VICTOR SARLI ISSA
Projetos de Pesquisa
Unidades Organizacionais
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
10 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 10
- Exercise training improves ambulatory blood pressure but not arterial stiffness in heart transplant recipients(2015) PASCOALINO, Lucas Nobilo; CIOLAC, Emmanuel Gomes; TAVARES, Aline Cristina; CASTRO, Rafael Ertner; AYUB-FERREIRA, Silvia Moreira; BACAL, Fernando; ISSA, Victor Sarli; BOCCHI, Edimar Alcides; GUIMARAES, Guilherme VeigaBACKGROUND: Hypertension is the most prevalent comorbidity after heart transplantation (HT). Exercise training (ET) is widely recommended as a key non-pharmacologic intervention for the prevention and management of hypertension, but its effects on ambulatory blood pressure (ABP) and some mechanisms involved in the pathophysiology of hypertension have not been studied in this population. The primary purpose of this study was to investigate the effects of ET on ABP and arterial stiffness of HT recipients. METHODS: 40 HT patients, randomized to ET (n = 31) or a control group (n = 9) underwent a maximal graded exercise test, 24-hour ABP monitoring, and carotid-femoral pulse wave velocity (PWV) assessment before the intervention and at a 12-week follow-up assessment. The ET program was performed thrice-weekly and consisted primarily of endurance exercise (40 minutes) at similar to 70% of maximum oxygen uptake (Vo(2MAX)) RESULTS: The ET group had reduced 24-hour (4.0 +/- 1.4 mm Hg, p < 0.01) and daytime (4.8 +/- 1.6 mm Hg, p < 0.01) systolic ABP, and 24-hour (7.0 +/- 1.4 mm Hg, p < 0.001) daytime (7.5 +/- 1.6 mm Hg, p < 0.001) and nighttime (5.9 +/- 1.5 mm Hg, p < 0.001) diastolic ABP after the intervention. The ET group also had improved Vo(2MAX) (9.7% +/- 2.6%, p < 0.001) after the intervention. However, PWV did not change after ET. No variable was changed in the control group after the intervention. CONCLUSIONS: The 12-week ET program was effective for reducing ABP but not PWV in heart transplant recipients. This result suggesfs that endurance ET may be a tool to counteract hypertension in this high-risk population.
conferenceObject Therapeutical Implications of Clinical Characteristics of Patients With Chagas Cardiomyopathy and Decompensated Heart Failure(2015) ISSA, V. S.; LIMA, G. C.; AYUB-FERREIRA, S. M.; LAGE, S. G.; OLIVEIRA JR., M. T.; NICOLAU, J.; BOCCHI, E. A.conferenceObject Necropsy findings in patients with heart failure(2015) DINARDI, L. F. Lipari; ISSA, V. S.; PEREIRA, T. V.; ALMEIDA, L. K. R.; ISPER, L.; BARBOSA, T. S.; AYUB-FERREIRA, S. M.; BENVENUTI, L. A.; BOCCHI, E. A.bookPart Choque cardiogênico(2015) NUNES, Rafael Amorim Belo; ISSA, Victor Sarli- Infectious agents and inflammation in donated hearts and dilated cardiomyopathies related to cardiovascular diseases, Chagas' heart disease, primary and secondary dilated cardiomyopathies(2015) MANGINI, Sandrigo; HIGUCHI, Maria de Lourdes; KAWAKAMI, Joyce Tiyeko; REIS, Marcia Martins; IKEGAMI, Renata Nishiyama; PALOMINO, Suely Aparecida Pinheiro; POMERANTZEFF, Pablo Maria Alberto; FIORELLI, Alfredo Inacio; MARCONDES-BRAGA, Fabiana Goulart; BACAL, Fernando; FERREIRA, Silvia Moreira Ayub; ISSA, Victor Sarli; SOUZA, Germano Emilio Conceicao; CHIZZOLA, Paulo Roberto; BOCCHI, Edimar AlcidesBackground: Clinical and experimental conflicting data have questioned the relationship between infectious agents, inflammation and dilated cardiomyopathy (DCM). Objectives: The aim of this study was to determine the frequency of infectious agents and inflammation in endomyocardial biopsy (EMB) specimens from patients with idiopathic DCM, explanted hearts from different etiologies, including Chagas' disease, compared to donated hearts. Methods: From 2008 to 2011, myocardial samples from 29 heart donors and 55 patients with DCMs from different etiologies were studied (32 idiopathic, 9 chagasic, 6 ischemic and 8 other specific etiologies). Inflammation was investigated by immunohistochemistry and infectious agents by immunohistochemistry, molecular biology, in situ hybridization and electron microscopy. Results: There were no differences regarding the presence of macrophages, expression of HLA class II and ICAM-I in donors and DCM. Inflammation in Chagas' disease was predominant. By immunohistochemistry, in donors, there was a higher expression of antigens of enterovirus and Borrelia, hepatitis B and C in DCMs. By molecular biology, in all groups, the positivity was elevated to microorganisms, including co-infections, with a higher positivity to adenovirus and HHV6 in donors towards DCMs. This study was the first to demonstrate the presence of virus in the heart tissue of chagasic DCM. Conclusions: The presence of inflammation and infectious agents is frequent in donated hearts, in the myocardium of patients with idiopathic DCM, myocardial dysfunction related to cardiovascular diseases, and primary and secondary cardiomyopathies, including Chagas' disease. The role of co-infection in Chagas' heart disease physiopathology deserves to be investigated in future studies.
conferenceObject Control of Sinus Node Tachycardia as Additional Therapy in Patients With Decompensated Heart Failure (CONSTATHE)(2015) LOFRANO-ALVES, M. S.; ISSA, V. S.; BOCCHI, E. A.bookPart Tamponamento cardíaco(2015) BARROSO, Ruth Carolina Nascimento Lima; ISSA, Victor; VIEIRA, Marcelo Luiz CamposconferenceObject Comparison between in vivo and post mortem diagnoses in patients with heart failure(2015) DINARDI, L. F. Lipari; PEREIRA, T. V.; ALMEIDA, L. K. R.; ISPER, L.; BARBOSA, T. S.; ISSA, V. S.; AYUB-FERREIRA, S. M.; BENVENUTI, L. A.; BOCCHI, E. A.- Reverse Auction: A Potential Strategy for Reduction of Pharmacological Therapy Cost(2015) BRANDAO, Sara Michelly Goncalves; ISSA, Victor Sarli; AYUB-FERREIRA, Silvia Moreira; STORER, Samantha; GONCALVES, Bianca Gigliotti; SANTOS, Valter Garcia; CARVAS JUNIOR, Nelson; GUIMARAES, Guilherme Veiga; BOCCHI, Edimar AlcidesBackground: Polypharmacy is a significant economic burden. Objective: We tested whether using reverse auction (RA) as compared with commercial pharmacy (CP) to purchase medicine results in lower pharmaceutical costs for heart failure (HF) and heart transplantation (HT) outpatients. Methods: We compared the costs via RA versus CP in 808 HF and 147 HT patients followed from 2009 through 2011, and evaluated the influence of clinical and demographic variables on cost. Results: The monthly cost per patient for HF drugs acquired via RA was $ 10.15 (IQ 3.51-40.22) versus $ 161.76 (IQ 86.05-340.15) via CP; for HT, those costs were $ 393.08 (IQ 124.74-774.76) and $ 1,207.70 (IQ 604.48-2,499.97), respectively. Conclusions: RA may reduce the cost of prescription drugs for HF and HT, potentially making HF treatment more accessible. Clinical characteristics can influence the cost and benefits of RA. RA may be a new health policy strategy to reduce costs of prescribed medications for HF and HT patients, reducing the economic burden of treatment.
- Case series of infective endocarditis caused by Granulicatella species(2015) ADAM, Eduardo Leal; SICILIANO, Rinaldo Focaccia; GUALANDRO, Danielle Menosi; CALDERARO, Daniela; ISSA, Victor Sarli; ROSSI, Flavia; CARAMELLI, Bruno; MANSUR, Alfredo Jose; STRABELLI, Tania Mara VarejaoBackground: Nutritionally variant streptococci (NVS) are Gram-positive cocci characterized by their dependence on pyridoxal or cysteine supplementation for growth in standard blood culture media. They are responsible for severe infections in immunocompetent and immunosuppressed hosts, including infective endocarditis (IE). NVS have been divided into two different genera, Granulicatella and Abiotrophia. Methods: We report four cases of IE caused by Granulicatella species, including clinical presentation, echocardiographic characteristics, treatments received, and outcomes. We also performed a literature search for previously reported cases of IE caused by Granulicatella species to better characterize this condition. Results: A total of 29 cases of Granulicatella endocarditis were analyzed, including the four newly reported cases. The aortic (44%) and mitral (38%) valves were those most commonly affected. Multivalvular involvement was observed in 13% of cases. The mean vegetation length was 16 mm. Complications were frequent, including heart failure (30%), embolism (30%), and perivalvular abscess (11%). The most frequent antibiotic regimen (85%) was penicillin or one of its derivatives plus gentamicin. The mortality rate was 17%. Conclusions: Endocarditis due to Granulicatella species is a rare and severe condition. Complications are frequent despite the use of appropriate antibiotic regimens. (C) 2014 The Authors.