FABIO SANDOLI DE BRITO JUNIOR
Índice h a partir de 2011
11
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
58 resultados
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- Myocardial Injury After Transcatheter Mitral Valve Replacement Versus Surgical Reoperation(2024) MARCHI, Mauricio Felippi de Sa; ROSA, Vitor Emer Egypto; NICZ, Pedro Felipe Gomes; FONSECA, Jose Honorio de Almeida Palma da; CALOMENI, Pedro; CHIODINI, Fernando; SAMPAIO, Roney Orismar; POMERANTZEFF, Pablo Maria Alberto; VIEIRA, Marcelo de Campos; TARASOUTCHI, Flavio; MIEGHEM, Nicolas M. Van; BRITO, Fabio Sandoli de; ABIZAID, Alexandre; RIBEIRO, Henrique BarbosaThis study aimed to evaluate the incidence and clinical implications of myocardial injury, as determined by cardiac biomarker increase, in patients who underwent mitral bioprosthesis dysfunction treatment with transcatheter mitral valve replacement (TMVR) versus surgical mitral valve replacement reoperation (SMVR-REDO). Between 2014 and 2023, 310 patients with mitral bioprosthesis failure were included (90 and 220 patients for TMVR and SMVR-REDO, respectively). Multivariable analysis and propensity score matching were performed to adjust for the intergroup differences in baseline characteristics. Creatinine kinase-MB (CK-MB) and cardiac troponin I (cTn) were collected at baseline and 6 to 12, 24, 48, and 72 hours after intervention. The cardiac biomarkers values were evaluated in relation to their reference values. The outcomes were determined according to the Mitral Valve Academic Research Consortium criteria. CK-MB and cTn increased above the reference level in almost all patients after SMVR-REDO and TMVR (100% vs 94%, respectively), with the peak occurring within 6 to 12 hours. SMVR-REDO was associated with a two- to threefold higher increase in cardiac biomarkers. After 30 days, the mortality rates were 13.3% in the TMVR and 16.8% in the SMVR-REDO groups. At a median follow-up of 19 months, the mortality rates were 21.1% in the TMVR and 17.7% in the SMVR-REDO groups. Left ventricular ejection fraction, estimated glomerular filtration rate, CK-MB, and cTn were predictors of mortality. In conclusion, some degree of myocardial injury occurred systematically after the treatment of mitral bioprosthetic degeneration, especially after SMVR, and higher CK-MB and cTn levels were associated with increased cumulative late mortality, regardless of the approach.
conferenceObject Atrial Fibrillation in Patients Undergoing Transcatheter Aortic Valve Implantation Is Associated With Increased Mortality(2021) NIEUWKERK, Astrid van; BLANCO, Roberto; TCHETCHE, Didier; BRITO JR., Fabio; BARBANTI, Marco; KORNOWSKI, Ran; LATIB, Azeem; D'ONOFRIO, Augusto; RIBICHINI, Flavio; DOMINGUEZ, Juan Francisco Oteo; DUMONTEIL, Nicolas; ABIZAID, Alexandre; BAAN, Jan; SARTORI, Samantha; D'ERRIGO, Paola; TARANTINI, Giuseppe; LUNARDI, Mattia; ORVIN, Katia; GHATTAS, Angie; PAGNESI, Matteo; DANGAS, George; MEHRAN, Roxana; DELEWI, Ronak- Seattle Angina Pectoris Questionnaire and Canadian Cardiovascular Society Angina Categories in the Assessment of Total Coronary Atherosclerotic Burden(2021) GUIMARAES, Welingson Vanucci Negreiros; NICZ, Pedro Felipe Gomes; GARCIA-GARCIA, Hector M.; ABIZAID, Alexandre; SANTOS, Luciano de Moura; ROSA, Vitor E.; RIBEIRO, Marcelo Harada; MEHTA, Sameer; RIBEIRO, Expedito; LEMOS, Pedro A.; BRITO JR., Fabio S.; HAJJAR, Ludhmila; KALIL FILHO, Roberto; CAMPOS, Carlos M.The patient reported angina measurement with the Seattle Angina Questionnaire (SAQ) has shown to have prognostic implications and became an endpoint in clinical trials. Our objective was to study physician-reported and SAQ severity with the total coronary atherosclerotic burden as assessed by 4 angiographic scores. We prospectively analyzed data of consecutive patients scheduled for coronary angiography or percutaneous coronary intervention. The Canadian Cardiovascular Society (CCS) angina categories was used as physician-reported angina. SAQ domains were categorized as severe (0 to 24), moderate 25 to 75 and mild angina (>75). All angina assessments were done before coronary angiography. Gensini, Syntax, Friesinger, and Sullivan angiographic scores were used for total atherosclerotic burden quantification: 261 patients were included in the present analysis. The median age was 66.0 (59.0 to 71.8) years, 53.6% were male and 43.7% had diabetes. The median SYNTAX score was 6.0 (0 to 18.0). The worse the symptoms of CCS categories, the more severe was the atherosclerotic burden in all angiographic scores: SYNTAX (p = 0.01); Gensini (p<0.01); Friesinger (p = 0.02) and Sullivan (p = 0.03). Conversely, SAQ domains were not able to discriminate the severity of CAD in any of the scores. The only exception was the severe SAQ quality of life that had worse Gensini score than the mild SAQ quality of life (p = 0.04). In conclusion, CCS angina categories are related to the total atherosclerotic burden in coronary angiography, by all angiographic scores. SAQ domains should be used as a measure of patient functionality and quality of life but not as a measure of CAD severity. (C) 2021 Published by Elsevier Inc.
conferenceObject Patients With Previous Cerebrovascular Events Undergoing Transcatheter Aortic Valve Implantation Have More Periprocedural Strokes(2023) NIEUWKERK, Astrid van; AARTS, Hugo; HEMELRIJK, Kimberley; CARRILLO, Cristobal A. Urbano; TCHETCHE, Didier; BRITO JR., Fabio; BARBANTI, Marco; KORNOWSKI, Ran; LATIB, Azeem; D'ONOFRIO, Augusto; RIBICHINI, Flavio; GARCIA-BLAS, Sergio; DUMONTEIL, Nicolas; ABIZAID, Alexandre; SARTORI, Samantha; D'ERRIGO, Paola; TARANTINI, Giuseppe; LUNARDI, Mattia; ORVIN, Katia; PAGNESI, Matteo; DANGAS, George; MEHRAN, Roxana; DELEWI, RonakconferenceObject Balloon-Expandable or Self-Expandable Valves in Valve-in-Valve Transcatheter Aortic Valve Implantation?(2021) NIEUWKERK, Astrid Van; FERNANDEZ-NOFRERIAS, Eduard; TCHETCHE, Didier; BRITO JR., Fabio; BARBANTI, Marco; KORNOWSKI, Ran; LATIB, Azeem; D'ONOFRIO, Augusto; RIBICHINI, Flavio; TELLO, Vicente Mainar; DUMONTEIL, Nicolas; BAAN, Jan; ABIZAID, Alexandre; SARTORI, Samantha; D'ERRIGO, Paola; TARANTINI, Giuseppe; LUNARDI, Mattia; ORVIN, Katia; PAGNESI, Matteo; GHATTAS, Angie; DANGAS, George; MEHRAN, Roxana; DELEWI, Ronak- Quantitative aortography assessment of aortic regurgitation(2020) MODOLO, Rodrigo; CHANG, Chun Chin; ONUMA, Yoshinobu; SCHULTZ, Carl J.; TATEISHI, Hiroki; ABDELGHANI, Mohammad; MIYAZAKI, Yosuke; ABEN, Jean-Paul; RUTTEN, Marcel C. M.; PIGHI, Michele; BOUZIANI, Abdelhak El; MOURIK, Martijn van; LEMOS, Pedro A.; WYKRZYKOWSKA, Joanna; BRITO JR., Fabio Sandoli de; SAHYOUN, Cherif; PIAZZA, Nicolo; ELTCHANINOFF, Helene; SOLIMAN, Osama; ABDEL-WAHAB, Mohamed; MIEGHEM, Nicolas M. Van; WINTER, Robbert de; SERRUYS, Patrick W.
conferenceObject EFFECTIVE NEOINTIMAL REDUCTION WITH TWO NOVEL DRUG-ELUTING STENTS COATED WITH BIODEGRADABLE POLYMER - AN INTRAVASCULAR ULTRASOUND ANALYSIS FROM THE PAINT RANDOMIZED TRIAL(2012) MEDEIROS, Cesar; MOULIN, Bruno; ARRUDA, Airton; PERIN, Marco; OLIVEIRA, Ludmilla; LIMA, Valter; LIMA, Antonio Augusto; CARAMORI, Paulo; BARBOSA, Mauricio; BRITO, Fabio; RIBEIRO, Expedito; MARTINEZ, Eulogio; LEMOS, PedroBackground: Sirolimus and Paclitaxel are well known anti-restenosis agents; they have been tested in different stents with different platforms and polymers. Methods: We aim to compare the neointimal inhibition efficacy of two drug eluting stents with identical platforms and biodegradable polymers, but with different drugs (Sirolimus or Paclitaxel) against bare metal stents (BMS) by intravascular ultrasound (IVUS). From the 274 patient (pts) randomized in the PAINT trial, who had a stent implanted in a de novo lesion in a native vessel, a pre-defined subset of 110 patients underwent 9-month IVUS follow-up. Patients were randomly allocated at a 2:2:1 ratio for sirolimus-eluting stent (SES; n=45), paclitaxel-eluting stent (PES; n=45), or BMS (n=20). All IVUS analyses were performed by a technician blinded to the study group. Results: There were no differences in the stent length or stent area among the three groups. Incomplete apposition was found in 2 pts (1 in the BMS and 1 in the SES group). The average neointimal hyperplasia (NIH) area was 0.8 ± 0.9 mm2, 1.0 ± 1,2 mm2, and 1.8 ± 1.3 mm2, for the SES, PES, and BMS groups respectively (p = 0,004 for the overall comparison). Also, the NIH obstruction was 12.0 ± 11.9%, 12.9 ± 13.3%, and 24.9 ± 15.8% respectively (p = 0,002). There were no differences in the NIH parameters for the comparison of SES vs. PES. There were no differences in the analysis of the stent edge portions. Conclusions: Both sirolimus- and paclitaxel-eluting stents coated with a novel biodegradable polymer carrier were effective in inhibiting neointimal hyperplasia, in comparison to bare stents. The efficacy of both formulations of drug-eluting stents, releasing either sirolimus or paclitaxel, did not appear to be different when compared in a head-to-head analysis by IVUS.- Improvement of renal function after transcatheter aortic valve replacement in patients with chronic kidney disease(2021) SILVA, Michel V. Lemes da; NUNES FILHO, Antonio C. B.; ROSA, Vitor E. E.; CAIXETA, Adriano; LEMOS NETO, Pedro A.; RIBEIRO, Henrique B.; ALMEIDA, Breno O.; MARIANI JR., Jose; CAMPOS, Carlos M.; ABIZAID, Alexandre A. C.; MANGIONE, Jose A.; SAMPAIO, Roney O.; CARAMORI, Paulo; SARMENTO-LEITE, Rogerio; TARASOUTCHI, Flavio; FRANKEN, Marcelo; BRITO JR., Fabio S. deBackground Chronic kidney disease is commonly found in patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) and has marked impact in their prognosis. It has been shown however that TAVR may improve renal function by alleviating the hemodynamic barrier imposed by AS. Nevertheless, the predictors of and clinical consequences of renal function improvement are not well established. Our aim was to assess the predictors of improvement of renal function after TAVR. Methods The present work is an analysis of the Brazilian Registry of TAVR, a national non-randomized prospective study with 22 Brazilian centers. Patients with baseline renal dysfunction (estimated glomerular filtration rate [eGFR] < 60mL/min/1.73m(2)) were stratified according to renal function after TAVR: increase >10% in eGFR were classified as TAVR induced renal function improvement (TIRFI); decrease > 10% in eGFR were classified as acute kidney injury (AKI) and stable renal function (neither criteria). Results A total of 819 consecutive patients with symptomatic severe AS were included. Of these, baseline renal dysfunction (estimated glomerular filtration rate [eGFR] < 60mL/min/1.73m(2)) was present in 577 (70%) patients. Considering variance in renal function between baseline and at discharge after TAVR procedure, TIRFI was seen in 197 (34.1%) patients, AKI in 203 (35.2%), and stable renal function in 177 (30.7%). The independent predictors of TIRFI were: absence of coronary artery disease (OR: 0.69; 95% CI 0.48-0.98; P = 0.039) and lower baseline eGFR (OR: 0.98; 95% CI 0.97-1.00; P = 0.039). There was no significant difference in 30-day and 1-year all-cause mortality between patients with stable renal function or TIRFI. Nonetheless, individuals that had AKI after TAVR presented higher mortality compared with TIRFI and stable renal function groups (29.3% vs. 15.4% vs. 9.5%, respectively; p < 0.001). Conclusions TIRFI was frequently found among baseline impaired renal function individuals but was not associated with improved 1-year outcomes.
- Quantitative Assessment of Acute Regurgitation Following TAVR A Multicenter Pooled Analysis of 2,258 Valves(2020) MODOLO, Rodrigo; CHANG, Chun Chin; ABDELGHANI, Mohammad; KAWASHIMA, Hideyuki; ONO, Masafumi; TATEISHI, Hiroki; MIYAZAKI, Yosuke; PIGHI, Michele; WYKRZYKOWSKA, Joanna J.; WINTER, Robbert J. de; RUCK, Andreas; CHIEFFO, Alaide; MOURIK, Martijn S. van; YAMAJI, Kyohei; BRITO JR., Fabio S. de; LEMOS, Pedro A.; AL-KASSOU, Baravan; PIAZZA, Nicolo; TCHETCHE, Didier; SINNING, Jan-Malte; ABDEL-WAHAB, Mohamed; SOLIMAN, Osama; SONDERGAARD, Lars; MYLOTTE, Darren; ONUMA, Yoshinobu; MIEGHEM, Nicolas M. Van; SERRUYS, Patrick W.OBJECTIVES The aim of this study was to assess acute regurgitation following transcatheter aortic valve replacement, comparing different implanted transcatheter heart valves. BACKGROUND Regurgitation following transcatheter aortic valve replacement in fluences all -cause mortality. Thus far, no quantitative comparison of regurgitation among multiple commercially available transcatheter heart valves has been performed. METHODS Aortograms from a multicenter cohort of consecutive 3,976 transcatheter aortic valve replacements were evaluated in this pooled analysis. A total of 2,258 (58.3%) were considered analyzable by an independent academic core laboratory using video densitometry. Results of quantitative regurgitation are shown as percentages. The valves eval- uated were the ACURATE (n = 115), Centera (n = 11), CoreValve (n = 532), Direct Flow Medical (n = 21), Evolut PRO (n = 95), Evolut R (n = 295), Inovare (n = 4), Lotus (n = 546), Lotus Edge (n = 3), SAPIEN XT (n = 239), and SAPIEN 3 (n = 397). For the main analysis, only valves with more than 50 procedures (7 types) were used. RESULTS The Lotus valve had the lowest mean regurgitation (3.5 +/- 4.4%), followed by Evolut PRO (7.4 +/- 6.5%), SAPIEN 3 (7.6 +/- 7.1%), Evolut R (7.9 +/- 7.4%), SAPIEN XT (8.8 +/- 7.5%), ACURATE (9.6 +/- 9.2%) and CoreValve (13.7 +/- 10.7%) (analysis of variance p < 0.001). The only valves that statistically differed from all their counterparts were Lotus (as the lowest regurgitation) and CoreValve (the highest). The proportion of patients presenting with moderate or severe regurgitation followed the same ranking order: Lotus (2.2%), Evolut PRO (5.3%), SAPIEN 3 (8.3%), Evolut R (8.8%), SAPIEN XT (10.9%), ACURATE (11.3%), and CoreValve (30.1%) (chi-square p < 0.001). CONCLUSIONS In this pooled analysis stemming from daily clinical practice, the Lotus valve was shown to have the best immediate sealing. This analysis re flects the objective evaluation of regurgitation by an academic core laboratory (nonsponsored) in a real -world cohort of patients using a quantitative technique.
conferenceObject Percutaneous Tricuspid Valve-in- Valve Implantation in Failed Surgical Bioprosthetic Valves: Brazilian Single Center Registry(2023) FILIPPINI, Filippe; BRATZ, Guilherme; SESSA, Bruno; MOREIRA, Cauyna Gurgel; HATTORI, Mario; COIMBRA, Germana; CASSAR, Renata; FREIRE, Antonio Fernando; RIBEIRO, Henrique; ABIZAID, Alexandre; BRITO JR., Fabio; ARRIETA, Raul