CAMILA PAIXAO JORDAO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
14 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 14
conferenceObject Obstructive sleep apnea impairs insulin resistance in metabolic syndrome patients with normal levels of glucose(2016) CEPEDA, Felipe Xerez; RODRIGUES, Sara; DUTRA-MARQUES, Akothirene C. B.; CARVALHO, Jefferson Cabral; TOSCHI-DIAS, Edgar; JORDAO, Camila Paixao; RONDON, Maria Urbana; ALVES, Maria Janieire N. N.; LORENZI-FILHO, Geraldo; TROMBETTA, Ivani Credidio- Effects of Exercise Training on Left Ventricular Diastolic Function Markers in Patients with Obstructive Sleep Apnea: A Randomized Study(2022) DURANTE, Bruno G.; FERREIRA-SILVA, Rosyvaldo; GOYA, Thiago T.; LIMA, Marta F.; RODRIGUES, Ana Clara T.; DRAGER, Luciano F.; JORDÃO, Camila P.; RODRIGUES, Amanda G.; ALVES, Maria Janieire de Nazare N.; LORENZI-FILHO, Geraldo; NEGRÃO, Carlos E.; UENO-PARDI, Linda M.Abstract Background Exercise training (ET) is an adjunctive treatment for obstructive sleep apnea (OSA) and its consequences. However, the effects of exercise on heart remodeling are unknown in the population with OSA. Objective We investigated the effect of ET on markers of diastolic function, sleep parameters, and functional capacity in patients with OSA. Methods Sedentary patients with OSA (apnea-hypopnea index, AHI ≥15 events/hr) were randomly assigned to untrained (n=18) and trained (n=20) strategies. Polysomnography, cardiopulmonary exercise test, and echocardiography were evaluated at the beginning and end of the study. ET consisted of 3 weekly sessions of aerobic exercise, resistance exercises, and flexibility training (72 sessions, completed in 11.65±0.86 months). A two-way analysis of variance (ANOVA) was used, followed by Tukey's post-hoc test. The level of statistical significance was set at p<0.05 for all analyses. Result Thirty-eight patients were included (AHI:45±29 events/hr, age:52±7 y, body mass index: 30±4 kg/m2). They had similar baseline parameters. ET caused a significant change in OSA severity (AHI:4.5±18 versus -5.7±13 events/hr; arousal index:1.5±8 versus -6.1±13 events/hr, in untrained and trained groups respectively, p<0.05). The trained patients had an increase in functional capacity after intervention. ET improved isovolumetric relaxation time (IVRT, untrained=6.5±17.3 versus trained=-5.1±17.1 msec, p<0.05). There was a significant correlation between changes in IVRT and arousal index in the trained group (r =-0.54, p<0.05). No difference occurred in the other diastolic function parameters evaluated. Conclusion ET promotes modest but significant improvement in AHI, functional capacity, and cardiac IVRT, a validated parameter of diastolic function.
- Arterial stiffness and its association with clustering of metabolic syndrome risk factors(2017) LOPES-VICENTE, Wanda R. P.; RODRIGUES, Sara; CEPEDA, Felipe X.; JORDAO, Camila Paixao; COSTA-HONG, Valeria; DUTRA-MARQUES, Akothirene C. B.; CARVALHO, Jefferson C.; ALVES, Maria Janieire N. N.; BORTOLOTTO, Luiz A.; TROMBETTA, Ivani C.Background: Metabolic syndrome (MetS) is associated with structural and functional vascular abnormalities, which may lead to increased arterial stiffness, more frequent cardiovascular events and higher mortality. However, the role played by clustering of risk factors and the combining pattern of MetS risk factors and their association with the arterial stiffness have yet to be fully understood. Age, hypertension and diabetes mellitus seem to be strongly associated with increased pulse wave velocity (PWV). This study aimed at determining the clustering and combining pattern of MetS risk factors and their association with the arterial stiffness in non-diabetic and non-hypertensive patients. Methods: Recently diagnosed and untreated patients with MetS (n = 64, 49 +/- 8 year, 32 +/- 4 kg/m(2)) were selected, according to ATP III criteria and compared to a control group (Control, n = 17, 49 +/- 6 year, 27 +/- 2 kg/m(2)). Arterial stiffness was evaluated by PWV in the carotid-femoral segment. Patients were categorized and analyzed according MetS risk factors clustering (3, 4 and 5 factors) and its combinations. Results: Patients with MetS had increased PWV when compared to Control (7.8 +/- 1.1 vs. 7.0 +/- 0.5 m/s, p < 0.001). In multivariate analysis, the variables that remained as predictors of PWV were age (beta = 0.450, p < 0.001), systolic blood pressure (beta = 0.211, p = 0.023) and triglycerides (beta = 0.212, p = 0.037). The increased number of risk factors reflected in a progressive increase in PWV. When adjusted to systolic blood pressure, PWV was greater in the group with 5 risk factors when compared to the group with 3 risk factors and Control (8.5 +/- 0.4 vs. 7.5 +/- 0.2, p = 0.011 and 7.2 +/- 0.3 m/s, p = 0.012). Similarly, the 4 risk factors group had higher PWV than the Control (7.9 +/- 0.2 vs. 7.2 +/- 0.3, p = 0.047). Conclusions: The number of risk factors seems to increase arterial stiffness. Notably, besides age and increased systolic blood pressure, alterations in the triglycerides worsened the stiffness of large vessels, emphasizing the importance in addressing this risk factor in MetS patients.
- Decreased Native T1 Values and Impaired Myocardial Contractility in Anabolic Steroid Users(2022) SOUZA, Francis Ribeiro de; SANTOS, Marcelo Rodrigues dos; ROCHITTE, Carlos Eduardo; SANTOS, Rafael Parenquine dos; JORDAO, Camila Paixao; LEITE, Ivanhoe Stuart; FONSECA, Guilherme Wesley Peixoto da; FONSECA, Rafael Almeida; OLIVEIRA, Tiago Franco de; YONAMINE, Mauricio; PEREIRA, Rosa Maria Rodrigues; NEGRAO, Carlos Eduardo; ALVES, de Nazare Nunes Maria JanieireAnabolic androgenic steroid (AAS) abuse leads to myocardial toxicity. Human studies are conflicting about the myocardial fibrosis in AAS users. We evaluated cardiac tissue characterization, left ventricle (LV) function, and cardiac structure by cardiovascular magnetic resonance (CMR). Twenty strength-trained AAS users (AASU) aged 29 +/- 5yr, 20 strength-trained AAS nonusers (AASNU), and 7 sedentary controls (SC) were enrolled. Native T1 mapping, late-gadolinium enhancement (LGE), extracellular volume (ECV), and myocardial strain were evaluated. AASU showed lower Native T1 values than AASNU (888 +/- 162 vs. 1020 +/- 179ms p=0.047). Focal myocardial fibrosis was found in 2 AASU. AASU showed lower LV radial strain (30 +/- 8 vs. 38 +/- 6%, p<0.01), LV circumferential strain (-17 +/- 3 vs. -20 +/- 2%, p<0.01), and LV global longitudinal strain (-17 +/- 3 vs. -20 +/- 3%, p<0.01) than AASNU by CMR. By echocardiography, AASU demonstrated lower 4-chamber longitudinal strain than AASNU (-15 +/- g3 vs. -18 +/- 2%, p=0.03). ECV was similar among AASU, AASNU, and SC (28 +/- 10 vs. 28 +/- 7 vs. 30 +/- 7%, p=0.93). AASU had higher LV mass index than AASNU and SC (85 +/- 14 vs. 64 +/- 8 vs. 58 +/- 5g/m(2), respectively, p<0.01). AAS abuse may be linked to decreased myocardial native T1 values, impaired myocardial contractility, and focal fibrosis. These alterations may be associated with maladaptive cardiac hypertrophy in young AAS users.
- Neurovascular and hemodynamic responses to mental stress and exercise in severe COVID-19 survivors(2023) FARIA, Diego; MOLL-BERNARDES, Renata; TESTA, Laura; MONIZ, Camila M. V.; RODRIGUES, Erika C.; MOTA, Jose M.; SOUZA, Francis R.; ALVES, Maria Janieire N. N.; ONO, Bruna E.; IZAIAS, Joao E.; SALES, Artur O.; RODRIGUES, Thais S.; SALEMI, Vera M. C.; JORDAO, Camila P.; ANGELIS, Katia De; CRAIGHEAD, Daniel H.; ROSSMAN, Matthew J.; BORTOLOTTO, Luiz A.; CONSOLIM-COLOMBO, Fernanda M.; IRIGOYEN, Maria C. C.; SEALS, Douglas R.; NEGRAO, Carlos E.; SALES, Allan R. K.Previous studies show that COVID-19 survivors have elevated muscle sympathetic nerve activity (MSNA), endothelial dysfunction, and aortic stiffening. However, the neurovascular responses to mental stress and exercise are still unexplored. We hypothesized that COVID-19 survivors, compared with age-and body mass index (BMI)-matched control subjects, exhibit abnormal neurovascular responses to mental stress and physical exercise. Fifteen severe COVID-19 survivors (aged: 49 +/- 2 yr, BMI: 30 +/- 1 kg/m(2)) and 15 well-matched control subjects (aged: 46 +/- 3 yr, BMI: 29 +/- 1 kg/m(2)) were studied. MSNA (microneurography), forearm blood flow (FBF), and forearm vascular conductance (FVC, venous occlusion plethysmography), mean arterial pressure (MAP, Finometer), and heart rate (HR, ECG) were measured during a 3-min mental stress (Stroop Color-Word Test) and during a 3-min isometric handgrip exercise (30% of maximal voluntary contraction). During mental stress, MSNA (frequency and incidence) responses were higher in COVID-19 survivors than in controls (P < 0.001), and FBF and FVC responses were attenuated (P < 0.05). MAP was similar between the groups (P > 0.05). In contrast, the MSNA (frequency and incidence) and FBF and FVC responses to handgrip exercise were similar between the groups (P > 0.05). MAP was lower in COVID-19 survivors (P < 0.05). COVID-19 survivors exhibit an exaggerated MSNA and blunted vasodilatory response to mental challenge compared with healthy adults. However, the neurovascular response to handgrip exercise is preserved in COVID-19 survivors. Overall, the abnormal neurovascular control in response to mental stress suggests that COVID-19 survivors may have an increased risk to cardiovascular events during mental challenge.
- Sympathetic Neural Overdrive, Aortic Stiffening, Endothelial Dysfunction, and Impaired Exercise Capacity in Severe COVID-19 Survivors: A Mid-Term Study of Cardiovascular Sequelae(2023) FARIA, Diego; MOLL-BERNARDES, Renata J.; TESTA, Laura; MONIZ, Camila M. V.; RODRIGUES, Erika C.; RODRIGUES, Amanda G.; ARAUJO, Amanda; ALVES, Maria J. N. N.; ONO, Bruna E.; IZAIAS, Joao E.; SALEMI, Vera M. C.; JORDAO, Camila P.; AMARO-VICENTE, Graziela; RONDON, Maria U. P. B.; LUDWIG, Katelyn R.; CRAIGHEAD, Daniel H.; ROSSMAN, Matthew J.; CONSOLIM-COLOMBO, Fernanda M.; ANGELIS, Katia De; IRIGOYEN, Maria C. C.; SEALS, Douglas R.; NEGRAO, Carlos E.; SALES, Allan R. K.Background:COVID-19 has become a dramatic health problem during this century. In addition to high mortality rate, COVID-19 survivors are at increased risk for cardiovascular diseases 1-year after infection. Explanations for these manifestations are still unclear but can involve a constellation of biological alterations. We hypothesized that COVID-19 survivors compared with controls exhibit sympathetic overdrive, vascular dysfunction, cardiac morpho-functional changes, impaired exercise capacity, and increased oxidative stress. Methods:Nineteen severe COVID-19 survivors and 19 well-matched controls completed the study. Muscle sympathetic nerve activity (microneurography), brachial artery flow-mediated dilation and blood flow (Doppler-Ultrasound), carotid-femoral pulse wave velocity (Complior), cardiac morpho-functional parameters (echocardiography), peak oxygen uptake (cardiopulmonary exercise testing), and oxidative stress were measured similar to 3 months after hospital discharge. Complementary experiments were conducted on human umbilical vein endothelial cells cultured with plasma samples from subjects. Results:Muscle sympathetic nerve activity and carotid-femoral pulse wave velocity were greater and brachial artery flow-mediated dilation, brachial artery blood flow, E/e ' ratio, and peak oxygen uptake were lower in COVID-19 survivors than in controls. COVID-19 survivors had lower circulating antioxidant markers compared with controls, but there were no differences in plasma-treated human umbilical vein endothelial cells nitric oxide production and reactive oxygen species bioactivity. Diminished peak oxygen uptake was associated with sympathetic overdrive, vascular dysfunction, and reduced diastolic function in COVID-19 survivors. Conclusions:Our study revealed that COVID-19 survivors have sympathetic overactivation, vascular dysfunction, cardiac morpho-functional changes, and reduced exercise capacity. These findings indicate the need for further investigation to determine whether these manifestations are persistent longer-term and their impact on the cardiovascular health of COVID-19 survivors.
conferenceObject Sympathetic Neural Overdrive, Endothelial Dysfunction and Aortic Stiffness in Coronavirus Disease 2019 Survivors: A Short-Term Study of Cardiovascular Sequelae(2021) FARIA, Diego; TESTA, Laura; MOLL-BERNARDES, Renata; MONIZ, Camila; RODRIGUES, Erika; COSTA-NETO, Abel; SOUSA, Andrea; RODRIGUES, Amanda; OLIVEIRA, Patricia; ALVES, Maria Janieire; SANTOS, Gabriel; SALEMI, Vera; PIMENTA, Ruan; PAIXAO, Camila; SANTOS, Beatriz; RONDON, Maria U.; CRAIGHEAD, Daniel; ROSSMAN, Matthew; CONSOLIM-COLOMBO, Fernanda M.; IRIGOYEN, Maria C.; MARTINEZ-LEMUS, Luis A.- 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; AZEVEDO, Luciene; OLIVEIRA, Thiago; ALVES, Maria Nunes; RODRIGUES, Amanda; OLIVEIRA, Patricia; JORDAO, Camila; ANDRADE, Ana; URIAS, Ursula; GUIMARAES, Guilherme; BOCCHI, Edimar; GRUNEWALD, Zachary; MARTINEZ-LEMUS, Luis; PADILLA, Jaume; NEGRAO, Carlos
- Sacubitril/valsartan versus enalapril on exercise capacity in patients with heart failure with reduced ejection fraction: A randomized, double-blind, active-controlled study(2021) SANTOS, Marcelo Rodrigues dos; ALVES, Maria-Janieire de Nazare Nunes; JORDAO, Camila Paixao; PINTO, Caio Eduardo Novaes; CORREA, Kelly Thayane Souza; SOUZA, Francis Ribeiro de; FONSECA, Guilherme Wesley Peixoto da; TOMAZ FILHO, Joaquim; COSTA, Marcel; PEREIRA, Rosa Maria Rodrigues; NEGRAO, Carlos Eduardo; BARRETTO, Antonio Carlos PereiraBackground Sacubitril/valsar tan reduces mortality in patients with heart failure with reduced ejection fraction (HFrEF) when compared with enalapril. However, it is unknown the effect of both treatments on exercise capacity. We compared sacubitril/valsartan versus enalapril in patients with HFrEF based on peak oxygen consumption (VO2) and 6-minute walk test (6-MWT). Methods We included 52 participants with HFrEF with a left ventricular ejection fraction <40% to receive either sacu-bitril/ valsartan (target dose of 400 mg daily) or enalapril (target dose of 40 mg daily). Peak VO2 was measured by using cardiopulmonary exercise testing. Six-minute walk test was also performed. Results At 12 weeks, the sacubitril/valsartan (mean dose 382.6 +/- 57.6 mg daily) group had increased peak VO2 of 13.1% (19.35 +/- 0.99 to 21.89 +/- 1.04 mL/kg/min) and enalapril (mean dose 34.4 +/- 9.2 mg daily) 5.6% (18.58 +/- 1.19 to 19.62 +/- 1.25 mL/kg/min). However, no difference was found between groups (P = .332 interaction). At 24 weeks, peak VO2 increased 13.5% (19.35 +/- 0.99 to 21.96 +/- 0.98 mL/kg/min) and 12.0% (18.58 +/- 1.19 to 20.82 +/- 1.18 mL/kg/min) in sacubitril/valsartan (mean dose 400 +/- 0 mg daily) and enalapril (mean dose 32.7 +/- 11.0 mg daily), respectively. However, no differences were found between groups (P = .332 interaction). At 12 weeks, 6-MWT increased in both groups (sacubitril/valsartan: 459 +/- 18 to 488 +/- 17 meters [6.3%] and enalapril: 443 +/- 22 to 477 +/- 21 meters [7.7%]). At 24 weeks, sacubitril/valsartan increased 18.3% from baseline (543 +/- 26 meters) and enalapril decreased slightly to 6.8% (473 +/- 31 meters), but no differences existed between groups (P = .257 interaction). Conclusions Compared to enalapril, sacubitril/valsartan did not substantially improve peak VO2 or 6-MWT after 12 or 24 weeks in participants with HFrEF.
- 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.