ALESSANDRO CAVALCANTI LIANZA

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Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico

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  • article 0 Citação(ões) na Scopus
    Kawasaki Disease: A Never-ending Story?
    (2023) LIANZA, Alessandro Cavalcanti; DINIZ, Maria de Fatima Rodrigues; SAWAMURA, Karen Saori Shiraishi; MENEZES, Carolina da Rocha Brito; SILVA, Isabela de Sousa Lobo; LEAL, Gabriela Nunes
    The most severe complication of Kawasaki disease, an inflammatory disorder of young children, is the formation of coronary artery aneurysms. It is known that patients with coronary artery aneurysms, particularly those with medium and large lesions, have a higher risk of future major cardiovascular events. In contrast, there is a lack of data on the cardiovascular status in long-term follow-up for Kawasaki disease patients without coronary involvement or with self-limited coronary artery aneurysms, resulting in most patients being discharged after 5 years. Even though some paediatricians may believe these patients should not be followed at all, studies indicating a dysfunctional endothelium show the need for further investigation. Consequently, a review of the most significant aspects of Kawasaki disease, and the necessity of correctly identifying, treating and monitoring these patients, particularly those with a higher risk of complications, was conducted.
  • article
    Speckle-Tracking: Incremental Role in Diastolic Assessment of Pediatric Patients with Chronic Kidney Disease
    (2024) PENACHIO, Flora Maciel; DINIZ, Maria de Fatima Rodrigues; LAURINO, Rosana Sbruzzi Prado; WATANABE, Andreia; SAWAMURA, Karen Saori Shiraishi; LIANZA, Alessandro Cavalcanti; MENEZES, Carolina Rocha Brito; SILVA, Isabela de Sousa Lobo; LEAL, Gabriela Nunes
    Background: Cardiovascular complications are the leading cause of mortality in pediatric patients with chronic kidney disease (CKD). Echocardiographic assessment of diastolic function in CKD has been limited to spectral and tissue Doppler imaging, known to be less reliable techniques in pediatrics. Two-dimensional Speckle tracking echocardiography (2DST) derived left atrial (LA) strain has recently been confirmed as a robust measure of diastolic function. Objectives: To investigate LA strain role in diastolic assessment of children at different stages of CKD. Methods: From February 2019 to July 2022, 55 CKD patients without cardiovascular symptoms and 55 controls were evaluated by standard and 2DST echocardiograms. The level of significance was set at 5% (p<0.05). Results: Patients and controls had similar age [9.78 (0.89 - 17.54) vs. 10.72 (1.03 -18,44) years; p = 0.41] and gender (36M:19F vs. 34M:21F; p=0.84). There were 25 non-dialysis patients and 30 dialysis patients. Left ventricular ejection fraction was >= 55% in all of them. Comparing CKD and controls, LA reservoir strain was lower (48.22 +/- 10.62% vs. 58.52 +/- 10.70%) and LA stiffness index was higher [0.14 (0.08-0.48)% -1 vs. 0.11 (0.06-0.23) % -1 ]; p<0.0001. LV hypertrophy was associated with lower LA reservoir strain (42.05 +/- 8.74% vs. 52.99 +/- 9.52%), higher LA stiffness [0.23(0.11 - 0.48)% -1 vs. 0.13 (0.08-0.23) % -1 and filling indexes (2.39 +/- 0.63 cm/s x % -1 vs. 1.74 +/- 0.47 cm/s x % (-1) ; p<0.0001. Uncontrolled hypertension was associated with lower LA reservoir strain (41.9 +/- 10.6% vs. 50.6 +/- 9.7; p=0.005). Conclusions: LA strain proved to be a feasible tool in the assessment of pediatric CKD patients and was associated with known cardiovascular risk factors.