THIAGO ANDRADE DE MACEDO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
26 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 26
article Does Obstructive Sleep Apnea Treatment Influence Lipoprotein (a) Concentrations? Data from the TREATOSA-MS Clinical Trial(2023) GIAMPA, Sara Q. C.; VIANA, Luciana G.; CARDOZO, Karina H. M.; MACEDO, Thiago A.; FURLAN, Sofia F.; FREITAS, Lunara S.; BORTOLOTTO, Luiz A.; LORENZI-FILHO, Geraldo; DRAGER, Luciano F.conferenceObject Effects of CPAP on Metabolic Syndrome in Patients with Obstructive Sleep Apnea: The TREATOSA-MS Randomized Controlled Trial(2020) GIAMPA, S. Q.; FREITAS, L. S.; FURLAN, S. F.; MACEDO, T. A.; LEBKUCHEN, A.; CARDOZO, K. H. M.; MARTINS, F. C.; AZAM, I. F. B.; COSTA-HONG, V.; BAPTISTA, M. L.; ROCHITTE, C. E.; BORTOLOTTO, L. A.; LORENZI-FILHO, G.; DRAGER, L. F.- Obstructive sleep apnea and hypertension-mediated organ damage in nonresistant and resistant hypertension(2023) CABRINI, Mayara L.; MACEDO, Thiago A.; CASTRO, Emerson; BARROS, Silvana de; AZAM, Indira; PIO-ABREU, Andrea; SILVA, Giovanio V.; LORENZI-FILHO, Geraldo; BORTOLOTTO, Luiz A.; DRAGER, Luciano F.The potential role of obstructive sleep apnea (OSA) in hypertension-mediated organ damage (HMOD) may be influenced by the presence of resistant hypertension (RH). Herein, we enrolled patients with hypertension from a tertiary center for clinical evaluation and performed a sleep study to identify OSA (apnea-hypopnea index >= 15 events/h) and a blinded analysis of four standard HMOD parameters (left ventricular hypertrophy [LVH], increased arterial stiffness [>= 10 m/s], presence of retinopathy, and nephropathy). RH was diagnosed based on uncontrolled blood pressure (BP) (>= 140/90 mmHg) despite concurrent use of at least three antihypertensive drug classes or controlled BP with concurrent use of >= 4 antihypertensive drug classes at optimal doses. To avoid the white-coat effect, ambulatory BP monitoring was performed to confirm RH diagnosis. One-hundred patients were included in the analysis (mean age: 54 +/- 8 years, 65% females, body mass index: 30.4 +/- 4.5 kg/m(2)). OSA was detected in 52% of patients. Among patients with non-RH (n = 53), the presence of OSA (52.8%) was not associated with an increased frequency of HMOD. Conversely, among patients with RH, OSA (51.1%) was associated with a higher incidence of LVH (RH-OSA,61%; RH + OSA,87%; p = 0.049). Logistic regression analysis using the total sample revealed that RH (OR:7.89; 95% CI:2.18-28.52; p = 0.002), systolic BP (OR:1.04; 95% CI:1.00-1.07; p = 0.042) and OSA (OR:4.31; 95% CI:1.14-16.34; p = 0.032) were independently associated with LVH. No significant association was observed between OSA and arterial stiffness, retinopathy, or nephropathy. In conclusion, OSA is independently associated with LVH in RH, suggesting a potential role of OSA in RH prognosis.
- What is the effect of catecholamines on diastolic function in patients with pheochromocytoma and paraganglioma?(2023) MACEDO, Thiago Andrade; DRAGER, Luciano F. F.; VIEIRA, Marcelo Luiz Campos
conferenceObject Gender Differences of Aortic Wave Reflection and Influence of Menopause on Central Blood Pressure in Patients With Arterial Hypertension.(2017) COSTA-HONG, Valeria; MUELA, Henrique C.; MACEDO, Thiago A.; SALES, Allan R.; BORTOLOTTO, Luiz A.- INTERMITTENT CLAUDICATION IS COMMON AND INDEPENDENTLY ASSOCIATED WITH RENAL ARTERY STENOSIS IN HYPERTENSIVE PATIENTS REFERRED FOR RENAL ARTERIOGRAPHY(2015) BORTOLOTTO, L.; MACEDO, T. A.; PEDROSA, R.; GIORGI, D. M. A.; BRITO, T. M.; DRAGER, L. F.
- Intermittent claudication and severe renal artery stenosis are independently associated in hypertensive patients referred for renal arteriography(2017) MACEDO, Thiago Andrade; DRAGER, Luciano Ferreira; PEDROSA, Rodrigo Pinto; MUELA, Henrique Cotchi Simbo; COSTA-HONG, Valeria; KAJITA, Luiz Junia; BORTOLOTTO, Luiz AparecidoOBJECTIVE: The purpose of this study was to evaluate the association between the presence of clinical symptoms of peripheral artery disease and severe renal artery stenosis in patients referred for renal angiography. METHOD: We included 82 patients with clinical suspicion of renovascular hypertension and performed an imaging investigation (renal Doppler ultrasound and/or renal scintigraphy) for possible renal artery stenosis. All patients underwent renal arteriography and were examined for peripheral artery disease based on the presence of intermittent claudication and ankle-brachial index test results. Severe renal artery stenosis was defined as a lesion causing 70% obstruction. RESULTS: Severe renal artery stenosis was present in 32 of 82 (39%) patients. Patients with severe renal artery stenosis were older (63 +/- 12 vs 56 +/- 12 years, p=0.006), had more intermittent claudication (55 vs 45%, p=0.027), and had a greater prevalence of an ankle-brachial index <0.9 (44% vs 20%, p=0.021) than patients without severe renal artery stenosis. Multivariate logistic regression analysis showed that the presence of intermittent claudication was independently associated with renal artery stenosis >= 70% (OR: 3.33; 95% CI 1.03-10.82, p=0.04), unlike the ankle-brachial index, which showed no association (OR: 1.44; 95% CI 0.37-5.66, p=0.60). CONCLUSION: Intermittent claudication is independently associated with severe renal artery stenosis (>= 70%) in patients clinically suspected of having renovascular hypertension.
conferenceObject IMPACT OF PREVIOUS HYPERTENSIVE DISORDER DURING PREGNANCY ON ANTHROPOMETRIC MEASUREMENTS, 24-HOUR BLOOD PRESSURE AND ARTERIAL STIFFNESS(2021) VERARDINO, Renata; RODRIGUES, Sara; BERGER, Ana; COSTA-HONG, Valeria; MACEDO, Thiago; BAPTISTA, Fernanda; BORTOLOTTO, Maria; FRANCISCO, Rossana; ZUGAIB, Marcelo; BORTOLOTTO, Luiz- Effects of CPAP on Metabolic Syndrome in Patients With OSA A Randomized Trial(2022) GIAMPA, Sara Q. C.; FURLAN, Sofia F.; FREITAS, Lunara S.; MACEDO, Thiago A.; LEBKUCHEN, Adriana; CARDOZO, Karina H. M.; CARVALHO, Valdemir M.; MARTINS, Franco C.; AZAM, Indira F. B.; COSTA-HONG, Valeria; LOPES, Heno F.; BAPTISTA, Mariana L.; ROCHITTE, Carlos E.; BORTOLOTTO, Luiz A.; LORENZI-FILHO, Geraldo; DRAGER, Luciano F.BACKGROUND: OSA is associated with metabolic syndrome (MS), but it is unclear whether OSA treatment with CPAP can revert MS. RESEARCH QUESTION: Does OSA treatment with CPAP per se have effects on the MS reversibility and the associated metabolic, adiposity and vascular parameters? STUDY DESIGN AND METHODS: The TREATOSA-MS trial is a randomized placebo-controlled trial that enrolled adult patients with a recent diagnosis of MS and moderate or severe OSA (apnea-hypopnea index [AHI], >= 15 events/h) to undergo therapeutic CPAP or nasal dilator strips (placebo group) for 6 months. Before and after each intervention, we measured anthropometric variables, BP, glucose, and lipid profile. To control potential-related mechanisms and consequences, we also measured adiposity biomarkers (leptin and adiponectin), body composition, food intake, physical activity, subcutaneous and abdominal fat (visceral and hepatic fat), and endothelial function. RESULTS: One hundred patients (79% men; mean age, 48 +/- 9 years; BMI, 33 +/- 4 kg/m(2); AHI, 58 +/- 29 events/h) completed the study (n = 50 per group). The mean CPAP adherence was 5.5 +/- 1.5 h/night. After 6 months, most patients with OSA randomized to CPAP retained the MS diagnosis, but the rate of MS reversibility was higher than observed in the placebo group (18% vs 4%; OR, 5.27; 95% CI, 1.27-35.86; P = .04). In the secondary analysis, CPAP did not promote significant reductions in the individual components of MS, weight, hepatic steatosis, lipid profile, adiponectin, and leptin, but did promote a very modest reduction in visceral fat and improved endothelial function (all analyses were adjusted for baseline values). INTERPRETATION: Despite the higher rate of MS reversibility after CPAP therapy as compared with placebo, most patients retained this diagnosis. The lack of significant or relevant effects on adiposity biomarkers and depots supports the modest role of OSA in modulating MS.
- Gender differences of aortic wave reflection and influence of menopause on central blood pressure in patients with arterial hypertension(2018) COSTA-HONG, Valeria Aparecida; MUELA, Henrique Cotchi Simbo; MACEDO, Thiago Andrade; SALES, Allan Robson Kluser; BORTOLOTTO, Luiz AparecidoBackground: Evidences suggest that central hemodynamics indexes are independent predictors of future cardiovascular events and all-cause mortality. Multiple factors have been pointed to have potential influence on central aortic function: height, heart rate, left ventricular ejection duration and blood pressure level. Data related to the influence of gender and postmenopausal status on aortic waveform reflection is scarce. We aim to evaluate the impact of gender and menopause on central blood pressure of hypertensive patients. Methods: In a cross sectional study 122 hypertensive patients (52 men and 70 women) were studied. Hypertension was defined as blood pressure (BP) levels >= 140/90 mmHg or use of antihypertensive drugs. Central arterial pressure, augmentation index (AIx) and augmentation index normalized to 75 bpm (AIx75) were obtained using applanation tonometry. Menopause and postmenopause history were accessed by a direct series of questions. Postmenopause was defined as at least one year since last menstruation. Patients were paired by age, gender and menopausal status, and the data were compared considering gender and menopausal status. Results: Height and weight were significantly lower in women than in men at the same age. Conversely, AIx (32.7 +/- 9.8% vs. 20.1 +/- 11.7%, p < 0.01), AIx75 (29.6 +/- 6.7% vs. 18.3 +/- 9.4%, p < 0.01) and central systolic blood pressure (136 +/- 30 vs. 125 +/- 23 mmHg, p = 0.03) were higher in women than men. The menopausal women (mean age of menopause = 48 years) had the worst indexes of aortic wave reflection, compared to men at the same age and younger women. Conclusion: Hypertensive women had both higher reflected aortic pressure waveform and central blood pressure indexes than hypertensive men, and these findings were worsened by the menopausal status.
- «
- 1 (current)
- 2
- 3
- »