JEANE MIKE TSUTSUI
Projetos de Pesquisa
Unidades Organizacionais
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
conferenceObject Effects of High Mechanical Index Impulses From a Diagnostic Ultrasound Transducer During an Intravenous Ultrasound Contrast Infusion in Preventing Adverse Left Ventricular Remodeling in Acute ST Segment Myocardial Infarction(2016) MATHIAS, Wilson; TSUTSUI, Jeane M.; TAVARES, Bruno G.; AGUIAR, Miguel O.; OLIVEIRA, Mucio T.; SOEIRO, Alexandre; LEMOS, Pedro A.; RAMIRES, Jose; KALIL, Roberto; PORTER, Thomas R.- Diagnostic Ultrasound Impulses Improve Microvascular Flow in Patients With STEMI Receiving Intravenous Microbubbles(2016) MATHIAS JR., Wilson; TSUTSUI, Jeane M.; TAVARES, Bruno G.; XIE, Feng; AGUIAR, Miguel O. D.; GARCIA, Diego R.; OLIVEIRA JR., Mucio T.; SOEIRO, Alexandre; NICOLAU, Jose C.; LEMOS NETO, Pedro A.; ROCHITTE, Carlos E.; RAMIRES, Jose A. F.; KALIL FILHO, Roberto; PORTER, Thomas R.BACKGROUND Pre-clinical trials have demonstrated that, during intravenous microbubble infusion, high mechanical index (HMI) impulses from a diagnostic ultrasound (DUS) transducer might restore epicardial and microvascular flow in acute ST-segment elevation myocardial infarction (STEMI). OBJECTIVES The purpose of this study was to test the safety and efficacy of this adjunctive approach in humans. METHODS From May 2014 through September 2015, patients arriving with their first STEMI were randomized to either DUS intermittent HMI impulses (n = 20) just prior to emergent percutaneous coronary intervention (PCI) and for an additional 30 min post-PCI (HMI + PCI), or low mechanical index (LMI) imaging only (n = 10) for perfusion assessments before and after PCI (LMI + PCI). All studies were conducted during an intravenous perflutren lipid microsphere infusion. A control reference group (n = 70) arrived outside of the time window of ultrasound availability and received emergent PCI alone (PCI only). Initial epicardial recanalization rates prior to emergent PCI and improvements in microvascular flow were compared between ultrasound-treated groups. RESULTS Median door-to-dilation times were 82 +/- 26 min in the LMI + PCI group, 72 +/- 15 min in the HMI + PCI group, and 103 +/- 42 min in the PCI-only group (p = NS). Angiographic recanalization prior to PCI was seen in 12 of 20 HMI + PCI patients (60%) compared with 10% of LMI + PCI and 23% of PCI-only patients (p = 0.002). There were no differences in microvascular obstructed segments prior to treatment, but there were significantly smaller proportions of obstructed segments in the HMI + PCI group at 1 month (p = 0.001) and significant improvements in left ventricular ejection fraction (p < 0.005). CONCLUSIONS HMI impulses from a diagnostic transducer, combined with a commercial microbubble infusion, can prevent microvascular obstruction and improve functional outcome when added to the contemporary PCI management of acute STEMI. (Therapeutic Use of Ultrasound in Acute Coronary Artery Disease; NCT02410330) (C) 2016 by the American College of Cardiology Foundation.
- The impact of ligation of proximal side branches on blood flow and functional status of the internal thoracic artery in coronary anastomosis(2016) ABREU, Jose Sebastiao; TSUTSUI, Jeane Mike; FALCAO, Sandra Nivea R.; FEITOSA, Jose Acacio; ROCHA, Eduardo Arraes; OLIVEIRA, Italo Martins; DIOGENES, Teresa Cristina; PAES JR., Jose N.; SBANO, Joao C.; DALLAN, Luis A.; KALIL FILHO, Roberto; MATHIAS JR., WilsonBackgroundThe effect of proximal side branches on the patency of the internal thoracic artery (ITA) is controversial. We used echocardiography and Doppler to verify the effect of ligation of branches on the flow and coronary flow reserve (CFR) of the grafted ITA in patients after coronary artery bypass grafting (CABG). MethodsWe prospectively investigated 53 patients with preserved left ventricular ejection fraction (LVEF >50%) who underwent CABG of the ITA. In Group I (25 patients), major branches were ligated during ITA anastomosis to the left anterior descending (LAD) coronary artery, whereas no ligation was performed in Group II (28 patients). Systolic flow (SF), diastolic flow (DF), and total flow (TF = SF + DF) were measured by Doppler echocardiography at the proximal level of the ITA preoperatively, at early postoperative stage, and 6months after surgery. Dobutamine stress echocardiography (DSE) was performed at 6months to determine CFR. ResultsThe ITA flow was predominantly systolic before surgery and diastolic in the postoperative period. We found no differences between the groups in DF. On DSE, SF (19.59mL/min vs 32.7 +/- 19mL/min; P=.003) and TF (79 +/- 21mL/min vs 101 +/- 47mL/min; P=.037) were higher in Group II. There were no differences in CFR (1.9 +/- 0.46 vs 2.11 +/- 0.56; P=.143). ConclusionIn patients with preserved LVEF, ligation of major side branches during anastomosis to the LAD does not alter ITA flow or CFR.
conferenceObject Effects of High Mechanical Index Impulses From a Diagnostic Ultrasound Transducer During an Intravenous Ultrasound Contrast Infusion in Preventing Adverse Left Ventricular Remodeling in Acute ST Segment Myocardial Infarction(2016) MATHIAS, Wilson; TSUTSUI, Jeane M.; TAVARES, Bruno G.; AGUIAR, Miguel O.; OLIVEIRA, Mucio T.; SOEIRO, Alexandre; LEMOS, Pedro A.; RAMIRES, Jose; KALIL, Roberto; PORTER, Thomas R.