MARIA CRISTINA DONADIO ABDUCH

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina

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Autor e Coautores FMUSP-HC Normalizados: MARCO STEPHAN LOFRANO ALVES ×

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  • conferenceObject
    Right ventricular strain: a noninvasive tool to predict cardiac rejection
    (2018) CRUZ, C. B. Bittencourt Viana; LOFRANO-ALVES, M.; LIMA, M. Silva Miguel; ABDUCH, M. C. Donadio; VIEIRA, M. L. Campos; SBANO, J. C. Nunes; HAJJAR, L. Abrahao; SALVIANO, J. Bittencourt Cruz; MATHIAS JR., W.; BACAL, F.; TSUTSUI, J. Mike
  • conferenceObject
    CARVEDILOL FOR PREVENTION OF CHEMOTHERAPY-INDUCED CARDIOTOXICITY: FINAL RESULTS OF THE PROSPECTIVE, RANDOMIZED, DOUBLE-BLIND, PLACEBO CONTROLLED CECCY TRIAL
    (2020) AYUB-FERREIRA, Silvia M.; AVILA, Monica; BRANDAO, Sara; CRUZ, Fatima D.; WANDERLEY JR., Mauro; RIGAUD, Vagner O. C.; HAJJAR, Ludhmila; KALIL-FILHO, Roberto; CRUZ, Cecilia B. V.; ALVES, Marco Stephan; GUIMARAES, Guilherme V.; ABDUCH, Maria; ISSA, Victor S.; SANTOS, Marilia; BITTENCOURT, Marcio; BOCCHI, Edimar Alcides
  • conferenceObject
    Does acute cellular rejection affect all the cardiac segments in the heart transplant? An approach by speckle tracking echocardiography
    (2017) CRUZ, C. B. Bittencourt Viana; ALVES, M. S. Lofrano; VIEIRA, M. L. Campos; SBANO, J. C. Nunes; ABDUCH, M. C. Donadio; SALVIANO, J. Bittencourt Cruz; MATHIAS JR., W.; LIMA, M. Silva Miguel; AGUIAR, M. O. Dias; HAJJAR, L. Abrahao; BACAL, F.; TSUTSUI, J. Mike
  • article 0 Citação(ões) na Scopus
    Usefulness of speckle tracking echocardiography and biomarkers for detecting acute cellular rejection after heart transplantation (vol 19, 6, 2021)
    (2021) CRUZ, Cecilia Beatriz Bittencourt Viana; HAJJAR, Ludhmila A.; BACAL, Fernando; LOFRANO-ALVES, Marco S.; LIMA, Marcio S. M.; ABDUCH, Maria C.; VIEIRA, Marcelo Luiz Campos; CHIANG, Hsu P.; SALVIANO, Juliana B. C.; COSTA, Isabela Bispo Santos da Silva; FUKUSHIMA, Julia Tizue; SBANO, Joao C. N.; MATHIAS JR., Wilson; TSUTSUI, Jeane M.
    An amendment to this paper has been published and can be accessed via the original article.
  • article 343 Citação(ões) na Scopus
    Carvedilol for Prevention of Chemotherapy-Related Cardiotoxicity
    (2018) AVILA, Monica Samuel; AYUB-FERREIRA, Silvia Moreira; WANDERLEY JR., Mauro Rogerio de Barros; CRUZ, Fatima das Dores; BRANDAO, Sara Michelly Goncalves; RIGAUD, Vagner Oliveira Carvalho; HIGUCHI-DOS-SANTOS, Marilia Harumi; HAJJAR, Ludhmila Abrahao; KALIL FILHO, Roberto; HOFF, Paulo Marcelo; SAHADE, Marina; FERRARI, Marcela S. M.; COSTA, Romulo Leopoldo de Paula; MANO, Max Senna; CRUZ, Cecilia Beatriz Bittencourt Viana; ABDUCH, Maria Cristina; ALVES, Marco Stephan Lofrano; GUIMARAES, Guilherme Veiga; ISSA, Victor Sarli; BITTENCOURT, Marcio Sommer; BOCCHI, Edimar Alcides
    BACKGROUND Anthracycline (ANT) chemotherapy is associated with cardiotoxicity. Prevention with beta-blockers remains controversial. OBJECTIVES This prospective, randomized, double-blind, placebo-controlled study sought to evaluate the role of carvedilol in preventing ANT cardiotoxicity. METHODS The authors randomized 200 patients with HER2-negative breast cancer tumor status and normal left ventricular ejection fraction (LVEF) referred for ANT (240 mg/m(2)) to receive carvedilol or placebo until chemotherapy completion. The primary endpoint was prevention of a >= 10% reduction in LVEF at 6 months. Secondary outcomes were effects of carvedilol on troponin I, B-type natriuretic peptide, and diastolic dysfunction. RESULTS Primary endpoint occurred in 14 patients (14.5%) in the carvedilol group and 13 patients (13.5%) in the placebo group (p = 1.0). No differences in changes of LVEF or B-type natriuretic peptide were noted between groups. A significant difference existed between groups in troponin I levels over time, with lower levels in the carvedilol group (p = 0.003). Additionally, a lower incidence of diastolic dysfunction was noted in the carvedilol group (p = 0.039). A nonsignificant trend toward a less-pronounced increase in LV end-diastolic diameter during the follow-up was noted in the carvedilol group (44.1 +/- 3.64 mm to 45.2 +/- 3.2 mm vs. 44.9 +/- 3.6 mm to 46.4 +/- 4.0 mm; p = 0.057). CONCLUSIONS In this largest clinical trial of beta-blockers for prevention of cardiotoxicity under contemporary ANT dosage, the authors noted a 13.5% to 14.5% incidence of cardiotoxicity. In this scenario, carvedilol had no impact on the incidence of early onset of LVEF reduction. However, the use of carvedilol resulted in a significant reduction in troponin levels and diastolic dysfunction.(Carvedilol Effect in Preventing Chemotherap-Induced Cardiotoxicity [CECCy] NCTO1724450)(C) 2018 by the American College of Cardiology Foundation.
  • article 9 Citação(ões) na Scopus
    Usefulness of speckle tracking echocardiography and biomarkers for detecting acute cellular rejection after heart transplantation
    (2021) CRUZ, Cecilia Beatriz Bittencourt Viana; HAJJAR, Ludhmila A.; BACAL, Fernando; LOFRANO-ALVES, Marco S.; LIMA, Marcio S. M.; ABDUCH, Maria C.; VIERA, Marcelo L. C.; CHIANG, Hsu P.; SALVIANO, Juliana B. C.; COSTA, Isabela Bispo Santos da Silva; FUKUSHIMA, Julia Tizue; SBANO, Joao C. N.; JR, Wilson Mathias; TSUTSUI, Jeane M.
    Background: Acute cellular rejection (ACR) is a major complication after heart transplantation. Endomyocardial biopsy (EMB) remains the gold standard for its diagnosis, but it has concerning complications. We evaluated the usefulness of speckle tracking echocardiography (STE) and biomarkers for detecting ACR after heart transplantation. Methods: We prospectively studied 60 transplant patients with normal left and right ventricular systolic function who underwent EMB for surveillance 6 months after transplantation. Sixty age- and sex-matched healthy individuals constituted the control group. Conventional echocardiographic parameters, left ventricular global longitudinal, radial and circumferential strain (LV-GLS, LV-GRS and LV-GCS, respectively), left ventricular systolic twist (LV-twist) and right ventricular free wall longitudinal strain (RV-FWLS) were analyzed just before the procedure. We also measured biomarkers at the same moment. Results: Among the 60 studied patients, 17 (28%) had severe ACR (grade >= 2R), and 43 (72%) had no significant ACR (grade 0 - 1R). The absolute values of LV-GLS, LV-twist and RV-FWLS were lower in transplant patients with ACR degree >= 2 R than in those without ACR (12.5% +/- 2.9% vs 14.8% +/- 2.3%, p=0.002; 13.9 degrees +/- 4.8 degrees vs 17.1 degrees +/- 3.2 degrees, p=0.048; 16.6% +/- 2.9% vs 21.4%+/- 3.2%, p < 0.001; respectively), while no differences were observed between the LV-GRS or LV-GCS. All of these parameters were lower in the transplant group without ACR than in the nontransplant control group, except for the LV-twist. Cardiac troponin I levels were significantly higher in patients with significant ACR than in patients without significant ACR [0.19 ng/mL (0.09-1.31) vs 0.05 ng/mL (0.01-0.18), p=0.007]. The combination of troponin with LV-GLS, RV-FWLS and LV-Twist had an area under curve for the detection of ACR of 0.80 (0.68-0.92), 0.89 (0.81-0.93) and 0.79 (0.66-0.92), respectively. Conclusion: Heart transplant patients have altered left ventricular dynamics compared with control individuals. The combination of troponin with strain parameters had higher accuracy for the detection of ACR than the isolated variables and this association might select patients with a higher risk for ACR who will benefit from an EMB procedure in the first year after heart transplantation.