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Pinto Diniz C, Felix Mediano MF, Rodrigues Junior LF, Mendes FDSNS, Magalhães Saraiva R, Horta Veloso H, Rodrigues da Costa A, Hasslocher-Moreno AM, Borghi-Silva A, Silvestre de Sousa A, Mazzoli-Rocha F. Inspiratory muscle endurance is similarly reduced in the early and late stages of chronic Chagas heart disease. Trop Med Int Health 2024; 29:405-413. [PMID: 38503276 DOI: 10.1111/tmi.13984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVE Inspiratory muscle strength (IMS) appears to be reduced in subjects with chronic Chagas heart disease (CHD), especially in the presence of heart failure (HF). However, only one study about IMS and inspiratory muscle endurance (IME) in those with CHD without heart failure is available. This study aimed to compare IMS and IME in subjects with CHD in the presence and absence of HF. METHODS This is a cross-sectional study in which 30 CHD adult patients were divided into CHD-CC group (initial phase of CHD, without HF; n = 15) and CHD-HF group (advanced phase of CHD, with HF; n = 15). We assessed IMS by maximum inspiratory pressure (MIP) and IME by incremental (Pthmax) and constant load (TLim) tests. Reduced IMS and IME were considered by predicted MIP values <70% and Pthmax/MIP <75%, respectively. RESULTS Inspiratory muscle weakness (IMW) was more frequent in CHD-HF than in CHD-CC (46.7% vs. 13.3%; p = 0.05), and both groups had high frequencies of reduced IME (93.3% CHD-CC vs. 100.0% CHD-HF; p = 0.95). Age-adjusted logistic regression analysis using HF as a dependent variable showed that HF was associated with an increased chance of IMW compared with the CHD-CC group (OR = 7.47; p = 0.03; 95% CI 1.20-46.19). CONCLUSION This study suggests that, in patients with CHD, HF is associated with IMW, and that reduction of IME is already present in the initial phase, similar to the advanced phase with HF.
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Affiliation(s)
- Clara Pinto Diniz
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz Foundation, Rio de Janeiro, Brazil
| | | | | | | | - Roberto Magalhães Saraiva
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz Foundation, Rio de Janeiro, Brazil
| | - Henrique Horta Veloso
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz Foundation, Rio de Janeiro, Brazil
| | - Andréa Rodrigues da Costa
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz Foundation, Rio de Janeiro, Brazil
| | | | | | - Andréa Silvestre de Sousa
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz Foundation, Rio de Janeiro, Brazil
| | - Flavia Mazzoli-Rocha
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz Foundation, Rio de Janeiro, Brazil
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2
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Marin-Neto JA, Rassi A, Oliveira GMM, Correia LCL, Ramos Júnior AN, Luquetti AO, Hasslocher-Moreno AM, Sousa ASD, Paola AAVD, Sousa ACS, Ribeiro ALP, Correia Filho D, Souza DDSMD, Cunha-Neto E, Ramires FJA, Bacal F, Nunes MDCP, Martinelli Filho M, Scanavacca MI, Saraiva RM, Oliveira Júnior WAD, Lorga-Filho AM, Guimarães ADJBDA, Braga ALL, Oliveira ASD, Sarabanda AVL, Pinto AYDN, Carmo AALD, Schmidt A, Costa ARD, Ianni BM, Markman Filho B, Rochitte CE, Macêdo CT, Mady C, Chevillard C, Virgens CMBD, Castro CND, Britto CFDPDC, Pisani C, Rassi DDC, Sobral Filho DC, Almeida DRD, Bocchi EA, Mesquita ET, Mendes FDSNS, Gondim FTP, Silva GMSD, Peixoto GDL, Lima GGD, Veloso HH, Moreira HT, Lopes HB, Pinto IMF, Ferreira JMBB, Nunes JPS, Barreto-Filho JAS, Saraiva JFK, Lannes-Vieira J, Oliveira JLM, Armaganijan LV, Martins LC, Sangenis LHC, Barbosa MPT, Almeida-Santos MA, Simões MV, Yasuda MAS, Moreira MDCV, Higuchi MDL, Monteiro MRDCC, Mediano MFF, Lima MM, Oliveira MTD, Romano MMD, Araujo NNSLD, Medeiros PDTJ, Alves RV, Teixeira RA, Pedrosa RC, Aras Junior R, Torres RM, Povoa RMDS, Rassi SG, Alves SMM, Tavares SBDN, Palmeira SL, Silva Júnior TLD, Rodrigues TDR, Madrini Junior V, Brant VMDC, Dutra WO, Dias JCP. SBC Guideline on the Diagnosis and Treatment of Patients with Cardiomyopathy of Chagas Disease - 2023. Arq Bras Cardiol 2023; 120:e20230269. [PMID: 37377258 PMCID: PMC10344417 DOI: 10.36660/abc.20230269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023] Open
Affiliation(s)
- José Antonio Marin-Neto
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | - Anis Rassi
- Hospital do Coração Anis Rassi , Goiânia , GO - Brasil
| | | | | | | | - Alejandro Ostermayer Luquetti
- Centro de Estudos da Doença de Chagas , Hospital das Clínicas da Universidade Federal de Goiás , Goiânia , GO - Brasil
| | | | - Andréa Silvestre de Sousa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Antônio Carlos Sobral Sousa
- Universidade Federal de Sergipe , São Cristóvão , SE - Brasil
- Hospital São Lucas , Rede D`Or São Luiz , Aracaju , SE - Brasil
| | | | | | | | - Edecio Cunha-Neto
- Universidade de São Paulo , Faculdade de Medicina da Universidade, São Paulo , SP - Brasil
| | - Felix Jose Alvarez Ramires
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Fernando Bacal
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Martino Martinelli Filho
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Maurício Ibrahim Scanavacca
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Roberto Magalhães Saraiva
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Adalberto Menezes Lorga-Filho
- Instituto de Moléstias Cardiovasculares , São José do Rio Preto , SP - Brasil
- Hospital de Base de Rio Preto , São José do Rio Preto , SP - Brasil
| | | | | | - Adriana Sarmento de Oliveira
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Ana Yecê das Neves Pinto
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Andre Schmidt
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | - Andréa Rodrigues da Costa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | - Barbara Maria Ianni
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Carlos Eduardo Rochitte
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
- Hcor , Associação Beneficente Síria , São Paulo , SP - Brasil
| | | | - Charles Mady
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Christophe Chevillard
- Institut National de la Santé Et de la Recherche Médicale (INSERM), Marselha - França
| | | | | | | | - Cristiano Pisani
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | | | - Edimar Alcides Bocchi
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Evandro Tinoco Mesquita
- Hospital Universitário Antônio Pedro da Faculdade Federal Fluminense , Niterói , RJ - Brasil
| | | | | | | | | | | | - Henrique Horta Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | - Henrique Turin Moreira
- Hospital das Clínicas , Faculdade de Medicina de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP - Brasil
| | | | | | | | - João Paulo Silva Nunes
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
- Fundação Zerbini, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | | | | | | | - Luiz Cláudio Martins
- Universidade Estadual de Campinas , Faculdade de Ciências Médicas , Campinas , SP - Brasil
| | | | | | | | - Marcos Vinicius Simões
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | | | | | - Maria de Lourdes Higuchi
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Mauro Felippe Felix Mediano
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
- Instituto Nacional de Cardiologia (INC), Rio de Janeiro, RJ - Brasil
| | - Mayara Maia Lima
- Secretaria de Vigilância em Saúde , Ministério da Saúde , Brasília , DF - Brasil
| | | | | | | | | | - Renato Vieira Alves
- Instituto René Rachou , Fundação Oswaldo Cruz , Belo Horizonte , MG - Brasil
| | - Ricardo Alkmim Teixeira
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Roberto Coury Pedrosa
- Hospital Universitário Clementino Fraga Filho , Instituto do Coração Edson Saad - Universidade Federal do Rio de Janeiro , RJ - Brasil
| | | | | | | | | | - Silvia Marinho Martins Alves
- Ambulatório de Doença de Chagas e Insuficiência Cardíaca do Pronto Socorro Cardiológico Universitário da Universidade de Pernambuco (PROCAPE/UPE), Recife , PE - Brasil
| | | | - Swamy Lima Palmeira
- Secretaria de Vigilância em Saúde , Ministério da Saúde , Brasília , DF - Brasil
| | | | | | - Vagner Madrini Junior
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | - João Carlos Pinto Dias
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
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Sperandio da Silva GM, Mediano MFF, Murgel MF, Andrade PM, de Holanda MT, da Costa AR, Veloso HH, Carneiro FM, Valete Rosalino CM, de Sousa AS, Mendes FDSNS, Pinheiro RO, Veloso VG, Saraiva RM, Hasslocher-Moreno AM. Corrigendum: Impact of COVID-19 in-hospital mortality in chagas disease patients. Front Med (Lausanne) 2022; 9:963805. [PMID: 35957851 PMCID: PMC9361712 DOI: 10.3389/fmed.2022.963805] [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] [Received: 06/09/2022] [Accepted: 06/30/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Gilberto Marcelo Sperandio da Silva
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
- *Correspondence: Gilberto Marcelo Sperandio da Silva ;
| | | | | | - Patricia Mello Andrade
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | | | | | - Henrique Horta Veloso
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | | | | | | | | | | | | | - Roberto Magalhães Saraiva
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
- Ibero-American Network for Chagas Disease, Barcelona, Spain
| | - Alejandro Marcel Hasslocher-Moreno
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
- Ibero-American Network for Chagas Disease, Barcelona, Spain
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4
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Sperandio da Silva GM, Mediano MFF, Murgel MF, Andrade PM, de Holanda MT, da Costa AR, Veloso HH, Carneiro FM, Valete Rosalino CM, de Sousa AS, Mendes FDSNS, Pinheiro RO, Veloso VG, Saraiva RM, Hasslocher-Moreno AM. Impact of COVID-19 In-hospital Mortality in Chagas Disease Patients. Front Med (Lausanne) 2022; 9:880796. [PMID: 35615087 PMCID: PMC9125174 DOI: 10.3389/fmed.2022.880796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/31/2022] [Indexed: 11/22/2022] Open
Abstract
The COVID-19 virus infection caused by the new SARS-CoV-2 was first identified in Rio de Janeiro (RJ), Brazil, in March 2020. Until the end of 2021, 504,399 COVID-19 cases were confirmed in RJ, and the total death toll reached 68,347. The Evandro Chagas National Institute of Infectious Diseases from Oswaldo Cruz Foundation (INI-Fiocruz) is a referral center for treatment and research of several infectious diseases, including COVID-19 and Chagas disease (CD). The present study aimed to evaluate the impact of COVID-19 on in-hospital mortality of patients with CD during the COVID-19 pandemic period. This observational, retrospective, longitudinal study evaluated all patients with CD hospitalized at INI-Fiocruz from May 1, 2020, to November 30, 2021. One hundred ten hospitalizations from 81 patients with CD (58% women; 68 ± 11 years) were evaluated. Death was the study's main outcome, which occurred in 20 cases. The mixed-effects logistic regression was performed with the following variables to test whether patients admitted to the hospital with a COVID-19 diagnosis would be more likely to die than those admitted with other diagnoses: admission diagnosis, sex, age, COVID-19 vaccination status, CD clinical classification, and the number of comorbidities. Results from multiple logistic regression analysis showed a higher risk of in-hospital mortality in patients diagnosed with COVID-19 (OR 6.37; 95% CI 1.78–22.86) compared to other causes of admissions. In conclusion, COVID-19 infection had a significant impact on the mortality risk of INI-Fiocruz CD patients, accounting for one-third of deaths overall. COVID-19 presented the highest percentage of death significantly higher than those admitted due to other causes during the COVID-19 pandemic.
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Affiliation(s)
- Gilberto Marcelo Sperandio da Silva
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
- *Correspondence: Gilberto Marcelo Sperandio da Silva ;
| | | | | | - Patricia Mello Andrade
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | | | | | - Henrique Horta Veloso
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | | | | | | | | | | | | | - Roberto Magalhães Saraiva
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
- Ibero-American Network for Chagas Disease, Barcelona, Spain
| | - Alejandro Marcel Hasslocher-Moreno
- Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
- Ibero-American Network for Chagas Disease, Barcelona, Spain
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5
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Hasslocher-Moreno AM, Saraiva RM, do Brasil PEAA, Sangenis LHC, Xavier SS, de Sousa AS, Sperandio-da-Silva GM, Mendes FDSNS, da Costa AR, de Holanda MT, Veloso HH, Mazzoli-Rocha F, Carneiro FM, Portela LF, Mediano MFF. Temporal changes in the clinical-epidemiological profile of patients with Chagas disease at a referral center in Brazil. Rev Soc Bras Med Trop 2021; 54:e00402021. [PMID: 34105626 PMCID: PMC8186889 DOI: 10.1590/0037-8682-0040-2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/27/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION We aimed to describe the sociodemographic, epidemiological, and clinical characteristics of patients with chronic Chagas disease (CD) at an infectious disease referral center. Changes in patient profiles over time were also evaluated. METHODS This retrospective study included patients with CD from November 1986-December 2019. All patients underwent an evaluation protocol that included sociodemographic profile; epidemiological history; anamnesis; and physical, cardiologic, and digestive examinations. Trend differences for each 5-year period from 1986 to 2019 were tested using a nonparametric trend test for continuous and generalized linear models with binomial distribution for categorical variables. RESULTS A total of 2,168 patients (52.2% women) were included, with a mean age of 47.8 years old. White patients with low levels of education predominated. The reported transmission mode was vectorial in 90.2% of cases. The majority came from areas with a high prevalence (52.2%) and morbidity (67.8%) of CD. The most common clinical presentation was the indeterminate form (44.9%). The number of patients referred gradually decreased and the age at admission increased during the study period, as did the patients' levels of education. CONCLUSIONS The clinical profile of CD is characterized by a predominance of the indeterminate form of the disease. Regarding the patients who were followed up at the referral center, there was a progressive increase in the mean age and a concomitant decrease in the number of new patients. This reflects the successful control of vector and transfusion transmission in Brazil as well as the aging population of patients with CD.
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Affiliation(s)
| | - Roberto Magalhaes Saraiva
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | | | | | - Sergio Salles Xavier
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Andréa Silvestre de Sousa
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro, RJ, Brasil
| | | | | | - Andréa Rodrigues da Costa
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | | | - Henrique Horta Veloso
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Flavia Mazzoli-Rocha
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Fernanda Martins Carneiro
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Luciana Fernandes Portela
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
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Frota AX, Vieira MC, Soares CCS, da Silva PS, da Silva GMS, Mendes FDSNS, Mazzoli-Rocha F, Veloso HH, da Costa AD, Lamas CDC, Valete-Rosalino CM, Gonçalves TR, Costa HS, Rodrigues LF, Mediano MFF. Functional capacity and rehabilitation strategies in Covid-19 patients: current knowledge and challenges. Rev Soc Bras Med Trop 2021; 54:e07892020. [PMID: 33533821 PMCID: PMC7849325 DOI: 10.1590/0037-8682-0789-2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/15/2020] [Indexed: 12/15/2022] Open
Abstract
Covid-19 is a novel infectious disease whose spectrum of presentation ranges from absence of symptoms to widespread interstitial pneumonia associated with severe acute respiratory syndrome (SARS), leading to significant mortality. Given the systemic pattern of Covid-19, there are many factors that can influence patient's functional capacity after acute infection and the identification of such factors can contribute to the development of specific rehabilitation strategies. Pulmonary impairment is the primary cause of hospitalization due to Covid-19, and can progress to SARS as well as increase length of hospitalization. Moreover, cardiac involvement is observed in approximately 30% of hospitalized patients, with an increased risk of acute myocarditis, myocardial injury, and heart failure, which may compromise functional capacity in the long-term. Thromboembolic complications have also been reported in some patients with Covid-19 and are associated with a poor prognosis. Musculoskeletal complications may result from long periods of hospitalization and immobility, and can include fatigue, muscle weakness and polyneuropathy. Studies that address the functional capacity of patients after Covid-19 infection are still scarce. However, based on knowledge from the multiple systemic complications associated with Covid-19, it is reasonable to suggest that most patients, especially those who underwent prolonged hospitalization, will need a multiprofessional rehabilitation program. Further studies are needed to evaluate the functional impact and the rehabilitation strategies for patients affected by Covid-19.
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Affiliation(s)
- Aline Xavier Frota
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Marcelo Carvalho Vieira
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | | | - Paula Simplício da Silva
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | | | | | - Flavia Mazzoli-Rocha
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Henrique Horta Veloso
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Ananda Dutra da Costa
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Cristiane da Cruz Lamas
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
- Instituto Nacional de Cardiologia, Departamento de Pesquisa e Educação, Rio de Janeiro, RJ, Brasil
| | - Claudia Maria Valete-Rosalino
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
- Universidade Federal do Rio de Janeiro, Departamento de Otorrinolaringologia e Oftalmologia, Rio de Janeiro, RJ, Brasil
- Conselho Nacional de Desenvolvimento Científico e Tecnológico, Programa de Produtividade em Pesquisa, Brasília, DF, Brasil
| | - Tatiana Rehder Gonçalves
- Universidade Federal do Rio de Janeiro, Instituto de Medicina Social, Rio de Janeiro, RJ, Brasil
| | - Henrique Silveira Costa
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Fisioterapia, Diamantina, MG, Brasil
| | - Luiz Fernando Rodrigues
- Instituto Nacional de Cardiologia, Departamento de Pesquisa e Educação, Rio de Janeiro, RJ, Brasil
- Universidade Federal do Estado do Rio de Janeiro, Departamento de Ciências Fisiológicas, Rio de Janeiro, RJ, Brasil
| | - Mauro Felippe Felix Mediano
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
- Instituto Nacional de Cardiologia, Departamento de Pesquisa e Educação, Rio de Janeiro, RJ, Brasil
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7
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Frota AX, Mendes FDSNS, Vieira MC, Saraiva RM, Veloso HH, da Silva PS, Sperandio da Silva GM, de Sousa AS, Mazzoli-Rocha F, Costa HS, Rodrigues Junior LF, Mediano MFF. Acute and subacute hemodynamic responses and perception of effort in subjects with chronic Chagas cardiomyopathy submitted to different protocols of inspiratory muscle training: a cross-over trial. Disabil Rehabil 2020; 44:1305-1312. [PMID: 32779544 DOI: 10.1080/09638288.2020.1800837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 12/15/2022]
Abstract
PURPOSE This study aimed to evaluate acute and subacute hemodynamic responses and perception of effort in individuals with CCC submitted to different IMT protocols. MATERIALS AND METHODS This was a randomized cross-over trial conducted on CCC subjects with systolic left ventricular dysfunction (<45% left ventricular ejection fraction) without or with heart failure (stages B2 and C, respectively). Twenty-one participants performed two IMT protocols, one targeting 60% maximal inspiratory pressure with 3 × 10 repetitions (MIP60) and the other targeting 30% maximal inspiratory pressure (MIP30) with 3 × 20 repetitions with a 2 min recovery between sets for both. MIP60 and MIP30 were performed on the same day with a 2 h washout period. Measurements were taken at baseline, during and 60 min after IMT. RESULTS No differences in hemodynamic variables were observed across protocols. The perception of effort increased in both protocols, with higher scores for the MIP30 protocol (β = +1.6, p = 0.01; β = +1.1, p = 0.02; β = +0.9, p = 0.08 for the 1st, 2nd and 3rd sets, respectively). CONCLUSIONS There were no differences in hemodynamic responses comparing MIP60 and MIP30 protocols in subjects with CCC. Despite the higher perception of effort during endurance protocol, both protocols can be considered a safe therapeutic strategy.IMPLICATIONS FOR REHABILITATIONDespite inspiratory muscle training may result in functional capacity improvements, no previous study evaluated the hemodynamic acute and subacute responses to inspiratory muscle training in chronic Chagas cardiomyopathy.The two inspiratory muscle training protocols (30% and 60% of maximal inspiratory pressure) did not cause significant hemodynamic repercussions in subjects with chronic Chagas cardiomyopathy.Inspiratory muscle training seems to be an effective strategy to improve functional capacity and can be implemented in the rehabilitation programs for patients with Chagas cardiomyopathy.Since no significant adverse responses were observed in any of the hemodynamic parameters during the inspiratory muscle training sessions, these two protocols of inspiratory muscle training (30% and 60% of maximal inspiratory pressure) seems to be safe in subjects with Chagas cardiomyopathy.
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Affiliation(s)
- Aline Xavier Frota
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Marcelo Carvalho Vieira
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Center for Cardiology and Exercise, Aloysio de Castro State Institute of Cardiology, Rio de Janeiro, Brazil
| | - Roberto Magalhães Saraiva
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Henrique Horta Veloso
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Paula Simplício da Silva
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Andréa Silvestre de Sousa
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Flavia Mazzoli-Rocha
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Henrique Silveira Costa
- Physical Therapy Department, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Luiz Fernando Rodrigues Junior
- Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, Brazil.,Physiological Sciences Department, Biomedical Institute, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mauro Felippe Felix Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, Brazil
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8
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Abstract
Direct current cardioversion is a low-risk and standard procedure to restore normal sinus rhythm in patients with tachyarrhythmias. It requires sedation to facilitate the procedure, as it is painful and distressful. The preferred anesthetic drug must be short acting, producing conscious sedation, to enable rapid recovery after the procedure. In this sense, this narrative review focuses on the critical analysis of recent randomized studies and presents about the safety and effectiveness of propofol, comparing it with other established sedatives, mainly etomidate and midazolam. The research was performed on MEDLINE database with Propofol and Cardioversion keywords. In most cases, propofol comes to be the best option, with a quick recovery time and low rates of side effects. Different studies have demonstrated no inferiority when comparing to other drugs and, when these adverse events happened, they were easily and quickly handled. Exceptions in this scenario are those patients, particularly the elderly, with baseline important structural heart disease, in which etomidate with fentanyl has been pointed to lead to better hemodynamic stability.
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Affiliation(s)
- Bruna Galvão de Wafae
- Medical Sciences Faculty, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rose Mary Ferreira da Silva
- Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Henrique Horta Veloso
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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9
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Hasslocher-Moreno AM, Salles Xavier S, Magalhães Saraiva R, Conde Sangenis LH, Teixeira de Holanda M, Horta Veloso H, Rodrigues da Costa A, de Souza Nogueira Sardinha Mendes F, Alvarenga Americano do Brasil PE, Sperandio da Silva GM, Felix Mediano MF, Silvestre de Sousa A. Progression Rate from the Indeterminate Form to the Cardiac Form in Patients with Chronic Chagas Disease: Twenty-Two-Year Follow-Up in a Brazilian Urban Cohort. Trop Med Infect Dis 2020; 5:tropicalmed5020076. [PMID: 32408570 PMCID: PMC7345528 DOI: 10.3390/tropicalmed5020076] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 04/07/2020] [Revised: 05/08/2020] [Accepted: 05/09/2020] [Indexed: 11/30/2022] Open
Abstract
Most patients with chronic Chagas disease (CD) present the indeterminate form and are at risk to develop the cardiac form. However, the actual rate of progression to the cardiac form is still unknown. Methods: In total, 550 patients with the indeterminate CD form were followed by means of annual electrocardiogram at our outpatient clinic. The studied endpoint was progression to cardiac form defined by the appearance of electrocardiographic changes typical of CD. The progression rate was calculated as the cumulative progression rate and the incidence progression rate per 100 patient years. Results: Thirty-seven patients progressed to the CD cardiac form within a mean of 73 ± 48 months of follow-up, which resulted in a 6.9% cumulative progression rate and incidence rate of 1.48 cases/100 patient years. Patients who progressed were older (mean age 47.8 ± 12.2 years), had a higher prevalence of associated heart diseases (p < 0.0001), positive xenodiagnosis (p = 0.007), and were born in the most endemic Brazilian states (p = 0.018). Previous co-morbidities remained the only variable associated with CD progression after multivariate Cox proportional hazards regression analysis (p = 0.002). Conclusion: The progression rate to chronic CD cardiac form is low and inferior to rates previously reported in other studies.
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10
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Holanda MT, Mediano MFF, Hasslocher-Moreno AM, Xavier SS, Saraiva RM, Sousa AS, Maciel ER, Carneiro FM, da Silva PS, Sangenis LHC, Veloso HH, Cardoso CSDA, Bonecini-Almeida MDG, Souza AL, Roma EH, Azevedo MJ, Pereira-Silva FS, Pimentel LO, Mendes MO, Garzoni LR, Gonzaga BMS, Carvalho ACC, Brasil PEAA, Sperandio da Silva GM, Araújo-Jorge TC. A protocol update for the Selenium Treatment and Chagasic Cardiomyopathy (STCC) trial. Trials 2018; 19:507. [PMID: 30231899 PMCID: PMC6147028 DOI: 10.1186/s13063-018-2889-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 06/07/2018] [Accepted: 08/30/2018] [Indexed: 01/08/2023] Open
Abstract
Abstract Several studies evaluating clinical forms of chronic Chagas disease show that about one-third of patients present cardiac involvement. Heart failure, sudden death and cardioembolic stroke are the main mechanisms of death in Chagas heart disease. The impact of specific etiologic treatment on the prognosis of patients with chronic Chagas heart disease is very limited regardless of the presence or absence of heart failure. Patients with symptomatic Chagas heart disease present serum selenium (Se) levels lower than patients without Chagas heart disease. Moreover, Se supplementation in animal models showed promising results. The aim of this trial is to estimate the effect of Se treatment on prevention of heart disease progression in patients with Chagas cardiomyopathy. However, we had to introduce some protocol modifications in order to keep trial feasibility, as follows: the primary outcome was restricted to left ventricular ejection fraction as a continuous variable, excluding disease progression; the follow-up period was decreased from 5 years to 1 year, an adjustment that might increase the participation rate of our study; the superior age limit was increased from 65 to 75 years; and diabetes mellitus was no longer considered an exclusion criterion. All of these protocol modifications were extensively debated by the research team enrolled in the design, recruitment and conduction of the clinical trial to guarantee a high scientific quality. Trial registration Clinical Trials.gov, NCT00875173. Registered on 20 October 2008.
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Affiliation(s)
- Marcelo Teixeira Holanda
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| | | | | | - Sérgio Salles Xavier
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Roberto Magalhães Saraiva
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Andrea Silvestre Sousa
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Erica Rodrigues Maciel
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Fernanda Martins Carneiro
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Paula Simplicio da Silva
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Henrique Horta Veloso
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Claudia Santos de Aguiar Cardoso
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Andreia Lamoglia Souza
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Eric Henrique Roma
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Marcos José Azevedo
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Fernanda Sant'Ana Pereira-Silva
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Luis Otavio Pimentel
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Marcelo Oliveira Mendes
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Luciana Ribeiro Garzoni
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Beatriz M S Gonzaga
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Anna Cristina Calçada Carvalho
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | - Tania Cremonini Araújo-Jorge
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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11
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Mendes FDSNS, Sousa AS, Souza FCDCC, Pinto VLM, Silva PS, Saraiva RM, Xavier SS, Veloso HH, Holanda MT, Costa AR, Carneiro FM, Silva GMS, Borges JP, Tibirica E, Pinheiro RO, Lara FA, Hasslocher-Moreno AM, Brasil PEAA, Mediano MFF. Effect of physical exercise training in patients with Chagas heart disease: study protocol for a randomized controlled trial (PEACH study). Trials 2016; 17:433. [PMID: 27590681 PMCID: PMC5010675 DOI: 10.1186/s13063-016-1553-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 04/21/2016] [Accepted: 08/13/2016] [Indexed: 12/21/2022] Open
Abstract
Background The effects of exercise training on Chagas heart disease are still unclear. This study aimed to evaluate the effect of exercise training over functional capacity, cardiac function, quality of life, and biomarkers in Chagas heart disease. Methods The PEACH study is a superiority randomized clinical trial which will include subjects who meet the following criteria: Chagas heart disease with a left ventricular ejection fraction below 45 % with or without heart failure symptoms; clinical stability in the last 3 months; adherence to clinical treatment; and age above 18 years. The exclusion criteria are: pregnancy; neuromuscular limitations; smoking; evidence of non-chagasic heart disease; systemic conditions that limit exercise practice or cardiopulmonary exercise test; unavailability to attend the center three times a week during the intervention period; and practitioners of regular exercise. The intervention group will perform an exercise training intervention three times per week during 6 months and will be compared to the control group without exercise. Both groups will undergo the same monthly pharmaceutical and nutritional counseling as well as standard medical treatment according to the Brazilian consensus on Chagas disease. The primary outcome is functional capacity based on peak exercise oxygen consumption during cardiopulmonary exercise testing. Secondary outcomes are: cardiac function; body composition; muscle respiratory strength; microvascular reactivity; cardiac rhythm abnormalities; autonomic function; biochemical; oxidative stress and inflammatory biomarkers; and quality of life. Subjects will be evaluated at baseline, and at 3 and 6 months after randomization. Thirty patients will be randomly assigned into exercise or control groups at a ratio of 1:1. Discussion Findings of the present study will be useful to determine if physical exercise programs should be included as an important additional therapy in the treatment of patients with Chagas heart disease. Trial registration ClinicalTrials.gov ID: NCT02517632 (registered on 6 August 2015). Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1553-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Andréa Silvestre Sousa
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | | | - Vivian Liane Mattos Pinto
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | - Paula Simplicio Silva
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | - Roberto Magalhães Saraiva
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | - Sergio Salles Xavier
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | - Henrique Horta Veloso
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | - Marcelo Teixeira Holanda
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | - Andréa Rodrigues Costa
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | - Fernanda Martins Carneiro
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | - Gilberto Marcelo Sperandio Silva
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | - Juliana Pereira Borges
- National Institute of Cardiology, Rua das Laranjeiras 374, Laranjeiras, Rio de Janeiro, 22240-006, Brazil.,Physical Education and Sports Institute, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Maracanã, Rio de Janeiro, 20550-900, Brazil.,Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Pavilhão Cardoso Fontes, Sala 64, Rio de Janeiro, 21040-360, Brazil
| | - Eduardo Tibirica
- National Institute of Cardiology, Rua das Laranjeiras 374, Laranjeiras, Rio de Janeiro, 22240-006, Brazil.,Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Pavilhão Cardoso Fontes, Sala 64, Rio de Janeiro, 21040-360, Brazil
| | - Roberta Olmo Pinheiro
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Pavilhão Cardoso Fontes, Sala 64, Rio de Janeiro, 21040-360, Brazil
| | - Flávio Alves Lara
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Pavilhão Cardoso Fontes, Sala 64, Rio de Janeiro, 21040-360, Brazil
| | - Alejandro Marcel Hasslocher-Moreno
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | | | - Mauro Felippe Felix Mediano
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
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12
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Veloso HH. When to resume anticoagulation after acute gastrointestinal bleeding? Dig Liver Dis 2016; 48:690. [PMID: 26776877 DOI: 10.1016/j.dld.2015.12.007] [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] [Received: 12/09/2015] [Accepted: 12/14/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Henrique Horta Veloso
- Evandro Chagas National Institute of Infectious Diseases, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil.
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13
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Affiliation(s)
- Henrique Horta Veloso
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation - FIOCRUZ, Rio de Janeiro, Brazil.
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14
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Veloso HH, Hasslocher-Moreno AM, Mediano MFF. Chagas heart disease in professional athletes from endemic countries: A notorious case calls attention for its identification and stratification. Int J Cardiol 2016; 207:115-6. [DOI: 10.1016/j.ijcard.2016.01.106] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 01/05/2016] [Indexed: 11/27/2022]
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15
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Veloso HH. Anticoagulation for Atrial Fibrillation after Resolution of Dengue Haemorrhagic Fever. J Clin Diagn Res 2016; 10:OL02. [PMID: 27134923 DOI: 10.7860/jcdr/2016/18314.7480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 01/31/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Henrique Horta Veloso
- Public Health Researcher, Department of Chagas Disease Clinical Research Laboratory, Evandro Chagas National Institute of Infectious Diseases , Fundação Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, Brazil
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16
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Veloso HH, Chaves JC, Sobrinho JJ. Inappropriate shocks of implantable cardioverter-defibrillator during central venous access: A preventable complication. Int J Cardiol 2016; 204:61-3. [PMID: 26655541 DOI: 10.1016/j.ijcard.2015.11.162] [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] [Received: 11/20/2015] [Accepted: 11/22/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Henrique Horta Veloso
- Department of Cardiology (Cardioteam), Hospital do Rio, Rio de Janeiro, Brazil; National Institute of Infectology Evandro Chagas, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil.
| | - Jefferson Cavalcanti Chaves
- Department of Cardiology (Cardioteam), Hospital do Rio, Rio de Janeiro, Brazil; VOTCOR, Hospital São Francisco, Rio de Janeiro, Brazil
| | - Jose Jazbik Sobrinho
- Department of Cardiovascular Surgery, Hospital Pedro Ernesto, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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17
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Veloso HH. Underutilization of implantable cardioverter-defibrillator in studies proposing risk scores to predict death in Chagas heart disease: Just a reflection of the real world. Int J Cardiol 2016; 203:1082-3. [PMID: 26638058 DOI: 10.1016/j.ijcard.2015.11.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 11/16/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Henrique Horta Veloso
- Evandro Chagas National Institute of Infectious Diseases, Fundação Oswaldo Cruz - Fiocruz, Rio de Janeiro, Brazil
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Veloso HH. Negative association between right bundle branch block and inducibility of ventricular tachyarrhythmias in Chagas disease. Einstein (São Paulo) 2014. [PMID: 25295461 PMCID: PMC4872959 DOI: 10.1590/s1679-45082014ce3126] [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: 11/27/2022] Open
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Veloso HH, Rezende AG, de Paola AAV. Syncope by psychogenic hyperventilation in a patient with Chagas' disease. Int J Cardiol 2014; 175:e43-4. [DOI: 10.1016/j.ijcard.2014.05.037] [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] [Received: 04/23/2014] [Accepted: 05/12/2014] [Indexed: 11/28/2022]
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20
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Veloso HH. Cost-effectiveness analysis of in-hospital heart failure treatment of Chagas' cardiomyopathy in comparison to other etiologies. Int J Cardiol 2014; 174:872. [DOI: 10.1016/j.ijcard.2014.04.213] [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] [Received: 04/17/2014] [Accepted: 04/18/2014] [Indexed: 10/25/2022]
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Veloso HH. Incidence of sudden cardiac death in congestive heart failure: Chagas disease versus systemic arterial hypertension. Int J Cardiol 2014; 175:175-6. [PMID: 24852839 DOI: 10.1016/j.ijcard.2014.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 04/02/2014] [Indexed: 10/25/2022]
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Silva GGD, Veloso HH, Leite LR, Farias RL, Paola AAVD. Epicardial mapping of sustained ventricular tachycardia in nonischemic heart disease. Arq Bras Cardiol 2011; 96:114-20. [PMID: 21271170 DOI: 10.1590/s0066-782x2011005000009] [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] [Received: 09/27/2009] [Accepted: 07/16/2010] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The complexity of reentrant circuits related to ventricular tachycardias decreases the success rate of radiofrequency ablation procedures. OBJECTIVE To evaluate whether the epicardial mapping with multiple electrodes carried out simultaneously with the endocardial mapping helps in ablation procedures of sustained ventricular tachycardia (VT) in patients with nonischemic heart disease. METHODS Twenty-six patients with recurrent sustained VT, of which 22 (84.6%) presenting chronic chagasic cardiomyopathy, 2 (7.7%) with idiopathic dilated cardiomyopathy and 2 with right ventricular arrhythmogenic dysplasia (RVAD), were submitted to epicardial mapping with two or three microcatheters, with 8 electrodes each, simultaneously to the conventional endocardial mapping. A catheter with a 4-mm tip was used for the ablation by radiofrequency (RF) carried out during the induced VT. RESULTS Of the 33 induced VT, 25 were mapped and 20 had their origin defined. Eleven had epicardial and 9 had endocardial origin. The programmed ventricular stimulation did not induce sustained VT in 11 (42.0%) of the 26 patients after the ablation. Events such as VT recurrence and death occurred in 10.0% of the patients submitted to successful ablation and in 59.0% of the unsuccessful cases, during a mean ambulatory follow-up of 357 ± 208 days. CONCLUSION Subepicardial circuits are frequent in patients with nonischemic heart disease. The epicardial mapping with multiple catheters carried out simultaneously with the endocardial mapping contributes to the identification of these circuits in a same procedure.
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Affiliation(s)
- Geórgia Guedes da Silva
- Escola Paulista de Medicina, UNIFESP, Rua Alves Guimarães 960/12, Pinheiros, São Paulo-SP, Brazil.
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Abstract
Vardenafil is a new oral phosphodiesterase inhibitor used for erectile dysfunction. We report a case admitted with a first-detected, symptomatic paroxysmal atrial fibrillation in a healthy patient after self-medication with vardenafil.
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Affiliation(s)
- H H Veloso
- VOTCOR, Hospital da Venerável Ordem Terceira da Penitência, Rio de Janeiro, RJ, Brazil.
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Veloso HH, de Paola AAV. Sotalol and amiodarone versus digoxin for conversion of recent onset atrial fibrillation. Am Heart J 2005; 150:e1; author reply e3. [PMID: 16290949 DOI: 10.1016/j.ahj.2005.01.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2004] [Accepted: 01/27/2005] [Indexed: 05/05/2023]
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25
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Horta Veloso H. Amiodarone and plebitis. J Appl Biomed 2005. [DOI: 10.32725/jab.2005.006] [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: 11/05/2022] Open
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Veloso HH, De Paola AAV. Thrombophlebitis: a common complication of amiodarone. Am Fam Physician 2004; 70:1448. [PMID: 15526730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Horta Veloso H, Ferreira Júnior JA, Braga de Paiva JM, Faria Honório J, Junqueira Bellei NC, Vicenzo de Paola AA. Acute atrial fibrillation during dengue hemorrhagic fever. Braz J Infect Dis 2004; 7:418-22. [PMID: 14636482 DOI: 10.1590/s1413-86702003000600010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Dengue fever is a viral infection transmitted by the mosquito, Aedes aegypti. Cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, appear during infection and are attributed to viral myocarditis. However, supraventricular arrhythmias have not been reported. We present a case of acute atrial fibrillation, with a rapid ventricular rate, successfully treated with intravenous amiodarone, in a 62-year-old man with dengue hemorrhagic fever, who had no structural heart disease.
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Affiliation(s)
- Henrique Horta Veloso
- VotCor - Department of Cardiology, Hospital of Venerável Ordem Terceira da Penitência, Rio de Janeiro, RJ, Brazil.
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Veloso HH, De Paola AAV. Atrial fibrillation or flutter and stroke: effectiveness of oral anticoagulation in clinical practice. J Intern Med 2003; 253:92-3. [PMID: 12588541 DOI: 10.1046/j.1365-2796.2003.01093.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
OBJECTIVE To investigate the initial energy level required for electrical cardioversion of atrial fibrillation (AF). METHODS We studied patients undergoing electrical cardioversion in the 1st Multicenter Trial of SOCESP. Patients were divided into 2 groups according to the initial energy level of electrical cardioversion: 100J and >/=150J. We compared the efficacy of the initial and final shock of the procedure, the number of shocks administered, and the cumulative energy levels. RESULTS Eight-six patients underwent electrical cardioversion. In 53 patients (62%), cardioversion was started with 100J, and in 33 patients (38%), cardioversion was started with >/=150J. Groups did not differ regarding clinical features and therapeutical interventions. A tendency existed towards greater efficacy of the initial shock in patients who received >/=150J (61% vs. 42% in the 100J group, p=0.08). The number of shocks was smaller in the >/=150J group (1.5+/-0.7 vs. 2.1+/-1.3, p=0.04). No difference existed regarding the final efficacy of electrical cardioversion and total cumulative energy levels in both groups. In the subgroup of patients with recent-onset AF (</=48h), the cumulative energy level was lower in the 100J group (240+/-227J vs. 324+/-225J, p=0.03). CONCLUSION Patients who were given initial energy of >/=150J received fewer counter shocks with a tendency toward greater success than those patients who were given 100J; however, in patients with recent-onset AF, the average cumulative energy level was lower in the 100J group. These data suggest that electrical cardioversion should be initiated with energy levels >/=150J in patients with chronic AF.
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Affiliation(s)
- Edilberto Figueiredo
- Universidade Federal de Sao Paulo, Escola Paulista de Medicina, Sao Paulo, Brazil
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Veloso HH, Harrison RA, de Paola AVV. Digoxin for cardioversion in patients with atrial fibrillation. Hippokratia 2002. [DOI: 10.1002/14651858.cd003612] [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: 11/07/2022]
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Veloso HH. Effects of cardiac glycosides on atrial fibrillation. Chest 2001; 120:1753-4. [PMID: 11713174 DOI: 10.1378/chest.120.5.1753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Veloso HH. Amiodarone before electrical cardioversion of atrial fibrillation. Am J Cardiol 2001; 88:466. [PMID: 11558468 DOI: 10.1016/s0002-9149(01)01661-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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33
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Veloso HH. Comparison of class III antiarrhythmic drugs versus digoxin for the reversion of new-onset atrial fibrillation. Ann Emerg Med 2001; 37:735-6. [PMID: 11385352 DOI: 10.1067/mem.2001.115845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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35
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Veloso HH. Is amiodarone the first or the last choice for the maintenance of sinus rhythm after successful conversion of atrial fibrillation? Med Sci Monit 2001; 7:526-7; author reply 528-30. [PMID: 11386035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
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37
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Veloso HH. Rapid referral in the electrical cardioversion of atrial fibrillation. Br J Gen Pract 2001; 51:318. [PMID: 11458491 PMCID: PMC1313988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
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Veloso HH. Long-term efficacy of epicardial radiofrequency ablation of chronic atrial fibrillation during mitral valve surgery. Eur J Cardiothorac Surg 2001; 19:231-4;Author reply 233-4.. [PMID: 11300092 DOI: 10.1016/s1010-7940(00)00654-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Veloso HH, Lisboa da Silva RM. [Importance of syncope and electric stimulation for predicting sudden death in hypertrophic cardiomyopathy]. Rev Esp Cardiol 2000; 53:1672-3. [PMID: 11171495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Veloso HH, De Paola AA. Clinical trials for conversion of recent onset atrial fibrillation must consider the role of digoxin. Eur Heart J 2000; 21:2080-1. [PMID: 11102260 DOI: 10.1053/euhj.2000.2325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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de Paola AA, Veloso HH. Efficacy and safety of sotalol versus quinidine for the maintenance of sinus rhythm after conversion of atrial fibrillation. SOCESP Investigators. The Cardiology Society of São Paulo. Am J Cardiol 1999; 84:1033-7. [PMID: 10569659 DOI: 10.1016/s0002-9149(99)00494-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To compare the efficacy and safety of sotalol and quinidine after conversion of atrial fibrillation (AF) of <6 months, a prospective multicenter trial enrolled 121 patients who were randomized to receive dl-sotalol (160 to 320 mg/day, 58 patients) or quinidine sulfate (600 to 800 mg/day, 63 patients). Patients with left ventricular ejection fraction of <0.40 or left atrial diameter >5.2 cm were excluded. After 6 months of follow-up, using the Kaplan-Meier method, the probabilities of success were comparable between sotalol (74%) and quinidine (68%), but recurrences occurred later with sotalol than with quinidine (69 vs 10 days, p <0.05). Four patients developed proarrhythmic events, 3 (5%) with sotalol and 1 (2%) with quinidine, which were all associated with diuretic therapy. In patients converted from recent-onset AF (< or = 72 hours), sotalol was more effective than quinidine (93% vs 64%, p = 0.01), whereas in chronic AF (> 72 hours), quinidine was more effective than sotalol (68% vs 33%, p <0.05). During recurrences, the ventricular rate was significantly reduced in patients taking sotalol (98 to 82 beats/min, p <0.05). Independent predictors of therapeutic success were recent-onset AF in the sotalol group (p <0.001) and absence of hypertension in the quinidine group (p <0.05). In conclusion, sotalol and quinidine have comparable efficacy and safety for the maintenance of sinus rhythm in the overall group. In recent-onset AF, sotalol was more effective, whereas in chronic AF, quinidine had a better result. Recurrences occurred later with sotalol when compared with quinidine. Because of proarrhythmia, these drugs should be used judiciously in patients on diuretic therapy.
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Affiliation(s)
- A A de Paola
- Clinical Cardiac Electrophysiology Department of São Paulo Hospital, Federal University of São Paulo-Paulista School of Medicine, Brazil.
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Veloso HH, de Paola AA. Digoxin versus placebo for conversion of acute atrial fibrillation to sinus rhythm. Am J Cardiol 1999; 83:1300-1. [PMID: 10215309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Abstract
PURPOSE To analyze the recurrences of atrial fibrillation in patients treated with sotalol or quinidine. METHODS After conversion to sinus rhythm, 121 patients with paroxysmal atrial fibrillation were randomized to sotalol (58 patients) or quinidine (63 patients) and followed-up during 6 months. Symptoms and ventricular rates on the 12 lead electrocardiogram of the arrhythmic events were compared between the two groups. Clinical and echocardiographic characteristics were analyzed as predictors of atrial fibrillation recurrence. RESULTS Seventeen (14%) patients relapsed into atrial fibrillation; 7 (12%) were treated with sotalol and 10 (16%) with quinidine. Recurrence occurred later in the sotalol group (median 69 days) in comparison with the quinidine group (median 10 days) (p = 0.04). Symptoms were present in 14 (82%) patients during the initial crisis and in 10 (47%) during recurrence. Recurrence was less symptomatic during antiarrhythmic therapy (p < 0.04), with no statistical differences between the two groups. Only patients treated with sotalol had ventricular rates during the recurrences lower than during initial crisis (p < 0.02). All variables failed to predict recurrence of atrial fibrillation. CONCLUSIONS It was not possible demonstrate differences between sotalol and quinidine for the prevention of atrial fibrillation. Recurrence was less symptomatic during antiarrhythmic therapy. Patients treated with sotalol relapsed to atrial fibrillation later and had ventricular rates during recurrences significantly lower than during the initial crisis.
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