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Genetic analysis reveals candidate species in the Scinax catharinae clade (Amphibia: Anura) from Central Brazil
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Nogueira, Lídia

; Solé, Mirco

; Siqueira, Sérgio

; Affonso, Paulo Roberto Antunes de Mello

; Strüssmann, Christine

; Sampaio, Iracilda

Genetics and Molecular Biology

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mar 2016, Volume 39 N. 1 Pages 49 - 53

Abstract: En | Text: En | PDF: En

Abstract Scinax (Anura: Hylidae) is a species-rich genus of amphibians (113 spp.), divided into five species groups by morphological features. Cladistic analyses however revealed only two monophyletic clades in these groups: Scinax catharinae and Scinax ruber. Most species from the S. catharinae clade are found in Atlantic rainforest, except for Scinax canastrensis,S. centralis, S. luizotavioi, S. machadoi,S. pombali and S. skaios. In the present work, specimens of Scinax collected in Chapada dos Guimarães, central Brazil, were morphologically compatible with species from theS. catharinae group. On the other hand, genetic analysis based on mitochondrial (16S and 12S) and nuclear (rhodopsin) sequences revealed a nucleotide divergence of 6 to 20% between Scinax sp. and other congeners from the Brazilian savannah (Cerrado). Accordingly, Bayesian inference placed Scinax sp. in the S. catharinae clade with high support values. Hence, these findings strongly indicate the presence of a new species in the S. catharinae clade from the southwestern portion of the Brazilian savannah. To be properly validated as a novel species, detailed comparative morphological and bioacustic studies with other taxa from Brazil such asS. canastrensis, S. centralis, S. luizotavioi, S. machadoi, S. pombali and S. skaios are required.

https://doi.org/10.1590/1678-4685-GMB-2015-0037 1937 downloads

Predictors of Arrhythmic Events Detected by Implantable Loop Recorders in Renal Transplant Candidates
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Silva, Rodrigo Tavares

; Martinelli Filho, Martino

; Peixoto, Giselle de Lima

; Lima, José Jayme Galvão de

; Siqueira, Sérgio Freitas de

; Costa, Roberto

; Gowdak, Luís Henrique Wolff

; Paula, Flávio Jota de

; Kalil Filho, Roberto

; Ramires, José Antônio Franchini

Arquivos Brasileiros de Cardiologia

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nov 2015, Volume 105 N. 5 Pages 493 - 502

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

ResumoFundamento:A documentação de eventos arrítmicos (EA) em candidatos a transplante renal (CTR) submetidos à diálise é limitada pelo registro de eletrocardiograma convencional. Um monitoramento contínuo do ritmo cardíaco parece ser o procedimento mais adequado para a detecção automática de arritmia, contudo esse método não foi explorado anteriormente.Objetivo:O objetivo deste estudo foi investigar a incidência e os preditores de EA em CTR usando um gravador de eventos implantável, do inglês, “loop recorder implantável” (ILR).Métodos:Um estudo prospectivo observacional foi conduzido entre Junho/2009 a Janeiro/2011. Cem CTR ambulatoriais consecutivos foram submetidos ao ILR e acompanhados pelo menos por um ano. Uma regressão logística multivariada foi aplicada para definir os preditores de EA.Resultados:Durante o tempo médio de acompanhamento de 424 ± 127 dias, EA foram detectados em 98% dos pacientes, sendo que 92% deles tinham mais de um tipo de arritmia, a maioria não considerada potencialmente séria. Taquicardia atrial sustentada e fibrilação atrial ocorreram respectivamente em 7% e 13% dos pacientes; bradiarritmia em 25% e taquicardia ventricular (TV) não-sustentada ou sustentada em 57%. Ocorreram 18 óbitos, 7 por morte cardíaca súbita, 3 por bradiarritmias, 1 por fibrilação ventricular, 1 por infarto do miocárdio e 2 óbitos devido à causas desconhecidas. A presença de QTc longo (Razão de Probabilidade [RP] = 7,28; intervalo de confiança de 95% [IC] 2,01-26,35; p = 0,002) e duração do intervalo PR (RP = 1,05; IC 95%: 1,02-1,08; p < 0,001) foram associados independentemente a bradiarritmias. A dilatação ventricular esquerda (DVE) foi independentemente associada à TV não-sustentada (RP = 2,83; IC 95%: 1,01-7,96; p = 0,041).Conclusões:Em acompanhamento de médio prazo de CTR, o ILR detectou uma alta incidência de EA, a maioria sem relevância clínica. O intervalo PR e a presença de QTc longo foram preditivos de bradiarritmias e DVE de TV não‑sustentada.

AbstractBackground:The recording of arrhythmic events (AE) in renal transplant candidates (RTCs) undergoing dialysis is limited by conventional electrocardiography. However, continuous cardiac rhythm monitoring seems to be more appropriate due to automatic detection of arrhythmia, but this method has not been used.Objective:We aimed to investigate the incidence and predictors of AE in RTCs using an implantable loop recorder (ILR).Methods:A prospective observational study conducted from June 2009 to January 2011 included 100 consecutive ambulatory RTCs who underwent ILR and were followed-up for at least 1 year. Multivariate logistic regression was applied to define predictors of AE.Results:During a mean follow-up of 424 ± 127 days, AE could be detected in 98% of patients, and 92% had more than one type of arrhythmia, with most considered potentially not serious. Sustained atrial tachycardia and atrial fibrillation occurred in 7% and 13% of patients, respectively, and bradyarrhythmia and non-sustained or sustained ventricular tachycardia (VT) occurred in 25% and 57%, respectively. There were 18 deaths, of which 7 were sudden cardiac events: 3 bradyarrhythmias, 1 ventricular fibrillation, 1 myocardial infarction, and 2 undetermined. The presence of a long QTc (odds ratio [OR] = 7.28; 95% confidence interval [CI], 2.01–26.35; p = 0.002), and the duration of the PR interval (OR = 1.05; 95% CI, 1.02–1.08; p < 0.001) were independently associated with bradyarrhythmias. Left ventricular dilatation (LVD) was independently associated with non-sustained VT (OR = 2.83; 95% CI, 1.01–7.96; p = 0.041).Conclusions:In medium-term follow-up of RTCs, ILR helped detect a high incidence of AE, most of which did not have clinical relevance. The PR interval and presence of long QTc were predictive of bradyarrhythmias, whereas LVD was predictive of non-sustained VT.

https://doi.org/10.5935/abc.20150106 2069 downloads

Cytogenetic studies in six species of Scinax (Anura, Hylidae) clade Scinax ruber from northern and northeastern Brazil
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Nogueira, Lídia

; Zanoni, Juliani Bruna

; Solé, Mirco

; Affonso, Paulo Roberto Antunes de Mello

; Siqueira, Sérgio

; Sampaio, Iracilda

Genetics and Molecular Biology

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jun 2015, Volume 38 N. 2 Pages 156 - 161

Abstract: En | Text: En | PDF: En

Scinax species are still underrepresented in cytogenetic studies, mainly with respect to populations from northeastern and northern Brazil. In this study, we provide new chromosomal information on Scinax boesemani, S. camposseabrai, S. garbei, S. pachycrus, S. trilineatus and S. x-signatus, all belonging to clade S. ruber. They were collected at two locations in the Caatinga biome (northeastern Brazil) and at one in the Amazon (northern Brazil) biomes. Chromosomes were analyzed by conventional staining, C-banding, Ag-NOR staining, and fluorochrome staining. All species shared a modal diploid value of 2n = 24 and fundamental arm number (FN) of 48. Moreover, both chromosomal size and morphology were similar to other species in this Scinax clade. C-banding revealed centromeric heterochromatin in all species, along with terminal species-specific C-bands in some species. Active nucleolar organizer regions (Ag-NORs) were identified at 11q in most species, except for S. boesemani and S. garbei (Ag-NORs at interstitial region of 8q). Differing from most anurans, GC-rich regions were not restricted to NORs, but also coincident with some centromeric and terminal C-bands. These data contribute to the cytotaxonomy of Scinax by providing chromosomal markers and demonstrating the occurrence of microstructural rearrangements and inversions on chromosomal evolution of Scinax.

https://doi.org/10.1590/S1415-4757382220140280 1821 downloads

Cytogenetics and sperm ultrastructure of Atelopus spumarius (Anura, Bufonidae) from the Brazilian Amazon
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Siqueira, Sérgio

; Aguiar Junior, Odair

; Lima, Albertina Pimentel

; Recco-Pimentel, Shirlei Maria

Genetics and Molecular Biology

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2013, Volume 36 N. 4 Pages 528 - 532

Abstract: En | Text: En | PDF: En

The current taxonomy of most Atelopus species is based on morphological and color data only. Recent studies suggest that A. spumarius may represent a species complex assigned under the same name. Karyotypic data and description of sperm ultrastructure for 13 specimens of A. spumarius are presented here for the first time. A chromosomal analysis revealed 2n = 22 chromosomes, with centromeric heterochromatin in all pairs and a nucleolar organizer region (NOR) on the telomere of pair 7. The sperm was of the bufonoid type, presenting a filiform nucleus covered by an acrosomal complex and a mitochondrial collar in the neck region. The tail was composed of an axoneme, an undulating membrane and an axial rod. A karyotype analysis of A. spumarius showed the same chromosome number and similar chromosomal morphology as described for congeneric species, with slight differences probably resulting from pericentric inversions. The NOR location (on pair 7) was the same as that observed for species belonging to the genus Rhinella. The spermatological findings indicate a close relationship between Atelopus and the bufonoid lineage. The present data are useful for reference in future studies to determine whether more than one species are assigned to A. spumarius.

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The karyotype of three Brazilian Terrarana frogs (Amphibia, Anura) with evidence of a new Barycholos species
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Siqueira, Sérgio

; Aguiar Jr., Odair

; Pansonato, André

; Giaretta, Ariovaldo A.

; Strüssmann, Christine

; Martins, Itamar

; Recco-Pimentel, Shirlei M.

Genetics and Molecular Biology

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2009, Volume 32 N. 3 Pages 470 - 476

Abstract: En | Text: En | PDF: En

A recent substantial rearrangement of the 882 described eleutherodactyline frog species has considerably improved the understanding of their systematics. Nevertheless, many taxonomic aspects of the South American eleutherodactyline species remain unknown and require further investigation using morphological, cytogenetic and molecular approaches. In this work, the karyotypes of the Brazilian species Ischnocnema juipoca (Atibaia and Campos do Jordão, SP), Barycholos cf. ternetzi (Uberlândia, MG, and Porto Nacional, TO), and Pristimantis crepitans (Chapada dos Guimarães and São Vicente, MT) were analyzed using Giemsa staining, Ag-NOR labeling, and C-banding techniques. All individuals had a diploid number of 22 chromosomes, but the Fundamental Numbers were different among species. The herein described low chromosome number of Pristimantis crepitans is unique within this genus, suggesting that cytogenetically this species is not closely related either to its congeneric species or to Ischnocnema. In addition, karyotype differences, mainly in the NOR position, clearly distinguished the two Barycholos populations, besides indicating the existence of a so far undescribed species in this genus. A taxonomic review could clarify the systematic position of P. crepitans and verify the hypothetic new Barycholos species.

3129 downloads Cited 1 time in SciELO

Estimulação cardíaca artificial em pacientes portadores de cardiomiopatia hipertrófica: uma coorte com 24 anos de seguimento
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Silva, Lenine Angelo Alves

; Fernández, Edmundo Arteaga

; Martinelli Filho, Martino

; Costa, Roberto

; Siqueira, Sérgio

; Ianni, Barbara Maria

; Mady, Charles

Arquivos Brasileiros de Cardiologia

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oct 2008, Volume 91 N. 4 Pages 274 - 280

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

FUNDAMENTO: O benefício da estimulação cardíaca em pacientes portadores de cardiomiopatia hipertrófica (CMH) tem sido questionado, sendo escassas as pesquisas sobre este assunto no Brasil. OBJETIVO: Descrever a indicação, a resposta clínica, as complicações e a sobrevida relacionadas ao implante de marcapasso em pacientes portadores de CMH. MÉTODOS: Foram estudados, retrospectivamente, 39 pacientes portadores de cardiomiopatia hipertrófica (41% do sexo masculino) submetidos a implante de marcapasso, no período de maio de 1980 a novembro de 2003. RESULTADOS: Houve 27 portadores da forma obstrutiva e 12 portadores da forma não-obstrutiva com média de idade de 46,4 anos (14-77 anos) seguidos por 6,4 ± 4,1 anos. As principais indicações para implante foram: bloqueio atrioventricular espontâneo ou induzido (54%), refratariedade à terapêutica associada a gradiente elevado (33%), suporte para terapia medicamentosa por bradicardia (8%) e prevenção de fibrilação atrial (5%). Houve melhora na classe funcional de 2,41±0,87 para 1,97±0,92 (p = 0,008), bem como redução do número de sintomas referidos, sem ter havido diferença na utilização da terapia medicamentosa. Não houve óbitos relacionados ao procedimento que, apesar de demonstrar-se seguro, não foi isento de complicações (6 pacientes - 15,4%). Ocorreram três óbitos durante o seguimento, todos em pacientes mulheres, portadoras de fibrilação atrial e com evidências de deterioração funcional. Observou-se uma forte associação de piora clínica com surgimento de fibrilação atrial ou flutter. CONCLUSÃO: A estimulação cardíaca artificial em pacientes com CMH foi bem-sucedida, com evidências de alívio sintomático em pacientes portadores da forma obstrutiva. Não se observou melhora funcional para a forma não-obstrutiva.

BACKGROUND: The benefits of heart stimulation in hypertrophic cardiomyopathy (HCM) patients have been questioned. Research work available in Brazil on those benefits is scarce. OBJECTIVE: To describe the indication, clinical response, complications and survival time related to pacemaker implant in HCM patients. METHODS: Thirty-nine hypertrophic cardiomyopathy patients were studied (41% males) and submitted to pacemaker implant from May, 1980 through November, 2003. RESULTS: Twenty-seven patients presented obstructive hypertrophic cardiomyopathy, and 12, non-obstructive. Mean age was 46.4 years of age (range 14 - 77), with follow-up of 6.4 ± 4.1 years. Major indications for implant were: spontaneous or induced atrioventricular block (54%), refractoriness to therapeutic conduct associated to high gradient (33%), support for drug therapy to treat bradychardia (8%), and atrial fibrillation prevention (5%). Functional class was shown to improve from 2.41±0.87 to 1.97±0.92 (p = 0.008), and symptoms referred were reduced. No change was made in drug therapy administration. No procedure-related deaths were reported. Although shown to be safe, the procedure was not free from complications (6 patients - 15.4%). Three deaths occurred in the follow-up period - the three of them were atrial fibrillation female patients, with evidence of functional deterioration. A close association was observed between clinical condition worsening and the onset of atrial fibrillation or flutter. CONCLUSION: Cardiac pacing in HCM patients was successful, with evidence of symptoms relief in obstructive HCM patients. No functional improvement was observed in non-obstructive patients.

4032 downloads

Portadores de CDI com limiar de desfibrilação elevado: evolução clínica e alternativas terapêuticas
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Lima, Carlos Eduardo Batista de

; Martinelli Filho, Martino

; Silva, Rodrigo Tavares

; Tamaki, Wagner Tetsuji

; Oliveira, Júlio Cesar de

; Martins, Daniela Cabral

; Nishióka, Silvana Angelina D'Orio

; Pedrosa, Anísio Alexandre Andrade

; Siqueira, Sérgio Freitas

; Costa, Roberto

Arquivos Brasileiros de Cardiologia

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mar 2008, Volume 90 N. 3 Pages 177 - 184

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

FUNDAMENTO: A programação ideal da energia de choque do CDI deve ser pelo menos 10 J acima do limiar de desfibrilação (LDF), necessitando de técnicas alternativas quando o LDF é elevado. OBJETIVO: Avaliar o comportamento clínico dos portadores de CDI com LDF>25 J e a eficácia da terapêutica escolhida. MÉTODOS: Foram selecionados portadores de CDI, entre janeiro de 2000 e agosto de 2004 (banco de dados prospectivo), com LDF>25 J intra-operatório, e analisaram-se: características clínicas, FEVE, resgate de eventos arrítmicos pelo CDI e óbitos. RESULTADOS: dentre 476 pacientes, 16 (3,36%) apresentaram LDF>25J. Idade média de 56,5 anos, sendo 13 pacientes (81%) do sexo masculino. Quanto à cardiopatia de base 09 eram chagásicos, 04 isquêmicos e 03 com etiologia idiopática. A FEVE média dos pacientes foi 37% e 94% utilizavam amiodarona. O seguimento médio foi de 25,3 meses. Em 02 pacientes com LDF > Choque Máximo (CM), foi necessário implante de eletrodo de choque adicional (array), sendo mantido programação com CM em zona de FV (>182bpm) nos demais. Durante o seguimento 03 pacientes apresentaram 67 terapias de choque apropriadas (TCA) com sucesso. Ocorreram 07 óbitos sendo 5 por causas não cardíacas e 2 por insuficiência cardíaca avançada. Os pacientes que foram a óbito apresentaram níveis de LDF maiores (p=0,0446), entretanto sem relação com a causa dos mesmos tendo em vista que não ocorreram TCA sem sucesso. CONCLUSÃO: Nessa coorte de pacientes com CDI, a ocorrência de LDF elevado foi baixa, implicando terapêuticas alternativas. Houve associação com disfunção ventricular grave, entretanto sem correlação com as causas de óbito.

BACKGROUND: The ideal programming of the implantable cardioverter defibrillator (ICD) shock energy should be at least 10J above the defibrillation threshold (DFT), requiring alternative techniques when the DFT is elevated. OBJECTIVE: To assess the clinical behavior of ICD patients with DFT>25J and the efficacy of the chosen therapy. METHODS: Patients who had undergone ICD implantation between Jan/00 and Aug/04 (prospective database) and presented intraoperative DFT>25J were selected. The analyzed variables were: clinical characteristics, LVEF, rescue of arrhythmic events from ICD and causes of deaths. RESULTS: among 476 patients, 16 (3.36%) presented DFT>25J. The mean age was 56.5 years, and 13 patients (81%) were men. According to the baseline cardiomyopathy, 09 patients had Chagas' disease, 04 had ischemic cardiomyopathy and 03 had idiopathic cardiomyopathy. Mean LVEF was 0.37 and amiodarone was used by 94% of the patients. Mean follow-up (FU) period was 25.3 months. DFT was higher than maximum energy shock (MES) in 2 patients and it was necessary to implant an additional shock electrode (array). It was programmed MES in ventricular fibrillation zone of ICD therapy in the other patients. In the FU, 03 patients had 67 successful appropriate shock therapies (AST). There were 05 noncardiac and 02 heart failure deaths. The patients who died showed higher DFT levels (p=0.044) without correlation with death because there wasn't unsuccessful AST. CONCLUSION: In this cohort of ICD patients, the occurrence of elevated DFT (>25J) was low, leading to alternative therapies. There was an association with severe ventricular dysfunction, although without correlation to the causes of death.

6568 downloads

Incidência de choques e qualidade de vida em jovens com cardioversor-desfibrilador implantável
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Costa, Roberto

; Silva, Kátia Regina da

; Mendonça, Rodrigo Castro

; Nishioka, Silvana

; Siqueira, Sérgio

; Tamaki, Wagner Tetsuji

; Crevelari, Elizabeth Sartori

; Moreira, Luiz Felipe Pinho

; Martinelli Filho, Martino

Arquivos Brasileiros de Cardiologia

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mar 2007, Volume 88 N. 3 Pages 258 - 264

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVOS: Avaliar a incidência e a causa de choques de CDI em crianças e adolescentes e sua repercussão na qualidade de vida (QV). MÉTODOS: De março/1997 a fevereiro/2006, 29 pacientes (15,7±5,4 anos) foram submetidos a implante de CDI. Parada cardiorrespiratória recuperada (41,5%), taquicardia ventricular sustentada (27,6%) e profilaxia primária de morte súbita cardíaca (30,9%) motivaram os implantes. O número de terapias foi avaliado por entrevista e pela telemetria dos CDI. A QV foi avaliada pela aplicação do questionário SF-36 e comparada à de indivíduos saudáveis. Empregou-se o método de Kaplan-Meier para análise da sobrevida livre de choques. RESULTADOS: Após 2,6±1,8 anos de seguimento, 8 (27,6%) pacientes receberam 141 choques apropriados em razão de TV polimórfica (6) ou FV (2), e 11 (37,9%) sofreram 152 choques inapropriados em razão de taquiarritmias supraventriculares (8) ou oversensing (3). A expectativa de sobrevida livre de choques apropriados foi de 74,2%±9,0 após um ano, e de 66,7%±10,7 após três anos. Observou-se diminuição da QV nos aspectos físicos (61,7±28,7), na vitalidade (64,7±19,1), na saúde mental (65,9±22,7) e nos aspectos emocionais (66,7±38,5). Medo e preocupações relacionados ao CDI foram referidos por todos os pacientes. CONCLUSÃO: A despeito da grande eficácia dessa terapêutica, a incidência elevada de choques interferiu na QV e na adaptação ao dispositivo.

OBJECTIVES: To analyze the incidence and causes of ICD therapies in children and young adults and verify their impact on the quality of life (QoL). METHODS: From March/1977 to February/2006, 29 patients (15.7±5.4 years old) were submitted to ICD implants. Aborted cardiac arrest (41.5%), sustained ventricular tachycardia (27.6%) and primary prophylaxis of sudden cardiac death (30.9%) indicated device therapy. The number of therapies was evaluated by interviewing patients and by ICD diagnostic data. The SF-36 questionnaire was used to measure the QoL and the results were compared to healthy population. The expectative of freedom from ICD therapies were estimated by the Kaplan-Meier method. RESULTS: After 2.6±1.8 years follow-up, 8 (27.6%) patients received 141 appropriate ICD shocks due to ventricular tachycardia (6) or ventricular fibrillation (2), and 11 (37.9%) patients received 152 inappropriate ICD shocks due to supraventricular tachyarrhythmias (8) or oversensing (3). Expectative of freedom from appropriate shocks was 74.2±9.0% and 66.7±10.7% after one and three years, respectively. Compared to healthy population, QoL decreased in physical function (61.7±28.7), vitality (64.7±19.1), mental health (65.9±22.7) and role-emotional domains (66.7±38.5). All patients referred fear and concern related to ICD use. CONCLUSION: Despite the efficacy of ICD therapies, the high incidence of appropriate and inappropriate shocks interfered in patients’ QoL and adaptation to the device.

5437 downloads Cited 3 times in SciELO

Cardiomiopatia hipertrófica: importância dos eventos arrítmicos em pacientes com risco de morte súbita
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Medeiros, Paulo de Tarso Jorge

; Martinelli Filho, Martino

; Arteaga, Edmundo

; Costa, Roberto

; Siqueira, Sérgio

; Mady, Charles

; Piegas, Leopoldo Soares

; Ramires, José Antonio Franchini

Arquivos Brasileiros de Cardiologia

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nov 2006, Volume 87 N. 5 Pages 649 - 657

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Pretende-se avaliar em pacientes com cardiomiopatia hipertrófica e risco de MSC, submetidos a implante de cardioversor-desfibrilador implantável (CDI): a) ocorrência de eventos arrítmicos; b) ocorrência de eventos clínicos e correlações com eventos arrítmicos; c) ocorrência de terapia de choque do CDI e correlações clínico-funcionais; d) preditores clínico-funcionais de prognóstico. MÉTODOS: Foram estudados 26 pacientes com cardiomiopatia hipertrófica e fatores de risco de MSC, submetidos a implante de CDI no período de maio de 2000 a janeiro de 2004 (seguimento médio = 20 meses). Quatorze pacientes (53,8%) eram do sexo feminino e a idade média foi de 42,7 anos. Em 16 pacientes (61,5%), a indicação do CDI foi para prevenção primária de morte súbita cardíaca, e em 10 (38,5%), para prevenção secundária. Vinte pacientes (76,9%) apresentavam síncope prévia ao implante de CDI, metade desses relacionados a fibrilação ventricular ou taquicardia ventricular sustentada; 15 (57,7%) tinham história de morte súbita familiar; 12 pacientes (46,2%), taquicardia ventricular não-sustentada ao Holter de 24 horas; e 5 (19,2%) apresentavam o septo interventricular com espessura maior que 30 mm. RESULTADOS: No seguimento foram registrados no CDI 4 terapias de choque em arritmias potencialmente letais (3 pacientes com taquicardia ventricular sustentada e 1 paciente com fibrilação ventricular). Ocorreu um óbito por provável acidente vascular cerebral tromboembólico. Quatro pacientes tiveram recorrência de síncope sem evento arrítmico registrado pelo CDI. A análise estatística demonstrou significância da precocidade do choque do CDI em pacientes cujo septo interventricular tinha espessura maior que 30 mm. CONCLUSÃO: 1- ocorrência de eventos arrítmicos em 50% dos pacientes: a maioria (62%) foi taquicardia ventricular, sustentada (31%) e não-sustentada (31%); nos outros pacientes ocorreu taquicardia paroxística supraventricular; 2- síncopes recorrentes na minoria dos pacientes (16%), que, entretanto, não se associaram à presença de eventos arrítmicos; 3- presença de septo interventricular superior a 30 mm, ao ecocardiograma, se associou à ocorrência de terapia de choque precoce (p = 0,003); 4- ausência de preditores clínicos ou funcionais.

OBJECTIVE: It is controversial the correlation between complex ventricular arrhythmia of hypertrophic cardiomyopathy and cardiac sudden death (CSD). In patients with hypertrophic cardiomyopathy and at risk for CSD that have been undergone implantable cardioverter-defibrillator (ICD) implantation, we evaluated: a- occurrence of arrhythmic events; b- clinical event occurrence and its correlation with arrhythmic events; c- ICD shock therapy occurrence and clinical-functional correlation; d- prognosis clinical-functional predictors. METHODS: Twenty-six patients have been studied. They presented hypertrophic cardiomyopathy and risk factors for CSD. These patients underwent ICD implantation, period May, 2000 through January, 2004 (average follow-up - 19 months). Fourteen patients (53.8%) were female and the mean age was 42.7. Sixteen patients (61.5%) ICD was performed due to primary prevention for sudden death and ten (38.5%) secondary prevention. Twenty patients (76.9%) had had syncope, previus to ICD implantation, half of them associated with ventricular fibrillation or sustained ventricular tachycardia; 15 had had family sudden death; 12 patients (46.2%) presented non-sustained ventricular tachycardia at 24-hour Holter and 5 (19.2%) showed the ventricular septum thickness larger than 30 mm. RESULTS: During the follow-up, 4 shocks therapy were recorded by ICD in potentially lethal arrythmias (3 sustained ventricular tachycardia and 1 ventricular fibrillation). There was one death, due to likely stroke. Four patients had syncope recurrence, with no arrhythmic event recorded by ICD. The statistical analysis has showed precocity significance of ICD shock, in patients whose ventricular septum thickness was larger than 30 mm. CONCLUSION: 1- arrhythmic events have occurred in 50% of the patients. Most of those events (62%) were ventricular tachycardia, 31% sustained tachycardia and 31% non-sustained ventricular tachycardia. The remainders had supraventricular tachycardia. 2- recurrent syncope in only 16% of the patients. Nevertheless, they were not related to the presence of arrhythmic events. 3- the presence of ventricular septum larger than 30mm, at Echocardiogram, was associated with early shock therapy occurence (p = 0.003). 4- absence of clinical or functional predictors.

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10.

Biventricular pacing improves clinical behavior and reduces prevalence of ventricular srrhythmia in patients with heart failure
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Martinelli Filho, Martino

; Pedrosa, Anísio A. A.

; Costa, Roberto

; Nishioka, Silvana A. D.

; Siqueira, Sérgio F.

; Tamaki, Wagner T.

; Sosa, Eduardo

Arquivos Brasileiros de Cardiologia

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jan 2002, Volume 78 N. 1 Pages 110 - 113

Abstract: En | Text: En | PDF: En

PURPOSE: To analyze the influence of biventricular pacing (BP) on clinical behavior, ventricular arrhythmia (VA) prevalence, and left ventricular ejection fraction (LV EF) by gated ventriculography. METHODS: Twenty-four patients with left bundle branch block (LBBB) and NYHA class III and IV underwent pacemaker implantation and were randomized either to the conventional or BP group, all receiving BP after 6 months. RESULTS: Sixteen patients were in NYHA class IV (66.6%) and 8 were in class III (33.4%). After 1-year follow-up, 14 patients were in class II (70%) and 5 were in class III (25%). Two sudden cardiac deaths occurred. A significant reduction in QRS length was found with BP (p=0.006). A significant statistical increase, from a mean of 19.13 ± 5.19% (at baseline) to 25.33 ± 5.90% (with BP) was observed in LVEF Premature ventricular contraction prevalence decreased from a mean of 10,670.00 ± 12,595.39 SD or to a mean of 3,007.00 ± 3,216.63 SD PVC/24 h with BP (p<0.05). Regarding the hospital admission rate over 1 year, we observed a significant reduction from 60. To 16 admissions with BP (p<0.05). CONCLUSION: Patients with LBBB and severe heart failure experienced, with BP, a significant NYHA class and LVEF improvement. A reduction in the hospital admission rate and VA prevalence also occurred.

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11.

Diretrizes para Avaliação e Tratamento de Pacientes com Arritmias Cardíacas
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Feitosa, Gilson Soares

; Nicolau, José Carlos

; Lorga, Adalberto

; Lorga Filho, Adalberto

; D'Ávila, André

; Rassi Jr, Anis

; Paola, Angelo A. V. de

; Pedrosa, Anísio

; Costa, Álvaro Barros da

; Peres, Ayrton

; Grupi, César

; Cirenza, Cláudio

; Moreira, Dalmo

; Sobral, Dário

; Hachul, Denise

; D'Andréa, Eduardo

; Sosa, Eduardo

; God, Epotamênides M. Good

; Brito, Fábio Sândoli de

; Cruz, Fernando

; Fenelon, Guilherme

; Lima, Gustavo Glotz

; Brito, Hélio

; Maia, Ivan G.

; Atié, Jacob

; Jorge, José Carlos Moura

; Andrade, José Carlos de

; Mateos, José Carlos Pachón

; Ribeiro, José Carlos

; Pimenta, João

; Vasconcelos, José Tarcísio de

; Gizzi, Júlio

; Zimerman, Leandro

; Castilho, Luiz Antonio Teno

; Fagundes, Márcio

; Figueiredo, Márcio

; Martinelli Filho, Martino

; Scanavacca, Maurício I.

; Valente, Ney

; Medeiros, Paulo

; Brofman, Paulo

; Miranda, Reynaldo Castro

; Costa, Roberto

; Kunyioshi, Ricardo

; Sá, Roberto

; Rassi, Sérgio G.

; Siqueira, Sérgio

; Galvão, Silas

; Nishioka, Silvana

; Grillo, Tereza

; Rodrigues, Thiago da Rocha

; Maciel, Washington

Arquivos Brasileiros de Cardiologia

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2002, Volume 79 Suppl. 5 Pages 1 - 50

Abstract: Pt | Text: Pt | PDF: Pt

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12.

Atrioventricular pacemaker. Incidence and causes of reprogramming in long-term follow-up
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Martinelli Fº, Martino

; Melo, Sylton de Arruda

; Nishióka, Silvana A. D.

; Pedrosa, Anísio A. A.

; Siqueira, Sérgio Freitas de

; Costa, Roberto

; Sosa, Eduardo

Arquivos Brasileiros de Cardiologia

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jan 2001, Volume 76 N. 1 Pages 11 - 14

Abstract: En | Text: En | PDF: En

OBJECTIVE: To assess the incidence of problems requiring reprogramming of atrioventricular pacemakers in a long-term follow-up, and also the causes for this procedure. METHODS: During the period from May '98 to December '99, 657 patients were retrospectively studied, An actuarial curve for the event reprogramming of the stimulation mode was drawn. RESULTS: The follow-up period ranged from 12 to 178 months (mean = 81 months). Eighty-two (12.4%) patients underwent reprogramming of the stimulation mode as follows: 63 (9.5%) changed to VVI,(R/C); 10 (1.5%) changed to DVI,C; 6 (0.9%) changed to VDD,C; and 3 (0.5%) changed to DOO. The causes for the reprogramming were as follows: arrhythmia conducted by the pacemaker in 39 (37.6%) patients; loss of atrial sensitivity or capture, or both, in 39 (38.6%) patients; and microfracture of atrial electrode in 5 (4.9%) patients. The stimulation mode reprogramming free probability after 15 years was 58%. CONCLUSION: In a long-term follow-up, the atrioventricular pacemaker provided a low incidence of complications, a high probability of permanence in the DDD,C mode, and the most common cause of reprogramming was arrhythmia conducted by the pacemaker.

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13.

Simulação da soja geneticamente modificada tolerante ao glyphosate por meio do cultivo de explantes
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Siqueira, Sérgio C.

; Moreira, Maurílio A.

; Mosquim, Paulo R.

; José, Inês C.

; Ferreira, Francisco A.

; Sediyama, Carlos S.

Planta Daninha

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apr 1999, Volume 17 N. 1 Pages 95 - 107

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O objetivo do experimento consistiu na simulação in vitro da soja transgênica tolerante ao glyphosate, através do cultivo de explantes em meios de cultura contendo aminoácidos aromáticos. As avaliações basearam-se nos efeitos do glyphosate sobre sementes oriundas de explantes de soja (Glycine max (L.) Merr.) cv. UFV-16. Para tanto, explantes de soja foram cultivados em meios de cultura líquidos com pH em torno de 5,0. Cada explante constou de um legume completamente expandido contendo duas sementes de aproximadamente 100 mg, conectada a um segmento de caule de 45 mm de comprimento. Os tratamentos testados foram: A = glutamina (Gln); B = Gln + fenilalanina (Phe) + tirosina (Tyr) + triptofano (Trp); C = Gln + glyphosate; D = Gln + Phe + Tyr + Trp + glyphosate. O experimento foi conduzido sob irradiância de 80 mmol-2s-1 a 25oC por 204 horas. Nos tratamentos que receberam aminoácidos aromáticos e glutamina, o herbicida não afetou as massas fresca e seca das sementes, como também, não afetou seus constituintes bioquímicos (proteínas, óleo, ácidos graxos, carboidratos e clorofilas). Portanto, a suplementação exógena de aminoácidos aromáticos suprime os efeitos fitotóxicos do glyphosate sobre explantes de soja, permitindo estudos sobre o seu modo de ação e metabolismo nas sementes, uma vez que os explantes se comportaram analogamente à soja transgênica não suscetível ao herbicida.

The objective of this experiment consisted in simulation in vitro of the transgenic soybean tolerant to glyphosate through explant cultivation in culture medium containing aromatic amino acids. The effects of glyphosate on soybean (Glycine max (L.) Merrill) were evaluated in seeds harvested from explants of cv UFV-16. The soybean explants were cultivated in liquid medium culture with pH about 5.0. Each explant consisted of one fruit completely expanded, containing two seeds of 100 mg approximately, and connected to a stem segment of 45 mm length. The explants were submitted to the following treatments: A = glutamine (Gln); B = Gln + phenylalanine (Phe) + tyrosine (Try) + tryptophan (Trp); C = Gln + glyphosate; D = Gln + Phe + Tyr + Trp + glyphosate. The experiment was conducted under irradiance of 80 mmol-2s-1 at 25o for 204 hours. The treatments with aromatic amino acids and glutamine avoided the herbicide effect on seed fresh and dried weights and had no effect on their biochemical constituents (proteins, oil, fatty acids, carbohydrates and chlorophylls). Thus, an exogenous supplementation of aromatic amino acids eliminates phytotoxic effects of glyphosate on soybean explants. Therefore, it was developed an in vitro system that allows to study the mode of action and the metabolism of glyphosate in soybean seeds, since the explants behaved in a similar manner as the transgenic soybean unsusceptible to the herbicide.

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