GUILHERME SOBREIRA SPINA
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Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
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article 17 Citação(ões) na Scopus Natriuretic Peptides and Long-Term Mortality in Patients with Severe Aortic Stenosis(2012) KATZ, Marcelo; TARASOUTCHI, Flavio; PESARO, Antonio Eduardo Pereira; LOPES, Renato D.; SPINA, Guilherme Sobreira; VIEIRA, Marcelo Luiz Campos; GRINBERG, MaxBackground and aim of the study: The natriuretic peptides, brain natriuretic peptide (BNP) and its N-terminal prohormone (NT-proBNP), can be used as diagnostic and prognostic markers for aortic stenosis (AS). However, the association between BNP, NT-proBNP, and long-term clinical outcomes in patients with severe AS remains uncertain. Methods: A total of 64 patients with severe AS was prospectively enrolled into the study, and underwent clinical and echocardiographic assessments at baseline. Blood samples were drawn for plasma BNP and NT-proBNP analyses. The primary outcome was death from any cause, through a six-year follow up period. Cox proportional hazards modeling was used to examine the association between natriuretic peptides and long-term mortality, adjusting for important clinical factors. Results: During a mean period of 1,520 681 days, 51 patients (80%) were submitted to aortic valve replacement, and 13 patients (20%) were medically managed without surgical interventions. Mortality rates were 13.7% in the surgical group and 62% in the medically managed group (p <0.001). Patients with higher plasma BNP (>135 pg/ml) and NT-proBNP (>1,150 pg/ml) levels at baseline had a greater risk of long-term mortality (hazard ratio [HR] 3.2, 95% confidence interval [CI] 1.1-9.1; HR 4.3, 95% CI 1.4-13.5, respectively). After adjusting for important covariates, both BNP and NT-proBNP remained independently associated with long-term mortality (HR 2.9, 95%CI 1.5-5.7; HR 1.8, 95%CI 1.1-3.1, respectively). Conclusion: In patients with severe AS, plasma BNP and NT-proBNP levels were associated with long-term mortality. The use of these biomarkers to guide treatment might represent an interesting approach that deserves further evaluation. The Journal of Heart Valve Disease 2012;21:331-336conferenceObject Predictors of contractile reserve on dobutamine stress echocardiography in patients with classical low-flow, low-gradient aortic stenosis(2019) ROSA, V. Emer Egypto; RIBEIRO, H. B.; SAMAPIO, R. O.; MORAIS, T. C.; ROSA, M. E. E.; SANTIS, A. S. A. L. De; FERNANDES, J. R. C.; SPINA, G. S.; VIEIRA, M. L. C.; POMERANTZEFF, P. M. A.; ROCHITTE, C. E.; MATHIAS JR., W.; TARASOUTCHI, F.- Transcatheter Valve-in-Valve Procedures for Bioprosthetic Valve Dysfunction in Patients With Rheumatic vs. Non-Rheumatic Valvular Heart Disease(2021) LOPES, Mariana Pezzute; ROSA, Vitor Emer Egypto; PALMA, Jose Honorio; VIEIRA, Marcelo Luiz Campos; FERNANDES, Joao Ricardo Cordeiro; SANTIS, Antonio de; SPINA, Guilherme Sobreira; FONSECA, Rafael de Jesus; MARCHI, Mauricio F. de Sa; ABIZAID, Alexandre; BRITO, Fabio Sandoli de; TARASOUTCHI, Flavio; SAMPAIO, Roney Orismar; RIBEIRO, Henrique BarbosaBackground: Bioprosthetic heart valve has limited durability and lower long-term performance especially in rheumatic heart disease (RHD) patients that are often subject to multiple redo operations. Minimally invasive procedures, such as transcatheter valve-in-valve (ViV) implantation, may offer an attractive alternative, although data is lacking. The aim of this study was to evaluate the baseline characteristics and clinical outcomes in rheumatic vs. non-rheumatic patients undergoing ViV procedures for severe bioprosthetic valve dysfunction. Methods: Single center, prospective study, including consecutive patients undergoing transcatheter ViV implantation in aortic, mitral and tricuspid position, from May 2015 to September 2020. RHD was defined according to clinical history, previous echocardiographic and surgical findings. Results: Among 106 patients included, 69 had rheumatic etiology and 37 were non-rheumatic. Rheumatic patients had higher incidence of female sex (73.9 vs. 43.2%, respectively; p = 0.004), atrial fibrillation (82.6 vs. 45.9%, respectively; p < 0.001), and 2 or more prior surgeries (68.1 vs. 32.4%, respectively; p = 0.001). Although, device success was similar between groups (75.4 vs. 89.2% in rheumatic vs. non-rheumatic, respectively; p = 0.148), there was a trend toward higher 30-day mortality rates in the rheumatic patients (21.7 vs. 5.4%, respectively; p = 0.057). Still, at median followup of 20.7 [5.1-30.4] months, cumulative mortality was similar between both groups (p = 0.779). Conclusion: Transcatheter ViV implantation is an acceptable alternative to redo operations in the treatment of patients with RHD and severe bioprosthetic valve dysfunction. Despite similar device success rates, rheumatic patients present higher 30 day mortality rates with good mid-term clinical outcomes. Future studies with a larger number of patients and follow-up are still warranted, to firmly conclude on the role transcatheter ViV procedures in the RHD population.
conferenceObject Short- and Long-term Outcomes After Surgical Aortic Valve Replacement in Patients With Classical Low-flow, Low-gradient Aortic Stenosis(2019) ROSA, Vitor E.; RIBEIRO, Henrique B.; SAMPAIO, Roney O.; MORAIS, Thamara C.; ROSA, Marcela E.; SANTIS, Antonio S. De; FERNANDES, Joao Ricardo C.; SPINA, Guilherme S.; VIEIRA, Marcelo L.; POMERANTZEFF, Pablo M.; ROCHITTE, Carlos E.; MATHIAS JR., Wilson; TARASOUTCHI, FlavioconferenceObject EuroSCORE II, BNP, C-Reactive Protein, Creatinine and Delayed Myocardial Enhancement Imaging are Predictors of 1-Year Mortality in Patients with Low-Flow and Low-Gradient True Severe Aortic Stenosis with Low Ejection Fraction(2016) ROSA, Vitor E.; SAMPAIO, Roney O.; PAIXAO, Milena R.; FERNANDES, Joao Ricardo C.; ACCORSI, Tarso A.; SANTIS, Antonio S. de; SPINA, Guilherme S.; VIEIRA, Marcelo L.; MORAIS, Thamara C.; BELLO, Juliana H.; MATHIAS JR., Wilson; ROCHITTE, Carlos E.; BRANDAO, Carlos Manuel A.; TARASOUTCHI, FlavioconferenceObject Topographic pattern of valve calcification: a new determinant of disease severity in aortic valve stenosis(2017) SANTIS, A. De; TARASOUTCHI, F. T.; ARAUJO FILHO, J. A. B.; KATZ, M.; VIEIRA, M. C.; NOMURA, C. H.; SPINA, G. S.; SAMPAIO, R. O.; BROWN, J.; EDELMAN, E. R.; ROSA, V. E. E.; FERNANDES, J. R. C.; LEMOS, P. A.conferenceObject Correlation between Topographic Distribution of Aortic Valve Calcium and Hemodynamic Repercussion in Aortic Stenosis(2013) SANTIS, Antonio S. de; TARASOUTCHI, Flavio; SPINA, Guilherme; ROSA, Vitor; ACCORSI, Tarso; FERNANDES, Joao; NOMURA, Cesar; VIEIRA, Marcelo; SAMPAIO, Roney; GRINBERG, Max- Update of the Brazilian Guidelines for Valvular Heart Disease-2020(2020) TARASOUTCHI, Flavio; MONTERA, Marcelo Westerlund; RAMOS, Auristela Isabel de Oliveira; SAMPAIO, Roney Orismar; ROSA, Vitor Emer Egypto; ACCORSI, Tarso Augusto Duenhas; SANTIS, Antonio de; FERNANDES, Joao Ricardo Cordeiro; PIRES, Lucas Jose Tachotti; SPINA, Guilherme S.; VIEIRA, Marcelo Luiz Campos; LAVITOLA, Paulo de Lara; AVILA, Walkiria Samuel; PAIXAO, Milena Ribeiro; BIGNOTO, Tiago; TOGNA, Dorival Julio Della; MESQUITA, Evandro Tinoco; ESTEVES, William Antonio de Magalhaes; ATIK, Fernando; COLAFRANCESCHI, Alexandre Siciliano; MOISES, Valdir Ambrosio; KIYOSE, Alberto Takeshi; POMERANTZEFF, Pablo M. A.; LEMOS, Pedro A.; BRITO JUNIOR, Fabio Sandoli de; WEKSLER, Clara; BRANDAO, Carlos Manuel de Almeida; POFFO, Robinson; SIMOES, Ricardo; RASSI, Salvador; LEAES, Paulo Ernesto; MOURILHE-ROCHA, Ricardo; PENA, Jose Luiz Barros; JATENE, Fabio Biscegli; BARBOSA, Marcia de Melo; ABIZAID, Alexandre; RIBEIRO, Henrique Barbosa; BACAL, Fernando; ROCHITTE, Carlos Eduardo; FONSECA, Jose Honorio de Almeida Palma; GHORAYEB, Samira Kaissar Nasr; LOPES, Marcelo Antonio Cartaxo Queiroga; SPINA, Salvador Vicente; PIGNATELLI, Ricardo H.; SARAIVA, Jose Francisco Kerr
- Topographic Pattern of Valve Calcification A New Determinant of Disease Severity in Aortic Valve Stenosis(2018) SANTIS, Antonio de; TARASOUTCHI, Flavio; ARAUJO FILHO, Jose de Arimateia B.; VIEIRA, Marcelo C.; NOMURA, Cesar H.; KATZ, Marcelo; SPINA, Guilherme S.; SAMPAIO, Roney O.; ACCORSI, Tarso A. D.; ROSA, Vitor E. E.; FERNANDES, Joao R. C.; BROWN, Jonathan; EDELMAN, Elazer R.; LEMOS, Pedro A.
- Left Atrium Reverse Remodeling in Patients With Mitral Valve Stenosis After Percutaneous Valvuloplasty: A 2-and 3-Dimensional Echocardiographic Study(2013) VIEIRA, Marcelo L. Campos; SILVA, Murilo C.; WAGNER, Camila R.; DALLAN, Luis A.; KAJITA, Luis J.; OLIVEIRA, Wercules A.; SAMESINA, Nelson; HOTTA, Viviane T.; MATHIAS JR., Wilson; SPINA, Guilherme; CARDOSO, Luis; PASTORE, Carlos A.; TARASOUTCHI, Flavio; GRINBERG, MaxIntroduction and objectives: The left atrium is clinically relevant in patients with mitral valve stenosis. The objective of this study was to analyze the effects of percutaneous balloon valvuloplasty on left atrium volumes and the left atrium emptying fraction in symptomatic mitral valve stenosis patients using 2-dimensional and real-time 3 -dimensional transthoracic echocardiography. Methods: We carried out a prospective study of 28 consecutive symptomatic mitral valve stenosis patients, aged 22-72 (39 [11.5]) years, 24/28 (85.6%) women, who underwent to percutaneous balloon valvuloplasty between March 2009 and May 2011. Patients underwent 2- and 3-dimensional transthoracic and transesophageal echocardiography (atrial fibrillation) and invasive mitral valve area measurement. Echocardiographic analysis was performed before, 72 h after and 12 months after percutaneous balloon valvuloplasty. The following parameters were analyzed: a) mitral valve area (2-dimensional planimetry, pressure half-time, 3-dimensional echocardiography, invasive hemodynamic measurement); b) indexed left atrium maximum and indexed minimum volumes, and c) left atrium emptying fraction. Results: The 3-dimensional parameters of the mitral valve stenosis patients before and 72 h and 12 months after percutaneous balloon valvuloplasty were as follows: a) mitral valve area: 0.9 (0.1) cm(2); 1.8 (0.2) cm(2) (P<.001); 1.7 (0.2) cm(2) (P<.001); b) left atrium maximum volumes: 49.9 (12) mL/m(2); 42 (11.4) mL/m(2) (P<.001); 40.3 (10.2) mL/m(2)(P<.001), and c) left atrium emptying fraction: 30.1 (9.4%); 40.6 (7.4%) (P<.001); 44.1 (8%) (P<.001), respectively. Conclusions: In symptomatic mitral valve stenosis patients who underwent percutaneous balloon valvuloplasty analysis by 2- and 3-dimensional echocardiography, improvements in left atrium reverse remodeling and left atrium emptying fraction were observed 72 h and 12 months after the procedure. Full English text available from: www.revespcardiol.org/en (C) 2012 Sociedad Espanola de Cardiologia.