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Transcatheter aortic valve replacement in elderly patients

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Journal of Geriatric cardiology 2012年第2期9卷 78-82页

作者： Dimytri Siqueira Alexandre Abizaid Magaly Arrais J. Eduardo Sousa institute dante pazzanese of cardiology Av. Dr Dante Pazzanese 500 Ibirapuera S~o Paulo CEP 04012080 Brazil Heart Hospital Rua Desembargador Eliseu Guilherme 147 Paralso Sao Paulo CEP 040004030 Brazil

Aortic stenosis is the most common native valve disease, affecting up to 5% of the elderly population. Surgical aortic valve replacement reduces symptoms and improves survival, and is the definitive therapy in patients with symptomatic severe aortic stenosis. However, despite the good results of classic surgery, risk is markedly increased in elderly patients with co-morbidities. Transcatheter aortic valve replacement （TAVR） allows implantation of a prosthetic heart valve within the diseased native aortic valve without the need for open heart surgery and cardiopulmonary bypass, offering a new therapeutic option to elderly patients considered at high surgical risk or with contraindications to surgery. To date, several multicenter registries and a randomized trial have confirmed the safety and efficacy of TAVR in those patients. In this chapter, we review the background and clinical applications of TAVR in elderly patients.

关键词： Aortic stenosis Elderly patients Transcatheter aortic valve replacement Percutaneous valve therapies

Heart failure in the elderly

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Journal of Geriatric cardiology 2012年第2期9卷 101-107页

作者： Elizabete Viana de Freitas Michel Batlouni Roberto Gamarsky Department of cardiology Pedro Ernesto University HospitalState University of Rio de JaneiroBoulevard 28 Setembro77 Vila IsabelBrazil Department of Geriatrics Pro-Cardiaeo HospitalRua General Polidoro 182Brazil Department of cardiology Avenida Doutor Arnaldo455ConsolaqaoSao Paulo.CEP:01246-000Brazil Department of lnternal Medicine Federal University of GoiasAv.Contorno s/n°.Estado:GO Cidade:Gioidnia Bairro:Central CEP:74055-140Brazil Department of cardiology Dante Pazzanese InstituteAv.Doutor Dante Pazzanesen o 500.Bairro:IbirapuerafVila Mariana Cidade:Sao PauloBrazil Department of Geriatrics Federal University of Rio de JaneiroRJ20551-030Brazil

The aging of the population is, currently, a major phenomenon, drawing the attention of a number of investigators. The significant increase of life expectancies over the past few decades, in addition to social and economic consequences, has lead to a major change in the morbidity and mortality profile of elders. Heart failure （HF） is a condition in which the heart can not pump enough blood to meet the body＇s needs. HF is predominantly a disorder of the elderly with rates increasing exponentially. The prevalence of HF approximately doubles with each decade of life. As people live longer, the occurrence of HF rises, as well as other conditions that complicate its treatment. Impaired heart function implies a reduced duration of survival. Fortunately, many factors that can prevent HF and improve outcome are known and can be applied at any stage. This review emphasizes the importance of factors inherent in aging itself, focusing on heart disease, particularly as a disease of aging, can help critically refine management of this acute and chronic disease, as well as foster preventive strategies to reduce the incidence of this common malady.

关键词： Elderly people Geriatric problems Heart failure Hypertension

Laser-Treated Surfaces for VADs:From Inert Titanium to Potential Biofunctional Materials

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Biomedical Engineering Frontiers 2022年第1期3卷 399-406页

作者： Eduardo Bock Wilhelm Pfleging Dayane Tada Erenilda Macedo Nathalia Premazzi Rosa Sá Juliana Solheid Heino Besser Aron Andrade Laboratory of Bioengineering and Biomaterials Federal Institute of Technology in Sao Paulo(IFSP)Sao PauloBrazil Center of Engineering in Circulatory Assistance Institute Dante Pazzanese of Cardiology(IDPC)Sao PauloBrazil institute for Applied Materials-Applied Materials Physics Karlsruhe Institute of Technology(KIT)KarlsruheGermany Federal University of Sao Paulo(UNIFESP) Sao Jose dos CamposBrazil National institute for Space Research(INPE) Sao Jose dos CamposBrazil

***-treated surfaces for ventricular assist *** *** work has scientific impact since it proposes a biofunctional surface created with laser processing in bioinert *** diseases are the world’s leading cause of *** especially debilitating heart disease is congestive heart *** the possible therapies,heart transplantation and mechanical circulatory assistance are the main treatments for its severe form at a more advanced *** development of biomaterials for ventricular assist devices is still being carried *** polished titanium is currently employed in several devices,its performance could be improved by enhancing the bioactivity of its *** to improve the titanium without using coatings that can be detached,this work presents the formation of laser-induced periodic surface structures with a topology suitable for cell adhesion and neointimal tissue *** surface was modified by femtosecond laser ablation and cell adhesion was evaluated in vitro by using fibroblast *** results indicate the formation of the desired topology,since the cells showed the appropriate adhesion compared to the control *** electron microscopy showed several positive characteristics in the cells shape and their surface *** in vitro results obtained with different topologies point that the proposed LIPSS would provide enhanced cell adhesion and *** laser processes studied can create new interactions in biomaterials already known and improve the performance of biomaterials for use in ventricular assist devices.

关键词： titanium biomaterials Titanium

Left Ventricle Failure and Blood Flow Estimation for Centrifugal Blood Pumps

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Journal of Mechanics Engineering and Automation 2016年第3期6卷 162-166页

作者： Eduardo Guy Perpetuo Bock Tarcisio Leao Jeison Fonseca AronAndrade Lab. Bioeng. Dep. Mechanics Federal lnstitute of Technology in Sao Paulo IFSP Rua Pedro Vicente 625. Sao Paulo SP Brazil CEAC Institute Dante Pazzanese of Cardiology Av. Dr Dante Pazzanese 500. Sao Paulo SP Brazil

This paper shows the blood flow control （FwC） performance to adjust rotational speed of an ICBP （implantable centrifugal blood pump） in order to provide an adequate flow to left ventricle in different patient conditions. ICBP is a totally implantable LVAD （left ventricular assist device） with ceramic bearings developed for long term circulatory assistance. FwC uses PI （proportional-integral） control to adjust rotational speed in order to provide blood flow. FwC does not use sensor for feedback, as there is an estimation system to provide blood flow measurement. Control strategy has being studied in a HCS （hybrid cardiovascular simulator） as a tool that allows the physical connection of ICBP during evaluation. In addition, HCS allows changes of some cardiovascular parameters in order to simulate specific heart disease： ejection fraction （10-25%） and heart rate （50-110 bpm）. FwC was able to adjust blood flow with steady error less than 2%. Results demonstrated that FwC is adequate to LVAD control irL different left ventricle failure conditions.

关键词： Flow control left ventricle assist device implantable centrifugal blood pump heart failure artificial organs.

药物洗脱支架与裸金属支架治疗大的冠状动脉血管

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世界核心医学期刊文摘（心脏病学分册） 2007年第11期3卷 18-19页

作者： Quizhpe A.R. Feres F. de Ribamar Costa Jr. J. 赵君 institute dante pazzanese of cardiology So Paulo SP Brazil Dr.

背景:最近有证据显示,药物洗脱支架(DES)在广泛的病变和患者亚组中可显著降低再狭窄率和再次血运重建的需要。然而,其用于大血管(>3.0mm)的益处尚未确立。目的:观察DES用于大的冠状动脉血管的临床效果是否优于裸金属支架(BMS)。

关键词：药物洗脱支架冠状动脉血管金属支架矿山支架

Analysis of Participation and Performance in Half Marathon Runners

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Journal of Sports Science 2015年第2期3卷 96-104页

作者： Ana Paula Sierra Marino Benetti Nabil Ghorayeb Carlos Sierra Flavia da Cunha Bastos Ary Rocco Junior Maria Augusta Peduti Dal Molin Kiss School of Physical Education and Sport University of Sao Paulo Sao Paulo Sao Paulo 05508-030 Brazil Sports cardiology Department Dante Pazzanese Institute of Cardiology Sao Paulo Sao Paulo 04012-909 Brazil Department of Medicine Nove de Julho University Sao Paulo Sao Paulo 02169-280 Brazil Sports Management Master Program Nove de Julho University Sao Paulo Sao Paulo 01156-080 Brazil

Endurance running became a mass phenomenon throughout the 1980s around the world. Therefore, we wanted to investigate the participation and performance trends of runners in a half marathon. We analyzed a database containing the number of people who signed up and finished as well as age group, gender, placement, and runtime for all runners from a half marathon between 2003 and 2009. More than 35,000 runners participated in the half marathon, with an 80% increase in total participation during the 7 years analyzed. We verified that the annual participation increased, with a greater increase seen in female and middle-aged people of both genders, and runtimes of last finishers increased gradually in most of the age groups and both genders. However, while the number of people who signed up increased, there was a decrease in the number of participants who finished resulting in a negative correlation. This finding in association with the decrease in the percentage of finishers shows that each year the fitness deteriorated in both genders and across all ages.

关键词： Endurance lifestyle sports management.

紫杉醇洗脱支架自对照试验向临床实践过渡的12个月随访结果:WISDOM注册研究

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世界核心医学期刊文摘（心脏病学分册） 2007年第3期3卷 32-33页

作者： Abizaid A. Lim Y.-T. 杜媛 Dr. A. Abizaid Instituto de Cardiologia Dante Pazzanese So Paolo Brazil

WISDOM注册研究追踪了在自随机临床试验向日常心脏介入实践的商业使用过渡期间,置入紫杉醇洗脱支架(缓释且以聚合物为基础)患者的临床结局。

关键词： WISDOM 紫杉醇洗脱支架对照试验临床实践临床结局靶病变过渡期间心脏介入随机临床试验

对西罗莫司洗脱支架治疗患者进行4年血管造影和血管内超声随访

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世界核心医学期刊文摘（心脏病学分册） 2005年第10期1卷 36-36页

作者： Sousa J. E. Costa M. A. Abizaid A. 高登峰 institute dante pazzanese of cardiology Avenida Dr Dante Pazzanese 500 04012180 S o Paulo Brazil

Despite the proven superiority of sirolimus-eluting stents(SESs) compared with bare stents in the first year after implantation, long-term outcomes of patients treated with these novel devices remain unknown. Our goal was to evaluate the clinical, angiographic, and intravascular ultrasound(IVUS) outcomes of patients treated with SESs 4 years after implantation. Methods and Results-The study included 30 patients treated with sirolimus-eluting Bx Velocity stenting(slow release[SR; n=15] and fast release[FR; n=15]). Twenty-six patients underwent 4- year angiographic and IVUS follow-up and had matched assessments at all time points(index and 4- , 12- , 24- , and 48- month follow-up). One death occurred during the study period in a patient with a patent SES. There were no target-vessel revascularizations or thromboses between 2- and 4- year follow-up examinations. There was no stent thrombosis, target-lesion revascularization, death, or myocardial infarction in the SR group up to 4 years. Cumulative event-free survival rate was 87% for the total population(80% in the FR group and 93% in the SR group). In-stent late loss was slightly greater in the FR group(0.41± 0.49 mm) than the SR group(0.09± 0.23)after 4 years. One patient in the FR group had a 52% in-stent restenosis lesion. Percent neointimal hyperplasia volume, as detected by IVUS, remained minimal after 4 years(FR=9.1% and SR=5.7% ). Conclusions-This study confirms the longevity of the optimal outcomes observed in patients treated with sirolimus-eluting Bx Velocity stents 4 years after implantation. In-stent lumen dimensions remained essentially unchanged at 4-year follow-up, particularly in the population treated with the currently available SES(SR formulation).

关键词：血管内超声血管造影靶血管血运重建西罗莫司再狭窄无事件生存率血栓形成内膜增生体积百分比最小限度