GLAUCYLARA REIS GEOVANINI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/13 - Laboratório de Genética e Cardiologia Molecular, Hospital das Clínicas, Faculdade de Medicina
LIM/13 - Laboratório de Genética e Cardiologia Molecular, Hospital das Clínicas, Faculdade de Medicina
11 resultados
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bookPart Avaliação inical do paciente com marca-passo definitivo na emergência(2018) GOES, Creuza Macedo; GEOVANINI, Glaucylara Reis- Obstructive sleep apnea and its management in patients with atrial fibrillation: An International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT) global survey of practicing cardiologists(2022) FAULX, Michael D.; MEHRA, Reena; GEOVANINI, Glaucylara Reis; ANDO, Shin-ichi; ARZT, Michael; DRAGER, Luciano; FU, Michael; HOYOS, Camilla; HAI, Jo; HWANG, Juey-Jen; KARAOGUZ, Remzi; KIMOFF, John; LEE, Pei-Lin; MEDIANO, Olga; PATEL, Sanjay R.; PEKER, Yuksel; PEPIN, Jean Louis; SANCHEZ-DE-LA-TORRE, Manuel; SERIES, Frederic; STADLER, Stefan; STROLLO, Patrick; TAHRANI, A. A.; THUNSTROM, Erik; YAMAUCHI, Motoo; REDLINE, Susan; PHILLIPS, Craig L.Background: Among international cardiologists it is unclear whether equipoise exists regarding the benefit of diagnosing and managing obstructive sleep apnea (OSA) to improve atrial fibrillation (AF) outcomes and whether clinical practice and equipoise are linked. Methods: Between January 2019 and June 2020 we distributed a web-based 12-question survey regarding OSA and AF management to practicing cardiologists in 16 countries. Results: The United States, Japan, Sweden, and Turkey accounted for two-thirds of responses. 863 cardiologists responded; half were general cardiologists, a quarter electrophysiologists. Responses regarding treating OSA with CPAP to improve AF endpoints were mixed. 33% of respondents referred AF patients for OSA screening. OSA was diagnosed in 48% of referred patients and continuous positive airway pressure (CPAP) was prescribed for 59% of them. Nearly 70% of respondents believed randomized controlled trials (RCTs) of OSA treatment in AF patients were necessary and indicated willingness to contribute to such trials. Conclusions: There was no clinical equipoise among surveyed cardiologists; a majority expressed certainty that combined OSA and AF treatment is superior to AF treatment alone for improving AF outcomes. However, a minority of surveyed cardiologists referred AF patients for OSA testing, and while half of screened AF patients had OSA, CPAP was prescribed in little more than half of them, reflecting the view that better clinical trial evidence is needed to support this practice. Our results underscore the need for larger, multi-national prospective studies of OSA treatment and AF outcomes to inform more uniform society guideline recommendations.
bookPart Complicações associadas à estimulação cardíaca artificial(2016) LEAL, Tatiana de Carvalho Andreucci Torres; GEOVANINI, Glaucylara Reis- Poor sleep quality and lipid profile in a rural cohort (The Baependi Heart Study)(2019) GEOVANINI, Glaucylara Reis; LORENZI-FILHO, Geraldo; PAULA, Lilian K. de; OLIVEIRA, Camila Maciel; ALVIM, Rafael de Oliveira; BEIJAMINI, Felipe; NEGRAO, Andre Brooking; SCHANTZ, Malcolm von; KNUTSON, Kristen L.; KRIEGER, Jose Eduardo; PEREIRA, Alexandre CostaAim: To test the association between cardiometabolic risk factors and subjective sleep quality assessed by the Pittsburgh sleep quality index (PSQI), independent of obstructive sleep apnea (OSA) and sleep duration. Methods: A total of 573 participants from the Baependi Heart Study, a rural cohort from Brazil, completed sleep questionnaires and underwent polygraphy for OSA evaluation. Multivariable linear regression analysis tested the association between cardiovascular risk factors (outcome variables) and sleep quality measured by PSQI, adjusting for OSA and other potential confounders (age, sex, race, salary/wage, education, marital status, alcohol intake, obesity, smoking, hypertension, and sleep duration). Results: The sample mean age was 43 +/- 16 years, 66% were female, and mean body mass index (BMI) was 26 +/- 5 kg/m(2). Only 20% were classified as obese (BMI >= 30). Overall, 50% of participants reported poor sleep quality as defined by a PSQI score >= 5. A high PSQI score was significantly associated with higher very-low-density lipoprotein (VLDL) cholesterol levels (beta = 0.392, p = 0.012) and higher triglyceride levels (beta = 0.017, p = 0.006), even after adjustments, including the apneaehypopnea index. Further adjustments accounting for marital status, alcohol intake, and medication use did not change these findings. No significant association was observed between PSQI scores and glucose or blood pressure. According to PSQI components, sleep disturbances (beta = 1.976, p = 0.027), sleep medication use (beta = 1.121, p = 0.019), and daytime dysfunction (beta = 1.290, p = 0.024) were significantly associated with higher VLDL serum levels. Only the daytime dysfunction domain of the PSQI components was significantly associated with higher triglyceride levels (beta = 0.066, p = 0.004). Conclusion: Poorer lipid profile was independently associated with poor sleep quality, assessed by the PSQI questionnaire, regardless of a normal sleep duration and accounting for OSA and socio-economic status.
- Cardiac rhythm disorders in obstructive sleep apnea(2018) GEOVANINI, Glaucylara Reis; LORENZI-FILHO, GeraldoObstructive sleep apnea (OSA) is common among patients with cardiac rhythm disorders. OSA may contribute to arrhythmias due to acute mechanisms, such as generation of negative intrathoracic pressure during futile efforts to breath, intermittent hypoxia, and surges in sympathetic activity. In addition, OSA may lead to heart remodeling and increases arrhythmia susceptibility. Atrial distension and remodeling, that has been shown to be associated with OSA, is a well-known anatomical substrate for atrial fibrillation (AF). AF is the arrhythmia most commonly described in patients with OSA. Several observational studies have shown that the treatment of OSA with continuous positive airway pressure (CPAP) reduces recurrence of AF after electrical cardioversion and catheter ablation. There is also evidence that nocturnal hypoxemia, a hallmark of OSA, predicts sudden cardiac death (SCD) independently of well-established cardiovascular risk factors. Among patients with an implantable cardiac defibrillator, those with OSA have a higher risk of receiving treatment for life-threatening arrhythmias. Nocturnal hypoxemia may also increase vagal tone, which increases susceptibility to bradycardic and conduction rhythm disorders that have also been described in patients with OSA. In conclusion, there are several biological pathways linking OSA and increased cardiac arrhythmogenesis propensity. However, the independent association is derived from observational studies and the direction of the association still needs clarification due to the lack of large clinical trials. This review focuses on the current scientific evidence linking OSA to cardiac rhythm disorders and point out future directions.
- Atherosclerosis and inflammation: overview and updates(2018) GEOVANINI, Glaucylara Reis; LIBBY, PeterThe concept that inflammation participates pivotally in the pathogenesis of atherosclerosis and its complications has gained considerable attention, but has not yet entered clinical practice. Experimental work has elucidated molecular and cellular pathways of inflammation that promote atherosclerosis. The recognition of atherogenesis as an active process rather than a cholesterol storage disease or a repository of calcium has highlighted some key inflammatory mechanisms. For example, mononuclear phagocytes contribute to all stages of this disease, illustrating the link between inflammation and atherosclerosis. From a clinical perspective, harnessing inflammation may now help target therapeutics, change guidelines, and enter daily practice. Multiple lines of incontrovertible evidence have proven a causal role for low-density lipoprotein (LDL) cholesterol in atherosclerosis, and we have highly effective tools for lowering LDL, consequently reducing events. Yet, even with intense LDL reduction, events still occur. Inflammation can explain some of this residual risk. An anti-inflammatory intervention has now proven capable of improving outcomes in individuals well treated with LDL-lowering agents. A suite of trials are now pursuing anti-inflammatory therapies in this context. Assessment and treatment of residual inflammatory risk are poised to provide new inroads into preventive cardiology. This brief review aims to explore the potential mechanisms underlying the association of inflammation and atherogenesis, and their clinical consequences.
bookPart O impacto cardiovascular da apneia do sono(2016) LORENZI-FILHO, Geraldo; GEOVANINI, Glaucylara Reis; GENTA, Pedro Rodrigues; DRAGER, Luciano FerreirabookPart Avaliação inicial do paciente com marca-passo definitivo na emergência(2015) GEOVANINI, Glaucylara ReisbookPart Avaliação inicial do paciente com marca-passo definitivo na emergência(2018) GOES, Creuza Macedo; GEOVANINI, Glaucylara Reis- Age and Sex Differences in Heart Rate Variability and Vagal Specific Patterns - Baependi Heart Study(2020) GEOVANINI, Glaucylara Reis; VASQUES, Enio Rodrigues; ALVIM, Rafael de Oliveira; MILL, Jose Geraldo; ANDREAO, Rodrigo Varejao; VASQUES, Bruna Kim; PEREIRA, Alexandre Costa; KRIEGER, Jose EduardoBackground: Heart rate variability (HRV) is a noninvasive method for assessing autonomic function. Age, sex, and chronic conditions influence HRV. Objectives: Our aim was to evaluate HRV measures exploring differences by age, sex, and race in a sample from a rural area. Methods: Analytical sample (n = 1,287) included participants from the 2010 to 2016 evaluation period of the Baependi Heart Study, a family-based cohort in Brazil. Participants underwent 24-hour Holter-ECG (Holter) monitoring. To derive population reference values, we restricted our analysis to a 'healthy' subset (i.e. absence of medical comorbidities). A confirmatory analysis was conducted with a subgroup sample that also had HRV derived from a resting ECG 10'-protocol obtained during the same time period. Results: The 'healthy' subset included 543 participants. Mean age was 40 +/- 14y, 41% were male, 74% self-referred as white and mean body-mass-index was 24 +/- 3kg/m(2). Time domain HRV measures showed significant differences by age-decade and by sex. Higher values were observed for males across almost all age-groups. Parasympathetic associated variables (rMSSD and pNN50) showed a U-shaped distribution and reversal increase above 60y. Sympathetic-parasympathetic balance variables (SDNN, SDANN) decreased linearly by age. Race differences were no significant. We compared time domain variables with complete data (Holter and resting ECG) between 'healthy' versus 'unhealthy' groups. Higher HRV values were shown for the 'healthy' subset compared with the 'unhealthy' group. Conclusion: HRV measures vary across age and sex. A U-shaped pattern and a reversal increase in parasympathetic variables may reflect an age-related autonomic dysfunction even in healthy individuals that could be used as a predictor of disease development.