KAREN SAORI SHIRAISHI SAWAMURA

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Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico

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Revista / Livro: Arquivos Brasileiros de Cardiologia ×

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  • article 11 Citação(ões) na Scopus
    The Heart of Pediatric Patients with COVID-19: New Insights from a Systematic Echocardiographic Study in a Tertiary Hospital in Brazil
    (2021) DINIZ, Maria de Fatima Rodrigues; CARDOSO, Maira Freire; SAWAMURA, Karen Saori Shiraishi; MENEZES, Carolina Rocha Brito; LIANZA, Alessandro Cavalcanti; PEREIRA, Maria Fernanda Badue; LITVINOV, Nadia; FERRANTI, Juliana Ferreira; FORSAIT, Silvana; WATANABE, Andreia; FARHAT, Sylvia Costa Lima; AIKAWA, Nadia Emi; CAMPOS, Lucia Maria Arruda; DELGADO, Artur Figueiredo; CARNEIRO-SAMPAIO, Magda; CARVALHO, Werther Brunow de; SILVA, Clovis Artur; LEAL, Gabriela Nunes
    Background: COVID-19 pandemic represents a huge burden to the health system in the world. Although pediatric COVID-19 patients have been relatively spared compared with adults, recent reports showed an increasing number of critically ill patients with multisystemic inflammatory syndrome in children (MIS-c), with marked cardiovascular impairment. Nevertheless, little is known about the relationship between cardiac abnormalities and inflammatory and coagulation biomarkers. Objectives: to investigate echocardiographic abnormalities in pediatric patients with COVID-19 admitted to tertiary hospital. Methods: this was a retrospective longitudinal study, based on the review of medical records and echocardiograms of patients (0-19 years) admitted to a tertiary hospital between March 30 and June 30, 2020. For statistical analysis, the significance level was set at 5% (p < 0.05). Results: Forty-eight patients were enrolled, 73% with preexisting diseases, 20 (41.7%) with MIS-c. Median age was 7.5 (0-18.6) years; 27 (56.2%) were male. Median duration of hospitalization was 15.4 (2-92) days and seven (14.6%) patients died. A total of 70 echocardiograms were performed; 66.7% patients were scanned only once and 33.3% multiple times. Twenty-three (48%) patients showed echocardiographic abnormalities: eight (16.6%) left ventricle (LV) systolic dysfunction, six (12.5%) right ventricle (RV) systolic dysfunction and 12 (25%) coronary dilatation (Z-score>+2.5). Echocardiographic abnormalities were significantly associated with MIS-c, admission to the pediatric intensive care unit, multiple organ dysfunction, ventilatory/vasoactive support, and death (p<0.05). Significantly higher d-dimer (ng/mL) levels were detected in patients with LV dysfunction [16733(4157-115668) vs. 2406.5(190-95040)], RV dysfunction [25769(3422-115668) vs. 2803.5(190-95040)] and coronary artery dilation [9652.5(921-115668) vs. 2724(190- 95040)] (p<0.05). Conclusion: Echocardiographic abnormalities in COVID-19 pediatric patients were frequent and associated with worse clinical outcomes. Exacerbation of the inflammation and coagulation pathways may play an important role in cardiovascular injury in those patients.
  • article 5 Citação(ões) na Scopus
    Brazilian Position Statement on the Use Of Multimodality Imaging in Cardio-Oncology-2021
    (2021) MELO, Marcelo Dantas Tavares de; PAIVA, Marcelo Goulart; SANTOS, Maria Veronica Camara; ROCHITTE, Carlos Eduardo; MOREIRA, Valeria de Melo; SALEH, Mohamed Hassan; BRANDAO, Simone Cristina Soares; GALLAFRIO, Claudia Cosentino; GOLDWASSER, Daniel; GRIPP, Eliza de Almeida; PIVETA, Rafael Bonafim; SILVA, Tonnison Oliveira; SANTO, Thais Harada Campos Espirito; FERREIRA, Waldinai Pereira; SALEMI, Vera Maria Cury; CAUDURO, Sanderson A.; BARBERATO, Silvio Henrique; LOPES, Heloisa M. Christovam; PENA, Jose Luiz Barros; RACHED, Heron Rhydan Saad; MIGLIORANZA, Marcelo Haertel; PINHEIRO, Aurelio Carvalho; VRANDECIC, Barbara Athayde Linhares Martins; CRUZ, Cecilia Beatriz Bittencourt Viana; NOMURA, Cesar Higa; CERBINO, Fernanda Mello Erthal; COSTA, Isabela Bispo Santos da Silva; COELHO FILHO, Otavio Rizzi; CARNEIRO, Adriano Camargo de Castro; BURGOS, Ursula Maria Moreira Costa; FERNANDES, Juliano Lara; UELLENDAHL, Marly; CALADO, Eveline Barros; SENRA, Tiago; ASSUNCAO, Bruna Leal; FREIRE, Claudia Maria Vilas; MARTINS, Cristiane Nunes; SAWAMURA, Karen Saori Shiraishi; BRITO, Marcio Miranda; JARDIM, Maria Fernanda Silva; BERNARDES, Renata Junqueira Moll; DIOGENES, Tereza Cristina; VIEIRA, Lucas de Oliveira; MESQUITA, Claudio Tinoco; LOPES, Rafael Willain; SEGUNDO NETO, Elry Medeiros Vieira; RIGO, Leticia; MARIN, Valeska Leite Siqueira; SANTOS, Marcelo Jose; GROSSMAN, Gabriel Blacher; QUAGLIATO, Priscila Cestari; ALCANTARA, Monica Luiza de; TEODORO, Jose Aldo Ribeiro; ALBRICKER, Ana Cristina Lopes; BARROS, Fanilda Souto; AMARAL, Salomon Israel do; PORTO, Carmen Lucia Lascasas; BARROS, Marcio Vinicius Lins; SANTOS, Simone Nascimento Dos; CANTISANO, Armando Luis; PETISCO, Ana Claudia Gomes Pereira; BARBOSA, Jose Eduardo Martins; VELOSO, Orlando Carlos Gloria; SPINA, Salvador; PIGNATELLI, Ricardo; HAJJAR, Ludhmilla Abrahao; KALIL FILHO, Roberto; LOPES, Marcelo Antonio Cartaxo Queiroga; VIEIRA, Marcelo Luiz Campos; ALMEIDA, Andre Luiz Cerqueira
  • article
    Speckle-Tracking: Incremental Role in Diastolic Assessment of Pediatric Patients with Chronic Kidney Disease
    (2024) PENACHIO, Flora Maciel; DINIZ, Maria de Fatima Rodrigues; LAURINO, Rosana Sbruzzi Prado; WATANABE, Andreia; SAWAMURA, Karen Saori Shiraishi; LIANZA, Alessandro Cavalcanti; MENEZES, Carolina Rocha Brito; SILVA, Isabela de Sousa Lobo; LEAL, Gabriela Nunes
    Background: Cardiovascular complications are the leading cause of mortality in pediatric patients with chronic kidney disease (CKD). Echocardiographic assessment of diastolic function in CKD has been limited to spectral and tissue Doppler imaging, known to be less reliable techniques in pediatrics. Two-dimensional Speckle tracking echocardiography (2DST) derived left atrial (LA) strain has recently been confirmed as a robust measure of diastolic function. Objectives: To investigate LA strain role in diastolic assessment of children at different stages of CKD. Methods: From February 2019 to July 2022, 55 CKD patients without cardiovascular symptoms and 55 controls were evaluated by standard and 2DST echocardiograms. The level of significance was set at 5% (p<0.05). Results: Patients and controls had similar age [9.78 (0.89 - 17.54) vs. 10.72 (1.03 -18,44) years; p = 0.41] and gender (36M:19F vs. 34M:21F; p=0.84). There were 25 non-dialysis patients and 30 dialysis patients. Left ventricular ejection fraction was >= 55% in all of them. Comparing CKD and controls, LA reservoir strain was lower (48.22 +/- 10.62% vs. 58.52 +/- 10.70%) and LA stiffness index was higher [0.14 (0.08-0.48)% -1 vs. 0.11 (0.06-0.23) % -1 ]; p<0.0001. LV hypertrophy was associated with lower LA reservoir strain (42.05 +/- 8.74% vs. 52.99 +/- 9.52%), higher LA stiffness [0.23(0.11 - 0.48)% -1 vs. 0.13 (0.08-0.23) % -1 and filling indexes (2.39 +/- 0.63 cm/s x % -1 vs. 1.74 +/- 0.47 cm/s x % (-1) ; p<0.0001. Uncontrolled hypertension was associated with lower LA reservoir strain (41.9 +/- 10.6% vs. 50.6 +/- 9.7; p=0.005). Conclusions: LA strain proved to be a feasible tool in the assessment of pediatric CKD patients and was associated with known cardiovascular risk factors.