Papers by Nadine Clausell
Arquivos brasileiros de cardiologia, 2006
To describe non-pharmacological management of patients admitted with heart failure (HF) in a teac... more To describe non-pharmacological management of patients admitted with heart failure (HF) in a teaching hospital. A cohort longitudinal study of patients diagnosed with HF according to the Boston score. Within the first 72 hours of admission, the nursing staff of the HF clinic conducted structured interviews and medical chart reviews. Two hundred and eighty-three admissions of 239 patients (age = 64 +/- 15 years) were evaluated; approximately 50% of the patients were male and 37% had heart failure of ischemic etiology Non-pharmacological measures included salt restriction in 97%, urine output monitoring in 85%, fluid balance in 75%, weight monitoring in 61%, and fluid restriction in only 25% of the patients. However, they were often not carried out by the team in charge (p < 0.01 for all comparisons). Irregular use of prescribed drugs in the week prior to admission was 22% and 21% in non-readmitted and readmitted patients, respectively (p = 1.00). Readmitted patients (n = 38) had s...
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American Journal of Cardiology, 2001
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Journal of Cardiac Failure, 2003
... Author;RABELO ER(Hospital De Clinicas De Porto Alegre, Rio Grande Do Sul, Bra) DOMINGUES FB(H... more ... Author;RABELO ER(Hospital De Clinicas De Porto Alegre, Rio Grande Do Sul, Bra) DOMINGUES FB(Hospital De Clinicas De Porto Alegre, Rio Grande Do Sul, Bra) ALITI G(Hospital De Clinicas De Porto Alegre, Rio Grande Do Sul, Bra) RUSCHEL KB(Servico De Enfermagem ...
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Cardiovascular Pathology, 1996
Restenosis following coronary intervention is a complex process the mechanisms of which remains m... more Restenosis following coronary intervention is a complex process the mechanisms of which remains mostly unknown. Tissue obtained by atherectomy is an important means to study restenosis. Previous studies on atherectomy-retrieved tissue have not identified histologic features that correlate with restenosis. We performed an histopathologic evaluation on atherosclerotic plaque tissue obtained by atherectomy from 58 patients, all of whom had a
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American Journal of Emergency Medicine, 2000
BackgroundPhysicians often overlook trepopnea as a symptom, and its prevalence and clinical reper... more BackgroundPhysicians often overlook trepopnea as a symptom, and its prevalence and clinical repercussions are not usually described. We propose that trepopnea is a common symptom in heart failure (HF) and, because of patient avoidance of left lateral decubitus position, contributes to the greater prevalence of right-sided pleural effusion in patients with HF. Accordingly, this study aimed to determine trepopnea prevalence
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Summary During incremental exercise, the left ventricular ejection fraction increases up to the ... more Summary During incremental exercise, the left ventricular ejection fraction increases up to the intensity of the anaerobic threshold and tends to level off at higher exercise intensities. Since there is a correlation between the response of peak filling rate and ejection fraction to exercise, this study was conducted to determine whether the response of left ventricular diastolic function is similar to
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PLoS ONE, 2014
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Adriamycin cardiotoxicity is associated with oxidative stress in the presence of globally depress... more Adriamycin cardiotoxicity is associated with oxidative stress in the presence of globally depressed cardiac function. It is unknown if there is a similar profile with early diastolic changes and how it relates to baroreflex control of circulation. In this study, we evaluated baroreflex control of circulation in adriamycin-treated Wistar rats compared with controls, using invasive blood pressure recording processed by
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Journal of Diabetes Research, 2014
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Nutrition, 2015
To evaluate whether changes in hydration status (reflecting fluid retention) would be detected by... more To evaluate whether changes in hydration status (reflecting fluid retention) would be detected by bioelectrical impedance vector analysis (BIVA) and phase angle during hospitalization for acute decompensated heart failure (ADHF) and after clinical stabilization. Patients admitted to ADHF were evaluated at admission, discharge and after clinical stabilization (3 mo after discharge) for dyspnea, weight, brain natriuretic peptide, bioelectrical impedance resistance, reactance, and phase angle. Generalized estimating equations and chi-square detected variations among the three time points of evaluation. Were included 57 patients: Mean age was 61 ± 13 y, 65% were male, LVEF was 25 ± 8%. During hospitalization there were improvements in clinical parameters and increase in resistance/height (from 250 ± 72 to 302 ± 59 Ohms/m, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), reactance/height (from 24 ± 10 to 31 ± 9 Ohms/m, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and phase angle (from 5.3 ± 1.6 to 6 ± 1.6°, P = 0.007). From discharge to chronic stability, both clinical and BIVA parameters remained stable. At admission, 61% of patients had significant congestion by BIVA, and they lost more weight and had higher improvement in dyspnea during hospitalization (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). At discharge, more patients were in the upper half of the graph (characterizing some degree of dehydration) while at chronic stability normal hydration status was more prevalent (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). BIVA and phase angle were able to detect significant changes in hydration status during ADHF, which paralleled the clinical course of recompensation, both acutely and chronically. The classification of congestion by BIVA at admission identified patients with more pronounced changes in weight and dyspnea during compensation.
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Circulation, Jan 6, 2015
Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) pat... more Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) patients with heart failure and preserved left ventricular ejection fraction assigned to spironolactone did not achieve a significant reduction in the primary composite outcome (time to cardiovascular death, aborted cardiac arrest, or hospitalization for management of heart failure) compared with patients receiving placebo. In a post hoc analysis, an ≈4-fold difference was identified in this composite event rate between the 1678 patients randomized from Russia and Georgia compared with the 1767 enrolled from the United States, Canada, Brazil, and Argentina (the Americas). To better understand this regional difference in clinical outcomes, demographic characteristics of these populations and their responses to spironolactone were explored. Patients from Russia/Georgia were younger, had less atrial fibrillation and diabetes mellitus, but were more likely to have had prior myocardial infarctio...
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Value in Health, 2009
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Revista Latino-Americana de Enfermagem, 2007
Congestive heart failure (CHF) presents, besides the magnitude of epidemiological data, relevant ... more Congestive heart failure (CHF) presents, besides the magnitude of epidemiological data, relevant characteristics, including frequent hospitalizations caused by severe signs and symptoms, which should be studied to reduce the negative impact of the disease on the public health system. With the advent of several clinical trials in the area of CHF, the treatment has become more complex, with the need of a more organized structure to assist these patients. Education is considered essential to reduce morbidity and mortality. The setting, to begin or to continue the educational process, can be a hospital (hospitalization), outpatient clinic, home, a day-hospital or yet, a combination of these. The main researches in this area recognize and motivate an investigation of other paths to get better results in the pharmacological and non-pharmacological treatments. In this study we review recent data, approaching several educational settings in the management of patients with CHF.
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Progress in Cardiovascular Diseases, 2010
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Molecular and Cellular Biochemistry, 2010
In this study, we investigated the oxidative stress influence in some prosurvival and proapoptoti... more In this study, we investigated the oxidative stress influence in some prosurvival and proapoptotic proteins after myocardial infarction (MI). Male Wistar rats were divided in two groups: Sham-operated (control) and MI. MI was induced by left coronary artery occlusion. 28-days after surgery, echocardiographic, morphometric, and hemodynamic parameters were evaluated. Redox status (reduced to oxidized glutathione ratio, GSH/GSSG) and hydrogen peroxide levels (H(2)O(2)) were measured in heart tissue. The p-ERK/ERK, p-Akt/Akt, p-mTOR/mTOR and p-GSK-3beta/GSK-3beta ratios, as well as apoptosis-inducing factor (AIF) myocardial protein expression were quantified by Western blot. MI group showed an increase in cardiac hypertrophy (23%) associated with a decrease in ejection fraction (38%) and increase in left ventricular end-diastolic pressure (82%) when compared to control, characterizing ventricular dysfunction. Redox status imbalance was seen in MI animals, as evidenced by the decrease in the GSH/GSSG ratio (30%) and increased levels of H(2)O(2) (45%). This group also showed an increase in the ERK phosphorylation and a reduction of Akt and mTOR phosphorylation when compared to control. Moreover, we showed a reduction in the GSK-3beta phosphorylation and an increase in AIF protein expression in MI group. Taken together, our results show increased H(2)O(2) levels and cellular redox imbalance associated to a higher p-ERK and AIF immunocontent, which would contribute to a maladaptive hypertrophy phenotype.
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International Journal of Cardiology - INT J CARDIOL, 1999
Aims: To assess plasma levels of vascular cellular adhesion molecule-1, a marker of endothelial d... more Aims: To assess plasma levels of vascular cellular adhesion molecule-1, a marker of endothelial dysfunction, in patients presenting with coronary syndromes submitted to coronary angiography. Methods and results: Plasma levels of soluble vascular cellular adhesion molecule-1 were measured by enzymatic immunoabsorbent assay in eight patients with angina-like chest pain and angiographically normal coronary arteries; in 14 patients with stable angina and in 18 patients with unstable angina, both with coronary lesions by angiography, and in 10 healthy volunteers. Levels of soluble vascular cellular adhesion molecule-1 were higher in unstable angina patients (1777±161 SE pg ml−1) compared to patients with stable angina (1178±206 SE pg ml−1, P<0.05). Moreover, patients with angina-like chest pain and normal coronary arteries had significantly higher soluble vascular cellular adhesion molecule-1 levels (2307±295 SE pg ml−1) compared to stable angina patients (P<0.05), but similar leve...
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The Journal of Pathology, 1995
Expression of the vascular cell adhesion molecules intercellular adhesion molecule-1 (ICAM-1) and... more Expression of the vascular cell adhesion molecules intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) occurs in allograft myocardium and in coronary arteries, promoting adhesion and transendothelial migration of inflammatory cells. We therefore investigated, in cholesterol-fed rabbits 9-10 days following heterotopic cardiac transplantation, whether the reduction of both myocardial rejection and graft arteriopathy with cyclosporine A (CsA) or graft arteriopathy alone with tumour necrosis factor-alpha soluble receptor (TNFsr) was associated with suppression of ICAM-1 and VCAM-1 expression. Host hearts showed negative immunostaining for these adhesion molecules, whereas donor specimens from untreated (control) rabbits showed moderate immunostaining for ICAM-1 and weaker immunostaining for VCAM-1 in the coronary arteries, myocardium (cardiac myocytes), and perivenular regions. The selective reduction of the coronary arteriopathy with TNFsr was associated with somewhat reduced expression of these adhesion molecules in the arteries, whereas CsA also suppressed myocardial rejection and markedly decreased both vascular and myocyte expression of ICAM-1 and VCAM-1.
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Journal of Clinical Investigation, 1993
We previously described in piglets after heterotopic cardiac transplantation the early developmen... more We previously described in piglets after heterotopic cardiac transplantation the early development of a coronary arteriopathy characterized by increased immunostaining for fibronectin and interleukin-1 beta (IL-1 beta) in the vessel wall. The objective of this study was to culture smooth muscle cells from donor and host coronary arteries in these piglets to determine whether donor cells produce more fibronectin than host cells as judged by increased protein and mRNA levels, and whether IL-1 beta may be regulating this increase by an autocrine mechanism involving increased production of the cytokine. We documented increased donor coronary artery smooth muscle cell fibronectin protein synthesis and mRNA compared to host. By using neutralizing antibodies to IL-1 beta, fibronectin protein synthesis and mRNA levels were reduced in donor cells to the levels observed in the host cells and a similar reduction in synthesis was observed with the IL-1 receptor antagonist. Immunoprecipitation of newly synthesized IL-1 beta revealed increased endogenous levels in donor compared to host cells. We therefore suggest in the coronary arteriopathy a pathophysiologic mechanism whereby IL-1 beta-mediated increased fibronectin synthesis may promote lymphocyte trapping and migration of medial smooth muscle cells leading to progressive intimal thickening associated with the post-cardiac transplant coronary arteriopathy.
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Papers by Nadine Clausell