VERA MARIA CURY SALEMI
Projetos de Pesquisa
Unidades Organizacionais
LIM/65, Hospital das Clínicas, Faculdade de Medicina
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
5 resultados
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- Heart failure recognition using human voice analysis and artificial intelligence(2023) FIRMINO, Joao Vitor; MELO, Marcelo; SALEMI, Vera; BRINGEL, Kamilla; LEONE, Davi; PEREIRA, Renner; RODRIGUES, MarceloHeart failure (HF) is a clinical syndrome that disables the heart from pumping blood to effectively nourish the body or does it to elevated intracardiac pressures. Currently, the main diagnostic methods for this pathology are performed clinically by the measurement of biomarkers such as B-type natriuretic peptide (BNP), and by cardiac imaging methods. As cardiovascular diseases are the primary causes of premature death, new technologies to identify these diseases at an early stage are of great importance. Thus, this research presents the development of two artificial neural networks (ANNs), one for each gender, that recognize the vocal distortions caused by HF in an individual. Therefore, the voices of 142 individuals were collected, separated by sex and age. Among these 142, 84 voices of people already diagnosed with HF were collected at the Heart Institute of Sao Paulo University (INCOR-USP) and the Metropolitan Hospital of Paraiba. Also, the voices of 58 healthy individuals were collected in an extra-hospital environment. Then, the following techniques were applied to extract the signals' features: statistical analysis, FFT, discrete wavelet transform, and Mel-Cepstral analysis. The selected features were used to develop ANNs that aim to identify HF. Both ANNs achieved an efficiency of 96.7%. Also, values of 91.86%; 88.1%; and 92.1% were obtained for accuracy, sensitivity, and specificity, respectively. Therefore, comparing the results reached by this research to other studies in the field, it is possible to conclude that the use of voice analysis represents a great improvement in HF recognition and early treatment.
- Sympathetic Neural Overdrive, Aortic Stiffening, Endothelial Dysfunction, and Impaired Exercise Capacity in Severe COVID-19 Survivors: A Mid-Term Study of Cardiovascular Sequelae(2023) FARIA, Diego; MOLL-BERNARDES, Renata J.; TESTA, Laura; MONIZ, Camila M. V.; RODRIGUES, Erika C.; RODRIGUES, Amanda G.; ARAUJO, Amanda; ALVES, Maria J. N. N.; ONO, Bruna E.; IZAIAS, Joao E.; SALEMI, Vera M. C.; JORDAO, Camila P.; AMARO-VICENTE, Graziela; RONDON, Maria U. P. B.; LUDWIG, Katelyn R.; CRAIGHEAD, Daniel H.; ROSSMAN, Matthew J.; CONSOLIM-COLOMBO, Fernanda M.; ANGELIS, Katia De; IRIGOYEN, Maria C. C.; SEALS, Douglas R.; NEGRAO, Carlos E.; SALES, Allan R. K.Background:COVID-19 has become a dramatic health problem during this century. In addition to high mortality rate, COVID-19 survivors are at increased risk for cardiovascular diseases 1-year after infection. Explanations for these manifestations are still unclear but can involve a constellation of biological alterations. We hypothesized that COVID-19 survivors compared with controls exhibit sympathetic overdrive, vascular dysfunction, cardiac morpho-functional changes, impaired exercise capacity, and increased oxidative stress. Methods:Nineteen severe COVID-19 survivors and 19 well-matched controls completed the study. Muscle sympathetic nerve activity (microneurography), brachial artery flow-mediated dilation and blood flow (Doppler-Ultrasound), carotid-femoral pulse wave velocity (Complior), cardiac morpho-functional parameters (echocardiography), peak oxygen uptake (cardiopulmonary exercise testing), and oxidative stress were measured similar to 3 months after hospital discharge. Complementary experiments were conducted on human umbilical vein endothelial cells cultured with plasma samples from subjects. Results:Muscle sympathetic nerve activity and carotid-femoral pulse wave velocity were greater and brachial artery flow-mediated dilation, brachial artery blood flow, E/e ' ratio, and peak oxygen uptake were lower in COVID-19 survivors than in controls. COVID-19 survivors had lower circulating antioxidant markers compared with controls, but there were no differences in plasma-treated human umbilical vein endothelial cells nitric oxide production and reactive oxygen species bioactivity. Diminished peak oxygen uptake was associated with sympathetic overdrive, vascular dysfunction, and reduced diastolic function in COVID-19 survivors. Conclusions:Our study revealed that COVID-19 survivors have sympathetic overactivation, vascular dysfunction, cardiac morpho-functional changes, and reduced exercise capacity. These findings indicate the need for further investigation to determine whether these manifestations are persistent longer-term and their impact on the cardiovascular health of COVID-19 survivors.
- Position Statement on the Use of Myocardial Strain in Cardiology Routines by the Brazilian Society of Cardiology's Department Of Cardiovascular Imaging-2023(2023) ALMEIDA, Andre Luiz Cerqueira; MELO, Marcelo Dantas Tavares de; BIHAN, David Costa de Souza Le; VIEIRA, Marcelo Luiz Campos; PENA, Jose Luiz Barros; CASTILLO, Jose Maria Del; ABENSUR, Henry; HORTEGAL, Renato de Aguiar; OTTO, Maria Estefania Bosco; PIVETA, Rafael Bonafim; DANTAS, Maria Rosa; ASSEF, Jorge Eduardo; BECK, Adenalva Lima de Souza; SANTO, Thais Harada Campos Espirito; SILVA, Tonnison de Oliveira; SALEMI, Vera Maria Cury; ROCON, Camila; LIMA, Marcio Silva Miguel; BARBERATO, Silvio Henrique; RODRIGUES, Ana Clara; RABSCHKOWISKY, Arnaldo; FROTA, Daniela do Carmo Rassi; GRIPP, Eliza de Almeida; BARRETTO, Rodrigo Bellio de Mattos; SILVA, Sandra Marques e; CAUDURO, Sanderson Antonio; PINHEIRO, Aurelio Carvalho; ARAUJO, Salustiano Pereira de; TRESSINO, Cintia Galhardo; SILVA, Carlos Eduardo Suaide; MONACO, Claudia Gianini; PAIVA, Marcelo Goulart; FISHER, Claudio Henrique; ALVES, Marco Stephan Lofrano; GRAU, Claudia R. Pinheiro de Castro; SANTOS, Maria Veronica Camara dos; GUIMARAES, Isabel Cristina Britto; MORHY, Samira Saady; LEAL, Gabriela Nunes; SOARES, Andressa Mussi; CRUZ, Cecilia Beatriz Bittencourt Viana; GUIMARAES FILHO, Fabio Villaca; ASSUNCAO, Bruna Morhy Borges Leal; FERNANDES, Rafael Modesto; SARAIVA, Roberto Magalhaes; TSUTSUI, Jeane Mike; SOARES, Fabio Luis de Jesus; FALCAO, Sandra Nivea dos Reis Saraiva; HOTTA, Viviane Tiemi; ARMSTRONG, Anderson da Costa; HYGIDIO, Daniel de Andrade; MIGLIORANZA, Marcelo Haertel; CAMAROZANO, Ana Cristina; LOPES, Marly Maria Uellendahl; CERCI, Rodrigo Julio; SIQUEIRA, Maria Eduarda Menezes de; TORREAO, Jorge Andion; ROCHITTE, Carlos Eduardo; FELIX, Alex
- Morphological and functional cardiac alterations in children with congenital Zika syndrome and severe neurological deficits(2023) BARBOSA, Imara Correia de Queiroz; GOMES, Luizabel de Paula; FEITOSA, Israel Nilton de Almeida; BOTELHO, Luis Fabio Barbosa; BARBOSA, Bruno Robalinho Cavalcanti; BARBOSA, Alex; ARAUJO, Andre Telis de Vilela; MELO, Marcelo Dantas Tavares de; MELO, Adriana Suely de Oliveira; SALEMI, Vera Maria CuryIntroductionZika virus infection during pregnancy causes fetal microcephaly and brain damage. Congenital Zika syndrome (CZS) is characterized by systemic involvement with diffuse muscle impairment, a high frequency of arthrogryposis, and microphthalmia. Cardiac impairment in CZS has rarely been evaluated. Our study assessed morphology and biventricular cardiac function in children with CZS and advanced neurological dysfunction.Methods This cross-sectional study was conducted on 52 children with CZS (Zika group; ZG) and 25 healthy children (control group; CG) in Paraiba, Brazil. Clinical evaluation, electrocardiogram (EKG), and transthoracic echocardiogram (TTE) were performed on all children. Additionally, troponin I and natriuretic peptide type B (BNP) levels, the degree of cerebral palsy, and neuroimaging findings were assessed in the ZG group.Results The median age of the study population was 5 years in both groups, and 40.4% (ZG) and 60% (CG) were female. The most prevalent electrocardiographic alteration was sinus arrhythmia in both the ZG (n = 9, 17.3%) and CG (n = 4, 16%). The morphological parameters adjusted for Z score were as follows: left ventricular (LV) end-diastolic diameter in ZG: -2.36 [-5.10, 2.63] vs. CG: -1.07 [-3.43, 0.61], p<0.001); ascending aorta (ZG: -0.09 [-2.08, 1.60] vs. CG: 0.43 [-1.47, 2.2], p = 0.021); basal diameter of the right ventricle (RV) (ZG: -2.34 [-4.90, 0.97] vs. CG: -0.96 [-2.21, 0.40], p<0.01); and pulmonary artery dimension (ZG: -2.13 [-5.99, 0.98] vs. CG: -0.24 [-2.53, 0.59], p<0.01). The ejection fractions (%) were 65.7 and 65.6 in the ZG and CG, respectively (p = 0.968). The left atrium volume indices (mL/m2) in the ZG and CG were 13.15 [6.80, 18.00] and 18.80 [5.90, 25.30] (p<0.01), respectively, and the right atrium volume indices (mL/m2) were 10.10 [4.90, 15.30] and 15.80 [4.10, 24.80] (p<0.01). The functional findings adjusted for Z score were as follows: lateral systolic excursion of the mitral annular plane (MAPSE) (ZG: 0.36 [-2.79, 4.71] vs. CG: 1.79 [-0.93, 4.5], p = 0.001); tricuspid annular plane systolic excursion (TAPSE) (ZG: -2.43 [-5.47, 5.09] vs. CG: 0.07 [-1.98, 3.64], p<0.001); and the S' of the RV (ZG: 1.20 [3.35, 2.90] vs. CG: -0.20 [-2.15, 1.50], p = 0.0121). No differences in biventricular strain measurements were observed between the groups. Troponin I and BNP levels were normal in in the ZG. Grade V cerebral palsy and subcortical calcification were found in 88.6% and 97.22% of children in the ZG group, respectively.Conclusion A reduction in cardiac dimensions and functional changes were found in CZS patients, based on the TAPSE, S' of the RV, and MAPSE, suggesting the importance of cardiac evaluation and follow-up in this group of patients.
- Neurovascular and hemodynamic responses to mental stress and exercise in severe COVID-19 survivors(2023) FARIA, Diego; MOLL-BERNARDES, Renata; TESTA, Laura; MONIZ, Camila M. V.; RODRIGUES, Erika C.; MOTA, Jose M.; SOUZA, Francis R.; ALVES, Maria Janieire N. N.; ONO, Bruna E.; IZAIAS, Joao E.; SALES, Artur O.; RODRIGUES, Thais S.; SALEMI, Vera M. C.; JORDAO, Camila P.; ANGELIS, Katia De; CRAIGHEAD, Daniel H.; ROSSMAN, Matthew J.; BORTOLOTTO, Luiz A.; CONSOLIM-COLOMBO, Fernanda M.; IRIGOYEN, Maria C. C.; SEALS, Douglas R.; NEGRAO, Carlos E.; SALES, Allan R. K.Previous studies show that COVID-19 survivors have elevated muscle sympathetic nerve activity (MSNA), endothelial dysfunction, and aortic stiffening. However, the neurovascular responses to mental stress and exercise are still unexplored. We hypothesized that COVID-19 survivors, compared with age-and body mass index (BMI)-matched control subjects, exhibit abnormal neurovascular responses to mental stress and physical exercise. Fifteen severe COVID-19 survivors (aged: 49 +/- 2 yr, BMI: 30 +/- 1 kg/m(2)) and 15 well-matched control subjects (aged: 46 +/- 3 yr, BMI: 29 +/- 1 kg/m(2)) were studied. MSNA (microneurography), forearm blood flow (FBF), and forearm vascular conductance (FVC, venous occlusion plethysmography), mean arterial pressure (MAP, Finometer), and heart rate (HR, ECG) were measured during a 3-min mental stress (Stroop Color-Word Test) and during a 3-min isometric handgrip exercise (30% of maximal voluntary contraction). During mental stress, MSNA (frequency and incidence) responses were higher in COVID-19 survivors than in controls (P < 0.001), and FBF and FVC responses were attenuated (P < 0.05). MAP was similar between the groups (P > 0.05). In contrast, the MSNA (frequency and incidence) and FBF and FVC responses to handgrip exercise were similar between the groups (P > 0.05). MAP was lower in COVID-19 survivors (P < 0.05). COVID-19 survivors exhibit an exaggerated MSNA and blunted vasodilatory response to mental challenge compared with healthy adults. However, the neurovascular response to handgrip exercise is preserved in COVID-19 survivors. Overall, the abnormal neurovascular control in response to mental stress suggests that COVID-19 survivors may have an increased risk to cardiovascular events during mental challenge.