Browsing by Author "Nunes, Maria do Carmo Pereira"

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    Assessment of ventricular function in adults with sickle cell disease : role of two-dimensional speckle-tracking strain.
    (2014) Barbosa, Márcia M.; Vasconcelos, Maria Carmen Melo; Ferrari, Teresa Cristina de Abreu; Fernandes, Bárbara Martins; Passaglia, Luiz Guilherme; Silva, Célia Maria; Nunes, Maria do Carmo Pereira
    Background: Sickle cell disease (SCD) is a hemoglobinopathy that is common worldwide. It usually presents with cardiac involvement, although data on systolic function are somewhat controversial. The aim of this study was to investigate the value of speckle-tracking strain, a deformation index, in detecting ventricular dysfunction in SCD. Methods: Ninety adult patients with SCD were compared with 20 healthy controls. Doppler echocardiography with Doppler tissue imaging was performed in all, and the left and right ventricles were analyzed by the use of two-dimensional speckle-tracking strain. Results: The mean age of the patients with SCD was 26 years, and 43% were men. Left ventricular (LV) dimensions and mass were higher in patients with SCD, whereas LV ejection fraction did not differ from the controls. E and A waves, as well as E/e0 ratio, were also higher in patients with SCD. Two-dimensional speckle-tracking strain of both ventricles in the patients with SCD was not different from that of controls. The factors independently associated with LV longitudinal strain were age (P = .009), oximetry (P = .001), lactate dehydrogenase (P = .014), LV ejection fraction (P < .001), and right ventricular systolic annular velocity (P = .010). Conclusions: Ventricular enlargement with normal ventricular function was a frequent finding in SCD. Twodimensional speckle-tracking strain of both ventricles was similar in patients and controls, suggesting normal myocardial contractility in patients with SCD. LV global longitudinal strain was associated with age, intensity of hemolysis, and ventricular function. (J Am Soc Echocardiogr 2014;27:1216-22.)
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    Effect of pacemaker site on B-type natriuretic peptide levels and left ventricular function in a population with high prevalence of Chagas disease.
    (2015) Souza, Sônia Francisca de; Nascimento, Bruno Ramos; Nunes, Maria do Carmo Pereira; Silva, José Luiz Padilha da; Carvalho, Vinícius Tostes de; Beaton, Andrea Z.; Rocha, Manoel Otávio da Costa; Ribeiro, Antônio Luiz Pinho
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    Low levels of vasoactive intestinal peptide are associated with Chagas disease cardiomyopathy.
    (2013) Corrêa, Marielle Valério; Rocha, Manoel Otávio da Costa; Sousa, Giovane Rodrigo de; Nunes, Maria do Carmo Pereira; Gollob, Kenneth John; Dutra, Walderez Ornelas; Menezes, Cristiane Alves da Silva
    The interconnection between immune and neuroendocrine systems influences regulation of inflammatory responses. The possible relevance that this integrative response may have during the course of Chagas disease remains poorly characterized. In this context, our study was designed to determine the expression of vasoactive intestinal peptide (VIP), a neuropeptide with anti-inflammatory properties, in blood from the indeterminate and cardiac polarized forms of Chagas disease. Moreover, we determined whether the differential expression of VIP is associated with the development of cardiomyopathy in individuals infected with Trypanosoma cruzi. Finally, we analyzed gene polymorphisms of VIP receptors, VPAC1 and VPAC2, and performed correlation analysis of these polymorphisms with the different clinical forms of Chagas disease. Our results demonstrated that low plasma levels of VIP were associated with the cardiac morbidity in Chagas disease. Accordingly, correlation analysis showed that low plasma levels of VIP were associated with worse cardiac function, as determined by left ventricular ejection fraction and left ventricular diastolic diameter values. Polymorphism analysis showed a significant association between VPAC1 and the indeterminate form of Chagas disease development. Our data indicate that VIP expression and its receptors’ polymorphism may be important in determining susceptibility to progression from mild to severe forms of Chagas disease.
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    Plasma concentrations of tumour necrosis factor-alpha, tumour necrosis factor-related apoptosis-inducing ligand, and FasLigand/CD95L in patients with Chagas cardiomyopathy correlate with left ventricular dysfunction.
    (2009) Lula, Jamille Fernandes; Rocha, Manoel Otávio da Costa; Nunes, Maria do Carmo Pereira; Ribeiro, Antônio Luiz Pinho; Teixeira, Mauro Martins; Bahia, Maria Terezinha; Silva, André Talvani Pedrosa da
    Cardiomyocyte apoptosis is reported to be involved in the pathogenesis of human chronic Chagas cardiomyopathy (CCC). Members of the tumour necrosis factor (TNF) superfamily (TNF-a, FasLigand/CD95L, and TNF-related apoptosis-inducing ligand) are known to activate the death receptor pathway. We therefore investigated whether levels of TNF-a, FasLigand/CD95L, and TRAIL correlated with changes in heart function of patients with Chagas disease (n ¼ 31). Concentrations of TNF-a and TRAIL were clearly augmented in individuals with severe form CCC (n ¼ 16). Levels of FasLigand/CD95L were greater in chagasic patients than in non-infected individuals (n ¼ 15) but did not differentiate between clinical forms of Chagas disease. There was a good correlation between TNF-a (r ¼ 0.85 and r ¼ 0.68, P , 0.0001) or TRAIL (r ¼ 0.68 and r ¼ 0.60, P , 0.001) and left ventricular ejection fraction (LVEF) and left ventricular diastolic diameter (LVDD), respectively. In addition, TNF-a (r ¼ 0.57, P ¼ 0.0001), TRAIL (r ¼ 0.56, P ¼ 0.001), and FasLigand/CD95L (r ¼ 0.51, P ¼ 0.001) showed a good correlation with brain natriuretic peptide, a well-known parameter of ventricular dysfunction in CCC. There was a weak correlation between levels of FasLigand/CD95L (r ¼ 0.50, P , 0.004) and both LVEF and LVDD. There was no correlation between levels of TNF superfamily ligands and chronotropic incompetence, maximal heart rate, or number of ventricular premature beats in 24 h. Plasma levels of TNF superfamily ligands are elevated in patients with functional but not arrhythmogenic disturbances, and these death receptor ligands may be potential markers of ventricular dysfunction in CCC.
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    Treatment of Chagas cardiomyopathy.
    (2013) Botoni, Fernando Antônio; Ribeiro, Antônio Luiz Pinho; Marinho, Carolina Coimbra; Lima, Marcia Maria Oliveira; Nunes, Maria do Carmo Pereira; Rocha, Manoel Otávio da Costa
    Chagas’ disease (ChD), caused by the protozoa Trypanosoma cruzi (T. cruzi), was discovered and described by the Brazilian physician Carlos Chagas in 1909. After a century of original description, trypanosomiasis still bringsmuch misery to humanity and is classified as a neglected tropical disease prevalent in underdeveloped countries, particularly in South America. It is an increasing worldwide problem due to the number of cases in endemic areas and the migration of infected subjects tomore developed regions, mainly North America and Europe. Despite its importance, chronic chagas cardiomyopathy (CCC) pathophysiology is yet poorly understood, and independently of its social, clinical, and epidemiological importance, the therapeutic approach of CCC is still transposed from the knowledge acquired from other cardiomyopathies. Therefore, the objective of this review is to describe the treatment of Chagas cardiomyopathy with emphasis on its peculiarities.