AKOTHIRENE CRISTHINA DUTRA BRISOLLA MARQUES
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- Identifying the risk of obstructive sleep apnea in metabolic syndrome patients: Diagnostic accuracy of the Berlin Questionnaire(2019) CEPEDA, Felipe X.; VIRMONDES, Leslie; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene C. B.; TOSCHI-DIAS, Edgar; FERREIRA-CAMARGO, Fernanda C.; HUSSID, Maria Fernanda; RONDON, Maria Urbana P. B.; ALVES, Maria Janieire N. N.; TROMBETTA, Ivani C.Background Obstructive sleep apnea (OSA) is a risk factor frequently present in patients with metabolic syndrome (MetS). Additionally, moderate and severe OSA are highly prevalent in patients with cardiac disease, as they increase the riskfor cardiovascular events by 80%. The gold standard diagnostic method for OSA is overnight polysomnography (PSG), which remains unaffordable for the overall population. The aim of the present study was to evaluate whether the Berlin Questionnaire (BQ) is anuseful tool for assessing the risk of OSA in patients with MetS. Methods 97 patients, previously untreated and recently diagnosed with MetS (National Cholesterol Education Program, Adult Treatment Panel III, ATP-III) underwent a PSG. OSA was characterized by the apnea-hypopnea index (AHI). BQ was administered before PSG and we evaluated sensitivity, specificity, positive and negative predictive values, and accuracy. Results Of the 97 patients with MetS, 81 patients had OSA, with 47 (48.5%) presenting moderate and severe OSA. For all MetS with OSA (AHI >= 5 events/hour), the BQ showed good sensitivity (0.65, 95% CI 0.54 to 0.76) and fair specificity (0.38, 95% CI 0.15-0.65) with a positive predictive value of 0.84, a negative predictive value of 0.18 and an 84% accuracy. Similarly, for moderate-to-severe OSA (AHI >= 15 events/hour) we found good sensitivity (0.73, 95% CI 0.58-0.85) and fair specificity (0.40, 95% CI 0.27-0.55). Interestingly, for severe OSA (AHI. 30 events/hour), there was a very good sensitivity (0.91, 95% CI 0.72-0.99) and moderate specificity (0.42, 95% CI 0.31-0.54). Conclusion The BQ is a valid tool for screening the risk of OSA in MetS patients in general, and it is particularly useful in predicting severe OSA.
conferenceObject American Population Derived Donor Score System Assessment in a Brazilian Heart Transplantation Cohort(2017) ESCOSSIA, L. L.; BONATTO, M. G.; TONIN, M. H.; MANGINI, S.; MARCONDES-BRAGA, F.; BACAL, F.; AVILA, M. S.; WOSNIAK, I.; SEGURO, L.; DUTRA, A. C.; PAULO, A. R. de; MELO, J. L.; BARONE, F.conferenceObject Obstructive sleep apnea impairs insulin resistance in metabolic syndrome patients with normal levels of glucose(2016) CEPEDA, Felipe Xerez; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene C. B.; CARVALHO, Jefferson Cabral; TOSCHI-DIAS, Edgar; JORDAO, Camila Paixao; RONDON, Maria Urbana; ALVES, Maria Janieire N. N.; LORENZI-FILHO, Geraldo; TROMBETTA, Ivani CredidioconferenceObject Diet and Exercise Training Improve Insulin-Glucose Metabolism and Sympathetic Hyperactivation in Obstructive Sleep Apnea and Metabolic Syndrome(2017) CEPEDA, Felipe X.; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene C. B.; CARVALHO, Jefferson C.; TOSCHI-DIAS, Edgar; RONDON, Maria Urbana P. B.; ALVES, Maria Janieire N. N.; LORENZI-FILHO, Geraldo; TROMBETTA, Ivani C.- Arterial stiffness and its association with clustering of metabolic syndrome risk factors(2017) LOPES-VICENTE, Wanda R. P.; RODRIGUES, Sara; CEPEDA, Felipe X.; JORDAO, Camila Paixao; COSTA-HONG, Valeria; DUTRA-MARQUES, Akothirene C. B.; CARVALHO, Jefferson C.; ALVES, Maria Janieire N. N.; BORTOLOTTO, Luiz A.; TROMBETTA, Ivani C.Background: Metabolic syndrome (MetS) is associated with structural and functional vascular abnormalities, which may lead to increased arterial stiffness, more frequent cardiovascular events and higher mortality. However, the role played by clustering of risk factors and the combining pattern of MetS risk factors and their association with the arterial stiffness have yet to be fully understood. Age, hypertension and diabetes mellitus seem to be strongly associated with increased pulse wave velocity (PWV). This study aimed at determining the clustering and combining pattern of MetS risk factors and their association with the arterial stiffness in non-diabetic and non-hypertensive patients. Methods: Recently diagnosed and untreated patients with MetS (n = 64, 49 +/- 8 year, 32 +/- 4 kg/m(2)) were selected, according to ATP III criteria and compared to a control group (Control, n = 17, 49 +/- 6 year, 27 +/- 2 kg/m(2)). Arterial stiffness was evaluated by PWV in the carotid-femoral segment. Patients were categorized and analyzed according MetS risk factors clustering (3, 4 and 5 factors) and its combinations. Results: Patients with MetS had increased PWV when compared to Control (7.8 +/- 1.1 vs. 7.0 +/- 0.5 m/s, p < 0.001). In multivariate analysis, the variables that remained as predictors of PWV were age (beta = 0.450, p < 0.001), systolic blood pressure (beta = 0.211, p = 0.023) and triglycerides (beta = 0.212, p = 0.037). The increased number of risk factors reflected in a progressive increase in PWV. When adjusted to systolic blood pressure, PWV was greater in the group with 5 risk factors when compared to the group with 3 risk factors and Control (8.5 +/- 0.4 vs. 7.5 +/- 0.2, p = 0.011 and 7.2 +/- 0.3 m/s, p = 0.012). Similarly, the 4 risk factors group had higher PWV than the Control (7.9 +/- 0.2 vs. 7.2 +/- 0.3, p = 0.047). Conclusions: The number of risk factors seems to increase arterial stiffness. Notably, besides age and increased systolic blood pressure, alterations in the triglycerides worsened the stiffness of large vessels, emphasizing the importance in addressing this risk factor in MetS patients.
conferenceObject Insulin Resistance Impairs Arterial Stiffness and Peripheral Vascular Resistance in Metabolic Syndrome Patients(2015) RODRIGUES, Sara; CEPEDA, Felipe; DUTRA-MARQUES, Akothirene; CARVALHO, Jefferson; TOSCHI-DIAS, Edgar; MAKI-NUNES, Cristiane; BORTOLOTTO, Luiz; COSTA-HONG, Valeria; RONDON, Maria; ALVES, Maria; NEGRAO, Carlos; TOMBETTA, IvaniconferenceObject Berlin Questionnaire is a Useful Tool to Identify Risk of Obstructive Sleep Apnea in Metabolic Syndrome Patients(2017) CEPEDA, Felipe Xerez; VIRMONDES, Leslie; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene C. B.; CARVALHO, Jefferson C.; TOSCHI-DIAS, Edgar; ALVES, Maria Janieire N. N.; RONDON, Maria Urbana P. B.; LOPES-VICENTE, Wanda R. P.; HUSSID, Maria Fernanda; LORENZI-FILHO, Geraldo; TROMBETTA, Ivani C.conferenceObject Functional capacity in patients with restrictive syndromes: endomyocardial fibrosis versus constrictive pericarditis(2015) SAYEGH, A. L.; MELO, D. T. P.; SOUZA, F. R. De; SANTOS, M. R. Dos; DUTRA-MARQUES, A. C. B.; SALEMI, V. C.; NEGRAO, C. E.; MADY, C.; ALVES, M. J. N. N.; FERNANDES, F.conferenceObject Oxygen uptake efficiency slope in patients with metabolic syndrome and obstructive sleep apnea(2016) CARVALHO, Jefferson Cabral; CEPEDA, Felipe Xerez; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene Cristhina Brisolla; TOSCHI-DIAS, Edgar; RONDON, Maria Urbana Pinto Brandao; ALVES, Maria-Janieire Nazare Nunes; BRAGA, Ana Maria Fonseca Wanderley; LORENZI-FILHO, Gerald; TROMBETTA, Ivani CredidioconferenceObject Diet Associated with Exercise Training Improves Heart Rate Recovery and Autonomic Control in Metabolic Syndrome Subjects(2018) CEPEDA, Felipe Xerez; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene C. B.; TOSCHI-DIAS, Edgar; CARVALHO, Jefferson C.; CARVALHO, Glauce L.; RONDON, Maria Urbana P. B.; ALVES, Maria Janieire N. N.; TROMBETTA, Ivani C.