S1409-414220090002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422009000200001 Revistas cardiovasculares iberoamericanas. Propuestas para una colaboración necesaria Alfonso Fernando Almonte Katihurca Arai Kaduo Bacal Fernando Drago Silva José M Galeano Figueredo Javier Guarda Eduardo Gutiérrez Sotelo Oswaldo Guzmán Luis León Galindo Jorge Lombana Bey Mario Márquez Manlio F Moreno Martínez Francisco Luis Navarro Robles José Pinto Fausto Romero Carlos Tajer Carlos D Villarroel Hugo Wyss Quintana Fernando S ,Revista Española de Cardiología Madrid España ,Archivos Dominicanos de Cardiología Santo Domingo República Dominicana ,Avances Cardiológicos Caracas Venezuela ,Arquivos Brasileiros de Cardiología Río de Janeiro Brasil ,Revista Peruana de Cardiología Lima Perú ,Revista Paraguaya de Cardiología Asunción Paraguay ,Revista Chilena de Cardiología Santiago de Chile Chile ,Revista Costarricense de Cardiología San José Costa Rica ,Revista de la Federación Argentina de Cardiología Buenos Aires Argentina ,Revista Colombiana de Cardiología Bogotá Colombia ,Revista de Cardiología Panamá ,Archivos de Cardiología México DF México ,CorSalud La Habana Cuba ,Revista Mexicana de Cardiología México DF México ,Revista de Cardiología Lisboa Portugal ,Revista Uruguaya de Cardiología Montevideo Uruguay ,Revista Argentina de Cardiología Buenos Aires Argentina ,Revista de la Asociación Salvadoreña de Cardiología San Salvador El Salvador. * La Revista de la Asociación Salvadoreña de Cardiología se editó en el periodo 2003-2005 ,Revista de la Asociación Guatemalteca de Cardiología Ciudad de Guatemala Guatemala 12 2009 2009 11 03 09 Alfonso F Segovia J Heras M Bermejo J Revista española de CaRdiología 2008. Actividad, impacto científico y otras consideraciones editoriales Rev Esp Cardiol 2008 61 Alfonso F Bermejo J Heras M Segovia J Revista española de CaRdiología 2007. Impacto científico, gestión de manuscritos, actividad y difusión Rev Esp Cardiol 2007 60 Ribeiro C Ferreira R Revista Portuguesa de Cardiologia. Quality and prestige for the use of cardiovascular medicine Rev Port Cardiol 1992 11 Pinto FJ Evidence-based cardiology in the Revista Portuguesa de Cardiologia Rev Port Cardiol 2000 19 Mesquita ET Fonseca C Portuguese-Brazilian exchanges: challenges and opportunities Rev Port Cardiol 2004 S ep 233 Armas Merino R Las Sociedades Médicas Científicas de Chile se agrupan en una entidad común Rev Med Chil 2001 129 De Micheli A Aniversario de la Revista "Archivos de Cardiología de México" y de la Sociedad Mexicana de Cardiología Arch Cardiol Mex 2005 75 Juncos LI La investigación clínica, taller de la evidencia médica Revista de la Federación Argentina de Cardiología 2006 35 Tognoni G En la búsqueda de una identidad colectiva de investigación en la Federación Argentina de Cardiología: Una oportunidad a medida del presente y del futuro Revista de la Federación Argentina de Cardiología 2008 37 Bacal F La mejor publicación de cardiología de Latinoamérica ahora en español. Carta del Editor Arq Bras Cardiol 2008 Quesada Vargas O Pacheco Coronado R Medicina Costarricense: Algunos problemas y perspectivas. Manifiesto de la Academia Nacional de Medicina de Costa Rica Rev Costarr Cardiol 2004 6 3 Almonte K Nota editorial Arch Dom Card 2009 55 Arai K Tortoledo F Wielgosz A Terzic C Líneas editoriales de Avances Cardiológicos en apoyo a las estrategias de desarrollo de la Sociedad Venezolana de Cardiología Avances Cardiol 2009 29 Documento de Conclusiones y recomendaciones Documento de Conclusiones y recomendaciones Primer Encuentro Iberoamericano de editores Científicos: "Nuevos Paradigmas en la Edición Científica" Reyes H Del Sol M Prat AM V Simposio Chileno de Revistas en el área de la Salud Rev Med Chil 2002 130 Bermejo J Segovia J Heras M Alfonso F Gestión electrónica de manuscritos en Revista española de CaRdiología. Nuevas herramientas para viejos objetivos Rev Esp Cardiol 2007 60 Lantindex Lantindex SciELO SciELO Índice Médico Español Índice Médico Español Artemisa Artemisa Alfonso F Revistas biomédicas españolas: relevancia académica, impacto científico o factor de impacto. ¿Qué es lo que importa? Rev Neurol 2009 48 Alfonso F Bermejo J Segovia J Impactología, impactitis, impactoterapia Rev Esp Cardiol 2005 58 Aleixandre R Valderrama JC Castellano M Simó R Navarro C Factor de impacto nacional e internacional de las revistas médicas españolas Med Clin (Barc) 2004 123 Aréchaga J Spanish scientific journals; the forgotten investment Int Microbiol 2002 5 Mitelman J Gonzalo N Sosa F Chagas y Sociedad. La atención de la enfermedad Revista de la Federación Argentina de Cardiología 2006 35 Bocchi EA Guimarães G Tarasoutshi F Spina G Mangini S Bacal F Cardiomyopathy, adult valve disease and heart failure in South America Heart 2009 95 Alfonso F Bermejo J Segovia J Guías Europeas de Práctica Clínica en Revista española de CaRdiología. ¿Hacia una completa «globalización» de la asistencia cardiovascular? Rev Esp Cardiol 2004 57 Bocchi EA Vilas-Boas F Perrone S Caamaño AG Clausell N Moreira MC I Latin American Guidelines for the Assessment and Management of Decompensated Heart Failure Arq Bras Cardiol 2005 85 ^s3 Heras M Bermejo J Segovia J Alfonso F Revista española de CaRdiología suplementos. Nueva apuesta del Comité Editorial Rev Esp Cardiol 2008 61 Alfonso F Bermejo J Segovia J Nuevas recomendaciones del Comité Internacional de Editores de Revistas Médicas. Cambiando el énfasis: de la uniformidad de los requisitos técnicos a los aspectos bioéticos Rev Esp Cardiol 2004 57 Uniform requirements for manuscripts submitted to biomedical journals. International Committee of Medical Journal Editors N Engl J Med 1997 23 Alfonso F Segovia J Heras M Bermejo J Publicación de ensayos clínicos en revistas científicas: consideraciones editoriales Rev Esp Cardiol 2006 59 Alfonso F Bermejo J Segovia J Publicación duplicada o redundante: Podemos permitírnoslo Rev Esp Cardiol 2005 58 De Maria A Duplicate publication: insights into the essence of a medical journal J Am Coll Cardiol 2003 41 Relman AS Publish or perish -or both N Engl J Med 1977 297 Hildner FJ Ethical issues in cardiovascular publications: Observations during 25 years as an Editor Cathet Cardiovasc Interv 2003 60 Scott-Lichter D CSE’s White paper on promoting integrity in scientific journal publications CSE’s White paper on promoting integrity in scientific journal publications 2006 Reston CSE Declaración de principios éticos del grupo HEART Rev Esp Cardiol 2008 61 Alfonso F Ambrosio G Pinto FJ Van der Wall EE Kondili A Nibouche D Revistas cardiovasculares de las sociedades nacionales europeas. Antecedentes, fundamento y declaración de objetivos del «Club de Editores» Rev Esp Cardiol 2008 61 Seglen PO Why the impact factors of journals should not be used to evaluate research BMJ 1997 314 Nylenn M Riis P Karlsoon Y Multiple blind reviews of the same two manuscripts: effects of referee characteristics and publication language JAMA 1994 272 Link AM US and non-US submission: an analysis of reviewer bias JAMA 1998 280 Ortega Serrano J Martínez León J Sala Palau C Autoboicot científico entre los cirujanos españoles: por qué no nos citamos Cir Esp 1992 51 Fernández E Plasencia A Contamos contigo. ¿Contamos también con tus citas? Gac Sanit 2002 16
S1409-414220090002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422009000200002 Revascularización Percutánea de Emergencia del Tronco Común de la arteria coronaria izquierda. Resultados tempranos y seguimiento Díaz Picado Geiner Chavarría Víquez Jorge ,Hospital México Servicio de Cardiología San José Costa Rica 12 2009 2009 11 10 10
S1409-414220090002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422009000200003 Rendimiento diagnóstico de la Prueba de Esfuerzo y del Estudio de perfusión miocárdica con Sestamibi para detección de Enfermedad Arterial Coronaria Solís Barquero Juan Pablo Tortós Guzmán Jaime ,Hospital San Juan de Dios Servicio de Cardiología San José Costa Rica 12 2009 2009 11 10 10
S1409-414220090002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422009000200004 Resultados clínicos y complicaciones de la angioplastía coronaria con STENT en el Hospital México (Costa Rica) en el período 2005-2007 Coto Valldeperas Esteban Gutiérrez Jaikel Luis ,Hospital San Rafael de Alajuela Unidad de Cardiología Costa Rica ,Hospital México Servicio de Cardiología San José Costa Rica 12 2009 2009 11 10 10
S1409-414220090002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422009000200005 Reparación Quirúrgica de la Válvula Mitral. Reporte de 7 casos Kühn Delgadillo Klaus Sprok Tromp José Mario ,Hospital San Juan de Dios Servicio de Cirugía Cardiaca San José Costa Rica 12 2009 2009 11 11 11
S1409-414220090002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422009000200006 Variabilidad de la frecuencia cardiaca en pacientes con enfermedad de Chagas en fase "indeterminada". Reporte preliminar Gutiérrez Oswaldo Ramírez Mauricio Barboza Marypaz Calvo Nidia ,Caja Costarricense de Seguro Social Servicio de Cardiología ,Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud San José Costa Rica 12 2009 2009 11 11 11
S1409-414220090002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422009000200007 Resultados clínicos y complicaciones de la angioplastía coronaria con STENT en el Hospital México (Costa Rica) en el período 2005-2007 Coto Valldeperas Esteban Gutiérrez Jaikel Luis ,Hospital San Rafael de Alajuela Unidad de Cardiología Costa Rica ,Hospital México Servicio Cardiología San José Costa Rica 12 2009 2009 11 13 19

Introducción: La angioplastía coronaria percutánea es un procedimiento seguro y eficaz para tratar la cardiopatía isquémica, enfermedad de alta prevalencia y gran impacto en la morbilidad y mortalidad en la población. El propósito de este trabajo consistió en cuantificar los resultados obtenidos con esta terapia en el período comprendido entre enero del año 2005 y diciembre del año 2007 en el Hospital México de Costa Rica. Metodología: Se realizó un estudio observacional retrospectivo de una cohorte de 285 pacientes intervenidos en ese período, mediante revisión de expedientes. Se realizó un análisis descriptivo de todos los pacientes y de los subgrupos de pacientes diabéticos y no diabéticos. Resultados: Se documentó una mortalidad global a un año de 2.74%; reintervención de 8.07%: 4.56% restenosis, 1.05% trombosis tardía -es decir, 5.61% por "falla del vaso tratado"- y 2.46% de reintervenciones de lesiones nuevas. Ocurrieron complicaciones en 2.75% (sangrado mayor 1.75%), trombosis aguda de stent en 2.5% y trombosis subaguda en 1.4%. En los pacientes diabéticos se detectó, en comparación con pacientes no diabéticos, mayor incidencia de trombosis tardía de stent (3.75% vs. 0%), reintervención (12.5% vs. 6.34%) y reestenosis (7.5% vs. 3.41%) del vaso tratado. Se logró reducción o supresión de síntomas anginosos en el 91.95% de los casos, sin diferencias entre pacientes diabéticos y no diabéticos. Conclusión: La mortalidad global fue discretamente mayor que a nivel mundial, pero la "falla del vaso tratado" y la necesidad de reintervención fueron menores. Las complicaciones trombóticas fueron más frecuentes que en estudios comparables a nivel mundial y la diabetes mellitus fue un factor estadísticamente significativo para eventos trombóticos tardíos.

Clinical outcomes and complications of percutaneous coronary angioplasty with stent placement: México Hospital, San José, Costa Rica, 2005-2007 Background: Percutaneous coronary angioplasty (PTCA), which is usually performed with stent placement, is a safe and effective interventional treatment for ischemic heart disease. This is a very prevalent form of coronary heart disease and has a significant morbidity and mortality in the general population. The purpose of this study is to describe the outcomes obtained with PTCA/stent placement at the México Hosptial during the period between January 2005 and December 2007. Methodology: A retrospective, observational cohort study was performed by way of a clinical chart review of 285 patients treated with coronary artery interventions during the study period. An analysis of results was performed on all patients and a comparison between diabetic and nondiabetic patients was also made. Results: Total annual mortality was 2.75%. Reintervention was required in 8.07% of cases: 4.56% due to restenosis, 1.05% due to late thrombosis -i.e. 5.61% was due to occlusion of a native coronary artery segment not involved in the initial intervention-, and 2.46% due to treatment of new lesions. Complications were noted in 2.75% of patients (included major bleeding in 1.75%), acute stent thrombosis in 2.5% and subacute thrombosis in 1.4%. There was a higher incidence of late stent thrombosis in diabetic patients compared to nondiabetics (3.75% vs. 0%), as well as reintervention (12.5% vs. 6.34%) and restenosis of treated vessels (7.5% vs. 3.41%). Reduction or elimination of angina was achieved in 91.95% of patients, with no difference between diabetic and nondiabetic patients. Conclusion: Global mortality was slightly higher at México Hosptial than in comparable studies. However, occlusion of a native coronary artery segment not involved in the initial procedure and the need for reintervention were lower. Thrombotic complications were more frequent than in comparable series. As observed in other series, diabetes mellitus was a statistically significant risk factor for late thrombotic events.

 stent coronario angioplastia restenosis trombosis coronary stent angioplasty restenosis thrombosis Gibbons R Antman E Alpert JS ACC/AHA 2002 Guideline Update for the Management of Patients With Chronic Stable Angina J Am Coll Cardiol 2003 41 Stettler C Wandel S Allemann S Outcomes associated with drug-eluting and bare-metal stents: A collaborative network meta-analysis Lancet 2007 370 Babapulle MN Joseph J Bélisle P Brophy JM Eisenberg MJ A hierarchical Bayesian meta-analysis of randomized clinical trials of drug-eluting stents Lancet 2004 364 Baim D Grossman’s Cardiac Catheterization, Angiography, & Intervention Grossman’s Cardiac Catheterization, Angiography, & Intervention 2006 7th Philadelphia Lippincott Williams & Wilkins Mehran R Dangas G Abizaid AS Mintz GS Lansky AJ Angiographic Patterns of In-Stent Restenosis: Classification and Implications for Long Term Outcome Circulation 1999 100 Serruys P Kutryk MJ Ong AT Coronary-Artery Stents N Engl J Med 2006 354 483-95 Spaulding C Daemen J Boersma E A Pooled Analysis of Data Comparing Sirolimus-Eluting Stents with Bare-Metal Stents N Engl J Med 2007 356 Windecker S Meier B Late Coronary Stent Thrombosis Circulation 2007 116 Holmes DR Kereiakes DJ Laskey WK Thrombosis and Drug-Eluting Stents: An Objective Appraisal J Am Coll Cardiol 2007 50 Kastrati A Mehilli J Pache J Analysis of 14 Trials Comparing Sirolimus-Eluting Stents with Bare-Metal Stents N Engl J Med 2007 356 Blomkalns AL Chen AY Hochman JS Gender disparities in the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: large-scale observations from the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the American College of Cardiology/American Heart Association) National Quality Improvement Initiative J Am Coll Cardiol 2005 45 The PURSUIT Trial Investigators. Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patients with acute coronary syndromes N Engl J Med 1998 339 Yusuf S Zhao F Mehta SR Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation N Engl J Med 2001 345 Ferguson JJ Califf RM Antman EM Enoxaparin vs unfractioned heparin in high-risk patients with non-ST-segment elevation acute coronary syndromes managed with an intended early invasive strategy: primary results of the SYNERGY randomized trial JAMA 2004 292 Marroquin OC Selzer F Mulukutla SR A Comparison of Bare-Metal and Drug-Eluting Stents for Off-Label Indications N Engl J Med 2008 358 Spaulding C Henry P Teiger E Sirolimus-Eluting versus Uncoated Stents in Acute Myocardial Infarction N Engl J Med 2006 355 Stone GW Witzenbichler B Guagliumi G Bivalirudin during Primary PCI in Acute Myocardial Infarction N Engl J Med 2008 358 Messerli FH Mancia G Conti CR Guidelines on the management of stable angina pectoris: excecutive summary: the task force on the management of stable angina pectoris of the European Society of Cardiology Eur Heart J 2006 23 Inhibition of the platelet glycoprotein IIb/IIIa receptor with tirofiban in unstable angina and non-Q-wave myocardial infarction N Engl J Med 1998 338 Kastrati A Mehilli J Neumann FJ Dotzer F ten Berg J Bollwein H Graf I Ibrahim M Pache J Seyfarth Schuhlen H Dirschinger J Berger PB Schomig A Intracoronary Stenting and Antithrombotic: Regimen Rapid Early Action for Coronary Treatment 2 (ISAR-REACT 2) Trial Investigators. Abciximab in patients with acute coronary syndromes undergoing percutaneous coronary intervention after clopidogrel pretreatment: the ISAR-REACT 2 randomized trial JAMA 2006 A pr 295 13 Chesebro JH Knatterud G Roberts R Borer J Cohen LS Dalen J Dodge HT Francis CK Hillis D Ludbrook P Thrombolysis in Myocardial Infarction (TIMI) Trial, Phase I: A comparison between intravenous tissue plasminogen activator and intravenous streptokinase. Clinical findings through hospital discharge Circulation 1987 76 Gilchrist IC Berkowitz SD Thompson TD Califf RM Granger CB Heparin dosing and outcome in acute coronary syndromes: the GUSTO-IIb experience.Global use of strategies to open occluded coronary arteries Am Heart J 2002 144 Sunil R Eikelboom JA Granger CB Harrington RA Califf RM Bassand J Bleeding and blood transfusion issues in patients with non-ST-segment elevation acute coronary syndromes Eur Heart J 2007 28 A comparison of aspirin plus tirofiban with aspirin plus heparin for unstable angina N Engl J Med 1998 338 Inhibition of the platelet glycoprotein IIb/IIIa receptor with tirofiban in unstable angina and non-Q-wave myocardial infarction N Engl J Med 1998 338 Comparison of fondaparinux and enoxaparin in acute coronary syndromes N Engl J Med 2006 354 Lincoff AM Bittl JA Harrington RA Feit F Kleiman NS Jackman JD Sarembock IJ Cohen DJ Spriggs D Ebrahimi R Keren G Carr J Cohen EA Betriu A Desmet W Kereiakes DJ Rutsch W Wilcox RG de Feyter PJ Vahanian A Topol EJ REPLACE-2 Investigators. Bivalirudin and provisional glycoprotein IIb/IIIa blockade compared with heparin and planned glycoprotein IIb/IIIa blockade during percutaneous coronary intervention: REPLACE-2 randomized trial JAMA 2003 289 Flaherty JD Davidson CJ Diabetes and Coronary Revascularization JAMA 2005 293 12 Berry C Tardif J Bourassa MG Coronary Heart Disease in Patients with Diabetes: Part I: Prevention and Noninvasive management J Am Coll Cardiol 2007 49 Berry C Tardif J Bourassa MG Coronary Heart Disease in Patients with Diabetes: Part II: Recent Advances in Coronary Revascularization J Am Coll Cardiol 2007 49
S1409-414220090002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422009000200008 Fisiopatología de la Insuficiencia Cardiaca Diastólica Quiñones Miguel A ,Methodist DeBakey Heart & Vascular Center The Methodist Hospital Departamento de Cardiología Houston 12 2009 2009 11 20 23

Se discuten las principales características clínicas y fisiopatológicas de la insuficiencia cardiaca diastólica así como los factores intrínsecos y extrínsecos que pueden precipitarla o empeorarla.

Pathophysiology of Diastolic Heart Failure The principal clinical and pathophysiological characteristics of diastolic heart failure along with intrínsic and extrinsic factors that can induce or worsen it are discussed.

 Insuficiencia cardiaca diastólica fracción de eyección relajación miocárdica rigidez miocárdica Diastolic cardiac heart failure ejection fraction myocardial relaxation myocardial stiffness Kessler KM Heart failure with normal systolic function. Update of prevalence, differential diagnosis, prognosis, and therapy Arch Intern Med 1988 148 Yancy C.W Clinical presentation, management, and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function: a report from the Acute Decompensated Heart Failure National Registry (ADHERE) Database 2006 47 1 Gaasch WH Quinones MA Waisser E Thiel HG Alexander JK Diastolic compliance of the left ventricle in man Am J Cardiol 1975 36 Zile M.R Baicu C.F Gaasch W.H Diastolic heart failure--abnormalities in active relaxation and passive stiffness of the left ventricle N Engl J Med 2004 350 19 Weber KT Brilla CG Pathological hypertrophy and cardiac interstitium. 5. Fibrosis and renin-angiotensin-aldosterone system. [Review] Circulation 1991 83 Weber KT Janicki JS Shroff SG Pick R Chen RM Bashey RI Collagen remodeling of the pressure-overloaded, hypertrophied nonhuman primate myocardium Circ Res 1988 62 Watanabe J Levine MJ Bellotto F Left ventricular diastolic chamber stiffness and intramyocardial coronary capacitance in isolated dog hearts Circulation 993 Watanabe J Levine MJ Bellotto F Effects of coronary venous pressure on left ventricular diastolic distensibility Circ Res 1990 67 Gandhi SK Powers JC Nomeir AM The pathogenesis of acute pulmonary edema associated with hypertension N Engl J Med 2001 344 Vinch CS Aurigemma GP Simon HU Hill JC Tighe DA Meyer TE Analysis of left ventricular systolic function using midwall mechanics in patients >60 years of age with hypertensive heart disease and heart failure 2005 96 Nishikage T Nakai H Lang RM Takeuchi M Subclinical left ventricular longitudinal systolic dysfunction in hypertension with no evidence of heart failure Circ J 2008 72 Kawaguchi M Hay I Fetics B Kass DA Combined ventricular systolic and arterial stiffening in patients with heart failure and preserved ejection fraction: implications for systolic and diastolic reserve limitations Circulation 2003 107 Hundley GW Kitzman DW Morgan TM Cardiac Cycle-Dependent Changes in aortic area and distensibility are reduced in older patients with isolated diastolic heart failure and correlate with exercise intolerance J Am Coll Cardiol 2001 38 Gaasch WH Zile MR Left ventricular diastolic dysfunction and diastolicheart failure Annu Rev Med 2004 55 Adamson PB Magalski A Braunschweig F Böhm M Reynolds D Steinhaus D Luby A Linde C Ryden L Cremers B Takle T Bennett T Ongoing right ventricular hemodynamics in heart failure: clinical value of measurements derived from an implantable monitoring system J Am Coll Cardiol 2003 F eb 41 4 Hunt S.A ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society Circulation 2005 112 Solomon SD Janardhanan R Verma A Bourgoun M Daley WL Purkayastha D Lacourcière Y Hippler SE Fields H Naqvi TZ Mulvagh SL Arnold JM Thomas JD Zile MR Aurigemma GP Valsartan In Diastolic Dysfunction (VALIDD) Investigators. Effect of angiotensin receptor blockade and antihypertensive drugs on diastolic function in patients with hypertension and diastolic dysfunction: a randomized trial Lancet 2007 369 9579
S1409-414220090002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422009000200009 Choque cardiogénico: Historia, fisiopatología e implicaciones terapeúticas. Parte I Zeledón S Fernando Méndez J Edgar Pucci C Juan Escalante G Carlos Estrada G Carlos ,Hospital México Servicio de Cirugía de Tórax y Cardiovascular San José Costa Rica ,Servicio de Ginecología ,Hospital San Juan de Dios San José Costa Rica 12 2009 2009 11 24 32

El choque cardiogénico es la principal causa de muerte entre los pacientes que presentan un sindrome coronario agudo. Se presenta una revision histórica y conceptos fisiológicos y fisiopatológicos de esta condición clínica que son la base para su abordaje terapéutico, principalmente la revasculrización de emergencia con angioplastia o cirugía.

Cardiogenic shock: History, pathophysiology and therapeutic implications. Part I. Cardiogenic shock is the major cause of death among patients with acute coronary syndrome. The history as well as physiologic and pathophysiologic analysis of this clinical condition, based on its therapeutic management, are presented. This management predominantly involves urgent coronary angioplasty/stent placement or coronary artery bypass surgery.

 choque cardiogénico infarto agudo miocardio angioplastía cirugía de bypass coronario cardiogenic shock acute myocardial infarction angioplasty coronary artery bypass graft Reynolds H Hochman J Cardiogenic Shock: Current Concepts and Improving Outcomes Circulation 2008 117 Topalian S Ginsberg F Parrillo J Cardiogenic Shock Crit Care Med 2008 36 Ashby D Stone G Moses J Cardiogenic Shock in Acute Myocardial Infarction Catheterization and Cardiovascular Interventions 2003 59 Alpert JS Becker RC Cardiogenic Shock: Elements of Etiology, Diagnosis, and Therapy Clin. Cardiol 1993 16 Hasdai D Cardiogenic Shock. Contemporary Cardiology: Cardiogenic Shock Cardiogenic Shock. Contemporary Cardiology: Cardiogenic Shock Hollenberg S Kavinsky C Parrillo J Cardiogenic Shock Ann Intern Med 1999 131 Ginsberg F Parrillo J Cardiogenic Shock: A Historical Perspective Crit Care Clin 2009 25 Manji R Wood k Kumar A The History and Evolution of Circulatory Shock Crit Care Clin 2009 25 Martinez-Rumayor A Januzzi J Non- ST Segment Elevation Acute Coronary Syndromes: A Comprehensive Review Southern Medical Journal 2006 99 Valente S Lazzeri C Chiostri M Time of onset and outcome of cardiogenic shock in acute coronary syndromes Journal of Cardiovascular Medicine 2008 9 Dar O Cowie M Acute heart failure in the intensive care unit: Epidemiology Crit Care Med 2008 36 Goldberg R Spencer F Gore J Thirty-Year Trends (1975 to 2005) in the Magnitude of, Management of, and Hospital Death Rates Associated With Cardiogenic Shock in Patients With Acute Myocardial Infarction: A Population-Based Perspective Circulation 2009 119 Chatterjee K McGlothlin D Michaels A Analytic Reviews: Cardiogenic Shock with Preserved Systolic Function: A Reminder J Intensive Care Med 2008 23 Guyton AC Hall JE Tratado de Fisiología Médica Tratado de Fisiología Médica 1997 Philadelphia McGraw-Hill Barry W Sarembock I Cardiogenic Shock: Therapy and Prevention Clin Cardiol 1998 21 Okuda M A Multidisciplinary Overview of Cardiogenic Shock SHOCK 2006 25 Braunwald E Heart Disease Heart Disease 1996 Philadelphia W.B. Saunders Co Little RC Little WC Physiology of the Heart and Circulation Physiology of the Heart and Circulation St Louis Mosby-Year Book Boron W Boulpaep EL Textbook of Medical Physiology Textbook of Medical Physiology 2002 Philadelphia W.B. Saunders Co Mohrman DE Heller LJ Fisiología Cardiovascular Fisiología Cardiovascular 2007 México D.F McGraw-Hill Sperelakis N Heart Physiology and Pathophysiology Heart Physiology and Pathophysiology 2001 Philadelphia Academic Press van der Vusse G van Bilsen M Glatz J Cardiac fatty acid uptake and transport in health and disease Cardiovascular Research 2000 45 Williams S Wright D Tan L Management of cardiogenic shock complicating acute myocardial infarction: towards evidence based medical practice Heart 2000 83 Marín-García J Goldenthal M Fatty acid metabolism in cardiac failure: biochemical, genetic and cellular analysis Cardiovacular Research 2002 54 Stanley W Recchia F Lopaschuk G Myocardial Substrate Metabolism in the Normal and Failing Heart Physiol Rev 2005 85 Stanley W Lopaschuck G McCormack J Regulation of energy substrate metabolism in the diabetic heart Cardiovascular Research 1997 34 Lopaschuck G Folmes C Stanley W Cardiac Energy Metabolism in Obesity Circ Res 2007 101 Taegtmeyer H King L Jones B Energy Substrate Metabolism, Myocardial Ischemia, and Targets for Pharmacotherapy Am J Cardiol 1998 82 Schwenk R Luiken J Bonen A Regulation of sarcolemmal glucose and fatty acid trasnporters in cardiac disease Cardiovascular Research 2008 79 Ingwall J Weiss R Is the Failing Heart Energy Starved? On Using Chemical Energy to Support Cardiac Function Circ Res 2004 95 Patterson B Fields A Shannon R New insights into myocardial glucose metabolism: surviving under stress Curr Opin Clin Nutr Metab Care 2009 12 Sadoshima J Izumo S The Cellular And Molecular Response of Cardiac Myocytes to Mechanical Stress Annu Rev Physiol 1997 59 Ulate G Fisiología renal Fisiología renal 2006 San José Editorial Universidad de Costa Rica Debrunner M Schuiki E Minder E Proinflammatory cytokines in acute myocardial infarction with and without cardiogenic shock Clin Res Cardiol 2008 97 Sherwood E Mechanisms of the inflammatory response Best Practice & Research Clinical Anaesthesiology 2004 18 Kohl B Deutschman C The inflammatory response to surgery and trauma Curr Opin Crit Care 2006 12 Pfisterer M Right ventricular involment in myocardial infarction and cardiogenic shock Lancet 2003 362 Vlahakes G Right ventricular failure following cardiac surgery Coronary Artery Disease 2005 16 Gogo P The Evaluation and Management of Cardiogenic Shock Crit Pathways in Cardiol 2006 5 Gurm H Bates E Cardiogenic Shock Complicating Myocardial Infarction Crit Care Clin 2007 23 Antonelli M Levy M Andrews P Hemodynamic monitoring in shock and implications for management. International Consensus Conference, Paris, France Intensive Care Med 27-2 8 Ap 33 Pinsky M Hemodynamic Evaluation and Monitoring in the ICU Chest 2007 132 Pinsky M Rationale for cardiovascular monitoring Curr Opin Crit Care 2003 9 Pinsky MR Payen D Functional Hemodynamic Monitoring Functional Hemodynamic Monitoring 2005 ^eNew York Springer Tibby S Murdoch I Monitoring cardiac function in intensive care Arch Dis Child 2003 88 Hoffman G Ghanayem N Tweddell J Noninvasive Assessment of Cardiac Output Semin Thorac Cardiovasc Surg Pediatr Card Surg Ann 2005 8 Liepert D Rosenthal M Thomas S Shock: A Comparative Physiologic Approach to Mechanisms and Therapy Shock: A Comparative Physiologic Approach to Mechanisms and Therapy 18 Seminars in Anesthesia, Perioperative Medicine and Pain 1999 Hett D Jonas M Non-invasive cardiac output monitoring Current Anaesthesia & Critical Care 2003 14 Current Anaesthesia & Critical Care 2004 15 Maus T Lee D Arterial Pressure-Based Cardiac Output Assessment Journal of Cardiothoracic and Vascular Anesthesia 2008 22 Gelman S Venous Function and Central Venous Pressure Anesthesiology 2008 108 Madger S Central venous pressure: A useful but not so simple measurement Crit Care Med 2006 34 Hadian M Pinsky M Functional hemodynamic monitoring Curr Opin Crit Care 2007 13 Fincke R Hochman J Lowe A Cardiac Power Is the Strongest Hemodynamic Correlate of Mortality in Cardiogenic Shock: A Report from the SHOCK Trial Registry J Am Coll Cardiol 2004 44 Hasdai D Topol E Califf R Cardiogenic shock complicating acute coronary syndromes Lancet 2000 356 Santa-Cruz R Cohen M Ohman E Aortic Counterpulsation: A Review of the Hemodynamic Effects and Indications for Use Catheterization and Cardiovascular Interventions 2006 67 Tsagalou E Anastasiou-Nana M Nanas J Intra-Aortic Balloon Counterpulsation for the Treatment of Myocardial Infarction Complicated by Acute Severe Heart Failure Congest Heart Fail 2009 15 Trost J Hillis D Intra-Aortic Balloon Counterpulsation Am J Cardiol 2006 97 Papaioannou T Mathioulakis D Stametelopoulos K New Aspects on the Role of Blood Pressure and Arterial Stiffness in Mechanical Assistance by Intra-aortic Balloon Pump: In-vitro Data and Their Application in Clinical Practice Artif Organs 2004 28 Burkhoff D Cohen H Brunckhorst C A randomized multicenter clinical study to evaluate the safety and efficacy of the TandemHeart percutaneous ventricular assist device versus conventional therapy with intraaortic balloon pumping for treatment of cardiogenic shock Am Heart J 2006 152 469 Hillis L Lange R Optimal Management of Acute Coronary Syndromes N Engl J Med 2009 360 Keeley E Hillis L Primary PCI for Myocardial Infraction with ST-Segment Elevation N Engl J Med 2007 356 Silber S Albertsson P Avilés F Guidelines for Percuatneous Coronary Interventions. The Task Force for Percutanenous Coronary Interventions of the European Society of Cardiology European Heart Journal 2005 26 Ducas J Grech E Percutaneous coronary intervention: cardiogenic shock BMJ 2003 326 Williams S Wright D Tan L Management of cardiogenic shock complicating acute myocardial infarction: towards evidence based medical practice Heart 2000 83 Faxon D Early reperfusion strategies after acute ST-segment elevation myocardial infarction: the importance of timing Nature Clinical Practice Cardiovacular Medicine 2005 2 Hochman JS Sleeper L Webb J Should We Emergently Revascularize Occluded Coronaries for Cardiogenicc Shock: An International Randomizadel Trial of Emergency PTCA/CABG-trial design Am Heart J 1999 137 White H Assmann S Sanborn T Comparison of Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting After Acute Myocardial Infarction Complicated by Cardiogenic Shock: Results From the Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock ( SHOCK ) Trial Circulation 2005 112 Jeger R Harkness S Ramanathan K Emergency revascularization in patients with cardiogenic shock on admission: a report from the SHOCK trial and registry European Heart Journal 2006 27 Patel M Dehmer G Hirshfeld J ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization J Am Coll Cardiol 2009 53 Morrow D Antithrombotic Therapy to Support Primary PCI N Engl J Med 2008 358 Serruys P Kutryk M Ong A Coronary-Artery Stents N Engl J Med 2006 354 Mann H Nolan P Update on the management of cardiogenic shock Curr Opin Crit Care 2006 12 Sanborn T Feldman T Management strategies for cardiogenic shock Current Opinion in Cardiology 2004 19 Comas G Esrig B Oz M Surgery for Myocardial Salvage in Acute Myocardial Infarction and Acute Coronary Syndromes Heart Failure Clin 2007 3 Raanani E Avramovich A Hasdai D Operative Strategies for CArdiogenic Shock Complicating Acute Coronary Syndromes Operative Strategies for CArdiogenic Shock Complicating Acute Coronary Syndromes Sundell J Knuuti J Insulin and Myocardial blood flow Cardiovascular Research 2003 57 Bertrand L Horman S Beauloye C Insulin signalling the heart Cardiovascular Research 2008 79 Brownsey R Boone A Allard M Actions of insulin on the mammalian heart: metabolism, pathology and biochemical mechanisms Cardiovascular Research 1997 34 Metha SR Yusuf S Díaz R Effect of glucose-insulin-potassium infusion on mortality in patients with acute ST-segment elevation myocardial infarction: the CREATE-ECLA randomized controlled trial JAMA 2005 293 4 Rastan AJ Eckenstein JI Hentschel B Emergency coronary artery bypass graft surgery for acute coronary syndrome: beating heart vs conventional cardioplejic cardiac arrest strategies Circulation 2006 114 ^sI Leopold J Does Thrombolytic Therapy Facilitate of Foil Primary PCI N Engl J Med 2008 358 Kierman T Gersh B Thrombolysis in Acute Myocardial Infarction: Current Status Med Clin N Am 2007 91 De Luca G Suryapranata H Marino P Reperfusion Strategies in Acute ST-Elevation Myocardial Infarction: An Overview of Current Status Progress in Cardiovascular Diseases 2008 50 Ortolani P Marzocchi A Marrozzini C Clinical impacto from direct referral to primary percutaneous coronary intervention folllowing pre-hospital diagnosis of ST-elevation myocardial infarction European Heart Journal 2006 27 Mendoza C Bhatt M Virani S Management of failed thrombolysis after acute myocardial infarction: An overview of current treatment options International Journal of Cardiology 2007 114 Cantor W Fitchett D Borgundvaag B Routine Early Angioplasty after Fibrinolysis for Acute Myocardial Infarction N Engl J Med 2009 360 Davies C Revascularization for cardiogenic shock Q J Med 2001 94 Wilansky S Moreno C Lester S Complications of myocardial infarction Crit Care Med 2007 35 Burkhart H Dearani J Surgical Management of Mechanical Complications of Acute Coronary Syndromes Causing Cardiogenic Shock Surgical Management of Mechanical Complications of Acute Coronary Syndromes Causing Cardiogenic Shock Gowda R Fox J Khan I Cardiogenic Shock: Basics and clinical considerations International Journal of Cardiology 2008 123 Overgaard C Dzavík V Inotropes and Vasopressors: Review of Physiology and Clinical Use in Cardiovascular Disease Circulation 2008 118 Asfar P Hauser B Radermacher P Catecholamines and Vasopressin During Critical Illness Crit Care Clin 2006 22 Lawson NW Wallfisch HK Stoelting RD Barash PG Gallagher TJ Cardiovascular Pharmacology: A new look at the pressors. Advances in Anesthesia 1986 Chicago Year Book Medical Publishers den Uli C Lagrand W Valk S Management of Cardiogenic Shock: Focus on Tissue Perfusion Curr Probl Cardiol 2009 34 Cooper B Review and Update on Inotropes and Vasopressors AACN Advanced Critical Care 2008 19 Bayram M De Luca L Massie B Reassessment of Dobutamine, Dopamine, and Milrinone in the Management of Acute Heart Failure Syndromes Am J Cardiol 2005 96 Padayachee L Levosimendan: The Inotrope of Choice in Cardiogenic Shock Secondary to Takotsubo Cardiomyopathy? Heart, Lung and Circulation 2007 16 Metzsch C Liao Q Steen S Levosimendan cardioprotection reduces the metabolic response during temporary regional coronary occlusion in an open chest pig model Acta Anaesthesiol Scand 2007 51 Toller W Stranz C Levosimendan, a New Inotropic and Vasodilator Agent Anesthesiology 2006 104
S1409-414220090002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422009000200010 Anatomía básica cerebral para el cardiólogo intervencionista Poveda Fernández Jonathan ,Hospital San Juan de Dios Servicio de Cardiología San José Costa Rica 12 2009 2009 11 33 40

El estudio angiográfico de los vasos supraaórticos, las arterias carótidas y la circulación cerebral, se realiza con mayor frecuencia en los labotatorios de hemodinamia de los servicios de cardiología, debido a que un número importante de pacientes presenta enfermedad vascular coronaria, asÍ como carotídea y del sistema nervioso central concomitante. Esta revisión, provee al cardiólogo invasivo, los conocimientos generales de la circulación carotídea y cerebral, asi como la correlación de los síntomas asociados a enfermedad isquémica cerebral, de acuerdo a los lechos vasculares afectados así como algunos principios técnicos básicos para una óptima valoración de estos territorios vasculares.

Basic brain circulatory anatomy for the interventional cardiologist Angiographic studies of the supraortic vessels, including the carotid arteries and the cerebral circulation, are usually performed in the cardiac catheterization laboratory of a division or department of cardiology or cardiovascular medicine. This is a result of efficiency and of the clinical status of many coronary artery patients who have concomitant cerebrovascular disease.This review, provides the interventional cardiologist with general information involving the carotid and cerebral artery circulations and correlates symptoms associated with cerebral ischemia according to the artery involved. Basic techniques for an optimal assessment of these vascular territories are discussed.

 angiography cerebral coronary intervention Cho L Mukherjee D Basic cerebral anatomy for the carotid interventionalist Cath and Card. Interv 2006 68 Rosenfield KM Clinical competence statement on carotid stenting: Training and credentialingfor carotid stenting-Multispecialty consensus recommendations Catheter Cardiovasc Interv 2005 64 Renfro MB Day AL Rhoton AL Batjer HH The extracranial and intracraneal vessels: Normal anatomy and variation Cerebrovascular Disease Cerebrovascular Disease 1997 Philadelphia Lippinocott-Raven Baum S Abram’s Angiography: Vascular and Interventional Radiology Abram’s Angiography: Vascular and Interventional Radiology 1997 4th Boston Little Brown Osborn AG Diagnostic Cerebral Angiography Diagnostic Cerebral Angiography 1999 2nd Philadelphia Lippincott, William and Wilkins Al-Mubarak N Roubin GS Iyer SS Vitek JJ Carotid artery stenting Carotid artery stenting 2004 1st Lippincott Williams and Wilkins Yadav JS Casserly IP Sachar R Manual of Peripheral Vascular Intervention Manual of Peripheral Vascular Intervention 2005 1st Lippincott Williams and Wilkins
S1409-414220090002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422009000200011 Una taza de café y otras terapias alternativas en Medicina Clínica Whayne Thomas F ,University of Kentucky Gill Heart Institute Lexington, KY EEUU 12 2009 2009 11 41 46

El café es una bebida con una historia muy rica, que comienza con la leyenda que atribuye su origen en las tierras altas de Etiopía. Desde el punto de vista fisiológico, los efectos beneficiosos del café han sido bien documentados y, a diferencia de muchas otras sustancias, éste no aumenta el riesgo de mortalidad. En los pacientes con enfermedad coronaria existe muy poca restricción en cuanto al consumo del café como causante de arritmias: éstas sólo se asocian a su elevada ingesta. Las evidencias sugieren también que el café disminuye la incidencia de la diabetes mellitus tipo 2. En la medida que nuestros conocimientos sobre la génesis de la arterioesclerosis aumenten, podremos corroborar que el café puede ser beneficioso en la regeneración de la pared del endotelio vascular dañado, incluyendo los daños causados por la inflamación. Existe una excepción, dada por la presencia de un gen responsable de metabolizar lentamente la cafeína, que puede hacer aparecer al café como causante del aumento en la incidencia del infarto agudo del miocardio. Teniendo en cuenta estos hechos así como las terapias alternativas, el cardiólogo y el médico no especialista entenderán mejor los diversos efectos del café, que es consumido por muchos de nuestros pacientes.

One cup of coffee and other alternative therapies in clinical medicine Coffee is a drink with a very rich history, beginning with a legend about its discovery in the highlands of Ethiopia.Beneficial physiologic effects of coffee are well documented, and unlike many substances, coffee poses no increased risk for mortality. On the contrary, a possible mortality benefit has been reported.Patients with coronary heart disease have little reason to restrict their intake of coffee as a significant arrhythmia is usually only associated with consumption of very high quantities.Evidence also suggests that coffee decreases the incidence of diabetes mellitus type 2.As our understanding of the mechanisms of atherosclerosis continues to progress, we have learned that coffee may have benefit in regeneration of damaged endothelium, including the damage caused by inflammation.In one unique situation-a human genotype with slow caffeine metabolism-coffee appears to somewhat augment the incidence of acute myocardial infarction.With these facts in mind, as with alternative medications, it is important for the physician and cardiovascular specialist to understand the various effects of coffee, which is used by many of our patients.

 café enfermedad coronaria diabetes mellitus infarto del miocardio coffee coronary artery disease diabetes mellitus myocardial infarction Rayfield A A brief history of coffee: from Kaldi the goatherder to Pope Clemente VII A brief history of coffee: from Kaldi the goatherder to Pope Clemente VII The History of Coffee The History of Coffee July 2 9, History of Costa Rica Coffee History of Costa Rica Coffee Augu st 6 The Gourmet Coffee Bean The Gourmet Coffee Bean An Examination of Costa Rican Coffee Culture An Examination of Costa Rican Coffee Culture Augu st 2 Philip P Taillard J Moore N Delord S Valtat C Sagaspe P Bioulac B The effects of coffee and napping on nighttime highway driving: a randomized trial Ann Intern Med 2006 144 Guilleminault C Ramar K Naps and drugs to combat fatigue and sleepiness Ann Intern Med 2006 144 Lopez-Garcia E van Dam RM Li TY Rodriguez-Artalejo F Hu FB The relationship of coffee consumption with mortality Ann Intern Med 2008 148 Lopez-Garcia E van Dam RM Willett WC Rimm EB Manson JE Stampfer MJ Rexrode KM Hu FB Coffee consumption and coronary heart disease in men and women: a prospective cohort study Circulation 2006 113 van Woudenbergh GJ Vliegenthart R van Rooij FJ Hofman A Oudkerk M Witteman JC Geleijnse JM Coffee consumption and coronary calcification: the Rotterdam Coronary Calcification Study Arterioscler Thromb Vasc Biol 2008 28 Klatsky AL Koplik S Kipp H Friedman GD The confounded relation of coffee drinking to coronary artery disease Am J Cardiol 2008 101 Happonen P Voutilainen S Salonen JT Coffee drinking is dose-dependently related to the risk of acute coronary events in middle-aged men J Nutr 2004 134 Barcelo A Rajpathak S Incidence and prevalence of diabetes mellitus in the Americas Rev Panam Salud Publica 2001 10 Wild S Roglic G Green A Sicree R King H Global prevalence of diabetes: estimates for the year 2000 and projections for 2030 Diabetes Care 2004 27 van Dam RM Hu FB Coffee consumption and risk of type 2 diabetes: a systematic review JAMA 2005 294 Tuomilehto J Hu G Bidel S Lindstrom J Jousilahti P Coffee consumption and risk of type 2 diabetes mellitus among middle-aged Finnish men and women JAMA 2004 291 Arion WJ Canfield WK Ramos FC Schindler PW Burger HJ Hemmerle H Schubert G Below P Herling AW Chlorogenic acid and hydroxynitrobenzaldehyde: new inhibitors of hepatic glucose 6-phosphatase Arch Biochem Biophys 1997 339 vanDam RM Feskens EJ Coffee consumption and risk of type 2 diabetes mellitus Lancet 2002 360 Park S Jang JS Hong SM Long-term consumption of caffeine improves glucose homeostasis by enhancing insulinotropic action through islet insulin/insulin-like growth factor 1 signaling in diabetic rats Metabolism 2007 56 Keijzers GB De Galan BE Tack CJ Smits P Caffeine can decrease insulin sensitivity in humans Diabetes Care 2002 25 Salazar-Martinez E Willett WC Ascherio A Manson JE Leitzmann MF Stampfer MJ Hu FB Coffee consumption and risk for type 2 diabetes mellitus Ann Intern Med 2004 140 Pereira MA Parker ED Folsom AR Coffee consumption and risk of type 2 diabetes mellitus: an 11-year prospective study of 28 812 postmenopausal women Arch Intern Med 2006 166 Iso H Date C Wakai K Fukui M Tamakoshi A The relationship between green tea and total caffeine intake and risk for self-reported type 2 diabetes among Japanese adults Ann Intern Med 2006 144 Cornelis MC El-Sohemy A Kabagambe EK Campos H Coffee, CYP1A2 genotype, and risk of myocardial infarction JAMA 2006 295 Winkelmayer WC Stampfer MJ Willett WC Curhan GC Habitual caffeine intake and the risk of hypertension in women JAMA 2005 294 Klag MJ Wang NY Meoni LA Brancati FL Cooper LA Liang KY Young JH Ford DE Coffee intake and risk of hypertension: the Johns Hopkins precursors study Arch Intern Med 2002 162 Libby P Inflammation in atherosclerosis Nature 2002 420 Spyridopoulos I Fichtlscherer S Popp R Toennes SW Fisslthaler B Trepels T Zernecke A Liehn EA Weber C Zeiher AM Dimmeler S Haendeler J Caffeine enhances endothelial repair by an AMPK-dependent mechanism Arterioscler Thromb Vasc Biol 2008 28 Klatsky AL Morton C Udaltsova N Friedman GD Coffee, cirrhosis, and transaminase enzymes Arch Intern Med 2006 166 Prineas RJ Jacobs DR Crow RS Blackburn H Coffee, tea and VPB J Chronic Dis 1980 33 Myers MG Harris L Leenen FH Grant DM Caffeine as a possible cause of ventricular arrhythmias during the healing phase of acute myocardial infarction Am J Cardiol 1987 59 Whayne TF What should medical practitioners know about the role of alternative medicines in cardiovascular disease management? Cardiovascular Therapeutics What should medical practitioners know about the role of alternative medicines in cardiovascular disease management? Cardiovascular Therapeutics In Press
S1409-414220090002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422009000200012 Ectasia coronaria, angina inestable e insuficiencia aórtica Lanzas Rodríguez Róger A ,Hospital Regional Dr. Tony Facio Castro Servicio de Cardiología Limón Costa Rica 12 2009 2009 11 47 50

Se presenta el caso de una paciente femenina de 79 años, conocida portadora de cardiopatía hipertensiva, insuficiencia aórtica y dislipidemia, que se hospitalizó con un síndrome coronario agudo. Durante su evolución presentó cambios electrocardiográficos de isquemia subepicardica anterior extensa e inferior, por lo que se le realizó una coronariografia selectiva bilateral, detectándose ectasia de la arteria coronaria derecha, con flujo lento y retención del medio de contraste. Se refirió el caso para cirugía de reemplazo valvular.

Coronary artery ectasia, unstable angina and aortic insufficiency The case of a 79 year old female patient, who was hospitalized with acute coronary syndrome (ACS), is presented. She had known hypertensive heart disease, aortic insufficiency and dyslipidemia. During the evolution of her ACS, she presented electrocardiographic changes of ischemia. Selective coronary angiography detected ectasia of the right coronary artery with slow flow and retention of contrast medium. The patient was referred for aortic valve replacement surgery.

 Enfermedad coronaria Angiografía Ateroesclerosis Ectasia coronaria Coronary heart disease Angiography Atherosclerosis Coronary ectasia Moreno Martínez FL Fleites Vega LF Fleites Cárdenas HA Ibargollin Hernández RS León de la Torre RS De Lara Abab J López Bernal OJ Ectasia coronaria e infarto agudo de miocardio. Presentación de un caso Ectasia coronaria e infarto agudo de miocardio. Presentación de un caso VII Congreso Virtual Hispanoamericano de Anatomía Patológica y I Congreso de Preparaciones Virtuales por Internet 01 al 31 Octubre del 2005 Pinar Bermudez E Lopez Palop R Martínez Luengas R Ectasia Coronaria: Prevalencia, características clínicas y angiográficas Rev Esp Cardiol 2003 56 Hartnell GS Pamell BM Pridee RB Coronary artery ectasia its prevalence and clinical significance in 4993 patients Br Heart J 1985 54 Cokkinos DV Demopoulos VP Voudrin V Munginas A Cotileas P Foussas SG Coronary artery ectasia aspect of fitness to fly Eur Heat J 1999 1 Suzuki H Daida H Tanaka M Giant aneurysm of the left main coronary artery in Takayasu Aortitis Heart 1999 81 Pick RA Glover MU Vieweg WV Myocardial infartion in a young woman with isolate coronary arteritis Chest 1982 82 Sorrell VL Davis MJ Bove AA Current knowledge and significance of coronary artery ectasia: chronologic review of the literature, recomendation for treatment, possible etiologies and future considerations Clin Cardiol 1998 21 Markis JE Joffe CD Cohn PF Fesn DJ Erman MV Gorlin R Clinical significance of coronary arterial ectasia Am J Cardiol 1976 37 2 Nyamu P Ajit MS Joseph PK Venk itachalmal Sugirtham NA The prevalence and clinical profile of angiografphic coronary ectasia Asian Cardiovasc Thorac Ann 203 1 2 Hatanos Nobnoka S Tnaka H Nagashima J Ikeda K Miyake F A case of coronary artery ectasia with thrombus detected by transthoracic two dimensional echocardiography Ecocardiography 2002 19 8 Mavrogeni S Manginas A Pupadakis E Correlation between magnetic resonance angiography (MRA) and cuantitative coronary angiography (QCA) in ectatic coronary vessels J Cardio Vasc Magn Reson 2004 6 1 Gigorov V Goldberg L Mekel J Platelet Glycoprotein IIb/IIIa receptor blockade with integrilin (eptifibatide) for early postinfarction angina in a patient with coronary arterial ectasia Cardiovasc J S Afr 2002 13 3