In Peru, ST elevation myocardial infarction most frequently affects men between 60-70 years. The most frequent initial reperfusion treatment is fibrinolysis, followed by primary angioplasty, and pharmaco-invasive strategy. The main reason for the lack of administration of reperfusion treatment was the delay from symptoms onset to first medical contact. The most common cause of in-hospital death was cardiogenic shock.

Antecedentes. Los pacientes con lupus eritematoso sistémico (LES) tienen alto riesgo de compromiso cardíaco con elevada mortalidad, por lo que el diagnóstico subclínico podría mejorar su sobrevida. Se ha observado que el strain (deformación) miocárdico longitudinal (SGL) puede ser de utilidad para la evaluación de la función cardíaca en estos pacientes. Objetivos. Evaluar la función miocárdica mediante el análisis del strain longitudinal bidimensional (2D), comparar el strain longitudinal entre pacientes con LES y controles, y determinar la correlación con el índice de actividad del LES. Material y métodos. Se estudiaron a 44 pacientes con LES (50 ±13 años) y 50 controles (49 ±12 años) pareados por edad y sexo, a quienes se les realizó un ecocardiograma transtorácico bidimensional. Se valoró el strain longitudinal mediante el método de speckle tracking, y la actividad del LES se estimó mediante el Systemic Lupus Erythematous Disease Activity Index (SLEDAI). Se definió como LES activo con una puntuación ≥ 4. Resultados. El strain longitudinal global2D fue menor en pacientes con LES que los controles (– 17,3% ± 1,9% vs. – 20%, ± 1,9%; p=0,00). No hubo diferencias en la fracción de eyección de ventrículo izquierdo entre ambos grupos, ni en 2D (p=0,650), ni en 3D (p=0,718). En los pacientes lúpicos, el SLEDAI varió entre 0 y 10, y el 63,8% estuvieron inactivos. Se halló correlaciones negativas significativas entre el puntaje de SLEDAI y la FEVI bidimensional (r de Pearson=-0,372, p=0,017); no se encontró correlación entre el puntaje de SLEDAI y el strain longitudinal global 2D (rho de Spearman=- 0,091 p =0,582). Conclusiones. El strain longitudinal global 2D se encontró disminuida en aquellos afectados con LES, lo que sugiere que podría ser una herramienta útil para evaluar la función cardíaca en estos pacientes.                                                                  

Objectives To describe the use and findings of cardiopulmonary imaging - chest X-ray (cX-ray), echocardiography (cEcho), chest CT (cCT), lung ultrasound (LUS)) and/or cardiac magnetic resonance imaging (cMRI) - in COVID-19-associated hospitalizations in Latin America (LATAM) Background The SARS-Cov-2 is one of the largest and most active threats to healthcare in living memory. There is an information gap on imaging services resources (ISR) used and their findings during the pandemic in LATAM. Methods This was a multicenter, prospective, observational study of COVID-19 inpatients conducted from March to December 2020 from 12 high-complexity centers in nine LATAM countries. Adults (> 18 yrs) with at least one imaging modality performed, followed from admission until discharge and/or in-hospital death, were included. Results We studied 1435 hospitalized patients (64% males) with a median age of 58 years classified into three regions: 262 from Mexico (Mx), 428 from Central America and Caribbean (CAC), and 745 from South America (SAm). More frequent comorbidities were overweight/obesity (61%), hypertension (45%), and diabetes (27%). During hospitalization, 58% were admitted to ICU. The in-hospital mortality was 28% (95%CI 25-30) highest in Mx (37%). The most frequent cardiopulmonary imaging performed were cCT (61%)-more frequent in Mx and SAm-, and cX-ray (46%) -significantly used in CAC-. The cEcho was carried out in 18%, similarly among regions, and LUS in 7%, more frequently in Mx. The cMRI was performed in only one patient in the cohort. Abnormal findings on the cX-ray were related to peripheral (63%) or basal infiltrates (52%), and in cCT with ground glass infiltrates (89%). Both were more commonly in Mx. In LUS, interstitial syndrome (56%) was the most related abnormal finding, predominantly in Mx and CAC. Conclusions The use and findings of cardiopulmonary imaging in LATAM varied between regions and may have been influenced by clinical needs, the personnel protection measures and/or hospitalization location.