JEFFERSON LUIS VIEIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
conferenceObject RESPIRATORY MASK-FILTER PREVENTS CARDIOVASCULAR EFFECTS ASSOCIATED WITH DIESEL EXHAUST EXPOSURE: A RANDOMIZED, PROSPECTIVE, DOUBLE-BLIND, CONTROLLED, CROSSOVER STUDY IN HEART FAILURE (FILTER-HF TRIAL)(2015) VIEIRA, Jefferson L.; GUIMARAES, Guliherme V.; ANDRE, Paulo A. de; SALDIVA, Paulo H. N.; BOCCHI, Edimar A.conferenceObject Effects of Reducing Exposure to Air Pollution With a Filter on Exercise: A Randomized, Prospective, Double-Blind, Controlled Study of Heart Failure(2015) VIEIRA, Jefferson L.; GUIMARAES, Guilherme V.; ANDRE, Paulo A. de; SALDIVA, Paulo H.; BOCCHI, Edimar A.- Respiratory Filter Reduces the Cardiovascular Effects Associated With Diesel Exhaust Exposure A Randomized, Prospective, Double-Blind, Controlled Study of Heart Failure: The FILTER-HF Trial(2016) VIEIRA, Jefferson L.; GUIMARAES, Guilherme V.; ANDRE, Paulo A. de; CRUZ, Fatima D.; SALDIVA, Paulo H. Nascimento; BOCCHI, Edimar A.OBJECTIVES The goal of this study was to test the effects of a respiratory filter intervention (filter) during controlled pollution exposure. BACKGROUND Air pollution is considered a risk factor for heart failure (HF) decompensation and mortality. METHODS This study was a double-blind, randomized to order, controlled, 3-way crossover, single-center clinical trial. It enrolled 26 patients with HF and 15 control volunteers. Participants were exposed in 3 separate sessions to clean air, unfiltered diesel exhaust exposure (DE), or filtered DE. Endpoints were endothelial function assessed by using the reactive hyperemia index (RHi), arterial stiffness, serum biomarkers, 6-min walking distance, and heart rate variability. RESULTS In patients with HF, DE was associated with a worsening in RHi from 2.17 (interquartile range [IQR]: 1.8 to 2.5) to 1.72 (IQR: 1.5 to 2.2; p = 0.002) and an increase in B-type natriuretic peptide (BNP) from 47.0 pg/ml (IQR: 17.3 to 118.0 pg/ml) to 66.5 pg/ml (IQR: 26.5 to 155.5 pg/ml; p = 0.004). Filtration reduced the particulate concentration (325 +/- 31 mu g/m(3) vs. 25 +/- 6 mu g/m(3); p < 0.001); in the group with HF, filter was associated with an improvement in RHi from 1.72 (IQR: 1.5 to 2.2) to 2.06 (IQR: 1.5 to 2.6; p = 0.019) and a decrease in BNP from 66.5 pg/ml (IQR: 26.5 to 155.5 pg/ml) to 44.0 pg/ml (IQR: 20.0 to 110.0 pg/ml; p = 0.015) compared with DE. In both groups, DE decreased the 6-min walking distance and arterial stiffness, although filter did not change these responses. DE had no effect on heart rate variability or exercise testing. CONCLUSIONS To our knowledge, this trial is the first to show that a filter can reduce both endothelial dysfunction and BNP increases in patients with HF during DE. Given these potential benefits, the widespread use of filters in patients with HF exposed to traffic-derived air pollution may have beneficial public health effects and reduce the burden of HF. (Effects of Air Pollution Exposure Reduction by Filter Mask on Heart Failure; NCT01960920) (C) 2016 by the American College of Cardiology Foundation.
conferenceObject Effects of air pollution exposure reduction by filter mask on heart failure: a prospective randomized double-blind controlled trial(2014) VIEIRA, J. L.; GUIMARAES, G. V.; ANDRE, P. A. De; SALDIVA, P. H. N.; BOCCHI, E. A.- Effects of reducing exposure to air pollution on submaximal cardiopulmonary test in patients with heart failure: Analysis of the randomized, double-blind and controlled FILTER-HF trial(2016) VIEIRA, Jefferson L.; GUIMARAES, Guilherme V.; ANDRE, Paulo A. de; SALDIVA, Paulo H. Nascimento; BOCCHI, Edimar A.Background: Air pollution exposure could mitigate the health benefits of exercise in patients with heart failure (HF). We tested the effects of a respiratory filter on HF patients exposed to air pollution during exercise. Methods and Results: Ancillary analysis of the FILTER-HF trial, focused on the exercise outcomes. In a randomized, double-blind, 3-way crossover design, 26 HF patients and 15 control volunteers were exposed to clean air, unfiltered dilute diesel engine exhaust (DE), or filtered DE for 6 min during a submaximal cardiopulmonary testing in a controlled-exposure facility. Prospectively collected data included six-minute walking test [6mwt], VO2, VE/VCO2 Slope, O(2)Pulse, pulmonary ventilation [VE], tidal volume, VD/Vt, oxyhemoglobin saturation and CO2-rebreathing. Compared to clean air, DE adversely affected VO2 (11.0 +/- 3.9 vs. 8.4 +/- 2.8 ml/kg/min; p < 0.001); 6mwt (243.3 +/- 13.0 vs. 220.8 +/- 13.7 m; p = 0.030); and O(2)Pulse (8.9 +/- 1.0 vs. 7.8 +/- 0.7 ml/beat; p < 0.001) in HF patients. Compared to DE, filtration reduced the particulate concentration from 325 +/- 31 to 25 +/- 6 mu g/m(3), and was associated with an increase in VO2 (10.4 +/- 3.8 ml/kg/min; p < 0.001 vs. DE) and O(2)Pulse (9.7 +/- 1.1 ml/beat; p < 0.001 vs. DE) in patients with HF. Filtration was associated with higher VE and CO2-rebreathing in both groups. VE/VCO2 Slope was higher among patients with HF. Conclusion: DE adversely affects exercise capacity in patients with HF. A simple respiratory filter can reduce the adverse effects of pollution on VO2 and O(2)Pulse. Given the worldwide prevalence of exposure to traffic-related air pollution, these findings are relevant for public health especially in this highly susceptible population. The filter intervention holds great promise that needs to be tested in future studies.
conferenceObject Filter mask prevents adverse cardiovascular effects of diesel exhaust inhalation in heart failure patients: a randomized cross-over study(2014) VIEIRA, J. L.; GUIMARAES, G. V.; ANDRE, P. A. De; SALDIVA, P. H. N.; BOCCHI, E. A.