LUCIANO FERREIRA DRAGER
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/63, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/63, Hospital das Clínicas, Faculdade de Medicina - Líder
22 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 22
- 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.
- Screening for Obstructive Sleep Apnea in Patients with Atrial Fibrillation(2017) GENTA, Pedro R.; DRAGER, Luciano F.; LORENZI FILHO, Geraldo
- Update in Sleep-disordered Breathing 2016(2017) AYAS, Najib T.; DRAGER, Luciano F.; MORRELL, Mary J.; POLOTSKY, Vsevolod Y.
conferenceObject Accuracy Of Non-Dipping Blood Pressure In Predicting Obstructive Sleep Apnea In Patients SuBMItted To Ambulatory Blood Pressure Monitoring(2017) FURLAN, S. F.; GENTA-PEREIRA, D. C.; OMOTE, D. D. Q.; GIORGI, D.; BORTOLOTTO, L. A.; LORENZI-FILHO, G.; DRAGER, L. F.- Obstructive sleep apnea is independently associated with subclinical coronary atherosclerosis among middle-aged women(2017) MEDEIROS, Ana Kelley L.; COUTINHO, Ricardo Q.; BARROS, Isly M. L.; COSTA, Laura O. B. F.; LEITE, Ana Paula D. L.; BITTENCOURT, Marcio S.; LUSTOSA, Thais C.; CARVALHO, Martinha M. B.; LIRA, Maria Priscila Figueiredo; FERREIRA, Moacir N. L.; LORENZI-FILHO, Geraldo; DRAGER, Luciano F.; PEDROSA, Rodrigo P.Obstructive sleep apnea (OSA) is associated with coronary disease among men. However, this association is not clear for women. In this study, we evaluate the association between OSA and presence of subclinical atherosclerosis assessed by tomographic coronary calcium score in middle-aged women. We evaluated consecutive women aged between 45 and 65 years in perimenopause or postmenopause period (with menstrual irregularity-amenorrhea > 60 days), without manifest cardiovascular disease (heart failure, coronary disease, and stroke), from two gynecologic clinics. All patients underwent clinical evaluation, computed tomographic examination for coronary artery calcium (CAC > 100 Agatston units), and portable sleep study. Multiple logistic regression models were used to evaluate the association between OSA and CAC, controlling for traditional risk factors including Framingham Risk Score (FRS), body mass index (BMI), and diabetes. We studied 214 women (age 56 years (52-61); BMI 28 kg/m(2) (25-31), 25 % diabetes, 62 % hypertension). OSA (apnea-hypopnea index (AHI) 5 events/h) was diagnosed in 82 women (38.3 %). CAC was more prevalent in patients with moderate/severe OSA (AHI 15 events/h) than in patients without or with mild OSA, 19 % vs 4.5 and 1.6 %, respectively (p < 0.01). Moderate to severe OSA was associated with CAC in unadjusted (odds ratio = 6.25, 95 % CI 1.66-23.52; p < 0.01) and adjusted (odds ratio = 8.19, 95 % CI 1.66-40.32; p = 0.01) logistic regression analysis. Moderate to severe OSA is independently associated with the presence of CAC in middle-aged women. These results reinforce the concept that women are also susceptible to the cardiovascular consequences of OSA.
- Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis(2017) SILVA, Bruno C.; SANTOS, Roberto S. S.; DRAGER, Luciano F.; COELHO, Fernando M.; ELIAS, Rosilene M.Introduction: Obstructive sleep apnea (OSA) is common in edematous states, notably in hemodialysis patients. In this population, overnight fluid shift can play an important role on the pathogenesis of OSA. The effect of compression stockings (CS) and continuous positive airway pressure (CPAP) on fluid shift is barely known. We compared the effects of CS and CPAP on fluid dynamics in a sample of patients with OSA in hemodialysis, through a randomized crossover study. Methods: Each participant performed polysomnography (PSG) at baseline, during CPAP titration, and after 1 week of wearing CS. Neck circumference (NC) and segmental bioelectrical impedance were done before and after PSG. Results: Fourteen patients were studied (53 9 years; 57% men; body mass index 29.7 6.8 kg/m(2)). Apnea hypopnea index (AHI) decreased from 20.8 (14.2; 39.6) at baseline to 7.9 (2.8; 25.4) during CPAP titration and to 16.7 (3.5; 28.9) events/h after wearing CS (CPAP vs. baseline, p = 0.004; CS vs. baseline, p = 0.017; and CPAP vs. CS, p = 0.017). Nocturnal intracellular trunk water was higher after wearing CS in comparison to baseline and CPAP (p = 0.03). CS reduced the fluid accumulated in lower limbs during the day, although not significantly. Overnight fluid shift at baseline, CPAP, and CS was -183 +/- 72, 343 +/- 220, and 290 +/- 213 ml, respectively (p = 0.006). Overnight NC increased at baseline (0.7 +/- 0.4 cm), decreased after CPAP (-1.0 +/- 0.4 cm), and while wearing CS (-0.4 +/- 0.8 cm) (CPAP vs. baseline, p < 0.0001; CS vs. baseline, p = 0.001; CPAP vs. CS, p = 0.01). Conclusion: CS reduced AHI by avoiding fluid retention in the legs, favoring accumulation of water in the intracellular component of the trunk, thus avoiding fluid shift to reach the neck. CPAP improved OSA by exerting local pressure on upper airway, with no impact on fluid redistribution. CPAP performed significantly better than CS for both reduction of AHI and overnight reduction of NC. Complementary studies are needed to elucidate the mechanisms by which CPAP and CS reduce NC.
conferenceObject Impact of Cpap on Arterial Stiffness in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-analysis(2017) BITTENCOURT, Marcio S.; CHALEGRE, Sintya; LUSTOSA, Thais C.; FRANCA, Marcus V.; COUTO, Tarcya L.; DRAGER, Luciano F.; LORENZI-FILHO, Geraldo; PEDROSA, Rodrigo P.bookPart Hipertensão secundária e resistente(2017) DRAGER, Luciano- Effects of Ethnicity on the Prevalence of Obstructive Sleep Apnoea in Patients with Acute Coronary Syndrome: A Pooled Analysis of the ISAACC Trial and Sleep and Stent Study(2017) KOO, Chieh-Yang; TORRE, Alicia Sanchez de la; LOO, Germaine; TORRE, Manuel Sanchez-de-la; ZHANG, Junjie; DURAN-CANTOLLA, Joaquin; LI, Ruogu; MAYOS, Merce; SETHI, Rishi; ABAD, Jorge; FURLAN, Sofia F.; COLOMA, Ramon; HEIN, Thet; HO, Hee-Hwa; JIM, Man-Hong; ONG, Thun-How; TAI, Bee-Choo; TURINO, Cecilia; DRAGER, Luciano F.; LEE, Chi-Hang; BARBE, FerranBackground Obstructive sleep apnoea (OSA) is an emerging risk factor for acute coronary syndrome (ACS). We sought to determine the effects of ethnicity on the prevalence of OSA in patients presenting with ACS who participated in an overnight sleep study. Methods A pooled analysis using patient-level data from the ISAACC Trial and Sleep and Stent Study was performed. Using the same portable diagnostic device, OSA was defined as an apnoea-hypopnoea index of >= 15 events per hour. Results A total of 1961 patients were analysed, including Spanish (53.6%, n=1050), Chinese (25.5%, n=500), Indian (12.0%, n=235), Malay (6.1%, n=119), Brazilian (1.7%, n=34) and Burmese (1.2%, n=23) populations. Significant differences in body mass index (BMI) were found among the various ethnic groups, averaging from 25.3 kg/m(2) for Indians and 25.4 kg/m(2) for Chinese to 28.6 kg/m(2) for Spaniards. The prevalence of OSA was highest in the Spanish (63.1%), followed by the Chinese (50.2%), Malay (47.9%), Burmese (43.5%), Brazilian (41.2%), and Indian (36.1%) patients. The estimated odds ratio of BMI on OSA was highest in the Chinese population (1.17; 95% confidence interval: 1.10-1.24), but was not significant in the Spanish, Burmese or Brazilian populations. The area under the curve (AUC) for the Asian patients (ranging from 0.6365 to 0.6692) was higher than that for the Spanish patients (0.5161). Conclusion There was significant ethnic variation in the prevalence of OSA in patients with ACS. The magnitude of the effect of BMI on OSA was greater in the Chinese population than in the Spanish patients.
- Intermittent claudication and severe renal artery stenosis are independently associated in hypertensive patients referred for renal arteriography(2017) MACEDO, Thiago Andrade; DRAGER, Luciano Ferreira; PEDROSA, Rodrigo Pinto; MUELA, Henrique Cotchi Simbo; COSTA-HONG, Valeria; KAJITA, Luiz Junia; BORTOLOTTO, Luiz AparecidoOBJECTIVE: The purpose of this study was to evaluate the association between the presence of clinical symptoms of peripheral artery disease and severe renal artery stenosis in patients referred for renal angiography. METHOD: We included 82 patients with clinical suspicion of renovascular hypertension and performed an imaging investigation (renal Doppler ultrasound and/or renal scintigraphy) for possible renal artery stenosis. All patients underwent renal arteriography and were examined for peripheral artery disease based on the presence of intermittent claudication and ankle-brachial index test results. Severe renal artery stenosis was defined as a lesion causing 70% obstruction. RESULTS: Severe renal artery stenosis was present in 32 of 82 (39%) patients. Patients with severe renal artery stenosis were older (63 +/- 12 vs 56 +/- 12 years, p=0.006), had more intermittent claudication (55 vs 45%, p=0.027), and had a greater prevalence of an ankle-brachial index <0.9 (44% vs 20%, p=0.021) than patients without severe renal artery stenosis. Multivariate logistic regression analysis showed that the presence of intermittent claudication was independently associated with renal artery stenosis >= 70% (OR: 3.33; 95% CI 1.03-10.82, p=0.04), unlike the ankle-brachial index, which showed no association (OR: 1.44; 95% CI 0.37-5.66, p=0.60). CONCLUSION: Intermittent claudication is independently associated with severe renal artery stenosis (>= 70%) in patients clinically suspected of having renovascular hypertension.
- «
- 1 (current)
- 2
- 3
- »