AFONSO YOSHIKIRO MATSUMOTO

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  • article 15 Citação(ões) na Scopus
    Exercise-induced quantitative microvolt T-wave altemans in hypertrophic cardiomyopathy
    (2017) ANTUNES, Murillo de Oliveira; SAMESIMA, Nelson; PEREIRA FILHO, Horacio Gomes; MATSUMOTO, Afonso Yoshikiro; VERRIER, Richard L.; PASTORE, Carlos Alberto; ARTEAGA-FERNANDEZ, Edmund; MADY, Charles
    Background/Purpose: Patients with hypertrophic cardiomyopathy (HCM) have elevated risk for sudden cardiac death (SCD). Our study aimed to quantitatively characterize microvolt T-wave alternans (TWA), a potential arrhythmia risk stratification tool, in this HCM patient population. Methods: TWA was analyzed with the quantitative modified moving average (MMA) in 132 HCM patients undergoing treadmill exercise testing, grouped according to Maron score risk factors as high-risk (H-Risk, n = 67,), or low-risk (L-Risk, n = 65, without these risk factors). Results: TWA levels were much higher for the H-Risk than for the L-Risk group (101.40 +/- 75.61 vs. 54.35 +/- 46.26 mu V; p < 0.0001). A 53 mu V cut point, set by receiver operator characteristic (ROC), identified H-Risk patients (82% sensitivity, 69% specificity). Conclusions: High TWA levels were found for hypertrophic cardiomyopathy patients. Abnormal TWA associated with major risk factors for SCD: non-sustained ventricular tachycardia on Holter (p = 0.001), family history of SCD (p = 0.006), septal thickness >= 30 mm (p < 0.001); and inadequate blood pressure response to effort (p = 0.04).
  • article 1 Citação(ões) na Scopus
    Left Atrial Function in Patients with Chronic Chagasic Cardiomyopathy
    (2015) FRAGATA, Claudia da Silva; MATSUMOTO, Afonso Y.; RAMIRES, Felix J. A.; FERNANDES, Fabio; BUCK, Paula de Cassia; SALEMI, Vera Maria C.; NASTARI, Luciano; MADY, Charles; IANNI, Barbara Maria
    Background: Chagas disease is a cause of dilated cardiomyopathy, and information about left atrial (LA) function in this disease still lacks. Objective: To assess the different LA functions (reservoir, conduit and pump functions) and their correlation with the echocardiographic parameters of left ventricular (LV) systolic and diastolic functions. Methods: 10 control subjects (CG), and patients with Chagas disease as follows: 26 with the indeterminate form (GI); 30 with ECG alterations (GII); and 19 with LV dysfunction (GIII). All patients underwent M-mode and two-dimensional echocardiography, pulsed-wave Doppler and tissue Doppler imaging. Results: Reservoir function (Total Emptying Fraction: TEF): (p < 0.0001), lower in GIII as compared to CG (p = 0.003), GI (p < 0.001) and GII (p < 0.001). Conduit function (Passive Emptying Fraction: PEF): (p = 0.004), lower in GIII (GIII and CG, p = 0.06; GI and GII, p = 0.06; and GII and GIII, p = 0.07). Pump function (Active Emptying Fraction: AEF): (p = 0.0001), lower in GIII as compared to CG (p = 0.05), GI (p < 0.0001) and GII (p = 0.002). There was a negative correlation of E/e'(average) with the reservoir and pump functions (TEF and AEF), and a positive correlation of e'(average) with s' wave (both septal and lateral walls) and the reservoir, conduit and pump LA functions. Conclusion: An impairment of LA functions in Chagas cardiomyopathy was observed.
  • article 6 Citação(ões) na Scopus
    Plasma Pro-B-Type Natriuretic Peptide Testing as a Screening Method for Hypertrophic Cardiomyopathy
    (2012) FERNANDES, Fabio; ARTEAGA-FERNANDEZ, Edmundo; ANTUNES, Murillo de Oliveira; BUCK, Paula; MARSIGLIA, Julia Daher Carneiro; MATSUMOTO, Afonso; NASTARI, Luciano; KRIEGER, Jose Eduardo; PEREIRA, Alexandre Costa; MADY, Charles
    Background: Clinical multistage risk assessment associated with electrocardiogram (ECG) and NT-proBNP may be a feasible strategy to screen hypertrophic cardiomyopathy (HCM). We investigated the effectiveness of a screening based on ECG and NT-proBNP in first-degree relatives of patients with HCM. Methods and Results: A total of 106 first-degree relatives were included. All individuals were evaluated by echocardiography, ECG, NT-proBNP, and molecular screening (available for 65 individuals). From the 106 individuals, 36 (34%) had diagnosis confirmed by echocardiography. Using echocardiography as the gold standard, ECG criteria had a sensitivity of 0.71, 0.42, and 0.52 for the Romhilt-Estes, Sokolow-Lyon, and Cornell criteria, respectively. Mean values of NT-ProBNP were higher in affected as compared with nonaffected relatives (26.1 vs. 1290.5, P < .001). The AUC of NT-proBNP was 0.98. Using a cutoff value of 70 pg/mL, we observed a sensitivity of 0.92 and specificity of 0.96. Using molecular genetics as the gold standard, ECG criteria had a sensitivity of 0.67, 0.37, and 0.42 for the Romhilt-Estes, Sokolow-Lyon, and Cornell criteria, respectively. Using a cutoff value of 70 pg/mL, we observed a sensitivity of 0.83 and specificity of 0.98. Conclusion: Values of NT-proBNP above 70 pg/mL can be used to effectively select high-risk first-degree relatives for HCM screening. (J Cardiac Fail 2012;18:564-568)