JULIO YOSHIO TAKADA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
conferenceObject Multiple thrombogenic and atherogenic markers were involved in premature coronary artery disease(2012) MANSUR, A. P.; TAKADA, J. Y.; STRUNZ, C. M. C.; AVAKIAN, S. D.; CESAR, L. A. M.; RAMIRES, J. A. F.Atherogenic and thrombogenic factors are implicated in the pathogenesis of coronary artery disease (CAD). Polymorphisms in the lymphotoxin-alfa (LTA) gene, a pro-inflammatory cytokine, have been also associated with susceptibility to myocardial infarction, but results in different studies are conflicting. We examined the association of atherothrombotic markers and the LTA promoter A252G polymorphism with risk of premature CAD. Methods: A case-control study was conducted in 336 patients with documented premature CAD and 189 unrelated health controls both with less than 50 years old. Clinical characteristics and laboratorial data which included thrombogenic factors (fibrinogen, protein C, protein S and antithrombin III); and atherogenic factors (fasting glucose, lipid profile; lipoprotein (a), apolipoproteins AI and B fractions) were evaluated. Genetic variability of LTA was determined by polymerase chain reaction. Results: Male, history of premature CAD, smoking status, diabetes, hypertension and dyslipidemia were significantly more prevalent in the CAD group. Compared with controls, CAD cases had significantly lower mean concentrations of apolipoprotein AI (1.34±0.21 vs 1.23±0.22 mg/dL;<0.01), HDL-cholesterol (46.4±11.9 vs 41.1±11.2 mg/dL; p<0.01) and antithrombin III(100±12.7 vs 94.2±17.8%; p=0.02), and higher plasma concentration of fasting glucose (103.3±26.9 vs 112.1±45.3 mg/dL; p<0.01) and Lipoprotein (a) levels(32.8±32.6 vs 50.1±49.2 mg/dL; p<0.01). The LTA A252G polymorphism frequency for AA, AG and GG was respectively 55.0%, 37,6%, and 7.4% for control group and 42.7%, 46.0% and 11.3% for patients group (p=0.02). A multivariable logistic regression analysis showed that hypertension (OR 2.19 95% CI 1.290-3.716), smoker (OR 2.18; 95% CI 1.455-3.277), dyslipidemia (OR 1.94; 95% CI1.233-3.072), family history (OR 7.13; 95% CI 4.383-11.606) and LTA polymorphism (OR 1.88; 95% CI 1.193-2.972) were independent risk factors for susceptibility to CAD. LTA mutant was risk marker for CAD only in male without the traditional risk factors. Conclusions: Worse traditional risk factors profile and atherothrombogenic markers were associated with susceptibility to premature CAD. LTA mutant allelic was independently associated with premature CAD in male in the absence of traditional risk factors. Premature CAD was associated with worse clinical and laboratory multimarkers.conferenceObject Randomized study of 30 days of resveratrol and caloric restriction on serum levels of sirtuin-1 in healthy subjects(2015) MANSUR, A. P.; ROGGERIO, A.; GOES, M. F. S.; TAKADA, J. Y.; AVAKIAN, S. D.; STRUNZ, C. M. C.conferenceObject Effects of resveratrol and caloric restriction on serum levels of norepinephrine in healthy subjects(2015) MANSUR, A. P.; ROGGERIO, A.; GOES, M. F. S.; TAKADA, J. Y.; AVAKIAN, S. D.; STRUNZ, C. M. C.conferenceObject Left ventricular ejection fraction, systolic blood pressure and smoking history are good predictors of respiratory muscle weakness in systolic heart failure(2018) NAKAGAWA, N. K. Naomi Kondo; DIZ, M. A.; KAWAUCHI, T. S.; ANDRADE, G. N.; UMEDA, Iik; MURAKAMI, F. M.; OLIVEIRA-MAUL, J. P.; NASCIMENTO, J. A.; NUNES, N.; TAKADA, J. Y.; MANSUR, A. P.; CAHALIN, L. P.- Education and lifestyle measures for awareness of syncope prodroms to prevent syncope recurrence in schoolchildren(2021) MAIR, V.; SANTOS, F. R. A.; PEREIRA, H. G.; PASTORE, C. A.; SAMESIMA, N.; DINIZ, L. J.; TAKADA, J. Y.; MANSUR, A. P.; NAKAGAWA, N. K.
conferenceObject Prognosis in 10 years of follow-up of three therapeutic strategies for chronic multivessel coronary artery disease in women (study MASS)(2013) MANSUR, A. P.; HUEB, W. A.; TAKADA, J. Y.; AVAKIAN, S. D.; REZENDE, P. C.; SEGRE, A.; SOARES, P. R.; GARZILLO, C.; RAMIRES, J. A. F.; KALIL FILHO, R.conferenceObject Prognosis importance of absence of angina in non-ST elevation myocardial infarction(2012) TAKADA, J. Y.; RAMOS, R. B.; AVAKIAN, S. D.; RAMIRES, J. A. F.; MANSUR, A. P.Purpose: Cardiac troponins increased myocardial infarction diagnosis in patients without specific electrocardiographic changes. Absence of angina has become common and prognostic significance remains unclear. Methods: We followed 204 consecutive patients after myocardial infarction non-ST elevation(NSTEMI) at emergency department. Outcomes were in-hospital death and follow-up death or cardiac readmission. Results: No-angina (NAG) group (n = 27, 13.2%) had more women (p = 0.001), higher blood glucose (p =0.011) and B-type natriuretic factor (p < 0.001). In-hospital (14.8% vs 4.5%,p = 0.035) and 20-months follow-up mortality (43.5% vs 12.9%, p<0.001) were higher in NAG. Combination of death and cardiac read- mission was similar (70.4%vs 53.1%, p = 0.093). Age (HR = 1.038, 95% CI 1.006 to 1.071), absence of angina at admission (HR 2.554, 95% CI 1.037 to 6.289), male gender (HR 2.706, 95% CI 1.099 to 6.667) and dyspnea (HR 3.113, 95% CI 1.417 to 6.842) were independent predictors of long-term mortality. Conclusion: The absence of chest pain in NSTEMI implies in higher in-hospitaland long-term mortality.- Anomalous Coronary Artery Origin in a Young Patient with Marfan Syndrome(2017) DUARTE, S. B. C. P.; BERALDO, D. O.; CESAR, L. A. M.; MANSUR, A. P.; TAKADA, J. Y.Marfan syndrome is an autosomal dominant genetic disorder that a affects connective tissue and is caused by mutations in the fibrillin 1 gene present at chromosome 15. Aortic aneurysm is its main complication, and along the dilation of the aorta root and its descending portion (60-100%), with secondary aortic insufficiency, it increases risk of acute aortic dissection and death. Coronary artery anomalies a affect between 0.3% and 1.6% of the general population and are the second leading cause of sudden death in young adults, especially if the anomalous coronary passes through aorta and pulmonary artery. The anomalous origin of the left main coronary artery in the right Valsalva sinus has a prevalence of 0.02%-0.05% and is commonly related to other congenital cardiac anomalies, such as transposition of great vessels, coronary fistulas, bicuspid aortic valve, and tetralogy of Fallot. Its association with Marfan syndrome is not known, and there is no previous report in the literature. We describe here a case of a female with Marfan syndrome diagnosed with symptomatic anomalous origin of the left coronary artery in the right Valsalva sinus.
conferenceObject Gene expression of sirtuin-1 and receptor for advanced glycation end products in healthy and slightly overweight subjects after caloric restriction and resveratrol administration(2017) MANSUR, A. P.; ROGGERIO, A.; GOES, M. F. S.; AVAKIAN, S. D.; TAKADA, J. Y.; STRUNZ, C. M. C.- Prolonged heart rate recovery time after 6-minute walk test is an independent risk factor for cardiac events in heart failure: A prospective cohort study(2022) ANDRADE, G. N.; RODRIGUES, T.; TAKADA, J. Y.; BRAGA, L. M.; UMEDA, I. I. K.; NASCIMENTO, J. A.; PEREIRA-FILHO, H. G.; GRUPI, C. J.; SALEMI, V. M. C.; JACOB-FILHO, W.; CAHALIN, L. P.; MANSUR, A. P.; BOCCHI, E. A.; NAKAGAWA, N. K.Objectives To determine whether the time for peak exercise heart rate to return to resting heart rate after the 6-minute walk test (6MWT) can predict cardiac events in patients with heart failure (HF) within 2 years.& nbsp;Design Prospective cohort study.& nbsp;Setting HF outpatient facility at a tertiary teaching hospital.& nbsp;Participants Seventy-six patients with HF, New York Heart Association functional classification II and III, and left ventricular ejection fraction < 50%.& nbsp;Main outcome measures Patients used a heart rate monitor to measure the time for peak exercise heart rate to return to resting heart rate after the 6MWT. Data were analysed using Polar Pro-Trainer 5 software (Kempele, Finland). Patients were followed for > 2 years for cardiac events (hospitalisations and death).& nbsp;Results Thirty-four patients had cardiac events during the 2-year follow-up period. However, there was a significant difference in the time to return to resting heart rate between the groups with and without cardiac events {with 3.6 (SD 1.1) vs without 2.8 (SD 1.1) minutes; mean difference of 0.79 (95% confidence interval (CI) of the difference 0.28 to 1.28; P = 0.003}. No significant differences between patients with and without cardiac events were found for mean walking distance, mean heart rate recovery at 1 minute and mean heart rate recovery at 2 minutes. The receiver operating curve discriminated between patients with and without cardiac events (area under the curve 0.71, 95% CI 0.61 to 0.81; P < 0.001). Using logistic regression analysis, prolonged time to return to resting heart rate (>= 3 minutes) independently increased the risk for cardiac events 6.9-fold (95% CI 2.34 to 20.12; P < 0.001). The Kaplan-Meier curve showed more cardiac events in patients with prolonged time to return to resting heart rate (P = 0.028).& nbsp;Conclusions Prolonged time to return to resting heart rate (>= 3 minutes) after the 6MWT was an independent predictor of cardiac events in patients with HF. (C)& nbsp;2021 Chartered Society of Physiotherapy.