Navegando por Palavras-chave "Myocardial infarction"

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    Ablação por radiofreqüência do ventrículo esquerdo no rato: um novo modelo de insuficiência cardíaca com tamanhos de infarto do miocárdio semelhantes e baixa mortalidade
    (Universidade Federal de São Paulo (UNIFESP), 2010-08-25) Antonio, Ednei Luiz [UNIFESP]; Tucci, Paulo José Ferreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The Myocardial Infarction (MI) in rodents is the most frequently used animal model to reproduce experimentally the Congestive Heart Failure (CHF) in humans. Surgical closure of the anterior descending coronary artery (ADCA) is the method traditionally used to obtain the experimental MI decades. This model is well validated to simulate CHF, as evidenced by the large number of publications that provide relevant information significantly. The coronary artery ligation in rats is inherently associated with infarcts of variable size, and in some cases, absence of myocardial necrosis. Another unfavorable factor is the high rate of mortality after coronary occlusion (CO). The purpose of this study was to standardize a new model of CHF secondary to MI by applying radio frequency electric current in the left ventricle (LV), and analyze the characteristics of the model. To this end, we used 210 Wistar-EPM, male and female, in groups, operated by the traditional method of coronary occlusion, and radiofrequency ablation without surgical intervention or control group. After the promotion of MI, animals were separated into groups of one and four weeks for evaluation, which were anesthetized and sequentially assessed by echocardiography (ECHO), hemodynamic, myocardial mechanics, and pathological. The transmural infarction occurred in all cases operated ablation with immediate mortality of 7.5%. CO animals were included only MI> 40% LV. The variability in the size of the MI were lower in rats Ab (x ± SD: 45 ± 8%) when compared with coronary occlusion (CO, 40 ± 19% SD). The echocardiography and hemodynamic study showed comparable increases in the sizes of the LV end-diastolic pressure and pulmonary water content in one and four weeks post-MI. Myocardial mechanics six weeks post-MI were compatible in the inotropic and lusitropic dysfunction. Histopathological evaluations were identified lesions similar to those that occurred after CO, with complete healing phase in four weeks. Ab IM VE originated with similar size and low mortality. Resulted in histopathological changes, and ventricular dilation, mechanical dysfunction and myocardial failure. Results reproducing the IM by CO.
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    Angioplastia de resgate no infarto agudo do miocárdio
    (Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista - SBHCI, 2007-01-01) Moraes, Eraldo Ribeiro Ferreira Leão de [UNIFESP]; Carvalho, Antonio Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND: Acute myocardial infarction is a serious and frequent illness, and its treatment with thrombolytic therapy or percutaneous coronary intervention (PCI) is well established. Rescue PCI is an alternative when thrombolysis fails. In the last ten years several clinical studies have tested different features about this procedure. METHODS: Eighty four studies about rescue angioplasty published in the major cardiovascular relevance literary sources were analyzed between 1997 to 2007. RESULTS: Rescue PCI was superior to conservative treatment, such as rethrombolysis, when well indicated, and seemed similar to primary PCI, in some features. The concomitant use of GPIIb/IIIa inhibitors seemed to show clinical benefits. The use of drug-eluting stents and the association with mechanic thrombectomy still requires better scientific support. The latest metaanalysis about this topic have shown clear favorable results to rescue angioplasty according to clinical outcomes, heart failure and re-infarction, but not so definite results as to mortality. On the other hand, there was a trend of increased stroke risk, of the same magnitude as benefit. CONCLUSION: Rescue PCI has better results than conservative treatment or repeat fibrinolysis. However, the indication of the procedure still needs more precise selection criteria as well as better definition of the clinical benefit/safety ratio. These uncertainties persist due to the small number of rescue angioplasty procedures compared to the total number of angioplasties performed. In the CENIC Registry, rescue angioplasty amounts to 4% of all angioplasties performed.
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    Assistência de enfermagem a um paciente infartado portador de HIV, baseada na teoria do autocuidado: estudo de caso
    (Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2007-12-01) Lima, Gabriela Silvestre De [UNIFESP]; Cavalcante, Tatiana De Medeiros Colletti [UNIFESP]; Isabella, Adriana Paula Jordão; Magalhães, Adriana Da Silva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Nove de Julho; Hospital do Coração
    OBJECTIVE: Argued recent fact in the treatment of the patients with HIV is the possible increase of the cardiovascular risk in patients using inhibiting of proteasis. METHODS: Being thus, we objectify to apply the Systematization of the Assistance of Nursing (SAN) to a carrying of HIV and glutted patient. School is about a study of case carried through in a hospital located in the region metropolitan of São Paulo, in November of 2003, using the SAE and considering of diagnostics of nursing on the basis of taxonomy NANDA II(1) as well as the related interventions of nursing. RESULTS: The main identified disgnostic of nursing had been: Risk for inefficacious control of the therapeutical regimen, anxiety, perfusion to tissular cardiac modified, physical mobility harmed, modified protection, risk for infection, among others. CONCLUSION: The study it showed the importance of the SAE and the decision of the patient in engaging itself in the careful one in order to provide an improvement in the standard of reply of the sick person to the illness.
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    Avaliação do valor preditivo da angiotomografia de coronárias para eventos cardiovasculares nos pacientes submetidos a cirurgias vasculares
    (Universidade Federal de São Paulo, 2024-12-17) Lima, Vinícius Magaton [UNIFESP]; Mancuso, Frederico José Neves [UNIFESP]; http://lattes.cnpq.br/6573578676139315; http://lattes.cnpq.br/1018968894471657
    Introdução: As cirurgias vasculares possuem prevalência elevada de desfechos cardíacos adversos no período perioperatório. A angiotomografia de coronárias apresenta alto valor preditivo negativo e alta acurácia para o diagnóstico da doença arterial coronariana. Objetivo: Avaliar o valor preditivo da angiotomografia de coronárias para eventos cardiovasculares em curto prazo em pacientes submetidos à cirurgia vascular. Métodos: Estudo longitudinal, retrospectivo, realizado em hospital terciário. Oitenta e dois pacientes realizaram angiotomografia de coronárias para avaliação pré-operatória de cirurgia vascular. Os pacientes (n = 42) com redução luminal coronariana significativa (obstrução ≥ 50%) foram encaminhados para cineangiocoronariografia. Os pacientes submetidos diretamente à cirurgia (n = 40) foram avaliados até o terceiro dia pós-operatório ou alta hospitalar quanto ao desfecho primário combinado de morte cardiovascular e infarto agudo do miocárdio e aos desfechos secundários de tempo de internação hospitalar e injúria miocárdica. Resultados: A idade média foi de 65,7 ± 9,2 anos, 80% eram hipertensos, 60% dislipidêmicos, 35% diabéticos e 45% tabagistas. Pelo índice de risco do Estudo Multicêntrico de Avaliação Perioperatória (EMAPO), 5% dos pacientes eram de alto risco, 45% de risco intermediário e 42,5% de baixo risco. Os pacientes foram submetidos à endarterectomia de carótidas, correção de aneurisma de aorta abdominal ou revascularização de membros inferiores. Não houve desfecho primário no pós-operatório. A elevação dos níveis de troponina acima do percentil 99 foi observada em 42,5% dos pacientes (n = 17), porém apenas um paciente apresentou elevação da troponina acima de duas vezes o limite superior da normalidade. O tempo de internação após a cirurgia vascular foi de 4,5 ± 3,0 dias. Não houve diferença no tempo de internação entre aqueles com e sem injúria miocárdica (4,6 ± 2,9 vs. 4,5 ± 3,2, respectivamente; p = 0,44). Conclusão: A angiotomografia de coronárias sem lesões obstrutivas moderadas ou importantes foi preditora de ausência de eventos cardiovasculares em pacientes submetidos a cirurgia vascular.
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    Bone marrow cell therapy prevents infarct expansion and improves border zone remodeling after coronary occlusion in rats
    (Elsevier B.V., 2010-11-05) Santos, Leonardo dos [UNIFESP]; Santos, Alexandra A. [UNIFESP]; Goncalves, Giovana A.; Krieger, Jose Eduardo; Ferreira Tucci, Paulo Jose [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    Background: Since the cell therapy benefits for myocardial infarction are mainly related to infarct reduction by regenerating lost myocardium or increasing survival of tissues at risk, we evaluated the effects of bone marrow-derived mononuclear cells (MNC), implanted after the completion of necrosis, on infarct progression and cardiac remodeling.Methods: After 48 h of induction of myocardial infarction (MI), Lewis-inbred rats were injected with 6 x 10(6) cells (MI + MNC) or saline (MI). After six weeks, scar dimension, ventricular morphology and function were analyzed by echocardiography followed by histomorphology of the infarcted and border zones.Results: After therapy, the relative size of the infarct was smaller in MI + MNC (37 +/- 1% of the left ventricle) than in MI (43 +/- 1%). While the MI group exhibited parallel elongation of the infarcted (31.6 +/- 3.8% increase) and reminiscent ventricular portions (33.5 +/- 3.7%), MNC therapy preserved the initial infarct length. Infarcted walls were thicker (979 +/- 31 mm) in the MNC group than in the untreated group (709 +/- 41 mm), also demonstrating an absence of infarct expansion. in the border zones, MNC led to increased capillary densities and capillary/myocyte ratios. the cardiac systolic function remained depressed in MI, but improved by 19 +/- 5% in MI + MNC which reduced the incidence of pulmonary arterial hypertension (37.5% in MI and 6.25% in MI + MNC).Conclusion: MNC therapy prevented the infarct expansion and thinning related to cardiac remodeling and was associated with an improvement of border zone microcirculation: as a result, MNC therapy reduced typical MI dysfunctional repercussions. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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    Caracterização Morfológica e Tecidual de Lesões Culpadas em Pacientes comInfarto Agudo do Miocárdio com Supradesnivelamento do Segmento ST Após Uso deFibrinolítico. Análise com Ultrassom Intracoronário e TecnologiaiMAP®
    (Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista - SBHCI, 2014-09-01) Souza, Cristiano Freitas de; Maehara, Akiko; Lima, Eduardo; Guimarães, Leonardo de Freitas C.; Carvalho, Antonio Carlos [UNIFESP]; Alves, Claudia Maria Rodrigues [UNIFESP]; Caixeta, Adriano [UNIFESP]; Columbia University Medical Center Cardiovascular Research Foundation; Universidade Federal de São Paulo (UNIFESP); Hospital Israelita Albert Einstein
    Introdução:Atualmente, existe grande debate acerca da fisiopatologia do infarto agudo do miocárdio e da composição tecidual e morfológica das lesões responsáveis por eventos isquêmicos. Entretanto, poucos estudos investigaram a aplicabilidade da tecnologia iMAP® na caracterização tecidual desses pacientes. Avaliamo pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST pós-fibrinolítico com ultrassom intravascular em escala de cinzas e com a tecnologia iMAP®, a fim de descrever a composição tecidual das lesõe culpadas pelo infarto agudo do miocárdio.Métodos:Foram avaliadas três artérias coronárias epicárdicas com ultrassom intravascular em escala de cinzas e com a tecnologia iMAP® de 25 pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST pós-trombólise, com critérios de reperfusão.Resultados:A média de idade foi de 51 ± 11,5 anos, com predomínio do sexo masculino (72%). A artéria mais frequentemente envolvida foi a coronária direita (48%). O ultrassom intravascular mostrou que as lesões culpadas eram longas (extensão de 31,0 ± 17,2 mm) e com elevado porcentual de volume de placa (58,5 ± 5,1%). No ponto de maior obstrução, ou seja, na área luminal mínima, a carga de placa foi de 82,5 ± 7,5%. Além disso, o índice de remodelamento médio foi de 1,4 ± 1,0, denotando remodelamento positivo. As análises pelo iMAP®, tanto da lesão, quanto da área luminal mínima, mostraram predomínio em termos porcentuais de componente fibrótico e necrótico, quando comparados aos demais.Conclusões:As lesões ateroscleróticas culpadas pelo infarto agudo do miocárdio com supradesnivelamento do segmento ST apresentaram predomínio de remodelamento arterial positivo e do componente necrótico na composição da placa culpada, o que corrobora, in vivo, a principal fisiopatologia da doença aterosclerótica aguda.
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    Caracterização tecidual e fenotípica in vivo da placa aterosclerótica em pacientes com infarto agudo do miocárdio: análise pelo ultrassom intravascular utilizando o mapeamento tecidual iMAP®
    (Universidade Federal de São Paulo (UNIFESP), 2016-11-11) Souza, Cristiano Freitas de [UNIFESP]; Carvalho, Antonio Carlos de Camargo [UNIFESP]; http://lattes.cnpq.br/6569055379421505; http://lattes.cnpq.br/2847246252774147; Universidade Federal de São Paulo (UNIFESP)
    Background: There is limited data on plaque tissue characterization and phenotype classification using radiofrequency iMAP-IVUS?. Methods: In the iWonder study patients presenting with non-ST-elevation myocardial infarction (STEMI) or STEMI underwent 3-vessel grayscale IVUS and iMAP-IVUS? tissue characterization prior to percutaneous intervention. In total, 385 lesions from 100 patients were divided into culprit (n=100) and non-culprit (n=285) lesions. Lesion phenotype was classified in a hierarchical fashion into: (1) TCFA (thin-cap fibroatheroma ? at least 1 frame with >30° of necrotic core [NC] abutting to the lumen); (2) ThCFA (NC >10%, confluent dense calcium [DC] >10%, well-defined fibrous cap); (3) PIT (pathological intimal thickening ? mainly fibrofatty tissue, <10% confluent NC); (4) fibrotic plaque (mainly fibrous tissue, <10% confluent NC, <10% confluent DC) and (5) fibrocalcific plaque (mainly fibrous tissue, >10% confluent DC and <10% confluent NC). Results: Culprit lesions had smaller minimum lumen area with greater plaque burden compared to non-culprit lesions. Volumetric analysis showed that culprit lesions had longer length and larger vessel and plaque volumes compared to non-culprit lesions. iMAP-IVUS? revealed that culprit lesions presented more NC and fibrofatty volume, both at lesion level and at the minimum lumen area (MLA) site (all p<0.001). Any fibroatheroma was more frequently identified in the culprit lesions compared to non-culprit lesions (93% vs. 78.9%, p=0.001). Also, a TCFA was more prevalent within culprit vs. non-culprit lesions (39.0% vs. 19.0%, p<0.001) anywhere within the lesion as well as at the MLA site (18.0% vs. 9.5%, p=0.07). Conclusion: Three-vessel radiofrequency iMAP-IVUS? study demonstrated a greater plaque burden and higher prevalence of any fibroatheroma as well as TCFAs in culprit vs non-culprit lesions in patients presenting with STEMI or non-STEMI and undergoing percutaneous intervention.
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    Complicações vasculares em pacientes submetidos a intervenção coronária percutânea precoce por via femoral após fibrinólise com tenecteplase: registro de 199 pacientes
    (Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista - SBHCI, 2012-01-01) Gomes Junior, Manuel Pereira Marques [UNIFESP]; Falcão, Felipe José de Andrade [UNIFESP]; Alves, Claudia Maria Rodrigues [UNIFESP]; Sousa, José Marconi Almeida de [UNIFESP]; Herrmann, João Lourenço [UNIFESP]; Moreno, Antonio Celio Camargo [UNIFESP]; Oliveira, Carlos Alexandre Lemes de [UNIFESP]; Matos, Lívia Nascimento de [UNIFESP]; Barbosa, Adriano Henrique Pereira; Carvalho, Antonio Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Serviço de Atendimento Móvel de Urgência
    BACKGROUND: Fibrinolysis is often used in the treatment of acute coronary syndromes with ST segment elevation (STEMI). Major cardiac outcomes were reduced with antiplatelet therapy intensification, but with increased risk of bleeding. Our objective was to assess the risk of vascular bleeding in patients undergoing early percutaneous coronary intervention after thrombolysis. METHODS: Between February 2010 and December 2011, five public emergency rooms in the city of São Paulo and the Emergency Health Care Service (Serviço de Atendimento Móvel de Urgência - SAMU) used tenecteplase (TNK) to treat patients with STEMI. Patients were referred to a single tertiary hospital and were submitted to early cardiac catheterization during hospitalization. All examinations were performed via the femoral artery and BARC criteria were used to classify bleeding. RESULTS: We evaluated 199 patients, of whom 193 had no bleeding of vascular origin (group 1) and 6 (3%) developed this complication (group 2). The median time between the administration of the fibrinolytic agent and catheterization was 24 hours in group 1 and 14.7 hours in group 2. According to BARC criteria, 1 patient had type 3a bleeding (hematoma in the inguinal region with a hemoglobin decrease of 3-5 g/dL), 2 patients had type 3b bleeding (1 not related to vascular access and 1 retroperitoneal hematoma with a hemoglobin decrease ≥ 5 g/dL) and the remaining patients had type 1 bleeding (small inguinal hematomas). Blood transfusions were required in 2 patients. None of the patients died due to vascular complications after the intervention. CONCLUSIONS: In our study, early catheterization via the femoral artery as part of a pharmaco-invasive strategy, using TNK as a fibrinolytic agent, had a low vascular bleeding rate, comparable to that of elective angioplasties.
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    Ecocardiografia doppler em ratas com infarto do miocárdio
    (Universidade Federal de São Paulo (UNIFESP), 2007) Moisés, Valdir Ambrósio [UNIFESP]
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    Endurance training restores peritoneal macrophage function in post-MI congestive heart failure rats
    (Amer Physiological Soc, 2007-05-01) Batista, M. L.; Santos, Ronaldo Vagner Thomatieli dos [UNIFESP]; Oliveira, E. M.; Seelaender, M. C. L.; Rosa, L. F. B. P. Costa; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Univ Mogi das Cruzes
    Congestive heart failure (CHF) induces a state of immune activation, and peritoneal macrophages (M Phi s) may play an important role in the development and progression of one such condition. Moderate endurance training modulates peritoneal M Phi function. We evaluated the effect of endurance training on different stages of the phagocytic process and in the production of interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) after LPS stimulation. Either ligation of the left coronary artery or Sham operations were performed in adult Wistar rats. After 4 wk, control (Sham operated) and MI (ligation of the left coronary artery) animals were randomly assigned to either a sedentary (Sham-operated sedentary, n = 7 and MI sedentary, n = 10) or a trained group (Sham-operated trained, n = 8 and MI trained, n = 8). Trained rats ran on a treadmill (0% grade at 13-20 m/min) for 60 min/day, 5 days/wk, for 8-10 wk, whereas sedentary rats had only limited activity. Training increased maximal oxygen uptake normalized for body weight (ml . kg(-1). min(-1)), as well as skeletal muscle citrate synthase maximal activity, when compared with sedentary groups. the resident and total cell number, the chemotaxis index, and the production of TNF-alpha stimulated by LPS were significantly higher in the MI sedentary group when compared with the Sham sedentary group. Moderate endurance training reversed these alterations promoted by post-MI. These results demonstrate that moderate intensity exercise training modulates peritoneal M Phi function and induces beneficial metabolic effects in rats with post-MI CHF.
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    Exercício físico aeróbio potencializa a terapia com células-tronco mesenquimais derivadas do tecido adiposo em ratos com infarto do miocárdio
    (Universidade Federal de São Paulo (UNIFESP), 2016-11-11) Vieira, Stella de Souza [UNIFESP]; Serra, Andrey Jorge [UNIFESP]; http://lattes.cnpq.br/6499058447489317; http://lattes.cnpq.br/8786513800216063; Universidade Federal de São Paulo (UNIFESP)
    Aims: To analyze the effect of prior exercise training to myocardial infarction (MI) in the cardiac remodeling of rats undergoing therapy with mesenchymal stem cells from adipose tissue (ADSC). Methods: The study included 130 Fisher-344 rats allocated in one of the following groups: SHAM; IMC (infarcted control); T+IM (animals trained previously to IM); IM+CDTA (infarcted animals treated with ADSC); T+IM+CDTA (animals trained previously to IM and treated with ADSC) Exercise training consisted of five weekly sessions of 90 minutes of swimming, for nine weeks. The following analyses were conducted: peak oxygen consumption (VO2peak), cardiac structure and function, myocardial inotropism, apoptosis and capillary density. Molecular analyses were performed with quantitative PCR and Western blot. The myocardial detection of ADSC was performed after 60 minutes and seven days of transplantation by SRY gene expression and radiolabeling Results: Cell therapy led to attenuation of cardiac hypertrophy (SHAM 139±4; IMC 244±3*; T+IM 199±2*; IM+CDTA 171±2#; T+IM+CDTA 163±1#. *p<0,05 vs. SHAM e #p<0,05 vs. IMC), cavity dilatation (SHAM 3±5; IMC 26±5*; T+IM 29±4*; IM+CDTA 17±2; T+IM+CDTA 16±2. *p<0,05 vs. SHAM), improvement in ventricular function (SHAM 24±6; IMC -18±2*; T+IM -12±4*; IM+CDTA 19±3; T+IM+CDTA 38±2) and increased myocardial inotropismo (SHAM 54±1; IMC 31±7*; T+IM 22±8*; IM+CDTA 35±1; T+IM+CDTA 42±2#. *p<0,05 vs. SHAM e #p<0,05 vs. IMC).. Additional benefits of CDTA to capillarity, apoptosis, and fibrosis in the infarcted myocardium were found. The effects of cell therapy were potentiated with the exercise. This effect may be related to higher ADSC content in myocardial tissue and attenuation of inflammatory profile related to exercise. Conclusion: Exercise training positively influenced cell therapy-related attenuation in post-infarction cardiac remodeling, in which the benefits were related to changes in the myocardial microenvironment, providing improved receptor niche for transplantation.
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    O exercício prévio melhora a sobrevida e atenua as repercussões miocárdicas da reperfusão tardia em ratas
    (Universidade Federal de São Paulo (UNIFESP), 2016-11-08) Veiga, Eduardo Carvalho de Arruda [UNIFESP]; Tucci, Paulo Jose Ferreira [UNIFESP]; http://lattes.cnpq.br/5187930505942303; http://lattes.cnpq.br/9762488058584769; Universidade Federal de São Paulo (UNIFESP)
    Introduction: There is acceptable evidence that exercise benefits the heart function in diseases already established in the heart. The literature is less conclusive in respect to the beneficial effects of the previous exercise training in the evolution of transient and permanent coronary occlusion. Objective: This study aimed to evaluate the effects of previous swimming in structural, functional and molecular biology of rat hearts, evaluated four weeks after permanent coronary occlusion or one hour of ischemia followed by reperfusion. Methods: Rats were subjected to swimming protocol for eight weeks and randomized between four groups: 1) sedentary infarcted (SMI; n = 12); 2) exercised infarcted (EMI: n = 12), 3) sedentary ischemia/reperfusion (SIR; n= 9) and 4) exercised ischemia/reperfusion (EIR, n = 8). Thereafter, the rats remained four weeks under observation for spontaneous evolution of secondary pathophysiology of coronary occlusion. Results (x ± sem): The Kaplan Meyer curve indicated that sedentary rats had higher mortality than the exercised. Those suffering permanent occlusion and those reperfused had MI size (% LV) not differents (SMI: 44 ± 1; EMI: 47 ± 2; SIR: 46 ± 1; EIR: 49 ± 2). Sedentary groups denoted pulmonary congestion, in contrast to exercise animals, which has no pulmonary congestion. The cardiac masses of different groups did not differ in respect to LV and RV. The hemodynamic data included: a) higher heart rate in EMI group; b) LV systolic pressure reduced in SMI animals; c) attenuation of LV end diastolic pressure increase in EIR; d) first time derivatives of positive ventricular pressure reduction in infarcted groups. In Doppler echocardiogram, there were no differences between analyzed parameters: diastolic and systolic areas, transverse fractional shortening of areas and E/A ratio. In the analysis of the papillary muscles, the maximum forces developed by reperfused groups were higher than those of the infarcted and the same result was found for the positive derivative of force. The nuclear volume of the reminiscent cardiomyocytes of exercised groups was lower than those of the sedentary groups. Collagen content, apoptosis and caspase 3 in ischemia/reperfusion groups were lower than those subjected to permanent coronary occlusion. Quantification of phosphorylated AKT1 of SMI group was lower than that of other groups; the SERCA2a/GAPDH ratios were higher in the exercised animals, as well as phosphorylated phospholamban in the groups with isquemia/reperfusion. CaATPase of the SIM group was lower than all other groups. The values of the ryanodine receptor/GAPDH of EIM were lower than all other groups. Conclusion: Prior exercise training enhanced survival, structural, functional and molecular characteristics of rats submitted to late ischemia/reperfusion. In rats submitted to definitive coronary occlusion, previous exercise promoted: lesser nuclear volume, prolonged survival, normal systolic arterial and increased phosphorylated AKT1, SERCA2 of remanent myocardial.
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    Experiência inicial com a cânula de assistência ventricular TransCoreTM
    (Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista - SBHCI, 2010-01-01) Souza, Cristiano Freitas De [UNIFESP]; Minohara, Stéfano Franco; Alves, Claudia Maria Rodrigues [UNIFESP]; Lima, Valter Correia De [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); CMS Medical
    Cardiogenic shock is a condition associated to high mortality rates. For decades, the treatment consisted of vasoactive drugs and intra-aortic balloon pump. Left ventricular assist devices have been recently introduced, however the high costs of these devices have prevented their widespread use in public and private health care systems. Our initial experience with TransCoreTM, a left ventricular assist device manufactured in Brazil, is reported in this study.
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    Incidence of heart failure in infarcted rats that die spontaneously
    (Associação Brasileira de Divulgação Científica, 2006-10-01) Flumignan, Ronald Luiz Gomes [UNIFESP]; Kanashiro-Takeuchi, Rosimeire Miyuki [UNIFESP]; Saraiva, Roberto Magalhães [UNIFESP]; Portes, Leslie Andrews [UNIFESP]; Antonio, Ednei Luiz [UNIFESP]; Ishigai, Marcia Marcelino de Souza [UNIFESP]; Tucci, Paulo José Ferreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The present study reports for the first time the incidence of congestive heart failure (CHF) in previously infarcted rats that died spontaneously. Previously, pulmonary (PWC) and hepatic (HWC) water contents were determined in normal rats: 14 control animals were evaluated immediately after sacrifice, 8 placed in a refrigerator for 24 h, and 10 left at room temperature for 24 h. In the infarcted group, 9 rats died before (acute) and 28 died 48 h after (chronic) myocardial infarction. Thirteen chronic animals were submitted only to autopsy (N = 13), whereas PWC and HWC were also determined in the others (N = 15). Seven rats survived 48 h and died during anesthesia. Notably, PWC differed in normal rats: ambient (75.7 ± 1.3%) < control (77.5 ± 0.7%) < refrigerator (79.1 ± 1.4%) and there were no differences with respect to HWC. No clinical signs of CHF (dyspnea, lethargy or foot edema) were observed in infarcted rats before death. PWC was elevated in all chronic and anesthetized rats. HWC was increased in 48% of chronic and in all anesthetized rats. Our data showed that PWC needs to be evaluated before 24 h post mortem and that CHF is the rule in chronic infarcted rats suffering natural death. The congestive syndrome cannot be diagnosed correctly in rats by clinical signs alone, as previously proposed.
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    Linear and nonlinear analysis of heart rate variability in healthy subjects and after acute myocardial infarction in patients
    (Associação Brasileira de Divulgação Científica, 2012-05-01) Kunz, Vandeni Clarice; Borges, Érica Nicolau; Coelho, Regina Célia [UNIFESP]; Gubolino, Luiz Antonio; Martins, Luiz Eduardo Barreto; Silva, Ester da; Universidade Federal de São Carlos Departamento de Fisioterapia Núcleo de Pesquisa em Exercício Físico; Universidade Metodista de Piracicaba Faculdade de Ciências da Saúde; Universidade Federal de São Paulo (UNIFESP); Unidade Coronariana do Hospital dos Fornecedores de Cana de Piracicaba; Universidade Estadual de Campinas (UNICAMP)
    The objectives of this study were to evaluate and compare the use of linear and nonlinear methods for analysis of heart rate variability (HRV) in healthy subjects and in patients after acute myocardial infarction (AMI). Heart rate (HR) was recorded for 15 min in the supine position in 10 patients with AMI taking β-blockers (aged 57 ± 9 years) and in 11 healthy subjects (aged 53 ± 4 years). HRV was analyzed in the time domain (RMSSD and RMSM), the frequency domain using low- and high-frequency bands in normalized units (nu; LFnu and HFnu) and the LF/HF ratio and approximate entropy (ApEn) were determined. There was a correlation (P < 0.05) of RMSSD, RMSM, LFnu, HFnu, and the LF/HF ratio index with the ApEn of the AMI group on the 2nd (r = 0.87, 0.65, 0.72, 0.72, and 0.64) and 7th day (r = 0.88, 0.70, 0.69, 0.69, and 0.87) and of the healthy group (r = 0.63, 0.71, 0.63, 0.63, and 0.74), respectively. The median HRV indexes of the AMI group on the 2nd and 7th day differed from the healthy group (P < 0.05): RMSSD = 10.37, 19.95, 24.81; RMSM = 23.47, 31.96, 43.79; LFnu = 0.79, 0.79, 0.62; HFnu = 0.20, 0.20, 0.37; LF/HF ratio = 3.87, 3.94, 1.65; ApEn = 1.01, 1.24, 1.31, respectively. There was agreement between the methods, suggesting that these have the same power to evaluate autonomic modulation of HR in both AMI patients and healthy subjects. AMI contributed to a reduction in cardiac signal irregularity, higher sympathetic modulation and lower vagal modulation.
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    Mobilization and early hospital discharge for patients with acute myocardial infarction: literature review
    (Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2008-01-01) Lopes, Juliana de Lima [UNIFESP]; Santos, Juliana Turca dos; Lima, Sheila Cristina de; Barros, Alba Lucia Bottura Leite de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Instituto do Coração
    OBJECTIVE: This study was a literature review with the purpose of analyzing articles comparing early and late mobilization and those comparing early and late discharge for patients with acute myocardial infarction. METHODS: The literature review was performed using the Lilacs and Medline databases (1966-2007), and the length of the resting period, the hospitalization and possible complications were analyzed. RESULTS: We selected 18 articles; 11 of them compared early and late mobilization and 7 compared early and late discharge. The length of the resting period in the early mobilization group varied from 2 to 10 days and 5 to 28 days for the longest resting period. The early discharge group stayed in the hospital from 3 to 14 days and the late discharge group stayed in the hospital from 5 to 21 days. CONCLUSION: The studies show that there is no evidence of complications related to short periods of bed rest and hospitalization.
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    Potencial terapêutico cardíaco das células tronco mesenquimais precursoras de medula óssea CD271+
    (Universidade Federal de São Paulo (UNIFESP), 2018-03-29) Zuttion, Marilia Sanches Santos Rizzo [UNIFESP]; Kerkis, Irina [UNIFESP]; http://lattes.cnpq.br/4302687618153569; http://lattes.cnpq.br/2793231976810653; Universidade Federal de São Paulo (UNIFESP)
    MSCs are a particularly promising bone marrow-derived cell for cardiac regenerative therapy because of their availability, immunologic properties, and record of safety and efficacy. Several studies have confirmed the specificity of CD271 on MSC isolated from bone marrow. This marker has been suggested as a versatile marker to selectively isolate multipotent MSC with both immunosuppressive and lymphohematopoietic engraftment-promoting properties. Moreover MSC are preferentially selected in the CD271+ fraction compared to the CD271− fraction. Objective: We hypothesized that CD271+ MSCs isolated from normal human BM will repair ischemic heart damage in a mouse myocardial infarction (MI) model. Methods: CD271+ cells were isolated and injected in NOD/SCID mice following induction of a myocardial infarction (MI) and the effects on cardiac function and hemodynamic were determined by echocardiography and PV loop, respectively. MI size was calculated by dividing the length of MI, defined as the region with >50% of myocardial wall thickness with collagen (blue) deposition with left ventricle length through MIQuant software and the human injected CD271+ cells were tracked by immunofluorescence using anti-human mitochondrial ribosomal protein L11. The data were performed using the SIGMAPLOT software and the values were expressed as mean±standard error of the mean (SEM). The level of statistical significance was set at p<0.05.Results: The CD271+ cells were capable to adhere at the plastic and showed a high capacity of expansion in vitro. Culture of the CD271+ cells under adherent conditions were not able to differentiate in osteo and adipogenic lineages. Animals treated with CD271+ cells had no significant improvement in heart function, however it demonstrated a tendency to preserve EF. Moreover, it was possible to track human cells at the infarcted zone in cell treated animals. Conclusion: We conclude that CD271 inhibited the differentiation of this cells into osteo and adipogenic lineages. These results indicate a role for CD271 in inhibiting the differentiation of MSC CD271+ and the intracardiac injected CD271+ MSC were able to home to infarcted zone after 8 weeks post-MI and demonstrate a trend to preserve EF.
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    Predictive Factors of Anxiety and Depression in Patients with Acute Coronary Syndrome
    (W B Saunders Co-Elsevier Inc, 2017) Altino, Denise Meira [UNIFESP]; Nogueira-Martins, Luiz Antonio [UNIFESP]; Bottura Leite de Barros, Alba Lucia [UNIFESP]; Lopes, Juliana de Lima [UNIFESP]
    OBJECTIVE: To identify the predictive factors of anxiety and depression in patients with acute coronary syndrome. METHODS: Cross-sectional and retrospective study conducted with 120 patients hospitalized with acute coronary syndrome. Factors interfering with anxiety and depression were assessed. RESULTS: Anxiety was related to sex, stress, years of education, and depression, while depression was related to sex, diabetes mellitus, obesity, years of education, and trait-anxiety. CONCLUSIONS: Obesity and anxiety were considered predictive factors for depression, while depression and fewer years of education were considered predictive factors for anxiety. (C) 2017 Published by Elsevier Inc.
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    Rats with high left ventricular end-diastolic pressure can be identified by Doppler echocardiography one week after myocardial infarction
    (Associação Brasileira de Divulgação Científica, 2007-11-01) Saraiva, Roberto Magalhães [UNIFESP]; Kanashiro-Takeuchi, Rosimeire Miyuki [UNIFESP]; Antonio, Ednei Luiz [UNIFESP]; Campos Filho, Orlando [UNIFESP]; Tucci, Paulo José Ferreira [UNIFESP]; Moisés, Valdir Ambrósio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The severity of left ventricular (LV) dysfunction in rats with myocardial infarction (MI) varies widely. Because homogeneity in baseline parameters is essential for experimental investigations, a study was conducted to establish whether Doppler echocardiography (DE) could accurately identify animals with high LV end-diastolic pressure as a marker of LV dysfunction soon after MI. Direct measurements of LV end-diastolic pressure were made and DE was performed simultaneously 1 week after surgically induced MI (N = 16) or sham-operation (N = 17) in female Wistar rats (200 to 250 g). The ratio of peak early (E) to late (A) diastolic LV filling velocities and the ratio of E velocity to peak early (Em) diastolic myocardial velocity were the best predictors of high LV end-diastolic pressure (>12 mmHg) soon after MI. Cut-off values of 1.77 for the E/A ratio (P = 0.001) identified rats with elevated LV end-diastolic pressure with 90% sensitivity and 80% specificity. Cut-off values of 20.4 for the E/Em ratio (P = 0.0001) identified rats with elevated LV end-diastolic pressure with 81.8% sensitivity and 80% specificity. Moreover, E/A and E/Em ratios were the only echocardiographic parameters independently associated with LV end-diastolic pressure in multiple linear regression analysis. Therefore, DE identifies rats with high LV end-diastolic pressure soon after MI. These findings have implications for using serial DE in animal selection and in the assessment of their response to experimental therapies.
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    Rede de infarto com supradesnivelamento de ST: sistematização em 205 casos diminui eventos clínicos na rede pública
    (Sociedade Brasileira de Cardiologia - SBC, 2012-11-01) Caluza, Ana Christina Vellozo [UNIFESP]; Barbosa, Adriano H. [UNIFESP]; Gonçalves, Iran [UNIFESP]; Oliveira, Carlos Alexandre L. de [UNIFESP]; Matos, Lívia Nascimento de [UNIFESP]; Zeefried, Claus; Moreno, Antonio Célio C.; Tarkieltaub, Elcio; Alves, Claudia Maria Rodrigues [UNIFESP]; Carvalho, Antonio Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Serviço de Atendimento Móvel de Urgência; Prefeitura Municipal de São Paulo Secretaria de Saúde; Hospital Municipal Prof. Dr. Alípio Correa Netto
    BACKGROUND: The major cause of death in the city of São Paulo (SP) is cardiac events. At its periphery, in-hospital mortality in acute myocardial infarction is estimated to range between 15% and 20% due to difficulties inherent in large metropoles. OBJECTIVE:To describe in-hospital mortality in ST-segment elevation acute myocardial infarction (STEMI) of patients admitted via ambulance or peripheral hospitals, which are part of a structured training network (STEMI Network). METHODS: Health care teams of four emergency services (Ermelino Matarazzo, Campo Limpo, Tatuapé and Saboya) of the periphery of the city of São Paulo and advanced ambulances of the Emergency Mobile Health Care Service (abbreviation in Portuguese, SAMU) were trained to use tenecteplase or to refer for primary angioplasty. A central office for electrocardiogram reading was used. After thrombolysis, the patient was sent to a tertiary reference hospital to undergo cardiac catheterization immediately (in case of failed thrombolysis) or in 6 to 24 hours, if the patient was stable. Quantitative and qualitative variables were assessed by use of uni- and multivariate analysis. RESULTS: From January 2010 to June 2011, 205 consecutive patients used the STEMI Network, and the findings were as follows: 87 anterior wall infarctions; 11 left bundle-branch blocks; 14 complete atrioventricular blocks; and 14 resuscitations after initial cardiorespiratory arrest. In-hospital mortality was 6.8% (14 patients), most of which due to cardiogenic shock, one hemorrhagic cerebrovascular accident, and one bleeding. CONCLUSION: The organization in the public health care system of a network for the treatment of STEMI, involving diagnosis, reperfusion, immediate transfer, and tertiary reference hospital, resulted in immediate improvement of STEMI outcomes.