VIVIANE ZORZANELLI ROCHA GIRALDEZ
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Cholesterol and inflammation: The lesser the better in atherothrombosis(2018) ROCHA, Viviane Z.; SANTOS, Raul D.
- Position Statement on Fat Consumption and Cardiovascular Health-2021(2021) IZAR, Maria Cristina de Oliveira; LOTTENBERG, Ana Maria; GIRALDEZ, Viviane Zorzanelli Rocha; SANTOS FILHO, Raul Dias dos; MACHADO, Roberta Marcondes; BERTOLAMI, Adriana; ASSAD, Marcelo Heitor Vieira; SARAIVA, Jose Francisco Kerr; FALUDI, Andre Arpad; MOREIRA, Annie Seixas Bello; GELONEZE, Bruno; MAGNONI, Carlos Daniel; SCHERR, Carlos; AMARAL, Cristiane Kovacs; ARAUJO, Daniel Branco de; CINTRA, Dennys Esper Correa; NAKANDAKARE, Edna Regina; FONSECA, Francisco Antonio Helfenstein; MOTA, Isabela Cardoso Pimentel; SANTOS, Jose Ernesto dos; KATO, Juliana Tieko; BEDA, Lis Mie Misuzawa; VIEIRA, Lis Proenca; BERTOLAMI, Marcelo Chiara; ROGERO, Marcelo Macedo; LAVRADOR, Maria Silvia Ferrari; NAKASATO, Miyoko; DAMASCENO, Nagila Raquel Teixeira; ALVES, Renato Jorge; SOARES, Lara Roberta; COSTA, Rosana Perim; MACHADO, Valeria Arruda
- Insights into the Role of Inflammation in the Management of Atherosclerosis(2023) ROCHA, Viviane Zorzanelli; RACHED, Fabiana Hanna; MINAME, Marcio HiroshiAtherosclerosis is the biological basis of ischemic heart disease and ischemic stroke, the leading causes of death in the world. After decades of studies, the understanding of atherosclerosis has evolved dramatically, and inflammation has been recognized as one of the most relevant pillars in all phases of atherosclerotic disease. Nevertheless, only recently, the trial CANTOS, and subsequent outcome studies with colchicine, finally provided proof-of-concept evidence that anti-inflammatory therapies were able to reduce cardiovascular events with no influence on lipid levels. These landmark studies inaugurated an era of clinical and pre-clinical studies of immunomodulatory strategies focused on reduction of cardiovascular risk. Although there are promising results in the field, selection of the most appropriate immunomodulatory therapy and identification of patients who could benefit the most, are still enormous challenges. Further research is imperative before we can finally advance towards regular use of anti-inflammatory agents to reduce atherosclerotic events in our clinical practice.
- Effects of phytosterols on markers of inflammation: A systematic review and meta-analysis(2016) ROCHA, Viviane Z.; RAS, Rouyanne T.; GAGLIARDI, Ana C.; MANGILI, Leonardo C.; TRAUTWEIN, Elke A.; SANTOS, Raul D.Background and aims: Regular intake of phytosterols (PS) is proven to dose-dependently lower LDL-cholesterol (LDL-C). Whether PS consumption can also impact low-grade inflammation is unclear. Considering the low feasibility of outcomes studies involving PS consumption, investigation of surrogate markers of atherosclerosis represents a valuable approach. This study assessed the anti-inflammatory effect of PS consumption, according to inflammatory biomarkers, mainly C-reactive protein (CRP). Methods and results: A systematic search of Medline, Cab Abstracts, and Food Science & Technology Abstracts was conducted through January 2015. Our study selection included randomized controlled trials (RCT), involving intake of PS-enriched foods as active treatment, and measurement of plasma inflammatory biomarkers. Random-effects meta-analyses were performed using average baseline and end-of-intervention concentrations and control-adjusted absolute changes in CRP and blood lipids. There were 20 eligible RCTs including a total of 1308 subjects. The absolute change of plasma CRP levels with PS consumption was -0.10 mg/L (95% CI -0.26; 0.05), a non-significant change, and heterogeneity had borderline significance (I-2 = 29.1; p-value = 0.073). The absolute reduction of LDL-C was -14.3 mg/dL (95% CI -17.3; -11.3). Meta-regression analyses showed that both the dose and duration of PS intake significantly influenced the absolute changes in plasma CRP (beta = -0.35, p = 0.0255 and beta = -0.03, p = 0.0209, respectively). Conclusions: In this meta-analysis, regular intake of PS-enriched foods did not significantly change CRP, whilst LDL-C concentrations were significantly reduced. Further studies with higher PS doses may provide more definite conclusions on a potential anti-inflammatory effect of PS intake.
- Cardiovascular risk assessment in patients with diabetes(2017) BERTOLUCI, Marcello Casaccia; ROCHA, Viviane ZorzanelliAlthough patients with diabetes have 2 to 4 times increased risk of cardiovascular morbidity and mortality than individuals without diabetes, recent studies indicate that a significant part of patients are in a lower cardiovascular risk category. Men younger than 35 years, women younger than 45 years, patients with diabetes duration of less than 10 years without other risk factors have a much lower risk than patients who have traditional cardiovascular risk factors, and subclinical or established coronary artery disease (CAD). These patients are not risk equivalent as stated in previous studies. On the contrary, when in the presence of traditional risk factors or evidence of subclinical coronary disease (e.g. high coronary calcium score), the coronary risk is much increased and patients may be classified at a higher-risk category. Recent guidelines do not anymore consider diabetes as a CAD risk equivalent and recommend cardiovascular risk stratification for primary prevention. Stratification of diabetic patients improves accuracy in prediction of subclinical CAD, silent ischemia and future cardiovascular events. Stratification also discriminates higher from lower risk patients who may need intensive statin or aspirin prevention, while avoiding overtreatment in lower risk cases. It may also allow the clinician to decide whether to intensify risk reduction actions through specific newer drugs for glucose control such as SGLT-2 inhibitors or GLP-1 agonists, which recently have shown additional cardiovascular protector effect. This review addresses the assessment of cardiovascular disease risk using traditional and non-traditional cardiovascular risk factors. It also reviews the use of risk calculators and new reclassification tools, focusing on the detection of subclinical atherosclerosis as well as silent ischemia in the asymptomatic patients with diabetes.
- Bringing interleukin-6 complexity to preventive cardiology practice?(2020) SANTOS, Raul D.; ROCHA, Viviane Z.