SARA RODRIGUES
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
14 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 14
- Identifying the risk of obstructive sleep apnea in metabolic syndrome patients: Diagnostic accuracy of the Berlin Questionnaire(2019) CEPEDA, Felipe X.; VIRMONDES, Leslie; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene C. B.; TOSCHI-DIAS, Edgar; FERREIRA-CAMARGO, Fernanda C.; HUSSID, Maria Fernanda; RONDON, Maria Urbana P. B.; ALVES, Maria Janieire N. N.; TROMBETTA, Ivani C.Background Obstructive sleep apnea (OSA) is a risk factor frequently present in patients with metabolic syndrome (MetS). Additionally, moderate and severe OSA are highly prevalent in patients with cardiac disease, as they increase the riskfor cardiovascular events by 80%. The gold standard diagnostic method for OSA is overnight polysomnography (PSG), which remains unaffordable for the overall population. The aim of the present study was to evaluate whether the Berlin Questionnaire (BQ) is anuseful tool for assessing the risk of OSA in patients with MetS. Methods 97 patients, previously untreated and recently diagnosed with MetS (National Cholesterol Education Program, Adult Treatment Panel III, ATP-III) underwent a PSG. OSA was characterized by the apnea-hypopnea index (AHI). BQ was administered before PSG and we evaluated sensitivity, specificity, positive and negative predictive values, and accuracy. Results Of the 97 patients with MetS, 81 patients had OSA, with 47 (48.5%) presenting moderate and severe OSA. For all MetS with OSA (AHI >= 5 events/hour), the BQ showed good sensitivity (0.65, 95% CI 0.54 to 0.76) and fair specificity (0.38, 95% CI 0.15-0.65) with a positive predictive value of 0.84, a negative predictive value of 0.18 and an 84% accuracy. Similarly, for moderate-to-severe OSA (AHI >= 15 events/hour) we found good sensitivity (0.73, 95% CI 0.58-0.85) and fair specificity (0.40, 95% CI 0.27-0.55). Interestingly, for severe OSA (AHI. 30 events/hour), there was a very good sensitivity (0.91, 95% CI 0.72-0.99) and moderate specificity (0.42, 95% CI 0.31-0.54). Conclusion The BQ is a valid tool for screening the risk of OSA in MetS patients in general, and it is particularly useful in predicting severe OSA.
conferenceObject Hypocaloric diet and exercise training improve postexercise sympatho-vagal balance in patients with metabolic syndrome and obstructive sleep apnea(2014) CEPEDA, F. X.; TOSCHI-DIAS, E.; MAKI-NUNES, C.; RODRIGUES, S.; RONDON, M. U. P. B.; DRAGER, L. F.; ALVES, M. J. N. N.; LORENZI-FILHO, G.; NEGRAO, C. E.; TROMBETTA, I. C.- Exaggerated Exercise Blood Pressure as a Marker of Baroreflex Dysfunction in Normotensive Metabolic Syndrome Patients(2021) DUTRA-MARQUES, Akothirene C.; RODRIGUES, Sara; CEPEDA, Felipe X.; TOSCHI-DIAS, Edgar; RONDON, Eduardo; CARVALHO, Jefferson C.; ALVES, Maria Janieire N. N.; BRAGA, Ana Maria F. W.; RONDON, Maria Urbana P. B.; TROMBETTA, Ivani C.Introduction Exaggerated blood pressure response to exercise (EEBP = SBP >= 190 mmHg for women and >= 210 mmHg for men) during cardiopulmonary exercise test (CPET) is a predictor of cardiovascular risk. Sympathetic hyperactivation and decreased baroreflex sensitivity (BRS) seem to be involved in the progression of metabolic syndrome (MetS) to cardiovascular disease. Objective To test the hypotheses: (1) MetS patients within normal clinical blood pressure (BP) may present EEBP response to maximal exercise and (2) increased muscle sympathetic nerve activity (MSNA) and reduced BRS are associated with this impairment. Methods We selected MetS (ATP III) patients with normal BP (MetS_NT, n = 27, 59.3% males, 46.1 +/- 7.2 years) and a control group without MetS (C, n = 19, 48.4 +/- 7.4 years). We evaluated BRS for increases (BRS+) and decreases (BRS-) in spontaneous BP and HR fluctuations, MSNA (microneurography), BP from ambulatory blood pressure monitoring (ABPM), and auscultatory BP during CPET. Results Normotensive MetS (MetS_NT) had higher body mass index and impairment in all MetS risk factors when compared to the C group. MetS_NT had higher peak systolic BP (SBP) (195 +/- 17 vs. 177 +/- 24 mmHg, P = 0.007) and diastolic BP (91 +/- 11 vs. 79 +/- 10 mmHg, P = 0.001) during CPET than C. Additionally, we found that MetS patients with normal BP had lower spontaneous BRS- (9.6 +/- 3.3 vs. 12.2 +/- 4.9 ms/mmHg, P = 0.044) and higher levels of MSNA (29 +/- 6 vs. 18 +/- 4 bursts/min, P < 0.001) compared to C. Interestingly, 10 out of 27 MetS_NT (37%) showed EEBP (MetS_NT+), whereas 2 out of 19 C (10.5%) presented (P = 0.044). The subgroup of MetS_NT with EEBP (MetS_NT+, n = 10) had similar MSNA (P = 0.437), but lower BRS+ (P = 0.039) and BRS- (P = 0.039) compared with the subgroup without EEBP (MetS_NT-, n = 17). Either office BP or BP from ABPM was similar between subgroups MetS_NT+ and MetS_NT-, regardless of EEBP response. In the MetS_NT+ subgroup, there was an association of peak SBP with BRS- (R = -0.70; P = 0.02), triglycerides with peak SBP during CPET (R = 0.66; P = 0.039), and of triglycerides with BRS- (R = 0.71; P = 0.022). Conclusion Normotensive MetS patients already presented higher peak systolic and diastolic BP during maximal exercise, in addition to sympathetic hyperactivation and decreased baroreflex sensitivity. The EEBP in MetS_NT with apparent well-controlled BP may indicate a potential depressed neural baroreflex function, predisposing these patients to increased cardiovascular risk.
conferenceObject IMPACT OF PREVIOUS HYPERTENSIVE DISORDER DURING PREGNANCY ON ANTHROPOMETRIC MEASUREMENTS, 24-HOUR BLOOD PRESSURE AND ARTERIAL STIFFNESS(2021) VERARDINO, Renata; RODRIGUES, Sara; BERGER, Ana; COSTA-HONG, Valeria; MACEDO, Thiago; BAPTISTA, Fernanda; BORTOLOTTO, Maria; FRANCISCO, Rossana; ZUGAIB, Marcelo; BORTOLOTTO, LuizconferenceObject Obstructive sleep apnea impairs insulin resistance in metabolic syndrome patients with normal levels of glucose(2016) CEPEDA, Felipe Xerez; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene C. B.; CARVALHO, Jefferson Cabral; TOSCHI-DIAS, Edgar; JORDAO, Camila Paixao; RONDON, Maria Urbana; ALVES, Maria Janieire N. N.; LORENZI-FILHO, Geraldo; TROMBETTA, Ivani CredidioconferenceObject Diet and Exercise Training Improve Insulin-Glucose Metabolism and Sympathetic Hyperactivation in Obstructive Sleep Apnea and Metabolic Syndrome(2017) CEPEDA, Felipe X.; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene C. B.; CARVALHO, Jefferson C.; TOSCHI-DIAS, Edgar; RONDON, Maria Urbana P. B.; ALVES, Maria Janieire N. N.; LORENZI-FILHO, Geraldo; TROMBETTA, Ivani C.- Arterial stiffness and its association with clustering of metabolic syndrome risk factors(2017) LOPES-VICENTE, Wanda R. P.; RODRIGUES, Sara; CEPEDA, Felipe X.; JORDAO, Camila Paixao; COSTA-HONG, Valeria; DUTRA-MARQUES, Akothirene C. B.; CARVALHO, Jefferson C.; ALVES, Maria Janieire N. N.; BORTOLOTTO, Luiz A.; TROMBETTA, Ivani C.Background: Metabolic syndrome (MetS) is associated with structural and functional vascular abnormalities, which may lead to increased arterial stiffness, more frequent cardiovascular events and higher mortality. However, the role played by clustering of risk factors and the combining pattern of MetS risk factors and their association with the arterial stiffness have yet to be fully understood. Age, hypertension and diabetes mellitus seem to be strongly associated with increased pulse wave velocity (PWV). This study aimed at determining the clustering and combining pattern of MetS risk factors and their association with the arterial stiffness in non-diabetic and non-hypertensive patients. Methods: Recently diagnosed and untreated patients with MetS (n = 64, 49 +/- 8 year, 32 +/- 4 kg/m(2)) were selected, according to ATP III criteria and compared to a control group (Control, n = 17, 49 +/- 6 year, 27 +/- 2 kg/m(2)). Arterial stiffness was evaluated by PWV in the carotid-femoral segment. Patients were categorized and analyzed according MetS risk factors clustering (3, 4 and 5 factors) and its combinations. Results: Patients with MetS had increased PWV when compared to Control (7.8 +/- 1.1 vs. 7.0 +/- 0.5 m/s, p < 0.001). In multivariate analysis, the variables that remained as predictors of PWV were age (beta = 0.450, p < 0.001), systolic blood pressure (beta = 0.211, p = 0.023) and triglycerides (beta = 0.212, p = 0.037). The increased number of risk factors reflected in a progressive increase in PWV. When adjusted to systolic blood pressure, PWV was greater in the group with 5 risk factors when compared to the group with 3 risk factors and Control (8.5 +/- 0.4 vs. 7.5 +/- 0.2, p = 0.011 and 7.2 +/- 0.3 m/s, p = 0.012). Similarly, the 4 risk factors group had higher PWV than the Control (7.9 +/- 0.2 vs. 7.2 +/- 0.3, p = 0.047). Conclusions: The number of risk factors seems to increase arterial stiffness. Notably, besides age and increased systolic blood pressure, alterations in the triglycerides worsened the stiffness of large vessels, emphasizing the importance in addressing this risk factor in MetS patients.
conferenceObject Insulin Resistance Impairs Arterial Stiffness and Peripheral Vascular Resistance in Metabolic Syndrome Patients(2015) RODRIGUES, Sara; CEPEDA, Felipe; DUTRA-MARQUES, Akothirene; CARVALHO, Jefferson; TOSCHI-DIAS, Edgar; MAKI-NUNES, Cristiane; BORTOLOTTO, Luiz; COSTA-HONG, Valeria; RONDON, Maria; ALVES, Maria; NEGRAO, Carlos; TOMBETTA, IvaniconferenceObject Berlin Questionnaire is a Useful Tool to Identify Risk of Obstructive Sleep Apnea in Metabolic Syndrome Patients(2017) CEPEDA, Felipe Xerez; VIRMONDES, Leslie; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene C. B.; CARVALHO, Jefferson C.; TOSCHI-DIAS, Edgar; ALVES, Maria Janieire N. N.; RONDON, Maria Urbana P. B.; LOPES-VICENTE, Wanda R. P.; HUSSID, Maria Fernanda; LORENZI-FILHO, Geraldo; TROMBETTA, Ivani C.conferenceObject Oxygen uptake efficiency slope in patients with metabolic syndrome and obstructive sleep apnea(2016) CARVALHO, Jefferson Cabral; CEPEDA, Felipe Xerez; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene Cristhina Brisolla; TOSCHI-DIAS, Edgar; RONDON, Maria Urbana Pinto Brandao; ALVES, Maria-Janieire Nazare Nunes; BRAGA, Ana Maria Fonseca Wanderley; LORENZI-FILHO, Gerald; TROMBETTA, Ivani Credidio