VICTOR SARLI ISSA
Projetos de Pesquisa
Unidades Organizacionais
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
5 resultados
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- Diagnostic discrepancies in clinical practice An autopsy study in patients with heart failure(2017) ISSA, Victor Sarli; DINARDI, Layara Fernanda Lipari; PEREIRA, Thiago Vicente; ALMEIDA, Lyna Kyria Rodrigues de; BARBOSA, Thaisa Silveira; BENVENUTTI, Luiz Alberto; AYUB-FERREIRA, Silvia Moreira; BOCCHI, Edimar AlcidesAutopsies are the gold standard for diagnostic accuracy; however, no recent study has analyzed autopsies in heart failure (HF). We reviewed 1241 autopsies (January 2000-May 2005) and selected 232 patients with HF. Clinical and autopsy diagnoses were analyzed and discrepancies categorized according to their importance regarding therapy and prognosis. Mean age was 63.3 +/- 15.9 years; 154 (66.4%) patients were male. The causes of death at autopsy were end-stage HF (40.9%), acute myocardial infarction (17.2%), infection (15.9), and pulmonary embolism 36 (15.5). Diagnostic discrepancies occurred in 191 (82.3%) cases; in 56 (24.1%), discrepancies were related to major diagnoses with potential influence on survival or treatment; pulmonary embolism was the cause of death for 24 (42.9%) of these patients. In 35 (15.1%), discrepancies were related to a major diagnosis with equivocal influence on survival or treatment; in 100 (43.1%), discrepancies did not influence survival or treatment. In multivariate analysis, age (OR: 1.03, 95% CI: 1.008-1.052, P=0.007) and presence of diabetes mellitus (OR: 0.359, 95% CI: 0.168-0.767, P=0.008) influenced the occurrence discrepancies. Diagnostic discrepancies with a potential impact on prognosis are frequent in HF. These findings warrant reconsideration in diagnostic and therapeutic practices with HF patients.
conferenceObject Nutritional Characteristics of Patient with Chagas Cardiomyopathy with Decompensated Heart Failure(2017) TAVARES, L. C.; MOREIRA, H. F.; TERHOCH, C. B.; LAGE, S. H.; OLIVEIRA JUNIOR, M. T.; BOCCHI, E. A.; ISSA, V. S.- Circulating miR-1 as a potential biomarker of doxorubicin-induced cardiotoxicity in breast cancer patients(2017) RIGAUD, Vagner Oliveira-Carvalho; FERREIRA, Ludmila R. P.; AYUB-FERREIRA, Silvia M.; AVILA, Monica S.; BRANDAO, Sara M. G.; CRUZ, Fatima D.; SANTOS, Marilia H. H.; CRUZ, Cecilia B. B. V.; ALVES, Marco S. L.; ISSA, Victor S.; GUIMARAES, Guilherme V.; CUNHA-NETO, Edecio; BOCCHI, Edimar A.Cardiotoxicity is associated with the chronic use of doxorubicin leading to cardiomyopathy and heart failure. Identification of cardiotoxicity-specific miRNA biomarkers could provide clinicians with a valuable prognostic tool. The aim of the study was to evaluate circulating levels of miRNAs in breast cancer patients receiving doxorubicin treatment and to correlate with cardiac function. This is an ancillary study from ""Carvedilol Effect on Chemotherapy-induced Cardiotoxicity"" (CECCY trial), which included 56 female patients (49.9 +/- 3.3 years of age) from the placebo arm. Enrolled patients were treated with doxorubicin followed by taxanes. cTnI, LVEF, and miRNAs were measured periodically. Circulating levels of miR-1,-133b,-146a, and -423-5p increased during the treatment whereas miR-208a and -208b were undetectable. cTnI increased from 6.6 +/- 0.3 to 46.7 +/- 5.5 pg/mL (p<0.001), while overall LVEF tended to decrease from 65.3 +/- 0.5 to 63.8 +/- 0.9 (p=0.053) over 12 months. Ten patients (17.9%) developed cardiotoxicity showing a decrease in LVEF from 67.2 +/- 1.0 to 58.8 +/- 2.7 (p=0.005). miR-1 was associated with changes in LVEF (r=-0.531, p<0.001). In a ROC curve analysis miR-1 showed an AUC greater than cTnI to discriminate between patients who did and did not develop cardiotoxicity (AUC = 0.851 and 0.544, p = 0.0016). Our data suggest that circulating miR-1 might be a potential new biomarker of doxorubicin-induced cardiotoxicity in breast cancer patients.
- Chronic Chagas Heart Disease Management From Etiology to Cardiomyopathy Treatment(2017) BOCCHI, Edimar Alcides; BESTETTI, Reinaldo Bulgarelli; SCANAVACCA, Mauricio Ibrahim; NETO, Edecio Cunha; ISSA, Victor SarliTrypanosoma cruzi (T. cruzi) infection is endemic in Latin America and is becoming a worldwide health burden. It may lead to heterogeneous phenotypes. Early diagnosis of T. cruzi infection is crucial. Several biomarkers have been reported in Chagas heart disease (ChHD), but most are nonspecific for T. cruzi infection. Prognosis of ChHD patients is worse compared with other etiologies, with sudden cardiac death as an important mode of death. Most ChHD patients display diffuse myocarditis with fibrosis and hypertrophy. The remodeling process seems to be associated with etiopathogenic mechanisms and neurohormonal activation. Pharmacological treatment and antiarrhythmic therapy for ChHD is mostly based on results for other etiologies. Heart transplantation is an established, valuable therapeutic option in refractory ChHD. Implantable cardioverter-defibrillators are indicated for prevention of secondary sudden cardiac death. Specific etiological treatments should be revisited and reserved for select patients. Understanding and management of ChHD need improvement, including development of randomized trials. (C) 2017 by the American College of Cardiology Foundation.
conferenceObject Global analysis of survival of patients of the study remadhe randomized prospective submitted to the DMP with follow-up of 16 years(2017) CRUZ, F. D. C. Fatima Das Dores; ISSA, V. S.; CHIZZOLA, P. R.; CONCEICAO, G. E.; AYUB, S. F.; BOCCHI, E. A.