PAULO SAMPAIO GUTIERREZ
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
73 resultados
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conferenceObject THE PROPORTION OF LIPIDS IN HUMAN CORONARY ATHEROSCLEROTIC PLAQUES IS INDEPENDENT OF PLAQUE SIZE OR BURDEN(2014) GUTIERREZ, Paulo Sampaio; LEITE, Thiago V. L. G.conferenceObject The possible participation of telocytes as tissue modulators in normal and pathological human aorta(2018) BORGES, L.; FALCAO, R. S. P.; TABOGA, S. R.; GUTIERREZ, P. S.; MICHEL, J. B.conferenceObject Inhibition of TGfb axis and renin-angiotensin system in human ascending aorta aneurysms(2016) BORGES, L.; ALVARENGA, L. A. A.; FALCAO, R. S. P.; DIAS, R. R.; LACCHINI, S.; GUTIERREZ, P. S.; MICHEL, J. B.- Modelo porcino para avaliação e desenvolvimento de diferentes dispositivos coronários baseados em cateter: ferramenta pré-clínica fundamental(2013) GALON, Micheli Zanotti; TAKIMURA, Celso Kiyochi; CHAVES, Márcio J. Figueira; CAMPOS, Julliana Carvalho de; KRIEGER, J. Eduardo; GUTIERREZ, Paulo Sampaio; LAURINDO, Francisco Rafael Martins; KALIL FILHO, Roberto; LEMOS NETO, Pedro AlvesBACKGROUND: The experimental porcine model is anatomically and physiologically similar to the human heart, it is easily reproducible and very useful to test new stent and balloon generations. This study was aimed at analyzing an experimental model to evaluate different coronary devices for percutaneous coronary intervention. METHODS: We evaluated 131 juvenile commercial farm pigs, 109 were female, weighing 26.4 ± 3.2 kg. They were anesthetized and had mechanical ventilation and monitoring. Vascular access was obtained via the femoral artery by dissection or puncture. The coronary device was used after a selective catheterization of the coronary arteries with a JR 6 F catheter. Animals were maintained on mechanical ventilation until recovery and were submitted to angiographic evaluation 7, 28, 90 and/or 180 days after the procedure. After euthanasia, the hearts were collected and submitted to macro and microscopic analysis. RESULTS: Six drug-eluting stents, two drug-eluting balloons and two bare-metal stents were tested. Unplanned deaths were observed in 1.5% of the cases during the procedures and in 9.2% of the cases after the procedure, occurring within 12 hours to 6 days (2.3 ± 1.6 days). In addition to angiographic evaluations, intravascular ultrasound and optical coherence tomography were performed during the procedures in 20% and 60% of the cases, respectively. There was no deaths related to the use of the devices. CONCLUSIONS: The experimental percutaneous porcine model proved to be reproducible with similar outcomes and low mortality for the different devices tested and is an essential tool for the evaluation of new coronary devices.
- Male gender and smoking are related to single, but not to multiple, human aortic aneurysms(2015) GUTIERREZ, Paulo S.; LEITE, Thiago N. P.; MANGIONE, Fernanda M.There is scanty information concerning multiple aortic aneurysms. Thus, we verified if clinical or pathological characteristics are different in patients with multiple (two or more) aortic aneurysms in comparison with those with only one. Material and methods: We selected at the necropsy files of the Heart Institute, Sao Paulo University School of Medicine, the last 100 cases with aortic aneurysms, comparing between the two groups: sex, age, presence of systemic arterial hypertension, diabetes, dyslipedemia, history of smoking habit, cause of the aneurysm, cause of death, and if the diagnosis was reached during life. Age was analysed by Mann-Whitney test, and the other variables by chi-square or Fisher's exact test. Results: Multiple aneurysms corresponded to 14% of cases. The proportion of women among patients with multiple aneurysms was higher than among those with single aneurysm(64.3% versus 20.9%, P<.01), even if only cases with atherosclerosis were taken into consideration (women among multiple-6/10, 60.0%; among single-14/70, 20.0%; P=.01). Smoking was less reported in cases with multiple (4/14, 28.6%) than with single aneurysm (53/86, 61.6%; P=.04); considering cases with atherosclerosis, such difference decreases (40.0% of multiple versus 68.6% of single, P=.09). Conclusion: although atherosclerosis is present in most cases of both single and multiple aortic aneurysms, male gender and smoking, considered highly influential in such lesions, are less frequent in patients with multiple than in patients with single aneurysms. Thus mechanisms underlying multiple aortic aneurysms are probably different from those related to single, more common aneurysms.
conferenceObject HISTOPATHOLOGICAL FINDINGS IN CARDIAC VALVES SURGICALLY REMOVED FROM PATIENTS WITH INFECTIVE ENDOCARDITIS(2013) SICILIANO, R. F.; LEE, E. M.; VIEIRA, M. L. C.; POMERANTZEFF, P. M. A.; GRINBERG, M.; GUTIERREZ, P. S.; MANSUR, A. J.Objectives: To evaluate histopathological findings of cardiac valves surgically excised from patients with infective endocarditis relative to antimicrobial therapy and other clinical variables. Methods: We studied 44 patients, 30 men and 14 women aged 10–76 (median 52.5) years. Thirty biopsies were of bioprosthetic valves and 25 of native valves. The infecting microorganisms were streptococci in 18 (41%), Staphylococcus spp. in 9 (20%), Enterococcus spp. in 3 (7%), Gram-negative rods in 2 (4%) and others in 6 (13%). In 6 patients the infecting microorganism was not identified in blood cultures. All histopathological sections were reviewed by the same pathologist. A semi-quantitative analysis was used. Results: The mean of pre-operative antibiotic treatment was 19 days. Other findings are presented in Table 1. Conclusion: In patients with infective endocarditis treated for more than 30 days, histopathological sections of the excised valves may demonstrate bacteria and signs of acute inflammation.- Myocarditis, histological detection and parasitic load of Trypanosoma cruzi in endomyocardial biopsies presenting with reactivation of Chagas disease after heart transplantation(2023) BENVENUTI, Luiz A.; GUTIERREZ, Paulo S.; AIELLO, Vera D.
conferenceObject Infarct-like medial necrosis: A role for ischemia in ascending aorta aneurysms(2017) GUTIERREZ, P.- Case 6 / 2016-Heart Failure in a 23-Year-Old Male with a History of Illicit Drug Use(2016) RIBAS, Fernando Faglioni; GUTIERREZ, Paulo SampaioMale patient, 23 years-old, sought medical treatment for malaise, nausea, vomiting, and retrosternal burning pain for three days (09/25/2013). Two weeks before seeking medical attention, the patient was diagnosed with a heart disease after an evaluation done one month before his complaint of malaise, for a research of dyspnea during physical effort with progressive worsening. He stated to have been a cocaine user in the past, but had been clean for seven years. Transthoracic two-dimensional echocardiogram (09/11/2013) showed: left atrium diameter 58 mm; left ventricle diameters (diast./syst.) 81 mm/72 mm, LVEF = 24%; accentuated diffuse ventricular hypokinesis; restrictive filling pattern; moderate to severe mitral insufficiency. The patient was prescribed: enalapril 1 omg, furosemide 40 mg, spironolactone 25 mg, and carvedilol 6.25 mg daily. Lab exams (09/19/2013) revealed: urea 48 mg/dL, creatinine 1.82 mg/dL, sodium 140 mEq/L, potassium 4.8 mEq/L. During the physical exam (09/25/2013), the patient presented regular overall condition, acyanotic, afebrile, and hydrated; heart rate was 92 bpm; blood pressure was 80x60 mmHg, arterial saturation 98%; pulmonary auscultation was normal; heart auscultation showed the presence of third sound and regurgitant systolic murmur +++/6+ in mitral area; abdominal exam was normal, and there was no edema in the lower limbs. Electrocardiogram showed overload of the left chamber. Lab exams (09/25/2013) revealed: CKMB 1.61 ng/mL, troponin I 0.447 ng/mL, urea 60 mg/dL, creatinine 2 mg/dL, C-reactive protein 2.65 mg/L, sodium 139 mEq/L, potassium 4.3 mEq/L, PT (INR) 1.3, PTT (rel) 0.87, hemoglobin 16.8g/dL, hematocrit 49%, leukocytes 9100/mm(3) (61% neutrophils, 1% eosinophils, 1% basophils, 30% lymphocytes, and 7% monocytes), platelets 286000/mm(3).
conferenceObject MORPHOLOGIC ALTERATIONS IN KNOCKOUT LDL-/- MICE AORTA SUBJECT TO DIETARY RESTRICTION(2013) MELO, E. S.; AZEVEDO, F. R.; MONTEIRO, L. H.; JURADO, M. C.; GUTIERREZ, P. S.; CARAMELLI, B.