PEDRO FELIPE GOMES NICZ
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
19 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 19
- Myocardial Injury After Transcatheter Mitral Valve Replacement Versus Surgical Reoperation(2024) MARCHI, Mauricio Felippi de Sa; ROSA, Vitor Emer Egypto; NICZ, Pedro Felipe Gomes; FONSECA, Jose Honorio de Almeida Palma da; CALOMENI, Pedro; CHIODINI, Fernando; SAMPAIO, Roney Orismar; POMERANTZEFF, Pablo Maria Alberto; VIEIRA, Marcelo de Campos; TARASOUTCHI, Flavio; MIEGHEM, Nicolas M. Van; BRITO, Fabio Sandoli de; ABIZAID, Alexandre; RIBEIRO, Henrique BarbosaThis study aimed to evaluate the incidence and clinical implications of myocardial injury, as determined by cardiac biomarker increase, in patients who underwent mitral bioprosthesis dysfunction treatment with transcatheter mitral valve replacement (TMVR) versus surgical mitral valve replacement reoperation (SMVR-REDO). Between 2014 and 2023, 310 patients with mitral bioprosthesis failure were included (90 and 220 patients for TMVR and SMVR-REDO, respectively). Multivariable analysis and propensity score matching were performed to adjust for the intergroup differences in baseline characteristics. Creatinine kinase-MB (CK-MB) and cardiac troponin I (cTn) were collected at baseline and 6 to 12, 24, 48, and 72 hours after intervention. The cardiac biomarkers values were evaluated in relation to their reference values. The outcomes were determined according to the Mitral Valve Academic Research Consortium criteria. CK-MB and cTn increased above the reference level in almost all patients after SMVR-REDO and TMVR (100% vs 94%, respectively), with the peak occurring within 6 to 12 hours. SMVR-REDO was associated with a two- to threefold higher increase in cardiac biomarkers. After 30 days, the mortality rates were 13.3% in the TMVR and 16.8% in the SMVR-REDO groups. At a median follow-up of 19 months, the mortality rates were 21.1% in the TMVR and 17.7% in the SMVR-REDO groups. Left ventricular ejection fraction, estimated glomerular filtration rate, CK-MB, and cTn were predictors of mortality. In conclusion, some degree of myocardial injury occurred systematically after the treatment of mitral bioprosthetic degeneration, especially after SMVR, and higher CK-MB and cTn levels were associated with increased cumulative late mortality, regardless of the approach.
- Seattle Angina Pectoris Questionnaire and Canadian Cardiovascular Society Angina Categories in the Assessment of Total Coronary Atherosclerotic Burden(2021) GUIMARAES, Welingson Vanucci Negreiros; NICZ, Pedro Felipe Gomes; GARCIA-GARCIA, Hector M.; ABIZAID, Alexandre; SANTOS, Luciano de Moura; ROSA, Vitor E.; RIBEIRO, Marcelo Harada; MEHTA, Sameer; RIBEIRO, Expedito; LEMOS, Pedro A.; BRITO JR., Fabio S.; HAJJAR, Ludhmila; KALIL FILHO, Roberto; CAMPOS, Carlos M.The patient reported angina measurement with the Seattle Angina Questionnaire (SAQ) has shown to have prognostic implications and became an endpoint in clinical trials. Our objective was to study physician-reported and SAQ severity with the total coronary atherosclerotic burden as assessed by 4 angiographic scores. We prospectively analyzed data of consecutive patients scheduled for coronary angiography or percutaneous coronary intervention. The Canadian Cardiovascular Society (CCS) angina categories was used as physician-reported angina. SAQ domains were categorized as severe (0 to 24), moderate 25 to 75 and mild angina (>75). All angina assessments were done before coronary angiography. Gensini, Syntax, Friesinger, and Sullivan angiographic scores were used for total atherosclerotic burden quantification: 261 patients were included in the present analysis. The median age was 66.0 (59.0 to 71.8) years, 53.6% were male and 43.7% had diabetes. The median SYNTAX score was 6.0 (0 to 18.0). The worse the symptoms of CCS categories, the more severe was the atherosclerotic burden in all angiographic scores: SYNTAX (p = 0.01); Gensini (p<0.01); Friesinger (p = 0.02) and Sullivan (p = 0.03). Conversely, SAQ domains were not able to discriminate the severity of CAD in any of the scores. The only exception was the severe SAQ quality of life that had worse Gensini score than the mild SAQ quality of life (p = 0.04). In conclusion, CCS angina categories are related to the total atherosclerotic burden in coronary angiography, by all angiographic scores. SAQ domains should be used as a measure of patient functionality and quality of life but not as a measure of CAD severity. (C) 2021 Published by Elsevier Inc.
conferenceObject Spatial-Frequency Approach to Fibrous Tissue Classification in Intracoronary Optical Images(2016) MACEDO, Maysa M. G.; NICZ, Pedro F. G.; CAMPOS, Carlos M.; LEMOS, Pedro A.; GUTIERREZ, Marco A.Increased understanding about the mechanisms of coronary thrombosis in humans has been limited by the lack of imaging modalities with resolution sufficient to characterize fibrous cap tissue and determine its thickness in vivo. Intravascular optical coherence tomography (IOCT) provides images with micrometer axial (10-15 mu m) and lateral resolution (40 mu m), enabling detailed visualization of micro-structural changes of the arterial wall. This article describes a fully automated method for identification and quantification of fibrous tissue in IOCT human coronary images based on spatial-frequency analysis by means Short-Time Fourier transform. Forty IOCT frames from nine IOCT in-vivo datasets were annotated by an expert and used to evaluate the proposed fibrous tissue characterization method.bookPart Disfunção do ventrículo direito(2016) FERNANDES, Felipe Lourenço; NICZ, Pedro Felipe Gomes; HAJJAR, Ludhmila Abrahão- Combined transcatheter aortic valve replacement and left atrial appendage occlusion in patients ineligible for oral anticoagulation: A case series(2022) FREIRE, A. F. D.; FILIPPINI, F. B.; BIGNOTO, T. C.; BRITO, P. H. F. de; NICZ, P. F. G.; MELO, P. H. M. C. D.; SILVA, R. C. e; QUEIROGA, M.; RIBEIRO, H. B.; PROCóPIO, A. G. M.; BEZERRA, C. G.; GRUBE, E.; ABIZAID, A.; FILHO, R. K.; BRITO JR., F. S. dePatients presenting with aortic stenosis and atrial fibrillation (AF) undergoing transcatheter aortic valve replacement (TAVR) are commonly at increased risk for stroke and bleeding complications. Concomitant left atrial appendage occlusion (LAAO) after TAVR may be an alternative to oral anticoagulation (OAC). Between 2018 and 2022, 7 consecutive patients who were ineligible for OAC underwent simultaneous TAVR and LAAO. The mean age was 84.9 ± 4.9 years. The mean CHA2DS2-VASc, HAS-BLED, and STS predicted risk of mortality scores were 5.9 ± 0.7, 3.9 ± 1.1, and 8.8 ± 3.4%, respectively. The median follow-up time was 23 (1 to 27) months. All procedures achieved technical success and no adverse events were observed during follow-up. This case series shows that concomitant TAVR and LAAO is feasible and safe among patients with severe aortic stenosis and AF who are deemed ineligible for OAC. Learning objectives: Atrial fibrillation is the most common arrhythmia in the transcatheter aortic valve replacement (TAVR) population. In those who experience major or life-threatening bleeding, mortality is doubled. We report a case series of 7 concomitant left atrial appendage occlusions (LAAO) after TAVR in patients ineligible for oral anticoagulation. All procedures achieved technical success and no adverse events were observed. The simultaneous approach with TAVR and LAAO was feasible and safe in this case series.
- MINOCA: One Size Fits All? Probably Not-A Review of Etiology, Investigation, and Treatment(2022) OLIVEIRA, Lucas Lentini Herling de; CORREIA, Vinicius Machado; NICZ, Pedro Felipe Gomes; SOARES, Paulo Rogerio; SCUDELER, Thiago LuisMyocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous group of conditions that include both atherosclerotic (coronary plaque disruption) and non-atherosclerotic (spontaneous coronary artery dissection, coronary artery spasm, coronary artery embolism, coronary microvascular dysfunction, and supply-demand mismatch) causes resulting in myocardial damage that is not due to obstructive coronary artery disease. Failure to identify the underlying cause may result in inadequate and inappropriate therapy in these patients. The cornerstone of managing MINOCA patients is to identify the underlying mechanism to achieve the target treatment. Intravascular imaging is able to identify different morphologic features of coronary plaques, while cardiac magnetic resonance is the gold standard for detection of myocardial infarction in the setting of MINOCA. In this review, we summarize the relevant clinical issues, contemporary diagnosis, and treatment options of MINOCA.
conferenceObject Noncontrast Transcatheter Aortic Valve Implantation for Patients With Aortic Stenosis and Chronic Kidney Disease: Long-Term Follow-Up of The Pilot Study(2023) FILIPPINI, Filippe; FREIRE, Antonio Fernando; NICZ, Pedro; BRATZ, Guilherme; SESSA, Bruno; RIBEIRO, Henrique; ACCORSI, Tarso; LIBERATO, Gabriela; NOMURA, Cesar Higa; CASSAR, Renata; VIEIRA, Marcelo; BIHAN, David Le; BARRETTO, Rodrigo; MATHIAS, Wilson; POMERANTZEFF, Pablo; TARASOUTCHI, Flavio; ABIZAID, Alexandre; BRITO JR., FabiobookPart Choque cardiogênico(2016) FERNANDES, Felipe Lourenço; NICZ, Pedro Felipe Gomes; GALAS, Filomena Regina Barbosa Gomes; HAJJAR, Ludhmila Abrahão- Impact of the COVID-19 pandemic on coronary artery bypass graft surgery in Brazil: A nationwide perspective(2021) KHALIL, Kalil Hussein; SA, Michel Pompeu B. O.; VERVOORT, Dominique; ROEVER, Leonardo; PIRES, Marcos Alfredo de Andrade; LIMA, Jaqueline Maria de Oliveira; SALLES, Felipe Borsu de; KHALIL, Giovana Munhoz; GOMES, Pedro Felipe; MEJIA, Omar Asdrubal Vilca; OKINO, Arnaldo Akio; LIMA, Ricardo de CarvaihoIntroduction The coronavirus disease 2019 (COVID-19) pandemic has been a worldwide challenge, and efforts to ""flatten the curve,"" including restrictions imposed by policymakers and medical societies, have forced a reduction in the number of procedures performed in the Brazilian Health Care System. The aim of this study is to evaluate the outcomes of coronary artery bypass graft (CABG) from 2008 to 2020 in the SUS and to assess the impacts of the COVID-19 pandemic in the number of procedures and death rate of CABG performed in 2020 through the database DATASUS. Methods This study is based on publicly available material obtained from DATASUS, the Brazilian Ministry of Health's data processing system, on numbers of surgical procedures and death rates. Only isolated CABG procedures were included in our study. We used the TabNet software from the DATASUS website to generate reports. Results We identified 281,760 CABG procedures performed from January 2008 to December 2020. The average number of procedures until the end of 2019 was of 22,104. During 2020 there was a 25% reduction CABG procedures, to 16,501. There was an increase in the national death rate caused by a statistical significant increase in death rates in Brazil's Southeast and Central-west regions. Conclusion The COVID-19 pandemic remains a global challenge for Brazil's health care system. During the year of 2020 there was a reduction in access to CABG related to an increase in the number of COVID-19 cases. There was also an increase in the national CABG death rate.
conferenceObject Transcatheter aortic valve implantation without contrast media technique in chronic kidney disease population - pilot study(2022) NICZ, P.; FREIRE, A. F. D.; FILIPPINI, F. B.; KANHOUCHE, G.; ACCORSI, T. A. D.; RIBEIRO, H. B.; LIBERATO, G.; NOMURA, C. H.; CASSAR, R. S.; VIEIRA, M. L.; MATHIAS, W.; POMERANTZEFF, P. M. A.; TARASOUTCHI, F.; ABIZAID, A.; BRITO JR., F. S. De