Archivos Peruanos de Cardiología y Cirugía Cardiovascular
type: channel
description: Archivos Peruanos de Cardiología y Cirugía Cardiovascular created in December 2019, is the official scientific journal of the Instituto Nacional Cardiovascular - INCOR del Seguro Social de Salud del Perú. It is an exclusively virtual publication, peer-reviewed, quarterly and free full-text access. It publishes, in Spanish and English, topics related to cardiovascular diseases, cardiovascular surgery and endovascular surgery at national and international level, within the standards of scientific publication. It includes original clinical or basic research articles, reviews, unpublished clinical cases, special articles, scientific letters and editorials.
publisher: Instituto Nacional Cardiovascular “Carlos Alberto Peschiera Carrillo” – INCOR, EsSalud
language: es
publication name: Archivos Peruanos de Cardiología y Cirugía Cardiovascular
issn: 2708-7212
items: Use of beta-blockers and depressive symptoms in hypertensive older adults: a multicenter study
items: Vascular ring due to double aortic arch as a cause of stridor and dysphagia in infancy: a case report
items: Gender and ethnic disparities in carotid artery disease: experience from a national Peruvian hospital
items: Significant valvular heart disease in wild-type transthyretin amyloidosis: prevalence and impact on survival
items: Aortic valve assessment by cardiac tomography: application in clinical practice
items: Acute cardiorenal decompensation in the setting of chronic renal artery stenosis treated with successful renal artery stenting. A case report
items: Combined leadless pacing and subcutaneous defibrillation strategy in a high-risk patient: first case report from Peru
items: The hospitalized patient with severe aortic stenosis
items: Recommendations for the management of ST elevation myocardial infarction after reperfusion
items: Immune checkpoint inhibitor-induced myocarditis: a comprehensive review with clinical case insights
items: Single-stage repair of aortic arch hypoplasia and ventricular septal defect in a low-weight infant: a case report from a resource-limited center
items: Intramyocardial dissection of the left ventricle and post-myocardial infarction interventricular septal rupture. A clinical case
items: Takotsubo syndrome triggered by a pleasant emotional event: a case report
items: Monoclonal gammopathy evolving into sytemic amyloidosis with cardiac involvement. A case report
items: Case report of heterotaxy syndrome with sinus node dysfunction and left ventricular hypertrabeculation: clinical and genetic insights
items: Risk factors for postoperative acute kidney injury after cardiac surgery
items: Implementation and adaptation of the Society of Thoracic Surgeons´ standardized nomenclature for congenital heart surgery in a Peruvian hospital
items: The role of agitated saline contrast echocardiography in the evaluation of pulmonary hypertension
items: Translational medicine and atrial fibrillation: ¿What new therapies are available?
items: Double aortic arch in Honduras: unusual cause of dysphagia in an adult patient. A case report
items: Follow-up of patients with myocardial ischemia and non-obstructive coronary lesions
items: Pharmacological treatment of patients with chronic heart failure: a subanalysis of an ecuadorian registry
items: New atypical advanced interatrial block with triphasic morphology
items: Mediastinitis in pediatric cardiac surgery: an unusual complication. A single-center experience
items: Performance of scoring systems for predicting mortality after cardiacsurgery in the elderly
items: Right ventricular uncoupling in acute heart failure with preserved or mildly reduced ejection fraction: a simple parameter to predict long-term mortality
items: Percutaneous aortopulmonary window closure using muscular ventricular septal defect occluder. Instituto Nacional de Salud del Niño San Borja Lima- Perú. Case Report
items: Comparison of the epidemiological, clinical and diagnostic characteristics of infective endocarditis of native and prosthetic valves in a Peruvian reference center
items: Irreversible cardiotoxicity induced by trastuzumab: a systematic review based on a pharmacovigilance case report
items: Anatomical variant and venous access: the challenge of persistent left vena cava in neonates

Use of beta-blockers and depressive symptoms in hypertensive older adults: a multicenter study
type: item
description: Objectives. To evaluate the association between beta-blocker use and the presence of depressive symptoms in older adults with hypertension (HTN). Materials and Methods. A cross-sectional observational study was conducted among patients from the Central FAP Hospital and the Naval Medical Center. Older adults with a diagnosis of HTN who had been receiving antihypertensive treatment for at least one month were included. Depressive symptoms were assessed using the PHQ-9 questionnaire. Social, clinical, and functional variables were analyzed using bivariate tests (Chi-square and Fisher’s exact test), as well as Poisson regression with robust variance to estimate crude and adjusted prevalence ratios (PR). Results. A total of 149 older adults were included. Of these, 27.5% were taking beta-blockers, and 39% presented depressive symptoms. No significant association was found between beta-blocker use and the presence of depressive symptoms (PR:1.09; 95% CI: 0.70–1.69; p = 0.693). In contrast, a higher risk of depressive symptoms was observed among patients with greater frailty (PR: 5.72; 95% CI: 2.17–15.0; p < 0.001) and a lower risk among those with technical or university education (PR: 0.43; 95% CI: 0.25–0.74; p = 0.003). Conclusions. No association was found between beta-blocker use and depressive symptoms in patients with HTN. Factors such as frailty, educational level, and duration of HTN diagnosis showed significant associations and should be considered in the comprehensive assessment of emotional risk in this population.
subject: Original articles
  topic: section
subject: Aged
  topic: keywords
subject: Hypertension
  topic: keywords
subject: Adrenergic beta-Antagonists
  topic: keywords
subject: Depression
  topic: keywords
subject: Peru
  topic: keywords
creator: Mayra Valdivia-Herrera
creator: P. Alejandra Goicochea-Romero
creator: Christopher Butler Vallejo
creator: Ian Falvy-Bockos
creator: Carmen Eliana Peralta Vargas
creator: Fernando Runzer-Colmenares
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-09-22
publication date: 2025-09-22
starting page: 120
ending page: 128
doi: 10.47487/apcyccv.v6i3.520

Vascular ring due to double aortic arch as a cause of stridor and dysphagia in infancy: a case report
type: item
description: A double aortic arch is a rare congenital vascular anomaly with clinical significance in the pediatric population due to its potential to cause extrinsic compression of the trachea and esophagus. It should be suspected in infants with persistent respiratory and gastrointestinal symptoms refractory to conventional treatment. We report the case of a 2-year-7-month-old boy presenting with recurrent stridor, repeated respiratory infections, and progressive dysphagia. Cardiac CT angiography revealed a complete vascular ring causing tracheoesophageal compression. Dominance of the left aortic arch was identified, and surgical section and distal ligation of the non-dominant right arch were performed, without direct intervention on the tracheoesophageal structures. At the 12-month follow-up, there was complete resolution of symptoms and nutritional recovery. This case highlights the importance of maintaining high clinical suspicion and ensuring timely referral. Even when surgical correction is delayed, appropriate intervention can reverse symptoms and improve quality of life
subject: Case reports
  topic: section
subject: Vascular Rings
  topic: keywords
subject: Double Aortic Arch
  topic: keywords
subject: Dysphagia
  topic: keywords
subject: Stridor
  topic: keywords
subject: Pediatrics
  topic: keywords
creator: Diego Davila-Flores
creator: Christie Villasante-Villalta
creator: Renee Montesinos-Segura
creator: Juan Zúñiga-Meza
creator: Henry Peralta-Santos
creator: Luis Vera-Talledo
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-10-27
publication date: 2025-10-27
doi: 10.47487/apcyccv.v6i4.534

Gender and ethnic disparities in carotid artery disease: experience from a national Peruvian hospital
type: item
description: Atherosclerotic carotid artery disease is a significant cause of cerebrovascular events worldwide. Current international guidelines for the management of this condition provide general recommendations that often overlook differences among specific population groups. Although sex- and race-related disparities in disease prevalence are acknowledged, there remains a notable lack of studies focused on the prevalence, progression, and management of carotid artery disease in Latina women.
subject: Letters to the editor
  topic: section
subject: Carotid endarterectomy
  topic: keywords
subject: Carotid artery stenosis
  topic: keywords
subject: Latina women
  topic: keywords
creator: Georgette Vetanzo-Sánchez
creator: Alexander Brioso-Cevallos
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-09-03
publication date: 2025-09-03
starting page: 195
ending page: 196
doi: 10.47487/apcyccv.v6i3.526

Significant valvular heart disease in wild-type transthyretin amyloidosis: prevalence and impact on survival
type: item
description: Objective. There are limited data on the prevalence and prognostic impact of significant valvular heart disease in patients with wild-type transthyretin cardiac amyloidosis (ATTRwt). The aim of this study was to describe the prevalence of aortic stenosis (AS), mitral regurgitation (MR), and tricuspid regurgitation (TR) in this population and, secondarily, to evaluate their impact on survival. Methods. This was a retrospective, single-center cohort study including patients diagnosed with ATTRwt between 2011 and 2024. We calculated the prevalence of each significant valvular heart disease, and Kaplan-Meier survival curves were generated to estimate two-year all-cause mortality, stratified according to the presence or absence of each significant valvular disease. Finally, a multivariable Cox regression was performed to assess their association with survival. Results. We included 154 patients, with a mean age of 81 (±7) years; 85% (n=131) were male. Significant TR was the most prevalent valvular disease (27%, n=41), followed by significant MR (20%, n=30) and AS (13%, n=20). Patients with significant TR had a higher incidence of all-cause mortality compared to those without significant TR (41% vs. 16%, log-rank test, p=0.0007), whereas no differences were observed between patients with and without significant AS or MR. In multivariable Cox models, significant TR was independently associated with higher mortality, regardless of age, the presence of other valvular diseases, and NT-proBNP levels. Conclusions. Significant TR was the most prevalent valvular disease in patients with ATTRwt and was associated with lower survival in this population.
subject: Original articles
  topic: section
subject: Amyloidosis
  topic: keywords
subject: Transthyretin
  topic: keywords
subject: Valvular Heart Diseases
  topic: keywords
subject: Tricuspid regurgitation
  topic: keywords
creator: Santiago Decotto
creator: Pilar Domenech
creator: Pedro Touzas
creator: María Adela Aguirre
creator: Elsa Nucifora
creator: María Lourdes Posadas-Martínez
creator: Rocío Blanco
creator: Mariano Falconi
creator: Rodolfo Pizarro
creator: Diego Pérez de Arenaza
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-09-19
publication date: 2025-09-19
starting page: 112
ending page: 119
doi: 10.47487/apcyccv.v6i3.524

Aortic valve assessment by cardiac tomography: application in clinical practice
type: item
description: Aortic valve disease is a highly prevalent and clinically significant condition in the general population. Cardiac computed tomography (CT) has emerged as a widely available imaging modality that provides high-resolution static and dynamic information, enabling comprehensive evaluation of valve anatomy and function. This technique complements echocardiography and other imaging tools, adding incremental value to clinical decision-making. Its principal applications include identifying the etiology of valvular disease, grading severity, and assessing adjacent structures, all of which are critical for therapeutic planning. This non-systematic review synthesizes the evidence on the role of CT in the assessment of the aortic valve, focusing on aortic stenosis, aortic regurgitation, infective endocarditis, and postoperative evaluation. The current body of evidence underscores the expanding role of CT in the integrated diagnosis and longitudinal management of aortic valve disease.
subject: Review articles
  topic: section
subject: Aortic Valve
  topic: keywords
subject: Cardiac Tomography
  topic: keywords
subject: Aortic Stenosis
  topic: keywords
subject: Endocarditis
  topic: keywords
subject: Aortic Valve Insufficiency
  topic: keywords
creator: Danilo Weir-Restrepo
creator: Andrés Sanchez-Muñoz
creator: David Aristizábal-Colorado
creator: Santiago Sierra-Castillo
creator: Andrés Nicolás Arteaga Arellano
creator: María Isabel Carvajal-Vélez
creator: Pedro Abad-Díaz
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-09-22
publication date: 2025-09-22
starting page: 162
ending page: 169
doi: 10.47487/apcyccv.v6i3.516

Acute cardiorenal decompensation in the setting of chronic renal artery stenosis treated with successful renal artery stenting. A case report
type: item
description: Atherosclerotic renal artery stenosis may present with resistant hypertension, hypertensive crisis, ischemic nephropathy, and cardiac destabilization. Although early studies of renal artery stenting showed promise, later trials found no benefit over medical therapy—yet often excluded high-risk, acute cases. We describe an 85-year-old male with cardiovascular risk factors who developed a hypertensive crisis, acute kidney injury, and flash pulmonary edema. An angiogram revealed severe ostial right renal artery stenosis. Stenting resulted in the rapid resolution of the acute crisis and restoration of baseline renal function. This case underscores the potential benefit of revascularization in select high-risk presentations of renal artery stenosis.
subject: Case reports
  topic: section
subject: Renal Artery Obstruction
  topic: keywords
subject: Hypertension
  topic: keywords
subject: Pulmonary Edema
  topic: keywords
subject: Acute Kidney Injury
  topic: keywords
subject: Angioplasty, Balloon
  topic: keywords
creator: Nehaal Ahmed
creator: Jose Arriola-Montenegro
creator: Saad Rashid
creator: Ian R McPhail
creator: Benjamin Bizer
creator: Iasmina M Craici
creator: Samy M Riad
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-10-06
publication date: 2025-10-06
doi: 10.47487/apcyccv.v6i4.515

Combined leadless pacing and subcutaneous defibrillation strategy in a high-risk patient: first case report from Peru
type: item
description: We present the case of a 51-year-old male with non-ischemic dilated cardiomyopathy and complete atrioventricular block, who was previously implanted with a cardiac resynchronization therapy defibrillator. The patient developed signs of pocket infection with a high risk of extrusion. Partial system extraction was performed, followed by 14 days of intravenous antibiotic therapy. Due to a history of ventricular fibrillation and permanent pacing dependency, and in the absence of viable transvenous access, a sequential implantation strategy was adopted using a leadless pacemaker (Micra AV, Medtronic) and a subcutaneous implantable cardioverter-defibrillator (EMBLEM, Boston Scientific). Both procedures were completed without complications, and the patient showed favorable recovery, with effective pacing, no arrhythmic recurrences, and no signs of infection at the six-month follow-up. This case illustrates the feasibility of a fully leadless approach in high-risk patients with contraindications to conventional transvenous systems.
subject: Case reports
  topic: section
subject: Pacemaker, Artificial
  topic: keywords
subject: Defibrillators
  topic: keywords
subject: Heart Failure
  topic: keywords
subject: Infection
  topic: keywords
creator: Alexis Vallejos-Barrientos
creator: Diego Davila-Flores
creator: Richard Soto-Becerra
creator: Mario Cabrera-Saldaña
creator: Carolina Guevara-Caicedo
creator: Ana Cecilia Gonzales-Luna
creator: Ángel Cueva-Parra
creator: Marisel Payano-Rojas
creator: Pío Zelaya-Castro
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-10-18
publication date: 2025-10-18
doi: 10.47487/apcyccv.v6i4.513

The hospitalized patient with severe aortic stenosis
type: item
subject: Letters to the editor
  topic: section
subject: Estenosis aortica
  topic: keywords
creator: Frank W. Britto
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-07-30
publication date: 2025-07-30
starting page: 192
ending page: 194
doi: 10.47487/apcyccv.v6i3.511

Recommendations for the management of ST elevation myocardial infarction after reperfusion
type: item
description: The management of ST-segment elevation acute myocardial infarction after reperfusion involves critical decisions for patients with multivessel disease (MVD), acute heart failure, and left ventricular (LV) thrombus. Complete revascularization of non-culprit lesions ≥70% is recommended during the initial intervention or within the first 19 days, particularly in stable patients. Coronary artery bypass grafting is indicated for high-risk anatomies or complex lesions following a successful coronary intervention, where a hybrid strategy combines percutaneous intervention with surgery, with timing adjusted based on whether a stent was implanted. Post-infarction heart failure is common (28-31%) and requires urgent treatment. Continuous monitoring and prompt intervention can reduce complications. In cases of shock or mechanical complications, an intra-aortic balloon pump and inotropic support may be necessary. Right ventricular infarction is managed with volume support, urgent revascularization, and, if needed, pharmacological support or pacing. LV thrombus, which is more common in previous infarcts with LVEF <50%, requires early diagnosis through echocardiography and/or tomography, along with early anticoagulation, preferably with warfarin, considering triple therapy in cases of high thrombotic risk. This manuscript presents recommendations aimed at optimizing prognosis through early and personalized interventions based on the most recent evidence.
subject: Review articles
  topic: section
subject: Acute Coronary Syndromes
  topic: keywords
subject: Myocardial Infarction
  topic: keywords
subject: Heart Failure
  topic: keywords
subject: Myocardial Revascularization
  topic: keywords
creator: Frank W. Britto
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-08-18
publication date: 2025-08-18
starting page: 154
ending page: 161
doi: 10.47487/apcyccv.v6i3.508

Immune checkpoint inhibitor-induced myocarditis: a comprehensive review with clinical case insights
type: item
description: Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy by significantly improving long-term outcomes across multiple malignancies. Despite their benefits, ICIs can lead to immunerelated adverse events, including rare but severe cardiovascular toxicity such as myocarditis, which can be life-threatening. This comprehensive review aims to explore and discuss the mechanisms, clinical presentation, diagnostic challenges, and management strategies of ICI-induced myocarditis, emphasizing the need for early detection and timely intervention. As the use of ICIs continues to expand, further research is essential to fully elucidate the underlying mechanisms and optimize therapeutic strategies to mitigate this potentially fatal complication while maintaining the efficacy of cancer therapy.
subject: Review articles
  topic: section
subject: Immune Checkpoint Inhibitors
  topic: keywords
subject: Myocarditis
  topic: keywords
subject: Cardiotoxicity
  topic: keywords
subject: Cardiac Imaging
  topic: keywords
creator: María José Santa-Ana-Bayona
creator: Camila Ponce-Acosta
creator: Edgar Quispe-Silvestre
creator: Gilberto H. Acosta-Gutiérrez
creator: Alfonso González-Trejo
creator: Hugo A. Valencia-Hernández
creator: Enrique C. Guerra
creator: Pablo O. Alarcón-Toxqui
creator: Karina Martínez-Bañagas
creator: Nilda Espinola-Zavaleta
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-08-04
publication date: 2025-08-04
starting page: 144
ending page: 153
doi: 10.47487/apcyccv.v6i3.502

Single-stage repair of aortic arch hypoplasia and ventricular septal defect in a low-weight infant: a case report from a resource-limited center
type: item
description: Aortic arch hypoplasia associated with ventricular septal defect (VSD) is a life-threatening congenital condition that demands early intervention. In low-resource settings, the lack of advanced tools complicates the safe use of selective antegrade cerebral perfusion (SACP) and innovative repair techniques such as interdigitating patch reconstruction. We describe the case of a newborn with severe aortic arch hypoplasia and a large perimembranous VSD who underwent successful one-stage surgical correction. The repair included aortic arch reconstruction using an interdigitating bovine pericardial patch and VSD closure under SACP delivered via direct brachiocephalic trunk cannulation. Despite the challenges of limited monitoring and equipment, the infant had an excellent clinical outcome. This case highlights the feasibility of adapting high-complexity cardiac techniques in resource-limited environments when surgical fundamentals and teamwork are prioritized. With strategic planning, multidisciplinary coordination, and adherence to evidence-based principles, successful single-stage repair of complex congenital heart disease is achievable even in under-resourced settings.
subject: Case reports
  topic: section
subject: Aortic Coarctation
  topic: keywords
subject: Heart Defects, Congenital
  topic: keywords
subject: Cerebrovascular Circulation
  topic: keywords
creator: Jesús García Pinzás
creator: Cristhian J. Cueva Alvarez
creator: Martin Crosby Barabino
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-09-15
publication date: 2025-09-15
starting page: 181
ending page: 185
doi: 10.47487/apcyccv.v6i3.498

Intramyocardial dissection of the left ventricle and post-myocardial infarction interventricular septal rupture. A clinical case
type: item
description: Clinical case of an 86-year-old male patient presenting with a late anterior myocardial infarction without reperfusion is reported. Initial echocardiographic assessment revealed a rare and complex mechanical complication: intramyocardial dissection of the left ventricular apex associated with interventricular septal rupture. Given the severity of the condition, an urgent surgical intervention was undertaken using a bovine pericardial patch. Although the initial postoperative course was favourable, multiple subsequent complications ultimately led to the patient’s death from ventricular arrhythmia on day 50th of hospitalisation. This report underscores the importance of timely diagnosis and multidisciplinary management of this rare clinical entity.
subject: Case reports
  topic: section
subject: Heart Rupture, Post-Infarction
  topic: keywords
subject: Ventricular Septal Rupture
  topic: keywords
subject: Myocardial Infarction
  topic: keywords
subject: Cardiac Surgical Procedures
  topic: keywords
creator: Fernando Manuel Quevedo Candela
creator: Gabriela Guevara Castilla
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-07-30
publication date: 2025-07-30
starting page: 170
ending page: 175
doi: 10.47487/apcyccv.v6i3.499

Takotsubo syndrome triggered by a pleasant emotional event: a case report
type: item
description: Takotsubo Syndrome (TTS) is characterized by transient left ventricular dysfunction, often triggered by emotional or physical stress. While negative emotional events are common triggers, positive emotional events can also induce a rare variant known as Happy Heart Syndrome (HHS). This case report describes a 53-year-old male who presented with acute chest pain following a positive emotional stimulus: a birthday call offering him an opportunity to play with his favorite music group. Initial workup suggested an acute myocardial infarction, but coronary angiography revealed no obstruction. Left ventriculography showed the classic apical ballooning pattern of TTS. The patient was diagnosed with HHS. This case underscores the importance of considering positive emotional triggers in the diagnosis of TTS and highlights the need for further research into its diverse presentations and management strategies.
subject: Case reports
  topic: section
subject: Takotsubo Syndrome
  topic: keywords
subject: Apical Ballooning Syndrome
  topic: keywords
subject: Cardiology
  topic: keywords
subject: Case Report
  topic: keywords
creator: Eder Jonathan Amaro-Palomo
creator: Myles Andrew Laurence-Salinas
creator: Santiago Alba-Valencia
creator: Diego Araiza-Garaygordobil
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-07-25
publication date: 2025-07-25
starting page: 176
ending page: 180
doi: 10.47487/apcyccv.v6i3.500

Monoclonal gammopathy evolving into sytemic amyloidosis with cardiac involvement. A case report
type: item
description: We report a case of systemic light chain amyloidosis with cardiac involvement, preceded by a monoclonal IgG lambda gammopathy. The clinical diagnosis was based on signs of heart failure, elevated biomarkers, and imaging findings. The diagnosis was confirmed by elevated light chains in the blood and urine, and the presence of amyloid deposits in the periumbilical fat biopsy and in different segments of the digestive tract. Treatment with daratumumab plus bortezomib plus dexamethasone was initiated, and autologous hematopoietic stem cell therapy was administered 22 months after diagnosis, with a favorable clinical outcome.
subject: Case reports
  topic: section
subject: Light Chain Amyloidosis
  topic: keywords
subject: Cardiac
  topic: keywords
subject: Monoclonal Gammopathy of Undetermined Significance
  topic: keywords
creator: Germán Valenzuela-Rodríguez
creator: Ofelia Araoz Tarco
creator: Iván Fernández Vertiz
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-06-27
publication date: 2025-06-27
starting page: 104
ending page: 109
doi: 10.47487/apcyccv.v6i2.477

Case report of heterotaxy syndrome with sinus node dysfunction and left ventricular hypertrabeculation: clinical and genetic insights
type: item
description: We present the case of a 41-year-old woman with left atrial isomerism, severe sinus node dysfunction, and left ventricular hypertrabeculation, who required implantation of a dual-chamber implantable cardioverter-defibrillator with left bundle branch area pacing. Her family history revealed multiple cases of heterotaxy and conduction disorders. Genetic testing identified a heterozygous interstitial duplication on chromosome 17q23.2 involving the MED13 gene, whose clinical significance has not yet been determined.
subject: Case reports
  topic: section
subject: Heterotaxy Syndrome
  topic: keywords
subject: Sick Sinus Syndrome
  topic: keywords
subject: Ventricular Dysfunction
  topic: keywords
subject: Genetic Diseases
  topic: keywords
creator: María Gabriela Matta
creator: Prithviraj Dhonde
creator: Edward Dababneh
creator: Vaseekaran Gopalapillai
creator: Clayton Sciberras
creator: Kevin Ng
creator: Nasser Mohamed Essack
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-07-30
publication date: 2025-07-30
starting page: 186
ending page: 191
doi: 10.47487/apcyccv.v6i3.496

Risk factors for postoperative acute kidney injury after cardiac surgery
type: item
description: Objectives. To describe the frequency of postoperative acute kidney injury (AKI) following cardiac surgery and to analyse risk factors for its development. Materials and methods. We conducted an observational analytical cohort study using prospective data from adult patients who underwent cardiac surgery between 2003 and 2023 at a high-complexity centre in Argentina. AKI was defined according to KDIGO criteria. Risk factors were assessed using logistic regression. Results. A total of 13,215 patients were analysed, with a mean age of 64 years; most were men (75.7%). The frequency of AKI was 7.3%, with an in-hospital mortality of 4.7%. Independent risk factors included advanced age (OR: 1.05, p<0.001), urgent surgery (OR: 2.87, p<0.001), cardiopulmonary bypass (OR: 1.41, p<0.001), and comorbidities such as chronic obstructive pulmonary disease and preoperative anaemia. Asymptomatic status prior to surgery was identified as a protective factor. Conclusions. The frequency of postoperative AKI is comparable to international registries. The main predictors of risk were age, surgical urgency, and use of cardiopulmonary bypass. Identifying risk factors can improve perioperative prevention and management in cardiac surgery.
subject: Original articles
  topic: section
subject: Acute Kidney Injury
  topic: keywords
subject: Cardiac Surgery
  topic: keywords
subject: Risk Factors
  topic: keywords
subject: Extracorporeal Circulation
  topic: keywords
subject: Mortality
  topic: keywords
creator: Ignacio M. Piaggio
creator: Juan F. Furmento
creator: Juan P. Costabel
creator: Daniel Navia
creator: Francisco A. Olivares
creator: Alan Sigal
creator: Mariano Vrancic
creator: Fernando Piccinini
creator: Leonardo A. Seoane
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-09-19
publication date: 2025-09-19
starting page: 129
ending page: 134
doi: 10.47487/apcyccv.v6i3.491

Implementation and adaptation of the Society of Thoracic Surgeons´ standardized nomenclature for congenital heart surgery in a Peruvian hospital
type: item
description: Objective. To describe the process of implementing a congenital heart surgery database at the National Cardiovascular Institute (INCOR) in Peru, adapted to the standardized nomenclature of the Society of Thoracic Surgeons, and to present clinical–surgical outcomes in terms of morbidity and mortality within the framework of comprehensive multidisciplinary care. Materials and Methods. A prospective observational study was conducted in three phases: feasibility, database construction, and prospective data collection. Variables were adapted to the institutional context, and the process included a pilot test, strategic planning, multidisciplinary training, role assignment, monitoring, and periodic statistical analysis. Results. A total of 500 consecutive patients were registered between May 2022 and July 2023. Septal defects were the most common surgical indication. The most frequent complications included cardiac dysfunction and arrhythmias. In-hospital mortality was 7.6%. The database incorporated preoperative nutritional and dental assessments. Although 27.2% of the forms were fully completed, the remainder showed limitations such as missing data and the need for additional verification of information across modules. Conclusion. The implementation of a congenital heart surgery registry in Peru is feasible even in a resource-limited setting. This system allows the identification of critical areas for improving care and optimizing clinical outcomes, establishing a foundation for future quality improvement initiatives.
subject: Original articles
  topic: section
subject: Database
  topic: keywords
subject: Cardiac Surgical Procedures
  topic: keywords
subject: Heart Defects, Congenital
  topic: keywords
subject: Peru
  topic: keywords
creator: Marina Huamán Robles
creator: Samuel Y. Kim
creator: Ruht Villarroel Villa
creator: Rachel Bernier
creator: Carlos Carcausto Huamaní
creator: Arnaldo Munive Méndez
creator: Rosina Ruiz Roque
creator: María Isabel Picón Perla
creator: Luis Vera Talledo
creator: Tommy Prado Gómez
creator: Arcelia Reyes Barriga
creator: Corina Céspedes Solano
creator: Víctor Justo Robles Velarde
creator: Celia Mendoza Peltroche
creator: Miriam Gaby Escate
creator: Gloria Bernedo Gómez
creator: José Luis Yovera
creator: Rodrigo López Barreda
creator: Juan Ibla
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-09-24
publication date: 2025-09-24
starting page: 135
ending page: 143
doi: 10.47487/apcyccv.v6i3.489

The role of agitated saline contrast echocardiography in the evaluation of pulmonary hypertension
type: item
description: The diagnostic approach to pulmonary hypertension using cardiac imaging, particularly echocardiography, provides a practical, accessible, and highly valuable tool. It helps establish the initial diagnostic probability, offers prognostic information, and supports aetiological assessment. The agitated saline contrast test, also referred to as bubble contrast echocardiography, can aid not only in confirming the diagnosis but also in characterising the condition and identifying various underlying causes of pulmonary hypertension.
subject: Review articles
  topic: section
subject: Contrast Echocardiography
  topic: keywords
subject: Echocardiography
  topic: keywords
subject: Pulmonary Hypertension
  topic: keywords
subject: Heart Septal Defects, Atrial
  topic: keywords
creator: Emilio Herrera
creator: Jhon F. Salamanca
creator: Luisa F. Durango
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-06-27
publication date: 2025-06-27
starting page: 90
ending page: 95
doi: 10.47487/apcyccv.v6i2.486

Translational medicine and atrial fibrillation: ¿What new therapies are available?
type: item
subject: Letters to the editor
  topic: section
creator: Juan Santiago Serna-Trejos
creator: Stefanya Geraldine Bermúdez-Moyano
creator: Carlos Andrés Castro-Galvis
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-06-27
publication date: 2025-06-27
starting page: 110
ending page: 111
doi: 10.47487/apcyccv.v6i2.484

Double aortic arch in Honduras: unusual cause of dysphagia in an adult patient. A case report
type: item
description: Vascular rings represent less than 1% of congenital cardiovascular anomalies, with double aortic arch being the most common variant. It is typically diagnosed in infants, with respiratory symptoms in over 90% of cases. We present the case of a 31-year-old male patient with recurrent childhood respiratory infections and asthma, who presented with progressive dysphagia. Contrast-enhanced computed tomography angiography revealed a double aortic arch with right-sided dominance, and the esophagram revealed compression of the proximal third of the esophagus. A left posterolateral thoracotomy was performed with division of the distal left arch, division of the ligamentum arteriosum, adhesions release, and thoracic aorta reconstruction. Postoperative recovery was favorable, with complete resolution of symptoms. Double aortic arch is rarely diagnosed in adulthood. This case highlights its atypical presentation, with predominant gastrointestinal symptoms, and the importance of considering it in the differential diagnosis of dysphagia.
subject: Case reports
  topic: section
subject: Adult
  topic: keywords
subject: Aortic Arch Syndromes
  topic: keywords
subject: Cardiovascular Abnormalities
  topic: keywords
subject: Vascular Rings
  topic: keywords
creator: Skarleth Paola Bock Alvarado
creator: Andrea Nicole López García
creator: Mónica Isabel Yanes Oviedo
creator: Haroldo Arturo López García
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-06-27
publication date: 2025-06-27
starting page: 100
ending page: 103
doi: 10.47487/apcyccv.v6i2.482

Follow-up of patients with myocardial ischemia and non-obstructive coronary lesions
type: item
description: Objective. The presence of coronary lesions of less than 50% in patients with myocardial ischaemia is a common diagnosis in cardiac catheterisation laboratories. The aim of this study was to determine the clinical course of patients with myocardial ischaemia in the absence of obstructive coronary lesions. Materials and methods. A prospective analytical study was conducted in 110 patients of both sexes with documented myocardial ischaemia and coronary lesions of less than 50% on coronary angiography. The follow-up period was three years. Results. The mean age was 64.5 ± 7.2 years, with a predominance of females (57%). The most prevalent risk factors were hypertension (58.2%) and dyslipidaemia (44.5%). In 8.3% of cases, re-hospitalisation was required, with heart failure reported as the leading cause (6.5%). Cardiovascular event-free survival during follow-up was 80%, and was higher in patients without coronary lesions. A higher incidence of cardiovascular events was associated with diabetes mellitus, a family history of ischaemic heart disease, and chronic kidney disease. Conclusions. Patients with myocardial ischaemia in the absence of obstructive coronary lesions experienced adverse events during follow-up, particularly those with diabetes mellitus, a family history of ischaemic heart disease, and chronic kidney disease.
subject: Original articles
  topic: section
subject: Microcirculation
  topic: keywords
subject: Myocardial Ischemia
  topic: keywords
subject: Coronary Angiography
  topic: keywords
creator: Ana Liuvys Cuba Rodríguez
creator: Lázaro Isralys Aldama Pérez
creator: Myder Hernández Navas
creator: Snayder José Goelkel Pérez
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-06-27
publication date: 2025-06-27
starting page: 69
ending page: 74
doi: 10.47487/apcyccv.v6i2.472

Pharmacological treatment of patients with chronic heart failure: a subanalysis of an ecuadorian registry
type: item
description: Introduction. Introduction. In Ecuador, there is limited data on the treatment of patients with heart failure (HF). Objective. This study aimed to determine the rate of use of prognosis-modifying drugs and their association with prognosis. Materials and methods. A retrospective observational study was conducted on patients with chronic HF included in the “Los Ceibos” registry between January 2017 and December 2022. Patients were followed for a median of 2.28 years (interquartile range [IQR]: 1.25-3.49). Results. A total of 711 patients diagnosed with HF were included. Among them, 82.7% (n=588) received angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), or angiotensin receptor–neprilysin inhibitors (ARNIs); 82.3% (n=585) received beta-blockers (BBs); and 51.3% (n=365) were treated with mineralocorticoid receptor antagonists (MRAs). Among patients with HFrEF, those receiving triple therapy (ACEI/ARB/ARNI + BB + MRA) had lower all-cause mortality compared to other groups (38.8%, log-rank p=0.014). In patients with Heart Failure with preserved Ejection Fraction (HFpEF), no mortality differences were observed according to the number of medications used (log-rank p=0.720). MRA use was not associated with a prognostic benefit in HFpEF (p>0.05). Patients receiving triple therapy with ARNI + BB + MRA had better survival during follow-up compared to any other drug combination (log-rank p=0.027). Conclusions. A high rate of ACEI/ARB/ARNI and BB use was observed. The use of triple therapy, particularly the combination of ARNI + BB + MRA, was associated with improved prognosis in patients with HFrEF over a four-year follow-up period. No prognostic benefit of MRA use was observed in patients with HFpEF.
subject: Original articles
  topic: section
subject: Heart Failure
  topic: keywords
subject: Treatment
  topic: keywords
subject: Prognosis
  topic: keywords
creator: Luis Moreno-Rondón
creator: María Elizabeth Ortega-Armas
creator: Diego Pulla
creator: Robert Alarcón Cedeño
creator: Juan Díaz Heredia
creator: Diego Villavicencio
creator: Oscar Luces-Tejada
creator: Mario Gómez
creator: Alex Castro-Mejía
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-06-27
publication date: 2025-06-27
starting page: 75
ending page: 82
doi: 10.47487/apcyccv.v6i2.470

New atypical advanced interatrial block with triphasic morphology
type: item
subject: Letters to the editor
  topic: section
subject: Interatrial Block
  topic: keywords
subject: p Wave
  topic: keywords
creator: Jorge P. Juárez-Lloclla
creator: Marco A. Lazo-Soldevilla
creator: Sofía Rivera-Chávez
creator: Cengiz Burak
creator: Adrián Baranchuk
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-03-23
publication date: 2025-03-23
starting page: 60
ending page: 62
doi: 10.47487/apcyccv.v6i1.476

Mediastinitis in pediatric cardiac surgery: an unusual complication. A single-center experience
type: item
description: Objectives. Mediastinitis is an unusual postoperative complication in pediatric cardiovascular surgery, associated with high morbidity and mortality. Case reports are limited, especially in Latin America, where cardiac surgery has advanced significantly. Materials and methods. Retrospective study of mediastinitis post-cardiac surgery cases at a high-complexity center in Colombia, between January 2015 and June 2023. A detailed description of the clinical characteristics and therapeutic approaches was conducted. Results. A population of 16 children with mediastinitis was characterized, predominantly male (68.7%); 62.5% were aged of 1–3 months. The most common defects were transposition of the great arteries and univentricular heart. Gram-negative bacteria (37.5%) were the most common isolates, followed by gram-positive bacteria (25%). Vacuum-assisted closure (VAC) was required in 43.7% of cases. Conclusion. Advances in congenital heart disease management have led to complications such mediastinitis, prompting the development of therapeutic strategies that would benefit from better characterization in high-complexity centers to improve outcomes.
subject: Original articles
  topic: section
subject: Mediastinitis
  topic: keywords
subject: Pediatrics
  topic: keywords
subject: Cardiovascular Surgery
  topic: keywords
subject: Negative-Pressure Wound Therapy
  topic: keywords
creator: Laura Isabel Manosalva Arciniegas
creator: José Antonio Vargas Soler
creator: Lyneira Juliana Guevara Rodríguez
creator: Laura Constanza González Hakspiel
creator: Andrés Felipe Rubio Duarte
creator: Sara Elena Mendoza Crespo
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-06-27
publication date: 2025-06-27
starting page: 63
ending page: 68
doi: 10.47487/apcyccv.v6i2.471

Performance of scoring systems for predicting mortality after cardiacsurgery in the elderly
type: item
description: Objective. To evaluate the predictive ability of traditional risk scores and frailty assessment for 30-day mortality in elderly patients undergoing cardiac surgery. Materials and Methods. A single-center retrospective cohort study was conducted, including elderly patients (≥75 years old) who underwent cardiac surgery between January 2005 and December 2015. EuroSCORE II, STS (Society of Thoracic Surgeons) score, Charlson Comorbidity Index, and Electronic Frailty Index scores were calculated to assess their predictive ability for 30-day mortality using receiver operating characteristic (ROC) curves and corresponding areas under the curve (AUC). Results. A total of 203 patients were included during the study period, of whom 33% underwent isolated coronary bypass surgery. The overall 30- day mortality rate was 17.6%. Patients who died within the first 30 days exhibited higher scores on EuroSCORE II, STS, and the Electronic Frailty Index. The areas under the ROC curves were: EuroSCORE II, 0.74 (95% CI: 0.66-0.81); STS, 0.66 (95% CI: 0.57-0.77); Charlson Comorbidity Index, 0.60 (95% CI: 0.49-0.70); and Electronic Frailty Index, 0.63 (95% CI: 0.52-0.73). Conclusions. In this cohort of elderly patients undergoing cardiac surgery, EuroSCORE II demonstrated the best performance in predicting 30-day mortality.
subject: Original articles
  topic: section
subject: Cardiac Surgical Procedures
  topic: keywords
subject: Risk
  topic: keywords
subject: Aged
  topic: keywords
subject: Frail Elderly
  topic: keywords
creator: Arturo M. Ruiz-Beltrán
creator: Gerardo Chacón-Loyola
creator: Ricardo L. Barajas-Campos
creator: Alejandro Alcaraz-Guzmán
creator: Manuel A. Montoya-Hernández
creator: Leonardo D. Alcázar-Flores
creator: Laura L. Rodríguez-Chávez
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-03-25
publication date: 2025-03-25
starting page: 29
ending page: 35
doi: 10.47487/apcyccv.v6i1.459

Right ventricular uncoupling in acute heart failure with preserved or mildly reduced ejection fraction: a simple parameter to predict long-term mortality
type: item
description: Introduction. Risk prediction in acute heart failure (AHF) has led to the development of multiple prognostic models. Emerging data highlight the prognostic significance of right ventricular (RV) to pulmonary artery (PA) uncoupling, which has been linked to adverse outcomes. Among patients with heart failure with preserved ejection fraction (HFpEF) and mildly reduced ejection fraction (HFmrEF), a highly heterogeneous group, the prognostic relevance of RV-PA uncoupling in forecasting longterm mortality is still not well defined. This study aimed to evaluate the association between RV-PA uncoupling and long-term mortality in a cohort of hospitalized HFpEF and HFmrEF patients. Materials and Methods. We performed a retrospective analysis based on a prospective registry of adult patients admitted with a primary diagnosis of AHF between 2015 and 2020. Eligible patients had a left ventricular ejection fraction (LVEF) > 40%. The main outcome was all-cause mortality over long-term follow-up. RV-PA coupling was quantified using the ratio between tricuspid annular plane systolic excursion (TAPSE) and systolic pulmonary artery pressure (sPAP). Results. Out of 465 patients, simultaneous estimation of TAPSE and sPAP was feasible in 361 cases (77%). During a median follow-up of 20.9 months, 100 patients (27.7%) died. A TAPSE/sPAP ratio of 0.38 was identified as the optimal cut-off for risk discrimination. Notably, 41.8% of patients had values below this threshold. Multivariable analysis confirmed that RV-PA uncoupling (TAPSE/sPAP < 0.38) was independently associated with increased long-term mortality (HR: 2.21; 95% CI 1.26–3.81; P = 0.005). Conclusion. In patients hospitalized for AHF with preserved and mildly reduced ejection fraction, RV-PA uncoupling, as determined by the TAPSE/sPAP ratio, was independently associated with long-term all-cause mortality. This echocardiographic parameter may help identify a subgroup of patients at higher risk during follow-up.
subject: Original articles
  topic: section
subject: Heart Failure
  topic: keywords
subject: Prognosis
  topic: keywords
subject: Pulmonary Hypertension
  topic: keywords
creator: Lucrecia M. Burgos
creator: Lucía Campos Cervera
creator: María A. De Bortoli
creator: Rocío C. Baro Vila
creator: Franco N. Ballari
creator: Mirta Diez
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-06-27
publication date: 2025-06-27
starting page: 83
ending page: 89
doi: 10.47487/apcyccv.v6i2.466

Percutaneous aortopulmonary window closure using muscular ventricular septal defect occluder. Instituto Nacional de Salud del Niño San Borja Lima- Perú. Case Report
type: item
description: The aortopulmonary window is a rare congenital heart defect, and the aortopulmonary window without other associated defects represents up to 25% of these defects. Surgical closure has been and is the gold standard in many cardiovascular centers. However, percutaneous closure is being performed with different types of occluders, considering the type of defect, size, and edges in order to avoid complications such as valvular or coronary ostial involvement. We present the case of an infant with an aortopulmonary window who underwent percutaneous closure with a muscular ventricular septal defect occluder device without complications and was discharged 48 hours after the procedure.
subject: Case reports
  topic: section
subject: Heart Defects Congenital
  topic: keywords
subject: Aortopulmonary Septal Defect
  topic: keywords
subject: Septal Occluder Device
  topic: keywords
subject: Cardiac Catheterization
  topic: keywords
subject: Doppler Echocardiography
  topic: keywords
creator: Alex Ismael Catalán Cabrera
creator: Karen del Rosario Condori Alvino
creator: Mónica Karem Medina Durand
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-06-27
publication date: 2025-06-27
starting page: 96
ending page: 99
doi: 10.47487/apcyccv.v6i2.465

Comparison of the epidemiological, clinical and diagnostic characteristics of infective endocarditis of native and prosthetic valves in a Peruvian reference center
type: item
description: Objective. To compare the epidemiological, clinical and diagnostic characteristics of patients with native valve infective endocarditis (NVIE) and prosthetic valve infective endocarditis (PVIE) treated in a Peruvian reference center. Materials and methods. A retrospective, descriptive study was conducted on patients diagnosed with NVIE and PVIE at the Instituto Nacional Cardiovascular (INCOR), EsSalud, between 2017 and 2023. Results. A total of 65 NVIE and 55 PVIE cases were identified, with community-acquired infections predominating (92.3% in NVIE, 83.6% in PVIE). PVIE patients were older (mean age: 63.7 vs. 46.1 years, p<0.001) and had more comorbidities. The key predisposing factor in PVIE was prior endocarditis (20.0%) and valve repair (14.5%), while congenital heart disease (41.5%) and valvular disease (21.5%) predominated in NVIE. Fever and dyspnea were the most common symptoms in both groups. The aortic valve was the most frequently affected (78.5% in NVIE, 87.3% in PVIE). NVIE was associated with vegetation (92.3%) and leaflet perforations (41.5%), while PVIE showed more abscesses (34.5%) and pseudoaneurysms (36.4%). Cardiac computed tomography identified vegetations and pseudoaneurysms in both groups. Blood cultures were positive in 49.2% of NVIE and 65.5% of PVIE, with Streptococcus species predominant in NVIE and Staphylococcus species in PVIE. Surgical treatment was performed in 96.7% of NVIE and 82.6% of PVIE cases. Conclusions. NVIE predominantly affected younger patients with congenital heart disease, while PVIE was more common in older patients with comorbidities. Transesophageal echocardiography and microbiological findings were essential for diagnosis.
subject: Original articles
  topic: section
subject: Endocarditis
  topic: keywords
subject: Diagnosis
  topic: keywords
subject: Signs and Symptoms
  topic: keywords
subject: Peru
  topic: keywords
creator: Daniel Espinoza-Alva
creator: Renee Montesinos-Segura
creator: Annette Mantilla-Huertas
creator: Diego Davila-Flores
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-03-20
publication date: 2025-03-20
starting page: 20
ending page: 28
doi: 10.47487/apcyccv.v6i1.463

Irreversible cardiotoxicity induced by trastuzumab: a systematic review based on a pharmacovigilance case report
type: item
description: Irreversible cardiotoxicity (IC) induced by trastuzumab (TZB) is a rare but serious adverse event. As a result, its characteristics and the specific factors related to exposure remain poorly understood. This study aims to synthesize and evaluate the existing evidence on IC. We presented a pharmacovigilance case of longterm IC and conducted a systematic review (SR) of the clinical manifestations of cases reported worldwide. We reported the case using the CARE guidelines checklist and assessed the causality using the modified Algorithm of Karch and Lasagna. Following PRISMA guidelines, we conducted the SR using defined terms in PubMed, Embase, Scopus, and Web of Science from inception until June 2023. This SR included five case reports, including the pharmacovigilance case reported by us. While patients exhibited different severe clinical characteristics, receiving TZB at a 6 mg/kg dose was consistent. Despite varying treatment durations, the median time of IC diagnosis was 10 months, and the average difference between the basal and the final left ventricular ejection fraction was roughly 30%. According to the modified Karch and Lasagna algorithm, all cases were ranged from possible to probable. While TZB is generally considered a reversible cardiotoxic antineoplastic, clinicians and regulators must be aware of the potential IC risk with long-term manifestations. Vigilant cardiac monitoring and further research are crucial to better understanding and managing this serious adverse event.
subject: Original articles
  topic: section
subject: Breast Neoplasms
  topic: keywords
subject: Cardiotoxicity
  topic: keywords
subject: Trastuzumab
  topic: keywords
subject: Pharmacovigilance
  topic: keywords
creator: Víctor E. Lechuga-Noa
creator: L. Yesenia Rodríguez-Tanta
creator: Tania del Pilar Solis-Yucra
creator: Efraín Cesar Rojo Rosales
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-03-21
publication date: 2025-03-21
starting page: 1
ending page: 10
doi: 10.47487/apcyccv.v6i1.456

Anatomical variant and venous access: the challenge of persistent left vena cava in neonates
type: item
subject: Letters to the editor
  topic: section
subject: Persistent Left Superior Vena Cava
  topic: keywords
subject: Newborn
  topic: keywords
creator: Arianna Sofia García Calle
creator: Vanessa Patricia Moreno Ccama
creator: Ángel Francisco Samanez Obeso
rights: Copyright (c) 2025 The journal is headline of the first publication, then the author giving credit to the first publication. https://creativecommons.org/licenses/by/4.0
date: 2025-02-17
publication date: 2025-02-17
starting page: 58
ending page: 59
doi: 10.47487/apcyccv.v6i1.455