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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conferenceObject Estradiol Modulation of Brain Death Effects on Heart Tissue in Female Rats(2018) ARMSTRONG JUNIOR, R.; RICARDO-DA-SILVA, F. Y.; BASILIO, L. J. L.; VIDAL, M. S.; SANNOMIYA, P.; MOREIRA, L. F. P.; BREITHAUPT-FALOPPA, A. C.conferenceObject Bilateral Sympathetic Denervation Improves Left Ventricular Function and Prevents Post-Infarction Chamber Remodeling in Rats(2016) ZANONI, F. L.; MOREIRA, L. F.; SIMAS, R.; SILVA, R. G. da; JATENE, F. B.conferenceObject Positive Therapeutic Effect of Estradiol on Lung Inflammation in Brain Dead Female Rats(2018) SILVA, F. Yamamoto Ricardo da; ARMSTRONG JUNIOR, R.; VIDAL-DOS-SANTOS, M.; SANNOMIYA, P.; MOREIRA, L. F. P.; BREITHAUPT-FALOPPA, A. C.- Sexual Dimorphism in Lung Inflammatory Process After Brain Death Induction in Rats(2014) MOREIRA, L. P.; FERREIRA, S. G.; KUDO, G. K.; CORREIRA, C. J.; TAVARES-DE-LIMA, W.; BREITHAUPT-FALOPPA, A. C.; SANNOMIYA, P.
- Bilateral sympathectomy improves postinfarction left ventricular remodeling and function(2017) ZANONI, Fernando Luiz; SIMAS, Rafael; SILVA, Raphael Grillo da; BREITHAUPT-FALOPPA, Ana Cristina; SILVA, Raphael dos Santos Coutinho e; JATENE, Fabio Biscegli; MOREIRA, Luiz Felipe P.Objectives: To evaluate the influence of bilateral or left sympathectomy on left ventricular remodeling and function after myocardial infarction in rats. Methods: Myocardial infarction was induced in rats by ligation of the left anterior descending coronary. Seven days later, rats were divided into 4 groups: the myocardial infarction, myocardial infarction with left sympathectomy, myocardial infarction with bilateral sympathectomy, and sham groups. After 8 weeks, left ventricular function was evaluated with the use of a pressure-volume conductance catheter under steady-state conditions and pharmacological stress. Infarct size and extracellular matrix fibrosis were evaluated, and cardiac matrix metalloproteinases and myocardial inflammatory markers were analyzed. Results: The myocardial infarction and left sympathectomy group had an increased end diastolic volume, whereas the bilateral sympathectomy group had a mean end-diastolic volume similar to that of the sham group (P <. 002). Significant reduction in ejection fraction was observed in the myocardial infarction and left sympathectomy group, whereas it was preserved after bilateral sympathectomy (P < .001). In response to dobutamine, left ventricular contractility increased in sham rats, rising stroke work, cardiac output, systolic volume, end-diastolic volume, ejection fraction, and dP/dt max. Only bilateral sympathectomy rats had significant increases in ejection fraction (P <. 001) with dobutamine. Fibrotic tissue and matrix metalloproteinase expression decreased in the bilateral sympathectomy group compared to that in the myocardial infarction group (P <. 001) and was associated with left ventricular wall thickness maintenance and better apoptotic markers in noninfarcted myocardium. Conclusions: Bilateral sympathectomy effectively attenuated left ventricular remodeling and preserved systolic function after myocardial infarction induction in rats.
conferenceObject Waiting List Risk Factors in Pediatric Heart Transplant Center in the Developing Country(2012) CAUDURO, A. S.; MOREIRA, L. F. P.; TANAMATI, C.; CANEO, L. F.; PENHA, J.; JATENE, M. B.Purpose: Most of data upon waiting list risk factors are based in studies done in developed countries. In this study we aimed to identify what are these risk factors in a health system enviroment of a developing country like Brazil. Methods and Materials: Time on the waiting list was defined as the time of initial listing to the time of removal due a transplant, death, recovery or removed. Survival time in the waiting list was estimated using the Kaplan-Meier method. Univariate and multivariate relationships were evaluated with the Cox proportional hazards model. Results: Of 222 patients the median age was 3.9 yrs, median weight 13Kg; female 52%. Dilated cardiomyopathy 62%, congenital heart disease 25%, restrictive cardiomyopathy10%, chronic graft failure 3%. We had 45%listed as priority. 41% transplant, 40% died, 14% were removed, 5% are still waiting. Survival were 73% in 30 days, 60% in 90, 51% in 6m. Diagnosis, age, weight, urea, level and priorit status were considered predictors in the univariate analysis. Diagnosis of CHD and, priority status, were found as independent risk factors. Conclusions: Less has been known about the mortality risk factors in the waiting list in our enviroment. Actually these data are very similar to those ones retrieved in the early 1990 when the young and very ill children were destined to died. These results support the urgency of adoption of new technologies and new strategies addressed to child in the waiting list.conferenceObject Comparative Study between Cavopulmonary Anastomosis Associated with Left Ventricular Assist Device Support and Biventricular Circulatory Assistance in Acute Biventricular Failure(2012) SANTOS, L. A. S.; MOREIRA, L. F. P.; BENICIO, A.; CESTARI, I.; MATTOS JR., E.; STOLF, N. G.Purpose: Right ventricular failure during left ventricular assist device (LVAD) support can result in severe hemodynamic compromise with high mortality. This study investigated the acute effects of cavopulmonary anastomosis on LVAD performance and right ventricular myocardial compromise in comparison with biventricular circulatory support, in a model of severe biventricular failure. Methods and Materials: LVAD support was performed by means of centrifugal pump implantation in 21 anesthetized pigs (20-30 kg) with biventricular failure obtained by ventricular fibrillation induction. Animals were randomized to be submitted to modified cavopulmonary anastomosis, to biventricular circulatory support or to control group. They were maintained under circulatory support and hemodynamic monitoring for 3h. Venous lactate and cytokines serum levels were also determined. Endocardium samples of the ventricles were collected and analyzed by electronic microscopy. Results: Ventricular fibrillation was responsible for acute LVAD performance impairment after 180 min in the control group. Cavopulmonary anastomosis resulted in non-significant improvement of LVAD pump flow in relation to control group (+55±14 ml/kg/min, p=0.072), while animals under biventricular support maintained higher LVAD flow performance (+93±17 ml/kg/min, p=0.012). Mean arterial pressure remained constant only in biventricular group (p<0.001), which also presented significant decrease of right atrial and ventricular pressures. Similar increases in lactate and cytokines levels were observed in the three groups. Ultrastructural analysis documented the presence of higher levels of myocardial mitochondrial swelling in control group (p=0.018). Conclusions: Concomitant use of cavopulmonary anastomosis during LVAD support in a pig model of severe biventricular failure resulted in non-significant improvement of hemodynamic performance and it did not effectively replace the use of biventricular support.- Evaluation of the therapeutic effects of oestradiol on the systemic inflammatory response and on lung injury caused by the occlusion of the proximal descending aorta in male rats(2023) SOUSA, Marcelo Nunes de; ANUNCIACAO, Lucas Ferreira da; FREITAS, Pedro Luiz Zonta de; RICARDO-DA-SILVA, Fernanda Yamamoto; MOREIRA, Luiz Felipe Pinho; CORREIA, Cristiano Jesus; BREITHAUPT-FALOPPA, Ana CristinaOBJECTIVES: Ischaemia and reperfusion-induced microvascular dysfunction is a serious problem encountered during a variety surgical procedures, leading to systemic inflammation and affecting remote organs, specially the lungs. 17 beta-Oestradiol reduces pulmonary repercussions from various acute lung injury forms. Here, we focused on the 17 beta-oestradiol therapeutic effects after aortic ischaemia and reperfusion (I/R) by evaluating lung inflammation. METHODS: Twenty-four Wistar rats were submitted to I/R by insufflation of a 2-F catheter in thoracic aorta for 20 min. Reperfusion took 4 h and 17 beta-oestradiol (280 mg/kg, i.v.) was administered after 1 h of reperfusion. Sham-operated rats were controls. Bronchoalveolar lavage was performed and lung samples were prepared for histopathological analysis and tissue culture (explant). Interleukin (IL)-1 beta, IL-10 and tumour necrosis factor-a were quantified. RESULTS: After I/R, higher number of leukocytes in bronchoalveolar lavage were reduced by 17 beta-oestradiol. The treatment also decreased leukocytes in lung tissue. I/R increased lung myeloperoxidase expression, with reduction by 17 beta-oestradiol. Serum cytokine-induced neutrophil chemoattractant 1 and IL-1 beta increased after I/R and 17 beta-oestradiol decreased cytokine-induced neutrophil chemoattractant 1. I/R increased IL-1 beta and IL-10 in lung explants, reduced by 17 beta-oestradiol. CONCLUSIONS: Our results showed that 17 beta-oestradiol treatment performed in the period of reperfusion, modulated the systemic response and the lung repercussions of I/R by thoracic aortic occlusion. Thus, we can suggest that 17 beta-oestradiol might be a supplementary approach leading the lung deterioration after aortic clamping in surgical procedures.
- Acute administration of oestradiol or progesterone in a spinal cord ischaemia-reperfusion model in rats(2018) CAVALCANTE, Leonardo Pessoa; FERREIRA, Sueli Gomes; PEREIRA, Daniel Romano; MORAES, Sergio Rodrigues de; SIMAS, Rafael; SANNOMIYA, Paulina; BREITHAUPT-FALOPPA, Ana Cristina; MOREIRA, Luiz Felipe PinhoOBJECTIVES: Despite research into protective pharmacological adjuncts, paraplegia persists as a dreaded complication after thoracic and thoracoabdominal aortic interventions. Reports on gender-related neurological outcomes after ischaemic and traumatic brain injuries have led to increased interest in hormonal neuroprotective effects and have generated other studies seeking to prove the neuroprotective effects of the therapeutic administration of 17 beta-oestradiol and of progesterone. We hypothesised that acute administration of oestradiol or progesterone would prevent or attenuate spinal cord ischaemic injury induced by occlusion of the descending thoracic aorta. METHODS: Male rats were divided into groups receiving 280 A mu g/kg of 17 beta-oestradiol or 4 mg/kg of progesterone or vehicle 30 min before transitory endovascular occlusion of the proximal descending thoracic aorta for 12 min. Hindlimb motor function was assessed by a functional grading scale (that of Basso, Beattie and Bresnahan) for 14 days after reperfusion. On the 14th day, a segment of the thoracolumbar spinal cord was harvested and prepared for histological and immunohistochemical analyses. RESULTS: There was significant impairment of the motor function of the hindlimb in the 3 study groups, with partial improvement noticed over time, but no difference was detected between the groups. On Day 1 of assessment, the 17 beta-oestradiol group had a functional score of 9.8 (0.0-16.5); the progesterone group, a score of 0.0 (0-17.1) and the control group, a score of 6.5 (0-16.9); on the 14th day, the 17 beta-oestradiol group had a functional score of 18.0 (4.4-19.4); the progesterone group had a score of 7.5 (0-18.5) and the control group had a score of 17.0 (0-19.9). Analysis of the grey matter showed that the number of viable neurons per section was not different between the study groups on the 14th day. Immunostaining of the spinal cord grey matter was also similar among the 3 groups. CONCLUSIONS: Acute administration of oestradiol or of progesterone 30 min before transitory occlusion of the proximal descending thoracic aorta of male rats could not prevent or attenuate spinal cord ischaemic injury based on an analysis of functional and histological outcomes.
- Reversible pulmonary trunk banding: VII. Stress echocardiographic assessment of rapid ventricular hypertrophy in young goats(2013) FAVARO, Gustavo A. G.; ASSAD, Renato S.; ABDUCH, Maria C. D.; SILVA, Gustavo J. J.; GOMES, Guilherme S.; ANDRADE, Jose L.; KRIEGER, Jose E.; MOREIRA, Luiz Felipe P.Background: Ventricle retraining with abrupt systolic overload can cause myocardial edema and necrosis, followed by late ventricular failure. Intermittent systolic overload could minimize the inadequacy of conventional pulmonary artery banding. The present study compared ventricle function under dobutamine stress in 2 protocols of systolic overload in young goats. Methods: Nineteen young goats were divided into 3 groups: sham (n = 7; no systolic pressure overload), continuous (n = 6; systolic overload maintained for 96 hours), and intermittent (n = 6; 4 periods of 12-hour systolic overload, paired with a 12-hour resting period). Echocardiographic and hemodynamic evaluations were performed daily. The myocardial performance index and ejection fraction were evaluated at rest and during dobutamine stress. The goats were then killed for morphologic evaluation. Results: The intermittent group underwent less systolic overload than the continuous group (P <. 05). Nevertheless, both groups had increased right ventricular and septal masses compared with the sham group (P <. 0002). Echocardiography revealed a major increase in right ventricular wall thickness in the intermittent group (+64.8% +/- 23.37%) compared with the continuous group (+43.9% +/- 19.26%; P = .015). Only the continuous group remained with significant right ventricular dilation throughout the protocol (P <. 001). The intermittent group had a significantly better myocardial performance index at the end of the protocol, under resting and dobutamine infusion, compared with the continuous group (P <. 012). Conclusions: Both systolic overload protocols have induced rapid right ventricular hypertrophy. However, only the intermittent group had better preservation of right ventricular function at the end of the protocol, both at rest and during dobutamine infusion. (J Thorac Cardiovasc Surg 2013; 145:1345-51)