EDUARDO ARGENTINO SOSA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Redução da Densidade de Extrassístoles e dos Sintomas Relacionados após Administração de Magnésio por Via Oral(2012) FALCO, Cristina Nadja Muniz Lima De; GRUPI, Cesar; SOSA, Eduardo; SCANAVACCA, Mauricio; HACHUL, Denise; LARA, Sissy; SACILOTTO, Luciana; PISANI, Cristiano F.; RAMIRES, Jose A. F.; DARRIEUX, FranciscoBackground: Premature ventricular and supraventricular complexes (PVC and PsVC) are frequent and often symptomatic. The magnesium (Mg) ion plays a role in the physiology of cell membranes and cardiac rhythm. Objective: We evaluated whether the administration of Mg Pidolate (MgP) in patients with PVC and PsVC is superior to placebo (P) in improving symptoms and arrhythmia frequency. Methods: Randomized double-blind study with 60 consecutive symptomatic patients with more than 240 PVC or PsVC/h on 24-hour Holter monitoring who were selected to receive placebo or MgP. To evaluate symptom improvement, a categorical and a specific questionnaire for symptoms related to PVC and PsVC was made. Improvement in premature complex density (PCD) per hour was considered significant if percentage reduction was >= 70% after treatment. The dose of MgP was 3.0 g/day for 30 days, equivalent to 260mg of Mg element. None of the patients had structural heart disease or renal failure. Results: Of the 60 patients, 33 were female (55%). Ages ranged from 16 to 70 years old. In the MgP group, 76.6% of patients had a PCD reduction >70%, 10% of them >50% and only 13.4% <50%. In the P group, 40% showed slight improvement, <30%, in the premature complexes frequency (p < 0.001). Symptom improvement was achieved in 93.3% of patients in the MgP group, compared with only 16.7% in the P group (p < 0.001). Conclusion: Oral Mg supplementation decreases PCD, resulting in symptom improvement. (Arq Bras Cardiol 2012;98(6):480-487)
- Radiofrequency Ablation of Childhood Arrhythmia. Observational Registry in 125 Children(2012) MELO, Sissy Lara de; SCANAVACCA, Mauricio Ibrahim; PISANI, Cristiano; DARRIEUX, Francisco; HACHUL, Denise; HARDY, Carina; CAMARGO, Paulo Roberto; ATIK, Edmar; SOSA, Eduardo ArgentinoBackground: Radiofrequency ablation (RFA) in children is an increasingly common practice. Objective: To evaluate, in our institution, the results of RFA in children younger than 15 years. Methods: A total of 125 children submitted to RFA between May 1991 and May 2010 were analyzed. Results: Sixty-seven (53.6%) children were males, aged between 44 days and 15 years (mean 8.6 +/- 3.3 years) with median weight of 31 kg. Heart disease was present in 21 (16.8%) patients. The RFA of accessory pathways (AP) was the most common procedure (62 children - 49.6%). The RFA of nodal reentrant tachycardia (NRT) was the second most common arrhythmia in 27 (21.6%), followed by atrial tachycardia (AT) in 16 (12.8%) and ventricular tachycardias (VT) in 8 (6.4%) children. The success criteria were achieved in 86.9%, 96.1%, 80% and 62.5% of patients undergoing RFA of AP, NRT, AT and VT, respectively. Transient AVB occurred during RFA in 4 (3.2%) and LBBB in 7 (5.6%) children. Twenty-five children underwent a new RFA due to initial failure or recurrence. During the mean follow up of 5.5 +/- 3.4 years, 107 (88.4%) remained without recurrence. There was no statistical difference regarding the results and the age at which the patient underwent the procedure. No child had persistent AVB or required a permanent pacemaker. Conclusion: Catheter ablation is a safe and effective alternative therapy in children with recurrent tachycardias refractory to medical treatment. (Arq Bras Cardiol 2012;98(6):514-518)
- Late Outcome of a Randomized Study on Oral Magnesium for Premature Complexes(2014) FALCO, Cristina Nadja M. Lima De; DARRIEUX, Francisco Carlos da Costa; GRUPI, Cesar; SACILOTTO, Luciana; PISANI, Cristiano F.; LARA, Sissy; RAMIRES, Jose A. F.; SOSA, Eduardo; WU, Tan Chen; HACHUL, Denise; SCANAVACCA, MauricioBackground: Ventricular and supraventricular premature complexes (PC) are frequent and usually symptomatic. According to a previous study, magnesium pidolate (MgP) administration to symptomatic patients can improve the PC density and symptoms. Objective: To assess the late follow-up of that clinical intervention in patients treated with MgP or placebo. Methods: In the first phase of the study, 90 symptomatic and consecutive patients with PC were randomized (double-blind) to receive either MgP or placebo for 30 days. Monthly follow-up visits were conducted for 15 months to assess symptoms and control electrolytes. 24-hour Holter was performed twice, regardless of symptoms, or whenever symptoms were present. In the second phase of the study, relapsing patients, who had received MgP or placebo (crossing-over) in the first phase, were treated with MgP according to the same protocol. Results: Of the 45 patients initially treated with MgP, 17 (37.8%) relapsed during the 15-month follow-up, and the relapse time varied. Relapsing patients treated again had a statistically significant reduction in the PC density of 138.25/ hour (p < 0.001). The crossing-over patients reduced it by 247/ hour (p < 0.001). Patients who did not relapse, had a low PC frequency (3 PC/ hour). Retreated patients had a 76.5% improvement in symptom, and crossing-over patients, 71.4%. Conclusion: Some patients on MgP had relapse of symptoms and PC, indicating that MgP is neither a definitive nor a curative treatment for late follow-up. However, improvement in the PC frequency and symptoms was observed in the second phase of treatment, similar to the response in the first phase of treatment.
- Evaluation of the Autonomic Function in Patients with Hypertrophic Cardiomyopathy with and without Syncope(2013) MACATRAO-COSTA, Milena Frota; ARTEAGA-FERNANDEZ, Edmundo; BRITO, Fabio Sandoli de; DARRIEUX, Francisco; MELO, Sissy Lara de; SCANAVACCA, Mauricio; SOSA, Eduardo; HACHUL, DeniseBackground: Several mechanisms may be involved in the trigger of syncope in patients with hypertrophic cardiomyopathy (HCM), including hemodynamic collapses that might be related to an autonomic imbalance. Objective: To evaluate and compare the autonomic function of patients presenting HCM with unexplained syncope (US) to those without syncope. Methods: Thirty-seven patients were included, 16 with US and 21 without syncope. Their autonomic function was assessed by spontaneous and phenylephrine induced baroreflex sensitivity (BRS), by heart rate variability (HRV) in time domain during 24-hour Holter and in frequency domain (spectral analysis), both in supine position and at 70 head-up tilt (HUT). Results: The spontaneous BRS was similar in both groups (16,46 +/- 12,99 vs. 18,31 +/- 9,88 ms/mmHg, p = 0,464), as was phenylephrine-induced BRS (18,33 +/- 9,31 vs. 15,83 +/- 15,48 ms/mmHg, p = 0,521). No differences were observed in SDNN (137,69 +/- 36,62 vs. 145,95 +/- 38,07 ms, p = 0,389). The group presenting syncope had a significantly lower RMSSD (24,88 +/- 10,03 vs. 35,58 +/- 16,43 ms, p = 0,042) and a tendency to lower pNN50 (4,51 +/- 3,78 vs. 8,83 +/- 7,98%, p = 0,085) and lower values of the high frequency component of HRV spectral analysis at rest (637,59 +/- 1.295,53 vs. 782,65 +/- 1.264,14 ms2, p = 0,075). No significant difference was observed in response to HUT (p = 0,053). HUT sensitivity, specificity and accuracy in identifying the etiology of US in HCM patients were 6%, 66% and 40%, respectively. Conclusions: A lower parasympathetic tone was observed in HCM patients with US, but the clinical relevance of this finding remains unclear. HUT is not a valuable tool for evaluating the origin of syncope in these patients, mainly because of its poor specificity.