WILSON MATHIAS JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
6 resultados
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- Clinical Applications of Ultrasonic Enhancing Agents in Echocardiography: 2018 American Society of Echocardiography Guidelines Update(2018) PORTER, Thomas R.; MULVAGH, Sharon L.; ABDELMONEIM, Sahar S.; BECHER, Harald; BELCIK, J. Todd; BIERIG, Michelle; CHOY, Jonathan; GAIBAZZI, Nicola; GILLAM, Linda D.; JANARDHANAN, Rajesh; KUTTY, Shelby; LEONG-POI, Howard; LINDNER, Jonathan R.; MAIN, Michael L.; MATHIAS JR., Wilson; PARK, Margaret M.; SENIOR, Roxy; VILLANUEVA, FlordelizaThis document is endorsed by the following American Society of Echocardiography International Alliance Partners: the Argentinian Federation of Cardiology, the British Society of Echocardiography, the Canadian Society of Echocardiography, the Chinese Society of Echocardiography, the Echocardiography Section of the Cuban Society of Cardiology, the Indian Academy of Echocardiography, the Indian Association of Cardiovascular Thoracic Anaesthesiologists, the Iranian Society of Echocardiography, the Japanese Society of Echocardiography, the Korean Society of Echocardiography, the Saudi Arabian Society of Echocardiography, and the Vietnamese Society of Echocardiography.
- Myocardial Fibrosis in Classical Low-Flow, Low-Gradient Aortic Stenosis Insights From a Cardiovascular Magnetic Resonance Study(2019) ROSA, Vitor E. E.; RIBEIRO, Henrique B.; SAMPAIO, Roney O.; MORAIS, Thamara C.; ROSA, Marcela E. E.; PIRES, Lucas J. T.; VIEIRA, Marcelo L. C.; MATHIAS JR., Wilson; ROCHITTE, Carlos E.; SANTIS, Antonio S. A. L. de; FERNANDES, Joao Ricardo C.; ACCORSI, Tarso A. D.; POMERANTZEFF, Pablo M. A.; RODES-CABAU, Josep; PIBAROT, Philippe; TARASOUTCHI, FlavioBackground: Few data exist on the degree of interstitial myocardial fibrosis in patients with classical low-flow, low-gradient aortic stenosis (LFLG-AS) and its association with left ventricular flow reserve (FR) on dobutamine stress echocardiography. This study sought to evaluate the diffuse interstitial fibrosis measured by T1 mapping cardiac magnetic resonance technique in LFLG-AS patients with and without FR. Methods: Prospective study including 65 consecutive patients (41 LFLG-AS [mean age, 67.1 +/- 8.4 years; 83% men] and 24 high-gradient aortic stenosis used as controls) undergoing dobutamine stress echocardiography to assess FR and cardiac magnetic resonance to determine the extracellular volume (ECV) fraction of the myocardium, indexed ECV (iECV) to body surface area and late gadolinium enhancement. Results: Interstitial myocardial fibrosis measured by iECV was higher in patients with LFLG-AS with and without FR as compared with high-gradient aortic stenosis (35.25 +/- 9.75 versus 32.93 +/- 11.00 versus 21.19 +/- 6.47 mL/m(2), respectively; P<0.001). However, both ECV and iECV levels were similar between LFLG-AS patients with and without FR (P=0.950 and P=0.701, respectively). Also, FR did not correlate significantly with ECV (r=-0.16, P=0.31) or iECV (r=0.11, P=0.51). Late gadolinium enhancement mass was also similar in patients with versus without FR but lower in high-gradient aortic stenosis (13.3 +/- 10.2 versus 10.5 +/- 7.5 versus 4.8 +/- 5.9 g, respectively; P=0.018). Conclusions: Patients with LFLG-AS have higher ECV, iECV, and late gadolinium enhancement mass compared with high-gradient aortic stenosis. Moreover, among patients with LFLG-AS, the degree of myocardial fibrosis was similar in patients with versus those without FR. These findings suggest that diffuse myocardial fibrosis may not be the main factor responsible for the absence of FR in LFLG-AS patients.
- Safety of Ultrasound Contrast Agents in Patients With Known or Suspected Cardiac Shunts(2013) PARKER, Jeremy M.; WELLER, Mark W.; FEINSTEIN, Linda Maiman; ADAMS, Robin J.; MAIN, Michael L.; GRAYBURN, Paul A.; COSGROVE, David O.; GOLDBERG, Barry A.; DARGE, Kassa; NIHOYANNOPOULOS, Petros; WILSON, Stephanie; MONAGHAN, Mark; PISCAGLIA, Fabio; FOWLKES, Brian; MATHIAS, Wilson; MORIYASU, Fuminari; CHAMMAS, Maria Christina; GREENBAUM, Lennard; FEINSTEIN, Steven B.Contrast-enhanced ultrasound imaging is a radiation-free diagnostic tool that uses biocompatible ultrasound contrast agents (UCAs) to improve image clarity. UCAs, which do not contain dye, often salvage ""technically difficult"" ultrasound scans, increasing the accuracy and reliability of a front-line ultrasound diagnosis, reducing unnecessary downstream testing, lowering overall health care costs, changing therapy, and improving patient care. Two UCAs currently are approved and regulated by the US Food and Drug Administration. They have favorable safety profiles and risk/benefit ratios in adult and pediatric populations, including compromised patients with severe cardiovascular diseases. Nevertheless, these UCAs are contraindicated in patients with known or suspected right-to-left, bidirectional, or transient right-to-left cardiac shunts. These patients, who constitute 10% to 35% of the general population, typically receive no UCAs when they undergo echocardiography. If their echocardiographic images are suboptimal, they may receive inappropriate diagnosis and treatment, or they may be referred for additional diagnostic testing, including radiation-based procedures that increase their lifetime risk for cancer or procedures that use contrast agents containing dye, which may increase the risk for kidney damage. An exhaustive review of current peer-reviewed research demonstrated no scientific basis for the UCA contraindication in patients with known or suspected cardiac shunts. Initial safety concerns were based on limited rodent data and speculation related to macroaggregated albumin microspheres, a radioactive nuclear imaging agent with different physical and chemical properties and no relation to UCAs. Radioactive macroaggregated albumin is not contraindicated in adult or pediatric patients with cardiac shunts and is routinely used in these populations. In conclusion, the International Contrast Ultrasound Society Board recommends removal of the contraindication to further the public interest in safe, reliable, radiation-free diagnostic imaging options for patients with known or suspected cardiac shunts and to reduce their need for unnecessary downstream testing.
- Effects of Ticagrelor and Clopidogrel on Coronary Microcirculation in Patients with Acute Myocardial Infarction(2022) SCANAVINI-FILHO, Marco Antonio; BERWANGER, Otavio; MATTHIAS, Wilson; AGUIAR, Miguel O.; CHIANG, Hsu P.; AZEVEDO, Luciene; BARACIOLI, Luciano M.; LIMA, Felipe G.; FURTADO, Remo H. M.; DALCOQUIO, Talia F.; MENEZES, Fernando R.; FERRARI, Aline G.; LUCA, Fabio de; GIUGLIANO, Robert P.; GOODMAN, Shaun; NICOLAU, Jose C.Introduction Clopidogrel has been demonstrated to be effective in improving coronary microcirculation (CM) among patients with ST-elevation myocardial infarction (STEMI) treated with fibrinolytics. Ticagrelor is a more potent adenosine diphosphate (ADP) receptor blocker proven to be superior to clopidogrel among patients with acute coronary syndromes. The present study aimed to compare the effects of ticagrelor and clopidogrel on CM in patients with STEMI treated with fibrinolytics. Methods The present study prospectively included 48 patients participating in the TREAT trial, which randomly assigned patients with STEMI undergoing fibrinolysis to ticagrelor versus clopidogrel. The primary endpoint of this study was the evaluation of the CM using the global myocardial perfusion score index (global MPSI) obtained by myocardial contrast echocardiography (MCE). Platelet aggregation to ADP was evaluated by Multiplate (R) and expressed as area under the curve (AUC). Results The global MPSI demonstrated no differences between the groups [mean 1.4 (1.2-1.5) in the ticagrelor group and 1.2 (1.2-1.5) in the clopidogrel group (p = 0.41)]. Platelet aggregability was lower in the ticagrelor group (18.1 +/- 9.7 AUC), compared to the clopidogrel group (26.1 +/- 12.5 AUC, p = 0.01). Conclusion We found no improvement in coronary microcirculation with ticagrelor compared to clopidogrel among patients with STEMI treated with fibrinolytics, despite the fact that platelet aggregation to ADP was lower with ticagrelor.
- CEUS cardiac exam protocols International Contrast Ultrasound Society (ICUS) recommendations(2022) PORTER, Thomas R.; FEINSTEIN, Steven B.; SENIOR, Roxy; MULVAGH, Sharon L.; NIHOYANNOPOULOS, Petros; STROM, Jordan B.; MATHIAS JR., Wilson; GORMAN, Beverly; RABISCHOFFSKY, Arnaldo; MAIN, Michael L.; APPIS, AndrewThe present CEUS Cardiac Exam Protocols represent the first effort to promulgate a standard set of protocols for optimal administration of ultrasound enhancing agents (UEAs) in echocardiography, based on more than two decades of experience in the use of UEAs for cardiac imaging. The protocols reflect current clinical CEUS practice in many modern echocardiography laboratories throughout the world. Specific attention is given to preparation and dosing of three UEAs that have been approved by the United States Food and Drug Administration (FDA) and additional regulatory bodies in Europe, the Americas and Asia-Pacific. Consistent with professional society guidelines (J Am Soc Echocardiogr 31:241-274, 2018; J Am Soc Echocardiogr 27:797-810, 2014; Eur Heart J Cardiovasc Imaging 18:1205, 2017), these protocols cover unapproved ""off-label"" uses of UEAs-including stress echocardiography and myocardial perfusion imaging-in addition to approved uses. Accordingly, these protocols may differ from information provided in product labels, which are generally based on studies performed prior to product approval and may not always reflect state of the art clinical practice or guidelines.
- Untitled Reply(2016) GUERRA, Vitor C.; TSUTSUI, Jeane M.; MATHIAS JR., Wilson