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
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conferenceObject Impact of sympathectomy upon myocardium(2019) PESSOA, F. Fernanda; JORDAO, M. R.; FONSECA, K. C. B.; ZANONI, F.; SALEMI, V. M. C.; RIBEIRO, O. N.; SOUZA, L. E.; FERNANDES, F.; IRIGOYEN, M. C.; MOREIRA, L. F. P.; MADY, C.; RAMIRES, F. J. A.conferenceObject Echocardiographic findings of Trypanosoma cruzi seropositive blood donors(2017) SALEMI, V. M. C.; OLIVEIRA, C. D. L.; RIBEIRO, A. L.; MENEZES, M. M.; ANTUNES, A. P.; FERREIRA-FILHO, J. C.; SACHDEV, V.; FERNANDES, F.; NASTARI, L.; IANNI, B. M.; MADY, C.; CARNEIRO-PROIETTI, A. B.; KEATING, S. M.; BUSCH, M. P.; SABINO, E. G.conferenceObject Effects of sympathectomy on myocardium(2014) JORDAO, M.; RAMIRES, F.; PESSOA, F.; FONSECA, K.; ZANONI, F.; SOUZA, L.; SALEMI, V.; MADY, C.conferenceObject EMBOLIC EVENT IN A PATIENT WITH HYPERTROPHIC CARDIOMYOPATHY ANDNON-COMPACTION CARDIOMYOPATHYWITH GENE MUTATION MYBPC3: A CASE REPORT(2022) GONCALVES, Rallyson De Oliveira; MAZETTO, Amanda Bergamo; STEIN, Julien Ramos; PRESENTE, Gabrielle Darezzo; BARROSO, Natalia; ANDRADE, Ana Flavia Diez de; CAMPOS, Joaquim Tenente Ana de; ROCHA, Aroni Marceu Sousa e; SALEMI, Vera M.- Prognosis and risk stratification in patients with decompensated heart failure receiving inotropic therapy(2018) GOMES, Clara; TERHOCH, Caique Bueno; AYUB-FERREIRA, Silvia Moreira; CONCEICAO-SOUZA, Germano Emilio; SALEMI, Vera Maria Cury; CHIZZOLA, Paulo Roberto; JR, Mucio Tavares Oliveira; LAGE, Silvia Helena Gelas; FRIOES, Fernando; BOCCHI, Edimar Alcides; ISSA, Victor SarliObjectives The prognostic significance of transient use of inotropes has been sufficiently studied in recent heart failure (HF) populations. We hypothesised that risk stratification in these patients could contribute to patient selection for advanced therapies. Methods We analysed a prospective cohort of adult patients admitted with decompensated HF and ejection fraction (left ventricular ejection fraction (LVEF)) less than 50%. We explored the outcomes of patients requiring inotropic therapy during hospital admission and after discharge. Results The study included 737 patients, (64.0% male), with a median age of 58 years (IQR 48-66 years). Main aetiologies were dilated cardiomyopathy in 273 (37.0%) patients, ischaemic heart disease in 195 (26.5%) patients and Chagas disease in 163 (22.1%) patients. Median LVEF was 26 % (IQR 22%-35%). Inotropes were used in 518 (70.3%) patients. In 431 (83.2%) patients, a single inotrope was administered. Inotropic therapy was associated with higher risk of in-hospital death/urgent heart transplant (OR=10.628, 95% CI 5.055 to 22.344, p<0.001). At 180-day follow-up, of the 431 patients discharged home, 39 (9.0%) died, 21 (4.9%) underwent transplantation and 183 (42.4%) were readmitted. Inotropes were not associated with outcome (death, transplant and rehospitalisation) after discharge. Conclusions Inotropic drugs are still widely used in patients with advanced decompensated HF and are associated with a worse in-hospital prognosis. In contrast with previous results, intermittent use of inotropes during hospitalisation did not determine a worse prognosis at 180-day follow-up. These data may add to prognostic evaluation in patients with advanced HF in centres where mechanical circulatory support is not broadly available.
- Exercise training in heart failure with reduced ejection fraction and permanent atrial fibrillation: A randomized clinical trial(2022) ALVES, Leandro S.; BOCCHI, Edimar Alcides; CHIZZOLA, Paulo Roberto; CASTRO, Rafael Ertner; SALEMI, Vera Maria Cury; MELO, Marcelo Dantas Tavares de; ANDRETA, Camila Rocon de Lima; GUIMARAES, Guilherme VeigaBACKGROUND Heart failure (HF) associated with atrial fibrillation increases patients' physical inactivity, worsening their clinical condition and mortality. Exercise training is safe and has clear benefits in HF. However, little is known about the effects of exercise training on patients with HF with reduced ejection fraction and permanent atrial fibrillation (HFAF). OBJECTIVE The purpose of this study was to test the hypothesis that exercise training improves functional capacity, cardiac function, and quality of life in patients with HFAF. METHODS This randomized clinical trial was conducted at the Heart Institute. Patients with HFAF, left ventricular ejection fraction <= 40%, and resting heart rate (HR) <= 80 beats/min were included in the study. Cardiopulmonary testing, echocardiography, nervous system, and quality of life assessment were performed before and after the 12-week protocol period. RESULTS Twenty-six patients (mean age 58 +/- 1 years) were randomized to exercise training (HFAF-trained group; n = 13) or no training (HFAF-untrained group; n = 13). At baseline, no differences between the groups were found. Exercise improved peak oxygen consumption, slope of ventilation per minute/carbon dioxide production, and quality of life. The HFAF-trained group had significantly decreased resting HR (from 73 +/- 2 to 69 +/- 2 beats/ min; P = .02) and recovery HR (from 148 +/- 11 to 128 +/- 9 beats/min; P = .001). Concomitantly, left ventricular ejection fraction increased (from 31% 61% to 36% +/- 0.9%; P=.01), left atrial dimension decreased (from 52 +/- 1.2 to 47 +/- 1 mm; P = .03), and left ventricular end-systolic volume and left ventricular enddiastolic volume deceased (from 69 +/- 2 to 64 +/- 1.8 mL/m(2) and from 9962.1 to 9162 mL/m(2), respectively; P<.05). No changes were observed in the HFAF-untrained group. CONCLUSION Exercise training can improve exercise capacity, quality of life, and cardiac function in patients with HF with reduced ejection fraction and permanent atrial fibrillation.
- Usefulness of Myocardial Deformation Indices in Preventing Cardiotoxicity in Breast Cancer Patients(2019) MELO, Marcelo Dantas Tavares de; SALEMI, Vera Maria Cury
conferenceObject Brain natriuretic peptide predicts mortality in patients undergoing pericardiectomy for constrictive pericarditis(2014) MELO, D. T. P.; FERNANDES, F.; GUALANDRO, D. M.; SALEMI, V. M. C.; OLIVETTI, N. Q. S.; BUCK, P. C.; DIAS, R. R.; RAMIRES, F. J. A.; CARAMELLI, B.; MADY, C.conferenceObject A decrease in glycolytic metabolism in noncompaction cardiomyopathy - Insights into pathophysiological mechanisms(2016) MELO, M. Dantas Tavares De; GIORGI, M. Clementina; DANTAS JUNIOR, R. Nery; LIMA, C. Rocon De; PARGA FILHO, J. Roberto; SOARES JUNIOR, J.; MENEGHETTI, J. Claudio; BIERRENBACH, A. Luiza; BOCCHI, E. Alcides; SALEMI, V. M. C.conferenceObject Baroreflex and cardiac dysfunctions evaluated by transesophageal echocardiography, baroreflex sensitivity, autonomic control and invasive measurements in rats submitted to sinoaortic denervation(2012) SIRVENTE, R. A.; IRIGOYEN, M. C.; SOUZA, L.; MOSTARDA, C.; FUENTE, R. La; CANDIDO, G.; SOUZA, P.; MEDEIROS, A.; MADY, C.; SALEMI, V. M. C.Purpose: Sympathetic hyperactivity commonly seems to be related to cardiac dysfunction and baro and chemoreflexes impairment in hypertension. However, myocardial function has not been evaluated regarding the association of hypertension and baroreflex dysfunction using transesophageal echocardiography. Methods: Exercise test (ET), baroreflex sensitivity, cardiovascular autonomic control, transthoracic and transesophageal echocardiography using intracardiac echocardiographic catheter (AcuNav, Siemens, Mountain View, CA, USA), and invasively biventricular end-diastolic pressures (EDP) were evaluated in rats 10 weeks after sinoaortic denervation (SAD). The rats (n=32) were divided in 4 groups: 16 Wistar (W) with (n=8) or without SAD (n=8) and 16 spontaneously hypertensive rats (SHR) with (n=8) or without SAD (n=8). Results: Blood pressure (BP) and heart rate (HR) did not show any change between the groups SAD and without SAD, although, SHR showed higher BP levels in comparison to W. BP variability was increased in SHR groups compared to W. After SAD, BP variability increased in all groups compared to W (W: 15 mmHg2; *DSA: 49 mmHg2; *SHR: 60 mmHg2; *SHR-SAD:137 mmHg2, *p<0.05 vs. W). Exercise tests results showed that SHR had better functional capacity compared to SAD and SHRSAD (W: 1.16m/s; DSA: 0.9m/s; *SHR: 1.46; SHR-DSA: 1.02, *p<0.05 vs. SAD and SHRSAD). Left ventricular concentric hypertrophy, segmental systolic dysfunction and global diastolic LV dysfunction, segmental and global systolic dysfunction, and global diastolic RV dysfunction, indirect signals of pulmonary arterial hypertension were shown by echocardiography, mostly evident in SHRSAD. The RV-EDP increased in all groups compared to W(W:3±0.39mmHg, *SAD:4.7±0.52mmHg, *SHR: 6.6±1.1mmHg, *SHRSAD:7.8±0.87mmHg, *p<0.05 vs. W), and LV-EDP increased in SHR and SHRSAD groups compared to W, and in SHRSAD compared to SAD (W: 5,83±0,19 mmHg,SAD: 8.98±1.2 mmHg, *SHR: 12.51±4.73 mmHg, *#SHRSAD: 14.57±2.52mmHg, *p<0.05vs.W,#p<0.05 vs. DSA). There was a relation between invasive or noninvasive measurements of RV showing good accuracy of echocardiographic measurements. Conclusions: Our results suggest that baroreflex dysfunction impaired biventricular function. Moreover, the findings of RV dysfunction indicate that SAD may lead to increased pulmonary artery pressure, supporting a role for baroreflex dysfunction in the pathogenesis of the hypertensive cardiac disease.