Navegando por Palavras-chave "transplante cardíaco"

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    Avaliação de fatores prognósticos da insuficiência cardíaca em pacientes encaminhados para avaliação de transplante cardíaco
    (Sociedade Brasileira de Cardiologia - SBC, 2007-06-01) Areosa, Cleópatra Medina Noronha [UNIFESP]; Almeida, Dirceu Rodrigues de [UNIFESP]; Carvalho, Antonio Carlos [UNIFESP]; De Paola, Angelo Amato Vincenzo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: To evaluate the survival of patients with heart failure submitted to cardiac transplantation screening as well as identify poor prognostic factors using a risk score to identify patients with higher death risk. METHODS: 330 male and female patients aged 12 to 74 years old, referred for heart transplantation from January 1986 to November 2001 were evaluated. Clinical, laboratory, electrocardiographic, Holter monitoring, echocardiographic and radionuclide ventriculography data were analyzed. RESULTS: The median follow up period was 5 years; patients' survival rate was 84.5% in the first year, 74.3% in the second year, 68.9% in the third year and 60.5% in the fifth year. The prognostic variables selected through the univariate analysis were: age, Chagas' disease etiology for cardiomyopathy, NYHA functional classes III and IV, orthopnea, systolic blood pressure, mean blood pressure, pulse pressure, plasma urea, sodium, glucose, albumin, bilirubin, hemoglobin, and mean heart rate. The prognostic variables at the multivariate analysis were: ejection fraction, blood urea, and hemoglobin. The risk score: RR=exp[(-0.0942401 x ejection fraction) + (0.0105207 x blood urea) + (-0.2974991 x hemoglobin) + (-0.0132898 x age) + (-0.0099115 x blood glucose)] discriminated the population with a higher death risk. CONCLUSION: Patients' survival was satisfactory despite heart failure severity, suggesting they can be maintained on optimized clinical treatment until persistent clinical deterioration takes place. Ejection fraction, ventricular diameters, and clinical functional class alone should not be used as an indication for heart transplantation. The risk score could help discriminate the population with the poorest prognosis.
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    Neurologic complications after heart transplantation
    (Academia Brasileira de Neurologia - ABNEURO, 2002-06-01) Malheiros, Suzana Maria Fleury [UNIFESP]; Almeida, Dirceu Rodrigues de [UNIFESP]; Massaro, Ayrton R. [UNIFESP]; Castelo Filho, Adauto [UNIFESP]; Diniz, Rosiane Viana Zuza [UNIFESP]; Branco, João Nelson Rodrigues [UNIFESP]; Carvalho, Antonio Carlos [UNIFESP]; Gabbai, Alberto Alain [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: Neurologic complications are known as important cause of morbidity and mortality in orthotopic heart transplantation. Our aim was to identify the frequency and outcome of neurologic complications after heart transplantation in a prospective observational study. METHOD: From September 93 to September 99, as part of our routine heart transplantation protocol all patients with end-stage cardiac failure were evaluated by the same neurologist before and at the time of any neurologic event (symptom or complaint) after transplantation. RESULTS: Out of 120 candidates evaluated, 62 were successfully transplanted (53 male; median age 45.5 years, median follow-up 26.8 months). Fifteen patients (24%) had ischemic, 22 (35%) idiopathic, 24 (39%) Chagas' disease and 1 (2%) had congenital cardiomyopathy. Neurologic complications occurred in 19 patients (31%): tremor, severe headache, transient encephalopathy and seizures related to drug toxicity or metabolic changes in 13; peripheral neuropathy in 4; and spinal cord compression in two (metastatic prostate cancer and epidural abscess). No symptomatic postoperative stroke was observed. CONCLUSIONS: Although frequent, neurologic complications were seldom related to persistent neurologic disability or death. Most of the complications resulted from immunosuppression, however, CNS infection was rare. The absence of symptomatic stroke in our series may be related to the lower frequency of ischemic cardiomyopathy.
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    Respostas cardiorrespiratórias durante exercício em portadores de transplante cardíaco. Análise ergoespirométrica comparativa com indivíduos normais
    (Sociedade Brasileira de Cardiologia - SBC, 1998-01-01) Salles, Ana Fátima [UNIFESP]; Oliveira Filho, Japy Angelini [UNIFESP]; Barros Neto, Turibio Leite de [UNIFESP]; Almeida, Dirceu Rodrigues de [UNIFESP]; Carvalho, Antonio Carlos [UNIFESP]; Juliano, Yara [UNIFESP]; Buffolo, Enio [UNIFESP]; Martinez Filho, Eulogio Emílio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To evaluate the cardiorespiratory response of heart transplant (HT) recipients. METHODS: Nine HT recipients (GI) underwent ergospirometric tests and were compared to 9 apparently healthy, sedentary subjects with similar sex, age, weight and height (GII). All were male patients aging 48±12 years, in functional class I (NYHA) an average of 23±21 months after HT. They were receiving cyclosporin, azathioprine, prednisone, dipyridamole and antihypertensive drugs. The tests were symptom-limited and they were interrupted due to exhaustion. RESULTS: During peak exercise, GI had a significantly lower physical performance related to lower VO2, VE, VEO2, HR, endurance time and work load. At the anaerobic threshold, VO2, endurance time and work load levels were also significantly lower in GI. The physical performance was similar between the groups in the 40W load. CONCLUSION: The cardiorespiratory performance in GI was significantly lower at peak exercise and similar to GII in the 40W load, showing the HT benefits cardiac patients during usual activities.