array:25 [
  "pii" => "S0873215911001036"
  "issn" => "08732159"
  "doi" => "10.1016/j.rppneu.2011.07.004"
  "estado" => "S300"
  "fechaPublicacion" => "2012-01-01"
  "aid" => "49"
  "copyright" => "Sociedade Portuguesa de Pneumologia"
  "copyrightAnyo" => "2011"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Rev Port Pneumol. 2012;18:22-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 10582
    "formatos" => array:3 [
      "EPUB" => 250
      "HTML" => 8745
      "PDF" => 1587
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:20 [
      "pii" => "S2173511511000881"
      "issn" => "21735115"
      "doi" => "10.1016/j.rppnen.2011.11.011"
      "estado" => "S300"
      "fechaPublicacion" => "2012-01-01"
      "aid" => "49"
      "copyright" => "Sociedade Portuguesa de Pneumologia"
      "documento" => "article"
      "crossmark" => 0
      "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
      "subdocumento" => "fla"
      "cita" => "Rev Port Pneumol. 2012;18:22-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 5117
        "formatos" => array:3 [
          "EPUB" => 261
          "HTML" => 3599
          "PDF" => 1257
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
        "titulo" => "Sleep Apnea&#8211;Hypopnea Syndrome and Acute Coronary Syndrome &#8211; An association not to forget"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "22"
            "paginaFinal" => "28"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "S&#237;ndrome da Apneia-Hipopneia do Sono e S&#237;ndrome Coron&#225;ria Aguda &#8211; Uma Associa&#231;&#227;o a N&#227;o Esquecer"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "pt" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 847
                "Ancho" => 1576
                "Tamanyo" => 88873
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patients that performed AL&#46; AL&#58; ApneaLink&#8482;&#59; AHI&#58; apnea&#8211;hypopnea index&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "V&#46; Areias, J&#46; Romero, K&#46; Cunha, R&#46; Faria, J&#46; Mimoso, V&#46; Gomes, U&#46; Brito"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "V&#46;"
                "apellidos" => "Areias"
              ]
              1 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Romero"
              ]
              2 => array:2 [
                "nombre" => "K&#46;"
                "apellidos" => "Cunha"
              ]
              3 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Faria"
              ]
              4 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Mimoso"
              ]
              5 => array:2 [
                "nombre" => "V&#46;"
                "apellidos" => "Gomes"
              ]
              6 => array:2 [
                "nombre" => "U&#46;"
                "apellidos" => "Brito"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S0873215911001036"
          "doi" => "10.1016/j.rppneu.2011.07.004"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "pt"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215911001036?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511511000881?idApp=UINPBA00004E"
      "url" => "/21735115/0000001800000001/v1_201305151555/S2173511511000881/v1_201305151555/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S0873215911001048"
    "issn" => "08732159"
    "doi" => "10.1016/j.rppneu.2011.07.005"
    "estado" => "S300"
    "fechaPublicacion" => "2012-01-01"
    "aid" => "50"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Pneumol. 2012;18:29-33"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 8956
      "formatos" => array:3 [
        "EPUB" => 251
        "HTML" => 7208
        "PDF" => 1497
      ]
    ]
    "pt" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>"
      "titulo" => "Avalia&#231;&#227;o de efic&#225;cia de Sess&#245;es de Educa&#231;&#227;o a doentes com Asma e DPOC"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "29"
          "paginaFinal" => "33"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Efficacy Evaluation of educational sessions for patients with Asthma and COPD"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Figura 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 861
              "Ancho" => 1514
              "Tamanyo" => 71110
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Respostas correctas obtidas no Question&#225;rio na Sess&#227;o de DPOC&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46; van Zeller, A&#46;P&#46; Vaz, F&#46; Soares Pires, I&#46; Neves, M&#46; Drummond, A&#46;M&#46; Carvalho, P&#46; Moura Relvas"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "van Zeller"
            ]
            1 => array:2 [
              "nombre" => "A&#46;P&#46;"
              "apellidos" => "Vaz"
            ]
            2 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Soares Pires"
            ]
            3 => array:2 [
              "nombre" => "I&#46;"
              "apellidos" => "Neves"
            ]
            4 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Drummond"
            ]
            5 => array:2 [
              "nombre" => "A&#46;M&#46;"
              "apellidos" => "Carvalho"
            ]
            6 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Moura Relvas"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173511511000893"
        "doi" => "10.1016/j.rppnen.2011.11.012"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511511000893?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215911001048?idApp=UINPBA00004E"
    "url" => "/08732159/0000001800000001/v2_201509041308/S0873215911001048/v2_201509041308/pt/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S0873215911001024"
    "issn" => "08732159"
    "doi" => "10.1016/j.rppneu.2011.06.016"
    "estado" => "S300"
    "fechaPublicacion" => "2012-01-01"
    "aid" => "48"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Pneumol. 2012;18:15-21"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 7925
      "formatos" => array:3 [
        "EPUB" => 275
        "HTML" => 6279
        "PDF" => 1371
      ]
    ]
    "pt" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>"
      "titulo" => "Preval&#234;ncia de ins&#243;nia de novo em doentes com s&#237;ndrome de apneia obstrutiva do sono tratados com suporte ventilat&#243;rio nocturno"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "15"
          "paginaFinal" => "21"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Prevalence of new-onset insomnia in patients with obstructive sleep apnoea syndrome treated with nocturnal ventilatory support"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 903
              "Ancho" => 2243
              "Tamanyo" => 59329
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribui&#231;&#227;o dos subtipos de ins&#243;nia de novo &#40;IN&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "P&#46; Caetano Mota, S&#46; Morais Cardoso, M&#46; Drummond, A&#46;C&#46; Santos, J&#46; Almeida, J&#46;C&#46; Winck"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Caetano Mota"
            ]
            1 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Morais Cardoso"
            ]
            2 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Drummond"
            ]
            3 => array:2 [
              "nombre" => "A&#46;C&#46;"
              "apellidos" => "Santos"
            ]
            4 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Almeida"
            ]
            5 => array:2 [
              "nombre" => "J&#46;C&#46;"
              "apellidos" => "Winck"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S217351151100087X"
        "doi" => "10.1016/j.rppnen.2011.06.009"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217351151100087X?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215911001024?idApp=UINPBA00004E"
    "url" => "/08732159/0000001800000001/v2_201509041308/S0873215911001024/v2_201509041308/pt/main.assets"
  ]
  "pt" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>"
    "titulo" => "S&#237;ndrome da Apneia-Hipopneia do Sono e S&#237;ndrome Coron&#225;ria Aguda &#8211; Uma associa&#231;&#227;o a n&#227;o esquecer"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "22"
        "paginaFinal" => "28"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "V&#46; Areias, J&#46; Romero, K&#46; Cunha, R&#46; Faria, J&#46; Mimoso, V&#46; Gomes, U&#46; Brito"
        "autores" => array:7 [
          0 => array:4 [
            "nombre" => "V&#46;"
            "apellidos" => "Areias"
            "email" => array:1 [
              0 => "vandareias&#64;hotmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Romero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "K&#46;"
            "apellidos" => "Cunha"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Faria"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Mimoso"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "V&#46;"
            "apellidos" => "Gomes"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "U&#46;"
            "apellidos" => "Brito"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servi&#231;o de Pneumologia&#44; Hospital de Faro&#44; EPE&#44; Faro&#44; Portugal"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servi&#231;o de Cardiologia&#44; Hospital de Faro&#44; EPE&#44; Faro&#44; Portugal"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspond&#234;ncia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Sleep apnea-hypopnea syndrome and acute coronary syndrome &#8211; an association not to forget"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1194
            "Ancho" => 1556
            "Tamanyo" => 95344
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Gr&#225;fico Bland-Altman para IAH do AL e IAH PSG&#46;</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">IAH&#58; &#205;ndice de Apneia-Hipopneia&#59; AL&#58; ApneaLink&#59; PSG&#58; Polissonografia&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">A S&#237;ndrome de Apneia-Hipopneia do Sono &#40;SAHS&#41; &#233; um importante problema de sa&#250;de p&#250;blica n&#227;o s&#243; pela sua associa&#231;&#227;o a hipersonol&#234;ncia&#44; acidentes de via&#231;&#227;o&#44; morbilidade cardiovascular&#44; altera&#231;&#245;es cognitivas&#44; ansiedade&#44; depress&#227;o e altera&#231;&#245;es metab&#243;licas&#44; como tamb&#233;m pela sua elevada preval&#234;ncia<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; Segundo os cl&#225;ssicos estudos de Young&#44; 2-4&#37; da popula&#231;&#227;o adulta tem SAHS<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#44; embora os &#250;ltimos estudos apontem que entre 3&#44;7&#37; e 26&#37; da popula&#231;&#227;o tem um &#237;ndice de apneia-hipopneia &#40;IAH&#41; superior a 5 eventos por hora<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46; Se considerarmos um IAH &#62; 5&#47;h e a presen&#231;a de hipersonol&#234;ncia&#44; a preval&#234;ncia estimada para SAHS &#233; de 1&#44;2-7&#44;5&#37;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A cardiopatia isqu&#233;mica&#44; nomeadamente a S&#237;ndrome Coron&#225;ria Aguda &#40;SCA&#41; representa&#44; tamb&#233;m&#44; um grave problema devido &#224; sua elevada preval&#234;ncia&#44; complica&#231;&#245;es associadas e mortalidade&#46; V&#225;rios estudos t&#234;m demonstrado uma associa&#231;&#227;o independente entre SAHS e SCA&#44; sugerindo que a SAHS deve ser tida em conta como um factor de risco a considerar em doentes com SCA<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#8211;6</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">As altera&#231;&#245;es observadas na SAHS&#44; nomeadamente&#44; a hipox&#233;mia intermitente&#44; a acidose e a vasoconstri&#231;&#227;o simp&#225;tica&#44; podem originar stress hemodin&#226;mico&#44; que tem particular import&#226;ncia em doentes com doen&#231;a coron&#225;ria&#44; podendo originar isqu&#233;mia do mioc&#225;rdio ou angina nocturna<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;9</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">A maioria dos doentes com SAHS permanecem sem diagn&#243;stico e sem tratamento<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a>&#44; podendo isto ser particularmente importante em doentes com patologia cardiovascular&#44; que poderiam beneficiar do diagn&#243;stico para minimizar o risco de novos eventos cardiovasculares<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">O objectivo deste estudo foi analisar a preval&#234;ncia da SAHS em doentes com SCA e&#44; adicionalmente&#44; determinar a exist&#234;ncia de factores cl&#237;nicos preditivos de SAHS e comparar a correla&#231;&#227;o do IAH obtido com um equipamento de estudo de sono simplificado &#40;ESS&#41; com o IAH obtido na polissonografia completa &#40;PSG&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Material e m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Amostra</span><p id="par0030" class="elsevierStylePara elsevierViewall">Estudo prospectivo de 91 doentes consecutivos com SCA&#44; com les&#227;o demonstrada por coronariografia&#44; internados na unidade de cuidados intensivos coron&#225;rios &#40;UCIC&#41; do nosso hospital&#44; durante o per&#237;odo de Maio a Agosto de 2009&#46; Foram exclu&#237;dos os doentes&#58; n&#227;o residentes na &#225;rea de refer&#234;ncia do hospital&#44; com diagn&#243;stico pr&#233;vio de SAHS&#44; com estado confusional&#44; consumo de sedativos nas &#250;ltimas 24 horas&#44; instabilidade hemodin&#226;mica&#44; necessidade de oxigenoterapia e os que recusaram participar no estudo&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Foi obtida autoriza&#231;&#227;o da Comiss&#227;o de &#201;tica do Hospital de acordo com a Declara&#231;&#227;o de Hels&#237;nquia e assinado o consentimento informado pelo doente antes da realiza&#231;&#227;o do estudo&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Desenho do estudo</span><p id="par0040" class="elsevierStylePara elsevierViewall">Todos os doentes realizaram um question&#225;rio com as seguintes vari&#225;veis&#58; dados demogr&#225;ficos&#44; h&#225;bitos toxicof&#237;licos&#44; h&#225;bitos de sono&#44; antecedentes patol&#243;gicos&#44; medica&#231;&#227;o&#44; sintomas sugestivos de SAHS&#44; escala de sonol&#234;ncia de <span class="elsevierStyleItalic">Epworth</span> &#40;ESE&#41;&#44; dados cl&#237;nicos e cronol&#243;gicos do evento coron&#225;rio agudo&#44; exame objectivo e medi&#231;&#245;es antropom&#233;tricas&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Os doentes que cumpriam os crit&#233;rios de inclus&#227;o realizaram um primeiro ESS com o equipamento ApneaLink&#8482; &#40;ResMed Corporation&#44; Poway&#44; Calif&#41;&#46; O ApneaLink&#8482; &#40;AL&#41; tem 2 sensores &#40;c&#226;nula de fluxo nasal e ox&#237;metro&#41;&#44; fornecendo informa&#231;&#227;o sobre 4 vari&#225;veis&#58; fluxo respirat&#243;rio&#44; ressonar&#44; satura&#231;&#227;o perif&#233;rica de oxig&#233;nio e frequ&#234;ncia card&#237;aca&#46; O AL utiliza um programa pr&#243;prio que analisa de forma autom&#225;tica o IAH&#44; entre outros par&#226;metros e&#44; ainda&#44; permite realizar uma an&#225;lise manual &#40;vers&#227;o 8&#41;&#46; A leitura do AL foi realizada autom&#225;tica e manualmente&#44; sempre pelo mesmo m&#233;dico e de forma oculta&#46; Apneia foi definida como a diminui&#231;&#227;o de 90&#37; do sinal do fluxo durante um m&#237;nimo de 10 segundos&#46; A hipopneia foi definida como uma redu&#231;&#227;o do fluxo nasal igual ou superior a 30&#37; do basal&#44; durante pelo menos 10 segundos e acompanhada de dessatura&#231;&#227;o igual ou superior a 4&#37;&#46; N&#227;o foram considerados estudos com menos de 5 horas de registo&#46; Estudos de valida&#231;&#227;o do AL demonstram que este equipamento de estudo de sono tem uma boa sensibilidade e especificidade para IAH &#8805; 10&#47;h na PSG&#44; 82&#44;1&#37; e 83&#44;9&#37; respectivamente<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;14&#44;15</span></a>&#46; Assim&#44; o estudo realizado com o AL foi considerado positivo quando IAH &#8805; 10&#47;h&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Aos doentes que&#44; ap&#243;s leitura manual do registo do AL&#44; apresentavam um IAH &#8805; 10&#47;h foi proposta a realiza&#231;&#227;o de PSG e AL em simult&#226;neo&#46; Durante o estudo a c&#226;nula nasal foi ligada a um conector em &#8220;Y&#8221; permitindo o registo em simult&#226;neo do fluxo nasal no AL e PSG&#46; A PSG completa foi realizada no laborat&#243;rio de sono&#44; com o equipamento Embla<span class="elsevierStyleSup">&#174;</span> N7000 &#40;Embla Systems&#44; Broomfield&#44; CO&#44; USA&#41; com registo de vari&#225;veis fisiol&#243;gicas&#58; 6 canais de electroencefalograma&#44; electrooculograma&#44; electromiograma &#40;submentoniano e tibiais anteriores&#41;&#44; electrocardiograma&#44; termistor e c&#226;nula nasal&#44; bandas de esfor&#231;o tor&#225;cico e abdominal &#40;pletismografia de induct&#226;ncia&#41;&#44; microfone&#44; posi&#231;&#227;o corporal&#44; oximetria&#44; frequ&#234;ncia card&#237;aca e v&#237;deo&#46; A leitura da PSG foi manual&#44; sem o investigador ter conhecimento pr&#233;vio dos resultados do AL e da informa&#231;&#227;o do doente&#44; conforme as recomenda&#231;&#245;es da <span class="elsevierStyleItalic">American Academy of Sleep Medicine</span> &#40;AASM&#41; &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">A SAHS foi definida de acordo com os crit&#233;rios da <span class="elsevierStyleItalic">International Classification of Sleep Disorders</span> &#40;ICSD-2&#41;&#44; proposta pela AASM<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&#46; Considerou-se SAHS se tinham o IAH&#44; medido com PSG&#44; entre 5-14&#44;9&#47;h e apresentavam pelo menos um dos sintomas como ressonar&#44; fadiga&#44; sonol&#234;ncia diurna e apneias observadas durante o sono&#44; ou os indiv&#237;duos com o IAH &#8805; 15&#47;h independentemente da presen&#231;a de qualquer sintoma adicional&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">An&#225;lise estat&#237;stica</span><p id="par0060" class="elsevierStylePara elsevierViewall">Todas as vari&#225;veis foram testadas relativamente &#224; sua distribui&#231;&#227;o normal mediante o histograma de frequ&#234;ncias e teste de Kolmogorov-Smirnov&#46; A diferen&#231;a entre duas m&#233;dias foi determinada utilizando o teste <span class="elsevierStyleItalic">T-student</span> ou <span class="elsevierStyleItalic">Welch-test</span>&#46; Quando as vari&#225;veis apresentavam uma distribui&#231;&#227;o normal utilizou-se o teste <span class="elsevierStyleItalic">T-student</span>&#44; se pelo contr&#225;rio esta n&#227;o fosse normal&#44; usou-se o <span class="elsevierStyleItalic">Welch-test</span>&#46; Propor&#231;&#245;es e vari&#225;veis categ&#243;ricas foram analisadas com o teste do Qui-quadrado ou de <span class="elsevierStyleItalic">Fisher</span> quando adequado&#46; Considerou-se estatisticamente significativo um valor p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; A an&#225;lise de correla&#231;&#245;es foi efectuada utilizando o coeficiente de correla&#231;&#227;o de <span class="elsevierStyleItalic">Pearson</span> e o coeficiente de correla&#231;&#227;o intraclasse&#46; A an&#225;lise de <span class="elsevierStyleItalic">Bland-Altman</span> &#233; uma representa&#231;&#227;o gr&#225;fica das diferen&#231;as observadas entre as 2 t&#233;cnicas &#40;PSG e AL&#41; em rela&#231;&#227;o &#224; sua m&#233;dia&#44; de forma que os resultados com reduzida diferen&#231;a em rela&#231;&#227;o &#224; m&#233;dia indicam pouco enviesamento sistem&#225;tico&#46; Os dados foram analisados estatisticamente com o software MedCalc<span class="elsevierStyleSup">&#174;</span> &#40;vers&#227;o 9&#46;3&#44; Mariakerke&#44; B&#233;lgica&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><p id="par0065" class="elsevierStylePara elsevierViewall">Dos 91 doentes admitidos inicialmente na UCIC por SCA nos 4 meses do estudo&#44; 24 doentes n&#227;o residiam na &#225;rea hospitalar&#44; 7 n&#227;o aceitaram participar no estudo&#44; 1 faleceu nas primeiras horas do internamento e 1 j&#225; tinha diagn&#243;stico de SAHS&#46; Portanto&#44; foram inclu&#237;dos 58 doentes na an&#225;lise final&#46; A maioria era do sexo masculino &#40;74&#37;&#41;&#44; m&#233;dia et&#225;ria de 61&#44;7 anos e &#237;ndice de massa corporal &#40;IMC&#41; m&#233;dio de 27&#44;4 Kg&#47;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; As caracter&#237;sticas dos doentes encontram-se representadas na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; Vinte e oito doentes &#40;48&#44;3&#37;&#41; realizaram o estudo com o AL durante o internamento e os restantes 30 doentes &#40;51&#44;7&#37;&#41; realizaram-no em ambulat&#243;rio&#44; tendo sido a mediana do tempo desde a SCA at&#233; &#224; realiza&#231;&#227;o do AL de 4 e 17&#44;5 dias respectivamente&#46; Dos 58 doentes que realizaram o ESS com AL 43&#44;1&#37; obteve um IAH &#8805; 10&#47;h&#44; sendo que destes 27&#44;6&#37; tinham um IAH &#8805; 15&#47;h e 12&#44;1&#37; um IAH &#8805; 30&#47;h &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a> e <a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Os doentes foram comparados em dois grupos segundo o resultado do AL &#40;IAH<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10&#47;h <span class="elsevierStyleItalic">versus</span> IAH &#8805; 10&#47;h&#41;&#44; relativamente &#224;s caracter&#237;sticas antropom&#233;tricas&#44; cl&#237;nicas e antecedentes&#46; Observaram-se diferen&#231;as estatisticamente significativas nas vari&#225;veis&#58; exist&#234;ncia de obesidade&#59; per&#237;metros de pesco&#231;o&#44; abdominal e anca&#59; classifica&#231;&#227;o de Mallampati&#59; hist&#243;ria de apneias observadas&#59; hist&#243;ria de nict&#250;ria&#59; ESE e antecedentes de doen&#231;a isqu&#233;mica card&#237;aca &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46; Ainda&#44; em 48&#37; dos doentes do grupo com IAH &#8805; 10&#47;h os sintomas card&#237;acos tiveram in&#237;cio durante a noite &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;009&#41; e na maioria destes doentes a tradu&#231;&#227;o electrocardiogr&#225;fica da SCA foi sem eleva&#231;&#227;o de ST &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;043&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Dos 25 doentes com resultado de IAH &#8805; 10&#47;h no AL&#44; 3 doentes recusaram fazer posterior PSG e AL em simult&#226;neo&#46; A mediana da demora desde a SCA at&#233; &#224; realiza&#231;&#227;o da PSG foi de 30 dias&#46; Dos 22 doentes que realizaram em simult&#226;neo o AL e a PSG&#44; esta confirmou a positividade de todos os casos de SAHS detectados com o AL&#46; Comparando os resultados do IAH do primeiro AL com o IAH obtido na PSG&#44; em 14 doentes &#40;63&#44;6&#37;&#41; foi alterada a classifica&#231;&#227;o da SAHS ap&#243;s a realiza&#231;&#227;o da PSG &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46; Em 6 doentes que no primeiro AL foram classificados como ligeiros&#44; ap&#243;s a realiza&#231;&#227;o da PSG 5 foram classificados como moderados e 1 como grave&#59; 5 doentes que inicialmente foram classificados como moderados ap&#243;s PSG passaram a ser graves&#46; Apenas 3 doentes foram classificados num est&#225;dio de menor gravidade ap&#243;s a realiza&#231;&#227;o da PSG&#44; assim 1 doente que no primeiro AL tinha sido avaliado como moderado passou a ligeiro e 2 que eram graves passaram a moderados&#46; Houve 2 doentes que apresentavam um predom&#237;nio de apneias centrais na PSG&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">O gr&#225;fico <span class="elsevierStyleItalic">Bland-Altman</span> mostrou uma distribui&#231;&#227;o razo&#225;vel da diferen&#231;a entre o IAH da PSG e do AL realizados em simult&#226;neo &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46; Comparando com a PSG&#44; o AL subvalorizou o IAH em m&#233;dia 6&#44;3 eventos hora&#44; isto ocorreu principalmente quando IAH era superior a 30 eventos por hora&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Foi obtida uma correla&#231;&#227;o muito boa entre o IAH do AL e o IAH da PSG realizados em simult&#226;neo&#44; com um coeficiente de correla&#231;&#227;o de <span class="elsevierStyleItalic">Pearson</span> de 0&#44;91 &#40;0&#44;79-0&#44;96&#41; e coeficente de correla&#231;&#227;o intraclasse de 0&#44;93 &#40;0&#44;82-0&#44;97&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Segundo a defini&#231;&#227;o da AASM<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&#44; todos os doentes que realizaram a PSG cumpriam os crit&#233;rios de SAHS&#46; Portanto&#44; os doentes que concordaram&#44; iniciaram tratamento com auto-CPAP &#40;19 doentes&#41; e servoventila&#231;&#227;o &#40;2 doentes&#41;&#44; conforme indica&#231;&#227;o&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discuss&#227;o</span><p id="par0095" class="elsevierStylePara elsevierViewall">No nosso estudo foi detectado uma elevada preval&#234;ncia de SAHS &#40;43&#44;1&#37;&#41; em doentes admitidos com SCA numa UCIC e 27&#44;6&#37; foram classificados como moderados ou graves segundo o AL&#46; A PSG confirmou a positividade de todos os casos detectados com o AL&#46; Os nossos resultados foram consistentes com os obtidos noutros estudos&#44; que descrevem uma associa&#231;&#227;o entre SAHS e doen&#231;a coron&#225;ria<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;6&#44;7&#44;18&#44;19</span></a>&#46; Num trabalho desenvolvido noutro Centro Hospitalar em Portugal&#44; estes observaram uma preval&#234;ncia de SAHS em 65&#44;9&#37; dos doentes com SCA&#44; sendo que 22&#44;7&#37; foram classificados como graves<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Os doentes internados com SCA na UCIC eram na sua maioria do sexo masculino&#44; com m&#233;dia et&#225;ria de 61&#44;7 anos e um IMC m&#233;dio de 27&#44;4 Kg&#47;m<span class="elsevierStyleSup">2</span>&#46; Estes doentes apresentavam uma preval&#234;ncia elevada de HTA e dislipid&#233;mia&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Cerca de metade dos doentes realizaram o ESS com o AL durante o internamento &#40;no epis&#243;dio agudo&#41; e os restantes efectuaram-no em ambulat&#243;rio &#40;no domic&#237;lio&#41;&#44; numa fase est&#225;vel da sua doen&#231;a card&#237;aca&#46; Desta forma&#44; foi provavelmente&#44; eliminado algum eventual vi&#233;s&#44; nomeadamente&#58; efeito de alguma medica&#231;&#227;o que tenha sido administrada no internamento&#44; realiza&#231;&#227;o do ESS na fase aguda e poder existir algum grau de disfun&#231;&#227;o card&#237;aca e&#44; consequentemente&#44; aparecimento de eventos centrais ou sono de m&#225; qualidade derivado do stress da situa&#231;&#227;o cl&#237;nica ou da actividade incessante pr&#243;pria duma sala de cuidados intensivos&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Comparando os dois grupos de doentes &#40;IAH &#60; 10&#47;h versus IAH &#8805; 10&#47;h&#41;&#44; o grupo de doentes com SAHS&#44; do ponto de vista antropom&#233;trico&#44; apresentava maior n&#250;mero de obesos&#44; valores de per&#237;metros cervical&#44; abdominal e de anca superiores e classifica&#231;&#227;o III-IV de Mallampati&#44; aspectos caracter&#237;sticos do doente com &#8220;fenotipo t&#237;pico&#8221; de SAHS&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">O grupo de doentes com SAHS apresentava nict&#250;ria e apneias observadas em maior propor&#231;&#227;o&#44; sendo estes dois sintomas frequentes nesta doen&#231;a&#46; De real&#231;ar&#44; que mesmo os doentes com apneias observadas n&#227;o tinham recorrido ao seu m&#233;dico assistente para realiza&#231;&#227;o de um eventual estudo&#44; refletindo a escassa informa&#231;&#227;o da popula&#231;&#227;o sobre a import&#226;ncia deste sintoma&#46; Salienta-se que&#44; apesar dos doentes com SAHS apresentarem um valor m&#233;dio superior na ESE&#44; este era inferior ao valor de refer&#234;ncia para sonol&#234;ncia excessiva &#40;ESE &#8805; 10&#41;&#44; portanto n&#227;o parece ser este um factor determinante na defini&#231;&#227;o de SAHS nestes doentes&#46; S&#227;o conhecidas as limita&#231;&#245;es da ESE quando&#44; por vezes&#44; os doentes subestimam a sua sonol&#234;ncia e&#44; ainda &#233; motivo de controv&#233;rsia a exist&#234;ncia de doentes com SAHS grave sem sonol&#234;ncia excessiva<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Assim&#44; os dados que podem sugerir a presen&#231;a de SAHS s&#227;o os valores mais elevados nos dados antropom&#233;tricos&#44; as classes III ou IV da classifica&#231;&#227;o de Mallampati&#44; a hist&#243;ria de nict&#250;ria e de apneias observadas&#46; Contudo a inexist&#234;ncia destes n&#227;o nos permite excluir SAHS&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Em rela&#231;&#227;o aos antecedentes&#44; o grupo de doentes com SAHS apresentava significativamente maior n&#250;mero de epis&#243;dios pr&#233;vios de cardiopatia isqu&#233;mica &#40;angina e EAM&#41;&#44; situa&#231;&#227;o que poderia indicar uma maior vulnerabilidade dos doentes com les&#245;es coron&#225;rias aos epis&#243;dios de hipox&#233;mia intermitente e activa&#231;&#227;o simp&#225;tica&#46; Nos doentes com SAHS as apneias e hipopneias est&#227;o associadas a dessatura&#231;&#245;es e microdespertares que conduzem &#224; activa&#231;&#227;o do sistema nervoso simp&#225;tico&#44; que por sua vez provoca um aumento da frequ&#234;ncia card&#237;aca e da press&#227;o arterial sist&#243;lica&#46; A taquicardia e aumento da press&#227;o arterial sist&#243;lica aumentam a necessidade de oxig&#233;nio pelo mioc&#225;rdio&#44; que poder&#225; estar comprometida nos doentes com doen&#231;a arterial coron&#225;ria<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;9&#44;13</span></a>&#46; Por outro lado&#44; a hipox&#233;mia intermitente cr&#243;nica atrav&#233;s da indu&#231;&#227;o de mediadores inflamat&#243;rios&#44; de stress oxidativo e de disfun&#231;&#227;o endotelial conduz &#224; ateroesclerose<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;22</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Nos doentes com SAHS houve um predom&#237;nio de in&#237;cio dos sintomas caracter&#237;sticos da SCA durante a noite&#44; o que est&#225; de acordo com os resultados obtidos noutros estudos<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;18&#44;23</span></a>&#46; Na popula&#231;&#227;o em geral&#44; o in&#237;cio da SCA ocorre entre as 6-11 horas&#44; nos doentes com SAHS esta ocorre predominantemente entre as 22-6 horas&#46; Esta observa&#231;&#227;o sugere que a SAHS pode precipitar a SCA nocturna &#40;pelos mecanismos descritos anteriormente&#41; e que a SCA pode contribuir para uma predisposi&#231;&#227;o de morte s&#250;bita card&#237;aca nocturna observada nos doentes com SAHS<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;24&#44;25</span></a>&#46; Contudo&#44; n&#227;o foi detectada uma rela&#231;&#227;o entre a gravidade da doen&#231;a coron&#225;ria &#40;n&#250;mero de vasos afectados&#41; observada na angiografia e a presen&#231;a de SAHS&#46; Salienta-se que o grupo com SAHS apresentava&#44; na sua maioria&#44; SCA sem eleva&#231;&#227;o de ST&#44; o que pode estar em rela&#231;&#227;o com um aumento da necessidade de oxig&#233;nio ap&#243;s o per&#237;odo da apneia &#40;quando a satura&#231;&#227;o da oxihemoglobina se encontra no valor mais baixo&#41;&#44; devido ao aumento da press&#227;o arterial e da frequ&#234;ncia card&#237;aca<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;23</span></a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">No grupo total de doentes foram detectados&#44; com relativa frequ&#234;ncia&#44; eventos respirat&#243;rios centrais e epis&#243;dios breves de respira&#231;&#227;o de Cheyne-Stokes&#44; sendo significativos em 2 doentes&#44; embora os doentes apresentassem&#44; em m&#233;dia&#44; uma boa frac&#231;&#227;o de ejec&#231;&#227;o&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">A demora desde a SCA at&#233; &#224; realiza&#231;&#227;o da PSG foi razo&#225;vel&#44; dificultando o surgimento de alguns vi&#233;ses que pudessem modificar os resultados&#44; nomeadamente altera&#231;&#245;es do estilo de vida que conduzissem &#224; perda de peso ou altera&#231;&#245;es dos h&#225;bitos alco&#243;licos ou tab&#225;gicos&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Comparando os valores de IAH obtidos na PSG e AL simult&#226;neas&#44; estes apresentaram uma muito boa correla&#231;&#227;o&#44; confirmando a fiabilidade deste equipamento de estudo de sono&#44; j&#225; observada noutros estudos<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;14&#44;15</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Aos doentes com S&#237;ndrome de Apneia Obstrutiva do Sono &#40;SAOS&#41; foi-lhe proposta terap&#234;utica com as medidas higieno-diet&#233;ticas consensuais na SAOS e CPAP&#44; uma vez que o tratamento da SAOS em doentes com SCA est&#225; associado a uma redu&#231;&#227;o significativa nos eventos cardiovasculares&#44; definidos como morte de causa cardiovascular&#44; SCA&#44; internamentos por insufici&#234;ncia card&#237;aca ou necessidade de revasculariza&#231;&#227;o coron&#225;ria&#46; Por outro lado&#44; h&#225; um atraso na ocorr&#234;ncia destes eventos<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;13&#44;26&#8211;28</span></a>&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Apontamos como poss&#237;veis limita&#231;&#245;es do estudo o tamanho relativamente reduzido da amostra&#44; motivado em parte por exclus&#227;o de um elevado n&#250;mero de doentes turistas na regi&#227;o do Algarve que impossibilitava o seu seguimento e conclus&#227;o do estudo&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Um ponto &#8220;enigm&#225;tico&#8221; &#233; a possibilidade do n&#250;mero de eventos respirat&#243;rios&#44; detectados inicialmente&#44; diminuir com o tempo&#44; como sugerido num estudo realizado na Gr&#233;cia&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> onde os autores conclu&#237;ram que existia uma elevada preval&#234;ncia de SAHS na fase aguda da SCA &#40;54&#37;&#41; e que esta decrescia 6 meses ap&#243;s a SCA&#44; mantendo-se o diagn&#243;stico de SAHS apenas em 21&#37; dos doentes&#44; sugerindo que estas altera&#231;&#245;es podem ser transit&#243;rias&#46; Poss&#237;veis explica&#231;&#245;es s&#227;o a utiliza&#231;&#227;o de f&#225;rmacos &#40;por exemplo analg&#233;sicos opi&#243;ides&#44; e&#47;ou ansiol&#237;ticos&#41; enquanto os doentes est&#227;o internados na UCIC&#44; que podem afectar o padr&#227;o respirat&#243;rio durante o sono&#59; os doentes quando est&#227;o internados na UCIC encontram-se habitualmente na posi&#231;&#227;o supina&#59; a pr&#243;pria patologia cardiovascular aguda pode conduzir a altera&#231;&#245;es respirat&#243;rias durante o sono&#44; com tend&#234;ncia para o aparecimento de apneias centrais&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> S&#227;o necess&#225;rios mais estudos para confirmar ou contestar esta hip&#243;tese&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclus&#245;es</span><p id="par0165" class="elsevierStylePara elsevierViewall">Em s&#237;ntese&#44; e tendo em conta as limita&#231;&#245;es do estudo&#44; os resultados apontam para uma elevada preval&#234;ncia de SAHS em doentes com SCA&#46; Dada a elevada preval&#234;ncia observada&#44; parece justificada a inclus&#227;o de um estudo do sono no protocolo de investiga&#231;&#227;o dos doentes internados por SCA&#46; Apesar da PSG ser o teste de diagn&#243;stico <span class="elsevierStyleItalic">gold standard</span> para a SAHS &#233; imposs&#237;vel a sua realiza&#231;&#227;o devido aos recursos limitados e &#224; demora m&#233;dia prolongada para a sua execu&#231;&#227;o&#46; Tendo em conta a boa correla&#231;&#227;o do ESS com equipamentos como o ApneaLink&#8482; em rela&#231;&#227;o com a PSG&#44; assim como a sua f&#225;cil utiliza&#231;&#227;o e baixo custo&#44; poderia ser &#250;til como primeira linha diagn&#243;stica e em colabora&#231;&#227;o com a consulta de Sono&#46; Da mesma maneira que&#44; no contexto do SCA&#44; s&#227;o investigados e tratados outros factores de risco cardiovascular&#44; como por exemplo a HTA&#44; diabetes&#44; tabagismo ou a dislipidemia&#44; o diagn&#243;stico e controlo da SAHS poderia ser importante na preven&#231;&#227;o secund&#225;ria de novos eventos cardiovasculares&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflito de interesses</span><p id="par0170" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesses&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:2 [
          "identificador" => "xres547619"
          "titulo" => array:5 [
            0 => "Resumo"
            1 => "Objectivo"
            2 => "M&#233;todos"
            3 => "Resultados"
            4 => "Conclus&#227;o"
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec565499"
          "titulo" => "Palavras-chave"
        ]
        2 => array:2 [
          "identificador" => "xres547618"
          "titulo" => array:5 [
            0 => "Abstract"
            1 => "Aim"
            2 => "Methods"
            3 => "Results"
            4 => "Conclusion"
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec565498"
          "titulo" => "Keywords"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introdu&#231;&#227;o"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Material e m&#233;todos"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Amostra"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Desenho do estudo"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "An&#225;lise estat&#237;stica"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Resultados"
        ]
        7 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Discuss&#227;o"
        ]
        8 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Conclus&#245;es"
        ]
        9 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Conflito de interesses"
        ]
        10 => array:2 [
          "identificador" => "xack184909"
          "titulo" => "Agradecimentos"
        ]
        11 => array:1 [
          "titulo" => "Bibliografia"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2011-03-07"
    "fechaAceptado" => "2011-07-07"
    "PalabrasClave" => array:2 [
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec565499"
          "palabras" => array:4 [
            0 => "S&#237;ndrome de apneia do sono"
            1 => "S&#237;ndrome coron&#225;ria aguda"
            2 => "Preval&#234;ncia"
            3 => "Rastreio"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec565498"
          "palabras" => array:4 [
            0 => "Sleep apnea syndrome"
            1 => "Acute coronary syndrome"
            2 => "Prevalence"
            3 => "Screening"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span><span class="elsevierStyleSectionTitle">Objectivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Avaliar a preval&#234;ncia da S&#237;ndrome de Apneia-Hipopneia do Sono &#40;SAHS&#41; em doentes internados na Unidade de Cuidados Intensivos Coron&#225;rios &#40;UCIC&#41;&#59; determinar factores cl&#237;nicos preditivos de SAHS&#59; comparar os resultados obtidos com o estudo de sono simplificado &#40;ESS&#41; com os da polissonografia &#40;PSG&#41;&#46;</p></span> <span><span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudo prospectivo de doentes internados na UCIC com S&#237;ndrome Coron&#225;ria Aguda &#40;SCA&#41;&#44; confirmado por coronariografia&#46; Foram avaliados dados demogr&#225;ficos e antropom&#233;tricos&#44; factores de risco cardiovascular e valores da escala de sonol&#234;ncia de <span class="elsevierStyleItalic">Epworth</span>&#46; O ESS foi realizado com ApneaLink<span class="elsevierStyleSup">TM</span> durante o internamento ou ap&#243;s a alta&#46; Os doentes com &#237;ndice de apneia-hipopneia &#40;IAH&#41; &#8805; 10&#47;h foram convidados a realizar PSG&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Durante 4 meses foram seleccionados consecutivamente 91 doentes com SCA&#46; Cinquenta e oito doentes completaram o estudo&#44; sendo 43 &#40;74&#44;1&#37;&#41; do sexo masculino&#44; m&#233;dia et&#225;ria de 61&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;2 anos e &#237;ndice de massa corporal m&#233;dio de 27&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;5<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46; A mediana de tempo para realiza&#231;&#227;o do ESS foi de 17&#44;5 dias&#46; O estudo foi compat&#237;vel com SAHS em 25 casos &#40;43&#44;1&#37;&#41;&#46; Aos doentes com IAH &#8805; 10&#47;h no ESS foi proposta a realiza&#231;&#227;o de PSG e ESS em simult&#226;neo&#46; A mediana do tempo entre SCA e a PSG foi de 30 dias&#46; A PSG confirmou a positividade de todos os casos detectados pelo ESS&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Conclus&#227;o</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">No nosso estudo detect&#225;mos uma elevada preval&#234;ncia de SAHS em doentes com SCA internados na UCIC &#40;43&#44;1&#37;&#41;&#46; Os resultados suportam a necessidade de um m&#233;todo de rastreio da SAHS em doentes internados com SCA&#46; O ESS pode ter um papel importante no rastreio da SAHS nesta popula&#231;&#227;o&#46;</p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span><span class="elsevierStyleSectionTitle">Aim</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To evaluate the prevalence of Sleep Apnea-Hypopnea Syndrome &#40;SAHS&#41; in patients who were admitted with Acute Coronary Syndrome &#40;ACS&#41; to the Coronary Care Unit &#40;CCU&#41; and the clinical predictors of SAHS in patients with ACS and to compare the results of the simple sleep test &#40;SST&#41; with polysomnography &#40;PSG&#41;&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">This was a prospective study that included patients who were admitted to the CCU with ACS&#44; which was confirmed by coronary angiography&#46; Demographic and anthropometric data&#44; cardiovascular risk factors and measures on the Epworth Sleepiness Scale were collected&#46; The SST was conducted with the ApneaLink<span class="elsevierStyleSup">TM</span> device during hospitalization or after discharge&#46; Patients with an apnea-hypopnea index &#40;AHI&#41; &#8805; 10&#47;h were invited to participate in PSG&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Ninety-one patients with ACS were consecutively included over 4 months&#46; Of the fifty-eight patients who completed the study 43 &#40;74&#46;1&#37;&#41; were male&#46; The mean age was 61&#46;7&#177;12&#46;2 years&#44; and the mean body mass index was 27&#46;4&#177;3&#46;5<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46; The median time for SST performance was 17&#46;5 days&#46; This study was compatible with SAHS in 25 cases &#40;43&#46;1&#37;&#41;&#46; Patients who had an AHI &#8805; 10&#47;h in the SST were submitted to PSG and SST simultaneously&#46; The median interval between the ACS and the execution of PSG was 30 days&#46; PSG confirmed that all of the cases that were detected by SST were positive&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In our study&#44; we found a high prevalence of SAHS in patients who were admitted to the CCU with ACS &#40;43&#46;1&#37;&#41;&#46; These results support the need for SAHS screening in patients who are hospitalized with ACS&#46; The SST may have a role in the screening of SAHS in this population&#46;</p></span>"
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 847
            "Ancho" => 1576
            "Tamanyo" => 90318
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Doentes que realizaram AL&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">AL&#58; ApneaLink&#59; IAH&#58; &#205;ndice de Apneia-Hipopneia&#59; PSG&#58; Polissonografia&#59; SAHS&#58; S&#237;ndrome Apneia-Hipopneia do Sono&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 722
            "Ancho" => 1583
            "Tamanyo" => 96628
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Compara&#231;&#227;o do IAH nos doentes que realizaram AL e PSG posteriormente&#46;</p> <p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">AL&#58; ApneaLink&#59; PSG&#58; Polissonografia&#59; IAH&#58; &#205;ndice de Apneia-Hipopneia&#59; SAHS&#58; S&#237;ndrome Apneia-Hipopneia do Sono&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1194
            "Ancho" => 1556
            "Tamanyo" => 95344
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Gr&#225;fico Bland-Altman para IAH do AL e IAH PSG&#46;</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">IAH&#58; &#205;ndice de Apneia-Hipopneia&#59; AL&#58; ApneaLink&#59; PSG&#58; Polissonografia&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabela 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Dados apresentados em n&#250;mero &#40;&#37;&#41; excepto idade e IMC &#40;&#205;ndice de massa corporal&#41;&#44; com m&#233;dia<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD &#40;range&#41;&#46; &#205;ndice de Apneia-Hipopneia &#40;IAH&#41; segundo valores do estudo com ApneaLink&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Resultados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleBold">Caracter&#237;sticas demogr&#225;ficas</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Idade &#40;anos&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#44;7 &#177; 12&#44;2 &#40;22-87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">IMC &#40;Kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#44;4 &#177; 3&#44;5 &#40;20&#44;8-37&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Sexo</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Homem&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43 &#40;74&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Mulher&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;25&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleBold">Preval&#234;ncia de IAH</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IAH 10-14&#47;h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;15&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IAH 15-29&#47;h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;15&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IAH &#8805; 30&#47;h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;12&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleBold">Comorbilidades</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Dislipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43 &#40;74&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Hipertens&#227;o arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;72&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus tipo 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;29&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Cardiopatia isqu&#233;mica pr&#233;via&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;22&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab884588.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas demogr&#225;ficas&#44; preval&#234;ncia e comorbilidades dos 58 participantes do estudo&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Dados s&#227;o apresentados como n &#40;&#37;&#41; e m&#233;dia &#177; desvio padr&#227;o&#46; IMC&#58; &#205;ndice de massa corporal&#59; EAM&#58; Enfarte agudo do mioc&#225;rdio&#59; N&#176;&#58; N&#250;mero&#59; NS&#58; Estatisticamente n&#227;o significativo&#46; &#42; Teste do Qui-quadrado&#59; &#42;&#42; Teste <span class="elsevierStyleItalic">T-Student</span>&#59; &#42;&#42;&#42;<span class="elsevierStyleItalic">Welch-test&#46;</span></p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">IAH<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10&#47;h &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">IAH &#8805; 10&#47;h &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Valor p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sexo masculino</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;67&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;84&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Idade &#40;anos&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60 &#177; 12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64 &#177; 12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Obesidade &#40;IMC &#8805; 30 Kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;031&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Per&#237;metro do pesco&#231;o &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34 &#177; 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39 &#177; 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#42;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Per&#237;metro abdominal &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">93 &#177; 10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">99 &#177; 9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;012&#42;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Per&#237;metro das ancas &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">94 &#177; 10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100 &#177; 8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;034&#42;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Mallampati III &#43; IV</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">H&#225;bitos tab&#225;gicos &#40;Fumador&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">H&#225;bitos etan&#243;licos &#40;Habitual&#47;Ocasional&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27 &#40;81&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;76&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">N&#176; caf&#233;s por dia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;8 &#177; 1&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;6 &#177; 1&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">N&#176; de horas de sono</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;9 &#177; 1&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;8 &#177; 1&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Hipertens&#227;o arterial</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;70&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;76&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Dislipid&#233;mia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;73&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;76&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Diabetes mellitus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Cardiopatia isqu&#233;mica pr&#233;via</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;031&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Ressonar</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;79&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;84&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Apneias observadas</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Despertares nocturnos</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;32&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Nict&#250;ria &#40;n&#176; de vezes&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;018&#42;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sono agitado</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;21&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sono n&#227;o reparador</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;27&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Cefaleias</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Altera&#231;&#227;o da mem&#243;ria</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;39&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;52&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Altera&#231;&#227;o da concentra&#231;&#227;o</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Escala de Epworth</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;5 &#177; 2&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;4 &#177; 4&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;042&#42;&#42;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Escala de Epworth &#8805; 10</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Hora de in&#237;cio dos sintomas da SCA</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- 22&#58;01-06&#58;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;009&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- 06&#58;01-14&#58;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;45&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- 14&#58;01-22&#58;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;42&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">EAM sem supra de ST</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;69&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;043&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">N&#176; vasos afectados</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;7 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;0 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Frac&#231;&#227;o de ejec&#231;&#227;o</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#177; 14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59 &#177; 14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Hipertrofia do septo interventricular</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab884587.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas cl&#237;nicas e antropom&#233;tricas&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliografia"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:29 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obstrutive Sleep Apnea Syndrome in the Sao Paulo Epidemiologic Sleep Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Tufik"
                            1 => "R&#46; Silva"
                            2 => "J&#46; Taddei"
                            3 => "L&#46; Bittencourt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.sleep.2009.10.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Sleep Medicine"
                        "fecha" => "2010"
                        "volumen" => "11"
                        "paginaInicial" => "441"
                        "paginaFinal" => "446"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20362502"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of sleep apnoea&#47;hypopnoea syndrome and sleep-disordered breathing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Jennum"
                            1 => "R&#46; Riha"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Resp J"
                        "fecha" => "2009"
                        "volumen" => "33"
                        "paginaInicial" => "907"
                        "paginaFinal" => "914"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The occurrence of Sleep-Disorder Breathing among middle-aged adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46; Young"
                            1 => "M&#46; Palta"
                            2 => "J&#46; Dempsey"
                            3 => "J&#46; Skatrud"
                            4 => "S&#46; Weber"
                            5 => "S&#46; Badr"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Eng J Med"
                        "fecha" => "1993"
                        "volumen" => "328"
                        "paginaInicial" => "1230"
                        "paginaFinal" => "1235"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increased incidence of coronary artery disease in sleep apnoea&#58; a long-term follow up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46; Peker"
                            1 => "J&#46; Carlson"
                            2 => "J&#46; Hedner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.06.00107805"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2006"
                        "volumen" => "28"
                        "paginaInicial" => "596"
                        "paginaFinal" => "602"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16641120"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obstructive Sleep Apnea and Cardiovascular Disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Kato"
                            1 => "T&#46; Adachi"
                            2 => "Y&#46; Koshino"
                            3 => "V&#46; Somers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Circ J"
                        "fecha" => "2009"
                        "volumen" => "73"
                        "paginaInicial" => "1363"
                        "paginaFinal" => "1370"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19564701"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Accuracy of monitoring for sleep-related breathing disorders in the coronary care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Skinner"
                            1 => "M&#46; Choudhury"
                            2 => "S&#46; Homan"
                            3 => "J&#46; Cowan"
                            4 => "G&#46; Wilkins"
                            5 => "R&#46; Taylor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.127.1.66"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2005"
                        "volumen" => "127"
                        "paginaInicial" => "66"
                        "paginaFinal" => "71"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15653964"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obstrutive Sleep Apnea and Cardiovascular Disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Parish"
                            1 => "V&#46; Somers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4065/79.8.1036"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mayo Clin Proc"
                        "fecha" => "2004"
                        "volumen" => "79"
                        "paginaInicial" => "1036"
                        "paginaFinal" => "1046"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15301332"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sleep-Disordered Breathing and Myocardial Ischemia in Patients with Coronary Artery Disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46; Mooe"
                            1 => "K&#46; Franklin"
                            2 => "U&#46; Wiklund"
                            3 => "T&#46; Rabben"
                            4 => "K&#46; Holmstr&#246;m"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2000"
                        "volumen" => "117"
                        "paginaInicial" => "1597"
                        "paginaFinal" => "1602"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10858389"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular consequences of obstructive sleep apnoea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "F&#46; Kuniyoshi"
                            1 => "S&#46; Pusalavidyasagar"
                            2 => "P&#46; Singh"
                            3 => "V&#46; Somers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Indian J Med Res"
                        "fecha" => "2010"
                        "volumen" => "131"
                        "paginaInicial" => "196"
                        "paginaFinal" => "205"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20308745"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obstructive sleep apnea syndrome&#58; are we missing an at-risk population&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Lettieri"
                            1 => "A&#46; Eliasson"
                            2 => "T&#46; Andrada"
                            3 => "A&#46; Khramtsov"
                            4 => "M&#46; Raphaelson"
                            5 => "D&#46; Kristo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Sleep Med"
                        "fecha" => "2005"
                        "volumen" => "1"
                        "paginaInicial" => "381"
                        "paginaFinal" => "385"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17564406"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Underdiagnosis of sleep apnea syndrome in US communities"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "V&#46; Kapur"
                            1 => "K&#46; Strohl"
                            2 => "S&#46; Redline"
                            3 => "C&#46; Iber"
                            4 => "G&#46; O&#8217;Connor"
                            5 => "J&#46; Nieto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11325-002-0049-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Sleep Breath"
                        "fecha" => "2002"
                        "volumen" => "6"
                        "paginaInicial" => "49"
                        "paginaFinal" => "54"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12075479"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Utility of ApnealinkTM for the Diagnosis of Sleep Apnea-Hypopnea Syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Nigro"
                            1 => "F&#46; Serrano"
                            2 => "S&#46; Aimaretti"
                            3 => "S&#46; Gonzalez"
                            4 => "C&#46; Codinardo"
                            5 => "E&#46; Rhodius"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Medicina &#40;B Aires&#41;"
                        "fecha" => "2009"
                        "volumen" => "70"
                        "paginaInicial" => "53"
                        "paginaFinal" => "59"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Benefits of obstructive sleep apnoea treatment in coronary artery disease&#58; a long-term follow up study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "O&#46; Milleron"
                            1 => "R&#46; Pilliere"
                            2 => "A&#46; Foucher"
                            3 => "A&#46; Roquefeuil"
                            4 => "P&#46; Aegerter"
                            5 => "G&#46; Jondeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ehj.2004.02.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2004"
                        "volumen" => "25"
                        "paginaInicial" => "728"
                        "paginaFinal" => "734"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15120882"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validation of the ApneaLinkTM for the Screening of Sleep Apnea&#58; a Novel and Simple Single-Channel Recording Device"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Erman"
                            1 => "D&#46; Stewart"
                            2 => "D&#46; Einhorn"
                            3 => "N&#46; Gordon"
                            4 => "E&#46; Casal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Sleep Med"
                        "fecha" => "2007"
                        "volumen" => "3"
                        "paginaInicial" => "387"
                        "paginaFinal" => "392"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17694728"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validation of a portable recording device &#40;ApneaLink&#41; for identifying patients with suspected obstructive sleep apnoea syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Ng"
                            1 => "T&#46; Chan"
                            2 => "T&#46; Ngai"
                            3 => "A&#46; Tung"
                            4 => "F&#46; Ko"
                            5 => "D&#46; Hui"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1445-5994.2008.01827.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Internal Medicine Journal"
                        "fecha" => "2009"
                        "volumen" => "39"
                        "paginaInicial" => "757"
                        "paginaFinal" => "762"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19220528"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The AASM manual for the scoring of sleep and associated events&#58; rules&#44; terminology&#44; and technical specifications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Iber"
                            1 => "S&#46; Ancoli-Israel"
                            2 => "A&#46;L&#46; Chesson"
                            3 => "S&#46;F&#46; Quan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "edicion" => "1<span class="elsevierStyleSup">a</span> ed&#46;"
                        "fecha" => "2007"
                        "editorial" => "American Academy of Sleep Medicine"
                        "editorialLocalizacion" => "Westchester&#44; IL"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "International Classification of Sleep disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "American Academy of Sleep Medicine &#40;AASM&#41;"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2005"
                        "editorial" => "AASM"
                        "editorialLocalizacion" => "Wetchester"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An independent association between obstructive sleep apnoea and coronary artery disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Y&#46; Peker"
                            1 => "H&#46; Kraiczi"
                            2 => "J&#46; Hedner"
                            3 => "S&#46; L&#246;th"
                            4 => "A&#46; Johansson"
                            5 => "M&#46; Bende"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "1999"
                        "volumen" => "14"
                        "paginaInicial" => "179"
                        "paginaFinal" => "184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10489848"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospective Study of Obstructive Sleep Apnea and Incident Coronary Heart Disease and Heart Failure&#58; The Sleep Hearth Health Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Gottlieb"
                            1 => "G&#46; Yenokyan"
                            2 => "A&#46; Newman"
                            3 => "G&#46; O&#8217;Connor"
                            4 => "N&#46; Punjabi"
                            5 => "S&#46; Quan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.109.901801"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2010"
                        "volumen" => "122"
                        "paginaInicial" => "352"
                        "paginaFinal" => "360"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20625114"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "S&#237;ndrome coron&#225;ria aguda e SAOS &#8211; Uma associa&#231;&#227;o inequ&#237;voca &#40;estudo prospectivo&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:8 [
                            0 => "B&#46; Conde"
                            1 => "T&#46; Calvo"
                            2 => "E&#46; Matos"
                            3 => "A&#46; Ferreira"
                            4 => "C&#46; Barreiros"
                            5 => "I&#46; Ferradosa"
                            6 => "P&#46; Fontes"
                            7 => "A&#46; Afonso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Port Pneumol"
                        "fecha" => "2009"
                        "volumen" => "15"
                        "paginaInicial" => "S27"
                        "paginaFinal" => "S28"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "S&#237;ndrome de apneas-hiponeas durante el sue&#241;o sin somnolencia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46; Garcia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2008.07.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2009"
                        "volumen" => "45"
                        "paginaInicial" => "240"
                        "paginaFinal" => "244"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19395138"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular disease in obstructive sleep apnoea syndrome&#58; the role of intermittent hypoxia and inflammation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Garvey"
                            1 => "C&#46; Taylor"
                            2 => "W&#46; McNicholas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Resp J"
                        "fecha" => "2009"
                        "volumen" => "33"
                        "paginaInicial" => "1195"
                        "paginaFinal" => "1205"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obstructive Sleep apnea and Cardiovascular Disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Kato"
                            1 => "T&#46; Adachi"
                            2 => "Y&#46; Koshino"
                            3 => "V&#46; Somers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Circ J"
                        "fecha" => "2009"
                        "volumen" => "73"
                        "paginaInicial" => "1363"
                        "paginaFinal" => "1370"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19564701"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Day-night pattern of sudden death in obstrutive sleep apnea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Gami"
                            1 => "D&#46; Howard"
                            2 => "E&#46; Olson"
                            3 => "V&#46; Somers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Eng J Med"
                        "fecha" => "2005"
                        "volumen" => "352"
                        "paginaInicial" => "1206"
                        "paginaFinal" => "1214"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sleep-Disordered Breathing and Mortality&#58; A Prospective Cohort Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Punjabi"
                            1 => "B&#46; Caffo"
                            2 => "J&#46; Goodwin"
                            3 => "D&#46; Gottlieb"
                            4 => "A&#46; Newman"
                            5 => "G&#46; O¿Connor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pmed.1000132"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLoS Med"
                        "fecha" => "2009"
                        "volumen" => "6"
                        "paginaInicial" => "e1000132"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19688045"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term cardiovascular outcomes im men with obstructive sleep apnoea-hypopnoea syndrome with or without treatment with continuous positive airway pressure&#58; an observational study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Marin"
                            1 => "S&#46; Carrizo"
                            2 => "E&#46; Vicente"
                            3 => "A&#46; Agusti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(05)71141-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2005"
                        "volumen" => "365"
                        "paginaInicial" => "1046"
                        "paginaFinal" => "1053"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15781100"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Continuous positive airway pressure treatment of mild to moderate obstructive sleep apnea reduces cardiovascular risk"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46; Buchner"
                            1 => "B&#46; Sanner"
                            2 => "J&#46; Borgel"
                            3 => "L&#46; Rump"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.200611-1588OC"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2007"
                        "volumen" => "176"
                        "paginaInicial" => "1274"
                        "paginaFinal" => "1280"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17673692"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of obstructive sleep apnea is associated with decreased cardiac death after percutaneous coronary intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Cassar"
                            1 => "T&#46; Morgenthaler"
                            2 => "R&#46; Lennon"
                            3 => "C&#46; Rihal"
                            4 => "A&#46; Lerman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2007.06.028"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2007"
                        "volumen" => "50"
                        "paginaInicial" => "1310"
                        "paginaFinal" => "1314"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17903628"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sleep-disordered breathing in patients with acute coronary syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Bouloukaki"
                            1 => "E&#46; Simantirakis"
                            2 => "C&#46; Mermigis"
                            3 => "D&#46; Arfanakis"
                            4 => "S&#46; Chrysostomakis"
                            5 => "E&#46; Kallergis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Sleep Res"
                        "fecha" => "2010"
                        "volumen" => "19"
                        "paginaInicial" => "296"
                        "paginaFinal" => "297"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:3 [
        "identificador" => "xack184909"
        "titulo" => "Agradecimentos"
        "texto" => "<p id="par0175" class="elsevierStylePara elsevierViewall">Agradecemos a Linde Homecare e a Resmed o empr&#233;stimo dos equipamentos de estudo simplificado de sono para a realiza&#231;&#227;o do estudo&#46;</p>"
      ]
    ]
  ]
  "idiomaDefecto" => "pt"
  "url" => "/08732159/0000001800000001/v2_201509041308/S0873215911001036/v2_201509041308/pt/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9575"
    "tipo" => "SECCION"
    "pt" => array:2 [
      "titulo" => "Artigos originais"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "pt"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001800000001/v2_201509041308/S0873215911001036/v2_201509041308/pt/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215911001036?idApp=UINPBA00004E"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Artigo original
Síndrome da Apneia-Hipopneia do Sono e Síndrome Coronária Aguda – Uma associação a não esquecer
Sleep apnea-hypopnea syndrome and acute coronary syndrome – an association not to forget
V. Areiasa,
Corresponding author
vandareias@hotmail.com

Autor para correspondência.
, J. Romeroa, K. Cunhaa, R. Fariab, J. Mimosob, V. Gomesb, U. Britoa
a Serviço de Pneumologia, Hospital de Faro, EPE, Faro, Portugal
b Serviço de Cardiologia, Hospital de Faro, EPE, Faro, Portugal
Read
15663
Times
was read the article
3402
Total PDF
12261
Total HTML
Share statistics
 array:25 [
  "pii" => "S0873215911001036"
  "issn" => "08732159"
  "doi" => "10.1016/j.rppneu.2011.07.004"
  "estado" => "S300"
  "fechaPublicacion" => "2012-01-01"
  "aid" => "49"
  "copyright" => "Sociedade Portuguesa de Pneumologia"
  "copyrightAnyo" => "2011"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Rev Port Pneumol. 2012;18:22-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 10582
    "formatos" => array:3 [
      "EPUB" => 250
      "HTML" => 8745
      "PDF" => 1587
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:20 [
      "pii" => "S2173511511000881"
      "issn" => "21735115"
      "doi" => "10.1016/j.rppnen.2011.11.011"
      "estado" => "S300"
      "fechaPublicacion" => "2012-01-01"
      "aid" => "49"
      "copyright" => "Sociedade Portuguesa de Pneumologia"
      "documento" => "article"
      "crossmark" => 0
      "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
      "subdocumento" => "fla"
      "cita" => "Rev Port Pneumol. 2012;18:22-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 5117
        "formatos" => array:3 [
          "EPUB" => 261
          "HTML" => 3599
          "PDF" => 1257
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
        "titulo" => "Sleep Apnea&#8211;Hypopnea Syndrome and Acute Coronary Syndrome &#8211; An association not to forget"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "22"
            "paginaFinal" => "28"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "S&#237;ndrome da Apneia-Hipopneia do Sono e S&#237;ndrome Coron&#225;ria Aguda &#8211; Uma Associa&#231;&#227;o a N&#227;o Esquecer"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "pt" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 847
                "Ancho" => 1576
                "Tamanyo" => 88873
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patients that performed AL&#46; AL&#58; ApneaLink&#8482;&#59; AHI&#58; apnea&#8211;hypopnea index&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "V&#46; Areias, J&#46; Romero, K&#46; Cunha, R&#46; Faria, J&#46; Mimoso, V&#46; Gomes, U&#46; Brito"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "V&#46;"
                "apellidos" => "Areias"
              ]
              1 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Romero"
              ]
              2 => array:2 [
                "nombre" => "K&#46;"
                "apellidos" => "Cunha"
              ]
              3 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Faria"
              ]
              4 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Mimoso"
              ]
              5 => array:2 [
                "nombre" => "V&#46;"
                "apellidos" => "Gomes"
              ]
              6 => array:2 [
                "nombre" => "U&#46;"
                "apellidos" => "Brito"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S0873215911001036"
          "doi" => "10.1016/j.rppneu.2011.07.004"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "pt"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215911001036?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511511000881?idApp=UINPBA00004E"
      "url" => "/21735115/0000001800000001/v1_201305151555/S2173511511000881/v1_201305151555/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S0873215911001048"
    "issn" => "08732159"
    "doi" => "10.1016/j.rppneu.2011.07.005"
    "estado" => "S300"
    "fechaPublicacion" => "2012-01-01"
    "aid" => "50"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Pneumol. 2012;18:29-33"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 8956
      "formatos" => array:3 [
        "EPUB" => 251
        "HTML" => 7208
        "PDF" => 1497
      ]
    ]
    "pt" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>"
      "titulo" => "Avalia&#231;&#227;o de efic&#225;cia de Sess&#245;es de Educa&#231;&#227;o a doentes com Asma e DPOC"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "29"
          "paginaFinal" => "33"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Efficacy Evaluation of educational sessions for patients with Asthma and COPD"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Figura 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 861
              "Ancho" => 1514
              "Tamanyo" => 71110
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Respostas correctas obtidas no Question&#225;rio na Sess&#227;o de DPOC&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46; van Zeller, A&#46;P&#46; Vaz, F&#46; Soares Pires, I&#46; Neves, M&#46; Drummond, A&#46;M&#46; Carvalho, P&#46; Moura Relvas"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "van Zeller"
            ]
            1 => array:2 [
              "nombre" => "A&#46;P&#46;"
              "apellidos" => "Vaz"
            ]
            2 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Soares Pires"
            ]
            3 => array:2 [
              "nombre" => "I&#46;"
              "apellidos" => "Neves"
            ]
            4 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Drummond"
            ]
            5 => array:2 [
              "nombre" => "A&#46;M&#46;"
              "apellidos" => "Carvalho"
            ]
            6 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Moura Relvas"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173511511000893"
        "doi" => "10.1016/j.rppnen.2011.11.012"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511511000893?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215911001048?idApp=UINPBA00004E"
    "url" => "/08732159/0000001800000001/v2_201509041308/S0873215911001048/v2_201509041308/pt/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S0873215911001024"
    "issn" => "08732159"
    "doi" => "10.1016/j.rppneu.2011.06.016"
    "estado" => "S300"
    "fechaPublicacion" => "2012-01-01"
    "aid" => "48"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Pneumol. 2012;18:15-21"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 7925
      "formatos" => array:3 [
        "EPUB" => 275
        "HTML" => 6279
        "PDF" => 1371
      ]
    ]
    "pt" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>"
      "titulo" => "Preval&#234;ncia de ins&#243;nia de novo em doentes com s&#237;ndrome de apneia obstrutiva do sono tratados com suporte ventilat&#243;rio nocturno"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "15"
          "paginaFinal" => "21"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Prevalence of new-onset insomnia in patients with obstructive sleep apnoea syndrome treated with nocturnal ventilatory support"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 903
              "Ancho" => 2243
              "Tamanyo" => 59329
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribui&#231;&#227;o dos subtipos de ins&#243;nia de novo &#40;IN&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "P&#46; Caetano Mota, S&#46; Morais Cardoso, M&#46; Drummond, A&#46;C&#46; Santos, J&#46; Almeida, J&#46;C&#46; Winck"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Caetano Mota"
            ]
            1 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Morais Cardoso"
            ]
            2 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Drummond"
            ]
            3 => array:2 [
              "nombre" => "A&#46;C&#46;"
              "apellidos" => "Santos"
            ]
            4 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Almeida"
            ]
            5 => array:2 [
              "nombre" => "J&#46;C&#46;"
              "apellidos" => "Winck"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S217351151100087X"
        "doi" => "10.1016/j.rppnen.2011.06.009"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217351151100087X?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215911001024?idApp=UINPBA00004E"
    "url" => "/08732159/0000001800000001/v2_201509041308/S0873215911001024/v2_201509041308/pt/main.assets"
  ]
  "pt" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>"
    "titulo" => "S&#237;ndrome da Apneia-Hipopneia do Sono e S&#237;ndrome Coron&#225;ria Aguda &#8211; Uma associa&#231;&#227;o a n&#227;o esquecer"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "22"
        "paginaFinal" => "28"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "V&#46; Areias, J&#46; Romero, K&#46; Cunha, R&#46; Faria, J&#46; Mimoso, V&#46; Gomes, U&#46; Brito"
        "autores" => array:7 [
          0 => array:4 [
            "nombre" => "V&#46;"
            "apellidos" => "Areias"
            "email" => array:1 [
              0 => "vandareias&#64;hotmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Romero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "K&#46;"
            "apellidos" => "Cunha"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Faria"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Mimoso"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "V&#46;"
            "apellidos" => "Gomes"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "U&#46;"
            "apellidos" => "Brito"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servi&#231;o de Pneumologia&#44; Hospital de Faro&#44; EPE&#44; Faro&#44; Portugal"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servi&#231;o de Cardiologia&#44; Hospital de Faro&#44; EPE&#44; Faro&#44; Portugal"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspond&#234;ncia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Sleep apnea-hypopnea syndrome and acute coronary syndrome &#8211; an association not to forget"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1194
            "Ancho" => 1556
            "Tamanyo" => 95344
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Gr&#225;fico Bland-Altman para IAH do AL e IAH PSG&#46;</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">IAH&#58; &#205;ndice de Apneia-Hipopneia&#59; AL&#58; ApneaLink&#59; PSG&#58; Polissonografia&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">A S&#237;ndrome de Apneia-Hipopneia do Sono &#40;SAHS&#41; &#233; um importante problema de sa&#250;de p&#250;blica n&#227;o s&#243; pela sua associa&#231;&#227;o a hipersonol&#234;ncia&#44; acidentes de via&#231;&#227;o&#44; morbilidade cardiovascular&#44; altera&#231;&#245;es cognitivas&#44; ansiedade&#44; depress&#227;o e altera&#231;&#245;es metab&#243;licas&#44; como tamb&#233;m pela sua elevada preval&#234;ncia<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; Segundo os cl&#225;ssicos estudos de Young&#44; 2-4&#37; da popula&#231;&#227;o adulta tem SAHS<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#44; embora os &#250;ltimos estudos apontem que entre 3&#44;7&#37; e 26&#37; da popula&#231;&#227;o tem um &#237;ndice de apneia-hipopneia &#40;IAH&#41; superior a 5 eventos por hora<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46; Se considerarmos um IAH &#62; 5&#47;h e a presen&#231;a de hipersonol&#234;ncia&#44; a preval&#234;ncia estimada para SAHS &#233; de 1&#44;2-7&#44;5&#37;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A cardiopatia isqu&#233;mica&#44; nomeadamente a S&#237;ndrome Coron&#225;ria Aguda &#40;SCA&#41; representa&#44; tamb&#233;m&#44; um grave problema devido &#224; sua elevada preval&#234;ncia&#44; complica&#231;&#245;es associadas e mortalidade&#46; V&#225;rios estudos t&#234;m demonstrado uma associa&#231;&#227;o independente entre SAHS e SCA&#44; sugerindo que a SAHS deve ser tida em conta como um factor de risco a considerar em doentes com SCA<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#8211;6</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">As altera&#231;&#245;es observadas na SAHS&#44; nomeadamente&#44; a hipox&#233;mia intermitente&#44; a acidose e a vasoconstri&#231;&#227;o simp&#225;tica&#44; podem originar stress hemodin&#226;mico&#44; que tem particular import&#226;ncia em doentes com doen&#231;a coron&#225;ria&#44; podendo originar isqu&#233;mia do mioc&#225;rdio ou angina nocturna<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;9</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">A maioria dos doentes com SAHS permanecem sem diagn&#243;stico e sem tratamento<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a>&#44; podendo isto ser particularmente importante em doentes com patologia cardiovascular&#44; que poderiam beneficiar do diagn&#243;stico para minimizar o risco de novos eventos cardiovasculares<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">O objectivo deste estudo foi analisar a preval&#234;ncia da SAHS em doentes com SCA e&#44; adicionalmente&#44; determinar a exist&#234;ncia de factores cl&#237;nicos preditivos de SAHS e comparar a correla&#231;&#227;o do IAH obtido com um equipamento de estudo de sono simplificado &#40;ESS&#41; com o IAH obtido na polissonografia completa &#40;PSG&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Material e m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Amostra</span><p id="par0030" class="elsevierStylePara elsevierViewall">Estudo prospectivo de 91 doentes consecutivos com SCA&#44; com les&#227;o demonstrada por coronariografia&#44; internados na unidade de cuidados intensivos coron&#225;rios &#40;UCIC&#41; do nosso hospital&#44; durante o per&#237;odo de Maio a Agosto de 2009&#46; Foram exclu&#237;dos os doentes&#58; n&#227;o residentes na &#225;rea de refer&#234;ncia do hospital&#44; com diagn&#243;stico pr&#233;vio de SAHS&#44; com estado confusional&#44; consumo de sedativos nas &#250;ltimas 24 horas&#44; instabilidade hemodin&#226;mica&#44; necessidade de oxigenoterapia e os que recusaram participar no estudo&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Foi obtida autoriza&#231;&#227;o da Comiss&#227;o de &#201;tica do Hospital de acordo com a Declara&#231;&#227;o de Hels&#237;nquia e assinado o consentimento informado pelo doente antes da realiza&#231;&#227;o do estudo&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Desenho do estudo</span><p id="par0040" class="elsevierStylePara elsevierViewall">Todos os doentes realizaram um question&#225;rio com as seguintes vari&#225;veis&#58; dados demogr&#225;ficos&#44; h&#225;bitos toxicof&#237;licos&#44; h&#225;bitos de sono&#44; antecedentes patol&#243;gicos&#44; medica&#231;&#227;o&#44; sintomas sugestivos de SAHS&#44; escala de sonol&#234;ncia de <span class="elsevierStyleItalic">Epworth</span> &#40;ESE&#41;&#44; dados cl&#237;nicos e cronol&#243;gicos do evento coron&#225;rio agudo&#44; exame objectivo e medi&#231;&#245;es antropom&#233;tricas&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Os doentes que cumpriam os crit&#233;rios de inclus&#227;o realizaram um primeiro ESS com o equipamento ApneaLink&#8482; &#40;ResMed Corporation&#44; Poway&#44; Calif&#41;&#46; O ApneaLink&#8482; &#40;AL&#41; tem 2 sensores &#40;c&#226;nula de fluxo nasal e ox&#237;metro&#41;&#44; fornecendo informa&#231;&#227;o sobre 4 vari&#225;veis&#58; fluxo respirat&#243;rio&#44; ressonar&#44; satura&#231;&#227;o perif&#233;rica de oxig&#233;nio e frequ&#234;ncia card&#237;aca&#46; O AL utiliza um programa pr&#243;prio que analisa de forma autom&#225;tica o IAH&#44; entre outros par&#226;metros e&#44; ainda&#44; permite realizar uma an&#225;lise manual &#40;vers&#227;o 8&#41;&#46; A leitura do AL foi realizada autom&#225;tica e manualmente&#44; sempre pelo mesmo m&#233;dico e de forma oculta&#46; Apneia foi definida como a diminui&#231;&#227;o de 90&#37; do sinal do fluxo durante um m&#237;nimo de 10 segundos&#46; A hipopneia foi definida como uma redu&#231;&#227;o do fluxo nasal igual ou superior a 30&#37; do basal&#44; durante pelo menos 10 segundos e acompanhada de dessatura&#231;&#227;o igual ou superior a 4&#37;&#46; N&#227;o foram considerados estudos com menos de 5 horas de registo&#46; Estudos de valida&#231;&#227;o do AL demonstram que este equipamento de estudo de sono tem uma boa sensibilidade e especificidade para IAH &#8805; 10&#47;h na PSG&#44; 82&#44;1&#37; e 83&#44;9&#37; respectivamente<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;14&#44;15</span></a>&#46; Assim&#44; o estudo realizado com o AL foi considerado positivo quando IAH &#8805; 10&#47;h&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Aos doentes que&#44; ap&#243;s leitura manual do registo do AL&#44; apresentavam um IAH &#8805; 10&#47;h foi proposta a realiza&#231;&#227;o de PSG e AL em simult&#226;neo&#46; Durante o estudo a c&#226;nula nasal foi ligada a um conector em &#8220;Y&#8221; permitindo o registo em simult&#226;neo do fluxo nasal no AL e PSG&#46; A PSG completa foi realizada no laborat&#243;rio de sono&#44; com o equipamento Embla<span class="elsevierStyleSup">&#174;</span> N7000 &#40;Embla Systems&#44; Broomfield&#44; CO&#44; USA&#41; com registo de vari&#225;veis fisiol&#243;gicas&#58; 6 canais de electroencefalograma&#44; electrooculograma&#44; electromiograma &#40;submentoniano e tibiais anteriores&#41;&#44; electrocardiograma&#44; termistor e c&#226;nula nasal&#44; bandas de esfor&#231;o tor&#225;cico e abdominal &#40;pletismografia de induct&#226;ncia&#41;&#44; microfone&#44; posi&#231;&#227;o corporal&#44; oximetria&#44; frequ&#234;ncia card&#237;aca e v&#237;deo&#46; A leitura da PSG foi manual&#44; sem o investigador ter conhecimento pr&#233;vio dos resultados do AL e da informa&#231;&#227;o do doente&#44; conforme as recomenda&#231;&#245;es da <span class="elsevierStyleItalic">American Academy of Sleep Medicine</span> &#40;AASM&#41; &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">A SAHS foi definida de acordo com os crit&#233;rios da <span class="elsevierStyleItalic">International Classification of Sleep Disorders</span> &#40;ICSD-2&#41;&#44; proposta pela AASM<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&#46; Considerou-se SAHS se tinham o IAH&#44; medido com PSG&#44; entre 5-14&#44;9&#47;h e apresentavam pelo menos um dos sintomas como ressonar&#44; fadiga&#44; sonol&#234;ncia diurna e apneias observadas durante o sono&#44; ou os indiv&#237;duos com o IAH &#8805; 15&#47;h independentemente da presen&#231;a de qualquer sintoma adicional&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">An&#225;lise estat&#237;stica</span><p id="par0060" class="elsevierStylePara elsevierViewall">Todas as vari&#225;veis foram testadas relativamente &#224; sua distribui&#231;&#227;o normal mediante o histograma de frequ&#234;ncias e teste de Kolmogorov-Smirnov&#46; A diferen&#231;a entre duas m&#233;dias foi determinada utilizando o teste <span class="elsevierStyleItalic">T-student</span> ou <span class="elsevierStyleItalic">Welch-test</span>&#46; Quando as vari&#225;veis apresentavam uma distribui&#231;&#227;o normal utilizou-se o teste <span class="elsevierStyleItalic">T-student</span>&#44; se pelo contr&#225;rio esta n&#227;o fosse normal&#44; usou-se o <span class="elsevierStyleItalic">Welch-test</span>&#46; Propor&#231;&#245;es e vari&#225;veis categ&#243;ricas foram analisadas com o teste do Qui-quadrado ou de <span class="elsevierStyleItalic">Fisher</span> quando adequado&#46; Considerou-se estatisticamente significativo um valor p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; A an&#225;lise de correla&#231;&#245;es foi efectuada utilizando o coeficiente de correla&#231;&#227;o de <span class="elsevierStyleItalic">Pearson</span> e o coeficiente de correla&#231;&#227;o intraclasse&#46; A an&#225;lise de <span class="elsevierStyleItalic">Bland-Altman</span> &#233; uma representa&#231;&#227;o gr&#225;fica das diferen&#231;as observadas entre as 2 t&#233;cnicas &#40;PSG e AL&#41; em rela&#231;&#227;o &#224; sua m&#233;dia&#44; de forma que os resultados com reduzida diferen&#231;a em rela&#231;&#227;o &#224; m&#233;dia indicam pouco enviesamento sistem&#225;tico&#46; Os dados foram analisados estatisticamente com o software MedCalc<span class="elsevierStyleSup">&#174;</span> &#40;vers&#227;o 9&#46;3&#44; Mariakerke&#44; B&#233;lgica&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><p id="par0065" class="elsevierStylePara elsevierViewall">Dos 91 doentes admitidos inicialmente na UCIC por SCA nos 4 meses do estudo&#44; 24 doentes n&#227;o residiam na &#225;rea hospitalar&#44; 7 n&#227;o aceitaram participar no estudo&#44; 1 faleceu nas primeiras horas do internamento e 1 j&#225; tinha diagn&#243;stico de SAHS&#46; Portanto&#44; foram inclu&#237;dos 58 doentes na an&#225;lise final&#46; A maioria era do sexo masculino &#40;74&#37;&#41;&#44; m&#233;dia et&#225;ria de 61&#44;7 anos e &#237;ndice de massa corporal &#40;IMC&#41; m&#233;dio de 27&#44;4 Kg&#47;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; As caracter&#237;sticas dos doentes encontram-se representadas na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; Vinte e oito doentes &#40;48&#44;3&#37;&#41; realizaram o estudo com o AL durante o internamento e os restantes 30 doentes &#40;51&#44;7&#37;&#41; realizaram-no em ambulat&#243;rio&#44; tendo sido a mediana do tempo desde a SCA at&#233; &#224; realiza&#231;&#227;o do AL de 4 e 17&#44;5 dias respectivamente&#46; Dos 58 doentes que realizaram o ESS com AL 43&#44;1&#37; obteve um IAH &#8805; 10&#47;h&#44; sendo que destes 27&#44;6&#37; tinham um IAH &#8805; 15&#47;h e 12&#44;1&#37; um IAH &#8805; 30&#47;h &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a> e <a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Os doentes foram comparados em dois grupos segundo o resultado do AL &#40;IAH<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10&#47;h <span class="elsevierStyleItalic">versus</span> IAH &#8805; 10&#47;h&#41;&#44; relativamente &#224;s caracter&#237;sticas antropom&#233;tricas&#44; cl&#237;nicas e antecedentes&#46; Observaram-se diferen&#231;as estatisticamente significativas nas vari&#225;veis&#58; exist&#234;ncia de obesidade&#59; per&#237;metros de pesco&#231;o&#44; abdominal e anca&#59; classifica&#231;&#227;o de Mallampati&#59; hist&#243;ria de apneias observadas&#59; hist&#243;ria de nict&#250;ria&#59; ESE e antecedentes de doen&#231;a isqu&#233;mica card&#237;aca &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46; Ainda&#44; em 48&#37; dos doentes do grupo com IAH &#8805; 10&#47;h os sintomas card&#237;acos tiveram in&#237;cio durante a noite &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;009&#41; e na maioria destes doentes a tradu&#231;&#227;o electrocardiogr&#225;fica da SCA foi sem eleva&#231;&#227;o de ST &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;043&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Dos 25 doentes com resultado de IAH &#8805; 10&#47;h no AL&#44; 3 doentes recusaram fazer posterior PSG e AL em simult&#226;neo&#46; A mediana da demora desde a SCA at&#233; &#224; realiza&#231;&#227;o da PSG foi de 30 dias&#46; Dos 22 doentes que realizaram em simult&#226;neo o AL e a PSG&#44; esta confirmou a positividade de todos os casos de SAHS detectados com o AL&#46; Comparando os resultados do IAH do primeiro AL com o IAH obtido na PSG&#44; em 14 doentes &#40;63&#44;6&#37;&#41; foi alterada a classifica&#231;&#227;o da SAHS ap&#243;s a realiza&#231;&#227;o da PSG &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46; Em 6 doentes que no primeiro AL foram classificados como ligeiros&#44; ap&#243;s a realiza&#231;&#227;o da PSG 5 foram classificados como moderados e 1 como grave&#59; 5 doentes que inicialmente foram classificados como moderados ap&#243;s PSG passaram a ser graves&#46; Apenas 3 doentes foram classificados num est&#225;dio de menor gravidade ap&#243;s a realiza&#231;&#227;o da PSG&#44; assim 1 doente que no primeiro AL tinha sido avaliado como moderado passou a ligeiro e 2 que eram graves passaram a moderados&#46; Houve 2 doentes que apresentavam um predom&#237;nio de apneias centrais na PSG&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">O gr&#225;fico <span class="elsevierStyleItalic">Bland-Altman</span> mostrou uma distribui&#231;&#227;o razo&#225;vel da diferen&#231;a entre o IAH da PSG e do AL realizados em simult&#226;neo &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46; Comparando com a PSG&#44; o AL subvalorizou o IAH em m&#233;dia 6&#44;3 eventos hora&#44; isto ocorreu principalmente quando IAH era superior a 30 eventos por hora&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Foi obtida uma correla&#231;&#227;o muito boa entre o IAH do AL e o IAH da PSG realizados em simult&#226;neo&#44; com um coeficiente de correla&#231;&#227;o de <span class="elsevierStyleItalic">Pearson</span> de 0&#44;91 &#40;0&#44;79-0&#44;96&#41; e coeficente de correla&#231;&#227;o intraclasse de 0&#44;93 &#40;0&#44;82-0&#44;97&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Segundo a defini&#231;&#227;o da AASM<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&#44; todos os doentes que realizaram a PSG cumpriam os crit&#233;rios de SAHS&#46; Portanto&#44; os doentes que concordaram&#44; iniciaram tratamento com auto-CPAP &#40;19 doentes&#41; e servoventila&#231;&#227;o &#40;2 doentes&#41;&#44; conforme indica&#231;&#227;o&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discuss&#227;o</span><p id="par0095" class="elsevierStylePara elsevierViewall">No nosso estudo foi detectado uma elevada preval&#234;ncia de SAHS &#40;43&#44;1&#37;&#41; em doentes admitidos com SCA numa UCIC e 27&#44;6&#37; foram classificados como moderados ou graves segundo o AL&#46; A PSG confirmou a positividade de todos os casos detectados com o AL&#46; Os nossos resultados foram consistentes com os obtidos noutros estudos&#44; que descrevem uma associa&#231;&#227;o entre SAHS e doen&#231;a coron&#225;ria<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;6&#44;7&#44;18&#44;19</span></a>&#46; Num trabalho desenvolvido noutro Centro Hospitalar em Portugal&#44; estes observaram uma preval&#234;ncia de SAHS em 65&#44;9&#37; dos doentes com SCA&#44; sendo que 22&#44;7&#37; foram classificados como graves<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Os doentes internados com SCA na UCIC eram na sua maioria do sexo masculino&#44; com m&#233;dia et&#225;ria de 61&#44;7 anos e um IMC m&#233;dio de 27&#44;4 Kg&#47;m<span class="elsevierStyleSup">2</span>&#46; Estes doentes apresentavam uma preval&#234;ncia elevada de HTA e dislipid&#233;mia&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Cerca de metade dos doentes realizaram o ESS com o AL durante o internamento &#40;no epis&#243;dio agudo&#41; e os restantes efectuaram-no em ambulat&#243;rio &#40;no domic&#237;lio&#41;&#44; numa fase est&#225;vel da sua doen&#231;a card&#237;aca&#46; Desta forma&#44; foi provavelmente&#44; eliminado algum eventual vi&#233;s&#44; nomeadamente&#58; efeito de alguma medica&#231;&#227;o que tenha sido administrada no internamento&#44; realiza&#231;&#227;o do ESS na fase aguda e poder existir algum grau de disfun&#231;&#227;o card&#237;aca e&#44; consequentemente&#44; aparecimento de eventos centrais ou sono de m&#225; qualidade derivado do stress da situa&#231;&#227;o cl&#237;nica ou da actividade incessante pr&#243;pria duma sala de cuidados intensivos&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Comparando os dois grupos de doentes &#40;IAH &#60; 10&#47;h versus IAH &#8805; 10&#47;h&#41;&#44; o grupo de doentes com SAHS&#44; do ponto de vista antropom&#233;trico&#44; apresentava maior n&#250;mero de obesos&#44; valores de per&#237;metros cervical&#44; abdominal e de anca superiores e classifica&#231;&#227;o III-IV de Mallampati&#44; aspectos caracter&#237;sticos do doente com &#8220;fenotipo t&#237;pico&#8221; de SAHS&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">O grupo de doentes com SAHS apresentava nict&#250;ria e apneias observadas em maior propor&#231;&#227;o&#44; sendo estes dois sintomas frequentes nesta doen&#231;a&#46; De real&#231;ar&#44; que mesmo os doentes com apneias observadas n&#227;o tinham recorrido ao seu m&#233;dico assistente para realiza&#231;&#227;o de um eventual estudo&#44; refletindo a escassa informa&#231;&#227;o da popula&#231;&#227;o sobre a import&#226;ncia deste sintoma&#46; Salienta-se que&#44; apesar dos doentes com SAHS apresentarem um valor m&#233;dio superior na ESE&#44; este era inferior ao valor de refer&#234;ncia para sonol&#234;ncia excessiva &#40;ESE &#8805; 10&#41;&#44; portanto n&#227;o parece ser este um factor determinante na defini&#231;&#227;o de SAHS nestes doentes&#46; S&#227;o conhecidas as limita&#231;&#245;es da ESE quando&#44; por vezes&#44; os doentes subestimam a sua sonol&#234;ncia e&#44; ainda &#233; motivo de controv&#233;rsia a exist&#234;ncia de doentes com SAHS grave sem sonol&#234;ncia excessiva<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Assim&#44; os dados que podem sugerir a presen&#231;a de SAHS s&#227;o os valores mais elevados nos dados antropom&#233;tricos&#44; as classes III ou IV da classifica&#231;&#227;o de Mallampati&#44; a hist&#243;ria de nict&#250;ria e de apneias observadas&#46; Contudo a inexist&#234;ncia destes n&#227;o nos permite excluir SAHS&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Em rela&#231;&#227;o aos antecedentes&#44; o grupo de doentes com SAHS apresentava significativamente maior n&#250;mero de epis&#243;dios pr&#233;vios de cardiopatia isqu&#233;mica &#40;angina e EAM&#41;&#44; situa&#231;&#227;o que poderia indicar uma maior vulnerabilidade dos doentes com les&#245;es coron&#225;rias aos epis&#243;dios de hipox&#233;mia intermitente e activa&#231;&#227;o simp&#225;tica&#46; Nos doentes com SAHS as apneias e hipopneias est&#227;o associadas a dessatura&#231;&#245;es e microdespertares que conduzem &#224; activa&#231;&#227;o do sistema nervoso simp&#225;tico&#44; que por sua vez provoca um aumento da frequ&#234;ncia card&#237;aca e da press&#227;o arterial sist&#243;lica&#46; A taquicardia e aumento da press&#227;o arterial sist&#243;lica aumentam a necessidade de oxig&#233;nio pelo mioc&#225;rdio&#44; que poder&#225; estar comprometida nos doentes com doen&#231;a arterial coron&#225;ria<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;9&#44;13</span></a>&#46; Por outro lado&#44; a hipox&#233;mia intermitente cr&#243;nica atrav&#233;s da indu&#231;&#227;o de mediadores inflamat&#243;rios&#44; de stress oxidativo e de disfun&#231;&#227;o endotelial conduz &#224; ateroesclerose<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;22</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Nos doentes com SAHS houve um predom&#237;nio de in&#237;cio dos sintomas caracter&#237;sticos da SCA durante a noite&#44; o que est&#225; de acordo com os resultados obtidos noutros estudos<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;18&#44;23</span></a>&#46; Na popula&#231;&#227;o em geral&#44; o in&#237;cio da SCA ocorre entre as 6-11 horas&#44; nos doentes com SAHS esta ocorre predominantemente entre as 22-6 horas&#46; Esta observa&#231;&#227;o sugere que a SAHS pode precipitar a SCA nocturna &#40;pelos mecanismos descritos anteriormente&#41; e que a SCA pode contribuir para uma predisposi&#231;&#227;o de morte s&#250;bita card&#237;aca nocturna observada nos doentes com SAHS<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;24&#44;25</span></a>&#46; Contudo&#44; n&#227;o foi detectada uma rela&#231;&#227;o entre a gravidade da doen&#231;a coron&#225;ria &#40;n&#250;mero de vasos afectados&#41; observada na angiografia e a presen&#231;a de SAHS&#46; Salienta-se que o grupo com SAHS apresentava&#44; na sua maioria&#44; SCA sem eleva&#231;&#227;o de ST&#44; o que pode estar em rela&#231;&#227;o com um aumento da necessidade de oxig&#233;nio ap&#243;s o per&#237;odo da apneia &#40;quando a satura&#231;&#227;o da oxihemoglobina se encontra no valor mais baixo&#41;&#44; devido ao aumento da press&#227;o arterial e da frequ&#234;ncia card&#237;aca<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;23</span></a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">No grupo total de doentes foram detectados&#44; com relativa frequ&#234;ncia&#44; eventos respirat&#243;rios centrais e epis&#243;dios breves de respira&#231;&#227;o de Cheyne-Stokes&#44; sendo significativos em 2 doentes&#44; embora os doentes apresentassem&#44; em m&#233;dia&#44; uma boa frac&#231;&#227;o de ejec&#231;&#227;o&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">A demora desde a SCA at&#233; &#224; realiza&#231;&#227;o da PSG foi razo&#225;vel&#44; dificultando o surgimento de alguns vi&#233;ses que pudessem modificar os resultados&#44; nomeadamente altera&#231;&#245;es do estilo de vida que conduzissem &#224; perda de peso ou altera&#231;&#245;es dos h&#225;bitos alco&#243;licos ou tab&#225;gicos&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Comparando os valores de IAH obtidos na PSG e AL simult&#226;neas&#44; estes apresentaram uma muito boa correla&#231;&#227;o&#44; confirmando a fiabilidade deste equipamento de estudo de sono&#44; j&#225; observada noutros estudos<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;14&#44;15</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Aos doentes com S&#237;ndrome de Apneia Obstrutiva do Sono &#40;SAOS&#41; foi-lhe proposta terap&#234;utica com as medidas higieno-diet&#233;ticas consensuais na SAOS e CPAP&#44; uma vez que o tratamento da SAOS em doentes com SCA est&#225; associado a uma redu&#231;&#227;o significativa nos eventos cardiovasculares&#44; definidos como morte de causa cardiovascular&#44; SCA&#44; internamentos por insufici&#234;ncia card&#237;aca ou necessidade de revasculariza&#231;&#227;o coron&#225;ria&#46; Por outro lado&#44; h&#225; um atraso na ocorr&#234;ncia destes eventos<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;13&#44;26&#8211;28</span></a>&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Apontamos como poss&#237;veis limita&#231;&#245;es do estudo o tamanho relativamente reduzido da amostra&#44; motivado em parte por exclus&#227;o de um elevado n&#250;mero de doentes turistas na regi&#227;o do Algarve que impossibilitava o seu seguimento e conclus&#227;o do estudo&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Um ponto &#8220;enigm&#225;tico&#8221; &#233; a possibilidade do n&#250;mero de eventos respirat&#243;rios&#44; detectados inicialmente&#44; diminuir com o tempo&#44; como sugerido num estudo realizado na Gr&#233;cia&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> onde os autores conclu&#237;ram que existia uma elevada preval&#234;ncia de SAHS na fase aguda da SCA &#40;54&#37;&#41; e que esta decrescia 6 meses ap&#243;s a SCA&#44; mantendo-se o diagn&#243;stico de SAHS apenas em 21&#37; dos doentes&#44; sugerindo que estas altera&#231;&#245;es podem ser transit&#243;rias&#46; Poss&#237;veis explica&#231;&#245;es s&#227;o a utiliza&#231;&#227;o de f&#225;rmacos &#40;por exemplo analg&#233;sicos opi&#243;ides&#44; e&#47;ou ansiol&#237;ticos&#41; enquanto os doentes est&#227;o internados na UCIC&#44; que podem afectar o padr&#227;o respirat&#243;rio durante o sono&#59; os doentes quando est&#227;o internados na UCIC encontram-se habitualmente na posi&#231;&#227;o supina&#59; a pr&#243;pria patologia cardiovascular aguda pode conduzir a altera&#231;&#245;es respirat&#243;rias durante o sono&#44; com tend&#234;ncia para o aparecimento de apneias centrais&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> S&#227;o necess&#225;rios mais estudos para confirmar ou contestar esta hip&#243;tese&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclus&#245;es</span><p id="par0165" class="elsevierStylePara elsevierViewall">Em s&#237;ntese&#44; e tendo em conta as limita&#231;&#245;es do estudo&#44; os resultados apontam para uma elevada preval&#234;ncia de SAHS em doentes com SCA&#46; Dada a elevada preval&#234;ncia observada&#44; parece justificada a inclus&#227;o de um estudo do sono no protocolo de investiga&#231;&#227;o dos doentes internados por SCA&#46; Apesar da PSG ser o teste de diagn&#243;stico <span class="elsevierStyleItalic">gold standard</span> para a SAHS &#233; imposs&#237;vel a sua realiza&#231;&#227;o devido aos recursos limitados e &#224; demora m&#233;dia prolongada para a sua execu&#231;&#227;o&#46; Tendo em conta a boa correla&#231;&#227;o do ESS com equipamentos como o ApneaLink&#8482; em rela&#231;&#227;o com a PSG&#44; assim como a sua f&#225;cil utiliza&#231;&#227;o e baixo custo&#44; poderia ser &#250;til como primeira linha diagn&#243;stica e em colabora&#231;&#227;o com a consulta de Sono&#46; Da mesma maneira que&#44; no contexto do SCA&#44; s&#227;o investigados e tratados outros factores de risco cardiovascular&#44; como por exemplo a HTA&#44; diabetes&#44; tabagismo ou a dislipidemia&#44; o diagn&#243;stico e controlo da SAHS poderia ser importante na preven&#231;&#227;o secund&#225;ria de novos eventos cardiovasculares&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflito de interesses</span><p id="par0170" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesses&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:2 [
          "identificador" => "xres547619"
          "titulo" => array:5 [
            0 => "Resumo"
            1 => "Objectivo"
            2 => "M&#233;todos"
            3 => "Resultados"
            4 => "Conclus&#227;o"
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec565499"
          "titulo" => "Palavras-chave"
        ]
        2 => array:2 [
          "identificador" => "xres547618"
          "titulo" => array:5 [
            0 => "Abstract"
            1 => "Aim"
            2 => "Methods"
            3 => "Results"
            4 => "Conclusion"
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec565498"
          "titulo" => "Keywords"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introdu&#231;&#227;o"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Material e m&#233;todos"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Amostra"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Desenho do estudo"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "An&#225;lise estat&#237;stica"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Resultados"
        ]
        7 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Discuss&#227;o"
        ]
        8 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Conclus&#245;es"
        ]
        9 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Conflito de interesses"
        ]
        10 => array:2 [
          "identificador" => "xack184909"
          "titulo" => "Agradecimentos"
        ]
        11 => array:1 [
          "titulo" => "Bibliografia"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2011-03-07"
    "fechaAceptado" => "2011-07-07"
    "PalabrasClave" => array:2 [
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec565499"
          "palabras" => array:4 [
            0 => "S&#237;ndrome de apneia do sono"
            1 => "S&#237;ndrome coron&#225;ria aguda"
            2 => "Preval&#234;ncia"
            3 => "Rastreio"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec565498"
          "palabras" => array:4 [
            0 => "Sleep apnea syndrome"
            1 => "Acute coronary syndrome"
            2 => "Prevalence"
            3 => "Screening"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span><span class="elsevierStyleSectionTitle">Objectivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Avaliar a preval&#234;ncia da S&#237;ndrome de Apneia-Hipopneia do Sono &#40;SAHS&#41; em doentes internados na Unidade de Cuidados Intensivos Coron&#225;rios &#40;UCIC&#41;&#59; determinar factores cl&#237;nicos preditivos de SAHS&#59; comparar os resultados obtidos com o estudo de sono simplificado &#40;ESS&#41; com os da polissonografia &#40;PSG&#41;&#46;</p></span> <span><span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudo prospectivo de doentes internados na UCIC com S&#237;ndrome Coron&#225;ria Aguda &#40;SCA&#41;&#44; confirmado por coronariografia&#46; Foram avaliados dados demogr&#225;ficos e antropom&#233;tricos&#44; factores de risco cardiovascular e valores da escala de sonol&#234;ncia de <span class="elsevierStyleItalic">Epworth</span>&#46; O ESS foi realizado com ApneaLink<span class="elsevierStyleSup">TM</span> durante o internamento ou ap&#243;s a alta&#46; Os doentes com &#237;ndice de apneia-hipopneia &#40;IAH&#41; &#8805; 10&#47;h foram convidados a realizar PSG&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Durante 4 meses foram seleccionados consecutivamente 91 doentes com SCA&#46; Cinquenta e oito doentes completaram o estudo&#44; sendo 43 &#40;74&#44;1&#37;&#41; do sexo masculino&#44; m&#233;dia et&#225;ria de 61&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;2 anos e &#237;ndice de massa corporal m&#233;dio de 27&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;5<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46; A mediana de tempo para realiza&#231;&#227;o do ESS foi de 17&#44;5 dias&#46; O estudo foi compat&#237;vel com SAHS em 25 casos &#40;43&#44;1&#37;&#41;&#46; Aos doentes com IAH &#8805; 10&#47;h no ESS foi proposta a realiza&#231;&#227;o de PSG e ESS em simult&#226;neo&#46; A mediana do tempo entre SCA e a PSG foi de 30 dias&#46; A PSG confirmou a positividade de todos os casos detectados pelo ESS&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Conclus&#227;o</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">No nosso estudo detect&#225;mos uma elevada preval&#234;ncia de SAHS em doentes com SCA internados na UCIC &#40;43&#44;1&#37;&#41;&#46; Os resultados suportam a necessidade de um m&#233;todo de rastreio da SAHS em doentes internados com SCA&#46; O ESS pode ter um papel importante no rastreio da SAHS nesta popula&#231;&#227;o&#46;</p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span><span class="elsevierStyleSectionTitle">Aim</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To evaluate the prevalence of Sleep Apnea-Hypopnea Syndrome &#40;SAHS&#41; in patients who were admitted with Acute Coronary Syndrome &#40;ACS&#41; to the Coronary Care Unit &#40;CCU&#41; and the clinical predictors of SAHS in patients with ACS and to compare the results of the simple sleep test &#40;SST&#41; with polysomnography &#40;PSG&#41;&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">This was a prospective study that included patients who were admitted to the CCU with ACS&#44; which was confirmed by coronary angiography&#46; Demographic and anthropometric data&#44; cardiovascular risk factors and measures on the Epworth Sleepiness Scale were collected&#46; The SST was conducted with the ApneaLink<span class="elsevierStyleSup">TM</span> device during hospitalization or after discharge&#46; Patients with an apnea-hypopnea index &#40;AHI&#41; &#8805; 10&#47;h were invited to participate in PSG&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Ninety-one patients with ACS were consecutively included over 4 months&#46; Of the fifty-eight patients who completed the study 43 &#40;74&#46;1&#37;&#41; were male&#46; The mean age was 61&#46;7&#177;12&#46;2 years&#44; and the mean body mass index was 27&#46;4&#177;3&#46;5<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46; The median time for SST performance was 17&#46;5 days&#46; This study was compatible with SAHS in 25 cases &#40;43&#46;1&#37;&#41;&#46; Patients who had an AHI &#8805; 10&#47;h in the SST were submitted to PSG and SST simultaneously&#46; The median interval between the ACS and the execution of PSG was 30 days&#46; PSG confirmed that all of the cases that were detected by SST were positive&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In our study&#44; we found a high prevalence of SAHS in patients who were admitted to the CCU with ACS &#40;43&#46;1&#37;&#41;&#46; These results support the need for SAHS screening in patients who are hospitalized with ACS&#46; The SST may have a role in the screening of SAHS in this population&#46;</p></span>"
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 847
            "Ancho" => 1576
            "Tamanyo" => 90318
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Doentes que realizaram AL&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">AL&#58; ApneaLink&#59; IAH&#58; &#205;ndice de Apneia-Hipopneia&#59; PSG&#58; Polissonografia&#59; SAHS&#58; S&#237;ndrome Apneia-Hipopneia do Sono&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 722
            "Ancho" => 1583
            "Tamanyo" => 96628
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Compara&#231;&#227;o do IAH nos doentes que realizaram AL e PSG posteriormente&#46;</p> <p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">AL&#58; ApneaLink&#59; PSG&#58; Polissonografia&#59; IAH&#58; &#205;ndice de Apneia-Hipopneia&#59; SAHS&#58; S&#237;ndrome Apneia-Hipopneia do Sono&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1194
            "Ancho" => 1556
            "Tamanyo" => 95344
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Gr&#225;fico Bland-Altman para IAH do AL e IAH PSG&#46;</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">IAH&#58; &#205;ndice de Apneia-Hipopneia&#59; AL&#58; ApneaLink&#59; PSG&#58; Polissonografia&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabela 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Dados apresentados em n&#250;mero &#40;&#37;&#41; excepto idade e IMC &#40;&#205;ndice de massa corporal&#41;&#44; com m&#233;dia<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD &#40;range&#41;&#46; &#205;ndice de Apneia-Hipopneia &#40;IAH&#41; segundo valores do estudo com ApneaLink&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Resultados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleBold">Caracter&#237;sticas demogr&#225;ficas</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Idade &#40;anos&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#44;7 &#177; 12&#44;2 &#40;22-87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">IMC &#40;Kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#44;4 &#177; 3&#44;5 &#40;20&#44;8-37&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Sexo</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Homem&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43 &#40;74&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Mulher&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;25&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleBold">Preval&#234;ncia de IAH</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IAH 10-14&#47;h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;15&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IAH 15-29&#47;h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;15&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IAH &#8805; 30&#47;h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;12&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleBold">Comorbilidades</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Dislipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43 &#40;74&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Hipertens&#227;o arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;72&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus tipo 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;29&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Cardiopatia isqu&#233;mica pr&#233;via&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;22&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab884588.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas demogr&#225;ficas&#44; preval&#234;ncia e comorbilidades dos 58 participantes do estudo&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Dados s&#227;o apresentados como n &#40;&#37;&#41; e m&#233;dia &#177; desvio padr&#227;o&#46; IMC&#58; &#205;ndice de massa corporal&#59; EAM&#58; Enfarte agudo do mioc&#225;rdio&#59; N&#176;&#58; N&#250;mero&#59; NS&#58; Estatisticamente n&#227;o significativo&#46; &#42; Teste do Qui-quadrado&#59; &#42;&#42; Teste <span class="elsevierStyleItalic">T-Student</span>&#59; &#42;&#42;&#42;<span class="elsevierStyleItalic">Welch-test&#46;</span></p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">IAH<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10&#47;h &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">IAH &#8805; 10&#47;h &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Valor p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sexo masculino</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;67&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;84&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Idade &#40;anos&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60 &#177; 12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64 &#177; 12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Obesidade &#40;IMC &#8805; 30 Kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;031&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Per&#237;metro do pesco&#231;o &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34 &#177; 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39 &#177; 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#42;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Per&#237;metro abdominal &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">93 &#177; 10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">99 &#177; 9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;012&#42;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Per&#237;metro das ancas &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">94 &#177; 10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100 &#177; 8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;034&#42;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Mallampati III &#43; IV</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">H&#225;bitos tab&#225;gicos &#40;Fumador&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">H&#225;bitos etan&#243;licos &#40;Habitual&#47;Ocasional&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27 &#40;81&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;76&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">N&#176; caf&#233;s por dia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;8 &#177; 1&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;6 &#177; 1&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">N&#176; de horas de sono</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;9 &#177; 1&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;8 &#177; 1&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Hipertens&#227;o arterial</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;70&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;76&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Dislipid&#233;mia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;73&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;76&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Diabetes mellitus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Cardiopatia isqu&#233;mica pr&#233;via</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;031&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Ressonar</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;79&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;84&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Apneias observadas</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Despertares nocturnos</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;32&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Nict&#250;ria &#40;n&#176; de vezes&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;018&#42;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sono agitado</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;21&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sono n&#227;o reparador</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;27&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Cefaleias</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Altera&#231;&#227;o da mem&#243;ria</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;39&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;52&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Altera&#231;&#227;o da concentra&#231;&#227;o</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Escala de Epworth</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;5 &#177; 2&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;4 &#177; 4&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;042&#42;&#42;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Escala de Epworth &#8805; 10</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Hora de in&#237;cio dos sintomas da SCA</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- 22&#58;01-06&#58;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;009&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- 06&#58;01-14&#58;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;45&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- 14&#58;01-22&#58;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;42&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">EAM sem supra de ST</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;69&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;043&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">N&#176; vasos afectados</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;7 &#177; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;0 &#177; 0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Frac&#231;&#227;o de ejec&#231;&#227;o</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#177; 14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59 &#177; 14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Hipertrofia do septo interventricular</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab884587.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas cl&#237;nicas e antropom&#233;tricas&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliografia"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:29 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obstrutive Sleep Apnea Syndrome in the Sao Paulo Epidemiologic Sleep Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Tufik"
                            1 => "R&#46; Silva"
                            2 => "J&#46; Taddei"
                            3 => "L&#46; Bittencourt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.sleep.2009.10.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Sleep Medicine"
                        "fecha" => "2010"
                        "volumen" => "11"
                        "paginaInicial" => "441"
                        "paginaFinal" => "446"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20362502"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of sleep apnoea&#47;hypopnoea syndrome and sleep-disordered breathing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Jennum"
                            1 => "R&#46; Riha"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Resp J"
                        "fecha" => "2009"
                        "volumen" => "33"
                        "paginaInicial" => "907"
                        "paginaFinal" => "914"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The occurrence of Sleep-Disorder Breathing among middle-aged adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46; Young"
                            1 => "M&#46; Palta"
                            2 => "J&#46; Dempsey"
                            3 => "J&#46; Skatrud"
                            4 => "S&#46; Weber"
                            5 => "S&#46; Badr"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Eng J Med"
                        "fecha" => "1993"
                        "volumen" => "328"
                        "paginaInicial" => "1230"
                        "paginaFinal" => "1235"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increased incidence of coronary artery disease in sleep apnoea&#58; a long-term follow up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46; Peker"
                            1 => "J&#46; Carlson"
                            2 => "J&#46; Hedner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.06.00107805"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2006"
                        "volumen" => "28"
                        "paginaInicial" => "596"
                        "paginaFinal" => "602"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16641120"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obstructive Sleep Apnea and Cardiovascular Disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Kato"
                            1 => "T&#46; Adachi"
                            2 => "Y&#46; Koshino"
                            3 => "V&#46; Somers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Circ J"
                        "fecha" => "2009"
                        "volumen" => "73"
                        "paginaInicial" => "1363"
                        "paginaFinal" => "1370"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19564701"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Accuracy of monitoring for sleep-related breathing disorders in the coronary care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Skinner"
                            1 => "M&#46; Choudhury"
                            2 => "S&#46; Homan"
                            3 => "J&#46; Cowan"
                            4 => "G&#46; Wilkins"
                            5 => "R&#46; Taylor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.127.1.66"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2005"
                        "volumen" => "127"
                        "paginaInicial" => "66"
                        "paginaFinal" => "71"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15653964"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obstrutive Sleep Apnea and Cardiovascular Disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Parish"
                            1 => "V&#46; Somers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4065/79.8.1036"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mayo Clin Proc"
                        "fecha" => "2004"
                        "volumen" => "79"
                        "paginaInicial" => "1036"
                        "paginaFinal" => "1046"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15301332"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sleep-Disordered Breathing and Myocardial Ischemia in Patients with Coronary Artery Disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46; Mooe"
                            1 => "K&#46; Franklin"
                            2 => "U&#46; Wiklund"
                            3 => "T&#46; Rabben"
                            4 => "K&#46; Holmstr&#246;m"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2000"
                        "volumen" => "117"
                        "paginaInicial" => "1597"
                        "paginaFinal" => "1602"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10858389"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular consequences of obstructive sleep apnoea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "F&#46; Kuniyoshi"
                            1 => "S&#46; Pusalavidyasagar"
                            2 => "P&#46; Singh"
                            3 => "V&#46; Somers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Indian J Med Res"
                        "fecha" => "2010"
                        "volumen" => "131"
                        "paginaInicial" => "196"
                        "paginaFinal" => "205"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20308745"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obstructive sleep apnea syndrome&#58; are we missing an at-risk population&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Lettieri"
                            1 => "A&#46; Eliasson"
                            2 => "T&#46; Andrada"
                            3 => "A&#46; Khramtsov"
                            4 => "M&#46; Raphaelson"
                            5 => "D&#46; Kristo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Sleep Med"
                        "fecha" => "2005"
                        "volumen" => "1"
                        "paginaInicial" => "381"
                        "paginaFinal" => "385"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17564406"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Underdiagnosis of sleep apnea syndrome in US communities"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "V&#46; Kapur"
                            1 => "K&#46; Strohl"
                            2 => "S&#46; Redline"
                            3 => "C&#46; Iber"
                            4 => "G&#46; O&#8217;Connor"
                            5 => "J&#46; Nieto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11325-002-0049-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Sleep Breath"
                        "fecha" => "2002"
                        "volumen" => "6"
                        "paginaInicial" => "49"
                        "paginaFinal" => "54"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12075479"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Utility of ApnealinkTM for the Diagnosis of Sleep Apnea-Hypopnea Syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Nigro"
                            1 => "F&#46; Serrano"
                            2 => "S&#46; Aimaretti"
                            3 => "S&#46; Gonzalez"
                            4 => "C&#46; Codinardo"
                            5 => "E&#46; Rhodius"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Medicina &#40;B Aires&#41;"
                        "fecha" => "2009"
                        "volumen" => "70"
                        "paginaInicial" => "53"
                        "paginaFinal" => "59"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Benefits of obstructive sleep apnoea treatment in coronary artery disease&#58; a long-term follow up study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "O&#46; Milleron"
                            1 => "R&#46; Pilliere"
                            2 => "A&#46; Foucher"
                            3 => "A&#46; Roquefeuil"
                            4 => "P&#46; Aegerter"
                            5 => "G&#46; Jondeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ehj.2004.02.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2004"
                        "volumen" => "25"
                        "paginaInicial" => "728"
                        "paginaFinal" => "734"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15120882"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validation of the ApneaLinkTM for the Screening of Sleep Apnea&#58; a Novel and Simple Single-Channel Recording Device"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Erman"
                            1 => "D&#46; Stewart"
                            2 => "D&#46; Einhorn"
                            3 => "N&#46; Gordon"
                            4 => "E&#46; Casal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Sleep Med"
                        "fecha" => "2007"
                        "volumen" => "3"
                        "paginaInicial" => "387"
                        "paginaFinal" => "392"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17694728"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validation of a portable recording device &#40;ApneaLink&#41; for identifying patients with suspected obstructive sleep apnoea syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Ng"
                            1 => "T&#46; Chan"
                            2 => "T&#46; Ngai"
                            3 => "A&#46; Tung"
                            4 => "F&#46; Ko"
                            5 => "D&#46; Hui"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1445-5994.2008.01827.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Internal Medicine Journal"
                        "fecha" => "2009"
                        "volumen" => "39"
                        "paginaInicial" => "757"
                        "paginaFinal" => "762"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19220528"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The AASM manual for the scoring of sleep and associated events&#58; rules&#44; terminology&#44; and technical specifications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Iber"
                            1 => "S&#46; Ancoli-Israel"
                            2 => "A&#46;L&#46; Chesson"
                            3 => "S&#46;F&#46; Quan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "edicion" => "1<span class="elsevierStyleSup">a</span> ed&#46;"
                        "fecha" => "2007"
                        "editorial" => "American Academy of Sleep Medicine"
                        "editorialLocalizacion" => "Westchester&#44; IL"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "International Classification of Sleep disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "American Academy of Sleep Medicine &#40;AASM&#41;"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2005"
                        "editorial" => "AASM"
                        "editorialLocalizacion" => "Wetchester"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An independent association between obstructive sleep apnoea and coronary artery disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Y&#46; Peker"
                            1 => "H&#46; Kraiczi"
                            2 => "J&#46; Hedner"
                            3 => "S&#46; L&#246;th"
                            4 => "A&#46; Johansson"
                            5 => "M&#46; Bende"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "1999"
                        "volumen" => "14"
                        "paginaInicial" => "179"
                        "paginaFinal" => "184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10489848"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospective Study of Obstructive Sleep Apnea and Incident Coronary Heart Disease and Heart Failure&#58; The Sleep Hearth Health Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Gottlieb"
                            1 => "G&#46; Yenokyan"
                            2 => "A&#46; Newman"
                            3 => "G&#46; O&#8217;Connor"
                            4 => "N&#46; Punjabi"
                            5 => "S&#46; Quan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.109.901801"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2010"
                        "volumen" => "122"
                        "paginaInicial" => "352"
                        "paginaFinal" => "360"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20625114"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "S&#237;ndrome coron&#225;ria aguda e SAOS &#8211; Uma associa&#231;&#227;o inequ&#237;voca &#40;estudo prospectivo&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:8 [
                            0 => "B&#46; Conde"
                            1 => "T&#46; Calvo"
                            2 => "E&#46; Matos"
                            3 => "A&#46; Ferreira"
                            4 => "C&#46; Barreiros"
                            5 => "I&#46; Ferradosa"
                            6 => "P&#46; Fontes"
                            7 => "A&#46; Afonso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Port Pneumol"
                        "fecha" => "2009"
                        "volumen" => "15"
                        "paginaInicial" => "S27"
                        "paginaFinal" => "S28"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "S&#237;ndrome de apneas-hiponeas durante el sue&#241;o sin somnolencia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46; Garcia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2008.07.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2009"
                        "volumen" => "45"
                        "paginaInicial" => "240"
                        "paginaFinal" => "244"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19395138"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular disease in obstructive sleep apnoea syndrome&#58; the role of intermittent hypoxia and inflammation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Garvey"
                            1 => "C&#46; Taylor"
                            2 => "W&#46; McNicholas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Resp J"
                        "fecha" => "2009"
                        "volumen" => "33"
                        "paginaInicial" => "1195"
                        "paginaFinal" => "1205"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obstructive Sleep apnea and Cardiovascular Disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Kato"
                            1 => "T&#46; Adachi"
                            2 => "Y&#46; Koshino"
                            3 => "V&#46; Somers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Circ J"
                        "fecha" => "2009"
                        "volumen" => "73"
                        "paginaInicial" => "1363"
                        "paginaFinal" => "1370"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19564701"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Day-night pattern of sudden death in obstrutive sleep apnea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Gami"
                            1 => "D&#46; Howard"
                            2 => "E&#46; Olson"
                            3 => "V&#46; Somers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Eng J Med"
                        "fecha" => "2005"
                        "volumen" => "352"
                        "paginaInicial" => "1206"
                        "paginaFinal" => "1214"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sleep-Disordered Breathing and Mortality&#58; A Prospective Cohort Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Punjabi"
                            1 => "B&#46; Caffo"
                            2 => "J&#46; Goodwin"
                            3 => "D&#46; Gottlieb"
                            4 => "A&#46; Newman"
                            5 => "G&#46; O¿Connor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pmed.1000132"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLoS Med"
                        "fecha" => "2009"
                        "volumen" => "6"
                        "paginaInicial" => "e1000132"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19688045"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term cardiovascular outcomes im men with obstructive sleep apnoea-hypopnoea syndrome with or without treatment with continuous positive airway pressure&#58; an observational study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Marin"
                            1 => "S&#46; Carrizo"
                            2 => "E&#46; Vicente"
                            3 => "A&#46; Agusti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(05)71141-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2005"
                        "volumen" => "365"
                        "paginaInicial" => "1046"
                        "paginaFinal" => "1053"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15781100"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Continuous positive airway pressure treatment of mild to moderate obstructive sleep apnea reduces cardiovascular risk"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46; Buchner"
                            1 => "B&#46; Sanner"
                            2 => "J&#46; Borgel"
                            3 => "L&#46; Rump"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.200611-1588OC"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2007"
                        "volumen" => "176"
                        "paginaInicial" => "1274"
                        "paginaFinal" => "1280"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17673692"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of obstructive sleep apnea is associated with decreased cardiac death after percutaneous coronary intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Cassar"
                            1 => "T&#46; Morgenthaler"
                            2 => "R&#46; Lennon"
                            3 => "C&#46; Rihal"
                            4 => "A&#46; Lerman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2007.06.028"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2007"
                        "volumen" => "50"
                        "paginaInicial" => "1310"
                        "paginaFinal" => "1314"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17903628"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sleep-disordered breathing in patients with acute coronary syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Bouloukaki"
                            1 => "E&#46; Simantirakis"
                            2 => "C&#46; Mermigis"
                            3 => "D&#46; Arfanakis"
                            4 => "S&#46; Chrysostomakis"
                            5 => "E&#46; Kallergis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Sleep Res"
                        "fecha" => "2010"
                        "volumen" => "19"
                        "paginaInicial" => "296"
                        "paginaFinal" => "297"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:3 [
        "identificador" => "xack184909"
        "titulo" => "Agradecimentos"
        "texto" => "<p id="par0175" class="elsevierStylePara elsevierViewall">Agradecemos a Linde Homecare e a Resmed o empr&#233;stimo dos equipamentos de estudo simplificado de sono para a realiza&#231;&#227;o do estudo&#46;</p>"
      ]
    ]
  ]
  "idiomaDefecto" => "pt"
  "url" => "/08732159/0000001800000001/v2_201509041308/S0873215911001036/v2_201509041308/pt/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9575"
    "tipo" => "SECCION"
    "pt" => array:2 [
      "titulo" => "Artigos originais"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "pt"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001800000001/v2_201509041308/S0873215911001036/v2_201509041308/pt/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215911001036?idApp=UINPBA00004E"
]
Article information
ISSN: 08732159
Original language: Portuguese
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 12 34 46
2024 October 107 147 254
2024 September 109 41 150
2024 August 99 47 146
2024 July 92 31 123
2024 June 97 42 139
2024 May 167 34 201
2024 April 79 35 114
2024 March 80 24 104
2024 February 69 38 107
2024 January 57 24 81
2023 December 53 21 74
2023 November 63 31 94
2023 October 41 35 76
2023 September 43 37 80
2023 August 51 12 63
2023 July 65 32 97
2023 June 61 15 76
2023 May 71 29 100
2023 April 67 22 89
2023 March 88 27 115
2023 February 44 18 62
2023 January 39 24 63
2022 December 52 19 71
2022 November 99 32 131
2022 October 79 33 112
2022 September 73 30 103
2022 August 105 35 140
2022 July 74 52 126
2022 June 36 31 67
2022 May 41 49 90
2022 April 28 36 64
2022 March 26 40 66
2022 February 35 37 72
2022 January 38 43 81
2021 December 32 35 67
2021 November 44 28 72
2021 October 41 41 82
2021 September 21 28 49
2021 August 23 22 45
2021 July 24 18 42
2021 June 30 28 58
2021 May 33 27 60
2021 April 74 96 170
2021 March 64 14 78
2021 February 53 25 78
2021 January 34 17 51
2020 December 32 14 46
2020 November 53 25 78
2020 October 38 17 55
2020 September 61 21 82
2020 August 79 26 105
2020 July 98 32 130
2020 June 85 16 101
2020 May 91 20 111
2020 April 59 11 70
2020 March 64 13 77
2020 February 93 20 113
2020 January 87 12 99
2019 December 91 24 115
2019 November 81 13 94
2019 October 83 20 103
2019 September 87 23 110
2019 August 225 17 242
2019 July 278 18 296
2019 June 336 14 350
2019 May 323 28 351
2019 April 306 31 337
2019 March 368 18 386
2019 February 296 15 311
2019 January 319 17 336
2018 December 150 11 161
2018 November 50 1 51
2018 October 62 10 72
2018 September 42 9 51
2018 August 37 34 71
2018 July 58 31 89
2018 June 70 34 104
2018 May 98 27 125
2018 April 98 31 129
2018 March 119 19 138
2018 February 61 16 77
2018 January 31 22 53
2017 December 115 17 132
2017 November 41 28 69
2017 October 42 24 66
2017 September 32 18 50
2017 August 35 27 62
2017 July 21 15 36
2017 June 35 20 55
2017 May 31 15 46
2017 April 16 11 27
2017 March 11 50 61
2017 February 16 11 27
2017 January 21 8 29
2016 December 16 19 35
2016 November 17 6 23
2016 October 20 13 33
2016 September 6 4 10
2016 August 11 5 16
2016 July 7 12 19
2016 June 0 12 12
2016 April 22 3 25
2016 March 37 17 54
2016 February 33 21 54
2016 January 58 25 83
2015 December 36 19 55
2015 November 27 17 44
2015 October 32 14 46
2015 September 50 13 63
2015 August 70 10 80
2015 July 68 9 77
2015 June 67 10 77
2015 May 108 11 119
2015 April 118 13 131
2015 March 86 9 95
2015 February 102 11 113
2015 January 92 13 105
2014 December 74 14 88
2014 November 84 16 100
2014 October 115 13 128
2014 September 100 25 125
2014 August 103 9 112
2014 July 71 13 84
2014 June 100 23 123
2014 May 94 9 103
2014 April 101 9 110
2014 March 123 21 144
2014 February 106 17 123
2014 January 108 18 126
2013 December 109 11 120
2013 November 131 17 148
2013 October 117 14 131
2013 September 60 15 75
2013 August 67 18 85
2013 July 116 26 142
2013 June 63 15 78
2013 May 95 25 120
2013 April 122 36 158
2013 March 73 21 94
2013 February 91 26 117
2013 January 89 33 122
2012 December 100 31 131
2012 November 76 29 105
2012 October 105 30 135
2012 September 32 12 44
2012 January 815 0 815
Show all

Follow this link to access the full text of the article

Pulmonology

Are you a health professional able to prescribe or dispense drugs?