ABC | Volume 112, Nº2, February 2019

Review Article Fontes-Carvalho et al The Year in Cardiology 2018: ABC Cardiol and RPC at a glance Arq Bras Cardiol. 2019; 112(2):193-200 (<40%). Although most previous studies have assessed the role of peak VO2 as a prognostic marker, it is known that the VE/VCO2 slope is a particularly interesting parameter, because it reflects ventilatory efficiency and is independent on the level of patient effort. 57 The authors identified a threshold of VE/VCO2 slope > 39 as an excellent marker of worse outcome, with a c-statistic value of 0.79. Nevertheless, it is commonly said “in Medicine there are no magical numbers”. This is especially true in the selection of HF patients for heart transplantation, where individual clinical decision requires a team-based approach, with extensive clinical experience and a multiparametric approach. However, this interesting study highlights the importance of integrating the information provided by CPET, especially of VE/VCO2, as another important clinical parameter to better stratify these patients. Exercise training induces cardiovascular adaptations secondary to changes in blood pressure, as well as other hemodynamic and metabolic changes in response to physical exertion that are most of the time desired by the cardiologist. Rodrigues et al. 58 checked the effects of aerobic exercise training on contractility and intracellular calcium (Ca2+) transients of cardiomyocytes, and on the expression of microRNA 214 (miR-214) in the left ventricle of spontaneously hypertensive rats (SHR). They demonstrated that exercise training reduced systolic arterial pressure in hypertensive rats and increased the availability of intracellular Ca2+ by accelerating the sequestration of these ions in left ventricular myocytes of hypertensive rats, despite increased expression of miR-214 and maintenance of cell contractility. This study confirmed the anti-hypertensive effects of aerobic exercise, as already reported previously. But will any level of exercise be beneficial to all? Silva et al. 59 hypothesized that athletes engaging in high-intensity strength training for long periods of time show changes in cardiac structure associated with reduced cardiac function when compared to long-distance runners, and long-time exposure to high-intensity strength training could lead to a reduction of endothelial function caused by pressure overload. They evaluated 40 high-performance athletes (powerlifters [PG], n = 16; runners [RG], n = 24) and assessed heart structure and function performing echocardiography and checking systolic and diastolic blood pressure (SBP/DBP), flow-mediated dilation (FMD), peripheral vascular resistance (PVR), maximum force (squat, bench press, and deadlift), and maximal oxygen uptake (spirometry). The authors concluded that cardiovascular adaptations are dependent on training modality, and the borderline structural cardiac changes are not accompanied by impaired function in powerlifters. However, a mild increase in blood pressure seems to be related to PVR rather than endothelial function. Conclusions We hope this review of the best in Cardiology and Cardiovascular Science published in the Portuguese language by 2 major journals can help our readers to update their knowledge in an easy and pleasant format and yet, get excited and interested in going deeper on the articles published last year on their field of expertise. The specific areas covered by this review included coronary artery disease, arrhythmias, cardiovascular disease prevention and epidemiology, cardiomyopathy and valvular heart disease, and finally cardiac function, exercise and heart failure. Articles published in all these fields demonstrated important innovation, new and original information with direct effect on clinical routine patient management, and also new insights on better understanding of disease process and treatment. Population and epidemiological data of particular importance for Portuguese speaking countries were also presented. Author contributions Conception and design of the research, writing of the manuscript and critical revision of the manuscript for intellectual content: Fontes-Carvalho R, Oliveira GMM, Oliveira GMM, Rochitte CE. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This study is not associatedwith any thesis or dissertationwork. 1. Nascimento BR, Brant LCC, Oliveira GMM, Malachias MVB, Reis GMA,Teixeira RA, et al. Epidemiologia das doenças cardiovasculares em paísesde Língua Portuguesa: dados do “Global Burden of Disease”, 1990 a 2016. Arq Bras Cardiol. 2018;110(6):500-11. 2. Fontes-Carvalho R, Gonçalves L. The Portuguese Journal of Cardiology. Eur Heart J. 2018;39(10):829-30. 3. Rochitte CE. The New Impact Factor of the Arquivos Brasileiros de Cardiologia (ABC Cardiol), 1.318: An Achievement of the SBC for Our Scientific Community. 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