RAUL DIAS DOS SANTOS FILHO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
73 resultados
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conferenceObject TRIGLYCERIDE-RICH LIPOPROTEINS-CHOLESTEROL IS STRONGLY ASSOCIATED WITH COGNITIVE PERFORMANCE WHILE TRIGLYCERIDES NOT: A CROSS-SECTIONAL ANALYSIS(2020) GENEROSO, Giuliano; SUEMOTO, Claudia K.; BENSENOR, Isabela; SANTOS, Raul; JONES, Steven R.; KULKARNI, Krishnaji; BLAHA, Michael; TOTH, Peter; LOTUFO, Paulo; BITTENCOURT, Marcio- The contribution of the systolic and diastolic components for the diagnosis of arterial hypertension under the 2017 ACC/AHA Guideline and metabolic heterogeneity among individuals with Stage 1 hypertension(2020) CESENA, Fernando H. Y.; NARY, Fernando C.; SANTOS, Raul D.; BITTENCOURT, Marcio S.Little is known about the impact of the 2017 ACC/AHA hypertension guideline on the distribution pattern of hypertension modalities (isolated systolic hypertension [ISH], isolated diastolic hypertension [IDH], and systolic-diastolic hypertension [SDH]). This cross-sectional study had the following objectives: to compare the prevalence of hypertension, ISH, IDH, and SDH, according to the definitions of the JNC 7 or the 2017 guideline; to determine the relative contribution of the systolic and the diastolic components for the diagnosis of hypertension; and to compare the metabolic profile of ISH, IDH, or SDH among new hypertensive individuals by the 2017 guideline. The authors retrospectively evaluated 33 594 patients (42 +/- 10 years, 67% male) who underwent a routine health evaluation. Hypertensive patients not using antihypertensive medication were classified into ISH, IDH, or SDH using guideline-defined thresholds. The prevalence of hypertension increased from 21.1% by the JNC 7 definition to 54.7% using the 2017 criteria (2.6-fold increase). More profound increases were seen in the prevalence of IDH (8.7-fold) and SDH (3.3-fold), whereas the prevalence of ISH reduced from 1.1% (JNC 7) to 0.5% (2017 definition). Among patients with Stage 1 hypertension by the 2017 document, 85% had IDH and fewer metabolic abnormalities compared to those with SDH or ISH. The authors concluded that the 2017 guideline inflates the role of the diastolic component and diminishes the contribution of the systolic component for the diagnosis of hypertension. Individuals with Stage 1 hypertension by the 2017 guideline are metabolically heterogeneous and may have different long-term prognoses.
- CORONARY ARTERY CALCIFICATION IS SUPERIOR TO CLASSICAL RISK FACTORS AS PREDICTOR OF CARDIOVASCULAR DISEASE IN FAMILIAL HYPERCHOLESTEROLEMIA(2018) MINAME, Marcio; ALVES, Romulo; MORAES, Sergio; SILVA, Pamela; BITTENCOURT, Marcio; JANNES, Cinthia; PEREIRA, Alexandre; SANTOS, Raul
- Suboptimal Blood Pressure Control Increases the Risk of Non-alcoholic Fatty Liver Disease(2020) SAEED, Gul; ANENI, Ehimen; ABRAHAM, Bincy; BITTENCOURT, Marcio S.; ACHIRICA, Miguel Cainzos; SANTOS, Raul D.; NASIR, Khurram
- Relationship between TSH Levels and the Advanced Lipoprotein Profile in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)(2020) MIRANDA, Erique Jose F. Peixoto de; GOULART, Alessandra C.; BITTENCOURT, Matti Sommer; SANTOS, Raul D.; BLAHA, Michael J.; JONES, Steven; TOTH, Peter P.; KULKARNI, Krishnaji; SANTOS, Itamar S.; LOTUFO, Paulo A.; BENSENOR, Isabela M.Purpose/aims: The relationship between thyroid-stimulating hormone (TSH) and lipoprotein subfractions by Vertical Auto Profile (VAP) is unclear. We aimed to evaluate lipoprotein profiles according to TSH levels in euthyroid individuals.Material and Methods: Cross-sectional analysis of 3,525 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) with no previous thyroid disease and who were not on lipid-lowering medication. Total-cholesterol and its fractions, lipoprotein subfractions, triglycerides, and triglyceride-rich lipoprotein cholesterol [TRL-C (VLDL1+2-C, VLDL3-C, IDL-C)] were determined by VAP. Associations between TSH quintiles and lipoprotein subfractions were evaluated by crude and adjusted linear regression models.Results: For the total sample, significant beta-coefficients in full adjusted models for the 5(th) quintile of TSH (compared to 1(st)) were found for the following VAP lipids and lipoproteins: IDL-C (beta: 0.90; 0.11 to 1.69); VLDL-C (beta: 2.80; 1.51 to 4.08), triglycerides (beta: 18.66; 8.07 to 29.25), non-HDL-C (beta: 4.63; 0.50 to 8.75 mg/dl), TRL-C (beta:1.93;0.70 to 3.17), VLDL3-C (beta: 1.04; 0.50 to 1.57), as well as, TC/HDL-C (beta: 0.15; 0.03 to 0.26) and TG/HDL-C ratio (beta: 0.49;0.21 to 0.77). In women, similar results were found for VLDL-C, triglycerides, non-HDL-C, TRL-C, VLDL3-C, TC/HDL-C and TG/HDL-C-ratios. In men, we also found positive associations between the highest quintile of TSH with VLDL-C, triglycerides, VLDL3-C and TG/HDL-C.Conclusions: In the ELSA-Brasil, the highest TSH levels were mostly positively associated with lipoprotein levels, particularly TG, TRL and their remnants. Notwithstanding, our findings suggest that TSH levels within the normal range have little impact on the atherogenic profile.
- CXCR3 Controls T-Cell Accumulation in Fat Inflammation(2014) ROCHA, Viviane Zorzanelli; FOLCO, Eduardo J.; OZDEMIR, Cafer; SHEIKINE, Yuri; CHRISTEN, Thomas; SUKHOVA, Galina K.; TANG, Eva H. C.; BITTENCOURT, Marcio Sommer; SANTOS, Raul D.; LUSTER, Andrew D.; COHEN, David E.; LIBBY, PeterObjective-Obesity associates with increased numbers of inflammatory cells in adipose tissue (AT), including T cells, but the mechanism of T-cell recruitment remains unknown. This study tested the hypothesis that the chemokine (C-X-C motif) receptor 3 (CXCR3) participates in T-cell accumulation in AT of obese mice and thus in the regulation of local inflammation and systemic metabolism. Approach and Results-Obese wild-type mice exhibited higher mRNA expression of CXCR3 in periepididymal AT-derived stromal vascular cells compared with lean mice. We evaluated the function of CXCR3 in AT inflammation in vivo using CXCR3-deficient and wild-type control mice that consumed a high-fat diet. Periepididymal AT from obese CXCR3-deficient mice contained fewer T cells than obese controls after 8 and 16 weeks on high-fat diet, as assessed by flow cytometry. Obese CXCR3-deficient mice had greater glucose tolerance than obese controls after 8 weeks, but not after 16 weeks. CXCR3-deficient mice fed high-fat diet had reduced mRNA expression of proinflammatory mediators, such as monocyte chemoattractant protein-1 and regulated on activation, normal T cell expressed and secreted, and anti-inflammatory genes, such as Foxp3, IL-10, and arginase-1 in periepididymal AT, compared with obese controls. Conclusions-These results demonstrate that CXCR3 contributes to T-cell accumulation in periepididymal AT of obese mice. Our results also suggest that CXCR3 regulates the accumulation of distinct subsets of T cells and that the ratio between these functional subsets across time likely modulates local inflammation and systemic metabolism.
- Association of Lipoprotein Subfractions With Atherosclerosis in the Baseline Sample of ELSA-Brasil Cohort Study - A Cross-Sectional Analysis(2023) TEBAR, William R.; MENEGHINI, Vandrize; GOULART, Alessandra C.; SANTOS, Itamar S.; SANTOS, Raul D.; BITTENCOURT, Marcio S.; GENEROSO, Giuliano; PEREIRA, Alexandre; BLAHA, Michael J.; JONES, Steven R.; TOTH, Peter P.; OTVOS, James D.; LOTUFO, Paulo A.; BENSENOR, Isabela M.
- Vascular age derived from coronary artery calcium score on the risk stratification of individuals with heterozygous familial hypercholesterolaemia(2020) MINAME, Marcio H.; BITTENCOURT, Marcio Sommers; PEREIRA, Alexandre C.; JANNES, Cinthia E.; KRIEGER, Jose E.; NASIR, Khurram; SANTOS, Raul D.Aims The objective of this study was to evaluate if vascular age derived from coronary artery calcium (CAC) score improves atherosclerosis cardiovascular disease (ASCVD) risk discrimination in primary prevention asymptomatic heterozygous familial hypercholesterolaemia (FH) patients undergoing standard lipid-lowering therapy. Methods and results Two hundred and six molecularly confirmed FH individuals (age 45 +/- 14 years, 36% males, baseline LDL-cholesterol 6.2 +/- 2.2 mmol/L; 239 +/- 85mg/dL) were followed by 4.4 +/- 2.9 years (median: 3.7 years, interquartile ranges 2.7-6.8). CAC measurement was performed, and lipid-lowering therapy was optimized according to FH guidelines. Vascular age was derived from CAC and calculated according to the Multi Ethnic Study of Atherosclerosis algorithm. Risk estimation based on the Framingham equations was calculated for both biological (bFRS) and vascular (vaFRS) age. During follow-up, 15 ASCVD events (7.2%) were documented. The annualized rate of events for bFRS <10%, 10-20%, and >20% was respectively: 8.45 [95% confidence interval (CI) 3.17-22.52], 23.28 (95% CI 9.69-55.94), and 28.13 (95% CI 12.63-62.61) per 1000 patients. The annualized rate of events for vaFRS <10%, 10-20%, and >20% was respectively: 0, 0, and 50.37 (95% CI 30.37-83.56) per 1000 patients. vaFRS presented a better discrimination for ASCVD events compared to bFRS 0.7058 (95% CI 0.5866-0.8250) vs. vaFRS 0.8820 (95% CI 0.8286-0.9355), P= 0.0005. Conclusion CAC derived vascular age can improve ASCVD risk discrimination in primary prevention FH subjects. This tool may help further stratify risk in FH patients already receiving lipid-lowering medication who might be candidates for further treatment with newer therapies.
- Epicardial fat is associated with severity of subclinical coronary atherosclerosis in familial hypercholesterolemia(2016) MANGILI, Leonardo C.; MANGILI, Otavio C.; BITTENCOURT, Marcio S.; MINAME, Marcio H.; HARADA, Paulo H.; LIMA, Leonardo M.; ROCHITTE, Carlos E.; SANTOS, Raul D.Background and aims: Familial hypercholesterolemia (FH) is a common genetic disorder characterized by elevated blood cholesterol, increased prevalence of subclinical atherosclerosis and high risk of premature coronary heart disease. However, this risk is not explained solely by elevated LDL-cholesterol concentrations, and other factors may influence atherosclerosis development. There is evidence that increased adiposity may predispose to atherosclerosis in FH. Epicardial fat has been associated with subclinical coronary atherosclerosis in the general population. This study evaluated the association of epicardial fat (EFV) volume with the presence and extent of subclinical coronary atherosclerosis detected by computed tomography angiography in FH patients. Methods: Ninety-seven FH subjects (35% male, mean age 45 +/- 13 years, LDL-C 281 +/- 56 mg/dL, 67% with proven molecular defects) underwent computed tomography angiography and coronary artery calcium (CAC) scoring. EFV was measured in non-contrast images using a semi-automated method. Segment-stenosis score (SSS) and segment-involvement score (SIS) were calculated. Multivariate Poisson regression was utilized to assess an independent association of EFV with coronary atherosclerotic burden. Results: EFV was positively associated with age, body mass index, waist circumference, blood glucose, the presence of the metabolic syndrome components, but not with LDL-C. After adjusting for confounders and abdominal circumference, an independent association (shown as beta coefficients and 95% confidence intervals) of EVF with CAC scores [beta = 0.263 (0.234; 0.292), p = 0.000], SIS [beta = 0.304 (0.141; 0.465) p = 0.000] and SSS [beta = 0.296 (0.121; 0.471), p = 0.001] was found. Conclusions: In FH, EFV was independently associated with coronary atherosclerotic presence and severity.
conferenceObject PHYSICAL ACTIVITY LEVEL CHANGES AND THE OCCURRENCE OF NON-ALCOHOLIC FATTY-LIVER DISEASE: A PROSPECTIVE LONGITUDINAL FOLLOW UP STUDY(2017) BITTENCOURT, Marcio Sommer; RITTI-DIAS, Raphael M.; GERAGE, Aline; CUCATO, Gabriel G.; CONCEICAO, Raquel; SANTOS, Raul