MARCIO SILVA MIGUEL LIMA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
15 resultados
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bookPart Miocardiopatia Dilatada(2016) LIMA, Marta Fernandes; VOOS, Mariana Callil; LIMA, Marcio Silva Miguel- 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- Influence of Physical Training after a Myocardial Infarction on Left Ventricular Contraction Mechanics(2023) LIMA, Marcio Silva Miguel; DALCOQUIO, Talia Falcao; ABDUCH, Maria Cristina Donadio; TSUTSUI, Jeane Mike; MATHIAS, Wilson; NICOLAU, Jose CarlosBackground: Exercise plays a positive role in the course of the ischemic heart disease, enhancing functional capacity and preventing ventricular remodeling.Objective: To investigate the impact of exercise on left ventricular (LV) contraction mechanics after an uncomplicated acute myocardial infarction (AMI).Methods: A total of 53 patients was included, 27 of whom were randomized to a supervised training program (TRAINING group), and 26 to a CONTROL group, who received usual recommendations on physical exercise after AMI. All patients underwent cardiopulmonary stress testing and a speckle tracking echocardiography to measure several parameters of LV contraction mechanics at one month and five months after AMI. A p value < 0.05 was considered statistically significant in the comparisons of the variables.Results: No significant difference was found in the analysis of LV longitudinal, radial and circumferential strain parameters between groups after the training period. After the training program, analysis of torsional mechanics demonstrated a reduction in the LV basal rotation in the TRAINING group in comparison to the CONTROL group (5.9 +/- 2.3 vs. 7.5 +/- 2.9o; p=0.03), and in the basal rotational velocity (53.6 +/- 18.4 vs.68.8 +/- 22.1 degrees/s; p=0.01), twist velocity (127.4 +/- 32.2 vs. 149.9 +/- 35.9 degrees/s; p=0.02) and torsion (2.4 +/- 0.4 vs. 2.8 +/- 0.8 degrees/cm; p=0.02).Conclusions: Physical activity did not cause a significant improvement in LV longitudinal, radial and circumferential deformation parameters. However, the exercise had a significant impact on the LV torsional mechanics, consisting of a reduction in basal rotation, twist velocity, torsion and torsional velocity which can be interpreted as a ventricular ""torsion reserve"" in this population.
bookPart Avaliação ecocardiográfica no esforço(2019) LIMA, Márcio Silva Miguel; FALCãO, Sandra Nívea Reis Saraiva; TSUTSUI, Jeane Mike; JR, Wilson Mathias- 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.
- Indeterminate form of Chagas disease: is left ventricular torsional mechanics a clue to subclinical myocardial abnormalities?(2017) LIMA, Marcio Silva Miguel; VOOS, Mariana Callil; MATHIAS JR., Wilson; TSUTSUIL, Jeane MikeBackground Chagas disease (CD) is highly endemic in Latin America, and has been emerging in developed countries. Early diagnosis of left ventricular (LV) systolic dysfunction, routinely done by echocardiography, is crucial for therapy. Speckle tracking echocardiography allows determination of LV segmental rotations, twist/torsion, and this analysis may disclose an unapparent myocardial contractile deficit in initial stages of CD. Therefore, this study aimed to highlight a possible unapparent myocardial contractile deficit in CD indeterminate form (IF) by a comprehensive torsional mechanics analysis. Methods Patients with CDIF diagnosis, initial chagasic cardiomyopathy (CCMP characterized by ECG abnormalities and LVEF > 0.55), and normal controls were prospectively enrolled, and underwent conventional echocardiogram with images acquisition for STE offline analysis. Target parameters were basal and apical rotations, and calculation of twist and torsion. Results A total of 42 patients were included (CDIF, eight; CCMP, 13; and 21 controls). Chagasic patients had a mean age of 55 years, five (24 %) men, and controls, 50 years, seven (33 %) men. Torsional mechanics analyzes resulted in no significant difference in all parameters studied between groups. Twist in CDIF was 20.8A degrees A +/- 6.5A degrees; CCMP, 19.0A degrees A +/- 3.5A degrees and controls, 19.7A degrees A +/- 3.7A degrees (p = 0.67). Torsion in CDIF was 2.6A degrees A +/- 0.8A degrees; CCMP, 2.4A degrees A +/- 0.6A degrees and controls, 2.4A degrees A +/- 0.5A degrees (p = 0.63). Conclusion Patients with Chagas disease have no abnormalities in torsional mechanics during its indeterminate and initial cardiomyopathy stages.
- Position Statement on the Use of Myocardial Strain in Cardiology Routines by the Brazilian Society of Cardiology's Department Of Cardiovascular Imaging-2023(2023) ALMEIDA, Andre Luiz Cerqueira; MELO, Marcelo Dantas Tavares de; BIHAN, David Costa de Souza Le; VIEIRA, Marcelo Luiz Campos; PENA, Jose Luiz Barros; CASTILLO, Jose Maria Del; ABENSUR, Henry; HORTEGAL, Renato de Aguiar; OTTO, Maria Estefania Bosco; PIVETA, Rafael Bonafim; DANTAS, Maria Rosa; ASSEF, Jorge Eduardo; BECK, Adenalva Lima de Souza; SANTO, Thais Harada Campos Espirito; SILVA, Tonnison de Oliveira; SALEMI, Vera Maria Cury; ROCON, Camila; LIMA, Marcio Silva Miguel; BARBERATO, Silvio Henrique; RODRIGUES, Ana Clara; RABSCHKOWISKY, Arnaldo; FROTA, Daniela do Carmo Rassi; GRIPP, Eliza de Almeida; BARRETTO, Rodrigo Bellio de Mattos; SILVA, Sandra Marques e; CAUDURO, Sanderson Antonio; PINHEIRO, Aurelio Carvalho; ARAUJO, Salustiano Pereira de; TRESSINO, Cintia Galhardo; SILVA, Carlos Eduardo Suaide; MONACO, Claudia Gianini; PAIVA, Marcelo Goulart; FISHER, Claudio Henrique; ALVES, Marco Stephan Lofrano; GRAU, Claudia R. Pinheiro de Castro; SANTOS, Maria Veronica Camara dos; GUIMARAES, Isabel Cristina Britto; MORHY, Samira Saady; LEAL, Gabriela Nunes; SOARES, Andressa Mussi; CRUZ, Cecilia Beatriz Bittencourt Viana; GUIMARAES FILHO, Fabio Villaca; ASSUNCAO, Bruna Morhy Borges Leal; FERNANDES, Rafael Modesto; SARAIVA, Roberto Magalhaes; TSUTSUI, Jeane Mike; SOARES, Fabio Luis de Jesus; FALCAO, Sandra Nivea dos Reis Saraiva; HOTTA, Viviane Tiemi; ARMSTRONG, Anderson da Costa; HYGIDIO, Daniel de Andrade; MIGLIORANZA, Marcelo Haertel; CAMAROZANO, Ana Cristina; LOPES, Marly Maria Uellendahl; CERCI, Rodrigo Julio; SIQUEIRA, Maria Eduarda Menezes de; TORREAO, Jorge Andion; ROCHITTE, Carlos Eduardo; FELIX, Alex
- 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 MikeBackground: 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.
conferenceObject Does acute cellular rejection affect all the cardiac segments in the heart transplant? An approach by speckle tracking echocardiography(2017) CRUZ, C. B. Bittencourt Viana; ALVES, M. S. Lofrano; VIEIRA, M. L. Campos; SBANO, J. C. Nunes; ABDUCH, M. C. Donadio; SALVIANO, J. Bittencourt Cruz; MATHIAS JR., W.; LIMA, M. Silva Miguel; AGUIAR, M. O. Dias; HAJJAR, L. Abrahao; BACAL, F.; TSUTSUI, J. Mike