GABRIELA LIBERATO
Índice h a partir de 2011
6
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
4 resultados
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conferenceObject Noncontrast Transcatheter Aortic Valve Implantation for Patients With Aortic Stenosis and Chronic Kidney Disease: Long-Term Follow-Up of The Pilot Study(2023) FILIPPINI, Filippe; FREIRE, Antonio Fernando; NICZ, Pedro; BRATZ, Guilherme; SESSA, Bruno; RIBEIRO, Henrique; ACCORSI, Tarso; LIBERATO, Gabriela; NOMURA, Cesar Higa; CASSAR, Renata; VIEIRA, Marcelo; BIHAN, David Le; BARRETTO, Rodrigo; MATHIAS, Wilson; POMERANTZEFF, Pablo; TARASOUTCHI, Flavio; ABIZAID, Alexandre; BRITO JR., Fabio- Coronary computed tomography plaque-based scores predict long-term cardiovascular events(2023) LIMA, Thais Pinheiro; ASSUNCAO, Antonildes N. N.; BITTENCOURT, Marcio Sommer; LIBERATO, Gabriela; ARBAB-ZADEH, Armin; LIMA, Joao A. C.; ROCHITTE, Carlos EduardoObjectivesCoronary computed tomography angiography (coronary CTA) scores based on luminal obstruction, plaque burden, and characteristics are used for prognostication in coronary artery disease (CAD), such as segmental stenosis and plaque extent involvement and Gensini and Leaman scores. The use of coronary CTA scores for the long-term prognosis remains not completely defined. We sought to evaluate the long-term prognosis of CTA scores for cardiovascular events in symptomatic patients with suspected CAD.MethodsThe presence and extent of CAD were evaluated by coronary CTA in patients from two multicenter prospective studies, which were classified according to several coronary CTA scores. The primary endpoint was major adverse cardiac events (MACE). Two hundred and twenty-two patients were followed up for a median of 6.8 (6.3-9.1) years, and 73 patients met the composite endpoints of MACE.ResultsCompared to the clinical prediction model, the highest model improvement was observed when added obstructive CAD. After adjustment for the presence of obstructive CAD, the segment involvement score for non-calcified plaque (SISNoncalc) was independently associated with MACE, presenting incremental prognostic value over clinical data and CAD severity (chi(2) 39.5 vs 21.2, p < 0.001 for comparison with a clinical model; and chi(2) 39.5 vs 35.6, p = 0.04 for comparison with clinical + CAD severity). Patients with obstructive CAD and SISNoncalc > 3 were likely to experience events (HR 4.27, 95% CI 2.17-4.40, p < 0.001).ConclusionsCoronary CTA plaque-based scores provide incremental long-term prognostic value for up to 7 years. Among patients with obstructive CAD, the presence of extensive non-calcified disease (> 3 coronary segments) is associated with increased cardiovascular risk for late events independently of the presence of obstructive CAD.
- Non-contrast transcatheter aortic valve implantation for patients with aortic stenosis and chronic kidney disease: a pilot study(2023) FREIRE, Antonio Fernando Diniz; NICZ, Pedro Felipe Gomes; RIBEIRO, Henrique Barbosa; FILIPPINI, Filippe Barcellos; ACCORSI, Tarso Duenas; LIBERATO, Gabriela; NOMURA, Cesar Higa; CASSAR, Renata de Sa; VIEIRA, Marcelo Luiz Campos; JR, Wilson Mathias; POMERANTZEFF, Pablo Maria Alberto; TARASOUTCHI, Flavio; ABIZAID, Alexandre; FILHO, Roberto Kalil; JR, Fabio Sandoli de BritoBackgroundAcute kidney injury (AKI) is frequently observed after transcatheter aortic valve implantation (TAVI). Of note, it is associated with a threefold increase in all-cause and cardiac death. We propose a new non-contrast strategy for evaluating and performing the TAVI procedure that can be especially valuable for patients with aortic stenosis (AS) and chronic kidney disease (CKD) to prevent AKI. MethodsPatients with severe symptomatic AS and CKD stage & GE;3a were evaluated for TAVI using four non-contrast imaging modalities for procedural planning: transesophageal echocardiogram (TEE), cardiac magnetic resonance, multidetector computed tomography (MDCT), and aortoiliac CO2 angiography. Patients underwent transfemoral (TF) TAVI using the self-expandable Evolut R/Pro, and the procedures were guided by fluoroscopy and TEE. Contrast MDCT and contrast injection at certain checkpoints during the procedure were used in a blinded fashion to guarantee patient safety. ResultsA total of 25 patients underwent TF-TAVI with the zero-contrast technique. The mean age was 79.9 & PLUSMN; 6.1 years, 72% in NYHA class III/IV, with a mean STS-PROM of 3.0% & PLUSMN; 1.5%, and creatinine clearance of 49 & PLUSMN; 7 ml/min. The self-expandable Evolut R and Pro were implanted in 80% and 20% of patients, respectively. In 36% of the cases, the transcatheter heart valve (THV) chosen was one size larger than the one by contrast MDCT, but none of these cases presented adverse events. Device success and the combined safety endpoint (at 30 days) both achieved 92%. Pacemaker implantation was needed in 17%. ConclusionThis pilot study demonstrated that the zero-contrast technique for procedural planning and THV implantation was feasible and safe and might become the preferable strategy for a significant population of CKD patients undergoing TAVR. Future studies with a larger number of patients are still needed to confirm such interesting findings.
- Challenges and opportunities for early career medical professionals in cardiovascular magnetic resonance (CMR) imaging: a white paper from the Society for Cardiovascular Magnetic Resonance(2023) PARWANI, Purvi; CHEN, Tiffany; ALLEN, Bradley; KALLIANOS, Kimberly; NG, Ming-Yen; KOZOR, Rebecca; AREMU, Olukayode O.; FAROOQI, Kanwal M.; SECINARO, Aurelio; RICCI, Fabrizio; MOHAREM-ELGAMAL, Sarah; LIBERATO, Gabriela; NARANG, Akhil; OJHA, Vineeta; DUCCI, Chiara Bucciarelli; PLEIN, Sven; ORDOVAS, Karen G.The early career professionals in the field of Cardiovascular Magnetic Resonance (CMR) face unique challenges and hurdles while establishing their careers in the field. The Society for Cardiovascular Magnetic Resonance (SCMR) has expanded the role of the early career section within the society to foster the careers of future CMR leaders. This paper aims to describe the obstacles and available opportunities for the early career CMR professionals worldwide. Societal opportunities and actions targeted at the professional advancement of the early career CMR imagers are needed to ensure continuous growth of CMR as an imaging modality globally.