Paulo de Lara Lavítola

Universidade de São Paulo

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Flávio Tarasoutchi

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Roney Orismar Sampaio

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Guilherme Sobreira Spina

Universidade de São Paulo

Max Grinberg

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

João Ricardo Cordeiro Fernandes

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Luís Alberto Oliveira Dallan

University Hospitals of Cleveland

Berta Paula Napchan Boer

Universidade de São Paulo

Walter Amorim de Oliveira

Universidade de São Paulo

Vitor Emer Egypto Rosa

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Pablo Maria Alberto Pomerantzeff

Universidade de São Paulo

Cooperative Institutions

Universidade de São Paulo

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Instituto do Coração

Sociedade Brasileira de Cardiologia

Interamerican Society of Cardiology

Hospital do Coração

Hospital São Paulo

Hospital Israelita Albert Einstein

Universidade Brasil

Hospital Sírio-Libanês

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O que devemos saber sobre a anticoagulação em portadores de doença valvar e fibrilação atrial - parte 1

DOAJ (DOAJ: Directory of Open Access Journals) (2010)

Paulo de Lara Lavítola M Kubo

ABSTRACT The indication of oral anticoagulants is common in patients with atrial fibrillation and valvular dysfunction operated or not. Is long-term treatment and their management over time is complex because it is tied to standards often difficult to be obeyed. His suspension before surgical procedures is cause for concern, further increasing the complexity of treatment.

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Atualização das Diretrizes Brasileiras de Valvopatias – 2020

Arquivos Brasileiros de Cardiologia (2020)

Flávio Tarasoutchi Marcelo Westerlund Montera Auristela Isabel de Oliveira Ramos Roney Orismar Sampaio Vitor Emer Egypto Rosa

1. Introduction There are currently a wide modalities of interventional strategies – both transcatheter and surgical – which can be indicated for patients with valvular heart diseases (VHD), with the objective of reducing the morbidity and mortality. The correct timing for indication and the type of interventional treatment are linked to the precise anatomical and functional diagnosis of the VHD, and comprehensive global evaluation of the patient. The 2020 Update of the Brazilian Guidelines for VHD, in addition to compiling [...]

Modalities

10.36660/abc.20201047

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Tratamento cirurgico da comunicacao interventricular pos-infarto . Analise de 13 casos

Arquivos Brasileiros de Cardiologia (1985)

Luís Alberto Oliveira Dallan S. A. Oliveira R D Fontes Arlindo Riso Maria de Lourdes Higuchi

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Relationship Between Biomarkers and Different Types of Myocardial Fibrosis in Severe Aortic Valvular Heart Disease

Lucas José Tachotti Pires Vitor Emer Egypto Rosa Thamara Carvalho Morais Antonio S de Santis João Ricardo Cordeiro Fernandes

Myocardial fibrosis

valvular heart disease

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Varfarina ou Aspirina na prevenção de fenômenos embólicos na valvopatia mitral com fibrilação atrial

Arquivos Brasileiros de Cardiologia (2010)

Paulo de Lara Lavítola Roney Orismar Sampaio Walter Amorim de Oliveira Berta Napchan Bôer Flávio Tarasoutchi

FUNDAMENTO: A fibrilação atrial (FA) associada à doença valvar mitral reumatismal (DVMR) aumenta a incidência de tromboembolismo (TE), sendo a Varfarina a medicação padrão, apesar das dificuldades na adesão e no controle terapêutico. OBJETIVO: Comparar a eficácia da Aspirina contra a Varfarina na prevenção do TE em pacientes com FA e DVMR. MÉTODOS: Acompanhamos 229 pacientes (pts), portadores de FA e DVMR, em estudo prospectivo e randomizado. 110 pts receberam Aspirina 200 mg/dia, compondo o Grupo A (GA), e 119, a Varfarina, em doses ajustáveis individualmente, compondo o Grupo V (GV). RESULTADOS: Ocorreram 15 eventos embólicos no GA e 24 no GV (p = 0,187), dos quais 21 com o INR menor que 2,0. Assim, excluindo os pacientes com INR inadequado, houve maior número de eventos embólicos no GA (15 vs 3) (p < 0,0061). Houve menor adesão ao tratamento no GV (p = 0,001). Não houve sangramentos maiores em ambos os grupos. Pequenos sangramentos foram mais frequentes no GV (p < 0,01). O nível sérico de colesterol e triglicérides aumentados constituiu fator de risco para maior número de eventos tromboembólicos na população estudada, não havendo diferença entre os grupos. CONCLUSÃO: Na DVMR com FA há menos de um ano e sem embolia prévia, a Aspirina é uma opção pouco eficaz na prevenção do TE. Nos portadores de valvopatia mitral com menor risco (insuficiência mitral e prótese biológica mitral), sobretudo se houver contraindicação ou baixa aderência à Varfarina, a Aspirina pode ter algum benefício na prevenção do TE.

Contraindication

10.1590/s0066-782x2010005000140

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Abstract 16921: Relationship Between Biomarkers and Different Types of Myocardial Fibrosis in Severe Aortic Valvular Heart Disease

Circulation (2020)

Lucas José Tachotti Pires Vitor Emer Egypto Rosa Thamara Carvalho Morais Antonio S de Santis João Ricardo Cordeiro Fernandes

Introduction: Aortic stenosis (AS) and aortic regurgitation (AR) patients develop both myocardial hypertrophia and fibrosis. B-type natriuretic peptide (BNP) and troponin are biomarkers whose value in aortic valvular heart disease (VHD) remains controversial. Cardiac magnetic resonance (CMR) imaging can detect replacement myocardial fibrosis (MF) by using late gadolinium enhancement (LGE), and diffuse MF by using extracellular volume (ECV) based measures (relative - ECV fraction - and absolute - indexed ECV) calculated from T1 mapping. Data evaluating the relationship of these biomarkers with both types of MF are scarce in AS, and are missing in AR patients. Hypothesis: There is an association between preoperative BNP and troponin and preoperative MF measures in severe aortic VHD patients. Methods: Patients with isolated severe AS or AR were prospectively recruited to be submitted to CMR before surgery, including LGE and ECV measures quantifications. They also collected blood samples for quantification of BNP and high sensitivity T troponin. The relationship between biomarkers and MF parameters was evaluated using linear regression and nonparametric conventional tests. Results: The study population included 99 patients, 67 with AS and 32 with AR. BNP median was 63 (39-103) pg/mL and troponin median was 17 (5-34) ng/L, no difference between AS and AR (p=0.31 and p=0.88, respectively). BNP and troponin were associated with presence of LGE. BNP median was 47 (32-87) pg/mL without LGE vs. 87 (47-190) pg/mL with LGE (p=0.002). Troponin median was 13 (5-25) ng/L without LGE vs. 30 (10-71) ng/L with LGE (p=0.001). Regarding ECV measures, patients with ECV fraction higher than 28.25% had higher BNP levels (p<0.001) and patients with indexed ECV higher than 24.21mL/m 2 had higher troponin levels (p=0.015) (Figure 1). Conclusions: BNP and troponin are associated with quantity of MF in patients with severe aortic VHD with indication of intervention.

Myocardial fibrosis

valvular heart disease

Troponin T

Cardiac magnetic resonance

10.1161/circ.142.suppl_3.16921

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Trombose venosa central infectada: uma complicação incomum da nutrição parenteral prolongada (npp)

Livro de Resumos (1988)

Luís Alberto Oliveira Dallan S. A. Oliveira Paulo de Lara Lavítola A Sabino Jorge Rizzato Paschoal

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