WILSON MATHIAS JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
124 resultados
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- Cardiovascular Sonothrombolysis(2019) PORTER, Thomas R.; MATHIAS JR., WilsonPurpose of ReviewThis review will provide recent pre-clinical and initial clinical trials exploring the efficacy of sonothrombolysis as an adjunct to current emergent therapies in acute coronary syndromes.Recent FindingsThe initial clinical trials examining the efficacy of short pulse duration diagnostic ultrasound (DUS) high mechanical index impulses in patients with ST segment elevation myocardial infarction (STEMI) have demonstrated that there is improved patency of the infarct vessel, and improved microvascular flow following percutaneous coronary intervention. Subsequent randomized prospective trials have confirmed that in patients with acute STEMI receiving an intravenous microbubble infusion, diagnostic high mechanical index impulses applied in the apical windows pre- and post-percutaneous coronary intervention have reduced myocardial infarction size, as assessed by magnetic resonance imaging at 72h following presentation, and have been associated with better left ventricular systolic function at 6month follow-up.SummarySonothrombolysis has potential for improving early epicardial coronary artery patency and reduce left ventricular remodeling when added to current interventional strategies in STEMI.
- 3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY(2017) GUALANDRO, D. M.; YU, P. C.; CARAMELLI, B.; MARQUES, A. C.; CALDERARO, D.; FORNARI, L. S.; PINHO, C.; FEITOSA, A. C. R.; POLANCZYK, C. A.; ROCHITTE, C. E.; JARDIM, C.; VIEIRA, C. L. Z.; NAKAMURA, D. Y. M.; IEZZI, D.; SCHREEN, D.; ADAM, Eduardo L.; D'AMICO, E. A.; LIMA, M. Q.; BURDMANN, E. A.; PACHON, E. I. M.; BRAGA, F. G. M.; MACHADO, F. S.; PAULA, F. J.; CARMO, G. A. L.; FEITOSA-FILHO, G. S.; PRADO, G. F.; LOPES, H. F.; FERNANDES, J. R. C.; LIMA, J. J. G.; SACILOTTO, L.; DRAGER, L. F.; VACANTI, L. J.; ROHDE, L. E. P.; PRADA, L. F. L.; GOWDAK, L. H. W.; VIEIRA, M. L. C.; MONACHINI, M. C.; MACATRAO-COSTA, M. F.; PAIXAO, M. R.; OLIVEIRA JR., M. T.; CURY, P.; VILLACA, P. R.; FARSKY, P. S.; SICILIANO, R. F.; HEINISCH, R. H.; SOUZA, R.; GUALANDRO, S. F. M.; ACCORSI, T. A. D.; MATHIAS JR., W.
conferenceObject Quality of life and physical capacity after long-term right ventricular pacing in young adults with congenital atrioventricular block(2012) SILVA, K. R.; COSTA, R.; OLIVEIRA JR., R. M.; MARTINELLI FILHO, M.; LACERDA, M. S.; HUANG, A.; ROSSI, M. B.; MATHIAS JR., W.; PIETROBON, R.; STOLF, N. A. G.Background: Although several studies have demonstrated the deleterious consequences of chronic right ventricular (RV) pacing on ventricular function and synchronicity, its effects on health-related quality of life (HRQL) and physical capacity remains uncertain. Objectives: To evaluate the effect of RV pacing on HRQL and physical capacity of children and young adults with congenital complete atrioventricular (AV) block. Methods: Fifty consecutive patients with permanent RV cardiac pacing due to congenital AV block and under clinical follow-up for more than one year were enrolled. Multidimensional HRQL was assessed with the Short Form-36 Health Survey (SF-36) and Child Health Questionnaire (CHQ-PF50). Physical capacity was tested by the 6-minute walk distance test (6MWD). The scores for each domain and the distance performed at the 6MWD test were compared with demographic and clinical characteristics of patients, using the Student’s t-test and Qui-squaretest. Results: Domains presenting lower scores were Vitality (63.0±20.6), Pain(66.5±25.1) and Mental Health (67.3±20.4) in the SF-36 questionnaire; General Health Perceptions (64.0±15.0) and Parental Impact-Emotional (69.0±30.0) in the CHQ-PF50. Female gender (P=0.026), DDD pacing mode (0.008) and normal left ventricular ejection fraction (0.002) were associated with higher quality of life scores. The average distance performed at the 6MWD test was 677,2 meters (454,5 to 852,8). The 6MWD showed significant association with age (P=0.004), normal ventricular function (P= 0.031) and the absence of cardiovascular drugs use (P= 0.018). Conclusions: The results of this analysis indicated that chronic RV pacing did not affect the HRQL and physical capacity of young patients. Female gender, DDD pacing, normal ventricular function and the absence of cardiovascular medications were associated with better HRQL scores and with better results at 6MWD test.conferenceObject Predictors of contractile reserve on dobutamine stress echocardiography in patients with classical low-flow, low-gradient aortic stenosis(2019) ROSA, V. Emer Egypto; RIBEIRO, H. B.; SAMAPIO, R. O.; MORAIS, T. C.; ROSA, M. E. E.; SANTIS, A. S. A. L. De; FERNANDES, J. R. C.; SPINA, G. S.; VIEIRA, M. L. C.; POMERANTZEFF, P. M. A.; ROCHITTE, C. E.; MATHIAS JR., W.; TARASOUTCHI, F.- Risk prediction in patients with classical low-flow, low-gradient aortic stenosis undergoing surgical intervention(2023) TESSARI, Fernanda Castiglioni; LOPES, Maria Antonieta Albanez A. de M.; CAMPOS, Carlos M. M.; ROSA, Vitor Emer Egypto; SAMPAIO, Roney Orismar; SOARES, Frederico Jose Mendes Mendonca; LOPES, Rener Romulo Souza; NAZZETTA, Daniella Cian; JR, Fabio Sandoli de Brito; RIBEIRO, Henrique Barbosa; VIEIRA, Marcelo L. C.; JR, Wilson Mathias; FERNANDES, Joao Ricardo Cordeiro; LOPES, Mariana Pezzute; ROCHITTE, Carlos E. E.; POMERANTZEFF, Pablo M. A.; ABIZAID, Alexandre; TARASOUTCHI, FlavioIntroductionClassical low-flow, low-gradient aortic stenosis (LFLG-AS) is an advanced stage of aortic stenosis, which has a poor prognosis with medical treatment and a high operative mortality after surgical aortic valve replacement (SAVR). There is currently a paucity of information regarding the current prognosis of classical LFLG-AS patients undergoing SAVR and the lack of a reliable risk assessment tool for this particular subset of AS patients. The present study aims to assess mortality predictors in a population of classical LFLG-AS patients undergoing SAVR.MethodsThis is a prospective study including 41 consecutive classical LFLG-AS patients (aortic valve area & LE;1.0 cm(2), mean transaortic gradient <40 mmHg, left ventricular ejection fraction <50%). All patients underwent dobutamine stress echocardiography (DSE), 3D echocardiography, and T1 mapping cardiac magnetic resonance (CMR). Patients with pseudo-severe aortic stenosis were excluded. Patients were divided into groups according to the median value of the mean transaortic gradient (& LE;25 and >25 mmHg). All-cause, intraprocedural, 30-day, and 1-year mortality rates were evaluated.ResultsAll of the patients had degenerative aortic stenosis, with a median age of 66 (60-73) years; most of the patients were men (83%). The median EuroSCORE II was 2.19% (1.5%-4.78%), and the median STS was 2.19% (1.6%-3.99%). On DSE, 73.2% had flow reserve (FR), i.e., an increase in stroke volume & GE;20% during DSE, with no significant differences between groups. On CMR, late gadolinium enhancement mass was lower in the group with mean transaortic gradient >25 mmHg [2.0 (0.0-8.9) g vs. 8.5 (2.3-15.0) g; p = 0.034), and myocardium extracellular volume (ECV) and indexed ECV were similar between groups. The 30-day and 1-year mortality rates were 14.6% and 43.8%, respectively. The median follow-up was 4.1 (0.3-5.1) years. By multivariate analysis adjusted for FR, only the mean transaortic gradient was an independent predictor of mortality (hazard ratio: 0.923, 95% confidence interval: 0.864-0.986, p = 0.019). A mean transaortic gradient & LE;25 mmHg was associated with higher all-cause mortality rates (log-rank p = 0.038), while there was no difference in mortality regarding FR status (log-rank p = 0.114).ConclusionsIn patients with classical LFLG-AS undergoing SAVR, the mean transaortic gradient was the only independent mortality predictor in patients with LFLG-AS, especially if & LE;25 mmHg. The absence of left ventricular FR had no prognostic impact on long-term outcomes.
bookPart Ecocardiograma na emergência(2018) SOEIRO, Maria Carolina Feres de Almeida; HOTTA, Viviane Tiemi; VIEIRA, Marcelo Luiz Campos; JúNIOR, Wilson Mathias- Brazilian Cardio-oncology Guideline-2020(2020) HAJJAR, Ludhmila Abrahao; COSTA, Isabela Bispo Santos da Silva da; LOPES, Marcelo Antonio Cartaxo Queiroga; HOFF, Paulo Marcelo Gehm; DIZ, Maria Del Pilar Estevez; FONSECA, Silvia Moulin Ribeiro; BITTAR, Cristina Salvadori; REHDER, Marilia Harumi Higuchi dos Santos; RIZK, Stephanie Itala; ALMEIDA, Dirceu Rodrigues; FERNANDES, Gustavo S. Santos; BECK-DA-SILVA, Luis; CAMPOS, Carlos Augusto Homem de Magalhaes; MONTERA, Marcelo Westerlund; ALVES, Silvia Marinho Martins; FUKUSHIMA, Julia Tizue; SANTOS, Maria Veronica Camara dos; NEGRAO, Carlos Eduardo; SILVA, Thiago Liguori Feliciano da; FERREIRA, Silvia Moreira Ayub; MALACHIAS, Marcus Vinicius Bolivar; MOREIRA, Maria da Consolacao Vieira; VALENTE NETO, Manuel Maria Ramos; FONSECA, Veronica Cristina Quiroga; SOEIRO, Maria da Carolina Feres de Almeida; ALVES, Juliana Barbosa Sobral; SILVA, Carolina Maria Pinto Domingues Carvalho; SBANO, Joao; PAVANELLO, Ricardo; PINTO, Ibraim Masciarelli F.; SIMAO, Antonio Felipe; DRACOULAKIS, Marianna Deway Andrade; HOFF, Ana Oliveira; ASSUNCAO, Bruna Morhy Borges Leal; NOVIS, Yana; TESTA, Laura; ALENCAR FILHO, Aristoteles Comte de; CRUZ, Cecilia Beatriz Bittencourt Viana; PEREIRA, Juliana; GARCIA, Diego Ribeiro; NOMURA, Cesar Higa; ROCHITTE, Carlos Eduardo; MACEDO, Ariane Vieira Scarlatelli; MARCATTI, Patricia Tavares Felipe; MATHIAS JUNIOR, Wilson; WIERMANN, Evanius Garcia; VAL, Renata do; FREITAS, Helano; COUTINHO, Anelisa; MATHIAS, Clarissa Maria de Cerqueira; VIEIRA, Fernando Meton de Alencar Camara; SASSE, Andre Deeke; ROCHA, Vanderson; RAMIRES, Jose Antonio Franchini; KALIL FILHO, Roberto
- Novel device-based therapies to improve outcome in ST-segment elevation myocardial infarction(2021) MARIA, Giovanni Luigi De; GARCIA-GARCIA, Hector M.; SCARSINI, Roberto; FINN, Aloke; SATO, Yu; VIRMANI, Renu; BHINDI, Ravinay; CIOFANI, Jonathan L.; NUCHE, Jorge; RIBEIRO, Henrique B.; MATHIAS JR., Wilson; YERASI, Charan; FISCHELL, Tim A.; OTTERSPOOR, Luuk; RIBICHINI, Flavio; IBANEZ, Borja; PIJLS, Nico H. J.; SCHWARTZ, Robert S.; KAPUR, Navin K.; STONE, Gregg W.; BANNING, Adrian P.Primary percutaneous coronary intervention (PPCI) has dramatically changed the outcome of patients with ST-elevation myocardial infarction (STEMI). However, despite improvements in interventional technology, registry data show little recent change in the prognosis of patients who survive STEMI, with a significant incidence of cardiogenic shock, heart failure, and cardiac death. Despite a technically successful PPCI procedure, a variable proportion of patients experience suboptimal myocardial reperfusion. Large infarct size and coronary microvascular injury, as the consequence of ischaemia-reperfusion injury and distal embolization of atherothrombotic debris, account for suboptimal long-term prognosis of STEMI patients. In order to address this unmet therapeutic need, a broad-range of device-based treatments has been developed. These device-based therapies can be categorized according to the pathophysiological pathways they target: (i) techniques to prevent distal atherothrombotic embolization, (ii) techniques to prevent or mitigate ischaemia/reperfusion injury, and (iii) techniques to enhance coronary microvascular function/integrity. This review is an overview of these novel technologies with a focus on their pathophysiological background, procedural details, available evidence, and with a critical perspective about their potential future implementation in the clinical care of STEMI patients.
- Evaluation of cardiac masses by real-time perfusion imaging echocardiography(2015) UENISHI, Eliza K.; CALDAS, Marcia A.; TSUTSUI, Jeane M.; ABDUCH, Maria C. D.; SBANO, Joao C. N.; KALIL FILHO, Roberto; MATHIAS JR., WilsonBackground: Diagnosis of cardiac masses is still challenging by echocardiography and distinguishing tumors from thrombi has important therapeutical implications. We sought to determine the diagnostic value of real-time perfusion echocardiography (RTPE) for cardiac masses characterization. Methods: We prospectively studied 86 patients, 23 with malignant tumors (MT), 26 with benign tumors (BT), 33 with thrombi and 6 with pseudotumors who underwent RTPE. Mass perfusion was analyzed qualitatively and blood flow volume (A), blood flow velocity (beta), and microvascular blood flow (A x beta) were determined by quantitative RTPE. Results: Logistic regression models showed that the probability of having a tumor increased by 15.8 times with a peripheral qualitative perfusion pattern, and 34.5 times with a central perfusion pattern, in comparison with the absence of perfusion. Using quantitative RTPE analysis, thrombi group had parameters of blood flow lower than tumor group. A values for thrombi, MT, and BT were 0.1 dB (0.01-0.22), 2.78 dB (1-7) and 2.58 dB (1.44-5), respectively; p < 0.05, while A x beta values were 0.0 dB/s(-1) (0.01-0.14), 2.00 dB/s(-1) (1-6), and 1.18 dB/s(-1) (0.52-3), respectively; p < 0.05. At peak dipyridamole stress, MT had greater microvascular blood volume than BT [A = 4.18 dB (2.14-7.93) versus A = 2.04 dB (1.09-3.55); p < 0.05], but no difference in blood flow [Ax beta = 2.46 dB/s(-1) (1.42-4.59) versus Ax beta = 1.55 dB/s [1] (0.51-4.08); p=NS]. An A value >3.28 dB at peak dipyridamole stress predicted MT (AUC = 0.75) and conferred 5.8-times higher chance of being MT rather than BT. Conclusion: RTPE demonstrated that cardiac tumors have greater microvascular blood volume and regional blood flow when compared with thrombi. Dipyridamole stress was useful in differentiating MT from BT.
- The Clinical Course of Takotsubo Syndrome Diagnosed According to the InterTAK Criteria(2020) FUNDÃO, Nelson Henrique Fantin; RIBEIRO, Henrique Barbosa; CAMPOS, Carlos de Magalhães; SELEME, Vinicius Bocchino; SOEIRO, Alexandre de Matos; VIEIRA, Marcelo Luiz Campos; MATHIAS JR, Wilson; HAJJAR, Ludhmilla Abraão; RIBEIRO, Expedito E.; KALIL FILHO, RobertoAbstract Background There has been an increase in the number of cases of Takotsubo syndrome (TTS) and of scientific publications on the theme over the last years. However, little is known about the status of this disease in Brazilian hospitals. Objective To assess mortality and major adverse cardiovascular events (MACE) during hospitalization and follow-up of TTS patients seen in a tertiary hospital in Brazil. Methods This was a retrospective, observational study on 48 patients. Clinical data, signs and symptoms, complementary tests, MACE and all-cause mortality were assessed on admission and during follow-up. Kaplan-Meier curves were used for analysis of all-cause mortality and risk for MACE at median follow-up. The 95% confidence interval was also calculated for a significance level of 5%. Results Mean age of patients was 71 years (SD±13 years), and most patients were women (n=41; 85.4%). During hospitalization, four patients (8.3%) died and five (10.4%) developed MACE. At median follow-up of 354.5 days (IQR of 81.5-896.5 days), the risk of all-cause mortality and MACE was 11.1% (95% CI= 1.8-20.3%) and 12.7% (95% CI= 3.3-22.3%), respectively. Conclusion TTS was associated with high morbidity and mortality rates in a tertiary hospital in Brazil, which were comparable to those observed in acute coronary syndrome. Therefore, the severity of TTS should not be underestimated, and new therapeutic strategies are required. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0