LEA MARIA MACRUZ FERREIRA DEMARCHI

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico

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Autor e Coautores FMUSP-HC Normalizados: FLAVIO TARASOUTCHI ×

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  • article 0 Citação(ões) na Scopus
    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 Orismar
    Rheumatic 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.
  • conferenceObject
    COVID-19 in pregnant women with heart diseases. Adverse maternal and fetal outcomes. Case series from InCor registry of Pregnancy and Heart Disease
    (2021) KIRSCHBAUM, M. R.; DEVIDO, M. S.; AZEKA, E.; DEMARCHI, L. M. M. F.; SANTOS, J. S.; PINTO, D. V. R.; HAJJAR, L. A.; TARASOUTCHI, F.; PARK, M.; AVILA, W. S.
  • article 2 Citação(ões) na Scopus
    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 Orismar
    Rheumatic 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.