ACACIO FERNANDES CARDOSO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina

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Autor e Coautores FMUSP-HC Normalizados: MARCO AURELIO SANTO ×

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  • article 6 Citação(ões) na Scopus
    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 Aurelio
    The 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.
  • article 11 Citação(ões) na Scopus
    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.