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Abstract Background: Maternal mortality rates in Brazil remain above the goals established by the United Nations Sustainable Development Goals. Heart disease is estimated to affect 4% of all pregnancies and remains by itself the main indirect obstetric cause of maternal death. In the last decades, a significant improvement in the prognosis of heart diseases has made pregnancy possible in women with heart disease and provided better maternal and fetal outcomes. Objective: To establish a multicenter Brazilian Registry of pregnant women with heart disease; to study the causes of immediate and late maternal mortality; and to assess the prevalence of heart disease in the country’s macro-regions. Method: This is an observational study, with retrospective and prospective stages, of the clinical and obstetric progression of pregnant women with heart disease. These women consecutively received care during pregnancy and will be followed up for up to a year after delivery at public and private hospitals with infrastructure for the execution of this project, a principal investigator, and approval by Ethics and Research Committees. Results: Our results will be presented after data collection and statistical analysis, aiming to demonstrate immediate and late maternal mortality rates, as well as the prevalence of heart disease in the country and its cardiovascular and obstetric complications during pregnancy. Conclusion: REBECGA will be the Brazilian Registry of heart disease and pregnancy and it will contribute to planning preventive measures, raising financial resources for the improvement of high-risk prenatal care, and reducing immediate and late maternal mortality due to heart disease.

https://doi.org/10.36660/ijcs.20200419

Posicionamento da Sociedade Brasileira de Cardiologia para Gravidez e Planejamento Familiar na Mulher Portadora de Cardiopatia – 2020
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Avila, Walkiria Samuel

; Alexandre, Elizabeth Regina Giunco

; Castro, Marildes Luiza de

; Lucena, Alexandre Jorge Gomes de

; Marques-Santos, Celi

; Freire, Claudia Maria Vilas

; Rossi, Eduardo Giusti

; Campanharo, Felipe Favorette

; Rivera, Ivan Romero

; Costa, Maria Elizabeth Navegantes Caetano

; Rivera, Maria Alayde Mendonça

; Carvalho, Regina Coeli Marques de

; Abzaid, Alexandre

; Moron, Antonio Fernandes

; Ramos, Auristela Isabel de Oliveira

; Albuquerque, Carlos Japhet da Mata

; Feio, Claudine Maia Alves

; Born, Daniel

; Silva, Fábio Bruno da

; Nani, Fernando Souza

; Tarasoutchi, Flavio

; Costa Junior, José de Ribamar

; Melo Filho, José Xavier de

; Katz, Leila

; Almeida, Maria Cristina Costa

; Grinberg, Max

; Amorim, Melania Maria Ramos de

; Melo, Nilson Roberto de

; Medeiros, Orlando Otávio de

; Pomerantzeff, Pablo Maria Alberto

; Braga, Sérgio Luiz Navarro

; Cristino, Sonia Conde

; Martinez, Tania Leme da Rocha

; Leal, Tatiana de Carvalho Andreuci Torres

Arquivos Brasileiros de Cardiologia

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may 2020, Volume 114 N. 5 Pages 849 - 942

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

https://doi.org/10.36660/abc.20200406 10784 downloads

Lack of association between the prothrombin rs1799963 polymorphism and juvenile myoclonic epilepsy
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Born, João Paulo Lopes

; Santos, Bruna Priscila dos

; Secolin, Rodrigo

; Gameleira, Fernando Tenório

; Andrade, Tiago Gomes de

; Machado, Luciana Cláudia Herculano

; Gitaí, Lívia Leite Góes

; Gitaí, Daniel Leite Góes

Arquivos de Neuro-Psiquiatria

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apr 2015, Volume 73 N. 4 Pages 289 - 292

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

Epilepsia mioclônica juvenil (EMJ) representa 26% das síndromes epilépticas idiopáticas generalizadas. Níveis elevados de atividade da trombina estão intimamente envolvidos no desenvolvimento de distúrbios neurológicos, incluindo epilepsia. A variante c.20210G>A (rs1799963) do gene de protrombina, que altera a estabilidade do RNAm, está associada com altos níveis de protrombina no plasma. Objetivo: Investigar se o SNP rs1799963 é um fator de risco para EMJ em uma amostra da população do nordeste brasileiro. Resultados : O polimorfismo foi genotipado em 123 pacientes e 207 controles usando a reação de polimerase em cadeia com restrição de polimorfismo. Não observamos diferença significativa nas frequências alélicas e genotípicas deste polimorfismo, entre as populações de pacientes e controle. Conclusão : Estes resultados não demonstram evidências para uma associação do polimorfismo rs1799963 com EMJ. Estudos posteriores, incluindo outros tipos de epilepsia, são necessários para investigar o envolvimento do gene protrombina na susceptibilidade genética a crises crônicas.

Juvenile myoclonic epilepsy (JME) accounts for 26% of generalized idiopathic epileptic syndromes. The highest levels of thrombin activity are closely involved in the development of neurological diseases, including epilepsy. The prothrombin c.20210G>A (rs1799963) variation, which alters prothrombin mRNA stability, is associated with high plasma prothrombin levels. Objective : The present study was designed to investigate whether the SNP rs1799963 is a risk factor for JME in the northeastern Brazilian population. Results : The polymorphism was genotyped in 207 controls and 123 patients using polymerase chain reaction-restriction fragment length polymorphism method. No significant differences were observed in the genotype and allele frequencies of this polymorphism between cases and controls. Conclusion : These results present no evidence for an association of rs1799963 with JME. Further studies including other types of epilepsy are required to investigate the involvement of prothrombin gene in the genetic susceptibility to chronic seizure.

https://doi.org/10.1590/0004-282X20150010 1882 downloads

8. Cardiopatia congênita
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Born, Daniel

Arquivos Brasileiros de Cardiologia

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dec 2009, Volume 93 N. 6 Pages 130 - 132

Abstract: Pt | Text: Pt | PDF: Pt

138625 downloads

Gestação em portadora de arterite de Takayasu
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Lucena, Alexandre Jorge Gomes de

; Carvalho, Antonio Carlos

; Souza, Jose Augusto M.

; Moron, Antonio Fernandes

; Sun, Sue Y.

; Born, Daniel

Arquivos Brasileiros de Cardiologia

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may 2008, Volume 90 N. 5 Pages e34 - e36

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

No presente relato, que descreve a gestação de paciente portadora de arterite de Takayasu, serão avaliadas a interação dessa afecção com a gravidez e as intercorrências materno-fetais, do parto e do recém-nascido.

We describe here the pregnancy follow-up and outcome in a patient with Takayasu's arteritis, with a detailed account of the complications during gestation and delivery and the impact of the disease on the newborn's health.

4369 downloads

Síndrome da disfunção apical reversível (Takotsubo)
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Sousa, José Marconi Almeida de

; Knobel, Marcos

; Buchelle, Gustavo

; Sousa, José Augusto M. de

; Fisher, Cláudio H.

; Born, Daniel

; Akamine, Nelson

; Knobel, Elias

Arquivos Brasileiros de Cardiologia

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apr 2005, Volume 84 N. 4 Pages 340 - 342

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

Homem portador de miastenia gravis, internado por descompensação da doença de base, em insuficiência respiratória aguda. Na evolução, apresentou quadro sugestivo de infarto agudo do miocárdio, com alterações eletrocardiográficas e enzimáticas compatíveis com o diagnóstico. Submetido a coronariografia de urgência, não evidenciou obstrução coronariana grave, entretanto o ventrículo esquerdo apresentava disfunção sistólica importante, com alteração característica pela ventriculografia da síndrome descrita como disfunção ventricular transitória ou síndrome de Takotsubo. Na evolução, houve completa recuperação das alterações eletrocardiográficas e da função ventricular sistólica avaliada pelo ecocardiograma, confirmando a síndrome.

The patient was a male with myasthenia gravis, hospitalized with acute respiratory failure due to decompensation of the underlying disease. He evolved with findings suggestive of acute myocardial infarction, with electrocardiographic and enzymatic alterations compatible with that diagnosis. The patient underwent emergency coronary angiography, which showed no severe coronary obstruction, although his left ventricle had significant systolic dysfunction with characteristic alterations, on ventriculography, of the syndrome described as transient ventricular dysfunction or Takotsubo syndrome. On evolution, complete recovery of the electrocardiographic alterations and systolic ventricular function assessed on echocardiography occurred, confirming the syndrome.

9120 downloads

Mortalidade materna por cardiopatia
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Feitosa, Helvécio N.

; Moron, Antônio F.

; Born, Daniel

; Almeida, Pedro Augusto Marcondes de

Revista de Saúde Pública

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dec 1991, Volume 25 N. 6 Pages 443 - 451

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

Realizou-se estudo retrospectivo da mortalidade materna por cardiopatia, no período de janeiro de 1979 a dezembro de 1989. Dentre um total de 16.423 internações, houve 694 gestantes com o diagnóstico de cardiopatia (4,2%). No mesmo período, ocorreram 51 óbitos maternos, correspondendo a um coeficiente de mortalidade materna de 428,2/100.000 nascidos vivos. Houve 12 óbitos maternos por cardiopatia. A análise estatística permitiu a identificação de alguns fatores associados a maior risco de morte nas pacientes cardiopatas: primeira gravidez, primiparidade, ausência de assistência pré-natal, realização de cirurgia cardíaca anterior à gravidez e/ou na gestação. O maior número de mortes ocorreu no puerpério. A classificação funcional (NYHA) não se constituiu em parâmetro seguro para avaliar o prognóstico materno, pois 91,7% dos casos de óbito foram incluídos no grupo considerado favorável (classes I e II) ao iniciar a gestação.

A retrospective study on maternal mortality in pregnant women with cardiac disease over a period of eleven years (January 1979 to December 1989) was undertaken. The objetive was an analysis of the main aspects of this association. Cardiac disease was diagnosed in 694 patients (4.2%) of a total of 16,423 admitted to the Obstetrics Department of the Escola Paulista de Medicina. As for etiology, rheumatic disease (52.3%); Chagas's disease (19.3%) and congenital disease (8.1%) were the most frequent causes. There were 51 maternal deaths, according to FIGO's definition (1967), corresponding to a maternal mortality rate of 428.2/100,000 livebirths during the same period. Twelve of these maternal deaths were due to cardiac disease (maternal mortality rate of 100.8/100,000 livebirths). The statistical analysis identified the following aspects associated with maternal mortality among patients with cardiac disease: primigravida, lack of adequate prenatal care, and cardiac surgery performed previously to and/or during pregnancy. Congestive heart failure with pulmonary edema (41.7%) and thromboembolism (25.0%) were the most frequent causes of maternal death among patients with cardiac disease. The NYHA functional classification was not a good parameter for pregnancy prognosis: eleven patients (91.7%) were considered as belonging to the favorable group before they became pregnant. Most maternal deaths occurred during the first 72 hours after delivery. Therefore, this period was considered most critical for maternal mortality in patients with cardiac disease. No relation-ship was found among the factors: maternal age, race, marital status, delivery and maternal mortality among patients with cardiac disease. The effects of maternal death on the prognosis of the fetus and newborn were severe: 1/3 were undelivered; 1/2 premature liveborn, one fetus died during delivery and an other in the neonatal period. Thus a loss of 50.0% of the conceptuses occurred in this group.

4339 downloads

Mortalidade materna por cardiopatia
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Feitosa, Helvécio N.

; Moron, Antônio F.

; Born, Daniel

; Almeida, Pedro Augusto Marcondes de

Revista de Saúde Pública

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dec 1991, Volume 25 N. 6 Pages 443 - 451

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

3179 downloads

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