Vanesa Gregorietti is currently the President of the Cardiology Society of Buenos Aires, Deputy Chief of Cardiac Transplant and coordinates the area of pulmonary hypertension at El Cruce Hospital and Sagrado Corazon Sanatorium. He works in the area of heart failure and pulmonary hypertension at the Argentine Institute of Diagnosis and Treatment. She has received her Medical degree in the Faculty of Medicine from Favaloro University of Buenos Aires. She has completed specialization in Cardiology from Cardiology and Cardiovascular Surgery Service of Fundacion Favaloro. She has also completed her training in Advanced Cardiorespiratory Failure and Intrathoracic Transplantation in Transplant Services Favaloro Foundation, Stanford University, California, USA. She is also the Member of the Editorial Board of the Journal Insuficiencia Cardíaca. She is the Member of the Council of Heart Failure of the Argentine Society of Cardiology, Member of the Committee of Heart Failure and Pulmonary Hypertension of the Argentine Federation of Cardiology, Member of the Cardiac Transplant Advisory Committee for the Society Argentina de Transplante, the President of Sociedad de Cardiología de Buenos Aires International Society for Heart and Lung Transplantation, Vice-President of the Society of Cardio-oncology of the Republic of Argentina.
Background & Aim: Heart failure is a term used to define a constellation of symptoms and signs that are commonly attributed to the inability of the heart to produce a cardiac output that meets the demands of the body. It remains a deadly disease, affecting between 1-2% of the population and is more common in the elderly, with around 6-10% of patients over 65 suffering from the condition. Sacubitril/Valsartan (LCZ-696) is a combined neprilysin inhibitor and angiotensin AT1 receptor blocker approved in recent years for the treatment of chronic heart failure with reduced ejection fraction. In an area where there have been limited pharmacological advances in the last 10 years, this drug was a game changer and a great one. The optimal use of sacubitril/valsartan in clinical practice needs further investigation, in particular for patients with cardiomyopathy induced by chemotherapeutic toxicity as such patients are usually poorly represented in clinical trials. Method: 490 consecutive patients (p) with a history of breast cancer, who received treatment with chemotherapy, were enrolled prospectively from June 2016 to June 2017. Ventricular dysfunction was detected through clinical, echocardiographic and laboratory tests. For the statistical analysis the SPSS was used. Result: 490 patients, aged 69±7.2 years, female 482 (98.3%). 14 p presented ventricular dysfunction refractory to conventional treatment, all were optimally treated with beta-blockers, being with an average heart rate of 61±9 bpm, so in this group it was decided to rotate the angiotensin II receptor blocker treatment to the Sacubitril/Valsartan combination, whose titration was adjusted to the clinical response and the hemodynamic parameters. They were followed up at 14, 28 days and at 3 and 6 months. It was observed that at 3 months the patients improved the ejection fraction of the left ventricle (average 23% to 36%). Improvement of ProBNP 934 pg/ml (basal), with an average reduction of 30% at follow-up, normalizing in 100% of patients followed up at 3 months. Improvement of CF III-IV to CF I-II is observed in 100% of patients. The dose of loop diuretics was reduced in all patients. Conclusion: In patients with ventricular dysfunction secondary to chemotherapy and refractory to the tried and tested therapy, Sacubitril/Valsartan has shown a good safety profile with excellent results in follow-up and it would be a promising alternative in this cohort of patients.
Romano Jose Rene, Medical specialist in cardiology. He trained in an endemic region for Chagas disease, as a doctor and later as a cardiologist (during his training he rotated 3 years in rural areas of the province where he lived and there were patients with Chagas disease and vectors of it). Once he received work 2 years in a rural area where there were patients with Chagas disease and also vectors of the same he had the opportunity to see kissing, contagion of Chagas disease in all possible ways in adult and pediatric population, perform care of type free of charge to patients with this pathology on several occasions since it mainly affects patients with low economic resources. He has performed several observational research projects that were presented at national and international conferences. He is currently a member of the Chagas Commission of the Argentine Federation of Cardiology as a member of the province in which he lives now. Treatment and management of patients with this pathology in a specialized office Chagas disease in equipment with an infectious agent and an echocardiographer.
Introduction: Chagas disease, from the south of the United States to the south of Argentina with 20 million people infected. In particular through congenital transmission, third transmission route. Objectives: To inform the location of patients with positive serology found in Formosa, in the hospital La madre y el Niño. Positive newborns, pediatric, and Mothers with positive serology, in a period from 1 July to 30 November 2014. To know the prevalence of Chagas in the period 2012 to 2014 of the Mother and Child Hospital, and Formosa Argentina, by age group. Materials and methods: It is a descriptive observational study. We analyzed patients with positive serology of Chagas disease in the hospital Madre y El Niño, in a period from 2012 to 2014. The data of the pediatric infectology service of said hospital, records, clinical histories and laboratory records. from the hospital. Results: 100 patients with positive serology for Chagas were found in the period, of whom 19 were newborns, 3 were children, and the rest were pregnant. Of Formosa 52% of villages in the interior, 40%. Pregnant women (78%) with a mean age of 27 years, 16 years of age, of aboriginal race were 5%. Congenital Chagas were not from Formosa Capital. The results of the center of zoonoses presented mode of 5% in the age groups being the average 15% (1% to 42%). The lowest percentage per year was found in children aged 2 to 4 years, while the highest percentage per year was found in those over 65 years of age. Conclusions: The prevalence of Chagas disease in this study was lower than expected due to the prevalence reported in previous studies conducted in the region; however, finding children with the disease not previously treated show us that the prenatal screening system that needs to be increased.