CHARLES MADY
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina - Líder
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- Chagas' heart disease: gender differences in myocardial damage assessed by cardiovascular magnetic resonance(2016) ASSUNCAO JR., Antonildes N.; JEROSCH-HEROLD, Michael; MELO, Rodrigo L.; MAURICIO, Alejandra V.; ROCHA, Liliane; TORREAO, Jorge A.; FERNANDES, Fabio; IANNI, Barbara M.; MADY, Charles; KALIL-FILHO, Roberto; ROCHITTE, Carlos E.Background: Since a male-related higher cardiovascular morbidity and mortality in patients with Chagas' heart disease has been reported, we aimed to investigate gender differences in myocardial damage assessed by cardiovascular magnetic resonance (CMR). Methods and results: Retrospectively, 62 seropositive Chagas' heart disease patients referred to CMR (1.5 T) and with low probability of having significant coronary artery disease were included in this analysis. Amongst both sexes, there was a strong negative correlation between LV ejection fraction and myocardial fibrosis (male r = 0.64, female r = 0.73, both P < 0.001), with males showing significantly greater myocardial fibrosis (P = 0.002) and lower LV ejection fraction (P < 0.001) than females. After adjustment for potential confounders, gender remained associated with myocardial dysfunction, and 53% of the effect was mediated by myocardial fibrosis (P for mediation = 0.004). Also, the transmural pattern was more prevalent among male patients (23.7 vs. 9.9%, P < 0.001) as well as the myocardial heterogeneity or gray zone (2.2 vs. 1.3 g, P = 0.003). Conclusions: We observed gender-related differences in myocardial damage assessed by CMR in patients with Chagas' heart disease. As myocardial fibrosis and myocardial dysfunction are associated to cardiovascular outcomes, our findings might help to understand the poorer prognosis observed in males in Chagas' disease.
- The value of B-type natriuretic peptide as a predictor of mortality in patients with constrictive pericarditis undergoing pericardiectomy(2016) MELO, Dirceu Thiago Pessoa de; MADY, Charles; RAMIRES, Felix Jose Alvarez; DIAS, Ricardo Ribeiro; GUALANDRO, Danielle Menosi; CARAMELLI, Bruno; KALIL FILHO, Roberto; FERNANDES, Fabio
conferenceObject Sleep Apnea Worsens Muscle Vasoconstriction During Central and Peripheral Chemoreceptors Stimulation in Patients with Systolic Heart Failure(2016) LOBO, Denise M. L.; TREVIZAN, Patricia F.; TOSCHI-DIAS, Edgar; OLIVEIRA, Patricia A.; PIVETA, Rafael B.; MADY, Charles; BOCCHI, Edimar A.; ALMEIDA, Dirceu R.; LORENZI-FILHO, Gerald; MIDDLEKAUFF, Holly R.; NEGRAO, Carlos E.bookPart Cardiopatia restritiva, obstrutiva e infiltrativa(2016) SALEMI, Vera Maria Cury; TAVARES, Marcelo Dantas; SIMõES, Marcus Vinicius; MADY, CharlesconferenceObject The predictive value of plasma Galectin-3 for cardiac impairment and mortality in patients with Chagas disease(2016) FERNANDES, F.; MOREIRA, C. H.; OLIVEIRA, L. C.; IANNI, B. M.; LORENZO, C. D.; RAMIRES, F. J. A.; NASTARI, L.; RIBEIRO, A. L. P.; CUNHA NETO, E.; SABINO, E. C.; MADY, C.conferenceObject Exercise Training Increases Baroreflex Control of Heart Rate and Decreases Muscle Sympathetic Nerve Activity in Chronic Chagasic Cardiomyopathy Patients(2016) SARMENTO, Adriana Oliveira; ANTUNES-CORREA, Ligia Moraes; LOBO, Denise Moreira Lima; CARVALHO, Bruna Elisa Piovezani; TROMBETTA, Ivani Credidio; ALVES, Maria Janieire Nazare Nunes; RONDON, Maria Urbana Pinto Brandao; RONDON, Eduardo; VIEIRA, Marcelo Luiz Campos; MADY, Charles; NEGRAO, Carlos Eduardo; IANNI, Barbara MariabookPart Classificação das cardiomiopatias(2016) MADY, Charles; FERNANDES, Fabio- Sleep-Disordered Breathing Exacerbates Muscle Vasoconstriction and Sympathetic Neural Activation in Patients with Systolic Heart Failure(2016) LOBO, Denise M. L.; TREVIZAN, Patricia F.; TOSCHI-DIAS, Edgar; OLIVEIRA, Patricia A.; PIVETA, Rafael B.; ALMEIDA, Dirceu R.; MADY, Charles; BOCCHI, Edimar A.; LORENZI-FILHO, Geraldo; MIDDLEKAUFF, Holly R.; NEGRAO, Carlos E.Background-Sleep-disordered breathing (SDB) is common in patients with heart failure (HF), and hypoxia and hypercapnia episodes activate chemoreceptors stimulating autonomic reflex responses. We tested the hypothesis that muscle vasoconstriction and muscle sympathetic nerve activity (MSNA) in response to hypoxia and hypercapnia would be more pronounced in patients with HF and SDB than in patients with HF without SDB (NoSBD). Methods and Results-Ninety consecutive patients with HF, New York Heart Association functional class II-III, and left ventricular ejection fraction <= 40% were screened for the study. Forty-one patients were enrolled: NoSDB (n=13, 46 [39-53] years) and SDB (n=28, 57 [54-61] years). SDB was characterized by apnea-hypopnea index >= 15 events per hour (polysomnography). Peripheral (10% O-2 and 90% N-2, with CO2 titrated) and central (7% CO2 and 93% O-2) chemoreceptors were stimulated for 3 minutes. Forearm and calf blood flow were evaluated by venous occlusion plethysmography, MSNA by microneurography, and blood pressure by beat-to-beat noninvasive technique. Baseline forearm blood flow, forearm vascular conductance, calf blood flow, and calf vascular conductance were similar between groups. MSNA was higher in the SDB group. During hypoxia, the vascular responses (forearm blood flow, forearm vascular conductance, calf blood flow, and calf vascular conductance) were significantly lower in the SDB group compared with the NoSDB group (P<0.01 to all comparisons). Similarly, during hypercapnia, the vascular responses (forearm blood flow, forearm vascular conductance, calf blood flow, and calf vascular conductance) were significantly lower in the SDB group compared with the NoSDB group (P<0.001 to all comparisons). MSNA were higher in response to hypoxia (P=0.024) and tended to be higher to hypercapnia (P=0.066) in the SDB group. Conclusions-Patients with HF and SDB have more severe muscle vasoconstriction during hypoxia and hypercapnia than HF patients without SDB, which seems to be associated with endothelial dysfunction and, in part, increased MSNA response.
bookPart Cardiomiopatia hipertrófica(2016) ANTUNES, Murillo de Oliveira; ARTEAGA-FERNáNDEZ, Edmundo; MADY, CharlesconferenceObject Long-Term Prognostic Value of Myocardial Fibrosis in Chagas' Disease(2016) SENRA, Tiago; IANNI, Barbara; MADY, Charles; MARTINELLI, Martino; FILHO, Roberto Kalil; ROCHITTE, Carlos E.