FRANCISCO CARLOS DA COSTA DARRIEUX
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- Effects of anthracycline, cyclophosphamide and taxane chemotherapy on QTc measurements in patients with breast cancer(2018) VERONESE, Pedro; HACHUL, Denise Tessariol; SCANAVACCA, Mauricio Ibrahim; HAJJAR, Ludhmila Abrahao; WU, Tan Chen; SACILOTTO, Luciana; VERONESE, Carolina; DARRIEUX, Francisco Carlos da CostaAim Acute and subacute cardiotoxicity are characterized by prolongation of the corrected QT interval (QTc) and other measures derived from the QTc interval, such as QTc dispersion (QTdc) and transmural dispersion of repolarization (DTpTe). Although anthracyclines prolong the QTc interval, it is unclear whether breast cancer patients who undergo the ACT chemotherapy regimen of anthracycline (doxorubicin: A), cyclophosphamide (C) and taxane (T) may present with QTc, QTdc and DTpTe prolongation. Methods Twenty-three consecutive patients with breast cancer were followed prospectively during ACT chemotherapy and were analyzed according to their QT measurements. QTc, QTdc and DTpTe measurements were determined by a 12-lead electrocardiogram (EKG) prior to chemotherapy (baseline), immediately after the first phase of anthracycline and cyclophosphamide (AC) treatment, and immediately after T treatment. Serum troponin and B-type natriuretic peptide (BNP) levels were also measured. Results Compared to baseline values, the QTc interval was significantly prolonged after the AC phase (439.7 +/- 33.2 ms vs. 472.5 +/- 36.3 ms, p = 0.001) and after T treatment (439.7 +/- 33.2 ms vs. 467.9 +/- 42.6 ms, p < 0.001). Troponin levels were elevated after the AC phase (23.0 pg/mL [min-max: 6.0-85.0] vs. 6.0 pg/mL [min-max: 6.0-22.0], p < 0.001) and after T treatment (25.0 pg/mL [min-max: 6.0-80.0] vs. 6.0 pg/mL [min-max: 6.0-22.0], p < 0.001) compared to baseline values. Conclusion In this prospective study of patients with non-metastatic breast cancer who underwent ACT chemotherapy, significant QTc prolongation and an elevation in serum troponin levels were observed.
- European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on arrhythmias and cognitive function: What is the best practice?(2018) DAGRES, Nikolaos; CHAO, Tze-Fan; FENELON, Guilherme; AGUINAGA, Luis; BENHAYON, Daniel; BENJAMIN, Emelia J.; BUNCH, T. Jared; CHEN, Lin Yee; CHEN, Shih-Ann; DARRIEUX, Francisco; PAOLA, Angelo de; FAUCHIER, Laurent; GOETTE, Andreas; KALMAN, Jonathan; KALRA, Lalit; KIM, Young-Hoon; LANE, Deirdre A.; LIP, Gregory Y. H.; LUBITZ, Steven A.; MARQUEZ, Manlio F.; POTPARA, Tatjana; POZZER, Domingo Luis; RUSKIN, Jeremy N.; SAVELIEVA, Irina; TEO, Wee Siong; TSE, Hung-Fat; VERMA, Atul; ZHANG, Shu; CHUNG, Mina K.
conferenceObject Atrial fibrillation as a cornerstone of laminopathy(2018) CALIL, Z. O.; PESSENTE, G. A.; SACILOTTO, L.; OLIVETTI, N. Q. S.; HACHUL, D. T.; WU, T. C.; GRUPPI, C. J.; CARVALHO, M. L. P.; ARANHA, A. F.; PEDROSA, A. A. A.; HARDY, C. A.; PISANI, C. F.; PEREIRA, A. C.; SCANAVACCA, M. I.; DARRIEUX, F. C. C.bookPart Fibrilação atrial(2018) BASTOS FILHO, João Bosco Breckenfeld; LEITE, Thiago Nunes Pereira; DARRIEUX, Francisco Carlos da Costa- Accuracy of the pacemaker event recorder versus Holter-ECG to detect both symptomatic and asymptomatic ventricular arrhythmias(2018) SAMPAIO, Stela Maria Vitorino; CRAVEIRO, Neyle Moara; DARRIEUX, Francisco; OLIVEIRA, Italo Martins de; SCANAVACCA, Mauricio; HACHUL, DeniseBackground: Although new pacemakers can register cardiac rhythm, few studies were performed evaluating their accuracy in diagnosing ventricular arrhythmias (VA). This study aimed to assess the correlation and agreement between the pacemaker's monitor and the ambulatory Holter in detecting VA. Methods and results: We studied 129 patients with pacemakers, mean age 68.6 +/- 19.1 years, 54.8% female. Once Holter monitoring was connected, the pacemakers'event counters were reset and clocks of both systems were synchronized to register electrocardiograms (ECG) simultaneously. Pacemakers were programmed to detect the lowest ventricular rate and lowest number of sequential beats allowed in their event monitors. After 72 hours, Holter and pacemakers records were analyzed. VA was defined in Holter and event monitor, respectively, as: isolated premature ventricular complexes: ""PVC""; pairs: ""couplets""; nonsustained ventricular tachycardia (NSVT): ""triplets"" -3 beats; ""runs"" -4-8 or > 8 beats, and high ventricular rates (""HVR"")-3-4 beats. Spearman correlations evaluated whether pacemaker and Holter identified the same parameters. Intraclass correlation coefficients (ICCs) and respective 95% confidence intervals were calculated to assess the concordance between methods. The agreement between both systems was low, except for ""triplet"" and three beats NSVT (ICC = 0.984). The correlation for more than 10 PVC/h was moderate (Kappa = 0.483). When the pacemaker was programmed to detect HVR sequences of three beats lower than 140 bpm (< 140/3), the correlation with NSVT was perfect (r = 1) and agreement was also quite high (ICC = 0.800). Conclusions: Pacemakers' event monitors underestimate the occurrence of ventricular arrhythmias detected by Holter. Standardization of pacemakers' algorithms is required before using this function for patients' clinical follow-up.
bookPart Fibrilação atrial(2018) BASTOS FILHO, João Bosco Breckenfeld; LEITE, Thiago Nunes Pereira; DARRIEUX, Francisco Carlos da Costa- Pharmaceutical Care Increases Time in Therapeutic Range of Patients With Poor Quality of Anticoagulation With Warfarin(2018) MARCATTO, Leiliane Rodrigues; SACILOTTO, Luciana; TAVARES, Leticia Camargo; FACIN, Mirella; OLIVETTI, Natalia; STRUNZ, Celia Maria Cassaro; DARRIEUX, Francisco Carlos Costa; SCANAVACCA, Mauricio Ibrahim; KRIEGER, Jose Eduardo; PEREIRA, Alexandre Costa; SANTOS, Paulo Caleb Junior LimaThromboembolic events are associated with high mortality and morbidity indexes. In this context, warfarin is the most widely prescribed oral anticoagulant agent for preventing and treating these events. This medication has a narrow therapeutic range and, consequently, patients usually have difficulty in achieving and maintaining stable target therapeutics. Some studies on the literature about oral anticoagulant management showed that pharmacists could improve the efficiency of anticoagulant therapy. However, the majority of these studies included general patients retrospectively. The aim of this study was to prospectively evaluate a pharmacist's warfarin management in patients with poor quality of anticoagulation therapy (Time in the Therapeutic Range-TTR < 50%). We included 268 patients with atrial fibrillation (AF) and without stable dose of warfarin (TTR < 50%, based on the last three values of International Normalized Ratio-INR). We followed them up for 12 weeks, INR values were evaluated and, when necessary, the dose adjustments were performed. During the first four visits, patient's INR was measured every 7 days. Then, if INR was within the target therapeutic range (INR: 2-3), the patient was asked to return in 30 days. However, if INR was out the therapeutic target, the patient was asked to return in 7 days. Adherence evaluation was measured through questionnaires and by counting the pills taken. Comparison between basal TTR (which was calculated based on the three last INR values before prospective phase) and TTR of 4 weeks (calculated by considering the INR tests from visits 0 to 4, in the prospective phase of the study) and basal TTR and TTR of 12 weeks (calculated based on the INR tests from visits 0 to 12, in the prospective phase of the study) revealed significant statistical differences (0.144 +/- 0.010 vs. 0.382 +/- 0.016; and 0.144 +/- 0.010 vs. 0.543 +/- 0.014, p < 0.001, respectively). We also observed that the mean TTR of 1 year before (retrospective phase) was lower than TTR value after 12 weeks of pharmacist-driven treatment (prospective phase) (0.320 +/- 0.015; 0.540 +/- 0.015, p < 0.001). In conclusion, pharmaceutical care was able to improve TTR values in patients with AF and poor quality of anticoagulation with warfarin.
bookPart Manejo das extrassístoles ventriculares na emergência(2018) BEZERRA, Mariana Lins Baptista Guedes; OLIVETTI, Natália Quintela Sangiorgi; VIANA, Fernanda Farias; SOEIRO, Alexandre de Matos; DARRIEUX, Francisco Carlos da CostabookPart Manejo das extrassístoles ventriculares na emergência(2018) BEZERRA, Mariana Lins Baptista Guedes; OLIVETTI, Natália Quintella Sangiorgi; VIANNA, Fernanda Farias; SOEIRO, Alexandre de Matos; DARRIEUX, Francisco Carlos da Costa- Carotid Sinus Massage in Syncope Evaluation: A Nonspecific and Dubious Diagnostic Method(2018) WU, Tan Chen; HACHUL, Denise T. L.; DARRIEUX, Francisco Carlos da Costa; I, Mauricio ScanavaccaBackground: Carotid sinus hypersensitivity (CSH) is a frequent finding in the evaluation of syncope. However, its significance in the clinical setting is still dubious. A new criterion was proposed by Solari et al. with a symptomatic systolic blood pressure (SBP) cut-off value of <= 85 mmHg to refine the vasodepressor (VD) response diagnosis. Objective: To determine and compare the response to carotid sinus massage (CSM) in patients with and without syncope according to standard and proposed criteria. Methods: (3M was performed in 99 patients with and 66 patients without syncope. CSH was defined as cardioinhibitory (CI) for asystole >= 3 seconds, or as VD for SBP decrease >= 50 mmHg. Results: No differences in the hemodynamic responses were observed during CSM between the groups, with 24.2% and 25.8% CI, and 8.1% and 13.6% VD in the symptomatic and asymptomatic groups, respectively (p = 0.466). A p value < 0.050 was considered statistically significant. During the maneuvers, 45 (45.45%) and 34 (51.5%) patients in the symptomatic and asymptomatic groups achieved SBP below <= 85 mmHg. Symptoms were reported especially in those patients in whom CSM caused a SBP decrease to below 90 mmHg and/or asystole > 2.5 seconds, regardless of the pattern of response or the presence of previous syncope. Conclusion: The response to CSM in patients with and without syncope was similar; therefore, CSH may be an unspecific condition. Clinical correlation and other methods of evaluation, such as long-lasting ECG monitoring, may be necessary to confirm CSH as the cause of syncope.