CHARLES MADY
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
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 - Líder
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 - Líder
11 resultados
Resultados de Busca
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conferenceObject Effects of sympathectomy on myocardium(2014) JORDAO, M.; RAMIRES, F.; PESSOA, F.; FONSECA, K.; ZANONI, F.; SOUZA, L.; SALEMI, V.; MADY, C.- Clinical predictors of a positive genetic test in hypertrophic cardiomyopathy in the Brazilian population(2014) MARSIGLIA, Julia Daher Carneiro; CREDIDIO, Flavia Laghi; OLIVEIRA, Theo Gremen Mimary de; REIS, Rafael Ferreira; ANTUNES, Murillo de Oliveira; ARAUJO, Aloir Queiroz de; PEDROSA, Rodrigo Pinto; BARBOSA-FERREIRA, Joao Marcos Bemfica; MADY, Charles; KRIEGER, Jose Eduardo; ARTEAGA-FERNANDEZ, Edmundo; PEREIRA, Alexandre CostaBackground: Hypertrophic cardiomyopathy is a genetic autosomal dominant disease characterized by left ventricular hypertrophy. The molecular diagnosis is important but still expensive. This work aimed to find clinical predictors of a positive genetic test in a Brazilian tertiary centre cohort of index cases with HCM. Methods: In the study were included patients with HCM clinical diagnosis. For genotype x phenotype comparison we have evaluated echocardiographic, electrocardiographic, and nuclear magnetic resonance measures. All patients answered a questionnaire about familial history of HCM and/or sudden death. beta myosin heavy chain, myosin binding protein C, and troponin T genes were sequenced for genetic diagnosis. Results: The variables related to a higher probability of a positive genetic test were familial history of HCM, higher mean heart frequency, presence of NSVT and lower age. Probabilities of having a positive molecular genetic test were calculated from the final multivariate logistic regression model and were used to identify those with a higher probability of a positive molecular diagnosis. Conclusions: We developed an easy and fast screening method that takes into account only clinical data that can help to select the patients with a high probability of positive genetic results from molecular sequencing of Brazilian HCM patients.
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 Neurovascular Control and Spontaneous Baroreflex Sensitivity in Heart Failure Patients with Preserved Ejection Fraction(2014) SAYEGH, Ana Luiza C.; SANTOS, Marcelo R. dos; SOUZA, Francis R. de; SALEMI, Vera Maria C.; OLIVEIRA, Carlos Augusto P.; FONSECA, Felipe X.; RODRIGUES, Sara; TROMBETTA, Ivani C.; TOSCHI-DIAS, Edgar; NEGRAO, Carlos Eduardo; ALVES, Maria-Janieire N.; MADY, CharlesconferenceObject Chagas cardiomyopathy : prognostic value of genetic polymorphisms of TNF -alpha(2014) ALVES, S. M.; VIEIRA, J. Lannes; ARNEZ, L. E. A.; MORAES, M. O.; OLIVEIRA JR., W. A.; SARTESCHI, C.; MELO, M. G. A.; RAMIRES, F. J. A.; MADY, C.conferenceObject The role of erythropoieitin upon myocardial fibrosis(2014) PESSOA, FFernanda; RAMIRES, F.; FONSECA, K.; OLIVEIRA, A.; SALEMI, V.; FERNANDES, F.; MADY, C.- Mortalidade e Potencial Embólico dos Tumores Cardíacos(2014) DIAS, Ricardo Ribeiro; FERNANDES, Fabio; RAMIRES, Felix Jose Alvarez; MADY, Charles; ALBUQUERQUE, Cicero Piva; JATENE, Fabio BiscegliBackground: Cardiac tumors are rare, mostly benign with high embolic potential. Objectives: To correlate the histological type of cardiac masses with their embolic potential, implantation site and long term follow up in patients undergoing surgery. Methods: Between January 1986 and December 2011, we retrospectively analyzed 185 consecutive patients who underwent excision of intracardiac mass (119 females, mean age 48 +/- 20 years). In 145 patients, the left atrium was the origin site. 72% were asymptomatic and prior embolization was often observed (19.8%). The diagnosis was established by echocardiography, magnetic resonance and histological examination. Results: Most tumors were located in the left side of the heart. Myxoma was the most common (72.6%), followed by fibromas (6.9%), thrombi (6.4%) and sarcomas (6.4%). Ranging from 0.6cm to 15cm (mean 4.6 +/- 2.5cm) 37 (19.8%) patients had prior embolization, stroke 10.2%, coronary 4.8%, peripheral 4.3% 5.4% of hospital death, with a predominance of malignant tumors (40% p < 0.0001). The histological type was a predictor of mortality (rhabdomyomas and sarcomas p = 0.002) and embolic event (sarcoma, lipoma and fibroelastoma p = 0.006), but not recurrence. Tumor size, atrial fibrillation, cavity and valve impairment were not associated with the embolic event. During follow-up (mean 80 +/- 63 months), there were 2 deaths (1.1%) and two recurrences 1 and 11 years after the operation, to the same cavity. Conclusion: Most tumors were located in the left side of the heart. The histological type was predictor of death and preoperative embolic event, while the implantation site carries no relation with mortality or to embolic event.
conferenceObject The Role of Air Pollution upon Myocardial Remodeling(2014) FONOFF, Adriana M. O.; RAMIRES, Felix Jose Alvarez; FONSECA, Keila Barbosa; SALEMI, Vera Maria Cury; PESSOA, Fernanda Gallinaro; SALDIVA, Paulo Hilario; MADY, Charles- Plasma Cytokine Profile in Tropical Endomyocardial Fibrosis: Predominance of TNF-a, IL-4 and IL-10(2014) BOSSA, Aline S.; SALEMI, Vera M. C.; RIBEIRO, Susan P.; ROSA, Daniela S.; FERREIRA, Ludmila Rodrigues Pinto; FERREIRA, Suzete C.; NISHIYA, Anna Shoko; MADY, Charles; KALIL, Jorge; CUNHA-NETO, EdecioBackground: The participation of immune/inflammatory mechanisms in the pathogenesis of tropical endomyocardial fibrosis (EMF) has been suggested by the finding of early blood and myocardial eosinophilia. However, the inflammatory activation status of late-stage EMF patients is still unknown. Methodology/Principal findings: We evaluated pro- and anti-inflammatory cytokine levels in plasma samples from late stage EMF patients. Cytokine levels of Tumor Necrosis Factor (TNF)-alpha, Interferon (IFN)-gamma, Interleukin (IL)-2, IL-4, IL-6, and IL-10 were assayed in plasma samples from 27 EMF patients and compared with those of healthy control subjects. All EMF patients displayed detectable plasma levels of at least one of the cytokines tested. We found that TNF-alpha, IL-6, IL-4, and IL-10 were each detected in at least 74% of tested sera, and plasma levels of IL-10, IL-4, and TNF-alpha were significantly higher than those of controls. Plasma levels of such cytokines positively correlated with each other. Conclusions/Significance: The mixed pro-and anti-inflammatory/Th2circulating cytokine profile in EMF is consistent with the presence of a persistent inflammatory stimulus. On the other hand, the detection of increased levels of TNF-alpha may be secondary to the cardiovascular involvement observed in these patients, whereas IL-4 and IL-10 may have been upregulated as a homeostatic mechanism to buffer both production and deleterious cardiovascular effects of pro-inflammatory cytokines. Further studies might establish whether these findings play a role in disease pathogenesis.
- Cardiac Impairment Evaluated by Transesophageal Echocardiography and Invasive Measurements in Rats Undergoing Sinoaortic Denervation(2014) SIRVENTE, Raquel A.; IRIGOYEN, Maria C.; SOUZA, Leandro E.; MOSTARDA, Cristiano; FUENTE, Raquel N. La; CANDIDO, Georgia O.; SOUZA, Pamella R. M.; MEDEIROS, Alessandra; MADY, Charles; SALEMI, Vera M. C.Background: Sympathetic hyperactivity may be related to left ventricular (LV) dysfunction and baro- and chemoreflex impairment in hypertension. However, cardiac function, regarding the association of hypertension and baroreflex dysfunction, has not been previously evaluated by transesophageal echocardiography (TEE) using intracardiac echocardiographic catheter. Methods and Results: We evaluated exercise tests, baroreflex sensitivity and cardiovascular autonomic control, cardiac function, and biventricular invasive pressures in rats 10 weeks after sinoaortic denervation (SAD). The rats (n = 32) were divided into 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 (SHRSAD) (n = 8). Blood pressure (BP) and heart rate (HR) did not change between the groups with or without SAD; however, compared to W, SHR groups had higher BP levels and BP variability was increased. Exercise testing showed that SHR had better functional capacity compared to SAD and SHRSAD. Echocardiography showed left ventricular (LV) concentric hypertrophy; segmental systolic and diastolic biventricular dysfunction; indirect signals of pulmonary arterial hypertension, mostly evident in SHRSAD. The end-diastolic right ventricular (RV) pressure increased in all groups compared to W, and the end-diastolic LV pressure increased in SHR and SHRSAD groups compared to W, and in SHRSAD compared to SAD. Conclusions: Our results suggest that baroreflex dysfunction impairs cardiac function, and increases pulmonary artery pressure, supporting a role for baroreflex dysfunction in the pathogenesis of hypertensive cardiac disease. Moreover, TEE is a useful and feasible noninvasive technique that allows the assessment of cardiac function, particularly RV indices in this model of cardiac disease.