all therapeutic developments, HF should be perceived as the malignant phase of heart disease deserving at least a similar investment to cancer in evidence-based treatments and research.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Due to the progressive nature of HF, early diagnosis is crucial to start pharmacologic and device interventions that reverse or slow the progression of cardiac dysfunction and change the natural history of HF.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> The importance of early diagnosis of HF is underscored by the authors through four dedicated statements. Since the diagnosis of HF requires the presence of symptoms and/or signs of HF and objective evidence of structural and/or functional abnormality of the heart, echocardiography, and measurement of natriuretic peptides (NP) are essential for this purpose.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> Furthermore, the detection of structural heart disease, abnormal cardiac function, or elevated NP levels enables the identification of patients with pre-HF (ACC/AHA stage B), in the absence of current or prior symptoms and/or signs of HF.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">7</span></a> This population with subclinical heart disease calls for the development of effective treatment strategies for the prevention of HF. The PORTuguese Heart failure Observational Study (PORTHOS)<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a> designed to determine the HF prevalence in the Portuguese population will also identify the burden of pre-HF.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Combined pharmacologic therapy including beta-blocker, angiotensin receptor-neprilysin inhibitor, mineralocorticoid receptor antagonist and newer sodium-glucose cotransporter-2 (SGLT-2) inhibitor can reduce the relative risk of all-cause death by 70% and HF hospitalization by 80% in patients with HF with reduced ejection fraction (EF).<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> The benefit of these four fantastic drugs in reducing cardiovascular death or HF hospitalization and improving quality of life can be extended to patients with mildly reduced EF and even for those with preserved EF receiving SGLT-2 inhibitor. Although this impressive impact on the natural history of HF, contemporary real-world studies demonstrate a clear underuse of these guideline-directed medical therapies (GDMT).<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">10,11</span></a> The authors describe four statements highlighting the need for adherence to guideline treatment recommendations. Barriers to the implementation of HF clinical guidelines have been described at the healthcare system, clinician, and patient level that must be addressed comprehensively<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>).</p><p id="par0035" class="elsevierStylePara elsevierViewall">Finally, the authors proposed four statements to improve the organization of the HF healthcare system. In addition to the hierarchy of three levels of care, primary care, regional hospitals, and central hospitals, they propose the development of a single, integrated, shared electronic health record (EHR) combined with quality of care indicators (QI).<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">13</span></a> The European Society of Cardiology recognizes the need for reporting QI and outcomes of cardiovascular care through continuous clinical registries to assess adherence to clinical guidelines and develop quality improvement programs designated by the EuroHeart project.<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">14,15</span></a> A single shared EHR with encoded demographic and clinical data can be the platform for launching a high-quality continuous clinical registry harmonized with the EuroHeart. Furthermore, EHR can be used to alert the clinician to prescribe dose targeted GDMT, a strategy that led to significantly higher rates of GDMT at 30 days when compared with usual care.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1761 "Ancho" => 2925 "Tamanyo" => 432685 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Barriers and facilitators of knowledge translation in heart failure.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">4,12</span></a></p>" ] ] ] "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" => "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:2 [ "doi" => "10.1093/eurheartj/ehab368" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2021" "volumen" => "42" "paginaInicial" => "3599" "paginaFinal" => "3726" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34447992" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0090" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "What does the lay public know about heart failure? Findings from the Heart Failure Awareness Day Initiative" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S. Stork" 1 => "A. Kavoliuniene" 2 => "D. Vinereanu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ejhf.425" "Revista" => array:6 [ "tituloSerie" => "Eur J Heart Fail" "fecha" => "2016" "volumen" => "18" "paginaInicial" => "66" "paginaFinal" => "70" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26515299" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0095" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Funding of cardiovascular research in the USA: Robert Califf and Peter Libby – speak about cardiovascular research funding in the United States and what the latest trends are with Mark Nicholls" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Nicholls" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur Heart J" "fecha" => "2018" "volumen" => "39" "paginaInicial" => "3629" "paginaFinal" => "3631" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0100" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "conTemporary reflectiOns regarding heart Failure manaGEmenT – how to ovERcome the PorTuguese barriers (TOGETHER-PT)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Silva-Cardoso" 1 => "J. Santos" 2 => "I. Araújo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.repc.2023.05.012" "Revista" => array:2 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2023" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0105" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Population impact of heart failure and the most common forms of cancer: a study of 1<span class="elsevierStyleHsp" style=""></span>162<span class="elsevierStyleHsp" style=""></span>309 hospital cases in Sweden (1988 to 2004)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S. Stewart" 1 => "I. Ekman" 2 => "T. Ekman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Circ Cardiovasc Qual Outcomes" "fecha" => "2010" "volumen" => "3" "paginaInicial" => "573" "paginaFinal" => "580" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0110" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Do patients have worse outcomes in heart failure than in cancer? A primary care-based cohort study with 10-year follow-up in Scotland" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M.A. Mamas" 1 => "M. Sperrin" 2 => "M.C. Watson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ejhf.822" "Revista" => array:6 [ "tituloSerie" => "Eur J Heart Fail" "fecha" => "2017" "volumen" => "19" "paginaInicial" => "1095" "paginaFinal" => "1104" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28470962" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0115" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Universal definition and classification of heart failure. A report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "B. Bozkurt" 1 => "A.J.S. Coats" 2 => "H. Tsutsui" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Card Fail" "fecha" => "2021" "volumen" => "27" "paginaInicial" => "387" "paginaFinal" => "413" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0120" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "PORTHOS – PORTuguese Heart Failure Observational Study (PORTHOS). Available from: <a target="_blank" href="https://classic.clinicaltrials.gov/ct2/show/NCT05434923">https://classic.clinicaltrials.gov/ct2/show/NCT05434923</a> [assessed 26.09.23]." ] ] ] 8 => array:3 [ "identificador" => "bib0125" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Network meta-analysis of medical therapy efficacy in more than 90,000 patients with heart failure and reduced ejection fraction" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "V. De Marzo" 1 => "G. Savarese" 2 => "L. Tricarico" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/joim.13487" "Revista" => array:6 [ "tituloSerie" => "J Intern Med" "fecha" => "2022" "volumen" => "292" "paginaInicial" => "333" "paginaFinal" => "349" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35332595" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0130" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Medical therapy for heart failure with reduced ejection fraction: the CHAMP-HF registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S.J. Greene" 1 => "J. Butler" 2 => "N.M. Albert" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2018.04.070" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2018" "volumen" => "72" "paginaInicial" => "351" "paginaFinal" => "366" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30025570" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0135" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global disparities in prescription of guideline-recommended drugs for heart failure with reduced ejection fraction" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Tromp" 1 => "W. Ouwerkerk" 2 => "T.H.K. Teng" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehac103" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2022" "volumen" => "43" "paginaInicial" => "2224" "paginaFinal" => "2234" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35393622" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0140" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Underutilization of guideline-directed medical therapy in heart failure: can digital health technologies PROMPT change?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H.G.C. Van Spall" 1 => "G.C. Fonarow" 2 => "M.A. Mamas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2022.03.351" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2022" "volumen" => "79" "paginaInicial" => "2214" "paginaFinal" => "2218" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35385797" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0145" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "European Society of Cardiology quality indicators for the care and outcomes of adults with heart failure. Developed by the Working Group for Heart Failure Quality Indicators in collaboration with the Heart Failure Association of the European Society of Cardiology" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S. Aktaa" 1 => "M. Polovina" 2 => "G. Rosano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ejhf.2371" "Revista" => array:6 [ "tituloSerie" => "Eur J Heart Fail" "fecha" => "2022" "volumen" => "24" "paginaInicial" => "132" "paginaFinal" => "142" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35083826" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0150" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "EuroHeart: European Unified Registries On Heart Care Evaluation and Randomized Trials: an ESC project to develop a new IT registry system which will encompass multiple features of cardiovascular medicine" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "L. Wallentin" 1 => "C.P. Gale" 2 => "A. Maggioni" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehz599" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2019" "volumen" => "40" "paginaInicial" => "2745" "paginaFinal" => "2749" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31505603" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0155" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Data standards for heart failure: the European Unified Registries for Heart Care Evaluation and Randomized Trials (EuroHeart)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S. Aktaa" 1 => "G. Batra" 2 => "J.G.F. Cleland" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehac151" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2022" "volumen" => "43" "paginaInicial" => "2185" "paginaFinal" => "2195" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35443059" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0160" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Electronic alerts to improve heart failure therapy in outpatient practice: a cluster randomized trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "L. Ghazi" 1 => "Y. Yamamoto" 2 => "R.J. Riello" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2022.03.338" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2022" "volumen" => "79" "paginaInicial" => "2203" "paginaFinal" => "2213" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35385798" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000004300000005/v1_202404230444/S0870255124000040/v1_202404230444/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/08702551/0000004300000005/v1_202404230444/S0870255124000040/v1_202404230444/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255124000040?idApp=UINPBA00004E" ]
| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 11 | 3 | 14 |
| 2024 Outubro | 64 | 60 | 124 |
| 2024 Setembro | 52 | 46 | 98 |
| 2024 Agosto | 55 | 43 | 98 |
| 2024 Julho | 52 | 37 | 89 |
| 2024 Junho | 73 | 39 | 112 |
| 2024 Maio | 135 | 58 | 193 |
| 2024 Abril | 92 | 40 | 132 |
| 2024 Maro | 65 | 28 | 93 |
| 2024 Fevereiro | 57 | 43 | 100 |
| 2024 Janeiro | 17 | 28 | 45 |
