MUCIO TAVARES DE OLIVEIRA JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
145 resultados
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- 3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY(2017) GUALANDRO, D. M.; YU, P. C.; CARAMELLI, B.; MARQUES, A. C.; CALDERARO, D.; FORNARI, L. S.; PINHO, C.; FEITOSA, A. C. R.; POLANCZYK, C. A.; ROCHITTE, C. E.; JARDIM, C.; VIEIRA, C. L. Z.; NAKAMURA, D. Y. M.; IEZZI, D.; SCHREEN, D.; ADAM, Eduardo L.; D'AMICO, E. A.; LIMA, M. Q.; BURDMANN, E. A.; PACHON, E. I. M.; BRAGA, F. G. M.; MACHADO, F. S.; PAULA, F. J.; CARMO, G. A. L.; FEITOSA-FILHO, G. S.; PRADO, G. F.; LOPES, H. F.; FERNANDES, J. R. C.; LIMA, J. J. G.; SACILOTTO, L.; DRAGER, L. F.; VACANTI, L. J.; ROHDE, L. E. P.; PRADA, L. F. L.; GOWDAK, L. H. W.; VIEIRA, M. L. C.; MONACHINI, M. C.; MACATRAO-COSTA, M. F.; PAIXAO, M. R.; OLIVEIRA JR., M. T.; CURY, P.; VILLACA, P. R.; FARSKY, P. S.; SICILIANO, R. F.; HEINISCH, R. H.; SOUZA, R.; GUALANDRO, S. F. M.; ACCORSI, T. A. D.; MATHIAS JR., W.
conferenceObject The journey of patients with Chagas cardiomyopathy during episodes of descompensated heart failure(2018) ISSA, V. S.; GOMES, C.; TERHOCH, C. B.; MOREIRA, H. F.; PAES, T. M.; PADUA, V. P.; LAGE, S. G.; OLIVEIRA, M. T.; BOCCHI, E. A.conferenceObject Endovascular Therapeutic Hypothermia Is Feasible as an Adjuvant Therapy in Acute ST-Segment Elevation Myocardial Infarction Patients Without Delay in Door-to-Balloon Time(2019) DALLAN, Luis; GIANNETTI, Natali; DAE, Michael; POLASTRI, Thatiane; ROCHITTE, Carlos Eduardo; NOMURA, Cesar Higa; HAJJAR, Ludhmila Abrahao; BERNOCHE, Claudia; LAGE, Silvia; LIMA, Felipe; NICOLAU, Jose Carlos; TAVARES JR., Mucio; RIBEIRO, Expedito; KALIL JR., Roberto; LEMOS, Pedro A.; TIMERMAN, SergioconferenceObject Superiority of prothrombin complex concentrate versus frozen fresh plasma in cardiologic patients with coumarin intoxication(2016) SOEIRO, A.; CESAR, M. C.; BISELLI, B.; BOSSA, A. S.; ARAUJO, V. A.; HAJJAR, L. A.; LEAL, T. C. A. T.; SOEIRO, M. C. F. A.; VELLA, J. P.; SERRANO JR., C. V.; OLIVEIRA JR., M. T.conferenceObject Use of an innovative humanized virtual digital interactive heart failure clinical cases training strategy for cardiologist in the covid 19 pandemic(2022) CANESIN, M. Manoel Fernandes; FURTADO, F.; GONCALVES, R.; BARRETTO, A.; OLIVEIRA JR., M.; PISANI, B.; BAPTISTA, R.; MOURA, B.- 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.
- Upper vena cava syndrome secondary to giant atrial myxoma(2018) LONGATTO, Flavia Contreira; SANTOS, Thamires Suellen Alves Pereira; SOARES, Marilia Joaquina de Medeiros; NEGRISOLI, Juliana; LEAL, Tatiana de Carvalho Andreucci Torres; BISELLI, Bruno; OLIVEIRA JR., Mucio Tavares; SOEIRO, Alexandre de MatosCardiac myxoma is a benign neoplasm, which corresponds to the most common primary heart tumour, responsible for about 50% of the cases. In general, 75-80% of myxomas are located in the left atrium, 18% in the right atrium, and more rarely in the ventricles or multicentric. Right atrial myxoma, in particular, can obstruct the tricuspid valve, causing symptoms of right heart failure, peripheral oedema, hepatic congestion, and syncope. Systemic embolization occurs in 30% of cases, by either tumour fragmentation or total tumour detachment. In the present report, we present a case of a symptomatic patient, who showed a large right intra-atrial lesion, with consequent superior vena cava syndrome, and then underwent surgical resection at admission.
- Diagnostic Accuracy of the Aortic Dissection Detection Risk Score Plus D-Dimer for Acute Aortic Syndromes The ADvISED Prospective Multicenter Study(2018) NAZERIAN, Peiman; MUELLER, Christian; SOEIRO, Alexandre de Matos; LEIDEL, Bernd A.; SALVADEO, Sibilla Anna Teresa; GIACHINO, Francesca; VANNI, Simone; GRIMM, Karin; OLIVEIRA, Mucio Tavares; PIVETTA, Emanuele; LUPIA, Enrico; GRIFONI, Stefano; MORELLO, FulvioBACKGROUND: Acute aortic syndromes (AASs) are rare and severe cardiovascular emergencies with unspecific symptoms. For AASs, both misdiagnosis and overtesting are key concerns, and standardized diagnostic strategies may help physicians to balance these risks. D-dimer (DD) is highly sensitive for AAS but is inadequate as a stand-alone test. Integration of pretest probability assessment with DD testing is feasible, but the safety and efficiency of such a diagnostic strategy are currently unknown. METHODS: In a multicenter prospective observational study involving 6 hospitals in 4 countries from 2014 to 2016, consecutive outpatients were eligible if they had >= 1 of the following: chest/abdominal/back pain, syncope, perfusion deficit, and if AAS was in the differential diagnosis. The tool for pretest probability assessment was the aortic dissection detection risk score (ADD-RS, 0-3) per current guidelines. DD was considered negative (DD-) if < 500 ng/mL. Final case adjudication was based on conclusive diagnostic imaging, autopsy, surgery, or 14-day follow-up. Outcomes were the failure rate and efficiency of a diagnostic strategy for ruling out AAS in patients with ADD-RS=0/DD-or ADD-RS = 1/DD-. RESULTS: A total of 1850 patients were analyzed. Of these, 438 patients (24%) had ADD-RS=0, 1071 patients (58%) had ADD-RS=1, and 341 patients (18%) had ADD-RS > 1. Two hundred forty-one patients (13%) had AAS: 125 had type A aortic dissection, 53 had type B aortic dissection, 35 had intramural aortic hematoma, 18 had aortic rupture, and 10 had penetrating aortic ulcer. A positive DD test result had an overall sensitivity of 96.7% (95% confidence interval [CI], 93.6-98.6) and a specificity of 64% (95% CI, 61.6-66.4) for the diagnosis of AAS; 8 patients with AAS had DD-. In 294 patients with ADD-RS=0/DD-, 1 case of AAS was observed. This yielded a failure rate of 0.3% (95% CI, 0.1-1.9) and an efficiency of 15.9% (95% CI, 14.3-17.6) for the ADD-RS=0/DD-strategy. In 924 patients with ADD-RS <= 1/DD-, 3 cases of AAS were observed. This yielded a failure rate of 0.3% (95% CI, 0.1-1) and an efficiency of 49.9% (95% CI, 47.7-52.2) for the ADD-RS <= 1/DD-strategy. CONCLUSIONS: Integration of ADD-RS (either ADD-RS=0 or ADD-RS = 1) with DD may be considered to standardize diagnostic rule out of AAS.
- Effect of a strategy of comprehensive vasodilation versus usual care on health-related quality of life among patients with acute heart failure(2021) BELKIN, Maria; WUSSLER, Desiree; GUALANDRO, Danielle Menosi; SHRESTHA, Samyut; STREBEL, Ivo; GOUDEV, Assen; MAEDER, Micha T.; WALTER, Joan; FLORES, Dayana; KOZHUHAROV, Nikola; LOPEZ-AYALA, Pedro; DANIER, Isabelle; OLIVEIRA JUNIOR, Mucio Tavares de; KOBZA, Richard; RICKLI, Hans; BREIDTHARDT, Tobias; ERNE, Paul; MUENZEL, Thomas; MUELLER, ChristianAims We aimed to assess the long-term effect of a strategy of comprehensive vasodilation versus usual care on health-related quality of life (HRQL) among patients with acute heart failure (AHF). Methods and results Health-related quality of life was prospectively assessed by the generic 3-levelled EQ-5D and the disease-specific Kansas City Cardiomyopathy Questionnaire (KCCQ) among adult AHF patients enrolled in an international, multicentre, randomised, open-label blinded-end-point trial of a strategy that emphasized early intensive and sustained vasodilation using maximally tolerated doses of established oral and transdermal vasodilators according to systolic blood pressure. Changes in EQ-5D and KCCQ from admission to 180 day follow-up were individually compared between the intensive vasodilatation and the usual care group. Among 666 patients eligible for 180 day follow-up, 284 (43%, median age 79 years, 35% women) and 198 (30%, median age 77 years, 35% women) had completed the EQ-5D and KCCQ at baseline and follow-up, respectively. There was a significant improvement in HRQL as quantified by both, EQ-5D and KCCQ, from hospitalization to 180 day follow-up, with no significant differences in the change of HRQL between both treatment strategies. For instance, 39 (26%) versus 33 (25%) patients had an improvement by at least one level in at least two categories in the EQ-5D. Median increase in KCCQ overall summary score (KCCQ-OSS) was 17.6 (IQR 2.0-42.6) in the intervention group versus 18.5 (IQR 3.9-39.3) in the usual care group (P < 0.001 vs. baseline, P = 0.945 between groups). Conclusions Among patients with AHF, long-term HRQL quantified by EQ-5D and KCCQ improved substantially, with overall no significant differences between a strategy of comprehensive vasodilation versus usual care.
bookPart Abordagem de dor torácica na emergência(2018) SOEIRO, Alexandre de Matos; REIS, Patrícia Feitosa Frota dos; MATTOS, Fernando Ramos de; PEDROTTI, Carlos Henrique Sartorato; JúNIOR, Múcio Tavares de Oliveira