DESIDERIO FAVARATO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
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- Red wine consumption, coronary calcification, and long-term clinical evolution(2018) LUZ, P. L. da; FAVARATO, D.; MORIGUCHI, E. H.; CARLI, W. de; BRUSCATO, N.; I, R. Mochiduky; SCHWARTZMAN, P.; ROCHITTE, C. E.; LAURINDO, F. R.Coronary artery calcification (CAC) is associated with atherosclerotic complications. However, elevated CAC may not always imply a worse prognosis. Herein, we report the clinical evolution of long-term red wine (RW) drinkers in relation to CAC. We followed 200 healthy male habitual RW drinkers and compared them to 154 abstainers for a period of 5.5 years. The initial evaluation included coronary computed tomography angiography (CTA), clinical, demographics, and laboratory data. CAC was quantified by the Agatston score. The follow-up process was conducted by telephone calls and/or hospital record review. The composite end-point of total death, acute myocardial infarction (AMI), or coronary revascularization (or major adverse cardiac event - MACE) was assessed. The RW drinkers ingested 28.9 +/- 15 g of alcohol/day for 23.4 +/- 12.3 years. They had higher high-density lipoprotein and low-density lipoprotein, but lower C-reactive protein than abstainers. Age, total cholesterol, triglycerides, glucose, and liver enzymes were similar. History of diabetes was lower among drinkers, but other risk factors were similar. However, drinkers had higher CAC than abstainers; the mean value was 131.5 +/- 362 in drinkers vs 40.5 +/- 320 in abstainers (P <0.001). The median and interquartile range were 15 (0.0-131.5) in RW drinkers and 1 (0.0-40.5) in abstainers (P=0.003). During the follow-up, MACE was significantly lower in drinkers than in abstainers, despite their higher CAC. The difference was driven mainly by AMI (0 vs 6; P <0.03). Greater CAC values in this setting did not predict worse prognosis. A possible underlying mechanism is lesion calcification, which leads to plaque stabilization and less clinical events.
- Case 1/2018-Young Male with Heart Disease Expressed Mainly as Ventricular Arrhythmia, Right Ventricular Dysfunction and Syncope(2018) FAVARATO, Desiderio; BENVENUTI, Luiz Alberto
- Action of Red Wine and Polyphenols Upon Endothelial Function and Clinical Events(2018) LUZ, P. L. da; FAVARATO, D.; BERWANGER, O.There is a strong epidemiological association between moderate consumption of alcoholic beverages, such as red wine, and other sources of polyphenols and the reduction of cardiovascular disease and mortality. Also, protective effects against atherogenic lipid profile, platelet activation, and systemic inflammation have been noted in observational studies. Glucose metabolism is also positively affected by polyphenols reducing the incidence of diabetes mellitus. Long-term consumption of moderate amounts of red wine consistently increases HDL. Polyphenols increase endothelial nitric oxide production, and decrease the endothelial abundance of endothelin-1. Resveratrol, the most abundant polyphenol of red wine, has been associated with prolongation of life span in animal experiments, and cognition preservation in humans. © 2018 Elsevier Inc. All rights reserved.
- Case 4-A 59-Year-Old Woman with Rheumatic Mitral Valve Disease (Severe Stenosis and Regurgitation), Severe Dyspnea, Shock and Pulmonary Condensation(2018) AIELLO, Vera Demarchi; FAVARATO, Desiderio
- Endothelial Function and Cardiovascular Risk Factors(2018) FAVARATO, D.; LUZ, P. L. daEndothelial dysfunction is the link between risk factors and atherosclerosis related diseases. Thus, their evaluation discloses the impact risk factors of upon endothelial functional and it is predictive of cardiovascular outcome in persons affected by them. Endothelial function suffers prejudice proportional to total cholesterol, LDL-cholesterol, and HDL-cholesterol levels, hyperglycemia, physical inactivity, aging, blood pressure, and tobacco smoke exposition as has been observed in several clinical studies. It is also affected by family history for coronary disease and gender. An important feature is that endothelial dysfunction precedes clinical manifestations of coronary artery disease; therefore endothelial dysfunction is a marker of atherosclerosis. Importantly, endothelial dysfunction of peripheral arteries correlates with alterations in coronary circulation. We may use the endothelial function evaluation to assess prognosis the effectiveness of medication or life style modification prescribed to patients. Furthermore corrections of risk factors improves endothelial dysfunction. © 2018 Elsevier Inc. All rights reserved.