MARCELO LUIZ CAMPOS VIEIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Cardiopulmonary exercise test in patients with refractory angina: functional and ischemic evaluation(2022) ASSUMPCAO, Camila R. A. de; PRADO, Danilo M. L. do; JORDAO, Camila P.; DOURADO, Luciana O. C.; VIEIRA, Marcelo L. C.; MONTENEGRO, Carla G. de S. P.; NEGRAO, Carlos E.; GOWDAK, Luis H. W.; MATOS, Luciana D. N. J. DeObjectives: Refractory angina (RA) is a chronic condition clinically characterized by low effort tolerance; therefore, physical stress testing is not usually requested for these patients. Cardiopulmonary exercise testing (CPET) is con-sidered a gold standard examination for functional capacity evaluation, even in submaximal tests, and it has gained great prominence in detecting ischemia. The authors aimed to determine cardiorespiratory capacity by using the oxygen consumption efficiency slope (OUES) in patients with refractory angina. The authors also stud-ied the O-2 pulse response by CPET and the association of ischemic changes with contractile modifications by exer-cise stress echocardiography (ESE). Methods: Thirty-one patients of both sexes, aged 45 to 75 years, with symptomatic (Canadian Cardiovascular Soci-ety class II to IV) angina who underwent CPET on a treadmill and exercise stress echocardiography on a lower limb cycle ergometer were studied. ClinicalTrials.gov: NCT03218891. Results: The patients had low cardiorespiratory capacity (OUES of 1.74 +/- 0.4 L/min; 63.9 +/- 14.7% of predicted), and 77% of patients had a flattening or drop in O-2 pulse response. There was a direct association between Heart Rate (HR) at the onset of myocardial ischemia detected by ESE and HR at the onset of flattening or drop in oxygen pulse response detected by CPET (R = 0.48; p = 0.019). Conclusion: Patients with refractory angina demonstrate low cardiorespiratory capacity. CPET shows good sensi-tivity for detecting abnormal cardiovascular response in these patients with a significant relationship between flattening O-2 pulse response during CEPT and contractile alterations detected by exercise stress echocardiography.
- Joint Guideline on Venous Thromboembolism-2022(2022) ALBRICKER, Ana Cristina Lopes; FREIRE, Claudia Maria Vilas; SANTOS, Simone Nascimento dos; ALCANTARA, Monica Luiza de; SALEH, Mohamed Hassan; CANTISANO, Armando Luis; TEODORO, Jose Aldo Ribeiro; PORTO, Carmen Lucia Lascasas; AMARAL, Salomon Israel do; VELOSO, Orlando Carlos Gloria; PETISCO, Ana Claudia Gomes Pereira; BARROS, Fanilda Souto; BARROS, Marcio Vinicius Lins de; SOUZA, Adriano Jose de; SOBREIRA, Marcone Lima; MIRANDA, Robson Barbosa de; MORAES, Domingos de; VERRASTRO, Carlos Gustavo Yuji; MANCANO, Alexandre Dias; LIMA, Ronaldo de Souza Leao; MUGLIA, Valdair Francisco; MATUSHITA, Cristina Sebastiao; LOPES, Rafael Willain; COUTINHO, Artur Martins Novaes; PIANTA, Diego Bromfman; SANTOS, Alair Augusto Sarmet Moreira Damas dos; NAVES, Bruno de Lima; VIEIRA, Marcelo Luiz Campos; ROCHITTE, Carlos Eduardo
conferenceObject Transcatheter aortic valve implantation without contrast media technique in chronic kidney disease population - pilot study(2022) NICZ, P.; FREIRE, A. F. D.; FILIPPINI, F. B.; KANHOUCHE, G.; ACCORSI, T. A. D.; RIBEIRO, H. B.; LIBERATO, G.; NOMURA, C. H.; CASSAR, R. S.; VIEIRA, M. L.; MATHIAS, W.; POMERANTZEFF, P. M. A.; TARASOUTCHI, F.; ABIZAID, A.; BRITO JR., F. S. De- Three and two-dimensional cardiac mechanics by speckle tracking are predictors of outcomes in chagas heart disease(2022) HOTTA, Viviane Tiemi; ABDUCH, Maria Cristina Donadio; VIEIRA, Marcelo Luiz Campos; VILELA, Andrea de Andrade; BOCCHI, Edimar AlcidesChagas disease (CD) is a neglected infectious disease associated with early mortality and substantial disability. Three-dimensional speckle tracking (3D STE) may play a role in the evaluation of CD. We aim to characterize new echocardiographic variables in patients with CD and to assess the hypothesis that 3D STE may predict outcomes. Seventy-two patients with CD were included. Clinical and conventional 2D and 3D STE analysis were performed. Patients were followed up for 60 months. Clinical events were defined as hospitalization for heart failure, complex ventricular arrhythmias, heart transplant and all-cause death. Seventy-two patients were recruited and enrolled in three groups: left ventricular ejection fraction (LVEF) < 0.40 (N = 22; reduced LVEF or rLVEF); 0.40 <= LVEF <= 0.50 (N = 10; mildly reduced LVEF or mrLVEF) and LVEF > 0.50 (N = 30; preserved LVEF or pLVEF). After a Cox model analysis, the top predictors of composite endpoints were 2D LV global longitudinal strain (GLS) <= - 11.3% (AUC = 0.87), 2D LV global circumferential strain (GCS) <= - 10.1% (AUC = 0.79), 3D LV GLS <= - 13% (AUC = 0.82), 3D LV area strain <= - 16% (AUC = 0.81) and right ventricle (RV) GLS <= - 17.2% (AUC = 0.78). Patients with CD and mrLVEF were morphologically similar to the rLVEF patients despite the benign evolution as the pLVEF group. RV GLS, 2D LV GLS, 2D LV GCS, 3D LV GLS, and 3D LV area strain are strong predictors of 60 months outcomes in patients with CD.
- Does Myocardial Injury Occur After an Acute Aerobic Exercise Session in Patients with Refractory Angina?(2022) MONTENEGRO, Carla Giuliano de Sa Pinto; DOURADO, Luciana Oliveira Cascaes; JORDAO, Camila Paixao; VIEIRA, Marcelo Luiz Campos; ASSUMPCAO, Camila Regina Alves; GOWDAK, Luis Henrique Wolff; PEREIRA, Alexandre da Costa; NEGRAO, Carlos Eduardo; MATOS, Luciana Diniz Nagem Janot deBackground: It is unclear whether exercise is safe in patients with more advanced forms of coronary artery disease, such as those with refractory angina (RA). Objective: We aimed to determine the effect of an acute aerobic exercise session (AAES) on high-sensitivity cardiac troponin T (hs-cTnT) levels in patients with RA. Methods: This was a longitudinal, non-randomized, and non-controlled clinical study. Participants were recruited from April 2015 to January 2019. On a visual pain scale from 0 to 10, pain rated up to 3 was considered as the top level allowed to continue exercising. We assessed hs-cTnT at baseline and 3 hours after the AAES. The protocol consisted of 5 minutes of warm-up, 30 minutes of continuous aerobic exercise at heart rate corresponding to the anaerobic threshold or angina threshold obtained in the cardiopulmonary exercise testing, and 5 minutes of cooling down. P values less than 0.05 were considered statistically significant. Results: Thirty-two patients with RA were included (61 +/- 9 years, 59.4% male). The baseline hs-cTnT concentration was 10.9 ng/L (95% confidence interval: 9.1 to 13.0 ng/L).The hs-cTnT collected 3 hours after the AAES was 11.1 ng/L (95% confidence interval: 9.1 to 13.5 ng/L). No difference occurred in hs-cTnT before and after AAES (p = 0.657). Conclusions: A single AAES performed at the angina threshold with corresponding visual pain scale did not alter hs-cTnT in patients with RA, suggesting that no significant myocardial injury was elicited by exercising and that this exercise protocol can be considered safe.
- Critical Analysis and Limitations of the Diagnosis of Heart Failure with Preserved Ejection Fraction (HFpEF)(2022) HOTTA, Viviane Tiemi; RASSI, Daniela do Carmo; PENA, Jose Luiz Barros; VIEIRA, Marcelo Luiz Campos; RODRIGUES, Ana Clara Tude; CARDOSO, Juliano Novaes; RAMIRES, Felix Jose Alvarez; NASTARI, Luciano; MADY, Charles; FERNANDES, FabioWith the increase in the population's life expectancy and the higher frequency of risk factors such as obesity, hypertension and diabetes, an increase in the prevalence of heart failure with preserved ejection fraction (HFpEF) is expected. However, to date, the diagnosis and treatment of patients with HFpEF remain challenging. The syndromic diagnosis of HFpEF includes several etiologies and diseases with specific treatments but has points in common regarding the clinical presentation, laboratory evaluation related to biomarkers, such as BNP and NT-ProBNP, and echocardiographic evaluation of cardiac remodeling and left ventricular diastolic filling pressures. Extensive randomized clinical trials involving the treatment of this condition have failed to demonstrate benefits to the patient, making it necessary to reflect on the diagnosis, mechanisms of morbidity, mortality and reversibility in this syndrome. In this review, the current concepts, controversies and challenges, especially regarding diagnosis, will be addressed, critically analyzing the European Heart Failure Association score for the diagnosis of HFpEF.
- Guidelines, Position Statements, and Standardizations: Documents to Assist Medical Practice(2022) SOUSA, Antonio Carlos Sobral; CORREA-FILHO, Harry; NASCIMENTO, Bruno; ISSA, Aurora Castro; VIEIRA, Marcelo Luiz Campos; MARKMAN-FILHO, Brivaldo