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- ItemRisk factors for early onset prosthetic valve endocarditis: a case-control study(Journal of Hospital Infection, 2018)Background: Early onset prosthetic valve endocarditis (EO-PVE) is an infrequent compli-cation of cardiac valve surgery. It is considered a healthcare-associated infection due to contamination of the prosthesis during the implant or in the early postoperative period. Aim: To evaluate which factors may be related to the acquisition of EO-PVE. Methods: A nested caseecontrol study was conducted from 2006 to 2016. Cases were patients who had definite prosthetic endocarditis by the modified Duke criteria up to 12 months of heart valve replacement. Cases and controls were matched by age, gender, date and type of surgery. Findings: There were 26 cases and 78 controls, in 2496 valve surgeries. The median incidence of EO-PVE was 1.1%. Risk factors identified during surgery were: use of 2 cryoprecipitate units (odds ratio (OR): 5.95; 95% confidence interval (CI): 1.31e27.0) and 2 plasma units (OR: 2.73; 95% CI: 1.0e7.5). In the postoperative period, associated factors were bloodstream infection (OR: 14.00; CI: 1.49e131.77), pneumonia (4.38; 1.21 e15.84), any infection (4.46; 1.63e12.21), central line for 2 weeks (5.33; 2.06e13.78), presence of dialysis catheter (3.22; 1.15e9.03), and new open chest surgery (3.89; 1.28 e11.78). Mortality at 12 months was 34.6% in cases and 6.4% in controls (OR: 7.73; CI: 2.3 e26.06). Conclusion: Cases had more infections, invasive procedures and surgical re-interventions in the early postoperative period, which favoured contamination of the newly implanted prosthesis. A preventive approach, with reinforcement of infection control practices, may curb the incidence of this condition.
- ItemDual-task training and cognitive performance in individuals with coronary artery disease and/or heart failure: a systematic review(Frontiers in Cardiovascular Medicine, 2025)Introduction: Dual-task training (DTT) emerged as a promising intervention strategy to improve cognition in individuals with cardiovascular diseases (CVDs). The aim of this study is to describe the literature on the relationship between motor-cognitive DTT and cognitive performance (CP) in individuals with coronary artery disease (CAD) and/or heart failure (HF). Method: This systematic review includes intervention and observational studies that assessed motor-cognitive DTT on CP in individuals with CAD and/or HF. Searches were performed in the MEDLINE/Pubmed, Scielo, Lilacs, PEDro, and EMBASE databases. Methodological quality was assessed using the PEDro and ROBII scales for intervention studies and the Newcastle-Ottawa Scale for observational studies. The certainty of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Results: A total of 2,098 articles were retrieved, and 21 articles were selected for full reading. Among these, 16 were excluded according to pre-specified exclusion criteria, resulting in five studies conducted between 2018 and 2022, conducted in three countries (United States, Portugal, and Russia). The studies included 228 individuals, comprising one study with HF participants, one including women with CAD, two including individuals that underwent myocardial revascularization, and one with patients with CAD enrolled in a phase 2 of cardiac rehabilitation program. Each study used different combinations of motor and cognitive tasks, conducted sequentially (n = 2 studies) or simultaneously (n = 3 studies), with one study using virtual training. The overall certainty of evidence for CP was low according to GRADE approach. Reduction in postoperative cognitive dysfunction after myocardial revascularization was observed in two studies. Moreover, the results indicate that DTT may have a positive impact on memory, selective attention, and conflict resolution capacity. Conclusion: The studies reviewed indicate motor-cognitive DTT as a potential approach to improve CP in individuals with CAD and/or HF.
- ItemImportance of the evaluation of systemic microvascular flow and reactivity in critically ill patients with coronavirus disease 2019 — COVID-19(Microvascular Research, 2020)Amidst the pandemic that has mesmerized the entire world, as it has not spared anyone according to any specific characteristic, some conditions have, in fact, emerged as risk factors for a complicated evolution of COVID-19. Older age, cardiovascular disease including hypertension, diabetes and pulmonary disease, have been associated with more severe presentations and/or adverse prognosis. In this letter to the editor, we propose that the link between cardiovascular and metabolic diseases and the higher incidence and worse prognosis of COVID-19 patients is the (micro) vascular endothelium.
- ItemRedução na biodisponibilidade sistêmica de óxido nítrico concomitante à disfunção endotelial microvascular durante o bypass cardiopulmonar(Arquivos Brasileiros de Cardiologia, 2021)
- ItemEffects of whey protein isolate on body composition, muscle mass, and strength of chronic heart failure patients: a randomized clinical trial(Nutrients, 2023)Heart failure (HF) is associated with a reduction of skeletal muscle mass. Whey protein isolate (WPI) has been beneficial in increasing muscle mass and strength, in addition to improving body composition. The goal of this research was to evaluate the effect of WPI on the body composition, muscle mass, and strength of chronic HF patients. For this purpose, twenty-five patients of both genders with predominantly NYHA I functional class and a median age of 65.5 (60.5–71.0) years were used to conduct a randomized, single-blind, placebo-controlled clinical trial and received 30 g per day of WPI for 12 weeks. Anthropometric measurements, body composition analysis, and biochemical exams were performed at the beginning and end of the study. An increase in skeletal muscle mass was observed in the intervention group after 12 weeks. A reduction in waist circumference, body fat percentage, and an increase in skeletal muscle index was observed when compared to the placebo group. No significant effect on muscle strength was observed after 12 weeks of intervention. These data demonstrate that WPI consumption contributed to the increase of skeletal muscle mass, strength, and reduction of body fat in HF patients.