Alexandre Rodrigues

Ecocardiografia de pacientes talassêmicos sem insuficiência cardíaca em tratamento com transfusões sanguíneas e quelação

BACKGROUND: Patients with thalassemia major present chronic hemolysis and require regular blood transfusions which may cause iron overload cardiomyopathy and chronic heart failure. Hemochromatosis is characterized by excessive iron accumulation in tissues, and heart involvement is the main cause of death in patients with thalassemia. OBJECTIVE: The aim of this study was to evaluate cardiac structure and function by conventional Doppler echocardiography and tissue Doppler imaging in patients with TM and no clinical evidence of heart failure. METHODS: This is a prospective observational study including 18 patients with thalassemia major (TM) receiving regular blood transfusion. To separately evaluate anemia and blood transfusion effects, two gender, age, weight, and height-matched control groups were included: one with healthy individuals (Healthy, n=18) and one with iron deficient anemia patients (Anemia, n=18). Statistical analysis was performed using ANOVA followed by Tukeys test or Kruskal-Walliss and Dunns test. RESULTS: The following echocardiographic variables presented significantly higher values in TM than the Anemia and Healthy groups: left atrium volume index (Healthy: 16.4±6.08; Anemia: 17.9±7.02; TM: 24.1±8.30 cm3/m2); mitral septal E/Em ratio (Healthy: 6.55±1.60; Anemia: 6.74±0.74; TM: 8.10±1.31); and duration of reverse pulmonary vein flow [Healthy: 74.0 (59.0-74.0); Anemia: 70.5 (67.0-74.0); TM: 111 (87.0-120) ms]. The mitral E/A ratio was higher in TM than Anemia (Healthy: 1.80±0.40; Anemia: 1.80±0.24; TM: 2.03±0.34). No differences were found in left ventricular structures and systolic function indexes. CONCLUSION: Conventional Doppler echocardiography and tissue Doppler allow changes in left ventricular diastolic function to be identified in asymptomatic patients with thalassemia major.

Ventricular systolic reserve in asymptomatic children previously treated with low doses of anthracyclines: a longitudinal, prospective exercise echocardiography study.

The time course of mild cardiotoxicity induced by anthracycline remains unknown. The aim of this study was to evaluate the long‐term evolution of decreased myocardial reserve in children previously treated with a cumulative dose of anthracycline up to 100 mg/m2.

Temporal Evaluation of Coronary Revascularization Procedures Performed through the Unified Health System (SUS) in Brazil: a 20-year overview

Fundamento: As taxas de mortalidade relacionadas a doenca aterosclerotica coronariana (DAC) vem reduzindo nas ultimas decadas devido, em parte, aos avancos nas tecnicas de revascularizacao. Objetivos: O objetivo deste estudo foi apresentar um visao dos ultimos 20 anos do tratamento da DAC pelo Sistema Unico de Saude (SUS) no Brasil. Metodos: Os dados foram obtidos atraves dos sistemas TABNET e SIGTAP do SUS e atraves do IBGE. Os procedimentos foram agrupados nas categorias de revascularizacao percutânea, cirurgica e percutânea primaria. Foram analisados o numero de autorizacoes de internacao hospitalar (AIH), duracao media de permanencia hospitalar, mortalidade hospitalar, valor do repasse total por procedimento e valores medios da AIH e dos servicos profissional e hospitalar. Resultados: Entre 1995 e 2015, houve aumento no numero de revascularizacoes cirurgicas (de 13.198 a 22.559) e percutâneas (de 10.522 a 66.345). De modo semelhante, o numero de angioplastias primarias apresentaram aumento entre 2004 e 2015 (de 1.901 a 8.524). Houve uma queda no tempo medio de permanencia hospitalar (de 14,4 a 12,8 dias) e da mortalidade hospitalar (de 7,6% a 5,9%) nas revascularizacoes cirurgicas e queda da permanencia hospitalar (de 5,3 dias a 3,7 dias) mas manutencao da taxa de mortalidade (2,2%) nas revascularizacoes percutâneas. Nas angioplastias primarias, o tempo medio de permanencia hospitalar variou de 5,3 a 5,6 dias e a taxa de mortalidade variou de 7,94% a 7,43% entre 2004 e 2015, respectivamente. O valor medio do repasse total para as revascularizacao cirurgicas variou de R

Ventricular Systolic Reserve in Asymptomatic Children Previously Treated With Low Doses of Anthracyclines

4.327,57 para R

Altered Left Ventricular Twist Is Associated with Clinical Severity in Adults and Adolescents with Homozygous Sickle Cell Anemia

12.839,13 e para as revascularizacoes percutâneas de R

Avaliação Temporal dos Procedimentos de Revascularização Coronariana pelo Sistema Único de Saúde (SUS) no Brasil: Um Panorama de 20 Anos

2.615,81 a R

Infarto agudo do miocárdio sob a ótica da população brasileira

6.187,87 entre 1995 e 2015, respectivamente. Os valores equivalentes para as angioplastias primarias foram de R

Acute myocardial infarction from the standpoint of the Brazilian population

5.415,58 em 2004 a R

Avaliação da função diastólica em portadores de talassemia major

6.581,51 em 2015. Conclusoes: O numero de procedimentos de revascularizacao aumentou no Brasil nos ultimos 20 anos, juntamente com uma melhora nas taxas de mortalidade e reducao no tempo de permanencia hospitalar. Observou-se importante defasagem de valores financeiros em relacao a inflacao acumulada neste periodo.