Papers by Renan Vaz-De-Melo
Atherosclerosis Supplements, Jun 1, 2007
The Endocrine Society's 93rd Annual Meeting & Expo, June 4–7, 2011 - Boston, 2011
Atherosclerosis Supplements, 2009
Atherosclerosis Supplements, 2009
DNA and Cell Biology, 2013
Hypertensive crisis (HC) stands out as a form of acute elevation of blood pressure (BP). It can m... more Hypertensive crisis (HC) stands out as a form of acute elevation of blood pressure (BP). It can manifest itself as hypertensive emergency (HE) or hypertensive urgency (HU), which is usually accompanied with levels of diastolic BP ‡ 120 mmHg. Angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism may influence manifestations of HC. Thus, this study evaluated the influence of ACE I/D polymorphism in individuals with HC. A total of 187 patients admitted with HC (HU [n = 69] and HE [n = 118]) and 75 normotensive individuals were included in the study. Peripheral blood was drawn for a biochemical and genetic analysis of the ACE I/D polymorphism by Polymerase Chain Reaction. HC group showed higher systolic BP, body mass index (BMI), glycemia, creatinine, and lower high-density lipoprotein (HDL) cholesterol compared with normotensive individuals. The use of renin-angiotensin system (RAS) blockers was more frequent in the HU group than in the HE group (p = 0.020). The II genotype was more predominant in normotensive and HU individuals than among HE individuals (18.7%, 11.6%, and 2.5%, respectively; p = 0.004). Higher BMI and glycemia were associated with HC in the logistic regression model. ACE II genotype (odds ratio [OR] 0.14; 95% confidence interval [CI] 0.04-0.51) and HDL cholesterol were protective for the development of HE. ACE II genotype was present in the HU group, compared with the HE group (OR 0.18; 95% CI 0.04-0.88). This study shows an association between the low prevalence of ACE I/D polymorphism II genotype and a greater occurrence of HE in Brazilian individuals. The lower blockage of RAS, which was detected in the HE group, may interact with the low frequency of II genotype, conferring an increased risk for HE.
Hypertension Research, 2010
Hypertensive crisis (HC) stands out as one type of acute elevation in blood pressure (BP) and can... more Hypertensive crisis (HC) stands out as one type of acute elevation in blood pressure (BP) and can manifest as hypertensive emergency (HE-with target-organ damage (TOD)) or hypertensive urgency (HU-without TOD), usually accompanied by levels of diastolic BP X120 mm Hg. The aim of this study was to characterize the clinical-epidemiological profile of HC over the course of 1 year in a university reference hospital and perform a review of the literature. The study was a cross-sectional study, conducted over a period of 1 year (2006) in 362 patients who presented for treatment at the emergency hospital with HC, as described above. Among all patients examined, 231 individuals met the criteria for HE and 131 met the criteria for HU. Patients with HE were older (Po0.001) and more sedentary (P¼0.026) than those with HU. Furthermore, fewer HE patients than HU patients had previously undergone antihypertensive treatment (P¼0.006). The groups did not differ regarding BP levels, gender, smoking or body mass index. Dyspnea (41.1%), thoracic pain (37.2%) and neurological deficit (27.2%) were common signs/symptoms in those with HE. Meanwhile, in the group with HU, we most frequently found headache (42.0%), thoracic pain (41.2%) and dyspnea (34.3%). Among the forms of HE, we most frequently observed acute lung edema (30.7%), myocardial infarction/unstable angina (25.1%), and ischemic (22.9%) and hemorrhagic (14.8%) stroke. HC is a clinical entity associated with high morbidity in the emergency room. Individuals with HE are older and sedentary and have lower rates of antihypertensive treatment. Adequate control of BP should be pursued as a way to avoid this severe complication of hypertension.
Background: Arterial stiffness is a variable predictor of morbidity and mortality and a possible ... more Background: Arterial stiffness is a variable predictor of morbidity and mortality and a possible marker of vascular injury. Its non-invasive assessment by radial tonometry and analysis of the augmentation index (r-AI) allows identifying patients exposed to higher cardiovascular risk. Objective: To analyze the influence of r-AI on clinical-biochemical variables and its influence on the prevalence of target-organ damage in hypertensive patients. Methods: 140 consecutive hypertensive patients, followed-up in an outpatient clinic, were analyzed in a cross-sectional study. Blood pressure (BP) levels and r-AI were obtained by applanation tonometry of the radial artery (HEM-9000AI, Onrom). The patients were allocated into r-AI tertiles (r-AI ≤ 85%; 85 < r-AI ≤ 97%; r-AI> 97%). Results: The sample was predominantly composed of women (56.4%), mean age of 61.7 ± 11.7 years and body mass index 29.6 ± 6.1 Kg/m2. The highest tertile showed higher proportion of women (p = 0.001), higher sys...
Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular, 2011
Cognitive dysfunction remains a frequent complication of cardiac surgery. Despite many years of r... more Cognitive dysfunction remains a frequent complication of cardiac surgery. Despite many years of research, few preventive strategies and no definitive therapeutic options exist for the management of this troublesome clinical problem. This shortcoming may be secondary to an incomplete understanding of the pathophysiology and etiology of cognitive loss after cardiac surgery; a better understanding of the etiology is essential to finding new therapies. The etiology of cognitive dysfunction after cardiac surgery is multifactorial and includes cerebral microembolization, global cerebral hypoperfusion, systemic and cerebral inflammation, cerebral temperature perturbations, cerebral edema, and possible blood-brain barrier dysfunction, all superimposed on genetic differences in patients that may make them more susceptible to injury or unable to repair from injury once it has occurred. This review expands on these potential etiologies in detailing the evidence for their existence.
Revista Brasileira De Fisioterapia, 2010
Contextualização: Pressão arterial sistólica (PAS) e pressão de pulso (PP) são preditores de remo... more Contextualização: Pressão arterial sistólica (PAS) e pressão de pulso (PP) são preditores de remodelamento e hipertrofia de VE. Com aumento da rigidez, a velocidade de transmissão da onda de pulso e sua reflexão aumentam, elevando a pressão sistólica tardia modificando o perfil da onda (Augmentation Index AIx). Aumento da rigidez arterial está associada à hipertrofia ventricular esquerda. Objetivos: Avaliar modificações da onda (AIx) e sua correlação com remodelamento e hipertrofia ventricular esquerda em hipertensos. Métodos: Foram estudados 88 indivíduos hipertensos (52F-36M) do ambulatório de HA-FAMERP critérios de HA (VI Diretrizes SBH-SBC). Mensuração de AIx mediante tonometria da artéria radial com equipamento OMRON HEM 9000AI. Ecocardiografia bidimensional com Doppler técnica padronizada e fórmula de Devereux para determinação de massa, índice de massa de VE (IMVE) e relação volume/massa (V/M). Teste e análise multivariada. Resultados: Valores de AIx foram respectivamente, 88...
Revista Brasileira de Cirurgia Cardiovascular, 2008
Postoperative cognitive dysfunction after cardiac surgery Disfunção cognitiva após cirurgia cardí... more Postoperative cognitive dysfunction after cardiac surgery Disfunção cognitiva após cirurgia cardíaca Artigo recebido em 25 de fevereiro de 2008 Artigo aprovado em 13 de maio de 2008 Resumo Disfunção cognitiva pós-operatória é situação freqüente em cirurgias cardíacas, o que pode levar a conseqüências imensuráveis para os indivíduos acometidos. Os processos fisiopatológicos envolvidos nessa condição ainda não se encontram totalmente elucidados, apresentando um caráter multifatorial. Além de fatores pré-operatórios, como idade e escolaridade, alguns fatores intra-operatórios também são de extrema importância. Entretanto, conforme ampla literatura sobre o tema, esses fatores não são capazes de esclarecer etiologicamente a totalidade dos casos, remetendo a uma base genética para essa seqüela neurológica. Nessa revisão, avaliamos fatores envolvidos na disfunção cognitiva e a terapia farmacoprotetora empregada em sua prevenção. Descritores: Revascularização miocárdica. Circulação extracorpórea. Cognição. Transtornos cognitivos/etiologia. Procedimentos cirúrgicos cardíacos/efeitos adversos.
Atherosclerosis Supplements, 2009
Atherosclerosis Supplements, 2009
Rev Bras Cir Cardiovasc, 2008
Brazilian Journal of Physical Therapy, 2010
Brazilian Journal of Physical Therapy, 2010
Rev Bras Cir Cardiovasc, 2008
European Journal of Medical Research, 2015
Brazilian Journal of Cardiovascular Surgery
Postoperative cognitive dysfunction, frequent in cardiac surgeries, leads to major consequences. ... more Postoperative cognitive dysfunction, frequent in cardiac surgeries, leads to major consequences. The physiopathological processes involved in this condition are still not completely elucidated, though its multifactor character is known. Besides pre-operative factors such as age and education, some intra-operative factors are of extreme importance. However, according to a vast literature on the subject, these factors are not sufficient to totality clarify the etiology of all cases, thus suggesting a genetic basis for this neurological sequel. In this review article, we briefly assess the factors involved in this cognitive dysfunction and discuss pharmacotherapy in the prevention of this event.
Postoperative cognitive dysfunction is frequent in cardiac surgeries leading to major consequence... more Postoperative cognitive dysfunction is frequent in cardiac surgeries leading to major consequences. The physiopathological processes involved in this condition are still not completely elucidated, despite the multifactor character. Besides pre-operative factors such as age and education, some intra-operative factors are also of extreme importance. However, according to a vast literature on the subject, these factors are not capable to clarify the totality of the cases, taking us to a genetic base for this neurological sequel. In this revision, we briefly assess the factors involved in this cognitive dysfunction as well as discuss the pharmacotherapy in the prevention of this event.
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Papers by Renan Vaz-De-Melo