MONICA SAMUEL AVILA GRINBERG
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
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- Brazilian Society of Cardiology Guideline on Myocarditis-2022(2022) MONTERA, Marcelo Westerlund; MARCONDES-BRAGA, Fabiana G.; SIMOES, Marcus Vinicius; MOURA, Lidia Ana Zytynski; FERNANDES, Fabio; MANGINE, Sandrigo; OLIVEIRA JUNIOR, Amarino Carvalho de; SOUZA, Aurea Lucia Alves de Azevedo Grippa de; IANNI, Barbara Maria; ROCHITTE, Carlos Eduardo; MESQUITA, Claudio Tinoco; AZEVEDO FILHO, Clerio F. de; FREITAS, Dhayn Cassi de Almeida; MELO, Dirceu Thiago Pessoa de; BOCCHI, Edimar Alcides; HOROWITZ, Estela Suzana Kleiman; MESQUITA, Evandro Tinoco; OLIVEIRA, Guilherme H.; VILLACORTA, Humberto; ROSSI NETO, Joao Manoel; BARBOSA, Joao Marcos Bemfica; FIGUEIREDO NETO, Jose Albuquerque de; LUIZ, Louise Freire; HAJJAR, Ludhmila Abrahao; BECK-DA-SILVA, Luis; CAMPOS, Luiz Antonio de Almeida; DANZMANN, Luiz Claudio; BITTENCOURT, Marcelo Imbroise; GARCIA, Marcelo Iorio; AVILA, Monica Samuel; CLAUSELL, Nadine Oliveira; JR, Nilson Araujo de Oliveira; SILVESTRE, Odilson Marcos; SOUZA, Olga Ferreira de; MOURILHE-ROCHA, Ricardo; KALIL FILHO, Roberto; AL-KINDI, Sadeer G.; RASSI, Salvador; ALVES, Silvia Marinho Martins; FERREIRA, Silvia Moreira Ayub; RIZK, Stephanie Itala; MATTOS, Tiago Azevedo Costa; BARZILAI, Vitor; MARTINS, Wolney de Andrade; SCHULTHEISS, Heinz-Peter
- Survival of Heart Transplant Patients with Chagas' Disease Under Different Antiproliferative Immunosuppressive Regimens(2023) FURQUIM, Silas Ramos; GALBIATI, Luana Campoli; AVILA, Monica S.; MARCONDES-BRAGA, Fabiana G.; FUKUSHIMA, Julia; MANGINI, Sandrigo; SEGURO, Luis Fernando Bernal da Costa; CAMPOS, Iascara Wozniak de; STRABELLI, Tania Mara Varejao; BARONE, Fernanda; PAULO, Audrey Rose da Silveira Amancio de; OHE, Luciana Akutsu; GALANTE, Mariana Cappelletti; GAIOTTO, Fabio Antonio; BACAL, FernandoBackground: Chagas' disease (CD) is an important cause of heart transplantation (HT). The main obstacle is Chagas' disease reactivation (CDR), usually associated to high doses of immunosuppressants. Previous studies have suggested an association of mycophenolate mofetil with increased CDR. However, mortality predictors are unknown.Objectives: To identify mortality risk factors in heart transplant patients with CD and the impact of antiproliferative regimen on survival.Methods: Retrospective study with CD patients who underwent HT between January 2004 and September 2020, under immunosuppression protocol that prioritized azathioprine and change to mycophenolate mofetil in case of rejection. We performed univariate regression to identify mortality predictors; and compared survival, rejection and evidence of CDR between who received azathioprine, mycophenolate mofetil and those who changed from azathioprine to mycophenolate mofetil after discharge (""Change"" group). A p-value < 0.05 was considered statistically significant. Results: Eighty-five patients were included, 54.1% men, median age 49 (39-57) years, and 91.8% were given priority in waiting list. Nineteen (22.4%) used azathioprine, 37 (43.5%) mycophenolate mofetil and 29 (34.1%) switched therapy; survival was not different between groups, 2.9 (1.6-5.0) x 2.9 (1.8-4.8) x 4.2 (2.0-5.0) years, respectively; p=0.4. There was no difference in rejection (42%, 73% and 59% respectively; p=0.08) or in CDR (T. cruzi positive by endomyocardial biopsy 5% x 11% x 7%; p=0.7; benznidazole use 58% x 65% x 69%; p=0.8; positive PCR for T. cruzi 20% x 68% x 42% respectively; p=0.1) rates.Conclusions: This retrospective study did not show difference in survival in heart transplant patients with CD receiving different antiproliferative regimens. Mycophenolate mofetil was not associated with statistically higher rates of CDR or graft rejection in this cohort. New randomized clinical trials are necessary to address this issue.
- Diretriz de Assistência Circulatória Mecânica da Sociedade Brasileira de Cardiologia(2016) AYUB-FERREIRA, Silvia Moreira; SOUZA NETO, Joao David de; ALMEIDA, Dirceu Rodrigues; BISELLI, Bruno; AVILA, Monica Samuel; COLAFRANCESCHI, Alexandre Siciliano; STEFANELLO, Bianca; CARVALHO, Braulio Matias de; POLANCZYK, Carisi Anne; GALANTINI, Danilo Ribeiro; BOCCHI, Edimar Alcides; CHAMLIAN, Eduardo Gregorio; HOJAIJ, Elaine Marques; GAIOTTO, Fabio Antonio; PINTON, Fabio Augusto; JATENE, Fabio Biscegli; RAMIRES, Felix Jose Alvarez; ATIK, Fernando Antibas; FIGUEIRA, Fernando; BACAL, Fernando; GALAS, Filomena Regina Barbosa Gomes; BRITO, Flavio de Souza; CONCEICAO-SOUZA, Germano Emilio; RIBEIRO, Gustavo Calado de Aguiar; PINHEIRO JUNIOR, Jairo Alves; SOUZA, Januario Manoel de; ROSSI NETO, Joao Manoel; LIMA, Jose Lindemberg da Costa; MEJIA, Juan Cosquillo; FERNANDES, Juliana Rolim; BAUMWORCEL, Leonardo; MOURA, Lidia Ana Zytynski; HAJJAR, Ludhmila Abrahao; BECK-DA-SILVA, Luis; ROHDE, Luis Eduardo Paim; SEGURO, Luis Fernando Bernal da Costa; PINHEIRO, Mabel Leite; PARK, Marcelo; FERNANDES, Marcelo Ramalho; MONTERA, Marcelo Westerlund; ALVES, Marco Stephan Lofrano; WANDERLEY JUNIOR, Mauro Rogerio de Barros; HOSSNE, Nelson; FERNANDES, Paulo Manuel Pego; LEMOS, Pedro; SCHNEIDEWIND, Rafael Otto; UCHOA, Ricardo Barreira; HONORATO, Ronaldo; MANGINI, Sandrigo; FALCAO, Sandra Nivea dos Reis Saraiva; LOPES, Sergio Augusto Veiga; STRABELLI, Tania Mara Varejao; GUIMARAES, Tereza Cristina Felippe; CAMPANILI, Ticiane Carolina Goncalves Faustino; ISSA, Victor Sarli
- 3rd Brazilian Directive on Cardiac Transplantation(2018) BACAL, Lemando; MARCONDES-BRAGA, Fabiana C.; ROHDE, Luis Eduardo Paim; XAVIER JUNIOR, Jose Leudo; BRITO, Flavio de Souza; MOURA, Lidia Ana Zytynski; COLAFRANCESCHI, Alexandre Siciliano; LAVAGNOLI, Carlos Fernando Ramos; GELAPE, Claudio Leo; ALMEIDA, Dirceu Rodrigues; GAIOTTO, Fabio Antonio; ATIK, Fernando Antibas; FIGUEIRA, Fernando Augusto M. S.; SOUZA, Germano Emilio Conceicao; RODRIGUES, Helcio; CAMPOS, Iascara Wozniak; SOUZA NETO, Joao David de; ROSSI NETO, Joao Manoel; GASPARETTO, Juliano; GOLDRAICH, Livia Adams; BENVENUTI, Luiz Alberto; SEGURO, Luis Fernando B. C.; ULHOA JUNIOR, Marcelo Boteiho; V, Maria da Consolacao Moreira; AVILA, Monica Samuel; CARNEIRO, Rodrigo; MANGINI, Sandrigo; FERREIRA, Silvia Moreira Ayub; STRABELLI, Tania Mara
- Emerging Topics in Heart Failure: Interventional Heart Failure Therapies(2020) ROSSI NETO, Joao Manoel; ALMEIDA, Dirceu Rodrigues de; ATIK, Fernando Antibas; AVILA, Monica Samuel; BONATTO, Marcely Gimenes
- Emerging Topics Update of the Brazilian Heart Failure Guideline-2021(2021) MARCONDES-BRAGA, Fabiana G.; MOURA, Lidia Ana Zytynski; ISSA, Victor Sarli; VIEIRA, Jefferson Luis; ROHDE, Luis Eduardo; SIMOES, Marcus Vinicius; FERNANDES-SILVA, Miguel Morita; RASSI, Salvador; ALVES, Silvia Marinho Martins; ALBUQUERQUE, Denilson Campos de; ALMEIDA, Dirceu Rodrigues de; BOCCHI, Edimar Alcides; RAMIRES, Felix Jose Alvarez; BACAL, Fernando; ROSSI NETO, Joao Manoel; DANZMANN, Luiz Claudio; MONTERA, Marcelo Westerlund; OLIVEIRA JUNIOR, Mucio Tavares de; CLAUSELL, Nadine; SILVESTRE, Odilson Marcos; BESTETTI, Reinaldo Bulgarelli; BERNADEZ-PEREIRA, Sabrina; JR, Aguinaldo F. Freitas; BIOLO, Andreia; BARRETTO, Antonio Carlos Pereira; JORGE, Antonio Jose Lagoeiro; BISELLI, Bruno; MONTENEGRO, Carlos Eduardo Lucena; SANTOS JUNIOR, Edval Gomes Dos; FIGUEIREDO, Estevao Lanna; FERNANDES, Fabio; SILVEIRA, Fabio Serra; ATIK, Fernando Antibas; BRITO, Flavio de Souza; SOUZA, Germano Emilio Conceicao; RIBEIRO, Gustavo Calado de Aguiar; VILLACORTA, Humberto; SOUZA NETO, Joao David de; GOLDRAICH, Livia Adams; BECK-DA-SILVA, Luis; CANESIN, Manoel Fernandes; BITTENCOURT, Marcelo Imbroinise; BONATTO, Marcely Gimenes; MOREIRA, Maria da Consolacao Vieira; AVILA, Monica Samuel; COELHO FILHO, Otavio Rizzi; SCHWARTZMANN, Pedro Vellosa; MOURILHE-ROCHA, Ricardo; MANGINI, Sandrigo; FERREIRA, Silvia Moreira Ayub; FIGUEIREDO NETO, Jose Albuquerque de; MESQUITA, Evandro Tinoco
- The first cardiac transplant experience in a patient with mucopolysaccharidosis(2012) GRINBERG, Henrique; QUAIO, Caio Robledo D'Angioli Costa; AVILA, Monica Samuel; FERREIRA, Silvia Moreira Ayub; VIEIRA, Marcelo Luiz Campos; BENVENUTI, Luiz Alberto; KIM, Chong Ae; BOCCHI, Edimar AlcidesHunter syndrome (MPSII) is a rare X-linked lysosomal storage disorder that can affect multiple systems but primarily affects the heart. We report the case of a previously asymptomatic 23-year-old patient who had an attenuated form of MPSII and presented with refractory heart failure that required a heart transplant. The diagnosis was confirmed by detection of an increase in urinary excretion of glycosaminoglycans, a deficiency in enzymatic activity, and molecular analysis. A myocardial biopsy revealed hypertrophic cardiomyocytes, mild fibrosis, and lysosomal storage in interstitial cells. Molecular analysis identified a novel mutation in the iduronate-2-sulfatase gene. Although the clinical outcome was not favorable, we believe that this approach may be valid in end-stage heart failure.
- Carvedilol for Prevention of Chemotherapy-Related Cardiotoxicity(2018) AVILA, Monica Samuel; AYUB-FERREIRA, Silvia Moreira; WANDERLEY JR., Mauro Rogerio de Barros; CRUZ, Fatima das Dores; BRANDAO, Sara Michelly Goncalves; RIGAUD, Vagner Oliveira Carvalho; HIGUCHI-DOS-SANTOS, Marilia Harumi; HAJJAR, Ludhmila Abrahao; KALIL FILHO, Roberto; HOFF, Paulo Marcelo; SAHADE, Marina; FERRARI, Marcela S. M.; COSTA, Romulo Leopoldo de Paula; MANO, Max Senna; CRUZ, Cecilia Beatriz Bittencourt Viana; ABDUCH, Maria Cristina; ALVES, Marco Stephan Lofrano; GUIMARAES, Guilherme Veiga; ISSA, Victor Sarli; BITTENCOURT, Marcio Sommer; BOCCHI, Edimar AlcidesBACKGROUND Anthracycline (ANT) chemotherapy is associated with cardiotoxicity. Prevention with beta-blockers remains controversial. OBJECTIVES This prospective, randomized, double-blind, placebo-controlled study sought to evaluate the role of carvedilol in preventing ANT cardiotoxicity. METHODS The authors randomized 200 patients with HER2-negative breast cancer tumor status and normal left ventricular ejection fraction (LVEF) referred for ANT (240 mg/m(2)) to receive carvedilol or placebo until chemotherapy completion. The primary endpoint was prevention of a >= 10% reduction in LVEF at 6 months. Secondary outcomes were effects of carvedilol on troponin I, B-type natriuretic peptide, and diastolic dysfunction. RESULTS Primary endpoint occurred in 14 patients (14.5%) in the carvedilol group and 13 patients (13.5%) in the placebo group (p = 1.0). No differences in changes of LVEF or B-type natriuretic peptide were noted between groups. A significant difference existed between groups in troponin I levels over time, with lower levels in the carvedilol group (p = 0.003). Additionally, a lower incidence of diastolic dysfunction was noted in the carvedilol group (p = 0.039). A nonsignificant trend toward a less-pronounced increase in LV end-diastolic diameter during the follow-up was noted in the carvedilol group (44.1 +/- 3.64 mm to 45.2 +/- 3.2 mm vs. 44.9 +/- 3.6 mm to 46.4 +/- 4.0 mm; p = 0.057). CONCLUSIONS In this largest clinical trial of beta-blockers for prevention of cardiotoxicity under contemporary ANT dosage, the authors noted a 13.5% to 14.5% incidence of cardiotoxicity. In this scenario, carvedilol had no impact on the incidence of early onset of LVEF reduction. However, the use of carvedilol resulted in a significant reduction in troponin levels and diastolic dysfunction.(Carvedilol Effect in Preventing Chemotherap-Induced Cardiotoxicity [CECCy] NCTO1724450)(C) 2018 by the American College of Cardiology Foundation.