EDUARDO LEAL ADAM
Projetos de Pesquisa
Unidades Organizacionais
LIM/13 - Laboratório de Genética e Cardiologia Molecular, Hospital das Clínicas, Faculdade de Medicina
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- 3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY(2017) GUALANDRO, D. M.; YU, P. C.; CARAMELLI, B.; MARQUES, A. C.; CALDERARO, D.; FORNARI, L. S.; PINHO, C.; FEITOSA, A. C. R.; POLANCZYK, C. A.; ROCHITTE, C. E.; JARDIM, C.; VIEIRA, C. L. Z.; NAKAMURA, D. Y. M.; IEZZI, D.; SCHREEN, D.; ADAM, Eduardo L.; D'AMICO, E. A.; LIMA, M. Q.; BURDMANN, E. A.; PACHON, E. I. M.; BRAGA, F. G. M.; MACHADO, F. S.; PAULA, F. J.; CARMO, G. A. L.; FEITOSA-FILHO, G. S.; PRADO, G. F.; LOPES, H. F.; FERNANDES, J. R. C.; LIMA, J. J. G.; SACILOTTO, L.; DRAGER, L. F.; VACANTI, L. J.; ROHDE, L. E. P.; PRADA, L. F. L.; GOWDAK, L. H. W.; VIEIRA, M. L. C.; MONACHINI, M. C.; MACATRAO-COSTA, M. F.; PAIXAO, M. R.; OLIVEIRA JR., M. T.; CURY, P.; VILLACA, P. R.; FARSKY, P. S.; SICILIANO, R. F.; HEINISCH, R. H.; SOUZA, R.; GUALANDRO, S. F. M.; ACCORSI, T. A. D.; MATHIAS JR., W.
- A prospective study of patients with refractory angina: outcomes and the role of high-sensitivity troponin T(2017) POPPI, Nilson T.; GOWDAK, Luis H. W.; DOURADO, Luciana O. C.; ADAM, Eduardo L.; LEITE, Thiago N. P.; MIOTO, Bruno M.; KRIEGER, Jose E.; CESAR, Luiz A. M.; PEREIRA, Alexandre C.BackgroundThe predictors of cardiovascular events in patients with chronic refractory angina are limited. High-sensitivity cardiac troponin T (hs-cTnT) assays are biomarkers that may be used to determine the prognosis of patients with stable coronary artery disease. HypothesisHs-cTnT is a predictor of death and nonfatal myocardial infarction (MI) in patients with refractory angina. MethodsWe prospectively enrolled 117 consecutive patients in this study. A heart team ruled out myocardial revascularization feasibility after assessing recent coronary angiograms; evidence of myocardial ischemia served as an inclusion criterion. Optimal medical therapy was encouraged via outpatient visits every 6 months; plasma hs-cTnT levels were determined at baseline. The primary endpoint was the composite incidence of death and nonfatal MI. ResultsDuring a median follow-up period of 28.0 months (interquartile range, 18.0-47.5 months), an estimated 28.0-month cumulative event rate of 13.4% was determined via the Kaplan-Meier method. Univariate predictors of the composite endpoint were hs-cTnT levels and LV dysfunction. Following a multivariate analysis, only hs-cTnT was independently associated with the events in question, either as a continuous variable (hazard ratio per unit increase in the natural logarithm: 2.83, 95% confidence interval: 1.62-4.92, P < 0.001) or as a categorical variable (hazard ratio for concentrations above the 99th percentile: 5.14, 95% confidence interval: 2.05-12.91, P < 0.001). ConclusionsIn patients with chronic refractory angina, plasma concentration of hs-cTnT is the strongest predictor of death and nonfatal MI. Notably, none of the outcomes in question occurred in patients with baseline plasma levels <5.0 ng/L.
- Artéria coronária direita anômala com origem na artéria pulmonar e pericardite constritiva: uma associação inusitada(2013) SILVESTRE, Odilson Marcos; ADAM, Eduardo Leal; MELO, Dirceu Thiago Pessoa de; DIAS, Ricardo Ribeiro; RAMIRES, Felix J. A.; MADY, CharlesThe association of anomalous right coronary artery originating from the pulmonary artery and constrictive pericarditis has never been showed in the literature. We present the first case of this unusual association in a patient with right heart failure. After diagnosis, the patient was referred to surgery and underwent phrenic-to-phrenic pericardiectomy; graft implant of right internal thoracic artery to right coronary artery; and ligation of the anomalous origin of the right coronary artery from the pulmonary artery. Such procedures solved the potential risk of sudden death related to anomalous right coronary artery originating from the pulmonary artery and alleviated the symptoms of heart failure caused by constrictive pericarditis.
bookPart Trombose de prótese valvar(2018) ADAM, Eduardo Leal; ACCORSI, Tarso Augusto DuenhasconferenceObject GRANULICATELLA SPP. ENDOCARDITIS: CASE SERIES(2013) SICILIANO, R. F.; ADAM, E. L.; GUALANDRO, D. M.; CALDERARO, D.; ISSA, V. S.; STRABELLI, T. M. Varejao; MANSUR, A. J.; ROSSI, F.; CARAMELLI, B.Introduction: Nutritionally variant streptococci (NVS) are fastidious organisms that could be responsible for up to 6% of cases of streptococcal infective endocarditis (IE). We report four cases of IE caused by Granulicatella species. Case 1: A 31-year-old male patient presented with fever in the past 15 days and weight loss in 5 months. Echocardiogram showed a bicuspid aortic valve with a 21mm vegetation, abscess and fistula formation. Patient had valve replacement surgery, he was treated with teicoplanin plus gentamycin for four weeks, and was discharged asymptomatic. Case 2: A 64-year-old male with diabetes was admitted with 30 days progressive dyspnea and loss of 25kg in 6 months. Echocardiogram revealedtwovegetationsintheaorticvalve(26mm). Patient developed cardiogenic shock, requiring emergency valve replacement surgery. Postoperatively, he was treated with multiple antibiotic regimens including teicoplanin, meropenem, polymyxin and fluconazole, being discharged fully recovered. He was readmittedtwo weeks later and died due to heart failure and nosocomial pneumonia. Case 3: A 75-year-old man was admitted with a 3-month weight loss. Echocardiogram showed vegetation (19mm) and severe aortic regurgitation. Penicillin plus gentamicin were initiated. Patient died before cardiac surgery due to central nervous system embolization. Case 4: A 59-year-old female reported a five-month fever prior to admission. At hospital admission, tomography showed spleen and kidney embolization. Echocardiogram identified a bicuspid aortic valve with severe regurgitation and vegetation (12mm). Valve replacement surgery was performed and the patient was treated with vancomycin plus gentamycin for 30 days. She was discharged home asymptomatic. Conclusion: NVS are important agents due to the difficulties in isolation and treatment response. We suggest that in IE cases with large vegetations (>10mm), early surgery and combined antibiotic therapy should be considered, probably leading to more favorable outcomes in NVS endocarditis.bookPart Trombose de prótese valvar(2018) ADAM, Eduardo Leal; ACCORSI, Tarso Augusto Duenhas- Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry(2016) BEZERRA, Cristiano Guedes; ADAM, Eduardo Leal; BAPTISTA, Mariana Lins; CIAMBELLI, Giuliano Serafino; KOPEL, Liliane; BERNOCHE, Claudia; LOPES, Leonardo Nicolau Geisler Daud; MACATRAO-COSTA, Milena Frota; FALCAO, Breno de Alencar Araripe; LAGE, Silvia GelasBackground: The use of aortic counterpulsation therapy in advanced heart failure is controversial. Objectives: To evaluate the hemodynamic and metabolic effects of intra-aortic balloon pump (IABP) and its impact on 30-day mortality in patients with heart failure. Methods: Historical prospective, unicentric study to evaluate all patients treated with IABP betwen August/2008 and July/2013, included in an institutional registry named TBRIDGE (The Brazilian Registry of Intra-aortic balloon pump in Decompensated heart failure - Global Evaluation). We analyzed changes in oxygen central venous saturation (ScvO(2)), arterial lactate, and use of vasoactive drugs at 48 hours after IABP insertion. The 30-day mortality was estimated by the Kaplan-Meier method and diferences in subgroups were evaluated by the Log-rank test. Results: A total of 223 patients (mean age 49 +/- 14 years) were included. Mean left ventricle ejection fraction was 24 +/- 10%, and 30% of patients had Chagas disease. Compared with pre-IABP insertion, we observed an increase in ScvO2 (50.5% vs. 65.5%, p < 0.001) and use of nitroprusside (33.6% vs. 47.5%, p < 0.001), and a decrease in lactate levels (31.4 vs. 16.7 mg/dL, p < 0.001) and use of vasopressors (36.3% vs. 25.6%, p = 0.003) after IABP insertion. Thirty-day survival was 69%, with lower mortality in Chagas disease patients compared without the disease (p = 0.008). Conclusion: After 48 hours of use, IABP promoted changes in the use of vasoactive drugs, improved tissue perfusion. Chagas etiology was associated with lower 30-day mortality. Aortic counterpulsation therapy is an effective method of circulatory support for patients waiting for heart transplantation.
conferenceObject Predictors of death and myocardial infarction in patients with refractory angina(2014) POPPI, N. Tavares; DOURADO, L. O. C.; VENTURINI, G.; ADAM, E. L.; LEITE, T. N. P.; CESAR, L. A. Machado; PEREIRA, A. C.; GOWDAK, L. H. W.- COMPUTED TOMOGRAPHY MYOCARDIAL PERFUSION ADDS DIAGNOSTIC POWER TO CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY IN RENAL TRANSPLANT CANDIDATES: PRELIMINARY RESULTS(2018) ADAM, Eduardo Leal; ROCHITTE, Carlos; LEMOS, Pedro; CESAR, Luiz Machado; LIMA, Jose Jayme de; GOWDAK, Luis Henrique
bookPart Trombose de prótese valvar(2015) ADAM, Eduardo Leal; ACCORSI, Tarso Augusto Duenhas