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Marcondes-Braga FG, Vieira JL, Souza Neto JDD, Calado G, Ayub-Ferreira SM, Bacal F, Clausell N. Emerging Topics in Heart Failure: Contemporaneous Management of Advanced Heart Failure. Arq Bras Cardiol 2021; 115:1193-1196. [PMID: 33470324 PMCID: PMC8133710 DOI: 10.36660/abc.20201194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 12/18/2022] Open
Affiliation(s)
- Fabiana G Marcondes-Braga
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor/HCFMUSP),São Paulo, SP - Brasil
| | | | | | - Gustavo Calado
- Pontifícia Universidade Católica de Campinas (PUCC), Campinas, SP - Brasil
| | - Silvia Moreira Ayub-Ferreira
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor/HCFMUSP),São Paulo, SP - Brasil
| | - Fernando Bacal
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor/HCFMUSP),São Paulo, SP - Brasil
| | - Nadine Clausell
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brasil
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2
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Nonaka CKV, Macêdo CT, Cavalcante BRR, Alcântara ACD, Silva DN, Bezerra MDR, Caria ACI, Tavora FRF, Neto JDDS, Noya-Rabelo MM, Rogatto SR, Ribeiro Dos Santos R, Souza BSDF, Soares MBP. Circulating miRNAs as Potential Biomarkers Associated with Cardiac Remodeling and Fibrosis in Chagas Disease Cardiomyopathy. Int J Mol Sci 2019; 20:ijms20164064. [PMID: 31434314 PMCID: PMC6721092 DOI: 10.3390/ijms20164064] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/11/2019] [Accepted: 07/14/2019] [Indexed: 12/21/2022] Open
Abstract
Chagas disease (CD) affects approximately 6–7 million people worldwide, from which 30% develop chronic Chagas cardiomyopathy (CCC), usually after being asymptomatic for years. Currently available diagnostic methods are capable of adequately identifying infected patients, but do not provide information regarding the individual risk of developing the most severe form of the disease. The identification of biomarkers that predict the progression from asymptomatic or indeterminate form to CCC, may guide early implementation of pharmacological therapy. Here, six circulating microRNAs (miR-19a-3p, miR-21-5p, miR-29b-3p, miR-30a-5p, miR-199b-5p and miR-208a-3p) were evaluated and compared among patients with CCC (n = 28), CD indeterminate form (n = 10) and healthy controls (n = 10). MiR-19a-3p, miR-21-5p, and miR-29b-3p were differentially expressed in CCC patients when compared to indeterminate form, showing a positive correlation with cardiac dysfunction, functional class, and fibrosis, and a negative correlation with ejection fraction and left ventricular strain. Cardiac tissue analysis confirmed increased expression of microRNAs in CCC patients. In vitro studies using human cells indicated the involvement of these microRNAs in the processes of cardiac hypertrophy and fibrosis. Our study suggests that miRNAs are involved in the process of cardiac fibrosis and remodeling presented in CD and indicate a group of miRNAs as potential biomarkers of disease progression in CCC.
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Affiliation(s)
- Carolina Kymie Vasques Nonaka
- Center for Biotechnology and Cell Therapy, Hospital São Rafael, 41253-190 Salvador, Brazil
- Gonçalo Moniz Institute, FIOCRUZ, 40296-710 Salvador, Brazil
- D'Or Institute for Research and Education (IDOR), 22281-100 Rio de Janeiro, Brazil
| | - Carolina Thé Macêdo
- Gonçalo Moniz Institute, FIOCRUZ, 40296-710 Salvador, Brazil
- Department of Cardiology, São Rafael Hospital, 41253-190 Salvador, Brazil
| | - Bruno Raphael Ribeiro Cavalcante
- Center for Biotechnology and Cell Therapy, Hospital São Rafael, 41253-190 Salvador, Brazil
- Gonçalo Moniz Institute, FIOCRUZ, 40296-710 Salvador, Brazil
- D'Or Institute for Research and Education (IDOR), 22281-100 Rio de Janeiro, Brazil
| | | | - Daniela Nascimento Silva
- Center for Biotechnology and Cell Therapy, Hospital São Rafael, 41253-190 Salvador, Brazil
- Gonçalo Moniz Institute, FIOCRUZ, 40296-710 Salvador, Brazil
| | | | - Alex Cleber Improta Caria
- Center for Biotechnology and Cell Therapy, Hospital São Rafael, 41253-190 Salvador, Brazil
- Federal University of Bahia, UFBA, 40231-300 Salvador, Brazil
| | | | | | | | - Silvia Regina Rogatto
- Department of Clinical Genetics, Vejle Hospital, Institute of Regional Health Research, University of Southern Denmark, 7100 Vejle, Denmark
| | - Ricardo Ribeiro Dos Santos
- Gonçalo Moniz Institute, FIOCRUZ, 40296-710 Salvador, Brazil
- National Institute of Science and Technology for Regenerative Medicine, 21941-902 Rio de Janeiro, Brazil
| | - Bruno Solano de Freitas Souza
- Center for Biotechnology and Cell Therapy, Hospital São Rafael, 41253-190 Salvador, Brazil
- Gonçalo Moniz Institute, FIOCRUZ, 40296-710 Salvador, Brazil
- D'Or Institute for Research and Education (IDOR), 22281-100 Rio de Janeiro, Brazil
- National Institute of Science and Technology for Regenerative Medicine, 21941-902 Rio de Janeiro, Brazil
| | - Milena Botelho Pereira Soares
- Gonçalo Moniz Institute, FIOCRUZ, 40296-710 Salvador, Brazil.
- National Institute of Science and Technology for Regenerative Medicine, 21941-902 Rio de Janeiro, Brazil.
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3
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Bacal F, Marcondes-Braga FG, Rohde LEP, Xavier Júnior JL, Brito FDS, Moura LAZ, Colafranceschi AS, Lavagnoli CFR, Gelape CL, Almeida DR, Gaiotto FA, Atik FA, Figueira FAMS, Souza GEC, Rodrigues H, Campos IW, Souza Neto JDD, Rossi Neto JM, Gasparetto J, Goldraich LA, Benvenuti LA, Seguro LFBC, Ulhôa Júnior MB, Moreira MDCV, Ávila MS, Carneiro R, Mangini S, Ferreira SMA, Strabelli TM. 3ª Diretriz Brasileira de Transplante Cardíaco. Arq Bras Cardiol 2019; 111:230-289. [PMID: 30335870 DOI: 10.5935/abc.20180153] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Fernando Bacal
- Instituto do Coração Hospital das Clínicas FMUSP (InCor-HCFMUSP), São Paulo, SP - Brasil
| | | | | | | | | | | | | | | | - Cláudio Leo Gelape
- Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil
| | | | - Fábio Antônio Gaiotto
- Instituto do Coração Hospital das Clínicas FMUSP (InCor-HCFMUSP), São Paulo, SP - Brasil
| | | | | | | | - Hélcio Rodrigues
- Instituto do Coração Hospital das Clínicas FMUSP (InCor-HCFMUSP), São Paulo, SP - Brasil
| | - Iáscara Wozniak Campos
- Instituto do Coração Hospital das Clínicas FMUSP (InCor-HCFMUSP), São Paulo, SP - Brasil
| | | | | | | | | | - Luiz Alberto Benvenuti
- Instituto do Coração Hospital das Clínicas FMUSP (InCor-HCFMUSP), São Paulo, SP - Brasil
| | | | | | | | - Mônica Samuel Ávila
- Instituto do Coração Hospital das Clínicas FMUSP (InCor-HCFMUSP), São Paulo, SP - Brasil
| | - Rodrigo Carneiro
- Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE - Brasil
| | - Sandrigo Mangini
- Instituto do Coração Hospital das Clínicas FMUSP (InCor-HCFMUSP), São Paulo, SP - Brasil
| | | | - Tânia Mara Strabelli
- Instituto do Coração Hospital das Clínicas FMUSP (InCor-HCFMUSP), São Paulo, SP - Brasil
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Larocca TF, Souza BSDF, Macêdo CT, Azevedo CM, Vasconcelos JF, Silva DN, Portella DCN, dos Santos WLC, Tavora FRF, Souza Neto JDD, dos Santos RR, Soares MBP. Assessment of syndecan-4 expression in the hearts of Trypanosoma cruzi-infected mice and human subjects with chronic Chagas disease cardiomyopathy. Surg Exp Pathol 2018. [DOI: 10.1186/s42047-018-0012-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Abstract
Background
Chronic Chagas cardiomyopathy (CCC) is characterized by the presence of a multifocal inflammatory response and myocardial damage, leading to fibrosis, arrhythmias and ventricular dysfunction. The expression of syndecan-4, a transmembrane proteoglycan, was previously found to be increased in the hearts of mice chronically infected with Trypanosoma cruzi. The possible involvement of syndecan-4 in the disease pathogenesis, however, remains unknown. Here we evaluated the pattern of expression of syndecan-4 in the heart tissue of T. cruzi infected mice and subjects with Chagas cardiomyopathy, correlating with the degree of inflammation and fibrosis.
Methods
The expression of syndecan-4 was evaluated by immunofluorescence and RT-qPCR in the hearts of C57Bl/6 mice at different time points after infection with the Colombian strain of T. cruzi. Immunostainings for syndecan-4 were performed in heart samples obtained from CCC patients and other etiologies of heart failure. The number of infiltrating inflammatory cells and area of fibrosis were also evaluated and quantified.
Results
In the experimental model, the number of infiltrating inflammatory cells and fibrosis area in the hearts progressively increased after the acute phase of infection, while syndecan-4 expression remained elevated in similar levels in both the acute and chronic phases. Confocal microscopy analysis demonstrated the localization of syndecan-4 expression in blood vessels, co-localized with α-SMA, a marker for vascular smooth muscle cells (VSMCs). Confocal microscopy analysis of human hearts samples showed a similar pattern of syndecan-4 expression in blood vessels. No correlation between syndecan-4 expression and inflammation or fibrosis was found in the hearts from subjects with CCC. We also compared the expression of syndecan-4 evaluated in subjects with CCC, idiopathic dilated cardiomyopathy and ischemic cardiomyopathy. No differences in the number of syndecan-4 positive vessels/mm2 were found comparing the three groups (P = 0.466), whereas CCC patients presented a higher number of infiltrating inflammatory cells, compared to the other etiologies of heart failure. Additionally, no correlation between syndecan-4 and fibrosis or numbers of inflammatory cells was found.
Conclusions
Syndecan-4 is expressed in the heart during the acute and chronic phases of Chagas disease, in association with VSMCs, independently of the degree of myocardial fibrosis or the number of infiltrating inflammatory cells.
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Fernandes LCBC, de Oliveira IM, Fernandes PFCBC, de Souza Neto JD, Farias MDSQ, de Freitas NA, Magalhães NC, Bacal F. Impact of Heart Transplantation on the Recovery of Peripheral and Respiratory Muscle Mass and Strength in Patients With Chronic Heart Failure. Transplant Direct 2018; 4:e395. [PMID: 30534588 PMCID: PMC6233658 DOI: 10.1097/txd.0000000000000837] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 08/28/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To assess the impact of heart transplantation (HT) on the recovery of peripheral and respiratory muscle mass and strength in patients with congestive heart failure. METHODS The study included 23 patients with an indication for HT (patients in the waiting list [WL] group). These patients were monitored for 1.5 to 3 years after HT; 8 died before 6 months of follow-up, 15 patients completed the early follow-up period of 6 months after HT (FU6m group), 4 died between 6 months and 3 years after HT, and 11 patients completed the late follow-up period 1.5 to 3 years after HT (FU1.5-3y group). Twenty-three healthy subjects were included in the control group. The study variables included inspiratory muscle strength, expressed as the maximum inspiratory pressure (MIP); expiratory muscle strength, expressed as the maximum expiratory pressure (MEP); peripheral muscle strength, expressed as bilateral handgrip strength (bHGS); and the cross-sectional area of the bilateral psoas major muscle (CSAbPm). RESULTS The results showed a reduction in the CSAbPm (1238.9 ± 312.3 mm2), a reduction in the bHGS (27.0 ± 5.7 kg/f), a reduction in the MIP (60.2 ± 29.8 cmH2O), and a reduction in the MEP (75.2 ± 33.4 cmH2O) in patients in the WL group compared with the healthy controls. In the time series comparison, for patients in the WL, FU6m, and FU1.5-3y groups, increases were found in the CSAbPm (1305.4 vs 1458.1 vs 1431.3 mm2, respectively), bHGS (27.3 vs 30.2 vs 34.7 kg/f, respectively), MIP (59.5 vs 85.5 vs 90.9 cmH2O, respectively), and MEP (79.5 vs 93.2 vs 101.8 cmH2O, respectively) (P < 0.00). CONCLUSIONS Sarcopenia was observed in patients in the WL group. Patients recovered peripheral and respiratory muscle mass and strength at 3 years after HT.
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Affiliation(s)
- Lenise C B C Fernandes
- Heart Institute University of São Paulo School of Medicine and Heart and Lung Messejana's Hospital, Fortaleza, CE, Brazil
| | | | | | | | | | | | | | - Fernando Bacal
- Heart Institute University of São Paulo School of Medicine and Heart and Lung Messejana's Hospital, Fortaleza, CE, Brazil
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Souza BSDF, Silva DN, Carvalho RH, Sampaio GLDA, Paredes BD, Aragão França L, Azevedo CM, Vasconcelos JF, Meira CS, Neto PC, Macambira SG, da Silva KN, Allahdadi KJ, Tavora F, de Souza Neto JD, Dos Santos RR, Soares MBP. Association of Cardiac Galectin-3 Expression, Myocarditis, and Fibrosis in Chronic Chagas Disease Cardiomyopathy. Am J Pathol 2017; 187:1134-1146. [PMID: 28322201 DOI: 10.1016/j.ajpath.2017.01.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 01/19/2017] [Indexed: 01/30/2023]
Abstract
Chronic Chagas disease cardiomyopathy, caused by Trypanosoma cruzi infection, is a major cause of heart failure in Latin America. Galectin-3 (Gal-3) has been linked to cardiac remodeling and poor prognosis in heart failure of different etiologies. Herein, we investigated the involvement of Gal-3 in the disease pathogenesis and its role as a target for disease intervention. Gal-3 expression in mouse hearts was evaluated during T. cruzi infection by confocal microscopy and flow cytometry analysis, showing a high expression in macrophages, T cells, and fibroblasts. In vitro studies using Gal-3 knockdown in cardiac fibroblasts demonstrated that Gal-3 regulates cell survival, proliferation, and type I collagen synthesis. In vivo blockade of Gal-3 with N-acetyl-d-lactosamine in T. cruzi-infected mice led to a significant reduction of cardiac fibrosis and inflammation in the heart. Moreover, a modulation in the expression of proinflammatory genes in the heart was observed. Finally, histological analysis in human heart samples obtained from subjects with Chagas disease who underwent heart transplantation showed the expression of Gal-3 in areas of inflammation, similar to the mouse model. Our results indicate that Gal-3 plays a role in the pathogenesis of experimental chronic Chagas disease, favoring inflammation and fibrogenesis. Moreover, by demonstrating Gal-3 expression in human hearts, our finding reinforces that this protein could be a novel target for drug development for Chagas cardiomyopathy.
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Affiliation(s)
- Bruno Solano de Freitas Souza
- Gonçalo Moniz Research Center, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil; Center for Biotechnology and Cell Therapy, São Rafael Hospital, Salvador, Brazil
| | | | | | | | - Bruno Diaz Paredes
- Center for Biotechnology and Cell Therapy, São Rafael Hospital, Salvador, Brazil
| | | | - Carine Machado Azevedo
- Gonçalo Moniz Research Center, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil; Center for Biotechnology and Cell Therapy, São Rafael Hospital, Salvador, Brazil
| | - Juliana Fraga Vasconcelos
- Gonçalo Moniz Research Center, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil; Center for Biotechnology and Cell Therapy, São Rafael Hospital, Salvador, Brazil
| | - Cassio Santana Meira
- Gonçalo Moniz Research Center, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil; Center for Biotechnology and Cell Therapy, São Rafael Hospital, Salvador, Brazil
| | - Paulo Chenaud Neto
- Center for Biotechnology and Cell Therapy, São Rafael Hospital, Salvador, Brazil
| | - Simone Garcia Macambira
- Gonçalo Moniz Research Center, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil; Center for Biotechnology and Cell Therapy, São Rafael Hospital, Salvador, Brazil; Health Sciences Institute, Federal University of Bahia, Salvador, Brazil
| | - Kátia Nunes da Silva
- Center for Biotechnology and Cell Therapy, São Rafael Hospital, Salvador, Brazil
| | - Kyan James Allahdadi
- Center for Biotechnology and Cell Therapy, São Rafael Hospital, Salvador, Brazil
| | - Fabio Tavora
- Messejana Heart and Lung Hospital, Fortaleza, Brazil
| | | | | | - Milena Botelho Pereira Soares
- Gonçalo Moniz Research Center, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil; Center for Biotechnology and Cell Therapy, São Rafael Hospital, Salvador, Brazil.
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Montera MW, Mesquita ET, Colafranceschi AS, Oliveira ACD, Rabischoffsky A, Ianni BM, Rochitte CE, Mady C, Mesquita CT, Azevedo CF, Bocchi EA, Saad EB, Braga FGM, Fernandes F, Ramires FJA, Bacal F, Feitosa GS, Figueira HR, Souza Neto JDD, Moura LAZ, Campos LADA, Bittencourt MI, Barbosa MDM, Moreira MDCV, Higuchi MDL, Schwartzmann P, Rocha RM, Pereira SB, Mangini S, Martins SM, Bordignon S, Salles VA. I Brazilian guidelines on myocarditis and pericarditis. Arq Bras Cardiol 2014; 100:1-36. [PMID: 23765413 DOI: 10.5935/abc.2013s004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Bacal F, Neto JDDS, Fiorelli AI, Mejia J, Marcondes-Braga FG, Mangini S, Oliveira JDL, de Almeida DR, Azeka E, Dinkhuysen JJ, Moreira MDCV, Neto JMR, Bestetti RB, Fernandes JR, Cruz FDD, Ferreira LP, da Costa HM, Pereira AAM, Panajotopoulos N, Benvenuti LA, Moura LZ, Vasconcelos GG, Branco JNR, Gelape CL, Uchoa RB, Ayub-Ferreira SM, Camargo LFA, Colafranceschi AS, Bordignon S, Cipullo R, Horowitz ESK, Branco KC, Jatene M, Veiga SL, Marcelino CAG, Teixeira Filho GF, Vila JH, Montera MW. [II Brazilian Guidelines for Cardiac Transplantation]. Arq Bras Cardiol 2010; 94:e16-e76. [PMID: 20625634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
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9
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Montera MW, Almeida DRD, Tinoco EM, Rocha RM, Moura LAZ, Réa-Neto Á, Pereira SB, Mangini S, Braga FGM, Albuquerque DC, Stefanini E, Saad EB, Vilas-Boas F, Silva FBD, Ramires FJA, Soriano FG, Westphal G, Ribeiro GCDA, Almeida Júnior GLGD, Júnior HV, Neto JDDS, Costa JLF, Neto JMR, Baracioli LM, Beck da Silva Neto L, Camanho LE, Bittencourt MI, Garcia MI, Moreira MDCV, Moritz RD, Gusmão R, Martins SM, Bordignon S, Fiorelli AI. [II Brazilian Guidelines on Acute Cardiac Insufficiency]. Arq Bras Cardiol 2009; 93:2-65. [PMID: 20721452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
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Bocchi EA, Braga FGM, Ferreira SMA, Rohde LEP, Oliveira WAD, Almeida DRD, Moreira MDCV, Bestetti RB, Bordignon S, Azevedo C, Tinoco EM, Rocha RM, Issa VS, Ferraz A, Cruz FDD, Guimarães GV, Montera VDSP, Albuquerque DC, Bacal F, Souza GEC, Rossi Neto JM, Clausell NO, Martins SM, Siciliano A, Souza Neto JDD, Moreira LF, Teixeira RA, Moura LZ, Beck-da-Silva L, Rassi S, Azeka E, Horowitz E, Ramires F, Simões MV, Castro RBPD, Salemi VMC, Villacorta Junior H, Vila JH, Simões R, Albanesi F, Montera MW. [III Brazilian Guidelines on Chronic Heart Failure]. Arq Bras Cardiol 2009; 93:3-70. [PMID: 20963312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Affiliation(s)
- Edimar Alcides Bocchi
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo.
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