BARBARA MARIA IANNI
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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bookPart Paciente chagásico na emergência(2018) GARCIA, Fábio Fumagalli; IANNI, Bárbara MariaconferenceObject Serum Microvesicles Containing Archaeal DNA as a New Pathogenetic Factor for Heart Failure in Chagas' Disease(2018) HIGUCHI, Maria de Lourdes; KAWAKAMI, Joyce T.; REIS, Marcia M.; OLIVEIRA, Luanda; PEREIRA, Jaqueline J.; IANNI, Barbara; BUCK, Paula; BOCCHI, Edimar A.bookPart Paciente chagásico na emergência(2018) GARCIA, Fábio Fumagalli; IANNI, Bárbara Maria- Archaea Symbiont of T. cruzi Infection May Explain Heart Failure in Chagas Disease(2018) HIGUCHI, Maria de Lourdes; KAWAKAMI, Joyce T.; IKEGAMI, Renata N.; REIS, Marcia M.; PEREIRA, Jaqueline de Jesus; IANNI, Barbara M.; BUCK, Paula; OLIVEIRA, Luanda Mara da Silva; SANTOS, Marilia H. H.; HAJJAR, Ludhmila A.; BOCCHI, Edimar A.Background: Archaeal genes present in Trypanosoma cruzi may represent symbionts that would explain development of heart failure in 30% of Chagas disease patients. Extracellular vesicles in peripheral blood, called exosomes (<0.1 mu m) or microvesicles (>0.1 mu m), present in larger numbers in heart failure, were analyzed to determine whether they are derived from archaea in heart failure Chagas disease. Methods: Exosomes and microvesicles in serum supernatant from 3 groups were analyzed: heart failure Chagas disease (N = 26), asymptomatic indeterminate form (N = 21) and healthy non-chagasic control (N = 16). Samples were quantified with transmission electron microscopy, flow cytometer immunolabeled with anti-archaemetzincin-1 antibody (AMZ 1, archaea collagenase) and probe anti-archaeal DNA and zymography to determine AMZ1 (Archaeal metalloproteinase) activity. Results: Indeterminate form patients had higher median numbers of exosomes/case vs. heart failure patients (58.5 vs. 25.5, P < 0.001), higher exosome content of AMZ1 antigens (2.0 vs. 0.0; P < 0.001), and lower archaeal DNA content (0.2 vs. 1.5, P = 0.02). A positive correlation between exosomes and AMZ1 content was seen in indeterminate form (r = 0.5, P < 0.001), but not in heart failure patients (r = 0.002, P = 0.98). Higher free archaeal DNA (63.0 vs. 11.1, P < 0.001) in correlation with exosome numbers (r = 0.66, P = 0.01) was seen in heart failure but not in indeterminate form (r = 0.29, P = 0.10). Flow cytometer showed higher numbers of AMZ1 microvesicles in indeterminate form (64 vs. 36, P = 0.02) and higher archaeal DNA microvesicles in heart failure (8.1 vs. 0.9, P < 0.001). Zymography showed strong% collagenase activity in HF group, mild activity in IF compared to non-chagasic healthy group (121 +/- 14, 106 +/- 13 and 100; P < 0.001). Conclusions: Numerous exosomes, possibly removing and degrading abnormal AMZ1 collagenase, are associated with indeterminate form. Archaeal microvesicles and their exosomes, possibly associated with release of archaeal AMZ1 in heart failure, are future candidates of heart failure biomarkers if confirmed in larger series, and the therapeutic focus in the treatment of Chagas disease.
conferenceObject Effects of exercise training on cardiovascular autonomic modulation and skeletal muscle tissue in chagasic cardiopathy patients and preserved systolic function(2018) SARMENTO, A. S. O.; ANTUNES-CORREA, L. M.; ALVES, M. J. N. N.; BACURAU, A. V. N.; FONSECA, K. C. B.; PESSOA, F. G.; TROMBETTA, I. C.; RONDON, M. U. P. B.; RAMIRES, F. J. A.; BRASILEIRO-SANTOS, M. S.; BRUM, P. C.; MADY, C.; NEGRAO, C. E.; THOMAS, S.; IANNI, B. M.conferenceObject Dysregulation of insulin levels in Chagas heart disease is associated with altered adipocytokine levels(2018) DABARIAN, A.; MADY, C.; FERREIRA, J. M. B.; IANNI, B.; HOTTA, V. T.; RAMIRES, F. J. A.; LOPES, H. F.; FERNANDES, F.- Long-Term Prognostic Value of Myocardial Fibrosis in Patients With Chagas Cardiomyopathy(2018) SENRA, Tiago; IANNI, Barbara M.; COSTA, Ana C. P.; MADY, Charles; MARTINELLI-FILHO, Martino; KALIL-FILHO, Roberto; ROCHITTE, Carlos E.BACKGROUND Myocardial fibrosis (MF) according to cardiac magnetic resonance (CMR) is a frequent finding in Chagas cardiomyopathy and has been associated with risk factors of poor outcome. OBJECTIVES The goal of this study was to determine the prognostic value of MF in predicting combined hard events or all-cause mortality. METHODS Patients with Chagas cardiomyopathy who had a previous CMR evaluation were included, and clinical follow-up was retrospectively obtained. The primary outcome was a combination of all-cause mortality, heart transplantation, antitachycardia pacing or appropriate shock from an implantable cardioverter-defibrillator, and aborted sudden cardiac death; the secondary outcome was all-cause mortality. RESULTS A total of 130 patients were included; mean age was 53.6 +/- 11.5 years, and 53.9% were female. The majority of patients reported no symptoms of heart failure or arrhythmia, but electrocardiographic and echocardiographic abnormalities were common. On CMR, left ventricular dilatation and dysfunction were frequent, and MF was found in 76.1%, with a mean mass of 15.2 +/- 16.5 g. Over a median follow-up of 5.05 years, 58 (44.6%) patients reached the combined endpoint, and 45 (34.6%) patients died. MF was associated with the primary outcome as a continuous variable (adjusted hazard ratio: 1.031; 95% CI: 1.013 to 1.049; p = 0.001) and as a categorical variable (MF >= 12.3 g) (adjusted hazard ratio: 2.107; 95% CI: 1.111 to 3.994; p = 0.022), independently from the Rassi risk score. MF expressed as a continuous variable was also associated with all-cause mortality (adjusted hazard ratio: 1.028; 95% CI: 1.005 to 1.051; p = 0.017) independently from the Rassi risk score. CONCLUSIONS MF is an independent predictor of adverse outcome in Chagas cardiomyopathy. Our data may support the use of CMR in better risk-stratifying this population and possibly guiding therapy. (c) 2018 by the American College of Cardiology Foundation.