CARLOS EDUARDO ROCHITTE

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/64, Hospital das Clínicas, Faculdade de Medicina - Líder

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  • article 4 Citação(ões) na Scopus
    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
  • article 0 Citação(ões) na Scopus
    ABC Cardiol - The Editor-in-Chief-Way Ahead in 2022 to 2025
    (2022) ROCHITTE, Carlos Eduardo
  • article 2 Citação(ões) na Scopus
    Cortical bone density by quantitative computed tomography mirrors disorders of bone structure in bone biopsy of non-dialysis CKD patients
    (2022) BITTENCOURT, Amandha L.; CANZIANI, Maria Eugenia F.; COSTA, Larissa D. B. R.; ROCHITTE, Carlos E.; CARVALHO, Aluizio B.
    Bone biopsy is still the gold standard tool to evaluate either trabecular or cortical bone, though the quantitative computed tomography of the vertebrae (QCT), a non-invasive technique, could be useful to evaluate bone structure in patients with chronic kidney disease (CKD). Cortical bone microstructure derangements have been associated with poor outcomes in the general population. An association between trabecular bone density, assessed by QCT, and bone volume and microarchitecture by histomorphometry, has been previously documented. This relationship has not yet been fully evaluated in cortical bone in the CKD scenario. The aim of this study was to evaluate the relationship among vertebrae density measured by QCT, structural histomorphometric parameters of cortical bone and biochemical and hormonal data in 50 CKD stage 2-5ND patients. This was a post hoc analysis of a cross-sectional study where cortical porosity and cortical thickness were analyzed in undecalcified bone samples from the iliac crest. The cortical bone density was obtained by QCT from the thoracic vertebrae. The patients were 52 +/- 10 years, 68% men, 30% diabetes and the estimated glomerular filtration rate 34 +/- 16 mL/min/1.73 m2. Cortical porosity was 4.6% (3.6; 6.6) and cortical thickness was 578.4 +/- 151.8 mu m, while cortical bone density was 149.2 +/- 58.3 HU. Cortical density correlated with cortical thickness (p = 0.001) but not with cortical porosity (p = 0.30). Higher porosity was associated with older age (p = 0.02), higher levels of PTH (p = 0.04) and lower renal function (p = 0.03), while smaller thickness was associated with higher levels of PTH (p = 0.02). Lower density was associated with older age (p = 0.02) and higher levels of PTH (p = 0.01). In conclusion, cortical bone density measured by QCT was able to mirror the cortical thickness of bone biopsy in pre-dialysis CKD patients. In addition, PTH action on cortical bone can be already seen in this population.
  • article 7 Citação(ões) na Scopus
    Perivascular fat attenuation for predicting adverse cardiac events in stable patients undergoing invasive coronary angiography
    (2022) CHATTERJEE, Devina; SHOU, Benjamin L.; MATHESON, Matthew B.; OSTOVANEH, Mohammad R.; ROCHITTE, Carlos; CHEN, Marcus Y.; DEWEY, Marc; ORTMAN, Jason; COX, Christopher; LIMA, Joao A. C.; ARBAB-ZADEH, Armin
    Background: Inflammation surrounding the coronary arteries can be non-invasively assessed using pericoronary adipose tissue attenuation (PCAT). While PCAT holds promise for further risk stratification of patients with low coronary artery disease (CAD) prevalence, its value in higher risk populations remains unknown. Methods: CORE320 enrolled patients referred for invasive coronary angiography with known or suspected CAD. Coronary computed tomography angiography (CCTA) images were collected for 381 patients for whom clinical outcomes were assessed 5 years after enrollment. Using semi-automated image analysis software, PCAT was obtained and normalized for the right coronary (RCA), left anterior descending (LAD), and left circumflex arteries (LCx). The association between PCAT and major adverse cardiovascular events (MACE) during follow up was assessed using Cox regression models. Results: Thirty-seven patients were excluded due to technical failure. For the remaining 344 patients, median age was 62 (interquartile range, 55-68) with 59% having >= 1 coronary artery stenosis of >= 50% by quantitative coronary angiography. Mean attenuation values for PCAT in RCA, LAD, and LCx were-74.9,-74.2, and-71.2, respectively. Hazard ratios and 95% confidence intervals (CI) for normalized PCAT in the RCA, LAD, and LCx for MACE were 0.96 (CI: 0.75-1.22, p = 0.71), 1.31 (95% CI: 0.96-1.78, p = 0.09), and 0.98 (95% CI: 0.78-1.22, p = 0.84), respectively. For death, stroke, or myocardial infarction only, hazard ratios were 0.68 (0.44-1.07), 0.85 (0.56-1.29), and 0.57 (0.41-0.80), respectively.Conclusions: In patients referred for invasive coronary angiography with suspected CAD, PCAT did not predict MACE during long term follow up. Further studies are needed to understand the relationship of PCAT with CAD risk.
  • conferenceObject
    Coronary inflammation by computed tomography pericoronary fat attenuation in young male anabolic androgenic steroid users
    (2022) SOUZA, F.; ROCHITTE, C. E.; SILVA, D. C.; GOMES, A. M. R.; SANTOS, M. R.; FONSECA, G. W. P.; BATTAGLIA, A. C. B. F.; CORREA, K. T. S.; YONAMINE, M.; PEREIRA, R. M. R.; NEGRAO, C. E.; ALVES, M. J. N. N.
  • article 2 Citação(ões) na Scopus
    Long-term prognostic value of late gadolinium enhancement and periprocedural myocardial infarction after uncomplicated revascularization: MASS-V follow-up
    (2022) LINHARES-FILHO, Jaime; HUEB, Whady; LIMA, Eduardo; REZENDE, Paulo; AZEVEDO, Diogo; ROCHITTE, Carlos; NOMURA, Cesar; SERRANO-JUNIOR, Carlos; RAMIRES, Jose; KALIL-FILHO, Roberto
    Aims Cardiac biomarkers elevation is common after revascularization, even in absence of periprocedural myocardial infarction (PMI) detection by imaging methods. Thus, late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) may be useful on PMI diagnosis and prognosis. We sought to evaluate long-term prognostic value of PMI and new LGE after revascularization. Methods and results Two hundred and two patients with multivessel coronary disease and preserved ventricular function who underwent elective revascularization were included, of whom 136 (67.3%) underwent coronary artery bypass grafting and 66 (32.7%) percutaneous coronary intervention. The median follow-up was 5 years (4.8-5.8 years). Cardiac biomarkers measurement and LGE-CMR were performed before and after procedures. The Society for Cardiovascular Angiography and Interventions definition was used to assess PMI. Primary endpoint was composed of death, infarction, additional revascularization, or cardiac hospitalization. Primary endpoint was observed in 29 (14.3%) patients, of whom 13 (14.9%) had PMI and 16 (13.9%) did not (P = 0.93). Thirty-six (17.8%) patients had new LGE. Twenty (12.0%) events occurred in patients without new LGE and 9 (25.2%) in patients with it (P = 0.045). LGE was also associated to increased mortality, with 4 (2.4%) and 4 (11.1%) deaths in subjects without and with it (P = 0.02). LGE was the only independent predictor of primary endpoint and mortality (P = 0.03 and P = 0.02). Median LGE mass was estimated at 4.6 g. Patients with new LGE had a greater biomarkers release (median troponin: 8.9 ng/mL vs. 1.8 ng/mL and median creatine kinase-MB: 38.0 ng/mL vs. 12.3 ng/mL; P < 0.001 in both comparisons). Conclusions New LGE was shown to be better prognostic predictor than biomarker-only PMI definition after uncomplicated revascularization. Furthermore, new LGE was the only independent predictor of cardiovascular events and mortality.
  • article 2 Citação(ões) na Scopus
    A bipartite graph approach to retrieve similar 3D models with different resolution and types of cardiomyopathies
    (2022) BERGAMASCO, Leila Cristina C.; LIMA, Karla R. P. S.; ROCHITTE, Carlos E.; NUNES, Fatima L. S.
    Three-dimensional (3D) model retrieval uses content-based image retrieval (CBIR) techniques to search for the most similar 3D objects in a dataset, usually considering their geometry and organization in a feature vector. Feature vectors from different objects were compared to establish their similarities. Although this type of comparison typically uses metric distances, such metrics present limitations when the vector lengths are different. Signal-based descriptors are a promising approach for extracting features from 3D objects, but they generate feature vectors with different lengths. Thus, new methods for measuring the similarity are required. This study proposes an approach to 3D model retrieval as a network flow problem using bipartite graphs. The approach was applied to support the diagnosis of cardiomyopathies, considering 3D objects reconstructed from cardiac images of the left ventricle. We achieved an AUC value of 0.93 under the best retrieval scenario. The results also indicate that modeling a 3D model retrieval technique as a network flow problem using graphs can provide a promising manner to compare 3D objects with different shapes and sizes. This strategy, coupled with personal patient data, achieves better results than methods using classical comparison approaches.
  • article 0 Citação(ões) na Scopus
    Endovascular therapeutic hypothermia adjunctive to percutaneous coronary intervention in acute myocardial infarction: realistic simulation as a game changer
    (2022) DALLAN, Luis Augusto Palma; DAE, Michael; GIANNETTI, Natali Schiavo; POLASTRI, Tathiane Facholi; LIMA, Marian Keiko Frossard; ROCHITTE, Carlos Eduardo; HAJJAR, Ludhmila Abrahao; MARTIN, Claudia Yanet Bernoche San; LIMA, Felipe Gallego; NICOLAU, Jose Carlos; JR, Mucio Tavares de Oliveira; DALLAN, Luis Alberto Oliveira; SILVA, Expedito Eustaquio Ribeiro da; FILHO, Roberto Kalil; ABIZAID, Alexandre; LEMOS NETO, Pedro Alves; TIMERMAN, Sergio
    Background: Endovascular therapeutic hypothermia (ETH) reduces the damage by ischemia/reperfusion cell syndrome in cardiac arrest and has been studied as an adjuvant therapy to percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI). New available advanced technology allows cooling much faster, but there is paucity of resources for training to avoid delays in door-to-balloon time (DTB) due to ETU and subsequently coronary reperfusion, which would derail the procedure. The aim of the study was to describe the process for the development of a simulation, training & educational protocol for the multidisciplinary team to perform optimized ETH as an adjunctive therapy for STEMI. Methods and results: We developed an optimized simulation protocol using modern mannequins in different realistic scenarios for the treatment of patients undergoing ETH adjunctive to PCI for STEN s starting from the emergency room, through the CathLab, and to the intensive care unit (ICU) using the Proteus (R) Endovascular System (loll Circulation Inc (TM), San Jose, CA, USA). The primary endpoint was door-to-balloon (DTB) time. We successfully trained 361 multidisciplinary professionals in realistic simulation using modern mannequins and sham situations in divisions of the hospital where real patients would be treated. The focus of simulation and training was logistical optimization and educational debriefing with strategies to reduce waste of time in patient's transportation from different departments, and avoiding excessive rewanning during transfer. Afterwards, the EHT protocol was successfully validated in a trial randomizing 50 patients for 18 minutes cooling before coronary recanalization at the target temperature of 32 +/- 1.0 degrees C or PCI-only. A total of 35 patients underwent FM (85.7% [30/35] in 90 +/- 15 minutes), without delays in the mean door-to-balloon time for primary PCI when compared to 15 control group patients (92.1 minutes versus 87 minutes, respectively; p = 0.509). Conclusions: Realistic simulation, intensive training and educational debriefing for the multidisciplinary team propitiated feasible endovascular therapeutic hypothermia as an adjuvant therapy to primary PCI in STEM.
  • article 4 Citação(ões) na Scopus
    Bone Marrow Cells Improve Coronary Flow Reserve in Ischemic Nonrevascularized Myocardium
    (2022) ASSUNCAO-JR, Antonildes N.; ROCHITTE, Carlos Eduardo; KWONG, Raymond Y.; GOWDAK, Luis Henrique Wolff; KRIEGER, Jose Eduardo; JEROSCH-HEROLD, Michael
    OBJECTIVES This study investigated whether intramyocardial bone marrow-derived hematopoietic progenitor cells (BMCs) increase coronary flow reserve (CFR) in ischemic myocardial regions where direct revascularization was unsuitable. BACKGROUND Patients with diffuse coronary artery disease frequently undergo incomplete myocardial revascularization, which increases their risk for future adverse cardiovascular outcomes. The residual regional ischemia related to both untreated epicardial lesions and small vessel disease usually contributes to the disease burden. METHODS The MiHeart/IHD study randomized patients with diffuse coronary artery disease undergoing incomplete coronary artery bypass grafting to receive BMCs or placebo in ischemic myocardial regions. After the procedure, 78 patients underwent cardiovascular magnetic resonance (CMR) at 1, 6, and 12 months and were included in this cardiac magnetic resonance substudy with perfusion quantification. Segments were classified as target (injected), adjacent (surrounding the injection site), and remote from injection site. RESULTS Of 1,248 segments, 269 were target (22%), 397 (32%) adjacent, and 582 (46%) remote. The target had significantly lower CFR at baseline (1.40 +/- 0.79 vs 1.64 +/- 0.89 in adjacent and 1.79 +/- 0.79 in remote; both P < 0.05). BMCs significantly increased CFR in target and adjacent segments at 6 and 12 months compared with placebo. In target regions, there was a progressive treatment effect (27.1% at 6 months, P = 0.037, 42.2% at 12 months, P = 0.001). In the adjacent segments, CFR increased by 21.8% (P = 0.023) at 6 months, which persisted until 12 months (22.6%; P = 0.022). Remote segments in both the BMC and placebo groups experienced similar improvements in CFR (not significant at 12 months compared with baseline). CONCLUSIONS BMCs, injected in severely ischemic regions unsuitable for direct revascularization, led to the largest CFR improvements, which progressed up to 12 months, compared with smaller but persistent CFR changes in adjacent and no improvement in remote segments. (J Am Coll Cardiol Img 2022;15:812-824) (c) 2022 The Authors.
  • article 20 Citação(ões) na Scopus
    Effects of CPAP on Metabolic Syndrome in Patients With OSA A Randomized Trial
    (2022) GIAMPA, Sara Q. C.; FURLAN, Sofia F.; FREITAS, Lunara S.; MACEDO, Thiago A.; LEBKUCHEN, Adriana; CARDOZO, Karina H. M.; CARVALHO, Valdemir M.; MARTINS, Franco C.; AZAM, Indira F. B.; COSTA-HONG, Valeria; LOPES, Heno F.; BAPTISTA, Mariana L.; ROCHITTE, Carlos E.; BORTOLOTTO, Luiz A.; LORENZI-FILHO, Geraldo; DRAGER, Luciano F.
    BACKGROUND: OSA is associated with metabolic syndrome (MS), but it is unclear whether OSA treatment with CPAP can revert MS. RESEARCH QUESTION: Does OSA treatment with CPAP per se have effects on the MS reversibility and the associated metabolic, adiposity and vascular parameters? STUDY DESIGN AND METHODS: The TREATOSA-MS trial is a randomized placebo-controlled trial that enrolled adult patients with a recent diagnosis of MS and moderate or severe OSA (apnea-hypopnea index [AHI], >= 15 events/h) to undergo therapeutic CPAP or nasal dilator strips (placebo group) for 6 months. Before and after each intervention, we measured anthropometric variables, BP, glucose, and lipid profile. To control potential-related mechanisms and consequences, we also measured adiposity biomarkers (leptin and adiponectin), body composition, food intake, physical activity, subcutaneous and abdominal fat (visceral and hepatic fat), and endothelial function. RESULTS: One hundred patients (79% men; mean age, 48 +/- 9 years; BMI, 33 +/- 4 kg/m(2); AHI, 58 +/- 29 events/h) completed the study (n = 50 per group). The mean CPAP adherence was 5.5 +/- 1.5 h/night. After 6 months, most patients with OSA randomized to CPAP retained the MS diagnosis, but the rate of MS reversibility was higher than observed in the placebo group (18% vs 4%; OR, 5.27; 95% CI, 1.27-35.86; P = .04). In the secondary analysis, CPAP did not promote significant reductions in the individual components of MS, weight, hepatic steatosis, lipid profile, adiponectin, and leptin, but did promote a very modest reduction in visceral fat and improved endothelial function (all analyses were adjusted for baseline values). INTERPRETATION: Despite the higher rate of MS reversibility after CPAP therapy as compared with placebo, most patients retained this diagnosis. The lack of significant or relevant effects on adiposity biomarkers and depots supports the modest role of OSA in modulating MS.