FLAVIO TARASOUTCHI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
LIM/64, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
LIM/64, Hospital das Clínicas, Faculdade de Medicina - Líder
17 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 17
- Is Heart Team Fundamental to Aortic Stenosis Transcatheter Treatment?(2014) ROSA, Vitor Emer Egypto; LOPES, Antnio Sergio de Santis Andrade; ACCORSI, Tarso Augusto Duenhas; LEMOS NETO, Pedro Alves; POMERANTZEFF, Pablo Maria Alberto; TARASOUTCHI, Flavio
- Improvement of renal function after transcatheter aortic valve replacement in patients with chronic kidney disease(2021) SILVA, Michel V. Lemes da; NUNES FILHO, Antonio C. B.; ROSA, Vitor E. E.; CAIXETA, Adriano; LEMOS NETO, Pedro A.; RIBEIRO, Henrique B.; ALMEIDA, Breno O.; MARIANI JR., Jose; CAMPOS, Carlos M.; ABIZAID, Alexandre A. C.; MANGIONE, Jose A.; SAMPAIO, Roney O.; CARAMORI, Paulo; SARMENTO-LEITE, Rogerio; TARASOUTCHI, Flavio; FRANKEN, Marcelo; BRITO JR., Fabio S. deBackground Chronic kidney disease is commonly found in patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) and has marked impact in their prognosis. It has been shown however that TAVR may improve renal function by alleviating the hemodynamic barrier imposed by AS. Nevertheless, the predictors of and clinical consequences of renal function improvement are not well established. Our aim was to assess the predictors of improvement of renal function after TAVR. Methods The present work is an analysis of the Brazilian Registry of TAVR, a national non-randomized prospective study with 22 Brazilian centers. Patients with baseline renal dysfunction (estimated glomerular filtration rate [eGFR] < 60mL/min/1.73m(2)) were stratified according to renal function after TAVR: increase >10% in eGFR were classified as TAVR induced renal function improvement (TIRFI); decrease > 10% in eGFR were classified as acute kidney injury (AKI) and stable renal function (neither criteria). Results A total of 819 consecutive patients with symptomatic severe AS were included. Of these, baseline renal dysfunction (estimated glomerular filtration rate [eGFR] < 60mL/min/1.73m(2)) was present in 577 (70%) patients. Considering variance in renal function between baseline and at discharge after TAVR procedure, TIRFI was seen in 197 (34.1%) patients, AKI in 203 (35.2%), and stable renal function in 177 (30.7%). The independent predictors of TIRFI were: absence of coronary artery disease (OR: 0.69; 95% CI 0.48-0.98; P = 0.039) and lower baseline eGFR (OR: 0.98; 95% CI 0.97-1.00; P = 0.039). There was no significant difference in 30-day and 1-year all-cause mortality between patients with stable renal function or TIRFI. Nonetheless, individuals that had AKI after TAVR presented higher mortality compared with TIRFI and stable renal function groups (29.3% vs. 15.4% vs. 9.5%, respectively; p < 0.001). Conclusions TIRFI was frequently found among baseline impaired renal function individuals but was not associated with improved 1-year outcomes.
- Transcatheter Valve-in-Valve Procedures for Bioprosthetic Valve Dysfunction in Patients With Rheumatic vs. Non-Rheumatic Valvular Heart Disease(2021) LOPES, Mariana Pezzute; ROSA, Vitor Emer Egypto; PALMA, Jose Honorio; VIEIRA, Marcelo Luiz Campos; FERNANDES, Joao Ricardo Cordeiro; SANTIS, Antonio de; SPINA, Guilherme Sobreira; FONSECA, Rafael de Jesus; MARCHI, Mauricio F. de Sa; ABIZAID, Alexandre; BRITO, Fabio Sandoli de; TARASOUTCHI, Flavio; SAMPAIO, Roney Orismar; RIBEIRO, Henrique BarbosaBackground: Bioprosthetic heart valve has limited durability and lower long-term performance especially in rheumatic heart disease (RHD) patients that are often subject to multiple redo operations. Minimally invasive procedures, such as transcatheter valve-in-valve (ViV) implantation, may offer an attractive alternative, although data is lacking. The aim of this study was to evaluate the baseline characteristics and clinical outcomes in rheumatic vs. non-rheumatic patients undergoing ViV procedures for severe bioprosthetic valve dysfunction. Methods: Single center, prospective study, including consecutive patients undergoing transcatheter ViV implantation in aortic, mitral and tricuspid position, from May 2015 to September 2020. RHD was defined according to clinical history, previous echocardiographic and surgical findings. Results: Among 106 patients included, 69 had rheumatic etiology and 37 were non-rheumatic. Rheumatic patients had higher incidence of female sex (73.9 vs. 43.2%, respectively; p = 0.004), atrial fibrillation (82.6 vs. 45.9%, respectively; p < 0.001), and 2 or more prior surgeries (68.1 vs. 32.4%, respectively; p = 0.001). Although, device success was similar between groups (75.4 vs. 89.2% in rheumatic vs. non-rheumatic, respectively; p = 0.148), there was a trend toward higher 30-day mortality rates in the rheumatic patients (21.7 vs. 5.4%, respectively; p = 0.057). Still, at median followup of 20.7 [5.1-30.4] months, cumulative mortality was similar between both groups (p = 0.779). Conclusion: Transcatheter ViV implantation is an acceptable alternative to redo operations in the treatment of patients with RHD and severe bioprosthetic valve dysfunction. Despite similar device success rates, rheumatic patients present higher 30 day mortality rates with good mid-term clinical outcomes. Future studies with a larger number of patients and follow-up are still warranted, to firmly conclude on the role transcatheter ViV procedures in the RHD population.
- Gender-Related Differences on Short- and Long-Term Outcomes of Patients Undergoing Transcatheter Aortic Valve Implantation(2017) KATZ, Marcelo; NUNES FILHO, Antonio Carlos Bacelar; CAIXETA, Adriano; CARVALHO, Luiz Antonio; SARMENTO-LEITE, Rogerio; LEMOS NETO, Pedro Alves; THIAGO, Luiz Eduardo Koenig Sao; OLIVEIRA, Adriano Dias Dourado; MARINO, Marcos Antonio; TUMELERO, Rogerio Tadeu; PERIN, Marco Antonio; ABIZAID, Alexandre; TARASOUTCHI, Flavio; BRITO JR., Fabio Sandoli deObjectives: This study aimed to compare gender-related differences in outcomes of patients undergoing TAVI over a long-term follow-up period. Background: Transcatheter aortic valve implantation (TAVI) has been considered the standard therapy for patients with inoperable or high-risk symptomatic aortic stenosis. The influence of gender-related differences in outcomes of patients undergoing TAVI is currently on debate. Methods: From January 2008 to January 2015, 819 patients (49% men) underwent TAVI and were included in a multicenter Brazilian registry. Patients were followed-up and clinical outcomes were evaluated according to the updated Valve Academic Research Consortium-2 criteria. Results: Mean follow-up was 4976478 days. Compared with women, men had a lower rate of major or life-threatening bleeding (12.0% vs. 20.6%; HR = 0.57 [95CI% 0.40-0.81]; P = 0.001), and major vascular complications (6% vs. 11.7%; HR = 0.50 [95CI% 0.31-0.82]; P = 0.004). At 30 days, all-cause mortality was lower in men than in women (6.5% vs. 11.5%; P = 0.013), however, cumulative all-cause mortality was similar between groups (25.9% vs. 29.7%, men and women, respectively, HR = 0.92 [95CI% 0.71-1.19]; P = 0.52) over the entire follow-up period. By adjusted Cox regression model, renal function, diabetes, peripheral artery disease, and chronic obstructive pulmonary disease (COPD) remained independently predictors of all-cause mortality. Conclusions: In this large-scale study evaluating patients undergoing TAVI, 30-day mortality was higher among women than men driven by significant higher rates of major or life-threatening bleeding and major vascular complications. However, all-cause mortality on long-term follow-up was similar between groups. (C) 2016 Wiley Periodicals, Inc.
- Percutaneous Treatment of Mitral Paraprosthetic Regurgitation: an Alternative to Surgery(2015) SAMPAIO, Roney Orismar; OLIVEIRA, Alessandra Gomes de; MIRANDA, George Barreto; LEMOS NETO, Pedro Alves; VIEIRA, Marcelo Luiz Campos; TARASOUTCHI, Flavio
- Multimodality imaging methods and systemic biomarkers in classical low-flow low-gradient aortic stenosis: Key findings for risk stratification(2023) LOPES, Maria Antonieta Albanez A. de M.; CAMPOS, Carlos M.; ROSA, Vitor Emer Egypto; SAMPAIO, Roney O.; MORAIS, Thamara C.; BRITO JUNIOR, Fabio Sandoli de; VIEIRA, Marcelo L. C.; JR, Wilson Mathias; FERNANDES, Joao Ricardo Cordeiro; SANTIS, Antonio de; SANTOS, Luciano de Moura; ROCHITTE, Carlos E.; CAPODANNO, Davide; TAMBURINO, Corrado; ABIZAID, Alexandre; TARASOUTCHI, FlavioObjectivesThe aim of the present study is to assess multimodality imaging findings according to systemic biomarkers, high-sensitivity troponin I (hsTnI) and B-type natriuretic peptide (BNP) levels, in low-flow, low-gradient aortic stenosis (LFLG-AS).BackgroundElevated levels of BNP and hsTnI have been related with poor prognosis in patients with LFLG-AS.MethodsProspective study with LFLG-AS patients that underwent hsTnI, BNP, coronary angiography, cardiac magnetic resonance (CMR) with T1 mapping, echocardiogram and dobutamine stress echocardiogram. Patients were divided into 3 groups according to BNP and hsTnI levels: Group 1 (n = 17) when BNP and hsTnI levels were below median [BNP < 1.98 fold upper reference limit (URL) and hsTnI < 1.8 fold URL]; Group 2 (n = 14) when BNP or hsTnI were higher than median; and Group 3 (n = 18) when both hsTnI and BNP were higher than median.Results49 patients included in 3 groups. Clinical characteristics (including risk scores) were similar among groups. Group 3 patients had lower valvuloarterial impedance (P = 0.03) and lower left ventricular ejection fraction (P = 0.02) by echocardiogram. CMR identified a progressive increase of right and left ventricular chamber from Group 1 to Group 3, and worsening of left ventricular ejection fraction (EF) (40 [31-47] vs. 32 [29-41] vs. 26 [19-33]%; p < 0.01) and right ventricular EF (62 [53-69] vs. 51 [35-63] vs. 30 [24-46]%; p < 0.01). Besides, there was a marked increase in myocardial fibrosis assessed by extracellular volume fraction (ECV) (28.4 [24.8-30.7] vs. 28.2 [26.9-34.5] vs. 31.8 [28.9-35.5]%; p = 0.03) and indexed ECV (iECV) (28.7 [21.2-39.1] vs. 28.8 [25.4-39.9] vs. 44.2 [36.4-51.2] ml/m(2), respectively; p < 0.01) from Group 1 to Group 3.ConclusionsHigher levels of BNP and hsTnI in LFLG-AS patients are associated with worse multi-modality evidence of cardiac remodeling and fibrosis.
- Low-Flow Aortic Stenosis and Reduced Ejection Fraction: New Insights(2015) ROSA, Vitor Emer Egypto; ACCORSI, Tarso Augusto Duenhas; FERNANDES, Joao Ricardo Cordeiro; LOPES, Antonio Sergio de Santis Andrade; SAMPAIO, Roney Orismar; TARASOUTCHI, Flavio
- B-type natriuretic peptide and N-terminal Pro-B-type natriuretic peptide in severe aortic stenosis: a comprehensive literature review(2023) CAVALCANTE, Pamela Nogueira; KANHOUCHE, Gabriel; ROSA, Vitor Emer Egypto; CAMPOS, Carlos M.; LOPES, Mariana Pezzute; LOPES, Maria Antonieta Albanez A. de M.; SAMPAIO, Roney Orismar; JR, Fabio Sandoli de Brito; TARASOUTCHI, Flavio; ABIZAID, Alexandre Antonio CunhaB-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-pro BNP) are cardiac biomarkers that are released in response to increased ventricular and atrial wall stress. Aortic stenosis (AS) leads to hemodynamic changes and left ventricular hypertrophy and may be associated with natriuretic peptide levels. Several studies have shown that increased natriuretic peptide levels are correlated with AS severity and can predict the need for intervention. It can be useful in risk stratification, monitoring follow-up, and predicting cardiovascular outcomes of patients with severe AS. This paper aims to summarize the evidence of the role of BNP and NT-pro BNP in AS, before and after intervention.
- Predictive performance of six mortality risk scores and the development of a novel model in a prospective cohort of patients undergoing valve surgery secondary to rheumatic fever(2018) MEJIA, Omar A. V.; ANTUNES, Manuel J.; GONCHAROV, Maxim; DALLAN, Luis R. P.; VERONESE, Elinthon; LAPENNA, Gisele A.; LISBOA, Luiz A. F.; DALLAN, Luis A. O.; BRANDAO, Carlos M. A.; ZUBELLI, Jorge; TARASOUTCHI, Flavio; POMERANTZEFF, Pablo M. A.; JATENE, Fabio B.Background Mortality prediction after cardiac procedures is an essential tool in clinical decision making. Although rheumatic cardiac disease remains a major cause of heart surgery in the world no previous study validated risk scores in a sample exclusively with this condition. Objectives Develop a novel predictive model focused on mortality prediction among patients undergoing cardiac surgery secondary to rheumatic valve conditions. Methods We conducted prospective consecutive all-comers patients with rheumatic heart disease (RHD) referred for surgical treatment of valve disease between May 2010 and July of 2015. Risk scores for hospital mortality were calculated using the 2000 Bernstein-Parsonnet, EuroSCORE II, InsCor, AmblerSCORE, GuaragnaSCORE, and the New York SCORE. In addition, we developed the rheumatic heart valve surgery score (RheSCORE). Results A total of 2,919 RHD patients underwent heart valve surgery. After evaluating 13 different models, the top performing areas under the curve were achieved using Random Forest (0.982) and Neural Network (0.952). Most influential predictors across all models included left atrium size, high creatinine values, a tricuspid procedure, reoperation and pulmonary hypertension. Areas under the curve for previously developed scores were all below the performance for the RheSCORE model: 2000 Bernstein-Parsonnet (0.876), EuroSCORE II (0.857), InsCor (0.835), Ambler (0.831), Guaragna (0.816) and the New York score (0.834). A web application is presented where researchers and providers can calculate predicted mortality based on the RheSCORE. Conclusions The RheSCORE model outperformed pre-existing scores in a sample of patients with rheumatic cardiac disease.
- Transcatheter implantation of aortic valve bioprosthesis: changing paradigms(2019) BRITO JUNIOR, Fabio Sandoli de; TARASOUTCHI, Flavio