CARLOS AUGUSTO HOMEM DE MAGALHAES CAMPOS
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
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- 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.- Bioresorbable Drug-Eluting Magnesium-Alloy Scaffold for Treatment of Coronary Artery Disease(2013) CAMPOS, Carlos M.; MURAMATSU, Takashi; IQBAL, Javaid; ZHANG, Ya-Jun; ONUMA, Yoshinobu; GARCIA-GARCIA, Hector M.; HAUDE, Michael; LEMOS, Pedro A.; WARNACK, Boris; SERRUYS, Patrick W.The introduction of metallic drug-eluting stents has reduced the risk of restenosis and widened the indications of percutaneous coronary intervention in treatment of coronary artery disease. However, this medical device can induce hypersensitive reaction that interferes with the endothelialization and healing process resulting in late persistent or acquired malapposition of the permanent metallic implant. Delayed endotheliaization and malapposition may lead to late and very late stent thrombosis. Bioresorbable scaffolds (BRS) have been introduced to potentially overcome these limitations, as they provide temporary scaffolding and then disappear, liberating the treated vessel from its cage. Magnesium is an essential mineral needed for a variety of physiological functions in the human body and its bioresorbable alloy has the strength-to-weight ratio comparable with that of strong aluminum alloys and alloy steels. The aim of this review is to present the new developments in Magnesium BRS technology, to describe its clinical application and to discuss the future prospects of this innovative therapy.
- Precise Vessel Sizing: A Trivial but Crucial Issue During Left Main Stenting(2014) CAMPOS, Carlos M.; LEMOS, Pedro A.
- Prasugrel monotherapy after PCI with the SYNERGY stent in patients with chronic stable angina or stabilised acute coronary syndromes: rationale and design of the ASET pilot study(2019) KOGAME, Norihiro; MODOLO, Rodrigo; TOMANIAK, Mariusz; CAVALCANTE, Rafael; MARTINO, Fernando de; TINOCO, Joao; RIBEIRO, Expedito E.; MEHRAN, Roxana; CAMPOS, Carlos M.; ONUMA, Yoshinobu; LEMOS, Pedro A.; SERRUYS, Patrick W.LIM/11
conferenceObject The External Validity of Prediction Models for Contrast-Induced Nephropathy After TAVI: Insights From the Brazilian TAVI Registry.(2018) ROSA, Vitor E. E.; CAMPOS, Carlos M.; BACELAR, Antonio; ABIZAID, Alexandre A. C.; MANGIONE, Jose A.; LEMOS, Pedro A.; ESTEVES, Vinicius; CARAMORI, Paulo; TARASOUTCHI, Flavio; BRITO JR., Fabio S.- Comparative clinical performance of two types of drug-eluting stents with abluminal biodegradable polymer coating: Five-year results of the DESTINY randomized trial(2021) JR, Guy F. A. Prado; ABIZAID, Alexandre A. C.; MEIRELES, George C.; SARMENTO-LEITE, Rogerio; PRUDENTE, Mauricio; CANTARELLI, Marcelo; DOURADO, Adriano D.; JR, Jose Mariani; PERIN, Marco A.; COSTANTINI, Costantino; COSTA, Ricardo; COSTA, J. Ribamar; CHAMIE, Daniel; CAMPOS, Carlos M.; RIBEIRO, Expedito E.; LEMOS, Pedro A.Introduction and Objectives: The Stents Coated With the Biodegradable Polymer on Their Abluminal Faces and Elution of Sirolimus Versus Biolimus Elution for the Treatment of de Novo Coronary Lesions - DESTINY Trial is a non-inferiority randomized study that compared the Inspiron (TM) sirolimus-eluting stent (SES) with the control Biomatrix (TM) Flex biolirms-eluting stent (BES). Previous reports in the first year showed similar outcomes for both stents, in clinical, angiographic, optical coherence tomography, and intravascular ultrasound assessments. The present analysis aims to compare the clinical performance of these two biodegradable polymer drug-eluting stents five years after the index procedure. Methods: A total of 170 patients (194 lesions) were randomized in a 2:1 ratio for treatment with SES or BES, respectively. The primary endpoint for the present study was the five-year rate of combined major adverse cardiac events, defined as cardiac death, myocardial infarction, or target lesion revascularization. Results: At five years, the primary endpoint occurred in 12.5% and 17.9% of the SES and BES groups, respectively (p=0.4). There was no definite or probable stent thrombosis among patients treated with the novel SES stent during the five years of follow-up, and no stent thrombosis after the first year in the BES group. Conclusions: The novel Inspiron (TM) stent had similar good clinical performance in long-term follow-up when compared head-to-head with the control latest-generation Biomatrix (TM) Flex biolimus-eluting stent. (C) 2020 Sociedade Portuguesa de Cardiologia.
- Renal denervation in patients with heart failure secondary to Chagas' disease: A pilot randomized controlled trial(2019) SPADARO, Andre G.; BOCCHI, Edimar A.; SOUZA, Germano E.; FILHO, Antonio E.; MARIANI JR., Jose; CAMPOS, Carlos M.; LEMOS, Pedro A.Introduction Chagas disease is one of the most relevant endemic parasitic diseases in Latin America, affecting approximately 6 million people. Overt Chagas heart disease is an ominous condition, occurring in 20-30% of infected individuals, which has besides the persistent myocarditis a peculiar intracardiac ganglionic neuronal depletion and dysautonomy. This study aims to evaluate the safety and feasibility of renal denervation for patients with advanced symptomatic Chagas cardiomyopathy. Methods Open-label prospective pilot study that randomized patients with Chagas heart disease to either renal denervation or conservative treatment (2:1 ratio). The primary endpoint was the incidence of major adverse events at 9 months, defined as a composite of all-cause death, myocardial infarction, stroke, need for renal artery invasive treatment, or worsening renal function. Results A total of 17 patients were allocated for renal denervation (n = 11) or conservative treatment (n = 6). Included patients had severe symptomatic heart disease, with markedly depressed left ventricular function (average ejection fraction 26.7 +/- 4.9%). For patients randomized to renal denervation, the procedure was performed successfully and uneventfully. After 9 months, the primary endpoint occurred in 36.4% of patients in the renal denervation group and 50.0% in the control arm (p = .6). After 9 months, clinical, laboratory, functional, echocardiographic, and quality of life parameters were similar between groups. Conclusions This pilot study suggests that renal denervation is safe and feasible in patients with Chagas cardiomyopathy, warranting future studies to better evaluate the clinical efficacy of the interventional strategy in improving the prognosis of this high-risk population.
article 13 Citação(ões) na Scopus The interaction of de novo and pre-existing aortic regurgitation after TAVI: insights from a new quantitative aortographic technique(2017) TATEISHI, Hiroki; ABDELGHANI, Mohammad; CAVALCANTE, Rafael; MIYAZAKI, Yosuke; CAMPOS, Carlos M.; COLLET, Carlos; SLOTS, Tristan L. B.; LEITE, Rogerio S.; MANGIONE, Jose A.; ABIZAID, Alexandre; SOLIMAN, Osama I. I.; SPITZER, Ernest; ONUMA, Yoshinobu; SERRUYS, Patrick W.; LEMOS, Pedro A.; BRITO JR., Fabio S. deAims: The aim of this study was to evaluate the intermediate-term clinical impact of aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) using a novel quantitative angiographic method taking into account the influence of pre-existing AR. Methods and results: AR after TAVI was quantified in 338 patients (age 82 [78-86] years; 55% male) and the influence on intermediate-term all-cause mortality was evaluated. In 228 aortograms, AR was quantitated using a dedicated videodensitometric method focused in the left ventricular outflow tract (LVOT-AR). Patients with LVOT-AR >0.17 had a significantly increased all-cause mortality at three years, compared with patients who had LVOT-AR <0.17 (adjusted hazard ratio [HR]: 1.73, 95% confidence interval [CI]: 1.05-2.86, p=0.032). Taking the influence of pre-existing AR into account, patients with post-procedural LVOT-AR >0.17 and <= mild pre-existing AR had a significantly increased mortality at two years, compared to patients with LVOT-AR >0.17 and >mild pre-existing AR (HR: 2.55, 95% CI: 1.16-5.58, p=0.029). In those with >mild pre-existing AR (n=70), post-TAVI LVOT-AR >0.17 was not associated with increased mortality (HR: 0.77, 95% CI: 0.31-1.91, 1)=0.578). Conclusions: AR after TAVI could be quantitated utilising LVOT-AR. The cut-point of >0.17 indicates a significant AR pertaining to increased intermediate-term mortality, especially in those with no significant pre-existing AR.- Video densitometric assessment of aortic regurgitation after transcatheter aortic valve implantation: results from the Brazilian TAVI registry(2016) TATEISHI, Hiroki; CAMPOS, Carlos M.; ABDELGHANI, Mohammad; LEITE, Rogerio S.; MANGIONE, Jose A.; BARY, Lizet; SOLIMAN, Osama I. I.; SPITZER, Ernest; PERIN, Marco A.; ONUMA, Yoshinobu; SERRUYS, Patrick W.; LEMOS, Pedro A.; BRITO JR., Fabio S.Aims: We sought to examine the feasibility and reproducibility of a new video densitometric (VD) quantification of aortic regurgitation (AR) on aortography, and its long-term clinical impact. Methods and results: Using dedicated video densitometry software, AR after TAVI was quantified, and inter- and intra-observer reproducibility was investigated in 182 aortograms of the Brazilian TAVI registry. The aortograms were analysed using two software algorithms: 1) the quantitative regurgitation analysis (qRA) index interrogating the entire left ventricle (LV), and 2) a new method with the left ventricle outflow tract (LVOT) as a region of interest (ROI) (LVOT-AR). LVOT-AR was feasible in 64.8% vs. 29.7% of aortograms, compared with qRA index. Using the LVOT-AR, inter-observer variability was low (mean difference standard deviation [SD]: 0.01 +/- 0.05, p=0.53), and the two observers' measurements were highly correlated (r=0.95, p<0.001). Patients with LVOT-AR >0.17 had a significantly higher one-year all-cause mortality risk compared with patients with LVOT-AR <= 0.17 (37.1% vs. 11.2%, p=0.0008). Conclusions: This study proposes an alternative methodology for AR assessment after TAVI by using the LVOT method (LVOT-AR) of VD angiography. The assessment of LVOT-AR is feasible, reproducible and potentially predictive of one-year mortality.