LUIZ FELIPE PINHO MOREIRA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
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 - Líder
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 - Líder
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- Insulin modulates inflammatory and repair responses to elastase-induced emphysema in diabetic rats(2011) PETTA, Antonio Di; GRECO, Karin V.; CASTRO, Eveline O.; LOPES, Fernanda D. T. Q. S.; MARTINS, Milton A.; CAPELOZZI, Vera L.; MOREIRA, Luiz F. P.; SANNOMIYA, PaulinaAs pulmonary emphysema and diabetes mellitus are common diseases, concomitance of both is correspondingly expected to occur frequently. To examine whether insulin influences the development of inflammation in the alveolar septa, diabetic male Wistar rats (alloxan, 42 mg/kg, i.v., n = 37) and matching controls (n = 31) were used. Ten days after alloxan injection, diabetic and control rats were instilled with physiologic saline solution containing porcine pancreatic elastase (PPE, 0.25 IU/0.2 ml, right lung) or saline only (left lung). The following analyses were performed: (i) number of leucocytes in the bronchoalveolar lavage (BAL) fluid of the animals, 6 h after PPE/saline instillation (early time point); and (ii) mean alveolar diameter (mu m) and quantification of elastic and collagen fibres (%) 50 days after PPE/saline instillation (late time point). Relative to controls, alloxan-induced diabetic rats showed a 42% reduction in the number of neutrophils in BAL fluid, a 20% increase in the mean alveolar diameter and a 33% decrease in elastic fibre density in the alveolar septa. Treatment of diabetic rats with 4 IU neutral protamine Hagedorn (NPH) insulin, 2 h before elastase instillation, restored the number of neutrophils in the BAL fluid. The mean alveolar diameter and elastic fibre content in alveolar septa matched the values observed in control rats if diabetic rats were treated with 4 IU NPH insulin 2 h before instillation followed by 2 IU/day for the next 50 days. Density of collagen fibres did not differ between the various groups. Thus, the data presented suggest that insulin modulates the inflammatory and repair responses in elastase-induced emphysema, and assures normal repair and tissue remodelling.
article 0 Citação(ões) na Scopus Brazilian Archives of Cardiology Scientific Publication Award and the National Scientific Production in Cardiology(2011) MOREIRA, Luiz Felipe P.- Effect of methylprednisolone on perivascular pulmonary edema, inflammatory infiltrate, VEGF and TGF-beta immunoexpression in the remaining lungs of rats after left pneumonectomy(2011) GUIMARAES-FERNANDES, F.; SAMANO, M. N.; VIEIRA, R. P.; CARVALHO, C. R.; PAZETTI, R.; MOREIRA, L. F. P.; PEGO-FERNANDES, P. M.; JATENE, F. B.Pneumonectomy is associated with high rates of morbimortality, with postpneumonectomy pulmonary edema being one of the leading causes. An intrinsic inflammatory process following the operation has been considered in its physiopathology. The use of corticosteroids is related to prevention of this edema, but no experimental data are available to support this hypothesis. We evaluated the effect of methylprednisolone on the remaining lungs of rats submitted to left pneumonectomy concerning edema and inflammatory markers. Forty male Wistar rats weighing 300 g underwent left pneumonectomy and were randomized to receive corticosteroids or not. Methylprednisolone at a dose of 10 mg/kg was given before the surgery. After recovery, the animals were sacrificed at 48 and 72 h, when the pO(2)/FiO(2) ratio was determined. Right lung perivascular edema was measured by the index between perivascular and vascular area and neutrophil density by manual count. Tissue expression of vascular endothelial growth factor (VEGF) and transforming growth factor-beta (TGF-beta) were evaluated by immunohistochemistry light microscopy. There was perivascular edema formation after 72 h in both groups (P = 0.0031). No difference was observed between operated animals that received corticosteroids and those that did not concerning the pO(2)/FiO(2) ratio, neutrophil density or TGF-beta expression. The tissue expression of VEGF was elevated in the animals that received methylprednisolone both 48 and 72 h after surgery (P = 0.0243). Methylprednisolone was unable to enhance gas exchange and avoid an inflammatory infiltrate and TGF-beta expression also showed that the inflammatory process was not correlated with pulmonary edema formation. However, the overexpression of VEGF in this group showed that methylprednisolone is related to this elevation.
article 38 Citação(ões) na Scopus Using the Impact Factor and H Index to Assess Researchers and Publications(2011) THOMAZ, Petronio Generoso; ASSAD, Renato Samy; MOREIRA, Luiz Felipe P.article 41 Citação(ões) na Scopus A Técnica do Cone para Correção da Anomalia de Ebstein: Resultados Imediatos e em Longo Prazo(2011) SILVA, Jose Pedro da; SILVA, Luciana da Fonseca da; MOREIRA, Luiz Felipe P.; LOPES, Lilian Maria; FRANCHI, Sonia Meiken; LIANZA, Alessandro Cavalcante; BAUMGRATZ, Jose Francisco; TAVARES, Glaucia Maria P.Background: The main Ebstein anomaly (EA) repairs are based on the monocusp reconstruction of the tricuspid valve and are limited by the frequent need for replacement or the high recurrence of valve regurgitation. Objectives: To evaluate the feasibility and effects of anatomical repair of Ebstein's anomaly using the cone reconstruction technique on patients' clinical evaluation, tricuspid valve function and right ventricular morphology. Methods: We compared the clinical, echocardiographic and radiological data of 52 consecutive patients, with a mean age of 18.5 +/- 13.8 years, submitted to the cone reconstruction technique, obtained in the preoperative, early postoperative (EPO) and long-term (LPO) periods. Results: There were two in-hospital deaths (3.8%) and two more during the follow-up. Mean functional class of pre-operative heart failure improved from 2.2 to 1.2 after 57 months of mean follow up of 97% of patients (p < 0.001). The mean degree of preoperative tricuspid regurgitation decreased from 3.6 to 1.6 in the EPO (p < 0.001), remaining at 1.9 in LPO period (p> 0.05). The indexed RV functional area increased from 8.53 +/- 7.02 cm(2)/m(2) preoperatively to 21.01 +/- 6.87 cm(2)/m(2) in the EPO (p < 0.001) and remained unchanged at 20.28 +/- 5.26 cm(2)/m(2) in LPO period (p> 0.05). The mean cardiothoracic ratio was decreased from 0.66 +/- 0.09 to 0.54 +/- 0.06 (p < 0.001) in the long term. Conclusions: The cone technique showed low in-hospital mortality, resulting in an effective and long-lasting repair of tricuspid regurgitation, restoring the functional area of the right ventricle and allowing reverse remodeling of the heart and clinical improvement in most patients in the long term. (Arq Bras Cardiol 2011; 97(3) : 199-208)- Minimally invasive cardiac surgery in Brazil(2011) MOREIRA, Luiz Felipe Pinho; CELULLARI, Alex Luiz
article 2 Citação(ões) na Scopus Estudo experimental comparativo do enxerto homólogo pulmonar tratado pelo processo L-Hydro com o homoenxerto pulmonar a fresco(2011) REY, Nei Antonio; MOREIRA, Luiz Felipe Pinho; CHEUNG, David T.; CASAGRANDE, Ivan Sergio Joviano; BENVENUTI, Luiz Alberto; STOLF, Noedir Antonio GroppoObjective: In an effort to make available homografts preserved in a simpler and less costly way, we evaluated the polyethyleneglycol, L-Hydro (LH) method, that consists in the controlled extraction of antigenic substances and the incorporation of anti-inflammatory and anti-thrombotic agent. Methods: We substituted the pulmonary trunk in ten ovines, seven received LH treated pulmonary homografts and three, fresh pulmonary homografts, orthotopically implanted and followed-up for 320 days. Ovines where evaluated by means of laboratory tests, echocardiographic exams. At the 320 days, were euthanized, hemodynamic, radiology, macroscopic, optic/electronic microscopic, scanning/transmission evaluations were performed. Results were analyzed by Student t test of independent samples for continuous data, by variance analysis of repeated measures, and by Fisher exact test for categorical data. Results: We couldn't establish relevant differences in clinical evolution and laboratory tests between groups. Echocardiogram revealed difference in pulmonary medium gradient, which was significant 10 months follow-up, higher in the control group. Radio logic and macroscopic evaluations didn't established differences. In the optic/electronic microscopic evaluation, liner and interstitial cells were equally found in both groups. The cell liner percent calculated in both groups was similar. Cellularity nodules were observed only infresh homograft group. Conclusions: These data indicate that both groups presented similar clinical/hemodynamic performances. The LH group's echocardiogram presented a better performance. It also presented histological evidences of interstitial and endothelial cell repopulation. In the macro/optic and electronic microscopic analysis, group L-H presented macroscopy/histological structure and ultra-structural similar to the fresh group, with the exception of nodules with higher interstitial cellularity, present only in the fresh homograft group.article Message from the Editor(2011) MOREIRA, Luiz Felipe P.