LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação
URI Permanente desta comunidade
O Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação é ligado ao Departamento de Cardiopneumologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP).
Linhas de pesquisa: estudo da reação inflamatória e da microcirculação nas disfunções circulatórias; alterações circulatórias e da resposta inflamatória no emprego da circulação artificial; métodos de prevenção e controle das alterações do enxerto após o transplante cardíaco; mecanismos de proteção medular na abordagem cirúrgica da aorta torácica; desenvolvimento biotecnológico e integração morfofuncional de substitutos valvares biológicos; mecanismos de hipertrofia e métodos de preparo das câmaras ventriculares.
Site oficial: http://limhc.fm.usp.br/portal/lim11-laboratorio-de-cirurgia-cardiovascular-e-fisiopatologia-da-circulacao/
Linhas de pesquisa: estudo da reação inflamatória e da microcirculação nas disfunções circulatórias; alterações circulatórias e da resposta inflamatória no emprego da circulação artificial; métodos de prevenção e controle das alterações do enxerto após o transplante cardíaco; mecanismos de proteção medular na abordagem cirúrgica da aorta torácica; desenvolvimento biotecnológico e integração morfofuncional de substitutos valvares biológicos; mecanismos de hipertrofia e métodos de preparo das câmaras ventriculares.
Site oficial: http://limhc.fm.usp.br/portal/lim11-laboratorio-de-cirurgia-cardiovascular-e-fisiopatologia-da-circulacao/
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Coleções desta Comunidade
- LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação
- LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação
- LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação
Submissões Recentes
Data-driven, cross-disciplinary collaboration: lessons learned at the largest academic health center in Latin America during the COVID-19 pandemic
(2024) RITTO, Ana Paula; ARAUJO, Adriana Ladeira de; CARVALHO, Carlos Roberto Ribeiro de; SOUZA, Heraldo Possolo De; FAVARETTO, Patricia Manga e Silva; SABOYA, Vivian Renata Boldrim; GARCIA, Michelle Louvaes; KULIKOWSKI, Leslie Domenici; KALLAS, Esper Georges; PEREIRA, Antonio Jose Rodrigues; COBELLO JUNIOR, Vilson; SILVA, Katia Regina; ABDALLA, Eidi Raquel Franco; SEGURADO, Aluisio Augusto Cotrim; SABINO, Ester Cerdeira; RIBEIRO JUNIOR, Ulysses; FRANCISCO, Rossana Pulcineli Vieira; MIETHKE-MORAIS, Anna; LEVIN, Anna Sara Shafferman; SAWAMURA, Marcio Valente Yamada; FERREIRA, Juliana Carvalho; SILVA, Clovis Artur; MAUAD, Thais; GOUVEIA, Nelson da Cruz; LETAIF, Leila Suemi Harima; BEGO, Marco Antonio; BATTISTELLA, Linamara Rizzo; DUARTE, Alberto Jose da Silva; SEELAENDER, Marilia Cerqueira Leite; MARCHINI, Julio; FORLENZA, Orestes Vicente; ROCHA, Vanderson Geraldo; MENDES-CORREA, Maria Cassia; COSTA, Silvia Figueiredo; CERRI, Giovanni Guido; BONFA, Eloisa Silva Dutra de Oliveira; CHAMMAS, Roger; BARROS FILHO, Tarcisio Eloy Pessoa de; BUSATTO FILHO, Geraldo
Introduction The COVID-19 pandemic has prompted global research efforts to reduce infection impact, highlighting the potential of cross-disciplinary collaboration to enhance research quality and efficiency.Methods At the FMUSP-HC academic health system, we implemented innovative flow management routines for collecting, organizing and analyzing demographic data, COVID-related data and biological materials from over 4,500 patients with confirmed SARS-CoV-2 infection hospitalized from 2020 to 2022. This strategy was mainly planned in three areas: organizing a database with data from the hospitalizations; setting-up a multidisciplinary taskforce to conduct follow-up assessments after discharge; and organizing a biobank. Additionally, a COVID-19 curated collection was created within the institutional digital library of academic papers to map the research output.Results Over the course of the experience, the possible benefits and challenges of this type of research support approach were identified and discussed, leading to a set of recommended strategies to enhance collaboration within the research institution. Demographic and clinical data from COVID-19 hospitalizations were compiled in a database including adults and a minority of children and adolescents with laboratory confirmed COVID-19, covering 2020-2022, with approximately 350 fields per patient. To date, this database has been used in 16 published studies. Additionally, we assessed 700 adults 6 to 11 months after hospitalization through comprehensive, multidisciplinary in-person evaluations; this database, comprising around 2000 fields per subject, was used in 15 publications. Furthermore, thousands of blood samples collected during the acute phase and follow-up assessments remain stored for future investigations. To date, more than 3,700 aliquots have been used in ongoing research investigating various aspects of COVID-19. Lastly, the mapping of the overall research output revealed that between 2020 and 2022 our academic system produced 1,394 scientific articles on COVID-19.Discussion Research is a crucial component of an effective epidemic response, and the preparation process should include a well-defined plan for organizing and sharing resources. The initiatives described in the present paper were successful in our aim to foster large-scale research in our institution. Although a single model may not be appropriate for all contexts, cross-disciplinary collaboration and open data sharing should make health research systems more efficient to generate the best evidence.
Delayed left main coronary obstruction following transfemoral inovare transcatheter aortic valve replacement: A challenging case
(2022) KANHOUCHE, G.; CIVIDANES, F. R.; SAMPAIO, R. O.; SILVA, J. C. A. da; MACHADO, R. D.; WERNECK, M.; ACCORSI, T. A. D.; MORALES, K. R. D. P.; ABIZAID, A. C.; BRITO, F. S. D. Jr.; TARASOUTCHI, F.; PALMA, J. H.; RIBEIRO, H. B.
Coronary obstruction is an uncommon and severe complication after a transcatheter aortic valve replacement (TAVR), that occurs during the procedure in the vast majority of patients. In the present case even in the absence of classic risk factors, an acute coronary syndrome occurred one day after TAVR. Selective angiography revealed a severe left main ostium obstruction by the bulky native leaflet calcification. This is the first case of delayed presentation of coronary obstruction with a transfemoral balloon-expandable valve using the Inovare bioprosthesis (Braile Biomedica, Brazil). In addition, after drug-eluting stent placement in the left main coronary, intravascular ultrasound revealed severe stent underexpansion, so that a second layer of a bare-metal stent and high-pressure balloon post-dilatation was necessary to improve the final result. The patient was discharged after 7 days, and at the 6-month follow-up remained asymptomatic.
Rare association between giant-cell aortitis and giant-cell aortic valvulitis
(2023) LUZURIAGA, G. C. J.; DIAS, R. R.; SANTIAGO, J. A. D.; JUNIOR, V. M.; ISHIKAWA, W. Y.; FERNANDES, F.; AIELLO, V. D.
Giant cell arteritis (GCA) is a type of chronic vasculitis that affects medium and large-caliber arteries, frequently related to aortic involvement and, consequently, to aneurysm formation. However, associated valvulitis with giant cells is uncommon. We describe the case of a 50-year-old female patient with aortic aneurysm and valvular insufficiency, whose anatomopathological examination revealed giant-cell aortic valvulitis associated with giant cell aortitis.
Reduced-dose prasugrel monotherapy without aspirin after PCI with the SYNERGY stent in East Asian patients presenting with chronic coronary syndromes or non-ST-elevation acute coronary syndromes: rationale and design of the ASET Japan pilot study
(2023) MASUDA, S.; MURAMATSU, T.; ISHIBASHI, Y.; KOZUMA, K.; TANABE, K.; NAKATANI, S.; KOGAME, N.; NAKAMURA, M.; ASANO, T.; OKAMURA, T.; MIYAZAKI, Y.; TATEISHI, H.; OZAKI, Y.; NAKAZAWA, G.; MORINO, Y.; KATAGIRI, Y.; GARG, S.; HARA, H.; ONO, M.; KAWASHIMA, H.; LEMOS, P. A.; SERRUYS, P. W.; ONUMA, Y.
The Acetyl Salicylic Elimination Trial (ASET) Japan pilot study is a multicentre, single-arm, open-label, proof-of-concept study with a stopping rule based on the occurrence of definite stent thrombosis. This study aims to demonstrate the feasibility and safety of low-dose prasugrel monotherapy following percutaneous coronary intervention (PCI) in Japanese patients presenting with chronic coronary syndromes (CCS) or non-ST-elevation acute coronary syndromes (NSTE-ACS). Four hundred patients with a SYNTAX score <23 requiring PCI due to CCS or NSTE-ACS will be screened and considered eligible for the study. The enrolment is planned in two phases: 1) 200 patients presenting with CCS, followed by 2) 200 patients presenting with NSTE-ACS. After optimal PCI with implantation of a SYNERGY (Boston Scientific) stent, patients will be enrolled and loaded with prasugrel 20 mg, followed by a maintenance dose of prasugrel 3.75 mg once daily without aspirin continued for 3 months in Phase 1 (CCS patients), and for 12 months in Phase 2 (NSTE-ACS patients). After these follow-up periods, prasugrel will be replaced by standard antiplatelet therapy according to local practice. The primary endpoint is a composite of cardiac death, target vessel myocardial infarction, or definite stent thrombosis after the index procedure. The primary bleeding endpoint is any Bleeding Academic Research Consortium type 3 or 5 bleeding occurring within 3 months of the index PCI for CCS patients, or 12 months for NSTE-ACS patients. The ASET Japan study is designed to demonstrate the feasibility and safety of reduced-dose prasugrel monotherapy after PCI in East Asian patients with acute and chronic coronary syndromes.
Rivaroxaban versus warfarin in postoperative atrial fibrillation: Cost-effectiveness analysis in a single-center, randomized, and prospective trial
(2023) PEREIRA, M. D. P.; LIMA, E. G.; PITTA, F. G.; GOWDAK, L. H. W.; MIOTO, B. M.; CARVALHO, L. N. S.; DARRIEUX, F. C. D. C.; MEJIA, O. A. V.; JATENE, F. B.; SERRANO JR., C. V
Objectives: Postoperative atrial fibrillation is the most common clinical complication after coronary artery bypass graft surgery. It is associated with a high risk of both stroke and death and increases the length of hospital stay and costs. This study aimed to evaluate anticoagulants in postoperative atrial fibrillation. Methods: A single-center, randomized, prospective, and open-label study. The trial was conducted in Heart Institute at University of São Paulo, Brazil. Patients who developed postoperative atrial fibrillation were randomized to anticoagulation with rivaroxaban or warfarin plus enoxaparin bridging. The primary objective was the cost-effectiveness evaluated by quality-adjusted life years, using the SF-6D questionnaire. The secondary end point was the combination of death, stroke, myocardial infarction, thromboembolic events, infections, bleeding, readmissions, and surgical reinterventions. The safety end point was any bleeding using the International Society on Thrombosis and Haemostasis score. Follow-up period was 30 days after hospital discharge. Results: We analyzed 324 patients and 53 patients were randomized. The median cost-effectiveness was $1423.20 in the warfarin group versus $586.80 in the rivaroxaban group (P = .002). The median cost was lower in the rivaroxaban group, $450.20 versus $947.30 (P < .001). The secondary outcome was similar in both groups, 44.4% in warfarin group versus 38.5% in the rivaroxaban group (P = .65). Bleeding occured in 25.9% in the warfarin group versus 11.5% in the rivaroxaban group (P = .18). Conclusions: Rivaroxaban was more cost-effective when compared with warfarin associated with enoxaparin bridging in postoperative atrial fibrillation after isolated coronary artery bypass grafting.
Degenerative or rheumatic: after all, what is the most prevalent etiology of mitral regurgitation in developing countries?
(2023) LIPARI, L. F. Vicente Pereira; FERNANDES, J. R. C.; ZIOTTI, S. V.; NAZZETTA, D. C.; TESSARI, F. C.; PESSOA, R. S.; HAUSSAUER JR., H. V.; ROSA, V. E. E.; PIRES, L. J. N. T.; ACCORSI, T. A. D.; LOPES, M. P.; SANTIS, A. S. De; SPINA, G. S.; SAMPAIO, R. O.; TARASOUTCHI, F.
PRIMARY RESULTS FROM APOLLO-B, A PHASE 3 STUDY OF PATISIRAN IN PATIENTS WITH TRANSTHYRETIN-MEDIATED AMYLOIDOSIS WITH CARDIOMYOPATHY
(2023) LONGHI, S.; MAURER, M.; FONTANA, M.; BERK, J.; GUSTAFSSON, F.; SIMOES, M.; GROGAN, M.; FERNANDES, F.; GOTTLIEB, R.; KUBANEK, M.; POULSEN, S.; DAMY, T.; DIEMBERGER, I.; TAHARA, N.; YU, W.; TANG, W.; OBICI, L.; GONZALEZ-DUARTE, A.; SEKIJIMA, Y.; WHITE, M.; YURENEVA, E.; JAY, P.; VEST, J.; GILLMORE, J.
USING MACHINE LEARNING TO ASSESS POTENTIAL CASES OF TRANSTHYRETIN CARDIAC AMYLOIDOSIS IN BRAZIL: A RETROSPECTIVE DATABASE APPROACH
(2023) LAPER, I. Zuppo; CAMACHO-HUBNER, C.; FERREIRA, R.; JULIAN, G. S.; SOUZA, C. L. de; V, M. Simoes; FERNANDES, F.; CORREIA, E. B.; ABREU, A. J.
EXPLORATORY ANALYSES FROM APOLLO-B, A PHASE 3 STUDY OF PATISIRAN IN PATIENTS WITH ATTR AMYLOIDOSIS WITH CARDIOMYOPATHY
(2023) CAPPELLI, F.; KALE, P.; MAURER, M.; FONTANA, M.; GROGAN, M.; FERNANDES, F.; PALACEK, T.; TAYLOR, M.; HUNG, R.; GONZALEZ-DUARTE, A.; PUOLSEN, S.; DONAL, E.; PERFETTO, F.; TSUJITA, K.; YU, W.; SARSWAT, N.; WHITE, M.; YURENEVA, E.; JAY, P.; VEST, J.; GILLMORE, J.
Non-invasive assessment of myocardial stiffness by the two-dimensional shear wave elastography ultrasound technique in patients with amyloidosis and Fabry disease
(2023) CAFEZEIRO, C.; NETO, A. C. Alencar; BUENO, B. V. K.; RISSATO, J. H.; PEREIRA, N. M.; PEREIRA, F. L.; RAMIRES, F. J. A.; MATHIAS JR., W.; ROCHITTE, C. E.; HOTTA, V. T.; DABARIAN, A. L.; FERNANDES, F.