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Almeida ALC, Melo MDTD, Bihan DCDSL, Vieira MLC, Pena JLB, Del Castillo JM, Abensur H, Hortegal RDA, Otto MEB, Piveta RB, Dantas MR, Assef JE, Beck ALDS, Santo THCE, Silva TDO, Salemi VMC, Rocon C, Lima MSM, Barberato SH, Rodrigues AC, Rabschkowisky A, Frota DDCR, Gripp EDA, Barretto RBDM, Silva SME, Cauduro SA, Pinheiro AC, Araujo SPD, Tressino CG, Silva CES, Monaco CG, Paiva MG, Fisher CH, Alves MSL, Grau CRPDC, Santos MVCD, Guimarães ICB, Morhy SS, Leal GN, Soares AM, Cruz CBBV, Guimarães Filho FV, Assunção BMBL, Fernandes RM, Saraiva RM, Tsutsui JM, Soares FLDJ, Falcão SNDRS, Hotta VT, Armstrong ADC, Hygidio DDA, Miglioranza MH, Camarozano AC, Lopes MMU, Cerci RJ, Siqueira MEMD, Torreão JA, Rochitte CE, Felix A. Position Statement on the Use of Myocardial Strain in Cardiology Routines by the Brazilian Society of Cardiology's Department Of Cardiovascular Imaging - 2023. Arq Bras Cardiol 2023; 120:e20230646. [PMID: 38232246 DOI: 10.36660/abc.20230646] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
Abstract
Central Illustration : Position Statement on the Use of Myocardial Strain in Cardiology Routines by the Brazilian Society of Cardiology's Department Of Cardiovascular Imaging - 2023 Proposal for including strain in the integrated diastolic function assessment algorithm, adapted from Nagueh et al.67 Am: mitral A-wave duration; Ap: reverse pulmonary A-wave duration; DD: diastolic dysfunction; LA: left atrium; LASr: LA strain reserve; LVGLS: left ventricular global longitudinal strain; TI: tricuspid insufficiency. Confirm concentric remodeling with LVGLS. In LVEF, mitral E wave deceleration time < 160 ms and pulmonary S-wave < D-wave are also parameters of increased filling pressure. This algorithm does not apply to patients with atrial fibrillation (AF), mitral annulus calcification, > mild mitral valve disease, left bundle branch block, paced rhythm, prosthetic valves, or severe primary pulmonary hypertension.
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Affiliation(s)
| | | | | | - Marcelo Luiz Campos Vieira
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (Incor/FMUSP), São Paulo, SP - Brasil
| | - José Luiz Barros Pena
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, MG - Brasil
- Hospital Felicio Rocho, Belo Horizonte, MG - Brasil
| | | | - Henry Abensur
- Beneficência Portuguesa de São Paulo, São Paulo, SP - Brasil
| | | | | | | | | | | | | | | | | | - Vera Maria Cury Salemi
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (Incor/FMUSP), São Paulo, SP - Brasil
| | - Camila Rocon
- Hospital do Coração (HCor), São Paulo, SP - Brasil
| | - Márcio Silva Miguel Lima
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (Incor/FMUSP), São Paulo, SP - Brasil
| | | | | | | | | | - Eliza de Almeida Gripp
- Hospital Pró-Cardiaco, Rio de Janeiro, RJ - Brasil
- Hospital Universitário Antônio Pedro da Universidade Federal Fluminense (UFF), Rio de Janeiro, RJ - Brasil
| | | | | | | | | | | | | | | | | | | | | | | | | | - Maria Veronica Camara Dos Santos
- Departamento de Cardiologia Pediátrica (DCC/CP) da Sociedade Brasileira de Cardiologia (SBC), São Paulo, SP - Brasil
- Sociedade Brasileira de Oncologia Pediátrica, São Paulo, SP - Brasil
| | | | | | - Gabriela Nunes Leal
- Instituto da Criança e do Adolescente do Hospital das Clinicas Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | | | | | | | | | | | | | | | | | - Viviane Tiemi Hotta
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (Incor/FMUSP), São Paulo, SP - Brasil
- Grupo Fleury, São Paulo, SP - Brasil
| | | | - Daniel de Andrade Hygidio
- Hospital Nossa Senhora da Conceição, Tubarão, SC - Brasil
- Universidade do Sul de Santa Catarina (UNISUL), Tubarão, SC - Brasil
| | - Marcelo Haertel Miglioranza
- EcoHaertel - Hospital Mae de Deus, Porto Alegre, RS - Brasil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS - Brasil
| | | | | | | | | | - Jorge Andion Torreão
- Hospital Santa Izabel, Salvador, BA - Brasil
- Santa Casa da Bahia, Salvador, BA - Brasil
| | - Carlos Eduardo Rochitte
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (Incor/FMUSP), São Paulo, SP - Brasil
- Hospital do Coração (HCor), São Paulo, SP - Brasil
| | - Alex Felix
- Diagnósticos da América SA (DASA), São Paulo, SP - Brasil
- Instituto Nacional de Cardiologia (INC), Rio de Janeiro, RJ - Brasil
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Barbosa ICDQ, de Paula Gomes L, de Almeida Feitosa IN, Botelho LFB, Barbosa BRC, Barbosa A, Araújo ATDV, de Melo MDT, Melo ASDO, Salemi VMC. Morphological and functional cardiac alterations in children with congenital Zika syndrome and severe neurological deficits. PLoS Negl Trop Dis 2023; 17:e0011762. [PMID: 38019886 PMCID: PMC10712894 DOI: 10.1371/journal.pntd.0011762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 12/11/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Zika virus infection during pregnancy causes fetal microcephaly and brain damage. Congenital Zika syndrome (CZS) is characterized by systemic involvement with diffuse muscle impairment, a high frequency of arthrogryposis, and microphthalmia. Cardiac impairment in CZS has rarely been evaluated. Our study assessed morphology and biventricular cardiac function in children with CZS and advanced neurological dysfunction. METHODS This cross-sectional study was conducted on 52 children with CZS (Zika group; ZG) and 25 healthy children (control group; CG) in Paraiba, Brazil. Clinical evaluation, electrocardiogram (EKG), and transthoracic echocardiogram (TTE) were performed on all children. Additionally, troponin I and natriuretic peptide type B (BNP) levels, the degree of cerebral palsy, and neuroimaging findings were assessed in the ZG group. RESULTS The median age of the study population was 5 years in both groups, and 40.4% (ZG) and 60% (CG) were female. The most prevalent electrocardiographic alteration was sinus arrhythmia in both the ZG (n = 9, 17.3%) and CG (n = 4, 16%). The morphological parameters adjusted for Z score were as follows: left ventricular (LV) end-diastolic diameter in ZG: -2.36 [-5.10, 2.63] vs. CG: -1.07 [-3.43, 0.61], p<0.001); ascending aorta (ZG: -0.09 [-2.08, 1.60] vs. CG: 0.43 [-1.47, 2.2], p = 0.021); basal diameter of the right ventricle (RV) (ZG: -2.34 [-4.90, 0.97] vs. CG: -0.96 [-2.21, 0.40], p<0.01); and pulmonary artery dimension (ZG: -2.13 [-5.99, 0.98] vs. CG: -0.24 [-2.53, 0.59], p<0.01). The ejection fractions (%) were 65.7 and 65.6 in the ZG and CG, respectively (p = 0.968). The left atrium volume indices (mL/m2) in the ZG and CG were 13.15 [6.80, 18.00] and 18.80 [5.90, 25.30] (p<0.01), respectively, and the right atrium volume indices (mL/m2) were 10.10 [4.90, 15.30] and 15.80 [4.10, 24.80] (p<0.01). The functional findings adjusted for Z score were as follows: lateral systolic excursion of the mitral annular plane (MAPSE) (ZG: 0.36 [-2.79, 4.71] vs. CG: 1.79 [-0.93, 4.5], p = 0.001); tricuspid annular plane systolic excursion (TAPSE) (ZG: -2.43 [-5.47, 5.09] vs. CG: 0.07 [-1.98, 3.64], p<0.001); and the S' of the RV (ZG: 1.20 [3.35, 2.90] vs. CG: -0.20 [-2.15, 1.50], p = 0.0121). No differences in biventricular strain measurements were observed between the groups. Troponin I and BNP levels were normal in in the ZG. Grade V cerebral palsy and subcortical calcification were found in 88.6% and 97.22% of children in the ZG group, respectively. CONCLUSION A reduction in cardiac dimensions and functional changes were found in CZS patients, based on the TAPSE, S' of the RV, and MAPSE, suggesting the importance of cardiac evaluation and follow-up in this group of patients.
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Affiliation(s)
- Imara Correia de Queiroz Barbosa
- Federal University of Campina Grande, Campina Grande, Brazil
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Luís Fábio Barbosa Botelho
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Federal University of Paraíba, João Pessoa, Brazil
| | | | - Alex Barbosa
- Federal University of Campina Grande, Campina Grande, Brazil
| | | | | | - Adriana Suely de Oliveira Melo
- Federal University of Campina Grande, Campina Grande, Brazil
- Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), Campina Grande, Brazil
| | - Vera Maria Cury Salemi
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Sirio Libanes Hospital, São Paulo, Brazil
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Espinoza Romero C, Lima ICV, Hotta VT, Bocchi EA, Salemi VMC. Endomyocardial fibrosis of the right ventricle in a patient with schistosomiasis: a case report. Eur Heart J Case Rep 2022; 6:ytac312. [PMID: 35949701 PMCID: PMC9356724 DOI: 10.1093/ehjcr/ytac312] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 02/08/2022] [Revised: 03/11/2022] [Accepted: 07/22/2022] [Indexed: 11/14/2022]
Abstract
Background Endomyocardial fibrosis (EMF) is a rare and underdiagnosed cause of restrictive cardiomyopathy. Its aetiology is not yet defined and could be caused by the influence of different clinical factors that seem to combine with genetic aspects of individuals susceptible to an inflammatory process that leads to formation of fibrosis. Case summary We describe a case of a 50-year-old man from the northeastern region of Brazil, where there is high prevalence of schistosomiasis. He presented to our centre with symptoms of right heart failure. The echocardiogram showed normal left ventricular ejection fraction. Right ventricular had normal systolic function but in the apical region was filled with a homogeneous and hypoechoic image causing obliteration and restriction of the apex. The late gadolinium enhancement with cardiac magnetic resonance showed diffuse and heterogeneous subendocardial fibrosis in the right ventricle apex consistent with EMF, but declined endocardiectomy. Discussion This report presents an interesting case of EMF and schistosomiasis simultaneously. The hypothesis of parasitosis as a probable cause of EMF was raised by helminth-induced hypereosinophilia. Complementary imaging tests such as magnetic resonance imaging and echocardiography, in addition to clinical and epidemiological suspicion, are essential for its diagnosis. Early surgical resolution becomes crucial for long-term survival.
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Affiliation(s)
- Cristhian Espinoza Romero
- Heart failure deparment.Heart Institute (InCor). Hospital das Clinicas da Universidade de São Paulo , São Paulo , Brazil
| | - Ivna Cunha Vieira Lima
- Heart failure deparment.Heart Institute (InCor). Hospital das Clinicas da Universidade de São Paulo , São Paulo , Brazil
| | - Viviane Tiemi Hotta
- Heart failure deparment.Heart Institute (InCor). Hospital das Clinicas da Universidade de São Paulo , São Paulo , Brazil
| | - Edimar Alcides Bocchi
- Heart failure deparment.Heart Institute (InCor). Hospital das Clinicas da Universidade de São Paulo , São Paulo , Brazil
| | - Vera Maria Cury Salemi
- Heart failure deparment.Heart Institute (InCor). Hospital das Clinicas da Universidade de São Paulo , São Paulo , Brazil
- Coronary Deparment. Hospital Sírio Libanês , São Paulo , Brazil
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Tavares de Melo MD, Araujo-Filho JDAB, Barbosa JR, Rocon C, Miranda Regis CD, dos Santos Felix A, Kalil Filho R, Bocchi EA, Hajjar LA, Tabassian M, D’hooge J, Salemi VMC. A machine learning framework for the evaluation of myocardial rotation in patients with noncompaction cardiomyopathy. PLoS One 2021; 16:e0260195. [PMID: 34843536 PMCID: PMC8629285 DOI: 10.1371/journal.pone.0260195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 11/05/2021] [Indexed: 11/19/2022] Open
Abstract
Aims Noncompaction cardiomyopathy (NCC) is considered a genetic cardiomyopathy with unknown pathophysiological mechanisms. We propose to evaluate echocardiographic predictors for rigid body rotation (RBR) in NCC using a machine learning (ML) based model. Methods and results Forty-nine outpatients with NCC diagnosis by echocardiography and magnetic resonance imaging (21 men, 42.8±14.8 years) were included. A comprehensive echocardiogram was performed. The layer-specific strain was analyzed from the apical two-, three, four-chamber views, short axis, and focused right ventricle views using 2D echocardiography (2DE) software. RBR was present in 44.9% of patients, and this group presented increased LV mass indexed (118±43.4 vs. 94.1±27.1g/m2, P = 0.034), LV end-diastolic and end-systolic volumes (P< 0.001), E/e’ (12.2±8.68 vs. 7.69±3.13, P = 0.034), and decreased LV ejection fraction (40.7±8.71 vs. 58.9±8.76%, P < 0.001) when compared to patients without RBR. Also, patients with RBR presented a significant decrease of global longitudinal, radial, and circumferential strain. When ML model based on a random forest algorithm and a neural network model was applied, it found that twist, NC/C, torsion, LV ejection fraction, and diastolic dysfunction are the strongest predictors to RBR with accuracy, sensitivity, specificity, area under the curve of 0.93, 0.99, 0.80, and 0.88, respectively. Conclusion In this study, a random forest algorithm was capable of selecting the best echocardiographic predictors to RBR pattern in NCC patients, which was consistent with worse systolic, diastolic, and myocardium deformation indices. Prospective studies are warranted to evaluate the role of this tool for NCC risk stratification.
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Affiliation(s)
- Marcelo Dantas Tavares de Melo
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Camila Rocon
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Sírio Libanês Hospital, São Paulo, Brazil
| | | | | | - Roberto Kalil Filho
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Sírio Libanês Hospital, São Paulo, Brazil
| | - Edimar Alcides Bocchi
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ludhmila Abrahão Hajjar
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Mahdi Tabassian
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jan D’hooge
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Vera Maria Cury Salemi
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Sírio Libanês Hospital, São Paulo, Brazil
- * E-mail:
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Aragão CADS, Salemi VMC. The Importance of Early Diagnosis and Treatment for Pericardial Effusion and Cardiac Tamponade. International Journal of Cardiovascular Sciences 2021. [DOI: 10.36660/ijcs.20210222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Mahmoodurrahman M, Marek J, Juhardeen HR, Al Otaibi T, Salemi VMC, Echahidi N, Al Buraiki J, Fadel BM, Mohty D. Diagnostic Accuracy of Dobutamine Stress Echocardiography for Detection of Cardiac Allograft Vasculopathy in Orthotopic Heart Transplant Patients. J Saudi Heart Assoc 2021; 33:279-283. [PMID: 35083117 PMCID: PMC8754441 DOI: 10.37616/2212-5043.1265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/07/2021] [Revised: 07/04/2021] [Accepted: 08/01/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Josef Marek
- 2nd Department of Medicine – Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague,
Czech Republic
| | | | - Talal Al Otaibi
- King Faisal Specialist Hospital & Research Center, Riyadh,
Saudi Arabia
| | - Vera Maria Cury Salemi
- Heart Failure Clinics, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo,
Brazil
| | | | - Jehad Al Buraiki
- King Faisal Specialist Hospital & Research Center, Riyadh,
Saudi Arabia
| | - Bahaa M. Fadel
- King Faisal Specialist Hospital & Research Center, Riyadh,
Saudi Arabia
| | - Dania Mohty
- King Faisal Specialist Hospital & Research Center, Riyadh,
Saudi Arabia
- Corresponding author at: King Faisal Specialist Hospital & Research Center, Heart Center, PO Box: 3354, MBC # 16, Riyadh, 11211, Saudi Arabia. Fax: +966 114427482. E-mail address: (D. Mohty)
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Melo MDTD, Paiva MG, Santos MVC, Rochitte CE, Moreira VDM, Saleh MH, Brandão SCS, Gallafrio CC, Goldwasser D, Gripp EDA, Piveta RB, Silva TO, Santo THCE, Ferreira WP, Salemi VMC, Cauduro SA, Barberato SH, Lopes HMC, Pena JLB, Rached HRS, Miglioranza MH, Pinheiro AC, Vrandecic BALM, Cruz CBBV, Nomura CH, Cerbino FME, Costa IBSDS, Coelho Filho OR, Carneiro ACDC, Burgos UMMC, Fernandes JL, Uellendahl M, Calado EB, Senra T, Assunção BL, Freire CMV, Martins CN, Sawamura KSS, Brito MM, Jardim MFS, Bernardes RJM, Diógenes TC, Vieira LDO, Mesquita CT, Lopes RW, Segundo Neto EMV, Rigo L, Marin VLS, Santos MJ, Grossman GB, Quagliato PC, Alcantara MLD, Teodoro JAR, Albricker ACL, Barros FS, Amaral SID, Porto CLL, Barros MVL, Santos SND, Cantisano AL, Petisco ACGP, Barbosa JEM, Veloso OCG, Spina S, Pignatelli R, Hajjar LA, Kalil Filho R, Lopes MACQ, Vieira MLC, Almeida ALC. Brazilian Position Statement on the Use Of Multimodality Imaging in Cardio-Oncology - 2021. Arq Bras Cardiol 2021; 117:845-909. [PMID: 34709307 PMCID: PMC8528353 DOI: 10.36660/abc.20200266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
| | | | | | - Carlos Eduardo Rochitte
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Hospital do Coração (HCOR), São Paulo, SP - Brasil
| | | | - Mohamed Hassan Saleh
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil
| | | | | | - Daniel Goldwasser
- Hospital Federal de Ipanema, Rio de Janeiro, RJ - Brasil
- Hospital Copa D'Or, Rio de Janeiro, RJ - Brasil
- Casa de Saúde São José, Rio de Janeiro, RJ - Brasil
| | - Eliza de Almeida Gripp
- Hospital Pró-Cardíaco, Rio de Janeiro, RJ - Brasil
- Hospital Universitário Antônio Pedro, Rio de Janeiro, RJ - Brasil
| | | | - Tonnison Oliveira Silva
- Hospital Cardio Pulmonar - Centro de Estudos em Cardiologia, Salvador, BA - Brasil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA - Brasil
| | | | | | - Vera Maria Cury Salemi
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | - Silvio Henrique Barberato
- CardioEco Centro de Diagnóstico Cardiovascular, Curitiba, PR - Brasil
- Quanta Diagnóstico, Curitiba, PR - Brasil
| | | | | | | | - Marcelo Haertel Miglioranza
- Instituto de Cardiologia do Rio Grande do Sul - Laboratório de Pesquisa e Inovação em Imagem Cardiovascular, Porto Alegre, RS - Brasil
- Hospital Mãe de Deus, Porto Alegre, RS - Brasil
| | | | | | | | - César Higa Nomura
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Hospital Sírio-Libanês, São Paulo, SP - Brasil
| | - Fernanda Mello Erthal Cerbino
- Clínica de Diagnóstico por Imagem, Rio de Janeiro, RJ - Brasil
- Diagnósticos da América AS, Rio de Janeiro, RJ - Brasil
| | | | | | | | | | - Juliano Lara Fernandes
- Radiologia Clínica de Campinas, Campinas, SP - Brasil
- Instituto de Ensino e Pesquisa José Michel Kalaf, Campinas, SP - Brasil
| | - Marly Uellendahl
- Diagnósticos da América AS, Rio de Janeiro, RJ - Brasil
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP - Brasil
| | | | - Tiago Senra
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil
- Hospital Sírio-Libanês, São Paulo, SP - Brasil
| | - Bruna Leal Assunção
- Universidade de São Paulo Instituto do Câncer do Estado de São Paulo, São Paulo, SP - Brasil
| | - Claudia Maria Vilas Freire
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- ECOCENTER, Belo Horizonte, MG - Brasil
| | | | - Karen Saori Shiraishi Sawamura
- Hospital do Coração (HCOR), São Paulo, SP - Brasil
- Hospital Universitário Antônio Pedro, Rio de Janeiro, RJ - Brasil
- Instituto da Criança da Universidade de São Paulo (USP), São Paulo, SP - Brasil
| | - Márcio Miranda Brito
- Universidade Federal do Tocantins - Campus de Araguaina, Araguaina, TO - Brasil
- Hospital Municipal de Araguaina, Araguaina, TO - Brasil
| | | | | | | | | | - Claudio Tinoco Mesquita
- Hospital Pró-Cardíaco, Rio de Janeiro, RJ - Brasil
- Universidade Federal Fluminense (UFF), Rio de Janeiro, RJ - Brasil
- Hospital Vitória, Rio de Janeiro, RJ - Brasil
| | | | | | - Letícia Rigo
- Hospital Beneficência Portuguesa, São Paulo, SP - Brasil
| | | | | | - Gabriel Blacher Grossman
- Clínica Cardionuclear, Porto Alegre, RS - Brasil
- Hospital Moinhos de Vento, Porto Alegre, RS - Brasil
| | | | - Monica Luiza de Alcantara
- Americas Medical City, Rio de Janeiro, Rio de Janeiro, RJ - Brasil
- Americas Serviços Médicos, Rio de Janeiro, RJ - Brasil
- Rede D'Or, Rio de Janeiro, RJ - Brasil
| | | | | | | | | | | | | | - Simone Nascimento Dos Santos
- Hospital Brasília - Ecocardiografia, Brasília, DF - Brasil
- Eccos Diagnóstico Cardiovascular Avançado, Brasília, DF - Brasil
| | | | | | | | | | | | - Ricardo Pignatelli
- Texas Children's Hospital, Houston, Texas - EUA
- Baylor College of Medicine, Houston, Texas - EUA
| | - Ludhmilla Abrahão Hajjar
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Universidade de São Paulo Instituto do Câncer do Estado de São Paulo, São Paulo, SP - Brasil
| | - Roberto Kalil Filho
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Universidade de São Paulo Instituto do Câncer do Estado de São Paulo, São Paulo, SP - Brasil
| | - Marcelo Antônio Cartaxo Queiroga Lopes
- Hospital Alberto Urquiza Wanderley - Hemodinâmica e Cardiologia Intervencionista, João Pessoa, PB - Brasil
- Hospital Metropolitano Dom José Maria Pires, João Pessoa, PB - Brasil
- Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brasil
| | - Marcelo Luiz Campos Vieira
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Hospital Israelita Albert Einstein, São Paulo, SP - Brasil
| | - André Luiz Cerqueira Almeida
- Santa Casa de Misericórdia de Feira de Santana - Cardiologia, Feira de Santana, BA - Brasil
- Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia, São Paulo, SP - Brasil
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Melo MDTD, Pena JLB, Oliveira Júnior JD, Salemi VMC. Should Patients with Heyde's Syndrome Undergo Early Valve Intervention? Arq Bras Cardiol 2021; 117:518-519. [PMID: 34550237 PMCID: PMC8462950 DOI: 10.36660/abc.20210734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
| | | | - Jorge de Oliveira Júnior
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo - Brasil
| | - Vera Maria Cury Salemi
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo - Brasil
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Santana VJD, Deângelo CEDO, Salemi VMC, Miranda DP. THE INFLUENCE OF ISCHEMIC PRECONDITIONING ON NEUROMUSCULAR PERFORMANCE. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127022020_0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Ischemic preconditioning (IPC) has been described in the literature as a resource capable of improving physical performance. Objective: The purpose of this randomized double-blind study was to evaluate the influence of IPC on the neuromuscular performance of trained individuals. Methods: Twenty-four (24) resistance training participants (6 of them women) with a mean age of 25.8 ± 4.6 years were selected and divided into two groups: the upper limb group (ULG) composed of 12 individuals (4 women) and the lower limb group (LLG) composed of 12 individuals (2 women). The maximum repetitions test was applied in the bench press for the ULG and in the 45° leg press for the LLG, with 50% of the one-repetition maximum under control, placebo and IPC conditions, at a random interval of 72 hours between tests. The IPC was applied four hours before the tests by means of an analog sphygmomanometer cuff inflated to 220 mmHg on the arm for the ULG and on the thigh for LLG, with three cycles of five minutes each of ischemia and reperfusion, alternating between the right and left sides. For the placebo, the cuff was inflated to 40 mmHg without causing ischemia. The significance level for the Wilcoxon test was p <0.017, due to the Bonferroni correction. The effect size (ES) was also analyzed. Results: With IPC, the ULG performed 34.8 ± 4.8 repetitions, representing an improvement of 11.29% (IPC vs. control, ES = 0.68 and p = 0.002) and the LLG performed 40.5 ± 15.7 repetitions, representing an improvement of 37.47% (IPC vs. control, ES = 0.84 and p = 0.002). No significant improvements were observed for the placebo in either group. Conclusion: Our data showed that IPC positively influenced neuromuscular performance of both the upper and lower limbs. Level of evidence II; Therapeutic studies investigating the results of treatment (Prospectived comparative studye).
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Affiliation(s)
| | | | | | - Douglas Pinheiro Miranda
- Centro Universitário da Fundação Educacional de Barretos, Brazil; Universidade de São Paulo, Brazil
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10
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Salemi VMC, Mohty D, de Altavila SLL, de Melo MDT, Kalil R, Bocchi EA. Insights into the Classification of Cardiomyopathies: Past, Present, and Future Directions. Clinics (Sao Paulo) 2021; 76:e2808. [PMID: 33787660 PMCID: PMC7978844 DOI: 10.6061/clinics/2021/e2808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/24/2021] [Indexed: 02/03/2023] Open
Affiliation(s)
- Vera Maria Cury Salemi
- Unidade Clinica de Insuficiencia Cardiaca, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Unidade Coronaria, Hospital Sirio Libanes, Sao Paulo, SP, BR
| | - Dania Mohty
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Sonia Lages Lustosa de Altavila
- Unidade Clinica de Insuficiencia Cardiaca, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | | | - Roberto Kalil
- Unidade Clinica de Insuficiencia Cardiaca, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Unidade Coronaria, Hospital Sirio Libanes, Sao Paulo, SP, BR
| | - Edimar Alcides Bocchi
- Unidade Clinica de Insuficiencia Cardiaca, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
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11
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Normando PG, Araujo-Filho JDA, Fonseca GDA, Rodrigues REF, Oliveira VA, Hajjar LA, Almeida ALC, Bocchi EA, Salemi VMC, Melo M. Reduction in Hospitalization and Increase in Mortality Due to Cardiovascular Diseases during the COVID-19 Pandemic in Brazil. Arq Bras Cardiol 2021; 116:371-380. [PMID: 33566937 PMCID: PMC8159562 DOI: 10.36660/abc.20200821] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/14/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND In the COVID-19 pandemic, the increase in the incidence of cardiovascular diseases (CVD) and mortality from them has been recognized worldwide. In Brazil, the impact of COVID-19 on CVD must be evaluated. OBJECTIVES To assess the impact of the current pandemic on the numbers of hospital admissions (HA), in-hospital deaths (ID), and in-hospital fatality (IF) from CVD by use of national epidemiological data from the Brazilian Unified Public Health System. METHODS Time-series observational study using comparative analysis of the HA, ID, and IF due to CVD recorded from January to May 2020, having as reference the values registered in the same period from 2016 to 2019 and the values projected by linear regression methods for 2020. The statistical significance level applied was 0.05. RESULTS Compared to the same period in 2019, there was a 15% decrease in the HA rate and a 9% decrease in the total ID due to CVD between March and May 2020, followed by a 9% increase in the IF rate due to CVD, especially among patients aged 20-59 years. The HA and IF rates registered in 2020 differed significantly from the projected trend for 2020 (p = 0.0005 and 0.0318, respectively). CONCLUSIONS During the first months of the pandemic, there were a decline in HA and an increase in IF due to CVD in Brazil. These data might have resulted from the inadequate planning of the CVD management during the pandemic. Thus, immediate actions are required to change this scenario. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0).
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Affiliation(s)
- Paulo Garcia Normando
- Universidade Federal da ParaíbaJoão PessoaPBBrasil Universidade Federal da Paraíba
,
João Pessoa
,
PB
-
Brasil
| | | | | | | | - Victor Agripino Oliveira
- Universidade Federal da ParaíbaJoão PessoaPBBrasil Universidade Federal da Paraíba
,
João Pessoa
,
PB
-
Brasil
| | - Ludhmila Abrahão Hajjar
- Instituto de Coração – CardiopneumologiaSão PauloSPBrasil Instituto de Coração – Cardiopneumologia
,
São Paulo
,
SP
-
Brasil
| | - André Luiz Cerqueira Almeida
- Santa Casa de Misericórdia de Feira de SantanaFeira de SantanaBABrasil Santa Casa de Misericórdia de Feira de Santana
– Cardiologia,
Feira de Santana
,
BA
-
Brasil
| | - Edimar Alcides Bocchi
- Universidade de São PauloInstituto do Coração - Centro de Diagnóstico por ImagemSão PauloSPBrasil Universidade de São Paulo
Instituto do Coração - Centro de Diagnóstico por Imagem
,
São Paulo
,
SP
-
Brasil
| | - Vera Maria Cury Salemi
- Universidade de São PauloInstituto do Coração - Centro de Diagnóstico por ImagemSão PauloSPBrasil Universidade de São Paulo
Instituto do Coração - Centro de Diagnóstico por Imagem
,
São Paulo
,
SP
-
Brasil
| | - Marcelo Melo
- Universidade Federal da ParaíbaJoão PessoaPBBrasil Universidade Federal da Paraíba
,
João Pessoa
,
PB
-
Brasil
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12
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Bocchi EA, Lima IGCV, Biselli B, Salemi VMC, Ferreira SMA, Chizzola PR, Munhoz RT, Pessoa RS, Cardoso FAM, Bello MVDO, Hajjar LA, Gomes BR. Worsening of heart failure by coronavirus disease 2019 is associated with high mortality. ESC Heart Fail 2021; 8:943-952. [PMID: 33498096 PMCID: PMC8006661 DOI: 10.1002/ehf2.13199] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/25/2020] [Accepted: 12/28/2020] [Indexed: 01/08/2023] Open
Abstract
AIMS Patients with advanced heart failure (HF) with reduced left ventricular ejection fraction (HFrEF) and concurrent coronavirus disease 2019 (COVID-19) might have a higher risk of severe events. METHODS AND RESULTS We retrospectively studied 16 patients with advanced HFrEF who developed COVID-19 between 1 March and 29 May 2020. Follow-up lasted until 30 September. Ten patients previously hospitalized with decompensated HFrEF were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during hospitalization. Six patients undergoing ambulatory care at initiation of COVID-19 symptoms were hospitalized because of advanced HFrEF. All patients who experienced worsening of HFrEF due to COVID-19 required higher doses or introduction of additional inotropic drugs or intra-aortic balloon pump in the intensive care unit. The mean intravenous dobutamine dose before SARS-CoV-2 infection in previously hospitalized patients (n = 10) and the median (inter-quartile range) peak intravenous dobutamine dose during SARS-CoV-2 infection in all patients (n = 16) were 2 (0-7) μg/kg/min and 20 (14-20) (P < 0.001), respectively. During follow-up, 56% underwent heart transplantation (n = 2) or died (n = 7). Four patients died during hospitalization from mixed shock consequent to severe acute respiratory syndrome with inflammatory storm syndrome associated with septic and cardiogenic shock during COVID-19. After COVID-19 recovery, two patients died from mixed septic and cardiogenic shock and one from sustained ventricular tachycardia and cardiogenic shock. Five patients were discharged from hospital to ambulatory care. Four were awaiting heart transplantation. CONCLUSION Worsening of advanced HF by COVID-19 is associated with high mortality. This report highlights the importance of preventing COVID-19 in patients with advanced HF.
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Affiliation(s)
- Edimar Alcides Bocchi
- Heart Failure Clinics of the Heart Institute (InCor) of São Paulo University Medical School, São Paulo, Brazil
| | | | - Bruno Biselli
- Heart Failure Clinics of the Heart Institute (InCor) of São Paulo University Medical School, São Paulo, Brazil
| | - Vera Maria Cury Salemi
- Heart Failure Clinics of the Heart Institute (InCor) of São Paulo University Medical School, São Paulo, Brazil
| | | | - Paulo Roberto Chizzola
- Heart Failure Clinics of the Heart Institute (InCor) of São Paulo University Medical School, São Paulo, Brazil
| | - Robinson Tadeu Munhoz
- Heart Failure Clinics of the Heart Institute (InCor) of São Paulo University Medical School, São Paulo, Brazil
| | - Ranna Santos Pessoa
- Heart Institute (Incor) of São Paulo University Medical School, São Paulo, Brazil
| | | | | | | | - Brenno Rizerio Gomes
- Heart Failure Clinics of the Heart Institute (InCor) of São Paulo University Medical School, São Paulo, Brazil
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13
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Gonçalves AEDSS, Rocha GZ, Marin R, Camargo RL, dos Santos A, do Carmo H, Guadagnini D, Petrucci O, Moysés ZP, Salemi VMC, Oliveira AG, Saad MJA. Pulmonary Hypertension in Obese Mice Is Accompanied by a Reduction in PPAR-γ Expression in Pulmonary Artery. Front Endocrinol (Lausanne) 2021; 12:701994. [PMID: 34552556 PMCID: PMC8450870 DOI: 10.3389/fendo.2021.701994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/16/2021] [Indexed: 11/14/2022] Open
Abstract
Obesity and insulin resistance (IR) are well-studied risk factors for systemic cardiovascular disease, but their impact on pulmonary hypertension (PH) is not well clarified. This study aims to investigate if diet-induced obesity induces PH and if peroxisome-proliferator-activated receptor (PPAR-γ) and/or endoplasmic reticulum (ER) stress are involved in this process. Mice were maintained on a high-fat diet (HFD) for 4 months, and IR and PH were confirmed. In a separate group, after 4 months of HFD, mice were treated with pioglitazone (PIO) or 4-phenylbutyric acid for the last month. The results demonstrated that HFD for at least 4 months is able to increase pulmonary artery pressure, which is maintained, and this animal model can be used to investigate the link between IR and PH, without changes in ER stress in the pulmonary artery. There was also a reduction in circulating adiponectin and in perivascular adiponectin expression in the pulmonary artery, associated with a reduction in PPAR-γ expression. Treatment with PIO improved IR and PH and reversed the lower expression of adiponectin and PPAR-γ in the pulmonary artery, highlighting this drug as potential benefit for this poorly recognized complication of obesity.
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Affiliation(s)
| | - Guilherme Zweig Rocha
- Department of Internal Medicine, Faculty of Medicine, State University of Campinas, Campinas, Brazil
| | - Rodrigo Marin
- Department of Internal Medicine, Faculty of Medicine, State University of Campinas, Campinas, Brazil
| | - Rafael Ludemann Camargo
- Department of Internal Medicine, Faculty of Medicine, State University of Campinas, Campinas, Brazil
| | - Andrey dos Santos
- Department of Internal Medicine, Faculty of Medicine, State University of Campinas, Campinas, Brazil
| | - Helison do Carmo
- Department of Internal Medicine, Faculty of Medicine, State University of Campinas, Campinas, Brazil
| | - Dioze Guadagnini
- Department of Internal Medicine, Faculty of Medicine, State University of Campinas, Campinas, Brazil
| | - Orlando Petrucci
- Department of Internal Medicine, Faculty of Medicine, State University of Campinas, Campinas, Brazil
| | - Zenaide Providello Moysés
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Vera Maria Cury Salemi
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Mario José Abdalla Saad
- Department of Internal Medicine, Faculty of Medicine, State University of Campinas, Campinas, Brazil
- *Correspondence: Mario José Abdalla Saad,
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14
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Rocon C, Tabassian M, Tavares de Melo MD, de Araujo Filho JA, Grupi CJ, Parga Filho JR, Bocchi EA, D'hooge J, Salemi VMC. Biventricular imaging markers to predict outcomes in non-compaction cardiomyopathy: a machine learning study. ESC Heart Fail 2020; 7:2431-2439. [PMID: 32608172 PMCID: PMC7524220 DOI: 10.1002/ehf2.12795] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/27/2020] [Accepted: 05/13/2020] [Indexed: 12/28/2022] Open
Abstract
Aims Left ventricular non‐compaction cardiomyopathy (LVNC) is a genetic heart disease, with heart failure, arrhythmias, and embolic events as main clinical manifestations. The goal of this study was to analyse a large set of echocardiographic (echo) and cardiac magnetic resonance imaging (CMRI) parameters using machine learning (ML) techniques to find imaging predictors of clinical outcomes in a long‐term follow‐up of LVNC patients. Methods and results Patients with echo and/or CMRI criteria of LVNC, followed from January 2011 to December 2017 in the heart failure section of a tertiary referral cardiologic hospital, were enrolled in a retrospective study. Two‐dimensional colour Doppler echocardiography and subsequent CMRI were carried out. Twenty‐four hour Holter monitoring was also performed in all patients. Death, cardiac transplantation, heart failure hospitalization, aborted sudden cardiac death, complex ventricular arrhythmias (sustained and non‐sustained ventricular tachycardia), and embolisms (i.e. stroke, pulmonary thromboembolism and/or peripheral arterial embolism) were registered and were referred to as major adverse cardiovascular events (MACEs) in this study. Recruited for the study were 108 LVNC patients, aged 38.3 ± 15.5 years, 48.1% men, diagnosed by echo and CMRI criteria. They were followed for 5.8 ± 3.9 years, and MACEs were registered. CMRI and echo parameters were analysed via a supervised ML methodology. Forty‐seven (43.5%) patients had at least one MACE. The best performance of imaging variables was achieved by combining four parameters: left ventricular (LV) ejection fraction (by CMRI), right ventricular (RV) end‐systolic volume (by CMRI), RV systolic dysfunction (by echo), and RV lower diameter (by CMRI) with accuracy, sensitivity, and specificity rates of 75.5%, 77%, 75%, respectively. Conclusions Our findings show the importance of biventricular assessment to detect the severity of this cardiomyopathy and to plan for early clinical intervention. In addition, this study shows that even patients with normal LV function and negative late gadolinium enhancement had MACE. ML is a promising tool for analysing a large set of parameters to stratify and predict prognosis in LVNC patients.
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Affiliation(s)
- Camila Rocon
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44, São Paulo, 05403-000, Brazil
| | - Mahdi Tabassian
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Marcelo Dantas Tavares de Melo
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44, São Paulo, 05403-000, Brazil
| | - Jose Arimateia de Araujo Filho
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44, São Paulo, 05403-000, Brazil
| | - Cesar José Grupi
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44, São Paulo, 05403-000, Brazil
| | - Jose Rodrigues Parga Filho
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44, São Paulo, 05403-000, Brazil
| | - Edimar Alcides Bocchi
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44, São Paulo, 05403-000, Brazil
| | - Jan D'hooge
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Vera Maria Cury Salemi
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44, São Paulo, 05403-000, Brazil
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15
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Bonatto MG, Albanez R, Salemi VMC, Moura LZ. Use of sacubitril/valsartan in non‐compaction cardiomyopathy: a case report. ESC Heart Fail 2020; 7:1186-1189. [PMID: 32304161 PMCID: PMC7261575 DOI: 10.1002/ehf2.12713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/10/2019] [Revised: 03/02/2020] [Accepted: 03/31/2020] [Indexed: 12/11/2022] Open
Abstract
The use of sacubitril/valsartan significantly reduces death or hospitalization in patients with ejection fraction < 40%. There is no study evaluating this drug effects in non‐compaction cardiomyopathy (NCCM) individuals. The aim of this article is to report a case of a patient with NCCM initially refractory to gold standard treatment and afterwards treated with sacubitril/valsartan and its improvements. This is a case report of a 48‐year‐old woman, presenting with NCCM heart failure, who had received standard guideline‐directed medical therapy for 18 months without any improvement in clinical and echocardiographic parameters. After that period, sacubitril/valsartan was initiated. After 18 months of refractory usage of guideline‐directed medical therapy, sacubitril/valsartan was started, and significant change in functional class (III to I) and important ventricular remodelling were achieved with an improvement of 29% in the ejection fraction, reduction of 7 mm in ventricular diastolic diameter, and mild to none mitral valve functional regurgitation. In this case report, sacubitril/valsartan use was associated with improvement of echocardiographic and clinical parameters in a patient with NCCM.
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Affiliation(s)
- Marcely Gimenes Bonatto
- Department of Cardiology Heart Failure and Heart Transplantation Section of Santa Casa de Misericórdia Hospital Curitiba Paraná Brazil
- Department of Cardiology Pontifical Catholic University of Paraná Curitiba Brazil
| | - Rodrigo Albanez
- Department of Cardiology Heart Failure and Heart Transplantation Section of Santa Casa de Misericórdia Hospital Curitiba Paraná Brazil
| | - Vera Maria Cury Salemi
- Heart Failure Section of Heart Institute (InCor) University of São Paulo Medical School São Paulo Brazil
| | - Lídia Zytynski Moura
- Department of Cardiology Pontifical Catholic University of Paraná Curitiba Brazil
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16
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Salemi VMC, Melo MDTD, Araujo Filho JDAB. Novos Paradigmas na Avaliação da Função Diastólica pela Ressonância Magnética Cardíaca na Valvopatia Aórtica. Arq Bras Cardiol 2020; 114:293-294. [PMID: 32215500 PMCID: PMC7077579 DOI: 10.36660/abc.20190903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Vera Maria Cury Salemi
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
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17
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Salemi VMC, Melo MDTD. Are Myocardium Deformation Indices Influenced by Cardiac Load, Age or Body Mass Index? Arq Bras Cardiol 2019; 113:685-686. [PMID: 31691750 PMCID: PMC7020874 DOI: 10.5935/abc.20190211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Vera Maria Cury Salemi
- Instituto do Coração (InCor) do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brazil
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18
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Guido MC, Debbas V, Lopes NM, Ferreira-Filho JCA, Salemi VMC, Pereira LV, Maranhao RC, Laurindo FRM. P2577Losartan diminishes the expression of TGF-beta and improves cardiomyopathy in mice with Marfan syndrome. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Marfan syndrome (MFS) is caused by mutations in the fibrillin-1 gene, leading to abnormal signaling of the transforming growth factor beta (TGF-β). This results in aortic root dilation, dissection and rupture, which are the main causes of morbidity and mortality of MFS patients. Current treatment with losartan, an angiotensin-II receptor-1 blocker, has shown beneficial effect on aortic disease in MFS murine models. However, the mechanisms whereby the treatment with losartan improves cardiac remodeling and function of the left ventricle (LV) in MFS are still unknown.
Purpose
To investigate the effects of losartan on mechanisms of the cardiomyopathy in mice with MFS.
Methods
mgΔloxPneo MFS murine model from C129/sv background was utilized in this study. To evaluate the effect of the treatment with losartan on the LV of MFS and wild-type mice, animals were allocated in 2 groups of treatments: Losartan group: mice were kept with water supplemented with losartan (0.6g/L); Untreated control group: mice were kept with water only. The animals received treatment from 1 month of age until completing 6 months. After five months of treatment, LV echocardiography was performed, and fragments of LV tissue were analyzed by morphometry and protein expression analysis by Western blot.
Results
Losartan MFS mice showed decrease in interventricular septum and posterior wall thickness and LV mass. Furthermore, losartan prevented aortic and mitral regurgitation, arrhythmia, bradycardia, septal hypokinesia and pulmonary hypertension when compared with control MFS mice. Systolic and diastolic LV function were not different between groups. Collagen volume fraction and the disorganization and disruptions of the elastic fibers in coronary arteries were lower in losartan treatment than in controls. The protein expression of pro-apoptotic factors (BAX/Bcl-2 and caspase 3 and 9), proliferating cell nuclear antigen and hypoxia-inducible factor 1 and 2α were lower in losartan treatment, whereas the expression of vascular endothelial growth factor was increased in losartan group when compared with control MFS mice. Moreover, the treatment with losartan strongly reduced the TGF-β, ERK and p38MAPK protein expression compared to controls.
Conclusion
In this murine model of MFS, losartan treatment has the ability to change several pathophysiological mechanisms related with the fibrillin-1 mutation, by decreasing apoptosis, cell proliferation and increasing angiogenesis. Overall, the treatment resulted in improved structural rearrangement and attenuation of the rupture of elastic fibers in the coronary arteries, of the cardiac hypertrophy and myocardial fibrosis. These effects were possibly related with the decreased TGF-β expression by ERK and p38MAPK signaling pathways by losartan. Our findings shed a new light on the mechanisms of action of losartan on MFS cardiomyopathy.
Acknowledgement/Funding
FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo)
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Affiliation(s)
- M C Guido
- Instituto do Coracao FMUSP, Sao Paulo, Brazil
| | - V Debbas
- Instituto do Coracao FMUSP, Sao Paulo, Brazil
| | - N M Lopes
- Instituto do Coracao FMUSP, Sao Paulo, Brazil
| | | | | | - L V Pereira
- University of Sao Paulo, Biosciences Institute, Sao Paulo, Brazil
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19
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Guido MC, Lopes NM, Tavares ER, Bispo DL, Tavares De Melo MD, Salemi VMC, Maranhao RC. P6295Methotrexate reduces cardiac remodeling and improves left ventricle function in rats with Takotsubo cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Takotsubo cardiomyopathy (TC) is characterized by cardiac disfunction and left ventricle (LV) remodeling caused, mainly, by physical or emotional stress. Previously, we have shown in atherosclerotic rabbits that methotrexate (MTX), an anti-inflammatory chemotherapeutic agent, is capable of reducing the inflammatory process and atherosclerotic lesions.
Purpose
To investigate the effect of MTX treatment in rats with TC.
Methods
TC was induced in Wistar rats with 2 injections of isoproterenol (85mg/kg) with a 24h interval. Animals were allocated in 3 experimental groups: CT: animals induced and treated with saline; TK: animal induced with isoproterenol and treated with saline; TK-MTX: animals induced with isoproterenol and treated with MTX (1mg/kg). Animals were treated every week for 4 weeks. After the treatment, echocardiography, morphometry and molecular analysis (Western blot) of the LV were performed.
Results
TK and TK-MTX groups did not show cardiac dilation or LV intraventricular septum and posterior wall thickening. However, compared to TK, the treatment with MTX improved both LV systolic and diastolic function. In addition, the treatment diminished myocytes diameter and subendocardial and interstitial fibrosis of the LV. Protein expression of pro-apoptotic factors (caspase 3 and BAX), pro-inflammatory cytokine TNF-α, metalloproteinase 2, transforming growth factor beta, collagen I and III and hypoxia-inducible factor 2 alfa were all decreased. Vascular endothelial growth factor (VEGF) and adenosine A1 receptor showed increased protein expression in TK-MTX group when compared to CT and TK. There was correlation of myocardial fibrosis (r2=-0.57), myocytes diameter (r2=-0.78) and VEGF expression (r2=0.58) with LV systolic disfunction. Also, myocardial fibrosis (r2=0.57) and VEGF expression (r2=-0.68) correlated with diastolic disfunction in the LV. Animals treated with MTX did not present any toxicity.
Conclusion
Treatment with MTX diminished apoptosis, the expression of TNF-α and metalloproteinases, cardiac hypertrophy and myocardial fibrosis. Besides that, the treatment increased angiogenesis and strongly improved cardiac function of the LV. MTX, possibly through an increase in the production of intracellular adenosine, could be considered as a feasible treatment for TC.
Acknowledgement/Funding
FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo)
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Affiliation(s)
- M C Guido
- Instituto do Coracao FMUSP, Sao Paulo, Brazil
| | - N M Lopes
- Instituto do Coracao FMUSP, Sao Paulo, Brazil
| | - E R Tavares
- Instituto do Coracao FMUSP, Sao Paulo, Brazil
| | - D L Bispo
- Instituto do Coracao FMUSP, Sao Paulo, Brazil
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Aoki AF, Dos Santos MR, Andretta CRL, Yeu SP, Tavares De Melo MD, Jordao CP, Guimaraes GV, Strunz CMC, Bocchi EA, Salemi VMC. P4681Early findings in patients with noncompaction cardiomyopathy and normal ejection fraction: a cardiopulmonary exercise test, echocardiographic and biomarkers study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Noncompaction cardiomyopathy (NCC) is a cardiomyopathy with controversial diagnostic criteria. Furthermore, it has been discussed whether asymptomatic individuals with normal left ventricular (LV) ejection fraction (EF) and diagnostic criteria for this disease could be classified as NCC. Therefore, the objective of this study was to evaluate the functional capacity of patients with NCC and the relation with echocardiographic and biomarkers indices.
Methods
Fifty-nine patients with NCC were prospectively divided into three groups: ejection fraction (EF)>50% (G1), EF between 40 - 50% (G2) and EF <40% (G3). In addition, 11 normal healthy volunteers were selected for control group (CG). All subjects underwent 2D echocardiography with tissue Doppler and myocardial deformation indices, cardiopulmonary exercise test (CPET), troponin I and BNP measurements.
Results
There was a decrease in VO2 peak (ml/km/min) in all NCC groups compared to CG (GC= 34.5±5.3, G1= 25.56±5.6, G2= 25.12±7.7 and G3= 21.86±6.3 ml/kg/min, p<0.001), but no difference was shown among NCC patients (p=0.37). In addition, the VO2 at anaerobic threshold (AT) was lower in all NCC groups compared to CG (GC= 22.88±3.3, G1= 17.30±4.7, G2= 18.58±5.2, e G3= 15.65±3.7 ml/kg/min, p<0.001). There was an increase in indexed ventricular mass in all NCC groups when compared to CG (p<0.001), but it was similar among NCC groups (p=0.72). Regarding to diastolic function, G2 and G3 presented a reduction in the peak velocity of the septal E' when compared to the control group (GC= 14.0±2.4, G2= 8.92±3.0 e G3= 6.86±3.9 cm/s, p<0,001), while E/E' was increased in G3 compared to all groups (p<0.001). G2 and G3 presented a decrease in global longitudinal strain (GLS) when compared to CG and G1 (p<0.001). The BNP levels were higher in G3 compared to the other groups (p<0.05), but no difference was found in troponin I levels. There was a positive correlation between VO2 peak and E' (r=0.56, p<0.001) and a negative correlation between VO2 peak and E/E' (r=−0.53, p<0.001). In addition, there was an inverse correlation between VO2 peak and BNP (r=−0.50, p<0.001).
Conclusion
Our results show that NCC patients present alterations in functional capacity, echocardiographic indices and biomarkers values according to LV dysfunction. Moreover, patients with preserved LV function already present predominant alterations in CPET suggesting subclinical myocardial dysfunction. For this reason, clinical treatment could be considered in this initial stage of this disease.
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Affiliation(s)
- A F Aoki
- Instituto do Coracao FMUSP, Sao Paulo, Brazil
| | | | | | - S P Yeu
- Instituto do Coracao FMUSP, Sao Paulo, Brazil
| | | | - C P Jordao
- Instituto do Coracao FMUSP, Sao Paulo, Brazil
| | | | | | - E A Bocchi
- Instituto do Coracao FMUSP, Sao Paulo, Brazil
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21
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Siqueira SRR, Ayub-Ferreira SM, Chizzola PR, Salemi VMC, Lage SHG, Oliveira MT, Soares PR, Bocchi EA, Issa VS. P4553Clinical and prognostic value of right ventricular dysfunction in patients with chagas heart disease during acute decompensated heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The occurrence of right ventricular disfunction (RVD) is common in heart failure (HF) patients due to Chagas' disease (ChD). However, its clinical and prognostic value has not been studied during episodes of acute decompensated heart failure (ADHF).
Purpose
Evaluate the prognostic value of RVD in ADHF patients with ChD during hospitalization and after 180 days of discharge compared to other etiologies.
Methods
We analysed a prospective cohort of consecutive 768 patients admitted for ADHF between March 2013 and October 2018; 490 (63.7%) patients were male and the median age was 58 (48.3–66.8) years and left ventricular ejection fraction was 26% (median) (IQR 22–35%). We compared the clinical characteristics and the prognosis of ChD patients according to the presence of RVD in the echocardiogram to other etiologies.
Results
RVD was presented in 289 (37.6%) patients. Among patients with non-chagasic etiologies, those with RVD were younger [53 (41–62) vs 61 (52–70) years, p<0.0001], had high levels of BNP in the moment of hospitalization [1195 (606–2209) vs 886 (366– 555) pg/mL], p<0,0001], received more inotropes (79.2% vs 57.9%, p<0,0001), had longer hospitalization [35 (17–51) vs 21 (10–37) days, p<0.001] and more clinical signs of congestion as hepatomegaly (49% vs 28.6%, p<0.0001); jugular venous distension (68.3% vs 41.2%, p<0.0001) and leg edema (65.4% vs 49.2%, p=0.001). Among patients with ChD, those with RVD were older [61 (48- 66) vs 58 (48 - 67) years, p=0.017], and had more frequently signs of hypoperfusion (56.8% vs 36.5%, p=0.029), jugular venous distension (72.8% vs 52.8%, p=0.01) and hepatomegaly (56.8% vs 31.1%, p=0.011), higher BNP levels [1288 (567–2180) vs 1066 (472–2007) pg/mL, p=0.006] and more frequent use of intravenous inotropes (88.9% vs 67.1%, p=0.003); additionally ChD patients with RVD had a higher rate of death and transplant during hospitalization (51.2% vs 38.3%, p=0.001). When all groups were compared together, ChD patients with RVD had the highest rate of death, transplant and readmissions at 180-days of follow-up (Figure).
Figure 1
Conclusion
Patients with RVD demonstrated a distinct clinical presentation, biomarkers and worse prognosis in all etiologies. ChD patients with RVD in ADHF had the worst prognosis with the highest rate of death, heart transplant e rehospitalization in follow-up.
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Affiliation(s)
- S R R Siqueira
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - S M Ayub-Ferreira
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - P R Chizzola
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - V M C Salemi
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - S H G Lage
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - M T Oliveira
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - P R Soares
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - E A Bocchi
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - V S Issa
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
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22
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Affiliation(s)
- Edimar Alcides Bocchi
- Heart Failure Team, Heart Institute (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Vera Maria Cury Salemi
- Heart Failure Team, Heart Institute (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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23
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Gomes C, Terhoch CB, Ayub-Ferreira SM, Conceição-Souza GE, Salemi VMC, Chizzola PR, Oliveira MT, Lage SHG, Frioes F, Bocchi EA, Issa VS. Prognosis and risk stratification in patients with decompensated heart failure receiving inotropic therapy. Open Heart 2019; 5:e000923. [PMID: 30687507 PMCID: PMC6330199 DOI: 10.1136/openhrt-2018-000923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/16/2018] [Accepted: 11/10/2018] [Indexed: 12/28/2022] Open
Abstract
Objectives The prognostic significance of transient use of inotropes has been sufficiently studied in recent heart failure (HF) populations. We hypothesised that risk stratification in these patients could contribute to patient selection for advanced therapies. Methods We analysed a prospective cohort of adult patients admitted with decompensated HF and ejection fraction (left ventricular ejection fraction (LVEF)) less than 50%. We explored the outcomes of patients requiring inotropic therapy during hospital admission and after discharge. Results The study included 737 patients, (64.0% male), with a median age of 58 years (IQR 48-66 years). Main aetiologies were dilated cardiomyopathy in 273 (37.0%) patients, ischaemic heart disease in 195 (26.5%) patients and Chagas disease in 163 (22.1%) patients. Median LVEF was 26 % (IQR 22%-35%). Inotropes were used in 518 (70.3%) patients. In 431 (83.2%) patients, a single inotrope was administered. Inotropic therapy was associated with higher risk of in-hospital death/urgent heart transplant (OR=10.628, 95% CI 5.055 to 22.344, p<0.001). At 180-day follow-up, of the 431 patients discharged home, 39 (9.0%) died, 21 (4.9%) underwent transplantation and 183 (42.4%) were readmitted. Inotropes were not associated with outcome (death, transplant and rehospitalisation) after discharge. Conclusions Inotropic drugs are still widely used in patients with advanced decompensated HF and are associated with a worse in-hospital prognosis. In contrast with previous results, intermittent use of inotropes during hospitalisation did not determine a worse prognosis at 180-day follow-up. These data may add to prognostic evaluation in patients with advanced HF in centres where mechanical circulatory support is not broadly available.
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Affiliation(s)
- Clara Gomes
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Caíque Bueno Terhoch
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Silvia Moreira Ayub-Ferreira
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Germano Emilio Conceição-Souza
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Vera Maria Cury Salemi
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Roberto Chizzola
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Mucio Tavares Oliveira
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Silvia Helena Gelas Lage
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Fernando Frioes
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Edimar Alcides Bocchi
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Victor Sarli Issa
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal.,Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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24
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Melo MDTD, Salemi VMC. Usefulness of Myocardial Deformation Indices in Preventing Cardiotoxicity in Breast Cancer Patients. Arq Bras Cardiol 2019; 112:57-58. [PMID: 30673016 PMCID: PMC6317626 DOI: 10.5935/abc.20190009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Marcelo Dantas Tavares de Melo
- Instituto do Coração (InCor) do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brazil
| | - Vera Maria Cury Salemi
- Instituto do Coração (InCor) do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brazil
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25
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Sanches IC, Buzin M, Conti FF, Dias DDS, dos Santos CP, Sirvente R, Salemi VMC, Llesuy S, Irigoyen MC, De Angelis K. Combined aerobic and resistance exercise training attenuates cardiac dysfunctions in a model of diabetes and menopause. PLoS One 2018; 13:e0202731. [PMID: 30192778 PMCID: PMC6128534 DOI: 10.1371/journal.pone.0202731] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 08/08/2018] [Indexed: 01/09/2023] Open
Abstract
The study aimed at evaluating the effects of combined aerobic and resistance exercise training on cardiac morphometry and function, oxidative stress and inflammatory parameters in diabetic ovariectomized rats. For this, female Wistar rats (10 weeks-old) were divided into 4 groups (n = 8): euglycemic (E), diabetic (streptozotocin, 50 mg/kg, iv) (D), diabetic ovariectomized (DO) and trained diabetic ovariectomized (TDO). The combined exercise training was performed on a treadmill and in a ladder adapted to rats (8 weeks, at 40-60% of maximal capacity). The left ventricle (LV) morphometry and function were evaluated by echocardiography. Oxidative stress and inflammatory markers were measured on ventricles tissue. The sedentary diabetic animals (D and DO) showed impaired systolic and diastolic functions, as well as increased cardiac overload, evaluated by myocardial performance index (MPI- D: 0.32 ± 0.05; DO: 0.39 ± 0.13 vs. E: 0.25 ± 0.07), in relation to E group. Systolic and MPI dysfunctions were exacerbated in DO when compared to D group. The DO group presented higher protein oxidation and TNF-α/IL-10 ratio than D groups. Glutathione redox ratio (GSH/GSSG) and IL-10 were decreased in both D and DO groups when compared to E group. Exercise training improved exercise capacity, systolic and diastolic functions and MPI (0.18±0.11). The TDO group showed reduced protein oxidation and TNF-α/IL-10 ratio and increased GSH/GSSG and IL-10 in relation to the DO group. These results showed that combined exercise training was able to attenuate the cardiac dysfunctions, probably by reducing inflammation and oxidative stress in an experimental model of diabetes and menopause.
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Affiliation(s)
| | - Morgana Buzin
- Laboratory of Translational Physiology, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Filipe Fernandes Conti
- Laboratory of Translational Physiology, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Danielle da Silva Dias
- Laboratory of Translational Physiology, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | | | - Raquel Sirvente
- Hypertension Unit, Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Vera Maria Cury Salemi
- Hypertension Unit, Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Susana Llesuy
- Laboratory of Translational Physiology, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
- Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Maria-Cláudia Irigoyen
- Hypertension Unit, Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Kátia De Angelis
- Laboratory of Translational Physiology, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
- Departament of Physiology, Federal University of Sao Paulo (UNIFESP), São Paulo, Brazil
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26
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Rocon C, Tabassian M, Tavares De Melo MD, Araujo Filho JA, Parga Filho JR, Hajjar LA, Kalil Filho R, Bocchi EA, D'hooge J, Salemi VMC. P6485Biventricular imaging markers to predict outcome in non-compaction cardiomyopathy: a machine learning study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Rocon
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | | | | | - J A Araujo Filho
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - J R Parga Filho
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - L A Hajjar
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - R Kalil Filho
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - E A Bocchi
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - J D'hooge
- University of Leuven, Leuven, Belgium
| | - V M C Salemi
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
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27
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Silva Alves L, Salemi VMC, Rocon C, Melo MDT, Chizzola PR, Amato JF, Vieira JL, Bocchi EA, Guimaraes GV. P6059Echocardiography parameters, respiratory eficiency, and quality of life in patients with permanent atrial fibrillation and heart failure: effect of exercise training. A randomized controlled trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L Silva Alves
- Institute of Heart, Medical School of University of São Paulo, Heart Failure Unit, São Paulo, Brazil
| | - V M C Salemi
- Institute of Heart, Medical School of University of São Paulo, Heart Failure Unit, São Paulo, Brazil
| | - C Rocon
- Institute of Heart, Medical School of University of São Paulo, Heart Failure Unit, São Paulo, Brazil
| | - M D T Melo
- Institute of Heart, Medical School of University of São Paulo, Heart Failure Unit, São Paulo, Brazil
| | - P R Chizzola
- Institute of Heart, Medical School of University of São Paulo, Heart Failure Unit, São Paulo, Brazil
| | - J F Amato
- Institute of Heart, Medical School of University of São Paulo, Heart Failure Unit, São Paulo, Brazil
| | - J L Vieira
- Institute of Heart, Medical School of University of São Paulo, Heart Failure Unit, São Paulo, Brazil
| | - E A Bocchi
- Institute of Heart, Medical School of University of São Paulo, Heart Failure Unit, São Paulo, Brazil
| | - G V Guimaraes
- Institute of Heart, Medical School of University of São Paulo, Heart Failure Unit, São Paulo, Brazil
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28
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Terhoch CB, Moreira HF, Ayub-Ferreira SM, Conceição-Souza GE, Salemi VMC, Chizzola PR, Oliveira MT, Lage SHG, Bocchi EA, Issa VS. Clinical findings and prognosis of patients hospitalized for acute decompensated heart failure: Analysis of the influence of Chagas etiology and ventricular function. PLoS Negl Trop Dis 2018; 12:e0006207. [PMID: 29432453 PMCID: PMC5809014 DOI: 10.1371/journal.pntd.0006207] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 01/04/2018] [Indexed: 12/15/2022] Open
Abstract
Aims Explore the association between clinical findings and prognosis in patients with acute decompensated heart failure (ADHF) and analyze the influence of etiology on clinical presentation and prognosis. Methods and results Prospective cohort of 500 patients admitted with ADHF from Aug/2013-Feb/2016; patients were predominantly male (61.8%), median age was 58 (IQ25-75% 47–66 years); etiology was dilated cardiomyopathy in 141 (28.2%), ischemic heart disease in 137 (27.4%), and Chagas heart disease in 113 (22.6%). Patients who died (154 [30.8%]) or underwent heart transplantation (53[10.6%]) were younger (56 years [IQ25-75% 45–64 vs 60 years, IQ25-75% 49–67], P = 0.032), more frequently admitted for cardiogenic shock (20.3% vs 6.8%, P<0.001), had longer duration of symptoms (14 days [IQ25-75% 4–32.8 vs 7.5 days, IQ25-75% 2–31], P = 0.004), had signs of congestion (90.8% vs 76.5%, P<0.001) and inadequate perfusion more frequently (45.9% vs 28%, P<0.001), and had lower blood pressure (90 [IQ25-75% 80–100 vs 100, IQ25-75% 90–120], P<0.001). In a logistic regression model analysis, systolic blood pressure (P<0.001, OR 0.97 [95%CI 0.96–0.98] per mmHg) and jugular distention (P = 0.004, OR 1.923 [95%CI 1.232–3.001]) were significant. Chagas patients were more frequently admitted for cardiogenic shock (15%) and syncope/arrhythmia (20.4%). Pulmonary congestion was rare among Chagas patients and blood pressure was lower. The rate of in-hospital death or heart transplant was higher among patients with Chagas (50.5%). Conclusions A physical exam may identify patients at higher risk in a contemporaneous population. Our findings support specific therapies targeted at Chagas patients in the setting of ADHF. It is recognized that the clinical evaluation of patients remains the basis for the characterization of diseases, data interpretation, and patient care. However, incorporation of technological methods into clinical practice has challenged the way cardiologists’ value of history and clinical examination. The present study sought to analyze the importance of clinical findings in a contemporaneous cohort of patients admitted with decompensated heart failure. Our results indicate that the physical exam may identify patients at higher risk in a contemporaneous patient population, and that clinical presentation varies according to etiology—especially Chagas disease—and ventricular function. Our findings support the need of development of specific therapeutic approaches targeted at Chagas patients in the setting of acute decompensated heart failure, as they represent a more vulnerable population.
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Affiliation(s)
- Caíque Bueno Terhoch
- Heart Failure Department, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Henry Fukuda Moreira
- Heart Failure Department, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Silvia Moreira Ayub-Ferreira
- Heart Failure Department, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Germano Emilio Conceição-Souza
- Heart Failure Department, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Vera Maria Cury Salemi
- Heart Failure Department, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Paulo Roberto Chizzola
- Heart Failure Department, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Mucio Tavares Oliveira
- Heart Failure Department, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Silvia Helena Gelas Lage
- Heart Failure Department, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Edimar Alcides Bocchi
- Heart Failure Department, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Victor Sarli Issa
- Heart Failure Department, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
- * E-mail:
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29
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Pessoa FG, Mady C, Fonseca KCB, de Oliveira-Fonoff AM, Salemi VMC, Jordão MR, Fernandes F, Ramires FJA. Erythropoietin reduces collagen deposition after myocardial infarction but does not improve cardiac function. Can J Physiol Pharmacol 2017; 96:541-549. [PMID: 29120671 DOI: 10.1139/cjpp-2017-0169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Myocardial remodeling includes inappropriate collagen deposition in the interstitium. Erythropoietin (EPO) may have cardioprotective effects. We aimed to assess the role of EPO on myocardial remodeling during the chronic phase. We studied 60 Wistar rats divided into the following groups: control (CT), control + EPO (CT + EPO), myocardial infarction + EPO (MI + EPO), and myocardial infarction (MI). The interstitial collagen volume fraction (ICVF) was quantified and echocardiography was performed. We quantified asymmetric dimethylarginine and glutathione by ELISA, and used real-time PCR to assess apoptosis and inflammation. Western blotting was used to evaluate inflammatory proteins and tissue inhibitors of metalloproteinases (TIMPs), and TUNEL staining was used to detect apoptosis. For matrix metalloproteinases (MMPs), we performed zymography. Parametric and nonparametric analyses were performed according to normality testing. ICVF was greater in MI groups (p < 0.001) and was attenuated by EPO (p = 0.05). The MMP-2 did not show any difference between groups. The TIMP-1 and TIMP-2 did not have difference between groups. The MI groups had worse fraction shortening (p < 0.001), without EPO protection (p = 0.666). The MI groups had increased left ventricle diastolic dimension (p < 0.001) without EPO attenuation (p = 0.79). EPO did not act on oxidative stress. Apoptosis and inflammation were not modulated by EPO. We concluded that EPO attenuated interstitial collagen accumulation, but did not protect from heart dilation or dysfunction.
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Affiliation(s)
- Fernanda Gallinaro Pessoa
- Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil.,Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil
| | - Charles Mady
- Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil.,Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil
| | - Keila Cardoso Barbosa Fonseca
- Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil.,Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil
| | - Adriana Morgan de Oliveira-Fonoff
- Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil.,Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil
| | - Vera Maria Cury Salemi
- Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil.,Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil
| | - Maurício Rodrigues Jordão
- Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil.,Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil
| | - Fabio Fernandes
- Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil.,Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil
| | - Felix José Alvarez Ramires
- Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil.,Heart Institute (InCor) - University of São Paulo, São Paulo, Brazil
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Akolkar G, da Silva Dias D, Ayyappan P, Bagchi AK, Jassal DS, Salemi VMC, Irigoyen MC, De Angelis K, Singal PK. Vitamin C mitigates oxidative/nitrosative stress and inflammation in doxorubicin-induced cardiomyopathy. Am J Physiol Heart Circ Physiol 2017; 313:H795-H809. [PMID: 28710069 DOI: 10.1152/ajpheart.00253.2017] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 06/22/2017] [Accepted: 07/06/2017] [Indexed: 12/17/2022]
Abstract
Increase in oxidative/nitrosative stress is one of the mechanisms associated with the development of cardiotoxicity due to doxorubicin (Dox), a potent chemotherapy drug. Previously, we reported mitigation of Dox-induced oxidative/nitrosative stress and apoptosis by vitamin C (Vit C) in isolated cardiomyocytes. In the present in vivo study in rats, we investigated the effect of prophylactic treatment with Vit C on Dox-induced apoptosis, inflammation, oxidative/nitrosative stress, cardiac dysfunction, and Vit C transporter proteins. Dox (cumulative dose: 15 mg/kg) in rats reduced systolic and diastolic cardiac function and caused structural damage. These changes were associated with a myocardial increase in reactive oxygen species, reduction in antioxidant enzyme activities, increased expression of apoptotic proteins, and inflammation. Dox also caused an increase in the expression of proapoptotic proteins Bax, Bnip-3, Bak, and caspase-3. An increase in oxidative/nitrosative stress attributable to Dox was indicated by an increase in superoxide, protein carbonyl formation, lipid peroxidation, nitric oxide (NO), NO synthase (NOS) activity, protein nitrosylation, and inducible NOS protein expression. Dox increased the levels of cardiac proinflammatory cytokines TNF-α, IL-1β, and IL-6, whereas the expression of Vit C transporter proteins (sodium-ascorbate cotransporter 2 and glucose transporter 4) was reduced. Prophylactic and concurrent treatment with Vit C prevented all these changes and improved survival in the Vit C + Dox group. Vit C also improved Dox-mediated systolic and diastolic dysfunctions and structural damage. These results suggest a cardioprotective role of Vit C in Dox-induced cardiomyopathy by reducing oxidative/nitrosative stress, inflammation, and apoptosis, as well as improving Vit C transporter proteins.NEW & NOTEWORTHY This in vivo study provides novel data that vitamin C improves cardiac structure and function in doxorubicin-induced cardiomyopathy by reducing oxidative/nitrosative stress, apoptosis, and inflammation along with upregulation of cardiac vitamin C transporter proteins. The latter may have a crucial role in improving antioxidant status in this cardiomyopathy.
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Affiliation(s)
- Gauri Akolkar
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Department of Physiology and Pathophysiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Danielle da Silva Dias
- Laboratory of Translational Physiology, Universidade Nove de Julho, São Paulo, Brazil; and
| | - Prathapan Ayyappan
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Department of Physiology and Pathophysiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ashim K Bagchi
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Department of Physiology and Pathophysiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Davinder S Jassal
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Department of Physiology and Pathophysiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | | | - Katia De Angelis
- Laboratory of Translational Physiology, Universidade Nove de Julho, São Paulo, Brazil; and
| | - Pawan K Singal
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Department of Physiology and Pathophysiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada;
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Tavares de Melo MD, Giorgi MCP, Assuncao AN, Dantas RN, Araujo Filho JDA, Parga Filho JR, Bierrenbach ALDS, de Lima CR, Soares J, Meneguetti JC, Mady C, Hajjar LA, Kalil Filho R, Bocchi EA, Salemi VMC. Decreased glycolytic metabolism in non-compaction cardiomyopathy by 18F-fluoro-2-deoxyglucose positron emission tomography: new insights into pathophysiological mechanisms and clinical implications. Eur Heart J Cardiovasc Imaging 2017; 18:915-921. [PMID: 28379356 DOI: 10.1093/ehjci/jex036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 01/16/2017] [Indexed: 12/28/2022] Open
Abstract
Aims The pathophysiological mechanisms of left ventricular non-compaction cardiomyopathy (LVNC) remain controversial. This study performed combined 18F-fluoro-2-deoxyglucose dynamic positron emission tomography (FDG-PET) and 99mTc-sestamibi single-photon emission computed tomography (SPECT) studies to evaluate myocardial glucose metabolism and perfusion in patients with LVNC and their clinical implications. Methods and results Thirty patients (41 ± 12 years, 53% male) with LVNC, diagnosed by cardiovascular magnetic resonance (CMR) criteria, and eight age-matched healthy controls (42 ± 12 years, 50% male) were prospectively recruited to undergo FDG-PET with measurement of the myocardial glucose uptake rate (MGU) and SPECT to investigate perfusion-metabolism patterns. Patients with LVNC had lower global MGU compared with that in controls (36.9 ± 8.8 vs. 44.6 ± 5.4 μmol/min/100 g, respectively, P = 0.02). Of 17 LV segments, MGU levels were significantly reduced in 8, and also a reduction was observed when compacted segments from LVNC were compared with the segments from control subjects (P < 0.001). Perfusion defects were also found in 15 (50%) patients (45 LV segments: 64.4% match, and 35.6% mismatch perfusion-metabolism pattern). Univariate and multivariate analyses showed that beta-blocker therapy was associated with increased MGU (beta coefficient = 10.1, P = 0.008). Moreover, a gradual increase occurred in MGU across the beta-blocker dose groups (P for trend = 0.01). Conclusion The reduction of MGU documented by FDG-PET in LVNC supports the hypothesis that a cellular metabolic pathway may play a role in the pathophysiology of LVNC. The beneficial effect of beta-blocker mediating myocardial metabolism in the clinical course of LVNC requires further investigation.
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Affiliation(s)
- Marcelo Dantas Tavares de Melo
- Heart Failure Unit, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44. Cerqueira César, São Paulo, 05403-000, Brazil
| | - Maria Clementina Pinto Giorgi
- Nuclear Medicine Department, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44. Cerqueira César, São Paulo, 05403-000, Brazil
| | - Antonildes Nascimento Assuncao
- Cardiovascular Magnetic Resonance and Computed Tomography Sector, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Roberto Nery Dantas
- Cardiovascular Magnetic Resonance and Computed Tomography Sector, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jose de Arimateia Araujo Filho
- Cardiovascular Magnetic Resonance and Computed Tomography Sector, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jose Rodrigues Parga Filho
- Cardiovascular Magnetic Resonance and Computed Tomography Sector, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Camila Rocon de Lima
- Heart Failure Unit, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44. Cerqueira César, São Paulo, 05403-000, Brazil
| | - José Soares
- Nuclear Medicine Department, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44. Cerqueira César, São Paulo, 05403-000, Brazil
| | - José Claudio Meneguetti
- Nuclear Medicine Department, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44. Cerqueira César, São Paulo, 05403-000, Brazil
| | - Charles Mady
- Cardiomyopathy Unit (CM), Department of Cardiopneumology, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Roberto Kalil Filho
- Indeed Teaching and Research Institute, Hospital Sírio-Libanes, São Paulo, Brazil
| | - Edimar Alcides Bocchi
- Heart Failure Unit, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44. Cerqueira César, São Paulo, 05403-000, Brazil
| | - Vera Maria Cury Salemi
- Heart Failure Unit, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44. Cerqueira César, São Paulo, 05403-000, Brazil
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Strunz CMC, Roggerio A, Cruz PL, Pacanaro AP, Salemi VMC, Benvenuti LA, Mansur ADP, Irigoyen MC. Down-regulation of fibroblast growth factor 2 and its co-receptors heparan sulfate proteoglycans by resveratrol underlies the improvement of cardiac dysfunction in experimental diabetes. J Nutr Biochem 2017; 40:219-227. [DOI: 10.1016/j.jnutbio.2016.11.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 10/26/2016] [Accepted: 11/14/2016] [Indexed: 01/10/2023]
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Martins Fernandes S, Badano L, Garcia Campos A, Erdei T, Mehdipoor G, Hanboly N, Michalski BW, Vriz O, Mo VY, Le TT, Ribeiro JM, Ternacle J, Yurdakul SELEN, Shetye A, Stoebe S, Lisowska A, Chinali M, Orabona M, Contaldi C, De La Chica JA, Codolosa JN, Trzcinski P, Prado Diaz S, Morales Portano JD, Ha SJ, Valente F, Joseph G, Valente F, Scali MC, Cordeiro F, Duchateau N, Fabris E, Costantino MF, Cho IJ, Goublaire C, Lam W, Galli E, Kim KH, Mariani M, Malev E, Zuercher F, Tang Z, Cimino S, Mahia P, De La Chica JA, Petrovic J, Ciobotaru V, Remsey- Semmelweiss E, Kogoj P, Guerreiro S, Saxena A, Mozenska O, Pontone G, Macaya Ten F, Caballero L, Avegliano G, Halmai L, Reis L, Trifunovic D, Gospodinova M, Makavos G, D'ascenzi F, Dantas Tavares De Melo M, Bonapace S, Kulkarni A, Cameli M, Ingvarsson A, Driessen MMP, Tufekcioglu O, Radulescu D, Barac A, Cioffi G, Almeida Morais L, Ledakowicz-Polak A, Portugal G, Naksuk N, Parato VM, Kovalova S, Cherubini A, Corrado G, Malev E, Wierzbowska-Drabik K, Lesevic H, Laredj N, Pieles GE, Generati G, Van Zalen JJ, Aquila I, Cheng HL, Lanzoni L, Asmarats Serra L, Kadrabulatova S, Ranjbar S, Szczesniak-Stanczyk D, Sharka I, Di Salvo G, Ben Kahla S, Li L, Hadeed HA, Habeeb HA, Toscano A, Granata F, Djikic D, Wdowiak-Okrojek K, Girgis HYA, Sharma A, Soro C, Gallego Page JC, Corneli M, Teixeira R, Roussin I, Lynch M, Muraru D, Romeo G, Ermacora D, Marotta C, Aruta P, Cucchini U, Iliceto S, Martin-Fernandez M, De La Hera Galarza JM, Corros-Vicente C, Colunga Blanco S, Velasco-Alonso E, Leon-Aguero V, Rodriguez-Suarez ML, Moris De La Tassa C, Edwards J, Braim D, Price C, Fraser AG, Salmani F, Arjmand Shabestari A, Szymczyk E, Kupczynska K, Peczek L, Nawrot B, Lipiec P, Kasprzak JD, Driussi C, Ferrara F, Brosolo G, Antonini-Canterin F, Magne J, Aboyans V, Bossone E, Bellucci BM, Fisher JM, Balekian AA, Idapalapati S, Huang F, Wong JI, Tan RS, Teixeira R, Madeira M, Almeida I, Reis L, Siserman A, Dinis P, Dias L, Ramos AP, Goncalves L, Wan FW, Sawaki DS, Dubois-Rande JLDR, Adnot SA, Czibik GC, Derumeaux GD, Ercan G, Tekkesin ILKER, Sahin ST, Cengiz B, Celik G, Demircan S, Aytekin SAIDE, Razvi NA, Nazir SA, Price N, Khan JN, Kanagala P, Singh A, Squire I, Mccann GP, Langel M, Pfeiffer D, Hagendorff A, Ptaszynska-Kopczynska K, Marcinkiewicz-Siemion M, Knapp M, Witkowski M, Musial WJ, Kaminski K, Natali B, D' Anna C, Leonardi B, Secinaro A, Pongiglione G, Rinelli G, Renard S, Michel N, Mancini J, Haentjens J, Sitbon O, Habib G, Imbriaco M, Alcidi G, Santoro C, Buonauro A, Lo Iudice F, Lembo M, Cuocolo A, Trimarco B, Galderisi M, Mora Robles J, Roldan Jimenez MA, Mancisidor MA, De Mora MA, Alnabelsi T, Goykhman I, Koshkelashvili N, Romero-Corral A, Pressman GS, Michalski BW, Kupczynska K, Miskowiec D, Lipiec P, Kasprzak JD, Montoro Lopez N, Refoyo Salicio E, Valbuena Lopez SC, Gonzalez O, Alvarez C, Moreno Yanguela M, Bartha Rasero JL, De La Calle M, Guzman Martinez G, Suarez-Cuenca JA, Merino JA, Gomez Alvarez EB, Delgado LG, Woo YM, Bang WD, Sohn GH, Cheong SS, Yoo SY, Rodriguez Palomares JF, Gutierrez L, Maldonado G, Pineda V, Galian L, Teixido G, Gonzalez Allujas MT, Evangelista A, Garcia Dorado D, Zaremba T, Ekeloef S, Heiberg E, Engblom H, Jensen SE, Sogaard P, Rodriguez Palomares JF, Gutierrez L, Garcia G, Pineda V, Galian L, Teixido G, Gonzalez Allujas MT, Evangelista A, Garcia Dorado D, Dini FL, Galli F, Lattanzi F, Picano E, Marzilli M, Leao S, Moz M, Magalhaes P, Trigo J, Mateus PS, Ferreira A, Moreira JI, De Craene M, Legallois D, Labombarda F, Pellissier A, Sermesant M, Saloux E, Merlo M, Moretti M, Barbati G, Stolfo D, Gigli M, Pinamonti B, Sinagra G, Dores E, Matera A, Innelli P, Innelli P, Lopizzo A, Violini R, Fiorilli R, Cappabianca G, Picano E, Tarsia G, Seo J, Chang HJ, Heo R, Kim IC, Shim CY, Hong GR, Chung N, Melissopoulou MM, Nguyen V, Brochet E, Cimadevilla C, Codogno I, Vahanian A, Messika-Zeitoun D, Pontana F, Vassiliou V, Prasad S, Leclercq C, Samset E, Donal E, Lim DS, Bianchi G, Rossi F, Gianetti J, Marchi F, Cerone E, Nardelli A, Terrazzi M, Solinas M, Maffei S, Pshepiy A, Vasina L, Timofeev E, Reeva S, Zemtsovsky E, Brugger N, Jahren S, De Marchi SF, Seiler C, Jin CN, Tang H, Fan K, Kam K, Yan BP, Yu CM, Lee PW, Reali M, Silvetti E, Salatino T, Mancone M, Pennacchi M, Giordano A, Sardella G, Agati L, Tirado G, Nogales-Romo MT, Marcos-Alberca P, De Agustin A, Almeria C, Rodrigo JL, Garcia Fernandez MA, Macaya C, Perez De Isla L, Mancisidor M, Lara Garcia C, Vivancos R, De Mora M, Petrovic M, Vujisic-Tesic B, Trifunovic D, Boricic-Kostic M, Petrovic I, Draganic G, Petrovic O, Tomic-Dragovic M, Furlan T, Ambrozic J, Mohorko Pleskovic PN, Bunc M, Ribeiras R, Abecasis J, Andrade MJ, Mendes M, Ramakrishnan S, Gupta SK, Juneja R, Kothari SS, Zaleska M, Segiet A, Chwesiuk S, Kroc A, Kosior DA, Andreini D, Solbiati A, Guglielmo M, Mushtaq S, Baggiano A, Beltrama V, Rota C, Guaricci AI, Pepi M, Pons Llinares J, Asmarats Serra L, Pericas Ramis P, Caldes Llull O, Grau Sepulveda A, Frontera G, Vaquer Segui A, Noris M, Bethencourt Gonzalez A, Climent Paya V, Martinez Moreno M, Saura D, Oliva MJ, Sanchez Quinones J, Garcia Honrubia A, Valdes M, De La Morena G, Terricabras M, Costabel JP, Ronderos R, Evangelista A, Venturini C, Galve E, Nemes A, Neubauer S, Rahman Haley S, Banner N, Teixeira R, Caetano F, Almeida I, Trigo J, Botelho A, Silva J, Nascimento J, Goncalves L, Tesic M, Jovanovic I, Petrovic O, Boricic-Kostic M, Dragovic M, Petrovic M, Stepanovic J, Banovic M, Vujisic-Tesic B, Guergelcheva V, Chamova T, Sarafov S, Tournev I, Denchev S, Ikonomidis I, Psarogiannakopoulos P, Tsirigotis P, Paraskevaidis I, Lekakis J, Pelliccia A, Natali BM, Cameli M, Focardi M, Bonifazi M, Mondillo S, Lima C, Assed L, Kalil Filho R, Mady C, Bochi EA, Salemi VMC, Targher G, Valbusa F, Rossi A, Lanzoni L, Lipari P, Zenari L, Molon G, Canali G, Barbieri E, Li L, Craft M, Nanda M, Lorenzo JM, Kutty S, Bombardini T, Sparla S, Di Tommaso C, Losito M, Incampo E, Maccherini M, Mondillo S, Werther Evaldsson A, Radegran G, Stagmo M, Waktare J, Roijer A, Meurling CJ, Hui W, Meijboom FJ, Bijnens B, Dragulescu A, Mertens L, Friedberg MK, Sensoy B, Suleymanoglu M, Akin Y, Sahan E, Sasmaz H, Pasca L, Buzdugan E, Chis B, Stoicescu L, Lynce FC, Smith KL, Mete M, Isaacs C, Viapiana O, Di Nora C, Ognibeni F, Fracassi E, Giollo A, Mazzone C, Faganello G, Di Lenarda A, Rossini M, Galrinho A, Branco L, Timoteo AT, Rodrigues I, Daniel P, Rosa S, Ferreira L, Ferreira R, Polak L, Krauza G, Stokfisz K, Zielinska M, Branco LM, Galrinho A, Mota Carmo M, Teresa Timoteo A, Aguiar Rosa S, Abreu J, Pinto Teixeira P, Viveiros Monteiro A, Cruz Ferreira R, Peeraphatdit T, Chaiteerakij R, Klarich KW, Masia S, Necas J, Nistri S, Negri F, Barbati G, Cioffi G, Russo G, Mazzone C, Faganello G, Pandullo C, Di Lenarda A, Durante A, Rovelli E, Genchi V, Trabattoni L, Zerboni SC, Cattaneo L, Butti E, Ferrari G, Luneva E, Mitrofanova L, Uspensky V, Zemtsovsky E, Kasprzak JD, Rosner S, Karl M, Ott I, Sonne C, Ali Lahmar HM, Hammou L, Forsey J, Gowing L, Miller F, Ramanujam P, Stuart AG, Williams CA, Bandera F, Pellegrino M, Carbone F, Labate V, Alfonzetti E, Guazzi M, Patel NR, Raju P, Beale L, Brickley G, Lloyd GW, Fernandez-Golfin C, Gonzalez A, Rincon LM, Hinojar R, Garcia A, Megias A, Jimenez-Nacher JJ, Moya JL, Zamorano JL, Molon G, Canali G, Bonapace S, Chiampan A, Albrigi L, Barbieri E, Noris Mora M, Rodriguez Fernandez A, Exposito Pineda C, Grande C, Gonzalez Colino R, Macaya Ten F, Fernandez Vazquez X, Fortuny Frau E, Bethencourt Gonzalez A, Karvandi M, Blaszczyk R, Zarczuk R, Brzozowski W, Janowski M, Wysokinski A, Stanczyk B, Myftiu S, Teferici D, Quka A, Dado E, Djamandi J, Kresto L, Duka A, Kristo A, Balla I, Issa Z, Moiduddin N, Siblini G, Bulbul Z, Abid L, Abid D, Kammoun S, Rush E, Craft M, Goodwin J, Kreikemeier R, Cantinotti M, Kutty S, Zolaly MA, Khoshhal SQ, El-Harbi K, Tarawah A, Al-Hawsawi Z, Al-Mozainy I, Bakhoum SWG, Nabil MN, Elebrashy IN, Chinali M, Albanese S, Carotti A, Iacobelli R, Esposito C, Secinaro A, Moscogiuri G, Pasquini L, Malvezzi Caracciolo M, Bianchi RM, Caso P, Arenga F, Riegler L, Scarafile R, D'andrea A, Russo MG, Calabro' P, Simic DS, Peric VP, Mujovic NM, Marinkovic MM, Jankovic NJ, Shim A, Wejner-Mik P, Kasprzak JD, Lipiec P, Jain N, Kharwar R, Saran RK, Narain VS, Dwivedi SK, Sethi R, Chandra S, Pradhan A, Safal S, Marchetti MF, Cacace C, Congia M, Nissardi V, Ruscazio M, Meloni L, Montisci R, Gallego Sanchez G, Calero S, Portero JJ, Tercero A, Garcia JC, Barambio M, Martinez Lazaro R, Meretta AH, Perea GO, Belcastro F, Aguirre E, De Luca I, Henquin R, Masoli O. Poster session 2THE IMAGING EXAMINATIONP536Appropriate use criteria of transthoracic echocardiography and its clinical impact: a continuous challengeP537Implementation of proprietary plug-ins in the DICOM-based computerized echo reporting system fuels the use of 3D echo and deformation imaging in the clinical routine of a multivendor laboratoryP538Exercise stress echocardiography appropriate use criteria: real-life cases classification ease and agreement among cardiologistsANATOMY AND PHYSIOLOGY OF THE HEART AND GREAT VESSELSP539Functional capacity in older people with normal ejection fraction correlates with left ventricular functional reserve and carotid-femoral pulse wave velocity but not with E/e and augmentation indexP540Survey of competency of practitioners for diagnosis of acute cardiopulmonary diseases manifest on chest x-rayASSESSMENT OF DIAMETERS, VOLUMES AND MASSP541Left atrium remodeling in dialysis patients with normal ejection fractionP542The prediction of postinfarction left ventricular remodeling and the role of of leptin and MCP-1 in regard to the presence of metabolic syndromeP543Ascending aorta and common carotid artery: diameters and stiffness in a group of 584 healthy subjectsAssessments of haemodynamicsP544Alternate echo parameters in patients without estimable RVSPAssessment of systolic functionP545Reduced contractile performance in heart failure with preserved ejection fraction: determination using novel preload-adjusted maximal left ventricular ejection forceP546Left ventricular dimensions and prognosis in acute coronary syndromesP547Time course of myocardial alterations in a murine model of high fat diet: A strain rate imaging studyP548Subclinical left ventricular systolic dysfunction in patients with premature ventricular contractionsP549Global myocardial strain by CMR-based feature tracking (FT) and tagging to predict development of severe left ventricular systolic dysfunction after acute st-elevation myocardial infarctionP550Echocardiographic analysis of left and right ventricular function in patients after mitral valve reconstructionP551The role of regional longitudinal strain assessment in predicting response to cardiac resynchronization therapy in patients with left ventricular systolic dysfunction and left bundle branch blockP552Speckle tracking automatic border detection improves echocardiographic evaluation of right ventricular systolic function in repaired tetralogy of fallot patients: comparison with MRI findingsP553Echocardiography: a reproducible and relevant tool in pah? intermediate results of the multicentric efort echogardiographic substudy (evaluation of prognostic factors and therapeutic targets in pah)Assessment of diastolic functionP554Relationship between left ventricular filling pressures and myocardial fibrosis in patients with uncomplicated arterial hypertensionP555Cardiac rehabilitation improves echocardiographic parameters of diastolic function in patients with ischemic heart diseaseP556Diastolic parameters in the calcified mitral annulusP557Biomarkers and echocardiography - combined weapon to diagnose and prognose heart failure with and without preserved ejection fractionP558Diastolic function changes of the maternal heart in twin and singleton pregnancyIschemic heart diseaseP559Syntax score as predictor for the correlation between epicardial adipose tissue and the severity of coronary lesions in patients with significant coronary diseaseP560Impact of strain analysis in ergonovine stress echocardiography for diagnosis vasospastic anginaP561Cardiac magnetic resonance tissue tracking: a novel method to predict infarct transmurality in acute myocardial infarctionP562Infarct size is correlated to global longitudinal strain but not left ventricular ejection fraction in the early stage of acute myocardial infarctionP563Magnetic resonance myocardial deformation assessment with tissue tracking and risk stratification in acute myocardial infarction patientsP564Increase in regional end-diastolic wall thickness by transthoracic echocardiography as a biomarker of successful reperfusion in anterior ST elevation acute myocardial infarctionP565Mitral regurgitation is associated with worse long-term prognosis in ST-segment elevation myocardial infarction treated with primary percutaneous coronary interventionP566Statistical significance of 3D motion and deformation indexes for the analysis of LAD infarctionHeart valve DiseasesP567Paradoxical low gradient aortic stenosis: echocardiographic progression from moderate to severe diseaseP568The beneficial effects of TAVI in mitral insufficiencyP569Impact of thoracic aortic calcification on the left ventricular hypertrophy and its regression after aortic valve replacement in patients with severe aortic stenosisP570Additional value of exercise-stress echocardiography in asymptomatic patients with aortic valve stenosisP571Valvulo-arterial impedance in severe aortic stenosis: a dual imaging modalities studyP572Left ventricular mechanics: novel tools to evaluate left ventricular performance in patients with aortic stenosisP573Comparison of long-term outcome after percutaneous mitral valvuloplasty versus mitral valve replacement in moderate to severe mitral stenosis with left ventricular dysfunctionP574Incidence of de novo left ventricular dysfunction in patient treated with aortic valve replacement for severe aortic regurgitationP575Transforming growth factor-beta dependant progression of the mitral valve prolapseP576Quantification of mitral regurgitation with multiple jets: in vitro validation of three-dimensional PISA techniqueP577Impaired pre-systolic contraction and saddle-shape deepening of mitral annulus contributes to atrial functional regurgitation: a three-dimensional echocardiographic studyP578Incidence and determinants of left ventricular (lv) reverse remodeling after MitraClip implantation in patients with moderate-to severe or severe mitral regurgitation and reduced lv ejection fractionP579Severe functional tricuspid regurgitation in rheumatic heart valve disease. New insights from 3D transthoracic echocardiographyP58015 years of evolution of the etiologic profile for prosthetic heart valve replacement through an echocardiography laboratoryP581The role of echocardiography in the differential diagnosis of prolonged fever of unknown originP582Predictive value for paravalvular regurgitation of 3-dimensional anatomic aortic annulus shape assessed by multidetector computed tomography post-transcatheter aortic valve replacementP583The significance and advantages of echo and CT imaging & measurement at transcatherter aortic valve implantation through the left common carotid accessP584Comparison of the self-expandable Medtronic CoreValve versus the balloon-expandable Edwards SAPIEN bioprostheses in high-risk patients undergoing transfemoral aortic valve implantationP585The impact of transcatheter aortic valve implantation on mitral regurgitation severityP586Echocardiographic follow up of children with valvular lesions secondary to rheumatic heart disease: Data from a prospective registryP587Valvular heart disease and different circadian blood pressure profilesCardiomyopathiesP588Comparison of transthoracic echocardiography versus cardiac magnetic for implantable cardioverter defibrillator therapy in primary prevention strategy dilated cardiomyopathy patientsP589Incidence and prognostic significance of left ventricle reverse remodeling in a cohort of patients with idiopathic dilated cardiomyopathyP590Early evaluation of diastolic function in fabry diseaseP591Echocardiographic predictors of atrial fibrillation development in hypertrophic cardiomyopathyP592Altered Torsion mechanics in patients with hypertrophic cardiomyopathy: LVOT-obstruction is the topdog?P593Prevention of sudden cardiac death in hypertrophic cardiomyopathy: what has changed in the guidelines?P594Coronary microcirculatory function as determinator of longitudinal systolic left ventricular function in hypertrophic cardiomyopathyP595Detection of subclinical myocardial dysfunction by tissue Doppler ehocardiography in patients with muscular dystrophiesP596Speckle tracking myocardial deformation analysis and three dimensional echocardiography for early detection of chemotherapy induced cardiac dysfunction in bone marrow transplantation patientsP597Left ventricular non compaction or hypertrabeculation: distinguishing between physiology and pathology in top-level athletesP598Role of multi modality imaging in familiar screening of Danon diseaseP599Early impairment of global longitudinal left ventricular systolic function independently predicts incident atrial fibrillation in type 2 diabetes mellitusP600Fetal cardiovascular programming in maternal diabetes mellitus and obesity: insights from deformation imagingP601Longitudinal strain stress echo evaluation of aged marginal donor hearts: feasibility in the Adonhers project.P602Echocardiographic evaluation of left ventricular size and function following heart transplantation - Gender mattersSystemic diseases and other conditionsP603The impact of septal kinetics on adverse ventricular-ventricular interactions in pulmonary stenosis and pulmonary arterial hypertensionP604Improvement in right ventricular mechanics after inhalation of iloprost in pulmonary hypertensionP605Does the treatment of patients with metabolic syndrome correct the right ventricular diastolic dysfunction?P606Predictors of altered cardiac function in breast cancer survivors who were treated with anthracycline-based therapyP607Prevalence and factors related to left ventricular systolic dysfunction in asymptomatic patients with rheumatoid arthritis: a prospective tissue-doppler echocardiography studyP608Diastolic and systolic left ventricle dysfunction presenting different prognostic implications in cardiac amyloidosisP609Diagnostic accuracy of Bedside Lung Ultrasonography in Emergency (BLUE) protocol for the diagnosis of pulmonary embolismP610Right ventricular systolic dysfunction and its incidence in breast cancer patients submitted to anthracycline therapyP611Right ventricular dysfunction is an independent predictor of survival among cirrhotic patients undergoing liver transplantCongenital heart diseaseP612Hypoplasia or absence of posterior leaflet: a rare congenital anomaly of the mitral valveP613ECHO screening for Barlow disease in proband's relativesDiseases of the aortaP614Aortic size distribution and prognosis in an unselected population of patients referred for standard transthoracic echocardiographyP615Abdominal aorta aneurysm ultrasonographic screening in a large cohort of asympromatic volounteers in an Italian urban settingP616Thoracic aortic aneurysm and left ventricular systolic functionStress echocardiographyP617Wall motion score index, systolic mitral annulus velocity and left ventricular mass predicted global longitudinal systolic strain in 238 patients examined by stress echocardiographyP618Prognostic parameters of exercise-induced severe mitral valve regurgitation and exercise-induced systolic pulmonary hypertensionP619Risk stratification after myocardial infarction: prognostic value of dobutamine stress echocardiographyP620relationship between LV and RV myocardial contractile reserve and metabolic parameters during incremental exercise and recovery in healthy children using 2-D strain analysisP621Increased peripheral extraction as a mechanism compensatory to reduced cardiac output in high risk heart failure patients with group 2 pulmonary hypertension and exercise oscillatory ventilationP622Can exercise induced changes in cardiac synchrony predict response to CRT?Transesophageal echocardiographyP623Fully-automated software for mitral valve assessment in chronic mitral regurgitation by three-dimensional transesophageal echocardiographyP624Real-time 3D transesophageal echocardiography provides more accurate orifice measurement in percutaneous transcatheter left atrial appendage closureP625Percutaneous closure of left atrial appendage: experience of 36 casesReal-time three-dimensional TEEP626Real-time three-dimensional transesophageal echocardiography during pulmonary vein cryoballoon ablation for atrial fibrilationP627Three dimensional ultrasound anatomy of intact mitral valve and in the case of type 2 disfunctionTissue Doppler and speckle trackingP629Left ventricle wall motion tracking from echocardiographic images by a non-rigid image registrationP630The first experience with the new prototype of a robotic system for remote echocardiographyP631Non-invasive PCWP influence on a loop diuretics regimen monitoring model in ADHF patients.P632Normal range of left ventricular strain, dimensions and ejection fraction using three-dimensional speckle-tracking echocardiography in neonatesP633Circumferential ascending aortic strain: new parameter in the assessment of arterial stiffness in systemic hypertensionP634Aortic vascular properties in pediatric osteogenesis imperfecta: a two-dimensional echocardiography derived aortic strain studyP635Assessment of cardiac functions in children with sickle cell anemia: doppler tissue imaging studyP636Assessment of left ventricular function in type 1 diabetes mellitus patients by two-dimensional speckle tracking echocardiography: relation to duration and control of diabetesP637A study of left ventricular torsion in l-loop ventricles using speckle-tracking echocardiographyP638Despite No-Reflow, global and regional longitudinal strains assessed by two-dimensional speckle tracking echocardiography are predictive indexes of left ventricular remodeling in patients with STEMIP639The function of reservoir of the left atrium in patients with medicaly treated arterial hypertensionP640The usefulness of speckle tracking analysis for predicting the recovery of regional systolic function after myocardial infarctionP641Two dimensional speckle tracking echocardiography in assessment of left ventricular systolic function in patients with rheumatic severe mitral regurgitation and normal ejection fractionP642The prediction of left-main and tripple vessel coronary artery disease by tissue doppler based longitudinal strain and strain rate imagingP643Role of speckle tracking in predicting arrhythmic risk and occurrence of appropriate implantable defibrillator Intervention in patients with ischemic and non-ischemic cardiomyopathyComputed Tomography & Nuclear CardiologyP644Cardiac adrenergic activity in patients with nonischemic dilated cardiomyopathy. Correlation with echocardiographyP645Different vascular territories and myocardial ischemia, there is a gradient of association? Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Barbosa-Ferreira JM, Mady C, Ianni BM, Lopes HF, Ramires FJA, Salemi VMC, Grupi CJ, Hachul DT, Fernandes F. Dysregulation of Autonomic Nervous System in Chagas' Heart Disease Is Associated with Altered Adipocytokines Levels. PLoS One 2015; 10:e0131447. [PMID: 26147101 PMCID: PMC4493107 DOI: 10.1371/journal.pone.0131447] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Accepted: 06/02/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Chagas disease (CD) induces autonomic dysfunction and inflammatory activity, which may promote metabolic abnormalities. We studied metabolism and his correlation with Autonomic Nervous System (ANS) and inflammation in CD. METHODS AND RESULTS Sixty subjects were divided into 4 groups: control group (CG), IF (indeterminate form) group; ECG group (ECG abnormalities and normal left ventricular systolic function), and LVD group (left ventricular sistolic dysfunction). Levels of adiponectin, leptin, insulin, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) were assayed in serum samples by ELISA. ANS was assessed by heart rate variability in frequency domain in 24-hour Holter and postural tilt test (rest and orthostatic position). High frequency (HFr) component values were used to estimate parasympathetic activity and low frequency (LFr) component, sympathetic activity. Analyzes were made of the correlations of each of the metabolic parameters (leptin and adiponectin) with the inflammatory cytokines (interleukin-6 and TNF- alpha) and with the ANS assessment measurements. No significant differences were observed in leptin and insulin levels. Adiponectin was higher in ECG and LVD groups: [CG = 4766.5 (5529.5), IF = 4003.5 (2482.5), ECG = 8376.5 (8388.5), LVD = 8798 (4188.0) ng/mL, p<0.001)]. IL-6 and TNF-alpha were higher in LVD group: [IL-6: CG = 1.85 (6.41); IF = 1.58 (1.91); ECG = 1.0 (1.57); LVD= 31.44 (72.19) pg/ml; p = 0.001. TNF-alpha: CG = 22.57 (88.2); IF = 19.31 (33.16); ECG = 12.45 (3.07); LVD = 75.15 (278.57) pg/ml; p = 0.04]. Adiponectin levels had a positive association with the HFr component (r = 0.539; p = 0.038) and an inverse association with the LFr component (r = - 0.539; p = 0.038) in ECG group. Leptin levels had a negative association with the HFr component (r= - 0.632; p = 0.011) and a positive association with the LFr component (r = 0.632; p = 0.011) in LVD group. CONCLUSIONS We found increased adiponectin levels in Chagas' heart disease with systolic dysfunction and in patients with ECG abnormalities and normal systolic function at rest. Adipocytokines levels (adiponectin and leptin) were associated with ANS parameters in Chagas' heart disease.
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Affiliation(s)
- João Marcos Barbosa-Ferreira
- Cardiomyopathy Unit of the Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Charles Mady
- Cardiomyopathy Unit of the Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Barbara Maria Ianni
- Cardiomyopathy Unit of the Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Heno Ferreira Lopes
- Hypertension Unit of the Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Universidade Nove de Julho—UNINOVE, São Paulo, Brazil
| | - Felix José Alvarez Ramires
- Cardiomyopathy Unit of the Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Vera Maria Cury Salemi
- Cardiomyopathy Unit of the Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Cesar José Grupi
- Electrocardiology Unit of the Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Denise Tessariol Hachul
- Clinical Arrhythmia Unit of the Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Fábio Fernandes
- Cardiomyopathy Unit of the Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Tavares de Melo MD, de Araújo Filho JAB, Parga Filho JR, de Lima CR, Mady C, Kalil-Filho R, Salemi VMC. Noncompaction cardiomyopathy: a substrate for a thromboembolic event. BMC Cardiovasc Disord 2015; 15:7. [PMID: 25618133 PMCID: PMC4407327 DOI: 10.1186/1471-2261-15-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 08/27/2014] [Accepted: 01/12/2015] [Indexed: 11/10/2022] Open
Abstract
Background Noncompaction cardiomyopathy (NCC) is a rare genetic cardiomyopathy characterized by a thin, compacted epicardial layer and an extensive noncompacted endocardial layer. The clinical manifestations of this disease include ventricular arrhythmia, heart failure, and systemic thromboembolism. Case presentation A 43-year-old male was anticoagulated by pulmonary thromboembolism for 1 year when he developed progressive dyspnea. Cardiovascular magnetic resonance imaging showed severe biventricular trabeculation with an ejection fraction of 15%, ratio of maximum noncompacted/compacted diastolic myocardial thickness of 3.2 and the presence of exuberant biventricular apical thrombus. Conclusion Still under discussion is the issue of which patients and when they should be anticoagulated. It is generally recommended to those presenting ventricular systolic dysfunction, antecedent of systemic embolism, presence of cardiac thrombus and atrial fibrillation. In clinical practice the patients with NCC and ventricular dysfunction have been given oral anticoagulation, although there are no clinical trials showing the real safety and benefit of this treatment. Electronic supplementary material The online version of this article (doi:10.1186/1471-2261-15-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marcelo Dantas Tavares de Melo
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
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Fonoff AM, Alvarez Ramires FJ, Fonseca KB, Cury Salemi VM, Pessoa FG, Saldiva PH, Mady C. The Role of Air Pollution upon Myocardial Remodeling. J Card Fail 2014. [DOI: 10.1016/j.cardfail.2014.06.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Miranda DP, dos Santos MJ, Salemi VMC, de Oliveira EPC, Verberne HJ, da Rocha ET. Differential effects of variation in athletes training on myocardial morphophysiological adaptation in men: focus on ¹²³I-MIBG assessed myocardial sympathetic activity. J Nucl Cardiol 2014; 21:570-7. [PMID: 24627344 DOI: 10.1007/s12350-014-9876-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 02/12/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE High intensity systematic physical training leads to myocardial morphophysiological adaptations. The goal of this study was to investigate if differences in training were correlated with differences in cardiac sympathetic activity. METHODS 58 males (19-47 years), were divided into three groups: strength group (SG), (20 bodybuilders), endurance group (EG), (20 endurance athletes), and a control group (CG) comprising 18 healthy non-athletes. Cardiac sympathetic innervation was assessed by planar myocardial (123)I-metaiodobenzylguanidine scintigraphy using the early and late heart to mediastinal (H/M) ratio, and washout rate (WR). RESULTS Left ventricular mass index was significantly higher both in SG (P < .001) and EG (P = .001) compared to CG without a statistical significant difference between SG and EG (P = .417). The relative wall thickness was significantly higher in SG compared to CG (P < .001). Both left ventricular ejection fraction and the peak filling rate showed no significant difference between the groups. Resting heart rate was significantly lower in EG compared to CG (P = .006) and SG (P = .002). The late H/M ratio in CG was significantly higher compared to the late H/M for SG (P = .003) and EG (P = .004). However, WR showed no difference between the groups. There was no significant correlation between the parameters of myocardial sympathetic innervation and parameters of left ventricular function. CONCLUSIONS Strength training resulted in a significant increase in cardiac dimensions. Both strength and endurance training seem to cause a reduction in myocardial sympathetic drive. However, myocardial morphological and functional adaptations to training were not correlated with myocardial sympathetic activity.
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Affiliation(s)
- Douglas Pinheiro Miranda
- Post Graduation Program in Research and Development - Medical Biotechnology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil,
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Gomes-Santos IL, Fernandes T, Couto GK, Ferreira-Filho JCA, Salemi VMC, Fernandes FB, Casarini DE, Brum PC, Rossoni LV, de Oliveira EM, Negrao CE. Effects of exercise training on circulating and skeletal muscle renin-angiotensin system in chronic heart failure rats. PLoS One 2014; 9:e98012. [PMID: 24859374 PMCID: PMC4032232 DOI: 10.1371/journal.pone.0098012] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 04/28/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Accumulated evidence shows that the ACE-AngII-AT1 axis of the renin-angiotensin system (RAS) is markedly activated in chronic heart failure (CHF). Recent studies provide information that Angiotensin (Ang)-(1-7), a metabolite of AngII, counteracts the effects of AngII. However, this balance between AngII and Ang-(1-7) is still little understood in CHF. We investigated the effects of exercise training on circulating and skeletal muscle RAS in the ischemic model of CHF. METHODS/MAIN RESULTS Male Wistar rats underwent left coronary artery ligation or a Sham operation. They were divided into four groups: 1) Sedentary Sham (Sham-S), 2) exercise-trained Sham (Sham-Ex), sedentary CHF (CHF-S), and exercise-trained CHF (CHF-Ex). Angiotensin concentrations and ACE and ACE2 activity in the circulation and skeletal muscle (soleus and plantaris) were quantified. Skeletal muscle ACE and ACE2 protein expression, and AT1, AT2, and Mas receptor gene expression were also evaluated. CHF reduced ACE2 serum activity. Exercise training restored ACE2 and reduced ACE activity in CHF. Exercise training reduced plasma AngII concentration in both Sham and CHF rats and increased the Ang-(1-7)/AngII ratio in CHF rats. CHF and exercise training did not change skeletal muscle ACE and ACE2 activity and protein expression. CHF increased AngII levels in both soleus and plantaris muscle, and exercise training normalized them. Exercise training increased Ang-(1-7) in the plantaris muscle of CHF rats. The AT1 receptor was only increased in the soleus muscle of CHF rats, and exercise training normalized it. Exercise training increased the expression of the Mas receptor in the soleus muscle of both exercise-trained groups, and normalized it in plantaris muscle. CONCLUSIONS Exercise training causes a shift in RAS towards the Ang-(1-7)-Mas axis in skeletal muscle, which can be influenced by skeletal muscle metabolic characteristics. The changes in RAS circulation do not necessarily reflect the changes occurring in the RAS of skeletal muscle.
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Affiliation(s)
| | - Tiago Fernandes
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Gisele Kruger Couto
- Department of Physiology and Biophysics, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | | | - Vera Maria Cury Salemi
- Heart Institute (InCor-HCFMUSP), University of São Paulo Medical School, São Paulo, Brazil
| | - Fernanda Barrinha Fernandes
- Division of Nephrology, Kidney and Hypertension Hospital, Federal University of São Paulo, São Paulo, Brazil
| | - Dulce Elena Casarini
- Division of Nephrology, Kidney and Hypertension Hospital, Federal University of São Paulo, São Paulo, Brazil
| | - Patricia Chakur Brum
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Luciana Venturini Rossoni
- Department of Physiology and Biophysics, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | | | - Carlos Eduardo Negrao
- Heart Institute (InCor-HCFMUSP), University of São Paulo Medical School, São Paulo, Brazil
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
- * E-mail:
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Betim Paes Leme AM, Salemi VMC, Weiss RG, Parga JR, Ianni BM, Mady C, Kalil-Filho R. Exercise-induced decrease in myocardial high-energy phosphate metabolites in patients with Chagas heart disease. J Card Fail 2014; 19:454-60. [PMID: 23834921 DOI: 10.1016/j.cardfail.2013.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 05/12/2013] [Accepted: 05/16/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The influence of exercise on cardiac metabolic response in patients with Chagas disease is incompletely understood. METHODS AND RESULTS Changes in cardiac energetic metabolism were investigated in Chagas disease patients before and during isometric handgrip exercise with (31)P magnetic resonance spectroscopy (MRS). Twenty-eight patients (10 with systolic dysfunction: group I; 10 with normal systolic function and electrocardiogram (ECG) abnormalities: group II; and 8 asymptomatic without ECG abnormalities: group III) and 8 healthy control subjects (group C) were evaluated by electrocardiogram, echocardiogram, functional tests for coronary artery disease, and image-selected localized cardiac (31)P-MRS. The myocardial phosphocreatine to [β-phosphate]adenosine triphosphate ratio (PCr/β-ATP) was measured at rest and during isometric handgrip exercise. Exercise testing or 99mTc-sestamibi scintigraphy were negative for myocardial ischemia in all individuals. At rest, cardiac PCr/β-ATP was decreased in all Chagas groups (1.23 ± 0.37) versus group C (1.88 ± 0.08; P < .001) and was lower in group I (0.89 ± 0.24) versus groups II (1.44 ± 0.23) and III (1.40 ± 0.37; P < .001). There was no stress-induced change in cardiac PCr/β-ATP (1.88 ± 0.08 at rest vs 1.89 ± 0.08 during exercise; P = NS) in group C. Mean cardiac PCr/β-ATP was 0.89 ± 0.24 and 0.56 ± 0.21 at rest and during exercise, respectively, in group I (37% decrease; P < .001). In group II, PCr/β-ATP was 1.44 ± 0.23 at rest and 0.97 ± 0.37 during exercise (33% decrease; P < .001). In group III, PCr/β-ATP was 1.40 ± 0.37 at rest and 0.60 ± 0.19 during exercise (57% decrease; P < .001). CONCLUSIONS Myocardial high-energy phosphates are reduced at rest in Chagas heart disease patients, and the reduction is greater in patients with left ventricular dysfunction. Regardless of left ventricular function, Chagas patients exhibit an exercise-induced decline in cardiac high-energy phosphates consistent with myocardial ischemia, suggesting the possibility that this metabolic approach may offer a tool to probe new interventions in Chagas disease patients.
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Affiliation(s)
- Ana Maria Betim Paes Leme
- Faculdade de Medicina, Heart Institute, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil
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Pimentel WDS, Ramires FJA, Lanni BM, Salemi VMC, Bilate AMB, Cunha-Neto E, Oliveira AMD, Fernandes F, Mady C. The effect of beta-blockade on myocardial remodelling in Chagas' cardiomyopathy. Clinics (Sao Paulo) 2012; 67:1063-9. [PMID: 23018305 PMCID: PMC3438248 DOI: 10.6061/clinics/2012(09)14] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 05/07/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Chagas' disease has spread throughout Latin America because of the high rate of migration among these countries. Approximately 30% of Chagas' patients will develop cardiomyopathy, and 10% of these will develop severe cardiac damage leading to heart failure. Beta-blockade improves symptoms and survival in heart failure patients; however, its efficacy has not been well established in Chagas' disease. We evaluated the role of carvedilol in cardiac remodeling and mortality in a Chagas' cardiomyopathy animal model. METHODS We studied Trypanosoma cruzi infection in 55 Syrian hamsters that were divided into three groups: control (15), infected (20), and infected + carvedilol (20). Animals underwent echocardiography, electrocardiography, and morphometry for collagen evaluation in ventricles stained with picrosirius red. RESULTS The left ventricular diastolic diameter did not change between groups, although it was slightly larger in infected groups, as was left ventricular systolic diameter. Fractional shortening also did not change between groups, although it was slightly lower in infected groups. Collagen accumulation in the interstitial myocardial space was significantly higher in infected groups and was not attenuated by carvedilol. The same response was observed in the perivascular space. The survival curve showed significantly better survival in the control group compared with the infected groups; but no benefit of carvedilol was observed during the study. However, in the acute phase (up to 100 days of infection), carvedilol did reduce mortality. CONCLUSION Carvedilol did not attenuate cardiac remodeling or mortality in this model of Chagas' cardiomyopathy. The treatment did improve survival in the acute phase of the disease.
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Affiliation(s)
- Walace de Souza Pimentel
- Unidade Clínica de Miocardiopatias, Hospital das Clínicas Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Voltarelli VA, Bacurau AVN, Bechara LRG, Bueno CR, Bozi LHM, Mattos KC, Salemi VMC, Brum PC. Lack of β2-AR improves exercise capacity and skeletal muscle oxidative phenotype in mice. Scand J Med Sci Sports 2012; 22:e125-32. [PMID: 22913394 DOI: 10.1111/j.1600-0838.2012.01519.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2012] [Indexed: 01/05/2023]
Abstract
β(2)-adrenergic receptor (β(2)-AR) agonists have been used as ergogenics by athletes involved in training for strength and power in order to increase the muscle mass. Even though anabolic effects of β(2)-AR activation are highly recognized, less is known about the impact of β(2)-AR in endurance capacity. We presently used mice lacking β(2)-AR [β(2)-knockout (β(2) KO)] to investigate the role of β(2)-AR on exercise capacity and skeletal muscle metabolism and phenotype. β(2) KO mice and their wild-type controls (WT) were studied. Exercise tolerance, skeletal muscle fiber typing, capillary-to-fiber ratio, citrate synthase activity and glycogen content were evaluated. When compared with WT, β(2) KO mice displayed increased exercise capacity (61%) associated with higher percentage of oxidative fibers (21% and 129% of increase in soleus and plantaris muscles, respectively) and capillarity (31% and 20% of increase in soleus and plantaris muscles, respectively). In addition, β(2) KO mice presented increased skeletal muscle citrate synthase activity (10%) and succinate dehydrogenase staining. Likewise, glycogen content (53%) and periodic acid-Schiff staining (glycogen staining) were also increased in β(2) KO skeletal muscle. Altogether, these data provide evidence that disruption of β(2)-AR improves oxidative metabolism in skeletal muscle of β(2) KO mice and this is associated with increased exercise capacity.
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Affiliation(s)
- V A Voltarelli
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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Fernandes F, Ramires FJA, Ianni BM, Salemi VMC, Oliveira AM, Pessoa FG, Canzian M, Mady C. Effect of Colchicine on Myocardial Injury Induced by Trypanosoma cruzi in Experimental Chagas Disease. J Card Fail 2012; 18:654-9. [DOI: 10.1016/j.cardfail.2012.06.419] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 06/05/2012] [Accepted: 06/08/2012] [Indexed: 10/28/2022]
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Salemi VMC, Atik E, Kairalla RA, Queiroz EL, Rosa LVD, Kalil Filho R. Takotsubo cardiomyopathy triggered by β(2) adrenergic agonist. J Bras Pneumol 2012; 37:560-2. [PMID: 21881747 DOI: 10.1590/s1806-37132011000400019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Mostarda C, Moraes-Silva IC, Salemi VMC, Machi JF, Rodrigues B, De Angelis K, Farah VDMA, Irigoyen MC. Exercise training prevents diastolic dysfunction induced by metabolic syndrome in rats. Clinics (Sao Paulo) 2012; 67:815-20. [PMID: 22892928 PMCID: PMC3400174 DOI: 10.6061/clinics/2012(07)18] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 03/14/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE High fructose consumption contributes to the incidence of metabolic syndrome and, consequently, to cardiovascular outcomes. We investigated whether exercise training prevents high fructose diet-induced metabolic and cardiac morphofunctional alterations. METHODS Wistar rats receiving fructose overload (F) in drinking water (100 g/l) were concomitantly trained on a treadmill (FT) for 10 weeks or kept sedentary. These rats were compared with a control group (C). Obesity was evaluated by the Lee index, and glycemia and insulin tolerance tests constituted the metabolic evaluation. Blood pressure was measured directly (Windaq, 2 kHz), and echocardiography was performed to determine left ventricular morphology and function. Statistical significance was determined by one-way ANOVA, with significance set at p<0.05. RESULTS Fructose overload induced a metabolic syndrome state, as confirmed by insulin resistance (F: 3.6 ± 0.2 vs. C: 4.5 ± 0.2 mg/dl/min), hypertension (mean blood pressure, F: 118 ± 3 vs. C: 104 ± 4 mmHg) and obesity (F: 0.31 ± 0.001 vs. C: 0.29 ± 0.001 g/mm). Interestingly, fructose overload rats also exhibited diastolic dysfunction. Exercise training performed during the period of high fructose intake eliminated all of these derangements. The improvements in metabolic parameters were correlated with the maintenance of diastolic function. CONCLUSION The role of exercise training in the prevention of metabolic and hemodynamic parameter alterations is of great importance in decreasing the cardiac morbidity and mortality related to metabolic syndrome.
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Affiliation(s)
- Cristiano Mostarda
- Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Hypertension Unit, Heart Institute (InCor), Sao Paulo/SP, Brazil
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Salemi VMC, Demarchi LMMF, Cabeda EV, Wagenführ J, Tanaka AC. Type III glycogen storage disease mimicking hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 2011; 13:197. [PMID: 22087010 DOI: 10.1093/ejechocard/jer231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Vera Maria Cury Salemi
- Cardiomyopathy Unit, Heart Institute, InCor, do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
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Flues K, Moraes-Silva IC, Mostarda C, Souza PRM, Diniz GP, Moreira ED, Piratello AC, Chaves MLB, De Angelis K, Salemi VMC, Irigoyen MC, Caldini EG. Cardiac and pulmonary arterial remodeling after sinoaortic denervation in normotensive rats. Auton Neurosci 2011; 166:47-53. [PMID: 22079748 DOI: 10.1016/j.autneu.2011.10.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 10/09/2011] [Accepted: 10/12/2011] [Indexed: 10/15/2022]
Abstract
Blood pressure variability (BPV) and baroreflex dysfunction may contribute to end-organ damage process. We investigated the effects of baroreceptor deficit (10 weeks after sinoaortic denervation - SAD) on hemodynamic alterations, cardiac and pulmonary remodeling. Cardiac function and morphology of male Wistar intact rats (C) and SAD rats (SAD) (n=8/group) were assessed by echocardiography and collagen quantification. BP was directly recorded. Ventricular hypertrophy was quantified by the ratio of left ventricular weight (LVW) and right ventricular weight (RVW) to body weight (BW). BPV was quantified in the time and frequency domains. The atrial natriuretic peptide (ANP), alpha-skeletal actin (α-skelectal), collagen type I and type III genes mRNA expression were evaluated by RT-PCR. SAD did not change BP, but increased BPV (11±0.49 vs. 5±0.3 mmHg). As expected, baroreflex was reduced in SAD. Pulmonary artery acceleration time was reduced in SAD. In addition, SAD impaired diastolic function in both LV (6.8±0.26 vs. 5.02±0.21 mmHg) and RV (5.1±0.21 vs. 4.2±0.12 mmHg). SAD increased LVW/BW in 9% and RVW/BW in 20%, and augmented total collagen (3.8-fold in LV, 2.7-fold in RV, and 3.35-fold in pulmonary artery). Also, SAD increased type I (~6-fold) and III (~5-fold) collagen gene expression. Denervation increased ANP expression in LV (75%), in RV (74%) and increased α-skelectal expression in LV (300%) and in RV (546%). Baroreflex function impairment by SAD, despite not changing BP, induced important adjustments in cardiac structure and pulmonary hypertension. These changes may indicate that isolated baroreflex dysfunction can modulate target tissue damage.
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Affiliation(s)
- K Flues
- Experimental Hypertension Laboratory, Hypertension Unit, Heart Institute, Department of Pathology, University of Sao Paulo Medical School, São Paulo, SP, Brazil
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Salemi VMC, Dabarian AL, Nastari L, Gama M, Soares Júnior J, Mady C. Treatment of left main coronary artery lesion after late thoracic radiotherapy. Arq Bras Cardiol 2011; 97:e53-5. [PMID: 22030704 DOI: 10.1590/s0066-782x2011001200018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Accepted: 07/01/2010] [Indexed: 11/22/2022] Open
Abstract
Prevention of late cardiovascular complications after radiation therapy (RT) for treatment of a malignant tumor is challenging. We report the case of a young male patient with Hodgkin's lymphoma treated with RT, who developed ischemic heart disease during follow-up, although he had no cardiovascular risk factors. We conclude that patients undergoing RT who experience chest pain should be fully investigated for coronary artery disease.
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Affiliation(s)
- Vera Maria Cury Salemi
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil.
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Fonseca GHH, Souza R, Salemi VMC, Jardim CVP, Gualandro SFM. Pulmonary hypertension diagnosed by right heart catheterisation in sickle cell disease. Eur Respir J 2011; 39:112-8. [PMID: 21778170 DOI: 10.1183/09031936.00134410] [Citation(s) in RCA: 181] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Recent studies have recognised the importance of pulmonary hypertension (PH) in sickle cell disease (SCD). The aim of this study was to determine the prevalence and prognostic impact of PH and its features in patients with SCD. 80 patients with SCD underwent baseline clinical evaluation, laboratory testing, 6-min walk tests (6MWTs) and echocardiography. Patients with a peak tricuspid regurgitant jet velocity (TRV) of ≥ 2.5 m·s(-1) were further evaluated through right heart catheterisation (RHC) to assure the diagnosis of PH. Our study evidenced a 40% prevalence of patients with elevated TRV at echocardiography. RHC (performed in 25 out of 32 patients) confirmed PH in 10% (95% CI 3.4-16.5%) of all patients, with a prevalence of post-capillary PH of 6.25% (95% CI 0.95-11.55%) and pre-capillary PH of 3.75% (95% CI -0.4-7.9%). Patients with PH were older, had worse performance in 6MWTs, and more pronounced anaemia, haemolysis and renal dysfunction. Survival was shorter in patients with PH. Our study reinforced the use of echocardiography as a screening tool for PH in SCD and the mandatory role of RHC for proper diagnosis. Our findings confirmed the prognostic significance of PH in SCD as its association to pronounced haemolytic profile.
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Affiliation(s)
- G H H Fonseca
- Hematology Dept, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 155 - 1° andar, São Paulo, 05403-000 Brazil.
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Rosa LVD, Salemi VMC, Alexandre LM, Mady C. Miocardiopatia não compactada: uma visão atual. Arq Bras Cardiol 2011; 97:e13-9. [DOI: 10.1590/s0066-782x2011000900021] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Accepted: 04/28/2010] [Indexed: 11/21/2022] Open
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Salemi VMC, D'andretta Iglezias S, Benvenuti LA, Filho JCAF, Rochitte CE, Shiozaki AA, Mady C. An unusual association of endomyocardial fibrosis and hypertrophic cardiomyopathy in a patient with heart failure. Cardiovasc Pathol 2011; 21:e23-5. [PMID: 21641824 DOI: 10.1016/j.carpath.2011.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Accepted: 04/06/2011] [Indexed: 11/25/2022] Open
Abstract
A 69-year-old female patient presented heart failure with preserved ejection fraction and atrial fibrillation. Echocardiography and late gadolinium enhancement magnetic resonance imaging were suggestive of endomyocardial fibrosis (EMF). The patient underwent cardiac surgery, and after surgery, she developed low cardiac output syndrome and died. Postmortem examination revealed residual fibrosis of the left ventricle (LV), mild endocardial fibrous deposition of the right ventricle, and severe concentric, symmetrical LV hypertrophy. Histological examination of the surgically resected material from the LV confirmed EMF. Histopathology of the interventricular septum disclosed myocardial hypertrophy and disarray plus fine interstitial fibrosis, typical of hypertrophic cardiomyopathy. The present case illustrates the association of two different patterns of cardiomyopathies in the same patient.
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