ANTONIO AUGUSTO BARBOSA LOPES
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Prothrombotic Endothelial Dysfunction in Pre-Fontan Subjects is Similar to Pulmonary Arterial Hypertension Associated with the Eisenmenger Syndrome (PAH-Eisenmenger)(2012) MAEDA, Nair Y.; SOARES, Rosangela P.; BINOTTO, Maria A.; BYDLOWSKI, Sergio P.; LOPES, Antonio A.article 0 Citação(ões) na Scopus Consenso sobre la clasificación de la enfermedad vascular pulmonar hipertensiva en niños: reporte del task force pediátrico del Pulmonary Vascular Research Institute (PVRI) Panamá 2011(2012) DEL CERRO, María Jesús; ABMAN, Steven; DÍAZ, Gabriel; HEATH FREUDENTHAL, Alexandra; FREUDENTHAL, Franz; HARIKRISHNAN, S; HAWORTH, Sheila G; DUNBAR, Ivy; LOPES, Antonio A; USHA RAJ, J; SANDOVAL, Julio; STENMARK, Kurt; ADATIA, IanCurrent classifications of pulmonary hypertension have contributed a great deal to our understanding of pulmonary vascular disease, facilitated drug trials, and improved our understanding of congenital heart disease in adult survivors. However, these classifications are not applicable readily to pediatric disease. The classification system that we propose is based firmly in clinical practice. The specific aims of this new system are to improve diagnostic strategies, to promote appropriate clinical investigation, to improve our understanding of disease pathogenesis, physiology and epidemiology, and to guide the development of human disease models in laboratory and animal studies. It should be also an educational resource. We emphasize the concepts of perinatal maladaptation, maldevelopment and pulmonary hypoplasia as causative factors in pediatric pulmonary hypertension. We highlight the importance of genetic, chromosomal and multiple congenital malformation syndromes in the presentation of pediatric pulmonary hypertension. We divide pediatric pulmonary hypertensive vascular disease into 10 broad categories.article 0 Citação(ões) na Scopus Clasificación funcional de la hipertensión pulmonar en niños: informe del task force pediátrico del Pulmonary Vascular Research Institute (PVRI), Panamá 2011(2012) LAMMERS, Astrid E; ADATIA, Ian; DEL CERRO, María Jesús; DÍAZ, Gabriel; HEATH FREUDENTHAL, Alexandra; FREUDENTHAL, Franz; HARIKRISHNAN, S; DUNBAR, Ivy; LOPES, Antonio A; USHA RAJ, J; SANDOVAL, Julio; STENMARK, Kurt; HAWORTH, Sheila GThe members of the Pediatric Task Force of the Pulmonary Vascular Research Institute (PVRI) were aware of the need to develop a functional classification of pulmonary hypertension in children. The proposed classification follows the same pattern and uses the same criteria as the Dana Point pulmonary hypertension specific classification for adults. Modifications were necessary for children, since age, physical growth and maturation influences the way in which the functional effects of a disease are expressed. It is essential to encapsulate a child's clinical status, to make it possible to review progress with time as he/she grows up, as consistently and as objectively as possible. Particularly in younger children we sought to include objective indicators such as thriving, need for supplemental feeds and the record of school or nursery attendance. This helps monitor the clinical course of events and response to treatment over the years. It also facilitates the development of treatment algorithms for children. We present a consensus paper on a functional classification system for children with pulmonary hypertension, discussed at the Annual Meeting of the PVRI in Panama City, February 2011.- Lack of Tight Association Between Quality of Life and Exercise Capacity in Pulmonary Arterial Hypertension(2012) CICERO, Cristina; FRANCHI, Sonia Meiken; BARRETO, Alessandra Costa; LOPES, Antonio Augusto BarbosaBackground: In pulmonary arterial hypertension (PAH) health-related quality of life (HRQOL) has been investigated over the short-term (weeks) but little is known about patient's perspective over the medium and long term. Objective: To analyze how patients on specific PAH therapies do over one year of observation in terms of HRQOL, and to investigate if possible associations between the exercise capacity (EC) and HRQOL persist over the medium term. Methods: Thirty-four patients on PAH therapies (bosentan and/or sildenafil) were enrolled (age 14 to 58 years, median 35.5 years, functional class II or III), and evaluated at baseline, and 3, 6, 9 and 12 months subsequently using the six-minute walk test and the SF-36 HRQOL questionnaire. Results: The six minute walked distance did not change over the follow-up (387-432 meters, median values, p=0.2775), the same for the functional class and peripheral oxygen saturation. The SF-36 scores also remained stable, with physical health always worse than mental health. Of 40 possible associations between EC and HRQOL, only 12 were significant (30%, p<0.05). Prediction of severely depressed HRQOL based on a walked distance of <235 meters was >90% specific but <43% sensitive. Conclusion: Patients with PAH who remain stable in terms of EC also seem to do so in terms of HRQOL. However, EC and HRQOL are not consistently tied over time, and should be analyzed as different perspectives in the individual patient.