JOAO CESAR NUNES SBANO

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico

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Agora exibindo 1 - 10 de 28
  • article 17 Citação(ões) na Scopus
    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
  • article 22 Citação(ões) na Scopus
    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., Wilson
    Background: 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.
  • article 12 Citação(ões) na Scopus
    Prognostic Value of Coronary and Microvascular Flow Reserve in Patients with Nonischemic Dilated Cardiomyopathy
    (2013) LIMA, Marta F.; MATHIAS JR., Wilson; SBANO, Joao C. N.; CRUZ, Victoria Yezinia de la; ABDUCH, Maria Cristina; LIMA, Marcio S. M.; BOCCHI, Edmar A.; HAJJAR, Ludhmila A.; RAMIRES, Jose A. F.; KALIL FILHO, Roberto; TSUTSUI, Jeane M.
    Background: Coronary and microvascular blood flow reserve have been established as important predictors of prognosis in patients with cardiovascular disease. The aim of this study was to assess the value of coronary flow velocity reserve (CFVR) and real-time myocardial perfusion echocardiography (RTMPE) for predicting events in patients with nonischemic dilated cardiomyopathy. Methods: One hundred ninety-five patients (mean age 54 +/- 12 years; 66% men) with dilated cardiomyopathy (left ventricular ejection fraction < 35% and no obstructive coronary disease on invasive angiography or multi-detector computed tomography) who underwent dipyridamole stress (0.84 mg/kg over 10 min) RTMPE were prospectively studied. CFVR was calculated as the ratio of hyperemic to baseline peak diastolic velocities in the distal left anterior coronary artery. The replenishment velocity (beta), plateau of acoustic intensity (A(N)), and myocardial blood flow reserve were obtained from RTMPE. Results: Mean CFVR was 2.07 +/- 0.52, mean A(N) reserve was 1.05 +/- 0.09, mean beta reserve was 2.05 +/- 0.39, and mean myocardial blood flow reserve (A(N) x beta) was 2.15 +/- 0.48. During a median follow-up period of 29 months, 45 patients had events (43 deaths and two urgent transplantations). Independent predictors of events were left atrial diameter (relative risk, 1.16; 95% confidence interval, 1.08-1.26; P < .001) and beta reserve <= 2.0 (relative risk, 3.22; 95% confidence interval, 1.18-8.79; P < .001). After adjustment for beta reserve, CFVR and myocardial blood flow reserve no longer had predictive value. Left atrial diameter added prognostic value over clinical factors and left ventricular ejection fraction (chi(2) = 36.8-58.5, P < .001). Beta reserve added additional power to the model (chi(2) = 70.2, P < .001). Conclusions: Increased left atrial diameter and depressed beta reserve were independent predictors of cardiac death and transplantation in patients with nonischemic dilated cardiomyopathy. Beta reserve by RTMPE provided incremental predictive value beyond that provided by current known prognostic clinical and echocardiographic factors. (J Am Soc Echocardiogr 2013;26:278-87.)
  • conferenceObject
    Right ventricular strain: a noninvasive tool to predict cardiac rejection
    (2018) CRUZ, C. B. Bittencourt Viana; LOFRANO-ALVES, M.; LIMA, M. Silva Miguel; ABDUCH, M. C. Donadio; VIEIRA, M. L. Campos; SBANO, J. C. Nunes; HAJJAR, L. Abrahao; SALVIANO, J. Bittencourt Cruz; MATHIAS JR., W.; BACAL, F.; TSUTSUI, J. Mike
  • bookPart
    Avaliação Ecocardiográfica da Reserva de Fluxo Coronariano
    (2015) TSUTSUI, Jeane Mike; LIMA, Marta Fernandes; SBANO, João César Nunes
  • conferenceObject
    Sonothrombolysis Improves Left Atrial Pressure and Volume in Patients With ST Elevation Acute Myocardial Infarction
    (2020) CHIANG, Hsu Po; AGUIAR, Miguel; TAVARES, Bruno; MATHIAS, Wilson; BORGES, Bruno C.; OLIVEIRA, Mucio; SOEIRO, Alexandre D.; NICOLAU, Jose C.; SBANO, Joao; GOLDSWEIG, Andrew M.; KALIL FILHO, Roberto; RAMIRES, Jose A.; PORTER, Thomas R.; TSUTSUI, Jeane M.
  • conferenceObject
    THE IMPACT OF SONOTHROMBOLYSIS ON LEFT VENTRICULAR DIASTOLIC FUNCTION AND LEFT ATRIAL MECHANICS IN PATIENTS WITH ST ELEVATION MYOCARDIAL INFARCTION
    (2020) CHIANG, Hsu; AGUIAR, Miguel Osman; TAVARES, Bruno Garcia; MATHIAS JR., Wilson; BORGES, Bruno Carter; AZEVEDO, Luciene; OLIVEIRA, Mucio; SOEIRO, Alexandre; NICOLAU, Jose C.; RIBEIRO, Henrique B.; SBANO, Joao Cesar; GOLDSWEIG, Andrew; KALIL-FILHO, Roberto; RAMIRES, Jose; PORTER, Thomas; TSUTSUI, Jeane
  • article 1 Citação(ões) na Scopus
    Sonothrombolysis Promotes Improvement in Left Ventricular Wall Motion and Perfusion Scores after Acute Myocardial Infarction
    (2022) TAVARES, Bruno G.; AGUIAR, Miguel Osman; TSUTSUI, Jeane; OLIVEIRA, Mucio; SOEIRO, Alexandre de Matos; NICOLAU, Jose; RIBEIRO, Henrique; POCHIANG, Hsu; SBANO, Joao; ROCHITTE, Carlos Eduardo; LOPES, Bernardo; RAMIREZ, Jose; KALIL FILHO, Roberto; MATHIAS, Wilson
    Background: It has recently been demonstrated that the application of high-energy ultrasound and microbubbles, in a technique known as sonothrombolysis, dissolves intravascular thrombi and increases the angiographic recanalization rate in patients with ST-segment-elevation myocardial infarction (STEMI). Objective: To evaluate the effects of sonothrombolysis on left ventricular wall motion and myocardial perfusion in patients with STEMI, using real-time myocardial perfusion echocardiography (RTMPE). Methods: One hundred patients with STEMI were randomized into the following 2 groups: therapy (50 patients treated with sonothrombolysis and primary coronary angioplasty) and control (50 patients treated with primary coronary angioplasty). The patients underwent RTMPE for analysis of left ventricular ejection fraction (LVEF), wall motion score index (WMSI), and number of segments with myocardial perfusion defects 72 hours after STEMI and at 6 months of follow-up. P < 0.05 was considered statistically significant. Results: Patients treated with sonothrombolysis had higher LVEF than the control group at 72 hours (50% +/- 10% versus 44% +/- 10%; p = 0.006), and this difference was maintained at 6 months of follow-up (53% +/- 10% versus 48% +/- 12%; p = 0.008). The WMSI was similar in the therapy and control groups at 72 hours (1.62 +/- 0.39 versus 1.75 +/- 0.40; p = 0.09), but it was lower in the therapy group at 6 months (1.46 +/- 0.36 versus 1.64 +/- 0.44; p = 0.02). The number of segments with perfusion defects on RTMPE was similar in therapy and control group at 72 hours (5.92 +/- 3.47 versus 6.94 +/- 3.39; p = 0.15), but it was lower in the therapy group at 6 months (4.64 +/- 3.31 versus 6.57 +/- 4.29; p = 0.01). Conclusion: Sonothrombolysis in patients with STEMI resulted in improved wall motion and ventricular perfusion scores over time.
  • article 5 Citação(ões) na Scopus
    Cardiac shock wave therapy improves myocardial perfusion and preserves left ventricular mechanics in patients with refractory angina: A study with speckle tracking echocardiography
    (2018) DUQUE, Anderson S.; CECCON, Conrado L.; JR, Wilson Mathias; MAJESKY, Joana Diniz; GOWDAK, Luis H.; SBANO, Joao C. N.; CESAR, Luis Antonio Machado; ABDUCH, Maria Cristina; LIMA, Marcio S. M.; DOURADO, Paulo M. M.; V, Cecilia B. B. Cruz; TSUTSUI, Jeane M.
    BackgroundCardiac shockwave therapy (CSWT) is a new potential option for the treatment of patients with chronic coronary disease and refractory angina (RA). We aimed to study the effects of CSWT on left ventricular myocardial perfusion and mechanics in patients with RA. MethodWe prospectively studied 19 patients who underwent CSWT. Left ventricular mechanics were evaluated by speckle tracking echocardiography (STE), and myocardial perfusion by single-photon emission computed tomography, using stress/rest-Technetium-99m Sestamibi, for determination of summed stress score (SSS). Canadian Cardiac Society (CCS), New York Heart Association (NYHA), and quality of life by Seattle Angina Questionnaire (SAQ) were assessed at baseline and 6months after therapy. ResultsCSWT therapy was applied without major side effects. At baseline, 18 patients (94.7%) had CCS class III or IV, and after CSWT there was reduction to 3 (15.8%), P=.0001, associated with improvement in SAQ (38.5%; P<.001). Thirteen (68.4%) had class NYHA III or IV before treatment, with significant reduction to 7 (36.8%); P=.014. No change was observed in the global SSS from baseline to 6-month follow-up (15.338.60 vs 16.60 +/- 8.06; P=.157). However, there was a significant reduction in the average SSS of the treated ischemic segments (2.1 +/- 0.87 pre vs 1.6 +/- 1.19 post CSWT; P=.024). Global longitudinal strain by STE remained unaltered (-13.03 +/- 8.96 pre vs -15.88 +/- 3.43 6-month post CSWT; P=.256). ConclusionCSWT is a safe procedure for the treatment of patients with RA that results in better quality of life, improvement in myocardial perfusion of the treated segments with preservation of left ventricular mechanics.
  • article 11 Citação(ões) na Scopus
    Comprehensive left ventricular mechanics analysis by speckle tracking echocardiography in Chagas disease
    (2016) LIMA, Marcio Silva Miguel; VILLARRAGA, Hector R.; ABDUCH, Maria Cristina Donadio; LIMA, Marta Fernandes; CRUZ, Cecilia Beatriz Bittencourt Viana; BITTENCOURT, Marcio Sommer; VOOS, Mariana Callil; SBANO, Joao Cesar Nunes; MATHIAS JR., Wilson; TSUTSUI, Jeane Mike
    Background: Chagas disease (CD) is a frequent cause of dilated cardiomyopathy (CMP) in developing countries, leading to clinical heart failure and worse prognosis. Therefore, the development and evolution of this CMP has always been a major topic in numbers of previous studies. A comprehensive echocardiographic study of left ventricular (LV) mechanics, fully assessing myocardial contraction, has never been done before. This could help characterize and improve the understanding of the evolution of this prevalent CMP. Methods: A total of 47 chagasic and 84 control patients were included in this study and allocated in groups according to LV ejection fraction. 2D-Echocardiogram was acquired for LV mechanics analysis by speckle tracking echocardiography. Results: Mean age of chagasic individuals was 55y and 16 (34 %) were men. Significant difference was found in global longitudinal velocity analysis, with lower values in indeterminate form. In the group with severe systolic dysfunction, a paradoxical increase in longitudinal and apical radial displacements were demonstrated. In parallel, segmental analyzes highlighted lower values of radial displacement, strain and strain rate into inferior and inferolateral walls, with increase of these values in septal and anterior walls. Conclusion: Chagasic CMP has a vicarious pattern of contraction in the course of its evolution, defined by reduced displacement and strain into inferior and posterior walls with paradoxical increase in septal and anterior segments. Also, lower longitudinal velocities were demonstrated in CD indeterminate form, which may indicate an incipient myocardial injury.