ACACIO FERNANDES CARDOSO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
6 resultados
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- Brazilian Society of Cardiology Guidelines on the Analysis and Issuance of Electrocardiographic Reports-2022(2022) SAMESIMA, Nelson; GOD, Epotamenides Good; KRUSE, Jose Claudio Lupi; LEAL, Marcelo Garcia; PINHO, Claudio; FRANCA, Francisco Faustino de A. C.; PIMENTA, Joao; CARDOSO, Acacio Fernandes; PAIXAO, Adail; FONSECA, Alfredo; PEREZ-RIERA, Andres R.; RIBEIRO, Antonio Luiz Pinho; MADALOSO, Bruna Affonso; LUNA FILHO, Braulio; OLIVEIRA, Carlos Alberto Rodrigues de; GRUPI, Cesar Jose; MOREIRA, Dalmo Antonio Ribeiro; KAISER, Elisabeth; PAIXAO, Gabriela Miana de Mattos; FEITOSA FILHO, Gilson; PEREIRA FILHO, Horacio Gomes; GRINDLER, Jose; AZIZ, Jose Luiz; MOLINA, Marcos Sleiman; FACIN, Mirella; TOBIAS, Nancy M. M. de Oliveira; OLIVEIRA, Patricia Alves de; SANCHES, Paulo Cesar R.; TEIXEIRA, Ricardo Alkmin; ATANES, Severiano Melo; PASTORE, Carlos Alberto
- Normality that is abnormal(2016) FERNANDES-CARDOSO, Acacio; DUTRA-KRELING, Gabriel Afonso; GRINDLER, Jose; PEREZ-RIERA, Andres RicardoSupernormal conduction is defined as better-than-expected conduction in patients with depressed conduction during a short interval in the ventricular cycle. It is mainly observed in long-duration electrocardiogram (ECG) assessments. Its occurrence during 12-lead ECG is uncommon and its interpretation demands knowledge on electrophysiological alterations that are hard to understand. By reporting this case we aim to propose a rationale sequence that should be considered when facing an ECG with these same features, which would enable a greater accuracy to make a definitive diagnosis. (C) 2016 Published by Elsevier Inc.
- Cardiac Remodeling Patterns in Severe Obesity According to Arterial Hypertension Grade(2018) CLEVA, Roberto de; ARAUJO, Victor Arrais; BUCHALLA, Carla Cristina Ornelas; COSTA, Fabio de Oliveira; CARDOSO, Acacio Fernandes; PAJECKI, Denis; SANTO, Marco AurelioThe purpose of this study is to correlate the left ventricular hypertrophy (LVH) patterns according to severe obesity and arterial hypertension (AHT) grades. A cross-sectional prospective study was conducted in 379 patients with severe obesity. Obesity was classified according to the BMI in the following: morbidly obese (MO; 40 < BMI < 50 kg/m(2)) and super obese (SO; BMI > 50 kg/m(2)). The AHT was classified into classes 1 and 2 according to American Heart Association. The presence of LVH and the pattern of cardiac remodeling were determined by transthoracic echocardiography. LVH was present in 58.6% of patients. Obesity and AHT had additive effects in LVH prevalence. LVH was found in 32.9 and 46.7% of MO with AHT grades 1 and 2, respectively. LVH was diagnosed in 39.1% in SO with AHT grade 1 and in 50% of AHT grade 2. Patients with AHT presented a significantly higher risk of developing LVH (OR 1.97; p = 0.003). Hypertension grade was also a determinant variable in the development of LVH. Patients with AHT 2 had 4.31-fold greater risk (p < 0.001) when compared to normotensive patients. BMI was only considered an independent risk factor for LVH in patients with BMI greater than 47.17 kg/m(2) (OR 1.62; p = 0.023). AHT is a stronger predictive factor of LVH than obesity grade.
- Evaluation of a new treadmill exercise protocol to unmask type 1 Brugada electrocardiographic pattern: can we improve diagnostic yield?(2023) PICHARA, Nemer L.; SACILOTTO, Luciana; I, Mauricio Scanavacca; CARDOSO, Acacio Fernandes; SOARES, Beatriz Moreira Ayub Ferreira; FALCOCHIO, Paola P. P. N. F.; FALCAO, Andrea M. G.; OLIVETTI, Natalia; DARRIEUX, Francisco Carlos da Costa; CHALELA, William A.Aims High precordial leads (HPL) on the resting electrocardiogram (ECG) are widely used to improve diagnostic detection of type 1 Brugada ECG pattern (Br1ECGp). A parasympathetic activation marks the initial recovery phase of treadmill stress testing (TET), and this can be useful for detecting the typical ECG pattern. Our study aimed to evaluate the role of a new HPL-treadmill exercise testing (TET) protocol in detecting Br1ECGp fluctuation compared to resting HPL-ECG. Methods and results 74 out of 163 patients of a Brugada syndrome (BrS) Brazilian cohort (GenBra Registry) underwent exercise testing with HPL-TET protocol. Precordial leads were displayed in strategic positions in the right and left parasternal spaces. The step-by-step analysis included ECG classification (as presence or absence of Br1ECGp) in standard vs. HPL leads placement in the following sequences: resting phase, maximal exercise, and the passive recovery phase (including 'quick lay down'). For heart rate recovery (HRR) measurements and comparisons, a Student's t-test was applied. McNemar tests compared the detection of Br1ECGp. The significance level was defined as P < 0.05. Fifty-seven patients (57/74; 77%) were male, the mean age was 49.0 & PLUSMN; 14, 78.4% had spontaneous BrS, and the mean Shanghai score was 4.5. The HPL-TET protocol increased Br1ECGp detection by 32.4% against resting HPL-ECG (52.7% vs. 20.3%, P = 0.001) alone. Conclusion Stress testing using HPL with the passive recovery phase in the supine position offers an opportunity to unmask the type 1 Br1ECGp, which could increase the diagnostic yield in this population.
- Epicardial fat thickness correlates with P-wave duration, left atrial size and decreased left ventricular systolic function in morbid obesity(2017) FERNANDES-CARDOSO, A.; SANTOS-FURTADO, M.; GRINDLER, J.; FERREIRA, L. A.; ANDRADE, J. L.; SANTO, M. A.Background and Aim: Epicardial fat (EF) is increased in obesity and has important interactions with atrial and ventricular myocardium. Most of the evidence in this scenario can be confused by the presence of comorbidities such as hypertension, diabetes and dyslipidemia, which are very common in this population. The influence of EF on atrial remodeling and cardiac function demands further investigation on morbidly obese without these comorbidities. Methods and Results: We prospectively recruited 20 metabolically healthy morbidly obese and 20 normo-weights controls. The maximum P-wave duration (PWD) was analyzed by 12-lead electrocardiogram. Left atrial diameter (LAD), left ventricular ejection fraction (LVEF) and EF thickness (EFT) were evaluated by two-dimensional echocardiography. The mean of maximum PWD and LAD were significantly larger in the obese group as compared to the control group: 109.55 +/- 11.52 ms x 89.38 +/- 11.19 ms and 36.12 +/- 3.46 mm x 31.45 +/- 2.64 mm, (p < 0.0001). The mean LVEF was lower in the obese group: 63.15 +/- 4.25% x 66.17 +/- 3.37% (p < 0.017). The mean EFT was higher in the obese group: 7.72 +/- 1.60 mm x 3.10 +/- 0.85 mm (p < 0.0001). A positive correlation was found between EFT and PWD (r = 0.70; p = 0.001) and LAD (r = 0.667; p = 0.001). An inverse correlation was found between EFT and LVEF (r = 0.523; p = 0.001). In a multiple multivariate regression analysis the EFT remains correlated with LAD and LVEF. Conclusions: In a select group of morbidly obese, the excess of EF had a significant impact on atrial remodeling and cardiac function.
- An unusual presentation of low QRS voltage in a patient with aortic aneurysm(2024) MAGALHAES, Eduardo Faria Soares de; FONSECA, Alfredo Jose da; JENSEN, Nicole Turin; MOREIRA, Amanda Maria Rodrigues Fialho; CARDOSO, Acacio FernandesThere are many causes of low QRS voltage on the electrocardiogram (ECG). Although uncommon, there is evidence that an enlarged aorta can cause diminished QRS amplitude on ECG. In this case report, we describe an unusual presentation of low QRS voltage confined to the first three precordial leads (V1-V3) in a 77-year-old female with ascending aortic aneurysm. Analysis of the patient's medical history, echocardiogram and contrast-enhanced computed tomography indicates that the ECG pattern was caused by interposition of the aortic aneurysm between the heart and the skin electrodes (V1-V3), revealing a possible indirect sign for large aortic aneurysm on ECG.