CAMILA PAIXAO JORDAO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Adjuvant Treatment with5-Fluorouraciland Oxaliplatin Does Not Influence Cardiac Function, Neurovascular Control, and Physical Capacity in Patients with Colon Cancer(2020) GROEHS, Raphaela V.; NEGRAO, Marcelo V.; HAJJAR, Ludhmila A.; JORDAO, Camila P.; CARVALHO, Bruna P.; TOSCHI-DIAS, Edgar; ANDRADE, Ana C.; HODAS, Fabiana P.; ALVES, Maria J. N. N.; SARMENTO, Adriana O.; TESTA, Laura; HOFF, Paulo M. G.; NEGRAO, Carlos E.; KALIL FILHO, RobertoBackground Adjuvant chemotherapy with 5-fluorouracil (5-FU) and oxaliplatin increases recurrence-free and overall survival in patients with colon adenocarcinoma. It is known that these drugs have been associated with cardio- and neurotoxicity. We investigated the effects of 5-FU +/- oxaliplatin on cardiac function, vascular responses, neurovascular control, and physical capacity in patients with colon cancer. Methods Twenty-nine patients with prior colectomy for stage II-III adenocarcinoma and clinical indication for adjuvant chemotherapy were allocated to receive 5-FU (n= 12) or 5-FU + oxaliplatin (n= 17), according to the oncologist's decision. All the analyses were performed just before and after the end of chemotherapy. Cardiac function was assessed by echocardiography and speckle tracking, and cardiac autonomic control was assessed by heart rate variability (HRV). Vascular endothelial function was assessed by flow-mediated dilation (FMD). Muscle sympathetic nerve activity (MSNA) was directly recorded by microneurography technique, and muscle blood flow by venous occlusion plethysmography. Physical capacity was evaluated by cardiopulmonary exercise test. Results Chemotherapy (pooled data) did not significantly change left ventricular ejection fraction (58 +/- 1 vs. 55 +/- 2%,p= .14), longitudinal strain (-18 +/- 1 vs. -18 +/- 1%,p= .66), and HRV. Likewise, chemotherapy did not significantly change FMD, muscle blood flow, and MSNA (33 +/- 2 vs. 32 +/- 1 bursts/min,p= .31). Physical capacity was not significantly changed in both groups. Similar findings were observed when the patients were subdivided in 5-FU and 5-FU + oxaliplatin treatment groups. 5-FU and 5-FU + oxaliplatin did not significantly change cardiac function, HRV, vascular responses, MSNA, and physical capacity. Conclusion This study provides evidence that adjuvant treatment with 5-FU +/- oxaliplatin is well tolerated and does not promote changes compatible with long-term cardiotoxicity. Implications for Practice Adjuvant chemotherapy with 5-fluorouracil (5-FU) and oxaliplatin increases recurrence-free and overall survival in patients with colon adenocarcinoma; however, these drugs have been associated with cardio- and neurotoxicity. This study investigated the effects of these drugs on cardiac function, vascular responses, neurovascular control, and physical capacity in patients with colon cancer. It was found that 5-FU and oxaliplatin did not significantly change cardiac function, cardiac autonomic control, vascular endothelial function, muscle sympathetic nerve activity, and physical capacity. This study provides evidence that adjuvant treatment with 5-FU +/- oxaliplatin is well tolerated and does not promote changes compatible with long-term cardiotoxicity.
- Sympathetic neural overdrive and diminished exercise capacity in reduced ejection fraction heart failure related to anthracycline-based chemotherapy(2023) RODRIGUES, Amanda G.; SALES, Allan R. K.; FARIA, Diego; FONSECA, Silvia M. R.; BOND, Marina M. K.; JORDAO, Camila P.; SOUZA, Francis R. de; BITTAR, Cristina S.; SANTOS, Marilia H. H. Dos; SARMENTO, Adriana O.; NEGRAO, Marcelo V.; HAJJAR, Ludhmila A.; NEGRAO, Carlos E.; KALIL FILHO, RobertoCardiotoxicity is the most worrying cardiovascular alteration in patients treated with chemotherapy. To improve the understanding regarding the cardiotoxicity, we studied whether 1) patients with cardiac dysfunction related to anthracycline-based chemotherapy have augmented sympathetic nerve activity and decreased exercise capacity and 2) these responses are similar to those observed in patients with heart failure caused by other etiologies. Sixteen patients with heart failure with reduced ejection fraction related to anthracycline-based chemotherapy with or without chest radiation (HFrEFCA), 10 patients with heart failure with reduced ejection not related to cancer therapy (HFrEF), and 16 age- and body mass index (BMI)-matched healthy control subjects were studied. Left ventricular ejection fraction (LVEF, echocardiography), peak oxygen consumption (peak (V)over dot(O2), cardiopulmonary exercise test), muscle sympathetic nerve activity (MSNA, microneurography), and forearm blood flow (FBF, venous occlusion plethysmography) were measured. We found that peak oxygen consumption peak (V)over dot(O2) and LVEF were significantly reduced in patients with HFrEFCA compared with that of control subjects (P < 0.0001) but similar to those found in patients with HFrEFCA. The sympathetic nerve activity burst frequency and incidence were significantly higher in patients with HFrEFCA than that in control subjects (P < 0.0001). No differences were found between patients with HFrEF and HFrEFCA. Peak (V)over dot(O2) was inversely associated with MSNA burst frequency (r = -0.53, P = 0.002) and burst incidence (r = -0.38, P = 0.01) and directly associated with LVEF (r = 0.71, P < 0.0001). Taken together, we conclude that patients who develop heart failure due to anthracycline-based chemotherapy have sympathetic neural overdrive and reduced exercise capacity. In addition, these physiological changes are similar to those observed in patients with HFrEF.
- Adjuvant Treatment with 5-Fluorouracil and Oxaliplatin Does Not Influence Cardiac Function, Neurovascular Control, and Physical Capacity in Patients with Colon Cancer (vol 25, pg e1956, 2020)(2021) GROEHS, Raphaela V.; NEGRAO, Marcelo V.; HAJJAR, Ludhmila A.; JORDAO, Camila P.; CARVALHO, Bruna P.; TOSCHI-DIAS, Edgar; ANDRADE, Ana C.; HODAS, Fabiana P.; ALVES, Maria J. N. N.; SARMENTO, Adriana O.; TESTA, Laura; HOFF, Paulo M. G.; NEGRAO, Carlos E.; KALIL FILHO, Roberto
- High-Intensity Interval Training Decreases Muscle Sympathetic Nerve Activity and Improves Peripheral Vascular Function in Patients With Heart Failure With Reduced Ejection Fraction(2020) SALES, Allan R. K.; AZEVEDO, Luciene F.; SILVA, Thiago O. C.; RODRIGUES, Amanda G.; OLIVEIRA, Patricia A.; JORDAO, Camila P.; ANDRADE, Ana C. M.; URIAS, Ursula; GUIMARAES, Guilherme V.; BOCCHI, Edimar A.; ALVES, Maria Janieire N. N.; HAJJAR, Ludhmila A.; FILHO, Roberto K.; GRUNEWALD, Zachary I.; MARTINEZ-LEMUS, Luis A.; PADILLA, Jaume; NEGRAO, Carlos E.
- Breast Cancer Promotes Cardiac Dysfunction Through Deregulation of Cardiomyocyte Ca2+-Handling Protein Expression That is Not Reversed by Exercise Training(2021) COSTA, Tassia S. R. da; URIAS, Ursula; V, Marcelo Negrao; JORDAO, Camila P.; PASSOS, Clevia S.; GOMES-SANTOS, Igor L.; SALEMI, Vera Maria C.; CAMARGO, Anamaria A.; BRUM, Patricia C.; OLIVEIRA, Edilamar M.; HAJJAR, Ludhmila A.; CHAMMAS, Roger; FILHO, Roberto K.; NEGRAO, Carlos E.Background Patients treated for breast cancer have a high incidence of cardiovascular complications. In this study, we evaluated the impact of breast cancer on cardiac function and cardiomyocyte Ca2+-handling protein expression. We also investigated whether exercise training (ET) would prevent these potential alterations. Methods and Results Transgenic mice with spontaneous breast cancer (mouse mammary tumor virus-polyomavirus middle T antigen [MMTV-PyMT+], n=15) and littermate mice with no cancer (MMTV-PyMT-, n=14) were studied. For the ET analysis, MMTV-PyMT+ were divided into sedentary (n=10) and exercise-trained (n=12) groups. Cardiac function was evaluated by echocardiography with speckle-tracking imaging. Exercise tolerance test was conducted on a treadmill. Both studies were performed when the tumor became palpable and when it reached 1 cm(3). After euthanasia, Ca2+-handling protein expression (Western blot) was evaluated. Exercise capacity was reduced in MMTV-PyMT+ compared with MMTV-PyMT- (P-interaction=0.031). Longitudinal strain (P-group <0.001) and strain rate (P-group=0.030) were impaired. Cardiomyocyte phospholamban was increased (P=0.011), whereas phospho-phospholamban and sodium/calcium exchanger were decreased (P=0.038 and P=0.017, respectively) in MMTV-PyMT+. No significant difference in sarcoplasmic or endoplasmic reticulum calcium 2 ATPase (SERCA2a) was found. SERCA2a/phospholamban ratio was reduced (P=0.007). ET was not associated with increased exercise capacity. ET decreased left ventricular end-systolic diameter (P-group=0.038) and end-diastolic volume (P-group=0.026). Other morphological and functional cardiac parameters were not improved by ET in MMTV-PyMT+. ET did not improve cardiomyocyte Ca2+-handling protein expression. Conclusions Breast cancer is associated with decreased exercise capacity and subclinical left ventricular dysfunction in MMTV-PyMT+, which is at least partly associated with dysregulation of cardiomyocyte Ca2+ handling. ET did not prevent or reverse these changes.