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Papers by Eveline B A R R O S Calado

This is a case report of a patient presenting an extremely rare cardiac malignancy: malignant per... more This is a case report of a patient presenting an extremely rare cardiac malignancy: malignant peripheral nerve sheath tumour. The 18 F-fluorodeoxyglucosis positron emission tomography associated to computed tomography (18 F-FDG PET/CT) accesses the tumour anatomy and metabolic activity, thereby making it possible to characterize a malignant neoplasm noninvasively. The diagnostic approach with 18 F-FDG PET/CT spared the heart from a likely futile invasive procedure when detecting a distant metastasis and changed the biopsy site and therapeutic planning.

Revista da Associação Médica Brasileira

OBJECTIVE: This study aimed to evaluate the agreement in the indication of implantable cardiovert... more OBJECTIVE: This study aimed to evaluate the agreement in the indication of implantable cardioverter-defibrillators in patients with Hypertrophic cardiomyopathy, as per the 2014 European Society of Cardiology and 2020 American Heart Association recommendations, and evaluate fragmented QRS as a predictor of cardiovascular outcome. METHODS: Retrospective cohort with 81 patients was evaluated between 2019 and 2021. Patients with hypertrophic cardiomyopathy ≥16 years old were included. Exclusion criteria include secondary myocardiopathy and follow-up <1 year. Kappa coefficient was used to determine the agreement. Survival and incidence curves were determined by Kaplan-Meier method. A p<0.05 was considered significant. RESULTS: The fragmented QRS was identified in 44.4% of patients. There were no differences between patients with and without fragmented QRS regarding clinical parameters, echocardiography, fibrosis, and sudden cardiac death risk. During follow-up of 4.8±3.4 years, there was no sudden cardiac death, but 20.6% patients with implantable cardioverter-defibrillator had at least one appropriate shock. Three of the seven appropriate shocks occurred in European Society of Cardiology low-to moderate-risk patients. Three shocks occurred in moderate-risk patients and four in American Heart Association high-risk patients. Overall recommendations agreement was 64% with a kappa of 0.270 (p=0.007). C-statistic showed no differences regarding the incidence of appropriate shock (p=0.644). CONCLUSION: sudden cardiac death risk stratification algorithms present discrepancies in implantable cardioverter-defibrillator indication, both with low accuracy.

Brazilian Journal of Cardiovascular Surgery

This is an open-access article distributed under the terms of the Creative Commons Attribution Li... more This is an open-access article distributed under the terms of the Creative Commons Attribution License.

ARQUIVOS BRASILEIROS DE CARDIOLOGIA - IMAGEM CARDIOVASCULAR

ABC., imagem cardiovasc, 2019

Rev. Soc. Cardiol. Estado de Säo Paulo, 2013

As melhorias na aquisição e no processamento de imagens na última década permitiram uma crescent... more As melhorias na aquisição e no processamento de imagens na
última década permitiram uma crescente evolução do papel
da ressonância cardíaca e da tomografia computadorizada na
avaliação das doenças do coração. Uma série de patologias
cardíacas puderam ser melhor avaliadas, dentre elas as neo
plasias
cardíacas. Os tumores cardíacos são encontrados em
0,002%-0,3% das autópsias e, embora sejam raros, apresentam
morbidade e mortalidade elevadas, especialmente quando
malignos. A grande maioria dos tumores cardíacos são se
cundários,
metastáticos, com acometimento preferencial das
câmaras direitas e comprometimento do pericárdio. Dentre os
tumores cardíacos primários, os mais comuns são os de origem
benigna e, dentre estes, os mais frequentes são os mixomas,
os lipomas e os fibroelastomas, necessariamente nessa ordem.
A melhor resolução espacial e o maior campo de visão destes
novos métodos também os colocam em vantagem em relação às
limitações de janela acústica da ecocardiografia transtorácica.
A caracterização tecidual realizada, sobretudo, pela ressonância
pode auxiliar na distinção entre o grau de malignidade de um
tumor, ao mesmo tempo que permite a avaliação da função ven
tricular
e do comprometimento hemodinâmico. O diagnóstico
diferencial com cistos, trombos ou achados da anatomia normal
pode ser realizado permitindo, em alguns casos, prescindir de
biópsia miocárdica. A ressonância magnética e a tomografi
computadorizada tornaram-se ferramentas importantes na
decisão terapêutica e no acompanhamento desses pacientes

Arquivos Brasileiros de Cardiologia, 2019

Background Fabry disease (FD) is an X-linked lysosomal storage disorder caused by mutations in th... more Background Fabry disease (FD) is an X-linked lysosomal storage disorder caused by mutations in the alpha galactosidase A gene (GLA) that lead to the enzymatic deficiency of alpha galactosidase (α-Gal A), resulting in the accumulation of globotriaosylceramide (Gb3) and globotriaosylsphingosine (lyso-Gb3), causing multiple organ dysfunctions. Objective To perform GLA gene screening in a group of patients with echocardiographic diagnosis of hypertrophic cardiomyopathy (HCM). Methods a cross-sectional study was conducted with HCM patients from a university hospital. Patients with coronary artery disease and valvulopathies were excluded. Mutation analysis of the GLA gene was performed. In male subjects, the analysis was performed after evidence of low α-Gal A activity. Results 60 patients with echocardiographic diagnosis of HCM were included. Age ranged from 12 to 85 years and 60% were women. Mean myocardial fibrosis percentage on MRI was 10.7 ± 13.1% and mean ventricular thickness was18...

Annales de Cardiologie et d'Angéiologie, 2021

BACKGROUND Apical hypertrophic cardiomyopathy (AHCM) is a rare cardiomyopathy, in which hypertrop... more BACKGROUND Apical hypertrophic cardiomyopathy (AHCM) is a rare cardiomyopathy, in which hypertrophy occurs predominantly in the ventricular apex, and in some cases with a high risk of sudden cardiac death. OBJECTIVE The aim of this paper is to present a case series of patients with AHCM and describe their main clinical, echocardiographic and electrocardiographic characteristics, the recommendation for an implantable cardioverter-defibrillator (ICD) and the frequency of sudden cardiac death (SCD). METHODS A retrospective case series was conducted at the referral center of a federal teaching hospital, between the years 2005 to 2020, involving patients with an echocardiographic diagnosis of AHCM. The parameters of the American College of Cardiology and the European Society of Cardiology were used to assess the risk of SCD. RESULTS A total of 11 individuals were assessed with a mean age of 55.3 years, mean follow-up of 41.2 months, most of whom were symptomatic at diagnosis (72.7%). The most frequent symptom was dyspnea (27.3%). A family history of SCD was described in 45.5% of cases. Due to a high risk of SCD, four patients received ICDs. One patient presented sudden cardiac death after having refused the ICD. CONCLUSIONS Symptoms and alterations in the imaging exams are significant factors in the clinical and prognostic assessment of patients with AHCM.

Arquivos Brasileiros de Cardiologia, 2021

Nota: Estes posicionamentos se prestam a informar e não a substituir o julgamento clínico do médi... more Nota: Estes posicionamentos se prestam a informar e não a substituir o julgamento clínico do médico que, em última análise, deve determinar o tratamento apropriado para seus pacientes.

Brazilian Journal of Nephrology, 2019

Introduction: There is evidence that aldosterone plays a role in the pathogenesis of vascular cal... more Introduction: There is evidence that aldosterone plays a role in the pathogenesis of vascular calcification. The aim of this study was to evaluate the effect of spironolactone, a mineralocorticoid receptor antagonist, on the progression of coronary calcification (CC) in peritoneal dialysis patients and to identify the factors involved in this progression. Methods: Thirty-three patients with a coronary calcium score (CCS) ≥ 30, detected through multi-detector computed tomography (MDCT) and expressed in Agatston units, were randomly assigned to a group receiving 25mg spironolactone per day for 12 months (spironolactone group) and a control group not receiving this drug. The primary outcome was a percentage change in CCS from baseline to end of the study (relative progression), when a further MDCT was conducted. Patients who had progression of CC were compared with those who did not progress. Results: Sixteen patients, seven in the spironolactone group and nine in the control group, co...

Arquivos Brasileiros de Cardiologia, 2016

Background: Chagas disease (CD) is an important cause of heart failure and mortality, mainly in L... more Background: Chagas disease (CD) is an important cause of heart failure and mortality, mainly in Latin America. This study evaluated the morphological and functional characteristics of the heart as well the extent of myocardial fibrosis (MF) in patients with CD by cardiac magnetic resonance (CMR). The prognostic value of MF evaluated by myocardialdelayed enhancement (MDE) was compared with that via Rassi score. Methods: This study assessed 39 patients divided into 2 groups: 28 asymptomatic patients as indeterminate form group (IND); and symptomatic patients as Chagas Heart Disease (CHD) group. All patients underwent CMR using the techniques of cine-MRI and MDE, and the amount of MF was compared with the Rassi score. Results: Regarding the morphological and functional analysis, significant differences were observed between both groups (p < 0.001). Furthermore, there was a strong correlation between the extent of MF and the Rassi score (r = 0.76). Conclusions: CMR is an important technique for evaluating patients with CD, stressing morphological and functional differences in all clinical presentations. The strong correlation with the Rassi score and the extent of MF detected by CMR emphasizes its role in the prognostic stratification of patients with CD.

Journal of Cardiovascular Magnetic Resonance, 2013