MARIA JANIEIRE DE NAZARE NUNES ALVES
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
113 resultados
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- Android to gynoid fat ratio and its association with functional capacity in male patients with heart failure(2020) SANTOS, Marcelo Rodrigues Dos; FONSECA, Guilherme Wesley Peixoto da; SHERVENINAS, Leticia Pironato; SOUZA, Francis Ribeiro de; BATTAGLIA FILHO, Antonio Carlos; NOVAES, Caio Eduardo; PEREIRA, Rosa Maria Rodrigues; NEGRAO, Carlos Eduardo; BARRETTO, Antonio Carlos Pereira; ALVES, Maria-Janieire de Nazare NunesAims We studied the association between android (A) to gynoid (G) fat ratio and functional capacity (peak VO2) in male patients with heart failure with reduced ejection fraction (HFrEF). Methods and results We enrolled 118 male patients with HFrEF with left ventricular ejection fraction (LVEF) <40%. Body composition (by using dual x-ray absorptiometry) and peak VO2 (by cardiopulmonary exercise testing) were measured. Sarcopenic obesity was defined according to the Foundation for the National Institutes of Health criteria (FNIH). Blood sample for metabolic and hormonal parameters were measured. Fifteen patients (12.7%) showed sarcopenic obesity (body mass index > 25 kg/m(2) with FNIH index < 0.789). The median A/G ratio was 0.55. A/G ratio > 0.55 was detected in 60 patients. Relative peak VO2 was lower in patients with A/G ratio > 0.55 than in patients with A/G ratio <0.55 (18.7 +/- 5.3 vs. 22.5 +/- 6.1 mL/kg/min, P < 0.001). Logistic regression analysis showed A/G ratio >0.55 to be independently associated with reduced peak VO2 adjusted for age, body mass index, LVEF, presence of sarcopenia, anabolic hormones, and haemoglobin (odds ratio 3.895, 95% confidence interval 1.030-14.730, P = 0.045). Conclusions Body fat distribution, particularly android and gynoid fat composition, together with other cofactors, might have an important adverse role on functional capacity in male patients with HFrEF. Future studies are needed to address possible mechanisms involved in this relationship.
- Mechanisms of Blunted Muscle Vasodilation During Peripheral Chemoreceptor Stimulation in Heart Failure Patients(2012) ALVES, M. J. N. N.; SANTOS, Marcelo Rodrigues dos; NOBRE, Thais Simoes; MARTINEZ, Dg; BARRETTO, Antonio Carlos Pereira; BRUM, Patricia Chakur; RONDON, Maria Urbana P. B.; MIDDLEKAUFF, Holly R.; NEGRAO, Carlos EduardoWe described recently that systemic hypoxia provokes vasoconstriction in heart failure (HF) patients. We hypothesized that either the exaggerated muscle sympathetic nerve activity and/or endothelial dysfunction mediate the blunted vasodilatation during hypoxia in HF patients. Twenty-seven HF patients and 23 age-matched controls were studied. Muscle sympathetic nerve activity was assessed by microneurography and forearm blood flow (FBF) by venous occlusion plethysmography. Peripheral chemoreflex control was evaluated through the inhaling of a hypoxic gas mixture (10% O-2 and 90% N-2). Basal muscle sympathetic nerve activity was greater and basal FBF was lower in HF patients versus controls. During hypoxia, muscle sympathetic nerve activity responses were greater in HF patients, and forearm vasodilatation in HF was blunted versus controls. Phentolamine increased FBF responses in both groups, but the increase was lower in HF patients. Phentolamine and N-G-monomethyl-L-arginine infusion did not change FBF responses in HF but markedly blunted the vasodilatation in controls. FBF responses to hypoxia in the presence of vitamin C were unchanged and remained lower in HF patients versus controls. In conclusion, muscle vasoconstriction in response to hypoxia in HF patients is attributed to exaggerated reflex sympathetic nerve activation and blunted endothelial function (NO activity). We were unable to identify a role for oxidative stress in these studies. (Hypertension. 2012; 60: 669-676.) . Online Data Supplement
conferenceObject Discriminating sarcopenia in male patients with heart failure: the influence of body mass index(2018) SANTOS, M. R. Dos; FONSECA, G. W. P.; SOUZA, F. R.; CASTRO, V. M.; TAKAYAMA, L.; PEREIRA, R. M. R.; NEGRAO, C. E.; ALVES, M. J. N. N.bookPart Exercício físico e reposição hormonal na doença cardiovascular(2019) ALVES, Maria Janieire de Nazaré Nunes; SANTOS, Marcelo Rodrigues dos; FONSECA, Guilherme Wesley Peixoto da- Identifying the risk of obstructive sleep apnea in metabolic syndrome patients: Diagnostic accuracy of the Berlin Questionnaire(2019) CEPEDA, Felipe X.; VIRMONDES, Leslie; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene C. B.; TOSCHI-DIAS, Edgar; FERREIRA-CAMARGO, Fernanda C.; HUSSID, Maria Fernanda; RONDON, Maria Urbana P. B.; ALVES, Maria Janieire N. N.; TROMBETTA, Ivani C.Background Obstructive sleep apnea (OSA) is a risk factor frequently present in patients with metabolic syndrome (MetS). Additionally, moderate and severe OSA are highly prevalent in patients with cardiac disease, as they increase the riskfor cardiovascular events by 80%. The gold standard diagnostic method for OSA is overnight polysomnography (PSG), which remains unaffordable for the overall population. The aim of the present study was to evaluate whether the Berlin Questionnaire (BQ) is anuseful tool for assessing the risk of OSA in patients with MetS. Methods 97 patients, previously untreated and recently diagnosed with MetS (National Cholesterol Education Program, Adult Treatment Panel III, ATP-III) underwent a PSG. OSA was characterized by the apnea-hypopnea index (AHI). BQ was administered before PSG and we evaluated sensitivity, specificity, positive and negative predictive values, and accuracy. Results Of the 97 patients with MetS, 81 patients had OSA, with 47 (48.5%) presenting moderate and severe OSA. For all MetS with OSA (AHI >= 5 events/hour), the BQ showed good sensitivity (0.65, 95% CI 0.54 to 0.76) and fair specificity (0.38, 95% CI 0.15-0.65) with a positive predictive value of 0.84, a negative predictive value of 0.18 and an 84% accuracy. Similarly, for moderate-to-severe OSA (AHI >= 15 events/hour) we found good sensitivity (0.73, 95% CI 0.58-0.85) and fair specificity (0.40, 95% CI 0.27-0.55). Interestingly, for severe OSA (AHI. 30 events/hour), there was a very good sensitivity (0.91, 95% CI 0.72-0.99) and moderate specificity (0.42, 95% CI 0.31-0.54). Conclusion The BQ is a valid tool for screening the risk of OSA in MetS patients in general, and it is particularly useful in predicting severe OSA.
conferenceObject Effects of Aerobic and Inspiratory Training on Skeletal Muscle Microrna-1 and Downstream-Associated Pathways in Patients With Systolic Heart Failure(2019) ANTUNES-CORREA, Ligia M.; TREVIZAN, Patricia; BACURAU, Aline V.; FERREIRA-SANTOS, Larissa; GOMES, Joao L.; URIAS, Ursula; OLIVEIRA, Patricia; ALVES, Maria-Janieire N.; ALMEIDA, Dirceu R.; BRUM, Patricia C.; OLIVEIRA, Edilamar M.; HAJJAR, Ludhmila; KALIL FILHO, Roberto; NEGRAO, Carlos E.conferenceObject EFFECT OF EXERCISE TRAINING ON PLATELET AGGREGATION AND ON P2Y12 INHIBITOR RESISTANCE AFTER MYOCARDIAL INFARCTION: A RANDOMIZED CLINICAL TRIAL(2020) DALCOQUIO, Talia; FURTADO, Remo Holanda de Mendonca; ARANTES, Flavia Bittar Britto Britto; SANTOS, Mayara Alves dos; ALVES, Leandro Silva; RONDON, Maria Urbana Pinto Brandao; FERREIRA-SANTOS, Larissa; ALVES, Maria Janieire de Nazare Nunes; FERRARI, Aline Gehlen; GENESTRETI, Paulo Rizzo; BARACIOLI, Luciano Moreira; FRANCI, Andre; SALSOSO, Rocio; NEGRAO, Carlos Eduardo; NICOLAU, Jose Carlos- Diminished cholesterol efflux mediated by HDL and coronary artery disease in young male anabolic androgenic steroid users(2019) SOUZA, Francis Ribeiro de; SANTOS, Marcelo Rodrigues Dos; PORELLO, Rafael Armani; FONSECA, Guilherme Wesley Peixoto da; SAYEGH, Ana Luiza Carrari; LIMA, Thais Pinheiro; FERREIRA, Fabiana Dias; OLIVEIRA, Tiago Franco de; YONAMINE, Mauricio; TAKAYAMA, Liliam; PEREIRA, Rosa Maria Rodrigues; NEGRAO, Carlos Eduardo; PASSARELLI, Marisa; ROCHITTE, Carlos Eduardo; ALVES, Maria Janieire de Nazare NunesBackground and aims: Anabolic androgenic steroids (AAS) have been associated with coronary artery disease (CAD). AAS abuse leads to a remarkable decrease in high-density lipoprotein (HDL) plasma concentration, which could be a key factor in the atherosclerotic process. Moreover, not only the concentration of HDL, but also its functionality, plays a pivotal role in CAD. We tested the functionality of HDL by cholesterol efflux and antioxidant capacity. We also evaluated the prevalence of CAD in AAS users. Methods: Twenty strength-trained AAS users (AASU) age 29 +/- 5 yr, 20 age-matched strength-trained AAS nonusers (AASNU), and 10 sedentary controls (SC) were enrolled in this cross-sectional study. Functionality of HDL was evaluated by C-14-cholesterol efflux and the ability of HDL in inhibiting LDL oxidation. Coronary artery was evaluated with coronary computed tomography angiography. Results: Cholesterol efflux was lower in AASU compared with AASNU and SC (20 vs. 23 vs. 24%, respectively, p < 0.001). However, the lag time for LDL oxidation was higher in AASU compared with AASNU and SC (41 vs 13 vs 11 min, respectively, p < 0.001). We found at least 2 coronary arteries with plaques in 25% of AASU. None of the AASNU and SC had plaques. The time of AAS use was negatively associated with cholesterol efflux. Conclusions: This study indicates that AAS abuse impairs the cholesterol efflux mediated by HDL. Long-term AAS use seems to be correlated with lower cholesterol efflux and early subclinical CAD in this population.
conferenceObject Obstructive Sleep Apnea Impairs the Time Delay of the Baroreflex Control and the Oscilattory Pattern of the Sympathetic Activity in Patients with Metabolic Syndrome(2012) TOSCHI-DIAS, Edgar; TROMBETTA, Ivani C.; SILVA, Valdo J. Dias da; MAKI-NUNES, Cristiane; CEPEDA, Felipe X.; ALVES, Maria Janieire N.; DRAGER, Luciano F.; LORENZI-FILHO, Geraldo; NEGRAO, Carlos E.; RONDON, Maria Urbana P.conferenceObject Coronary inflammation by computed tomography pericoronary fat attenuation in young male anabolic androgenic steroid users(2022) SOUZA, F.; ROCHITTE, C. E.; SILVA, D. C.; GOMES, A. M. R.; SANTOS, M. R.; FONSECA, G. W. P.; BATTAGLIA, A. C. B. F.; CORREA, K. T. S.; YONAMINE, M.; PEREIRA, R. M. R.; NEGRAO, C. E.; ALVES, M. J. N. N.