SILVIA MOREIRA AYUB FERREIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
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Resultados de Busca
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- Renin-angiotensin System Antagonists and Beta-blockers in Prevention of Anthracycline Cardiotoxicity: a Systematic Review and Meta-analysis(2023) AVILA, Monica Samuel; SIQUEIRA, Suellen Rodrigues Rangel; WALDECK, Lucas; AYUB-FERREIRA, Silvia Moreira; TAKX, Richard; BITTENCOURT, Marcio Sommer; BOCCHI, Edimar AlcidesBackground: The evidence supporting the use of renin-angiotensin-aldosterone system (RAAS) inhibitors and beta-blockers for the prevention of anthracycline-induced cardiomyopathy is controversial. Objective: We performed a meta-analysis to assess the effectiveness of these drugs in preventing cardiotoxicity. Methods: The meta-analysis included prospective, randomized studies in adults receiving anthracycline chemotherapy and compared the use of RAAS inhibitors or beta-blockers versus placebo with a follow-up of 6 to 18 months. The primary outcome was change in left ventricular ejection fraction (LVEF) during chemotherapy. Secondary outcomes were the incidence of heart failure, all-cause mortality, and changes in end-diastolic measurement. Heterogeneity was assessed by stratification and meta-regression. A significance level of p < 0.05 was adopted. Results: The search resulted in 17 studies, totaling 1,530 patients. The variation (delta) in LVEF was evaluated in 14 studies. Neurohormonal therapy was associated with a lower delta in pre- versus post-therapy LVEF (weighted mean difference 4.42 [95% confidence interval2.3 to 6.6]) and higher final LVEF (p < 0.001). Treatment resulted in a lower incidence of heart failure (risk ratio 0.45 [95% confidence interval0.3 to 0.7]). There was no effect on mortality (p = 0.3). For analysis of LVEF, substantial heterogeneity was documented, which was not explained by the variables explored in the study. Conclusion: The use of RAAS inhibitors and beta-blockers to prevent anthracycline-induced cardiotoxicity was associated with less pronounced reduction in LVEF, higher final LVEF, and lower incidence of heart failure. No changes in mortalitywere observed. (CRD PROSPERO 42019133615)
conferenceObject MYOCARDIAL FDG UPTAKE VARIATION AND ITS RELATIONSHIP WITH SURVIVAL DURING IMMUNOTHERAPY(2023) MARTINS, Juliana Goes; TORRES, Matheus; SOUSA, Thiago Lins Fagundes de; BOTELHO, Luis; FIGUEIREDO, Eudanusia; VERCOSA, Alinne; MELO, Marcelo Dantas Tavares De; FERREIRA, Silvia M.article 0 Citação(ões) na Scopus Treatment of fungal infection on left ventricle assist device driveline exit site: a case report and systematic review(2023) BRANDAO, Sara Michelly Goncalves; BISELI, Bruno; AYUB-FERREIRA, Silvia Moreira; STRABELLI, Tania Mara Varejao; BOCCHI, Edimar AlcidesObjective: The use of ventricular assist devices (VAD) is increasing; however, diagnosis and management of device complications, such as the driveline exit site (DES) being the portal of entry for fungal infection, is not well known. Method: A systematic review involving searching PubMed (2005 to July 2020) was conducted. The case of a 43-year-old female patient who had a left VAD (LVAD) (HeartMate 3, Abbott, US) is also reported. Results: The patient was successfully treated with ketoconazole cream and oral fluconazole for likely superficial DES fungal infections. We included 36 studies that met our inclusion criteria; however, only one was included in our review. In the literature, five cases of DES fungal infection were reported, with Candida being the only fungal pathogen. Conclusion: LVAD fungal infections are uncommon but can be responsible for high mortality rates, require a prolonged period of treatment, and can present a huge problem when surgical alternatives are not available. However, Candida species are most common. Fungal infections can only produce clear discharge, and so the classic definition of driveline infection based on purulent secretion can vary. Negative skin culture does not exclude the diagnosis of infection of the DES, and so empirical diagnosis may only be clinically based.- Effects of ss-blocker therapy on exercise oscillatory ventilation in reduced ejection fraction heart failure patients: A case series study(2022) BELLI-MARIN, Juliana Fernanda Calhado; BOCCHI, Edimar Alcides; AYUB-FERREIRA, Silvia; CARVAS JUNIOR, Nelson; GUIMARAES, Guilherme VeigaBackground: Exercise oscillatory ventilation (EOV) is an abnormal breathing pattern that occurs in similar to 20% of patients with heart failure (HF) and is associated with poor prognosis and exercise intolerance. ss-blockers (ss b) are prescribed for most HF patients; however, their effect on EOV remains unclear. We evaluated the effect of ss b on EOV in HF patients with reduced ejection fraction (HFrEF). Methods: Fifteen patients diagnosed with HF, ejection fraction < 45%, aged from 18 to 65 years, were included before starting ss b therapy. Patients underwent clinical evaluation, cardiopulmonary exercise testing, echocardiography, laboratory exams (norepinephrine levels, B type natriuretic peptide) at baseline and after ss b therapy optimized for six months. Presence of exercise oscillatory breathing was determined by two experienced observers who were blinded to the moment of the test (pre or post). Results: Fifteen patients (1 female), aged 49.5 +/- 2.5 years, with HFrEF, NYHA I-III enrolled in the study. The etiologies of the HFrEF were idiopathic (n = 8) and hypertensive (n = 7). LVEF increased after ss b therapy from 25.9 +/- 2.5% to 33 +/- 2.6%, P = 0.02; peak VO2 did not significantly change (21.8 +/- 1.7 vs 24.7 +/- 1.9, P = 0.4); VE/VCO2 slope changed from 32.1 +/- 10.6-27.5 +/- 9.1, P = 0.03. Before ss b initiation, nine patients (60%) had EOV, but only two (13%) did after optimized therapy. McNemar test was used to evaluate the significance of the association between the two moments (P = 0.02). Conclusion: In patients with HF, medical therapy with ss b can reverse EOV. This may explain why these patients experience symptom improvement after ss b therapy.
conferenceObject Cardiotoxicity surveillance among patients with cancer treated with immunotherapy(2023) FAGUNDES, Juliana Goes Martins; TORRES, Matheus Coelho; SOUSA, Thiago Lins Fagundes de; BOTELHO, Luis Fabio; FIGUEIREDO, Eudanusia Guilherme de; FLAMINI, Rodrigo de Carvalho; LACERDA, Emilio Carlos De Arruda; PEREIRA, Jean Fabricio De Lima; DUARTE, Igor Lemos; CASTRO, Gilberto; MELO, Marcelo Dantas Tavares de; FERREIRA, Silvia Moreira AyubconferenceObject CARDIOTOXICITY SECONDARY TO IMMUNOTHERAPY IN CANCER PATIENTS(2023) MARTINS, Juliana Goes; TORRES, Matheus; BOTELHO, Luis; SOUSA, Thiago Lins Fagundes de; FIGUEIREDO, Eudanusia; MELO, Marcelo Dantas Tavares de; FERREIRA, Silvia Moreira Ayub