MUCIO TAVARES DE OLIVEIRA JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
18 resultados
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conferenceObject Superiority of prothrombin complex concentrate versus frozen fresh plasma in cardiologic patients with coumarin intoxication(2016) SOEIRO, A.; CESAR, M. C.; BISELLI, B.; BOSSA, A. S.; ARAUJO, V. A.; HAJJAR, L. A.; LEAL, T. C. A. T.; SOEIRO, M. C. F. A.; VELLA, J. P.; SERRANO JR., C. V.; OLIVEIRA JR., M. T.bookPart Miocardite aguda(2016) SCUDELER, Thiago Luis; OLIVEIRA JR., Múcio Tavares debookPart A abordagem do paciente com dor torácica(2016) SOEIRO, Alexandre de Matos; PAULA, Leonardo Jorge Cordeiro; GAIOTTO, Fábio Antônio; OLIVEIRA JR., Múcio Tavares debookPart Dor Torá no Pronto-Socorro(2016) SOEIRO, Alexandre de Matos; LEAL, Tatiana de Carvalho Andreuci Torres; OLIVEIRA JR., Múcio TavaresconferenceObject Clinical outcomes of patients with decompensated heart failure(2016) MORAES, L. R.; GOMEZ, L. M.; TERHOCH, C. B.; MOREIRA, H. F.; AYUB-FERREIRA, S. M.; LAGE, S. G.; OLIVEIRA, M. T.; ISSA, V. S. Victor Sarli; BOCCHI, E. A.conferenceObject Effects of High Mechanical Index Impulses From a Diagnostic Ultrasound Transducer During an Intravenous Ultrasound Contrast Infusion in Preventing Adverse Left Ventricular Remodeling in Acute ST Segment Myocardial Infarction(2016) MATHIAS, Wilson; TSUTSUI, Jeane M.; TAVARES, Bruno G.; AGUIAR, Miguel O.; OLIVEIRA, Mucio T.; SOEIRO, Alexandre; LEMOS, Pedro A.; RAMIRES, Jose; KALIL, Roberto; PORTER, Thomas R.- Diagnostic Ultrasound Impulses Improve Microvascular Flow in Patients With STEMI Receiving Intravenous Microbubbles(2016) MATHIAS JR., Wilson; TSUTSUI, Jeane M.; TAVARES, Bruno G.; XIE, Feng; AGUIAR, Miguel O. D.; GARCIA, Diego R.; OLIVEIRA JR., Mucio T.; SOEIRO, Alexandre; NICOLAU, Jose C.; LEMOS NETO, Pedro A.; ROCHITTE, Carlos E.; RAMIRES, Jose A. F.; KALIL FILHO, Roberto; PORTER, Thomas R.BACKGROUND Pre-clinical trials have demonstrated that, during intravenous microbubble infusion, high mechanical index (HMI) impulses from a diagnostic ultrasound (DUS) transducer might restore epicardial and microvascular flow in acute ST-segment elevation myocardial infarction (STEMI). OBJECTIVES The purpose of this study was to test the safety and efficacy of this adjunctive approach in humans. METHODS From May 2014 through September 2015, patients arriving with their first STEMI were randomized to either DUS intermittent HMI impulses (n = 20) just prior to emergent percutaneous coronary intervention (PCI) and for an additional 30 min post-PCI (HMI + PCI), or low mechanical index (LMI) imaging only (n = 10) for perfusion assessments before and after PCI (LMI + PCI). All studies were conducted during an intravenous perflutren lipid microsphere infusion. A control reference group (n = 70) arrived outside of the time window of ultrasound availability and received emergent PCI alone (PCI only). Initial epicardial recanalization rates prior to emergent PCI and improvements in microvascular flow were compared between ultrasound-treated groups. RESULTS Median door-to-dilation times were 82 +/- 26 min in the LMI + PCI group, 72 +/- 15 min in the HMI + PCI group, and 103 +/- 42 min in the PCI-only group (p = NS). Angiographic recanalization prior to PCI was seen in 12 of 20 HMI + PCI patients (60%) compared with 10% of LMI + PCI and 23% of PCI-only patients (p = 0.002). There were no differences in microvascular obstructed segments prior to treatment, but there were significantly smaller proportions of obstructed segments in the HMI + PCI group at 1 month (p = 0.001) and significant improvements in left ventricular ejection fraction (p < 0.005). CONCLUSIONS HMI impulses from a diagnostic transducer, combined with a commercial microbubble infusion, can prevent microvascular obstruction and improve functional outcome when added to the contemporary PCI management of acute STEMI. (Therapeutic Use of Ultrasound in Acute Coronary Artery Disease; NCT02410330) (C) 2016 by the American College of Cardiology Foundation.
bookPart Manejo de inotrópicos na emergência(2016) BISELLI, Bruno; OLIVEIRA JR., Múcio Tavares deconferenceObject Effects of High Mechanical Index Impulses From a Diagnostic Ultrasound Transducer During an Intravenous Ultrasound Contrast Infusion in Preventing Adverse Left Ventricular Remodeling in Acute ST Segment Myocardial Infarction(2016) MATHIAS, Wilson; TSUTSUI, Jeane M.; TAVARES, Bruno G.; AGUIAR, Miguel O.; OLIVEIRA, Mucio T.; SOEIRO, Alexandre; LEMOS, Pedro A.; RAMIRES, Jose; KALIL, Roberto; PORTER, Thomas R.- Mortality reduction with use of oral beta-blockers in patients with acute coronary syndrome(2016) SOEIRO, Alexandre de Matos; SILVA, Pedro Gabriel Melo de Barros e; ROQUE, Eduardo Alberto de Castro; BOSSA, Aline Siqueira; ZULLINO, Cindel Nogueira; SIMOES, Sheila Aparecida; OKADA, Mariana Yumi; LEAL, Tatiana de Carvalho Andreucci Torres; SOEIRO, Maria Carolina Feres de Almeida; SERRANO JR., Carlos V.; OLIVEIRA JR., Mucio TavaresOBJECTIVES: Recent studies have revealed a relationship between beta-blocker use and worse prognosis in acute coronary syndrome, mainly due to a higher incidence of cardiogenic shock. However, the relevance of this relationship in the reperfusion era is unknown. The aim of this study was to analyze the outcomes of patients with acute coronary syndrome that started oral beta-blockers within the first 24 hours of hospital admission (group I) compared to patients who did not use oral beta-blockers in this timeframe (group II). METHODS: This was an observational, retrospective and multicentric study with 2,553 patients (2,212 in group I and 341 in group II). Data regarding demographic characteristics, coronary treatment and medication use in the hospital were obtained. The primary endpoint was in-hospital all-cause mortality. The groups were compared by ANOVA and the chi-square test. Multivariate analysis was conducted by logistic regression and results were considered significant when p < 0.05. RESULTS: Significant differences were observed between the groups in the use of angiotensin-converting enzyme inhibitors, enoxaparin, and statins; creatinine levels; ejection fraction; tabagism; age; and previous coronary artery bypass graft. Significant differences were also observed between the groups in mortality (2.67% vs 9.09%, OR= 0.35, p= 0.02) and major adverse cardiovascular events (11% vs 29.5%, OR= 4.55, p= 0.02). CONCLUSIONS: Patients with acute coronary syndrome who underwent early intervention with oral betablockers during the first 24 hours of hospital admission had a lower in-hospital death rate and experienced fewer major adverse cardiovascular events with no increase in cardiogenic shock or sustained ventricular arrhythmias compared to patients who did not receive oral beta-blockers within this timeframe.