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1. Diretriz Brasileira de Cardio-oncologia – 2020

Author

Ludhmila Abrahão Hajjar, Isabela Bispo Santos da Silva da Costa, Marcelo Antônio Cartaxo Queiroga Lopes, Paulo Marcelo Gehm Hoff, Maria Del Pilar Estevez Diz, Silvia Moulin Ribeiro Fonseca, Cristina Salvadori Bittar, Marília Harumi Higuchi dos Santos Rehder, Stephanie Itala Rizk, Dirceu Rodrigues Almeida, Gustavo dos Santos Fernandes, Luís Beck-da-Silva, Carlos Augusto Homem de Magalhães Campos, Marcelo Westerlund Montera, Sílvia Marinho Martins Alves, Júlia Tizue Fukushima, Maria Verônica Câmara dos Santos, Carlos Eduardo Negrão, Thiago Liguori Feliciano da Silva, Silvia Moreira Ayub Ferreira, Marcus Vinicius Bolivar Malachias, Maria da Consolação Vieira Moreira, Manuel Maria Ramos Valente Neto, Veronica Cristina Quiroga Fonseca, Maria Carolina Feres de Almeida Soeiro, Juliana Barbosa Sobral Alves, Carolina Maria Pinto Domingues Carvalho Silva, João Sbano, Ricardo Pavanello, Ibraim Masciarelli F. Pinto, Antônio Felipe Simão, Marianna Deway Andrade Dracoulakis, Ana Oliveira Hoff, Bruna Morhy Borges Leal Assunção, Yana Novis, Laura Testa, Aristóteles Comte de Alencar Filho, Cecília Beatriz Bittencourt Viana Cruz, Juliana Pereira, Diego Ribeiro Garcia, Cesar Higa Nomura, Carlos Eduardo Rochitte, Ariane Vieira Scarlatelli Macedo, Patricia Tavares Felipe Marcatti, Wilson Mathias Junior, Evanius Garcia Wiermann, Renata do Val, Helano Freitas, Anelisa Coutinho, Clarissa Maria de Cerqueira Mathias, Fernando Meton de Alencar Camara Vieira, André Deeke Sasse, Vanderson Rocha, José Antônio Franchini Ramires, and Roberto Kalil Filho

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Published
2020
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2. Diretriz Brasileira de Insuficiência Cardíaca Crônica e Aguda

Author

Luis Eduardo Paim Rohde, Marcelo Westerlund Montera, Edimar Alcides Bocchi, Nadine Oliveira Clausell, Denilson Campos de Albuquerque, Salvador Rassi, Alexandre Siciliano Colafranceschi, Aguinaldo Figueiredo de Freitas Junior, Almir Sergio Ferraz, Andreia Biolo, Antonio C. Pereira Barretto, Antonio Luiz Pinho Ribeiro, Carisi Anne Polanczyk, Danielle Menosi Gualandro, Dirceu Rodrigues Almeida, Eneida Rejane Rabelo da Silva, Estêvão Lanna Figueiredo, Evandro Tinoco Mesquita, Fabiana G. Marcondes-Braga, Fátima das Dores da Cruz, Felix José Alvarez Ramires, Fernando Antibas Atik, Fernando Bacal, Germano Emilio Conceição Souza, Gustavo Luiz Gouvêa de Almeida Junior, Gustavo Calado de Aguiar Ribeiro, Humberto Villacorta Junior, Jefferson Luís Vieira, João David de Souza Neto, João Manoel Rossi Neto, Jose Albuquerque de Figueiredo Neto, Lidia Ana Zytynsky Moura, Livia Adams Goldraich, Luis Beck-da-Silva, Luiz Claudio Danzmann, Manoel Fernandes Canesin, Marcelo Imbroinise Bittencourt, Marcelo Iorio Garcia, Marcely Gimenes Bonatto, Marcus Vinícius Simões, Maria da Consolação Vieira Moreira, Miguel Morita Fernandes da Silva, Mucio Tavares de Olivera Junior, Odilson Marcos Silvestre, Pedro Vellosa Schwartzmann, Reinaldo Bulgarelli Bestetti, Ricardo Mourilhe Rocha, Ricardo Simões, Sabrina Bernardez Pereira, Sandrigo Mangini, Sílvia Marinho Martins Alves, Silvia Moreira Ayub Ferreira, Victor Sarli Issa, Vitor Salvatore Barzilai, and Wolney de Andrade Martins

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
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3. Spatial analysis of the natural infection index for Triatomines and the risk of Chagas disease transmission in Northeastern Brazil

Author

Carolina de Araújo Medeiros, Maria Beatriz Araújo Silva, André Luiz Sá de Oliveira, Sílvia Marinho Martins Alves, Wilson de Oliveira Júnior, and Zulma Maria de Medeiros

Subjects
Chagas disease, Epidemiology, Spatial analysis, Triatomine
Abstract

This study aimed to analyze the spatial pattern of natural infection index (NII) for triatomines and the risk of Chagas disease transmission in an endemic area of Northeastern Brazil. An ecological study was conducted, based on 184 municipalities in five mesoregions. The NII for triatomines was evaluated in the Pernambuco State, Brazil, from 2016 to 2018. Spatial autocorrelations were evaluated using Global Moran Index (I) and Local Moran Index (II) and were considered positive when I > 0 and p < 0.05, respectively. In total, 7,302 triatomines belonging to seven different species were detected. Triatoma brasiliensis had the highest frequency (53%; n = 3,844), followed by Triatoma pseudomaculata (25%; n = 1,828) and Panstrongylus lutzi (18.5%; n=1,366). The overall NII was 12%, and the higher NII values were P. lutzi (21%) and Panstrongylus megistus (18%). In the mesoregions of Zona da Mata, Agreste, Sertao, and Sertao do Sao Francisco, 93% of triatomines were detected indoors. The global spatial autocorrelation of I to NII was positive (0.2; p = 0.01), and II values calculated using BoxMap, MoranMap, Lisa Cluster Map were statistically significant for natural infections. With regard to the risk areas for the presence of triatomines, Zone 2 (the Agreste and Sertao regions) presented a relative risk of 3.65 compared to other areas in the state. Our study shows the potential areas of vector transmission of Chagas disease. In this study, the application of different methods of spatial analysis made it possible to locate these areas, which would not have been identified by only applying epidemiological indicators.

Published
2023
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4. Delineamento e Racional do Estudo Rosa dos Ventos: Estudo Multicêntrico do Tipo Coorte de Pacientes com Insuficiência Cardíaca com Fração de Ejeção Reduzida ou Moderadamente Reduzida no Brasil

Author

Dhayn Cassi de Almeida Freitas, Larissa Maria de Paula Rebouças da Costa, Wilson Nadruz Jr., Fabiana G. Marcondes-Braga, Jefferson Luis Vieira, Sabrina Bernardez-Pereira, Wilson Rodrigues Barbosa Neto, Silvia Marinho Martins Alves, Gabriela Arcoverde Wanderley, Camila Nogueira Leandro Lira, Lucas Yugi de Souza Terui, Ana Luísa Guedes de França e Silva, Alana de Oliveira Castro, Aguinaldo F. Freitas Jr., José Albuquerque de Figueiredo Neto, Renato D. Lopes, Miguel Morita Fernandes-Silva, and Odilson Marcos Silvestre

Subjects
Insuficiência Cardíaca, Brazil, Estratégias de Saúde, Prognosis, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Resumo Fundamento: O Brasil é um país com diferentes biomas e desigualdades sociais. Existem poucos dados disponíveis sobre as diferenças regionais e o prognóstico da insuficiência cardíaca (IC) no país. Objetivo: O estudo Rosa dos Ventos tem como objetivo investigar as diferenças regionais e o prognóstico atual de pacientes com IC com fração de ejeção reduzida ou moderadamente reduzida no Brasil. Métodos: Este é um estudo prospectivo, multicêntrico, observacional, do tipo coorte que incluirá pacientes ambulatoriais com idade superior a 18 anos com IC e fração de ejeção < 50% em 30 centros privados distribuídos nas regiões brasileiras. Um total de 2500 pacientes serão incluídos entre junho de 2021 e outubro de 2023, com um período de 12 meses de seguimento. Coletaremos dados sobre status clínico e socioeconômico, prescrição médica e resultados de exames cardiológicos. Serão realizados telefonemas para o seguimento dos pacientes seis e 12 meses após a inclusão para coleta de informações sobre visitas ao departamento de emergência, internações e mortalidade. Conclusão: O estudo Rosa dos Ventos permitirá uma caracterização mais precisa da IC crônica no Brasil. Essa iniciativa proverá informações relevantes para o desenvolvimento de estratégias de manejo efetivas para mitigar o impacto dessa condição sobre os pacientes e o sistema de saúde.

Published
2024
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5. Mapping the morbidity and mortality of Chagas disease in an endemic area in Brazil

Author

Carolina de Araújo Medeiros, Maria Beatriz de Araújo Silva, André Luiz Sá de Oliveira, Sílvia Marinho Martins Alves, Maria das Neves Dantas da Silveira Barros, Maria da Glória Aureliano de Melo Cavalcanti, Gênova Maria de Azevedo Oliveira, Cristina de Fátima Velloso Carrazzone, Wilson Alves de Oliveira Jr, and Zulma Maria de Medeiros

Subjects
Male, Chagas disease, Acute Disease, Humans, Neglected Diseases, Chagas Disease, Female, Middle Aged, Morbidity, Mortality, Brazil, Chronic disease
Abstract

Chagas disease is among the 21 neglected diseases according to the World Health Organization. This study aimed to investigate the morbidity and mortality distribution of Chagas disease for identifying areas with greater prevalences and deaths of the disease in Northeast Brazil. A population-based ecological study was performed from 2016 to 2018 using data on acute Chagas disease patients from the Disease Notification Information System, chronic cases from the Chagas Disease and the referral Heart Failure Outpatient Clinic in Pernambuco, and Chagas disease-related mortality from the Mortality Information System. The unit of analysis were Pernambuco State mesoregions. The indicators were spatialized into thematic maps on the occurrence and mortality of the disease per 100,000 inhabitants. No cases of acute disease were reported in the period analyzed. Data on 801 chronic Chagas disease patients were analyzed. The population showed an average age of 62 years, with female predominance. The most prevalent comorbidity was systemic arterial hypertension and cardiologic involvement without ventricular dysfunction. The average chronic disease occurrence rate was 3.2/ 100,000 people/ year. As for deaths in the mortality system; in total, 350 deaths were recorded, showing male predominance, age ≥ 60 years, and chronic disease with cardiac involvement as the main mortality cause. The annual average mortality proportion was 1.6/100,000 people. The chronic case distribution showed spatial heterogeneity, with the highest rates of chronic disease and deaths observed in two mesoregions, with the main cause of death being heart-related. This highlights the need for more specialized services in areas with higher burden of the disease to avoid delay in the patients’ care.

Published
2022

6. Influence of angiotensin II type 1 receptors and angiotensin-converting enzyme I/D gene polymorphisms on the progression of Chagas' heart disease in a Brazilian cohort: Impact of therapy on clinical outcomes.

Author

Thayse do Espírito Santo Protásio da Silva, Lucia Elena Alvarado-Arnez, Angelica Martins Batista, Silvia Marinho Martins Alves, Gloria Melo, Cristina Veloso Carrazzone, Isabelle de Oliveira Moraes, Antonio G Pacheco, Camila Sarteschi, Milton Ozório Moraes, Wilson Oliveira, and Joseli Lannes-Vieira

Subjects
Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract

Chagas disease (CD), a neglected tropical disease, is caused by infection by the protozoan Trypanosoma cruzi. One-third of CD patients develop cardiac disease (CARD), an inflammatory and fibrotic process that may progress to heart failure associated with reduced left ventricular ejection fraction (LVEF). The determinants of CD progression are still uncertain. In non-infectious conditions, the angiotensin-converting enzyme (ACE) functional insertion (I)/deletion (D) and type 1 angiotensin II receptor (AT1R) +1166A>C gene polymorphisms have been linked to clinical outcomes. In a Brazilian cohort of 402 patients with positive serology for CD, in a case-control study we used PCR for genotyping the ACE rs4646994 I/D and AGTR1 rs5182C>T, rs275653 -119C>T, rs2131127A>G and rs5186 +1166A>C polymorphisms to evaluate association with CARD and progression to heart failure. Patients were classified as non-CARD (stage A; 109), and mild (stage B1; 161) or severe (stage C; 132) CARD. The groups were compared using unconditional logistic regression analysis and adjusted for non-genetic covariates (age, gender, and trypanocidal treatment). ACE II genotype appeared less frequent in C patients (15% in C vs 20% in B1 and 27% in A). After covariate adjustments, the ACE D allele showed a borderline association with susceptibility to severe CARD (C vs A: OR = 1.9; P = 0.08). AGTR1 +1166AC genotype showed a borderline association with protection against the progression and severity of CARD (C vs A: OR = 0.6; P = 0.09; C vs B1: OR = 0.6; P = 0.07; C vs A + B1: OR = 0.6; P = 0.05). However, adjustments for multiple comparisons showed no association of ACE I/D and AGTR1 polymorphisms with susceptibility and severity of CARD. The rs275653/rs2131127/rs5186/rs5182 T/A/C/T haplotype was protective against progression to the severe form of CARD (C vs B1: OR = 0.3; P = 0.03). Moreover, patients with ACE II and AGTR1 rs5186 +1166AC genotypes presented higher LVEF%. In C patients, TNF serum levels were higher in ACE D carriers than in II genotype. Although limited in number, a cross-sectional observation suggests that C-stage patients treated with benznidazole years prior to administration of ACE inhibitors/AT1R antagonists show reduced TNF serum levels and improved LVEF%. Therefore, variants of ACE and AGTR1 genes may influence the outcome of Chagas' heart disease and should be explored in precision medicine. Further, pharmacotherapies may improve immunological abnormality and clinical outcome in CD patients. Altogether, these data support prospective studies of this cohort and replication in other cohorts.

Published
2024
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7. Brazilian Cardio-oncology Guideline - 2020

Author

Ludhmila Abrahão, Hajjar, Isabela Bispo Santos da Silva da, Costa, Marcelo Antônio Cartaxo Queiroga, Lopes, Paulo Marcelo Gehm, Hoff, Maria Del Pilar Estevez, Diz, Silvia Moulin Ribeiro, Fonseca, Cristina Salvadori, Bittar, Marília Harumi Higuchi Dos Santos, Rehder, Stephanie Itala, Rizk, Dirceu Rodrigues, Almeida, Gustavo Dos Santos, Fernandes, Luís, Beck-da-Silva, Carlos Augusto Homem de Magalhães, Campos, Marcelo Westerlund, Montera, Sílvia Marinho Martins, Alves, Júlia Tizue, Fukushima, Maria Verônica Câmara Dos, Santos, Carlos Eduardo, Negrão, Thiago Liguori Feliciano da, Silva, Silvia Moreira Ayub, Ferreira, Marcus Vinicius Bolivar, Malachias, Maria da Consolação Vieira, Moreira, Manuel Maria Ramos, Valente Neto, Veronica Cristina Quiroga, Fonseca, Maria Carolina Feres de Almeida, Soeiro, Juliana Barbosa Sobral, Alves, Carolina Maria Pinto Domingues Carvalho, Silva, João, Sbano, Ricardo, Pavanello, Ibraim Masciarelli F, Pinto, Antônio Felipe, Simão, Marianna Deway Andrade, Dracoulakis, Ana Oliveira, Hoff, Bruna Morhy Borges Leal, Assunção, Yana, Novis, Laura, Testa, Aristóteles Comte de, Alencar Filho, Cecília Beatriz Bittencourt Viana, Cruz, Juliana, Pereira, Diego Ribeiro, Garcia, Cesar Higa, Nomura, Carlos Eduardo, Rochitte, Ariane Vieira Scarlatelli, Macedo, Patricia Tavares Felipe, Marcatti, Wilson, Mathias Junior, Evanius Garcia, Wiermann, Renata do, Val, Helano, Freitas, Anelisa, Coutinho, Clarissa Maria de Cerqueira, Mathias, Fernando Meton de Alencar Camara, Vieira, André Deeke, Sasse, Vanderson, Rocha, José Antônio Franchini, Ramires, and Roberto, Kalil Filho

Subjects
Neoplasms, Humans, Medical Oncology, Brazil
Published
2020

8. Diretriz sobre Diagnóstico e Tratamento da Cardiomiopatia Hipertrófica – 2024

Author

Fabio Fernandes, Marcus V. Simões, Edileide de Barros Correia, Fabiana Goulart Marcondes-Braga, Otavio Rizzi Coelho-Filho, Cláudio Tinoco Mesquita, Wilson Mathias Junior, Murillo de Oliveira Antunes, Edmundo Arteaga-Fernández, Carlos Eduardo Rochitte, Felix José Alvarez Ramires, Silvia Marinho Martins Alves, Marcelo Westerlund Montera, Renato Delascio Lopes, Mucio Tavares de Oliveira Junior, Fernando Luis Scolari, Walkiria Samuel Avila, Manoel Fernandes Canesin, Edimar Alcides Bocchi, Fernando Bacal, Lidia Zytynski Moura, Eduardo Benchimol Saad, Mauricio Ibrahim Scanavacca, Bruno Pereira Valdigem, Manuel Nicolas Cano, Alexandre Antonio Cunha Abizaid, Henrique Barbosa Ribeiro, Pedro Alves Lemos Neto, Gustavo Calado de Aguiar Ribeiro, Fabio Biscegli Jatene, Ricardo Ribeiro Dias, Luis Beck-da-Silva, Luis Eduardo Paim Rohde, Marcelo Imbroinise Bittencourt, Alexandre da Costa Pereira, José Eduardo Krieger, Humberto Villacorta Junior, Wolney de Andrade Martins, José Albuquerque de Figueiredo Neto, Juliano Novaes Cardoso, Carlos Alberto Pastore, Ieda Biscegli Jatene, Ana Cristina Sayuri Tanaka, Viviane Tiemi Hotta, Minna Moreira Dias Romano, Denilson Campos de Albuquerque, Ricardo Mourilhe-Rocha, Ludhmila Abrahão Hajjar, Fabio Sandoli de Brito Junior, Bruno Caramelli, Daniela Calderaro, Pedro Silvio Farsky, Alexandre Siciliano Colafranceschi, Ibraim Masciarelli Francisco Pinto, Marcelo Luiz Campos Vieira, Luiz Claudio Danzmann, Silvio Henrique Barberato, Charles Mady, Martino Martinelli Filho, Ana Flavia Malheiros Torbey, Pedro Vellosa Schwartzmann, Ariane Vieira Scarlatelli Macedo, Silvia Moreira Ayub Ferreira, Andre Schmidt, Marcelo Dantas Tavares de Melo, Moysés Oliveira Lima Filho, Andrei C. Sposito, Flávio de Souza Brito, Andreia Biolo, Vagner Madrini Junior, Stephanie Itala Rizk, and Evandro Tinoco Mesquita

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Published
2024
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9. Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023

Author

José Antonio Marin-Neto, Anis Rassi Jr, Gláucia Maria Moraes Oliveira, Luís Claudio Lemos Correia, Alberto Novaes Ramos Júnior, Alejandro Ostermayer Luquetti, Alejandro Marcel Hasslocher-Moreno, Andréa Silvestre de Sousa, Angelo Amato Vincenzo de Paola, Antônio Carlos Sobral Sousa, Antonio Luiz Pinho Ribeiro, Dalmo Correia Filho, Dilma do Socorro Moraes de Souza, Edecio Cunha-Neto, Felix Jose Alvarez Ramires, Fernando Bacal, Maria do Carmo Pereira Nunes, Martino Martinelli Filho, Maurício Ibrahim Scanavacca, Roberto Magalhães Saraiva, Wilson Alves de Oliveira Júnior, Adalberto Menezes Lorga-Filho, Adriana de Jesus Benevides de Almeida Guimarães, Adriana Lopes Latado Braga, Adriana Sarmento de Oliveira, Alvaro Valentim Lima Sarabanda, Ana Yecê das Neves Pinto, Andre Assis Lopes do Carmo, Andre Schmidt, Andréa Rodrigues da Costa, Barbara Maria Ianni, Brivaldo Markman Filho, Carlos Eduardo Rochitte, Carolina Thé Macêdo, Charles Mady, Christophe Chevillard, Cláudio Marcelo Bittencourt das Virgens, Cleudson Nery de Castro, Constança Felicia De Paoli de Carvalho Britto, Cristiano Pisani, Daniela do Carmo Rassi, Dário Celestino Sobral Filho, Dirceu Rodrigues de Almeida, Edimar Alcides Bocchi, Evandro Tinoco Mesquita, Fernanda de Souza Nogueira Sardinha Mendes, Francisca Tatiana Pereira Gondim, Gilberto Marcelo Sperandio da Silva, Giselle de Lima Peixoto, Gustavo Glotz de Lima, Henrique Horta Veloso, Henrique Turin Moreira, Hugo Bellotti Lopes, Ibraim Masciarelli Francisco Pinto, João Marcos Bemfica Barbosa Ferreira, João Paulo Silva Nunes, José Augusto Soares Barreto-Filho, José Francisco Kerr Saraiva, Joseli Lannes-Vieira, Joselina Luzia Menezes Oliveira, Luciana Vidal Armaganijan, Luiz Cláudio Martins, Luiz Henrique Conde Sangenis, Marco Paulo Tomaz Barbosa, Marcos Antonio Almeida-Santos, Marcos Vinicius Simões, Maria Aparecida Shikanai Yasuda, Maria da Consolação Vieira Moreira, Maria de Lourdes Higuchi, Maria Rita de Cassia Costa Monteiro, Mauro Felippe Felix Mediano, Mayara Maia Lima, Maykon Tavares de Oliveira, Minna Moreira Dias Romano, Nadjar Nitz Silva Lociks de Araujo, Paulo de Tarso Jorge Medeiros, Renato Vieira Alves, Ricardo Alkmim Teixeira, Roberto Coury Pedrosa, Roque Aras Junior, Rosalia Morais Torres, Rui Manoel dos Santos Povoa, Sergio Gabriel Rassi, Silvia Marinho Martins Alves, Suelene Brito do Nascimento Tavares, Swamy Lima Palmeira, Telêmaco Luiz da Silva Júnior, Thiago da Rocha Rodrigues, Vagner Madrini Junior, Veruska Maia da Costa Brant, Walderez Ornelas Dutra, and João Carlos Pinto Dias

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Published
2023
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10. Diretriz de Miocardites da Sociedade Brasileira de Cardiologia – 2022

Author

Marcelo Westerlund Montera, Fabiana G. Marcondes-Braga, Marcus Vinícius Simões, Lídia Ana Zytynski Moura, Fabio Fernandes, Sandrigo Mangine, Amarino Carvalho de Oliveira Júnior, Aurea Lucia Alves de Azevedo Grippa de Souza, Bárbara Maria Ianni, Carlos Eduardo Rochitte, Claudio Tinoco Mesquita, Clerio F. de Azevedo Filho, Dhayn Cassi de Almeida Freitas, Dirceu Thiago Pessoa de Melo, Edimar Alcides Bocchi, Estela Suzana Kleiman Horowitz, Evandro Tinoco Mesquita, Guilherme H. Oliveira, Humberto Villacorta, João Manoel Rossi Neto, João Marcos Bemfica Barbosa, José Albuquerque de Figueiredo Neto, Louise Freire Luiz, Ludhmila Abrahão Hajjar, Luis Beck-da-Silva, Luiz Antonio de Almeida Campos, Luiz Cláudio Danzmann, Marcelo Imbroise Bittencourt, Marcelo Iorio Garcia, Monica Samuel Avila, Nadine Oliveira Clausell, Nilson Araujo de Oliveira Jr, Odilson Marcos Silvestre, Olga Ferreira de Souza, Ricardo Mourilhe-Rocha, Roberto Kalil Filho, Sadeer G. Al-Kindi, Salvador Rassi, Silvia Marinho Martins Alves, Silvia Moreira Ayub Ferreira, Stéphanie Itala Rizk, Tiago Azevedo Costa Mattos, Vitor Barzilai, Wolney de Andrade Martins, and Heinz-Peter Schultheiss

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Published
2022
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11. Influence of Angiotensin-converting Enzyme Insertion/Deletion Gene Polymorphism in Progression of Chagas Heart Disease

Author

Silvia Marinho Martins Alves, Lúcia Elena Alvarado-Arnês, Maria da Glória Aureliano de Melo Cavalcanti, Cristina de Fátima Velloso Carrazzone, Antônio Guilherme Fonseca Pacheco, Camila Sarteschi, Milton Ozorio Moraes, Wilson Alves de Oliveira Junior, Carolina de Araújo Medeiros, Fernanda Gallinaro Pessoa, Charles Mady, Joseli Lannes-Vieira, and Felix José Alvarez Ramires

Subjects
Chagas disease, ACE I/D polymorphism, Cardiomyopathy, Heart failure, Arctic medicine. Tropical medicine, RC955-962
Abstract

Abstract INTRODUCTION: Chagas disease (CD) is a neglected disease caused by the parasite Trypanosoma cruzi. One-third of infected patients will develop the cardiac form, which may progress to heart failure (HF). However, the factors that determine disease progression remain unclear. Increased angiotensin II activity is a key player in the pathophysiology of HF. A functional polymorphism of the angiotensin-converting enzyme (ACE) gene is associated with plasma enzyme activity. In CD, ACE inhibitors have beneficial effects supporting the use of this treatment in chagasic cardiomyopathy. METHODS: We evaluated the association of ACE I/D polymorphism with HF, performing a case-control study encompassing 343 patients with positive serology for CD staged as non-cardiomyopathy (stage A; 100), mild (stage B1; 144), and severe (stage C; 99) forms of Chagas heart disease. For ACE I/D genotyping by PCR, groups were compared using unconditional logistic regression analysis and adjusted for nongenetic covariates: age, sex, and trypanocidal treatment. RESULTS: A marginal, but not significant (p=0.06) higher prevalence of ACE I/D polymorphism was observed in patients in stage C compared with patients in stage A. Patients in stage C (CD with HF), were compared with patients in stages A and B1 combined into one group (CD without HF); DD genotype/D carriers were prevalent in the HF patients (OR = 2; CI = 1.013.96; p = 0.04). CONCLUSIONS: Our results of this cohort study, comprising a population from the Northeast region of Brazil, suggest that ACE I/D polymorphism is more prevalent in the cardiac form of Chagas disease with HF.

Published
2020
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12. Tópicos Emergentes em Insuficiência Cardíaca: Novos Paradigmas na Amiloidose Cardíaca

Author

Marcus Vinicius Simões, Silvia Marinho Martins Alves, Fabio Fernandes, Otávio Rizzi Coelho Filho, and Sandrigo Mangini

Subjects
Insuficiência Cardíaca, Miocardiopatia Restritiva, Amiloidose, Imagem Cardiovascular, Doença Cardiovascular, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Resumo Evidências recentes sugerem que a amiloidose cardíaca é uma doença amplamente subdiagnosticada, particularmente na sua forma ligada à transtirretina, podendo ser uma causa comum de insuficiência cardíaca com fração de ejeção preservada (ICFEP) no idoso. Os novos paradigmas sobre a doença incluem o desenvolvimento de novas terapias específicas que modificam a história natural da doença. Este artigo traz uma síntese destes novos conceitos.

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13. Posicionamento sobre Diagnóstico e Tratamento da Amiloidose Cardíaca – 2021

Author

Marcus V. Simões, Fabio Fernandes, Fabiana G. Marcondes-Braga, Philip Scheinberg, Edileide de Barros Correia, Luis Eduardo P. Rohde, Fernando Bacal, Silvia Marinho Martins Alves, Sandrigo Mangini, Andréia Biolo, Luis Beck-da-Silva, Roberta Shcolnik Szor, Wilson Marques Junior, Acary Souza Bulle Oliveira, Márcia Waddington Cruz, Bruno Vaz Kerges Bueno, Ludhmila Abrahão Hajjar, Aurora Felice Castro Issa, Felix José Alvarez Ramires, Otavio Rizzi Coelho Filho, André Schmidt, Ibraim Masciarelli Francisco Pinto, Carlos Eduardo Rochitte, Flávio Henrique Valicelli, Marcelo Luiz Campos Vieira, Cláudio Tinoco Mesquita, Celso Dario Ramos, José Soares-Junior, Minna Moreira Dias Romano, Wilson Mathias Junior, Marcelo Iório Garcia Junior, Marcelo Westerlund Montera, Marcelo Dantas Tavares de Melo, Sandra Marques e Silva, Pedro Manoel Marques Garibaldi, Aristóteles Comte de Alencar Neto, Renato Delascio Lopes, Diane Xavier de Ávila, Denizar Viana, José Francisco Kerr Saraiva, Manoel Fernandes Canesin, Glaucia Maria Moraes de Oliveira, and Evandro Tinoco Mesquita

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
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14. Atualização de Tópicos Emergentes da Diretriz Brasileira de Insuficiência Cardíaca – 2021

Author

Fabiana G. Marcondes-Braga, Lídia Ana Zytynski Moura, Victor Sarli Issa, Jefferson Luis Vieira, Luis Eduardo Rohde, Marcus Vinícius Simões, Miguel Morita Fernandes-Silva, Salvador Rassi, Silvia Marinho Martins Alves, Denilson Campos de Albuquerque, Dirceu Rodrigues de Almeida, Edimar Alcides Bocchi, Felix José Alvarez Ramires, Fernando Bacal, João Manoel Rossi Neto, Luiz Claudio Danzmann, Marcelo Westerlund Montera, Mucio Tavares de Oliveira Junior, Nadine Clausell, Odilson Marcos Silvestre, Reinaldo Bulgarelli Bestetti, Sabrina Bernadez-Pereira, Aguinaldo F. Freitas Jr, Andréia Biolo, Antonio Carlos Pereira Barretto, Antônio José Lagoeiro Jorge, Bruno Biselli, Carlos Eduardo Lucena Montenegro, Edval Gomes dos Santos Júnior, Estêvão Lanna Figueiredo, Fábio Fernandes, Fabio Serra Silveira, Fernando Antibas Atik, Flávio de Souza Brito, Germano Emílio Conceição Souza, Gustavo Calado de Aguiar Ribeiro, Humberto Villacorta, João David de Souza Neto, Livia Adams Goldraich, Luís Beck-da-Silva, Manoel Fernandes Canesin, Marcelo Imbroinise Bittencourt, Marcely Gimenes Bonatto, Maria da Consolação Vieira Moreira, Mônica Samuel Avila, Otavio Rizzi Coelho Filho, Pedro Vellosa Schwartzmann, Ricardo Mourilhe-Rocha, Sandrigo Mangini, Silvia Moreira Ayub Ferreira, José Albuquerque de Figueiredo Neto, and Evandro Tinoco Mesquita

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
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