ABC | Volume 114, Nº3, March 2020

Review Article Oliveira The Top 10 Original Articles Published in the ABC Cardiol and in the RPC in 2019 Arq Bras Cardiol. 2020; 114(3):564-570 1. Fontes-Carvalho R, Moraes de Oliveira GM, Gonçalves L, Rochitte CE. The Year in Cardiology 2018: ABC Cardiol and RPC at a glance. O ano de 2018 em Cardiologia: uma visão geral da ABC Cardiol e RPC. Rev Port Cardiol. 2019;38(2):73–81. 2. da Silva PM, Aguiar C, Morais J; DISGEN-LIPID study Investigators. Suboptimal lipid levels in clinical practice among Portuguese adults with dyslipidemia under lipid-lowering therapy: Data from the DISGEN-LIPID study. Rev Port Cardiol. 2019;38(8):559–69. 3. vonHafe P. Gender differences in lipid profile and therapy. Rev Port Cardiol. 2019;38(8):571–2. 4. Marques da Silva P, Lima MJ, Neves PM, Espiga de Macedo M. Prevalence of cardiovascular risk factors and other comorbidities in patients with hypertension in Portuguese primary health care populations: The PRECISE study. Prevalência de fatores de risco cardiovascular e outras comorbilidades em doentes com hipertensão arterial assistidos nos Cuidados de Saúde Primários: estudo Precise. Rev Port Cardiol. 2019;38(6):427–37. References and the extent of late gadolinium enhancement. The challenge now is to understand how those results can influence the clinical approach of patients with myocarditis. 26 Assessing the risk of cardiotoxicity of anthracycline chemotherapy and humanized monoclonal antibodies is a clinical challenge that stimulates the search for predictors of left ventricular regional wall motion abnormalities (LVRWMA) that are easy to use and allow reassessment throughout treatment. Barros et al., 27 evaluating 112 patients (mean age, 51.3 ± 12.9 years) with breast cancer and treated with doxorubicin and/or trastuzumab, have carried out an echocardiographic study to assess cardiotoxicity, which was defined as a 10% decrease in LVEF. Cardiotoxicity was observed in 18 (16.1%) patients. On multivariate analysis, LVRWMA (OR = 6.25 [95% CI: 1.03; 37.95], p < 0.05), left ventricular systolic diameter (OR = 1.34 [95% CI: 1.01; 1.79], p < 0.05) and global longitudinal strain by speckle tracking (OR = 1.48 [95% CI: 1.02; 2.12], p < 0.05) were significant and independent predictors of cardiotoxicity. Those authors have concluded that LVRWMA is an independent predictor of cardiotoxicity and can be useful in the early detection of myocardial dysfunction. 27 Heart Surgery A meta-analysis of four controlled randomized studies, aimed at determining the clinical outcomes of 1528 patients with old-generation and contemporary mechanical and biological valvular prostheses, followed up for 2-20 years, showed no difference between patients with mechanical and biological valvular prostheses regarding the outcomes death (relative risk, RR = 1.07; 95% CI: 0.99-1.15), systemic arterial embolism (RR = 0.93; 95% CI: 0.66-1.31), and infective endocarditis (RR = 1.21; 95% CI: 0.78-1.88). However, the risk of bleeding was one-third lower (RR = 0.64; 95% CI: 0.52- 0.78) and the number of reoperations (RR = 3.60; 95% CI: 2.44-5.32) was three times higher in patients with biological valvular prostheses. Three studies had included old-generation valvular prostheses with results similar to those of the new generation ones. The authors highlight the lack of studies on the new generation valvular prostheses, emphasizing the need to compare contemporary mechanical and biological valvular prostheses. 28 Congenital heart diseases Pregnancy in patients with complex congenital heart disease (CCHD) has become a reality, maternal-fetal management being a current clinical challenge. Avila et al. have studied, for 10 years, 435 pregnant women with CCHD, included in the registry of the Instituto do Coraço (Registro-InCor). They have selected 42 pregnancies in 40 women with CCHD (24.5 ± 3.4 years), who had been advised not to get pregnant. The CCHD listed were as follows: transposition of the great arteries, pulmonary atresia, tricuspid atresia, single ventricle, double right ventricular outflow tract, and double left ventricular inlet. Those CCHD had been treated with the Rastelli, Fontan, Jatene, Senning and Mustard surgeries, and other procedures combined, such as tunneling, Blalock Taussig and Glenn. Of the 40 women with CCHD, 8 had not undergone surgery and 48%were hypoxemic. Despite the individualized and frequent follow-up, with hospitalization from the 28th week onward, most pregnancies (60%) had maternal or fetal complications, as follows: maternal complications reported in 31% of the pregnancies, including two deaths caused by post-partum hemorrhage and severe pre-eclampsia; 7 fetal losses; 17 premature babies; and 2 newborns with congenital heart disease. Despite the improvement in the prognosis of CCHD and the need to respect a woman’s intention to conceive, the authors highlight the current recommendations that maternal and fetal complications advise against pregnancy, especially in hypoxemic patients. Final Conclusions From the perspective of the editors of the Arq Bras Cardiol and the Rev Port Cardiol , this review of the best articles of the year is a small sample of what such scientific publications have to offer regarding updating and spreading of innovations to their readers. This review evidences the relevance of science in the Portuguese language. We aimed to provide the readers with the best information, in a brief, precise and efficient way. Science only moves forward when knowledge is shared. The role of the Arq Bras Cardiol and the Rev Port Cardiol is to publish, circulate and disseminate science, as well as to contribute to the global scientific progress. And why should we not do that elegantly and efficiently in our beloved mother language, with the accent that pleases us most? We hope everybody enjoys this review of the 2019 best articles and we are looking forward to the 2020 best ones. In addition, we invite our readers, members of our societies of cardiology, cardiologists, physicians and scientists in general to remain constantly connected to our scientific publications by using the traditional digital way (webpage), social media (Facebook, Twitter and LinkedIn), and smartphone apps. Enjoy the reading! 568