ALEXANDRE DE MATOS SOEIRO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
17 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 17
conferenceObject THE IMPACT OF SONOTHROMBOLYSIS ON LEFT VENTRICULAR DIASTOLIC FUNCTION AND LEFT ATRIAL MECHANICS IN PATIENTS WITH ST ELEVATION MYOCARDIAL INFARCTION(2020) CHIANG, Hsu; AGUIAR, Miguel Osman; TAVARES, Bruno Garcia; MATHIAS JR., Wilson; BORGES, Bruno Carter; AZEVEDO, Luciene; OLIVEIRA, Mucio; SOEIRO, Alexandre; NICOLAU, Jose C.; RIBEIRO, Henrique B.; SBANO, Joao Cesar; GOLDSWEIG, Andrew; KALIL-FILHO, Roberto; RAMIRES, Jose; PORTER, Thomas; TSUTSUI, Jeane- ACUTE PULMONAR EDEMA AND VENTRICULAR DYSFUNCTION DUE ADRENERGIC MYOCARDITIS ASSOCIATED TO PHEOCHROMOCYTOMA(2019) BORTOLOTTO, Luiz Aparecido; BORTOLOTTO, Alexandre L.; CASTRO, Rafael; SOUSA, Maria T. S.; SOEIRO, Alexandre; PEREIRA, Adelaide
conferenceObject Effects of High Mechanical Index Impulses From a Diagnostic Ultrasound Transducer During an Intravenous Ultrasound Contrast Infusion in Preventing Adverse Left Ventricular Remodeling in Acute ST Segment Myocardial Infarction(2016) MATHIAS, Wilson; TSUTSUI, Jeane M.; TAVARES, Bruno G.; AGUIAR, Miguel O.; OLIVEIRA, Mucio T.; SOEIRO, Alexandre; LEMOS, Pedro A.; RAMIRES, Jose; KALIL, Roberto; PORTER, Thomas R.- Nitazoxanide superiority to placebo to treat moderate COVID-19-A Pilot prove of concept randomized double-blind clinical trial(2021) BLUM, Vinicius Fontanesi; CIMERMAN, Sergio; HUNTER, James R.; TIERNO, Paulo; LACERDA, Acioly; SOEIRO, Alexandre; CARDOSO, Florentino; BELLEI, Nancy Cristina; MARICATO, Juliana; MANTOVANI, Nathalia; VASSAO, Marcella; DIAS, Danilo; GALINSKAS, Juliana; JANINI, Luis Mario Ramos; SANTOS-OLIVEIRA, Joanna Reis; DA-CRUZ, Alda Maria; DIAZ, Ricardo SobhieBackground: The absence of specific antivirals to treat COVID-19 leads to the repositioning of candidates' drugs. Nitazoxanide (NTZ) has a broad antiviral effect. Methods: This was a randomized, double-blind pilot clinical trial comparing NTZ 600 mg BID versus Placebo for seven days among 50 individuals (25 each arm) with SARS-COV-2 RT-PCR+ (PCR) that were hospitalized with mild respiratory insufficiency from May 20th, 2020, to September 21st, 2020 (ClinicalTrials.gov NCT04348409). Clinical and virologic endpoints and inflammatory biomarkers were evaluated. A five-point scale for disease severity (SSD) was used. Findings: Two patients died in the NTZ arm compared to 6 in the placebo arm (p = 0.564). NTZ was superior to placebo when considering SSD (p < 0001), the mean time for hospital discharge (6.6 vs. 14 days, p = 0.021), and negative PCR at day 21 (p = 0.035), whereas the placebo group presented more adverse events (p = 0.04). Among adverse events likely related to the study drug, 14 were detected in the NTZ group and 22 in placebo (p = 0.24). Among the 30 adverse events unlikely related, 21 occurred in the placebo group (p = 0.04). A decrease from baseline was higher in the NTZ group for D-Dimer (p = 0.001), US-RCP (p < 0.002), TNF (p < 0.038), IL-6 (p < 0.001), IL-8 (p = 0.014), HLA DR. on CD4(+) T lymphocytes (p < 0.05), CD38 in CD4(+) and CD8(+) T (both p < 0.05), and CD38 and HLA-DR. on CD4(+) (p < 0.01) Interpretation: Compared to placebo in clinical and virologic outcomes and improvement of inflammatory out-comes, the superiority of NTZ warrants further investigation of this drug for moderate COVID-19 in larger clinical trials. A higher incidence of adverse events in the placebo arm might be attributed to COVID-19 related symptoms. (C) 2021 The Authors.
- Diagnostic Ultrasound Impulses Improve Microvascular Flow in Patients With STEMI Receiving Intravenous Microbubbles(2016) MATHIAS JR., Wilson; TSUTSUI, Jeane M.; TAVARES, Bruno G.; XIE, Feng; AGUIAR, Miguel O. D.; GARCIA, Diego R.; OLIVEIRA JR., Mucio T.; SOEIRO, Alexandre; NICOLAU, Jose C.; LEMOS NETO, Pedro A.; ROCHITTE, Carlos E.; RAMIRES, Jose A. F.; KALIL FILHO, Roberto; PORTER, Thomas R.BACKGROUND Pre-clinical trials have demonstrated that, during intravenous microbubble infusion, high mechanical index (HMI) impulses from a diagnostic ultrasound (DUS) transducer might restore epicardial and microvascular flow in acute ST-segment elevation myocardial infarction (STEMI). OBJECTIVES The purpose of this study was to test the safety and efficacy of this adjunctive approach in humans. METHODS From May 2014 through September 2015, patients arriving with their first STEMI were randomized to either DUS intermittent HMI impulses (n = 20) just prior to emergent percutaneous coronary intervention (PCI) and for an additional 30 min post-PCI (HMI + PCI), or low mechanical index (LMI) imaging only (n = 10) for perfusion assessments before and after PCI (LMI + PCI). All studies were conducted during an intravenous perflutren lipid microsphere infusion. A control reference group (n = 70) arrived outside of the time window of ultrasound availability and received emergent PCI alone (PCI only). Initial epicardial recanalization rates prior to emergent PCI and improvements in microvascular flow were compared between ultrasound-treated groups. RESULTS Median door-to-dilation times were 82 +/- 26 min in the LMI + PCI group, 72 +/- 15 min in the HMI + PCI group, and 103 +/- 42 min in the PCI-only group (p = NS). Angiographic recanalization prior to PCI was seen in 12 of 20 HMI + PCI patients (60%) compared with 10% of LMI + PCI and 23% of PCI-only patients (p = 0.002). There were no differences in microvascular obstructed segments prior to treatment, but there were significantly smaller proportions of obstructed segments in the HMI + PCI group at 1 month (p = 0.001) and significant improvements in left ventricular ejection fraction (p < 0.005). CONCLUSIONS HMI impulses from a diagnostic transducer, combined with a commercial microbubble infusion, can prevent microvascular obstruction and improve functional outcome when added to the contemporary PCI management of acute STEMI. (Therapeutic Use of Ultrasound in Acute Coronary Artery Disease; NCT02410330) (C) 2016 by the American College of Cardiology Foundation.
- Nitazoxanide superiority to placebo to treat moderate COVID-19 - A Pilot prove of concept randomized double-blind clinical trial (vol 37, 100981, 2021)(2021) BLUM, Vinicius Fontanesi; CIMERMAN, Sergio; HUNTER, James R.; TIERNO, Paulo; LACERDA, Acioly; SOEIRO, Alexandre; CARDOSO, Florentino; BELLEI, Nancy Cristina; MARICATO, Juliana; MANTOVANI, Nathalia; VASSAO, Marcella; DIAS, Danilo; GALINSKAS, Juliana; JANINI, Luis Mario Ramos; SANTOS-OLIVEIRA, Joanna Reis; DA-CRUZ, Alda Maria; DIAZ, Ricardo Sobhie
- Sonothrombolysis in ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention(2019) JR, Wilson Mathias; TSUTSUI, Jeane M.; TAVARES, Bruno G.; FAVA, Agostina M.; AGUIAR, Miguel O. D.; BORGES, Bruno C.; JR, Mucio T. Oliveira; SOEIRO, Alexandre; NICOLAU, Jose C.; RIBEIRO, Henrique B.; CHIANG, Hsu Po; SBANO, Joao C. N.; MORAD, Abdulrahman; GOLDSWEIG, Andrew; ROCHITTE, Carlos E.; LOPES, Bernardo B. C.; RAMIREZ, Jose A. F.; KALIL FILHO, Roberto; PORTER, Thomas R.BACKGROUND Preclinical studies have demonstrated that high mechanical index (MI) impulses from a diagnostic ultrasound transducer during an intravenous microbubble infusion (sonothrombolysis) can restore epicardial and microvascular flow in acute ST-segment elevation myocardial infarction (STEMI). OBJECTIVES This study tested the clinical effectiveness of sonothrombolysis in patients with STEMI. METHODS Patients with their first STEMI were prospectively randomized to either diagnostic ultrasound-guided high MI impulses during an intravenous Definity (Lantheus Medical Imaging, North Billerica, Massachusetts) infusion before, and following, emergent percutaneous coronary intervention (PCI), or to a control group that received PCI only (n = 50 in each group). A reference first STEMI group (n = 203) who arrived outside the randomization window was also analyzed. Angiographic recanalization before PCI, ST-segment resolution, infarct size by magnetic resonance imaging, and systolic function (LVEF) at 6 months were compared. RESULTS ST-segment resolution occurred in 16 (32%) high MI PCI versus 2 (4%) PCI-only patients before PCI, and angiographic recanalization was 48% in high MI/PCI versus 20% in PCI only and 21% in the reference group (p < 0.001). Infarct size was reduced (29 +/- 22 g high MI/PCI vs. 40 +/- 20 g PCI only; p = 0.026). LVEF was not different between groups before treatment (44 +/- 11% vs. 43 +/- 10%), but increased immediately after PCI in the high MI/PCI group (p = 0.03), and remained higher at 6 months (p = 0.015). Need for implantable defibrillator (LVEF <= 30%) was reducedin the high MI/PCI group (5% vs. 18% PCI only; p = 0.045). CONCLUSIONS Sonothrombolysis added to PCI improves recanalization rates and reduces infarct size, resulting in sustained improvements in systolic function after STEMI. (C) 2019 by the American College of Cardiology Foundation.
conferenceObject Sonothrombolysis Improves Myocardial Dynamics and Microvascular Obstruction Preventing Left Ventricular Remodeling in Patients With ST Elevation Myocardial Infarction(2019) AGUIAR, Miguel O.; TSUTSUI, Jeane; TAVARES, Bruno G.; LOPES, Bernardo B. C.; NICOLAU, Jose; CHIANG, Hsu Po; PORTER, Thomas; BORGES, Bruno Carter C.; SOEIRO, Alexandre; OLIVEIRA JR., Mucio T.; ROCHITTE, Carlos; RAMIRES, Jose A. F.; KALIL, Roberto; MATHIAS, WilsonconferenceObject Effects of High Mechanical Index Impulses From a Diagnostic Ultrasound Transducer During an Intravenous Ultrasound Contrast Infusion in Preventing Adverse Left Ventricular Remodeling in Acute ST Segment Myocardial Infarction(2016) MATHIAS, Wilson; TSUTSUI, Jeane M.; TAVARES, Bruno G.; AGUIAR, Miguel O.; OLIVEIRA, Mucio T.; SOEIRO, Alexandre; LEMOS, Pedro A.; RAMIRES, Jose; KALIL, Roberto; PORTER, Thomas R.- THE EFFECTIVENESS OF MICROBUBBLE-MEDIATED SONOTHROMBOLYSIS FOR INDUCING EARLY RECANALIZATION OF DIFFERENT CULPRIT CORONARY ARTERIES IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION(2018) MATHIAS, Wilson; TAVARES, Bruno G.; AGUIAR, Miguel Osman; TSUTSUI, Jeane; CHIANG, Hsu; SOEIRO, Alexandre; OLIVEIRA, Mucio; NICOLAU, Jose; LEMOS, Pedro; LOPES, Bernardo; ROCHITTE, Carlos; VIANA, Erica; SBANO, Joao; KALIL-FILHO, Roberto; PORTER, Thomas