MARCIO SILVA MIGUEL LIMA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- 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.
- Usefulness of speckle tracking echocardiography and biomarkers for detecting acute cellular rejection after heart transplantation (vol 19, 6, 2021)(2021) CRUZ, Cecilia Beatriz Bittencourt Viana; HAJJAR, Ludhmila A.; BACAL, Fernando; LOFRANO-ALVES, Marco S.; LIMA, Marcio S. M.; ABDUCH, Maria C.; VIEIRA, Marcelo Luiz Campos; CHIANG, Hsu P.; SALVIANO, Juliana B. C.; COSTA, Isabela Bispo Santos da Silva; FUKUSHIMA, Julia Tizue; SBANO, Joao C. N.; MATHIAS JR., Wilson; TSUTSUI, Jeane M.An amendment to this paper has been published and can be accessed via the original article.
- Usefulness of speckle tracking echocardiography and biomarkers for detecting acute cellular rejection after heart transplantation(2021) CRUZ, Cecilia Beatriz Bittencourt Viana; HAJJAR, Ludhmila A.; BACAL, Fernando; LOFRANO-ALVES, Marco S.; LIMA, Marcio S. M.; ABDUCH, Maria C.; VIERA, Marcelo L. C.; CHIANG, Hsu P.; SALVIANO, Juliana B. C.; COSTA, Isabela Bispo Santos da Silva; FUKUSHIMA, Julia Tizue; SBANO, Joao C. N.; JR, Wilson Mathias; TSUTSUI, Jeane M.Background: Acute cellular rejection (ACR) is a major complication after heart transplantation. Endomyocardial biopsy (EMB) remains the gold standard for its diagnosis, but it has concerning complications. We evaluated the usefulness of speckle tracking echocardiography (STE) and biomarkers for detecting ACR after heart transplantation. Methods: We prospectively studied 60 transplant patients with normal left and right ventricular systolic function who underwent EMB for surveillance 6 months after transplantation. Sixty age- and sex-matched healthy individuals constituted the control group. Conventional echocardiographic parameters, left ventricular global longitudinal, radial and circumferential strain (LV-GLS, LV-GRS and LV-GCS, respectively), left ventricular systolic twist (LV-twist) and right ventricular free wall longitudinal strain (RV-FWLS) were analyzed just before the procedure. We also measured biomarkers at the same moment. Results: Among the 60 studied patients, 17 (28%) had severe ACR (grade >= 2R), and 43 (72%) had no significant ACR (grade 0 - 1R). The absolute values of LV-GLS, LV-twist and RV-FWLS were lower in transplant patients with ACR degree >= 2 R than in those without ACR (12.5% +/- 2.9% vs 14.8% +/- 2.3%, p=0.002; 13.9 degrees +/- 4.8 degrees vs 17.1 degrees +/- 3.2 degrees, p=0.048; 16.6% +/- 2.9% vs 21.4%+/- 3.2%, p < 0.001; respectively), while no differences were observed between the LV-GRS or LV-GCS. All of these parameters were lower in the transplant group without ACR than in the nontransplant control group, except for the LV-twist. Cardiac troponin I levels were significantly higher in patients with significant ACR than in patients without significant ACR [0.19 ng/mL (0.09-1.31) vs 0.05 ng/mL (0.01-0.18), p=0.007]. The combination of troponin with LV-GLS, RV-FWLS and LV-Twist had an area under curve for the detection of ACR of 0.80 (0.68-0.92), 0.89 (0.81-0.93) and 0.79 (0.66-0.92), respectively. Conclusion: Heart transplant patients have altered left ventricular dynamics compared with control individuals. The combination of troponin with strain parameters had higher accuracy for the detection of ACR than the isolated variables and this association might select patients with a higher risk for ACR who will benefit from an EMB procedure in the first year after heart transplantation.