LEA MARIA MACRUZ FERREIRA DEMARCHI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
9 resultados
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Agora exibindo 1 - 9 de 9
- StreptInCor, a Group A Streptococcal Adsorbed Vaccine: Evaluation of Repeated Intramuscular Dose Toxicity Testing in Rats(2021) SA-ROCHA, Luiz Carlos de; DEMARCHI, Lea Maria Macruz Ferreira; POSTOL, Edilberto; SAMPAIO, Roney Orismar; ALENCAR, Raquel Elaine de; KALIL, Jorge; GUILHERME, LuizaStreptococcus pyogenes infections continue to be a worldwide public health problem, causing various diseases in humans, with rheumatic fever and rheumatic heart disease being the most harmful manifestations. Impetigo and post-streptococcal glomerulonephritis are also important sequelae of skin infections. We have developed a candidate vaccine epitope (StreptInCor) that presents promising results in diverse animal models. To assess whether the StreptInCor alum-adsorbed vaccine could induce undesirable effects, a certified independent company conducted a repeated intramuscular dose toxicity evaluation in Wistar rats, a choice model for toxicity studies. We did not observe significant alterations in clinical, hematological, biochemical, anatomical, or histopathological parameters due to vaccine administration, even when the animals received the highest dose. In conclusion, repeated intramuscular doses did not show signs of macroscopic or other significant changes in the clinical or histopathological parameters, indicating that StreptInCor can be considered a safe candidate vaccine.
- Nonatherosclerotic Giant Right Coronary Artery Aneurysm(2022) CARDOSO, Lucas Figueredo; DIAS, Ricardo Ribeiro; DEMARCHI, Lea Maria Macruz Ferreira; SILVEIRA, Lucas Molinari Veloso da; MADY, Charles; JATENE, Fabio B.We present an unusual case of a 67-year-old woman with an incidental finding of a cardiac mass on a chest computed tomography. Coronary angiotomography confirmed the diagnosis of right coronary artery aneurysm, with 5.7x5.7 cm. The patient underwent aneurysm resection and coronary bypass surgery, with subsequent histologic study suggestive of arteritis sequelae. Giant coronary artery aneurysms have a high risk of complications and aneurysm exclusion must be beneficial. This is a rare condition that can also be part of a systemic inflammatory disease.
- Type III glycogen storage disease mimicking hypertrophic cardiomyopathy(2012) SALEMI, Vera Maria Cury; DEMARCHI, Lea Maria Macruz Ferreira; CABEDA, Estevan Vieira; WAGENFUEHR, Jaqueline; TANAKA, Ana Cristina
- COVID-19, congenital heart disease, and pregnancy: dramatic conjunction-case report(2021) AVILA, Walkiria Samuel; KIRSCHBAUM, Marcelo; DEVIDO, Marcela Santana; DEMARCHI, Lea Maria Macruz FerreiraBackground Epidemiological data from the COVID-19 pandemic report that patients with pre-existing cardiovascular disease have worse outcomes and higher mortality, and that pregnant women should be considered at high risk. Case summary A 25-year-old pregnant woman on the waiting list for a heart transplant, with a history of complete atrioventricular canal surgery, mitral mechanical prosthetic implant (St Jude-27), and cardiac resynchronization therapy (Boston Scientific) was hospitalized at 30 weeks of gestation for treatment of heart failure. After 7 days of hospitalization, she had a positive RT-PCR test for severe acute respiratory syndrome coronavirus 2 with progressive worsening of her clinical condition and acute foetal distress. Hence emergency caesarean section was performed. After the birth, the patient required mechanical ventilation, progressing to multiple organ system failures. Conventional inotropic drugs, antibiotics, and mechanical ventilation for 30 days in the intensive care unit provided significant clinical, haemodynamic, and respiratory improvement. However, on the 37th day, she suddenly experienced respiratory failure, gastrointestinal and airway bleeding, culminating in death. Discussion Progressive physiological changes during pregnancy cause cardiovascular complications in women with severe heart disease and higher susceptibility to viral infection and severe pneumonia. COVID-19 is known to incite an intense inflammatory and prothrombotic response with clinical expression of severe acute respiratory syndrome, heart failure, and thromboembolic events. The overlap of these COVID-19 events with those of pregnancy in this woman with underlying heart disease contributed to an unfortunate outcome and maternal death.
- Incidental Diagnosis of Rheumatic Myocarditis during Cardiac Surgery-Impact on Late Prognosis(2023) VIEIRA, Paulo Pinto Alves Campos; PEREIRA, Rodrigo Furtado; BRANCO, Carlos Eduardo Barros; ROSA, Vitor Emer Egypto; VIEIRA, Marcelo Luiz Campos; DEMARCHI, Lea Maria Macruz Ferreira; SILVA, Livia Santos; GUILHERME, Luiza; TARASOUTCHI, Flavio; SAMPAIO, Roney OrismarRheumatic fever (RF) and rheumatic heart disease (RHD) are still highly prevalent, particularly in low- and middle-income countries. RHD is a neglected and underdiagnosed disease for which no specific laboratory diagnostic test is completely reliable. This is a retrospective observational study, which included 118 patients with RHD who underwent cardiac surgery from 1985 to 2018. The aim of this investigation was to evaluate the clinical, epidemiological, echocardiographic and pathological characteristics in two cohorts of RHD patients: one cohort with Aschoff bodies present in their pathological results and the other without such histopathological characteristics. No conventional clinical and laboratory tests for RHD myocarditis were able to identify active carditis during the preoperative phase of valve repair or replacement. Patients who had Aschoff bodies in their pathological results were younger (median age of 13 years (11-24 years) vs. 27 years (17-37 years), p = 0.001) and had higher rate of late mortality (22.9% vs. 5.4%, p = 0.043). In conclusion, the presence of Aschoff bodies in pathological findings may predict increased long-term mortality, emphasizing the importance of comprehensive pathology analysis for suspected myocarditis during heart surgery.
- Case 2/2018-73-Year-Old Male with Ischemic Cardiomyopathy, Cachexia and Shock(2018) NUNES, Rafael Amorim Belo; BRUNO, Jussara de Almeida; RAMIREZ, Hilda Sara Monteiro; DEMARCHI, Lea Maria Macruz Ferreira
conferenceObject CARDIOVASCULAR DISEASE IN A PATIENT WITH TAKAYASU'S ARTERITIS AND APOLIPOPROTEIN DEFICIENCY(2021) ZIOTTI, Sara Del Vecchio; PINESI, Henrique Trombini; SPINA, Guilherme Sobreira; GAIOTTO, Fabio; DEMARCHI, Lea Maria Macruz Ferreira- 3D Echocardiography for Rheumatic Heart Disease Analysis: Ready for Prime Time(2021) VIEIRA, Marcelo Luiz Campos; BRANCO, Carlos Eduardo de Barros; GAZOLA, Alessandra Santos Lima; VIEIRA, Paulo Pinto Alves Campos; BENVENUTI, Luiz Alberto; DEMARCHI, Lea Maria Macruz Ferreira; GUTIERREZ, Paulo Sampaio; AIELLO, Vera Demarchi; TARASOUTCHI, Flavio; SAMPAIO, Roney OrismarRheumatic heart disease (RHD) remains to be a very important health issue worldwide, mainly in underdeveloped countries. It continues to be a leading cause of morbidity and mortality throughout developing countries. RHD is a delayed non-suppurative immunologically mediated inflammatory response to the throat infection caused by a hemolytic streptococcus from the A group (Streptococcus pyogenes). RHD keeps position 1 as the most common cardiovascular disease in young people aged < 25 years considering all the continents. The disease can lead to valvular cardiac lesions as well as to carditis. Rheumatic fever valvular injuries lead most commonly to the fusion and thickening of the edges of the cusps and to the fusion, thickening, and shortening of the chordae and ultimately to calcification of the valves. Valvular commissures can also be deeply compromised, leading to severe stenosis. Atrial and ventricular remodeling is also common following rheumatic infection. Mixed valvular lesions are more common than isolated valvular disorders. Echocardiography is the most relevant imaging technique not only to provide diagnostic information but also to enable prognostic data. Further, it presents a very important role for the correction of complications after surgical repair of rheumatic heart valvulopathies. Three-dimensional (3D) echocardiography provides additional anatomical and morphofunctional information of utmost importance for patients presenting rheumatic valvopathies. Accordingly, three-dimensional echocardiography is ready for routine use in patients with RHD presenting with valvular abnormalities.
- Case 2/2019-Man with Arrhythmogenic Cardiopathy Followed by Rapidly Progressive Heart Failure(2019) PEREIRA, Marcella Abunahman Freitas; RIBEIRO, Wilma Noia; DEMARCHI, Lea Maria Macruz FerreiraA 36-year-old man was referred to the medical service for surgical treatment of heart failure refractory to drug treatment. At the age of 26, 1st-degree atrioventricular block and episodes of non-sustained ventricular tachycardia were detected on the electrocardiogram (ECG). After 4 years, he started to have episodes of pre-syncope. The magnetic resonance performed at that time (09/29/2010) disclosed diastolic diameter of 59 mm; systolic diameter of 49 mm; 10-mm septum; posterior wall of 11 mm; 48% left ventricular ejection fraction and 53% right ventricular ejection fraction, with no contraction abnormalities. The late enhancement imaging showed an infero-septal, medium-basal subepicardial focus, compatible with fibrosis, suggestive of myocarditis or idiopathic dilated cardiomyopathy. The magnetic resonance performed at that time (09/29/2010) disclosed diastolic diameter of 59 mm; systolic diameter of 49 mm; 10-mm septum; posterior wall of 11 mm; 48% left ventricular ejection fraction and 53% right ventricular ejection fraction, with no contraction abnormalities. The late enhancement imaging showed an infero-septal, medium-basal subepicardial focus, compatible with fibrosis, suggestive of myocarditis or idiopathic dilated cardiomyopathy. An electrophysiological study was indicated. After extra-stimuli, sustained ventricular tachycardia with hemodynamic instability was triggered and an implantable-cardioverter defibrillator (ICD) was implanted and the patient received a beta-blocker. However, several episodes of ventricular tachycardia were recorded by the ICD and the use of amiodarone was initiated. An electrophysiological study was indicated. After extra-stimuli, sustained ventricular tachycardia with hemodynamic instability was triggered and an implantable-cardioverter defibrillator (ICD) was implanted and the patient received a beta-blocker. However, several episodes of ventricular tachycardia were recorded by the ICD and the use of amiodarone was initiated. An electrophysiological study was indicated. After extra-stimuli, sustained ventricular tachycardia with hemodynamic instability was triggered and an implantable-cardioverter defibrillator (ICD) was implanted and the patient received a beta-blocker. However, several episodes of ventricular tachycardia were recorded by the ICD and the use of amiodarone was initiated. He remained asymptomatic for approximately 3 years until he developed heart failure, which rapidly evolved into functional class IV, which resulted in hospitalization for compensation and with acute pulmonary edema at 34 years of age, followed by a new hospitalization a few months later for new heart failure compensation. At that time, hypothyroidism (TSH of 88 um / L) was diagnosed, which was attributed to amiodarone use. The echocardiogram disclosed severe left ventricular systolic dysfunction, with EF = 21%. Myocardial resynchronization was indicated, with pacemaker implantation with electrodes implanted at two points in the left ventricle in March 2015, but he was readmitted due to arterial hypotension, atrial fibrillation and heart failure decompensation in September 2015. Amiodarone, dobutamine, spironolactone, furosemide and rivaroxaban were administered.