GLAUCYLARA REIS GEOVANINI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/13 - Laboratório de Genética e Cardiologia Molecular, Hospital das Clínicas, Faculdade de Medicina
LIM/13 - Laboratório de Genética e Cardiologia Molecular, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
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- Obstructive sleep apnoea is associated with myocardial injury in patients with refractory angina(2016) GEOVANINI, Glaucylara R.; PEREIRA, Alexandre C.; GOWDAK, Luis H. W.; DOURADO, Luciana Oliveira Cascaes; POPPI, Nilson T.; VENTURINI, Gabriela; DRAGER, Luciano F.; LORENZI-FILHO, GeraldoObjective To investigate the association between obstructive sleep apnoea (OSA) severity with markers of overnight myocardial injury in patients with refractory angina. Methods Patients with refractory angina were characterised clinically and they underwent ischaemia imaging stress tests by single-photon emission computed tomography (SPECT) and/or cardiac MRI. The patients were admitted to the hospital, remained under resting conditions for blood determination of high-sensitivity cardiac troponin T (hs-cTnT) at 14:00, 22:00 and after overnight polysomnography at 7:00. Results We studied 80 consecutive patients (age: 62 +/- 10 years; male: 66%; body mass index (BMI): 29.5 +/- 4 kg/m(2)) with well-established diagnosis of refractory angina. The mean apnoea-hypopnoea index (AHI) was 37 +/- 29 events/h and OSA (AHI >15 events/h) was present in 75% of the population. Morning detectable hs-cTnT and above 99th percentile was present in 88% and 36% of the population, respectively. Patients in the first to third quartiles of OSA severity did not have circadian variation of hs-cTnT. In contrast, patients in the fourth quartile (AHI >= 51 events/h) had a circadian variation of hs-cTnT with a morning peak of hs-cTnT that was two times higher than that in the remaining population (p = 0.02). The highest quartile of OSA severity remained associated with the highest quartile of hs-cTnT (p = 0.028) in multivariate analysis. Conclusion Very severe OSA is common and independently associated with overnight myocardial injury in patients with refractory angina.
- Obstructive sleep apnea and its management in patients with atrial fibrillation: An International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT) global survey of practicing cardiologists(2022) FAULX, Michael D.; MEHRA, Reena; GEOVANINI, Glaucylara Reis; ANDO, Shin-ichi; ARZT, Michael; DRAGER, Luciano; FU, Michael; HOYOS, Camilla; HAI, Jo; HWANG, Juey-Jen; KARAOGUZ, Remzi; KIMOFF, John; LEE, Pei-Lin; MEDIANO, Olga; PATEL, Sanjay R.; PEKER, Yuksel; PEPIN, Jean Louis; SANCHEZ-DE-LA-TORRE, Manuel; SERIES, Frederic; STADLER, Stefan; STROLLO, Patrick; TAHRANI, A. A.; THUNSTROM, Erik; YAMAUCHI, Motoo; REDLINE, Susan; PHILLIPS, Craig L.Background: Among international cardiologists it is unclear whether equipoise exists regarding the benefit of diagnosing and managing obstructive sleep apnea (OSA) to improve atrial fibrillation (AF) outcomes and whether clinical practice and equipoise are linked. Methods: Between January 2019 and June 2020 we distributed a web-based 12-question survey regarding OSA and AF management to practicing cardiologists in 16 countries. Results: The United States, Japan, Sweden, and Turkey accounted for two-thirds of responses. 863 cardiologists responded; half were general cardiologists, a quarter electrophysiologists. Responses regarding treating OSA with CPAP to improve AF endpoints were mixed. 33% of respondents referred AF patients for OSA screening. OSA was diagnosed in 48% of referred patients and continuous positive airway pressure (CPAP) was prescribed for 59% of them. Nearly 70% of respondents believed randomized controlled trials (RCTs) of OSA treatment in AF patients were necessary and indicated willingness to contribute to such trials. Conclusions: There was no clinical equipoise among surveyed cardiologists; a majority expressed certainty that combined OSA and AF treatment is superior to AF treatment alone for improving AF outcomes. However, a minority of surveyed cardiologists referred AF patients for OSA testing, and while half of screened AF patients had OSA, CPAP was prescribed in little more than half of them, reflecting the view that better clinical trial evidence is needed to support this practice. Our results underscore the need for larger, multi-national prospective studies of OSA treatment and AF outcomes to inform more uniform society guideline recommendations.
- 1st Brazilian Positioning on the Impact of Sleep Disorders on Cardiovascular Diseases of the Brazilian Society of Cardiology(2018) DRAGER, Luciano E.; LORENZI-FILHO, Geraldo; CINTRA, Fatima Dumas; PEDROSA, Rodrigo P.; BITTENCOURT, Lia R. A.; POYARES, Dalva; CARVALHO, Carolina Gonzaga; MOURA, Sonia Maria Guimaraes Pereira Togeiro; SANTOS-SILVA, Rogerio; BRUIN, Pedro F. C. de; GEOVANINI, Glaucylara R.; ALBUQUERQUE, Felipe N.; OLIVEIRA, Vvercules Antonio Alves de; MOREIRA, Gustavo A.; UENO, Linda Massako; NERBASS, Flavia Baggio; RONDON, Maria Urbana Pinto Brandao; BARBOSA, Fine Rozaria Ferreira; BERTOLAMI, Adriana; PAOLA, Angelo Amato Vincenzo de; MARQUES, Betania Braga Silva; RIZZI, Camila Futado; NEGRAO, Carlos Eduardo; UCHOA, Carlos Henrique Gomes; MAKI-NUNES, Cristiane; MARTINEZ, Denis; FERNANDEZ, Edmundo Arteaga; MAROJA, Fabrizio U.; ALMEIDA, Fernanda R.; TROMBETTA, Ivani C.; STORTI, Luciana J.; BORTOLOTTO, Luiz Aparecido; MELLO, Marco Tulio de; BORGES, Melania Aparecida; ANDERSEN, Monica Levy; PORTILHO, Natanael de Paula; MACEDO, Paula; ALVES, Rosana; TUFIK, Sergio; FAGONDES, Simone C.; RISSO, Thais Telles
conferenceObject Obstructive sleep apnoea is highly frequent in consecutive patients with refractory angina(2012) GEOVANINI, G.; DRAGER, L.; DOURADO, L. O. C.; POPPI, N. T.; PEREIRA, A. C.; GOWDAK, L. H. W.; LORENZI-FILHO, G.Purpose: Obstructive sleep apnoea (OSA) is common among patients with stable coronary artery disease and may contribute to poor cardiovascular outcome. OSA has not been investigated in patients with refractory angina, a debilitating condition characterized by persistent symptoms despite optimized medical therapy. Methods: Consecutive patients with multi-vessel coronary disease by angiography and refractory angina (severe ischemic symptoms that persist despite optimal medical therapy and whom coronary revascularization procedures are no longer feasible or helpful) were recruited from a specialized out patient clinic. Regardless of sleep complaints, all patients were evaluated by standard overnight polysomnography, symptoms of excessive daytime sleepiness by Epworth Sleepiness Scale (ESS) and one week diary of angina. Results: We evaluated 31 patients (18 males, age: 62±10y, body mass index: 29.8±4.5kg/m2). Co-morbidities were common (dyslipidemia 100%, hypertension 93% and diabetes 61%) and all patients presented persistent angina despite optimal anti-ischemic medical therapy and preserved systolic function (ejection fraction on echocardiography: 53±11%). Patients presented poor sleep quality, poor sleep efficiency (60±16%) and the prevalence of OSA (AHI>15) and severe OSA (AHI>30) was 71 and 55%, respectively. As compared with patients without OSA patients with OSA presented similar age, gender, BMI (28.2±5 vs. 30.4±4.5kg/m2, p=0.26) similar ESS (10±6 vs. 11±6), non-significant trend to higher frequency of diurnal (66 vs. 91%, p=0.13) and nocturnal angina (45 vs. 77%, p=0.10). Conclusions: This preliminary study showed a high frequency of OSA in consecutive patients with refractory angina. Traditional risk factors for OSA, including age, male gender and BMI did not discriminate patients with OSA. Non-significant trends to higher frequency of diurnal and nocturnal angina suggest that OSA may contribute to trigger angina symptoms.- Age and Sex Differences in Heart Rate Variability and Vagal Specific Patterns - Baependi Heart Study(2020) GEOVANINI, Glaucylara Reis; VASQUES, Enio Rodrigues; ALVIM, Rafael de Oliveira; MILL, Jose Geraldo; ANDREAO, Rodrigo Varejao; VASQUES, Bruna Kim; PEREIRA, Alexandre Costa; KRIEGER, Jose EduardoBackground: Heart rate variability (HRV) is a noninvasive method for assessing autonomic function. Age, sex, and chronic conditions influence HRV. Objectives: Our aim was to evaluate HRV measures exploring differences by age, sex, and race in a sample from a rural area. Methods: Analytical sample (n = 1,287) included participants from the 2010 to 2016 evaluation period of the Baependi Heart Study, a family-based cohort in Brazil. Participants underwent 24-hour Holter-ECG (Holter) monitoring. To derive population reference values, we restricted our analysis to a 'healthy' subset (i.e. absence of medical comorbidities). A confirmatory analysis was conducted with a subgroup sample that also had HRV derived from a resting ECG 10'-protocol obtained during the same time period. Results: The 'healthy' subset included 543 participants. Mean age was 40 +/- 14y, 41% were male, 74% self-referred as white and mean body-mass-index was 24 +/- 3kg/m(2). Time domain HRV measures showed significant differences by age-decade and by sex. Higher values were observed for males across almost all age-groups. Parasympathetic associated variables (rMSSD and pNN50) showed a U-shaped distribution and reversal increase above 60y. Sympathetic-parasympathetic balance variables (SDNN, SDANN) decreased linearly by age. Race differences were no significant. We compared time domain variables with complete data (Holter and resting ECG) between 'healthy' versus 'unhealthy' groups. Higher HRV values were shown for the 'healthy' subset compared with the 'unhealthy' group. Conclusion: HRV measures vary across age and sex. A U-shaped pattern and a reversal increase in parasympathetic variables may reflect an age-related autonomic dysfunction even in healthy individuals that could be used as a predictor of disease development.
- 1st Brazilian Positioning on the Impact of Sleep Disorders on Cardiovascular Diseases of the Brazilian Society of Cardiology (vol 111, pg 290, 2018)(2019) DRAGER, Luciano F.; LORENZI-FILHO, Geraldo; CINTRA, Fatima Dumas; PEDROSA, Rodrigo P.; BITTENCOURT, Lia R. A.; POYARES, Dalva; CARVALHO, Carolina Gonzaga; MOURA, Sonia Maria Guimaraes Pereira Togeiro; SANTOS-SILVA, Rogerio; BRUIN, Pedro F. C. de; GEOVANINI, Glaucylara R.; ALBUQUERQUE, Felipe N.; OLIVEIRA, Wercules Antonio Alves de; MOREIRA, Gustavo A.; UENO, Linda Massako; NERBASS, Flavia Baggio; RONDON, Maria Urbana Pinto Brandao; BARBOSA, Eline Rozaria Ferreira; BERTOLAMI, Adriana; PAOLA, Angelo Amato Vincenzo de; MARQUES, Betania Braga Silva; RIZZI, Camila Futado; NEGRAO, Carlos Eduardo; UCHOA, Carlos Henrique Gomes; MAKI-NUNES, Cristiane; MARTINEZ, Denis; FERNANDEZ, Edmundo Arteaga; MAROJA, Fabrizio U.; ALMEIDA, Fernanda R.; TROMBETTA, Ivani C.; STORTI, Luciana J.; BORTOLOTTO, Luiz Aparecido; MELLO, Marco Tulio de; BORGES, Melania Aparecida; ANDERSEN, Monica Levy; PORTILHO, Natanael de Paula; MACEDO, Paula; ALVES, Rosana; TUFIK, Sergio; FAGONDES, Simone C.; RISSO, Thais Telles