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São Paulo, Brazil

Pereira C.,Instituto do Coracao HCFMUSP | Miname M.,Instituto do Coracao HCFMUSP | Makdisse M.,Hospital Israelita Albert Einstein | Filho R.K.,Instituto do Coracao HCFMUSP | Santos R.D.,Instituto do Coracao HCFMUSP
Arquivos Brasileiros de Cardiologia | Year: 2014

Background: Familial hypercholesterolemia (FH) is an autosomal dominant genetic disease characterized by an elevation in the serum levels of total cholesterol and of low-density lipoproteins (LDL- c). Known to be closely related to the atherosclerotic process, FH can determine the development of early obstructive lesions in different arterial beds. In this context, FH has also been proposed to be a risk factor for peripheral arterial disease (PAD).Objective: This observational cross-sectional study assessed the association of PAD with other manifestations of cardiovascular disease (CVD), such as coronary artery and cerebrovascular disease, in patients with heterozygous FH.Methods: The diagnosis of PAD was established by ankle-brachial index (ABI) values ≤ 0.90. This study assessed 202 patients (35% of men) with heterozygous FH (90.6% with LDL receptor mutations), mean age of 51 ± 14 years and total cholesterol levels of 342 ± 86 mg/dL.Results: The prevalences of PAD and previous CVD were 17% and 28.2%, respectively. On multivariate analysis, an independent association between CVD and the diagnosis of PAD was observed (OR = 2.50; 95% CI: 1.004 - 6.230; p = 0.049).Conclusion: Systematic screening for PAD by use of ABI is feasible to assess patients with FH, and it might indicate an increased risk for CVD. However, further studies are required to determine the role of ABI as a tool to assess the cardiovascular risk of those patients. © 1996-2014, Sociedade Brasileira de Cardiologia. All rights reserved. Source


Roque J.M.,Instituto do Coracao HCFMUSP | Roque J.M.,University of Sao Paulo | Carvalho V.O.,Instituto do Coracao HCFMUSP | Carvalho V.O.,University of Sao Paulo | And 6 more authors.
Arquivos Brasileiros de Cardiologia | Year: 2011

Becker muscular dystrophy (BMD) integrates dystrophy occurring due to genetic mutations that express the dystrophin protein in chromosome X. The onset of neuromuscular symptoms usually precedes the impairment of cardiac function, and may conversely happen by heart failure (HF). Physical training is well established in HF, however, when combined with BMD, it is controversial and without any scientific basis. This study presents the case of a patient with BMD associated with HF in cardiac transplant waiting list undergoing a physical training program. Source


Lima M.V.,Instituto do Coracao HCFMUSP | Ochiai M.E.,Instituto do Coracao HCFMUSP | Vieira K.N.,Instituto do Coracao HCFMUSP | Cardoso J.N.,Instituto do Coracao HCFMUSP | And 3 more authors.
Arquivos Brasileiros de Cardiologia | Year: 2012

Background: The clinical and hemodynamic assessment at the bedside and the use of pulmonary artery catheter for the estimation of hemodynamic data have been used in decompensated heart failure. However, there are no data on the use of continuous noninvasive hemodynamic monitoring. Objective: To compare the data obtained through noninvasive hemodynamic monitoring with invasive ones in patients with decompensated heart failure and refractory to treatment. Methods: The non-invasive hemodynamic measurements were obtained through continuous monitoring of systemic blood pressure by the pulse wave model (Modelflow) and compared with measurements obtained by the passage of a pulmonary artery catheter, simultaneously. Results: A total of 56 measurements were performed in 14 patients studied on different days and time periods. The correlation index between systolic blood pressure measurements was r = 0.26 (95% CI = 0.00 to 0.49, p = 0.0492) and diastolic ones, r = 0.50 (95% CI = 0.27 to 0.67, p <0.0001). The correlation was r = 0.55 (95% CI = 0.34 to 0.71, p <0.0001) for cardiac index and r = 0.32 (95% CI = 0.06 to 0 53, p = 0.0178) for systemic vascular resistance. Conclusion: There was a correlation between the hemodynamic measurements when compared to noninvasive pulmonary artery catheter measurements. The continuous noninvasive hemodynamic monitoring may be useful for hospitalized patients with decompensated heart failure. Source

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