WILSON MATHIAS JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
4 resultados
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- 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.
- 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.
- 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.
- 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.