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1.
Phys Chem Chem Phys ; 26(15): 11436-11444, 2024 Apr 17.
Article in English | MEDLINE | ID: mdl-38567569

ABSTRACT

Bottom-up mechanochemical synthesis (BUMS) has been demonstrated to be an efficient approach for the preparation of metal nanoparticles (NPs), protected by surface agents or anchored on solid supports. However, there are limitations, such as precise size and morphological control, due to a lack of knowledge about the mechanically induced processes of NP formation under milling. In this article, we further investigate the BUMS of AuNPs. Using SiO2 as a solid support, we studied the effect of typical reducing agents, namely NaBH4, L-ascorbic acid, and hydroquinone (HQ), on the conversion of a AuIII source. XANES showed that HQ is the strongest reducing agent under our experimental conditions, leading to the quantitative conversion of gold salt in a few minutes. Interestingly, even when HQ was used in sub-stoichiometric amounts, AuIII could be reduced to ratios higher than 85% after two minutes of milling. Investigations into the byproducts by 1H NMR and GC-FID/MS enabled the identification HQ regeneration and the formation of its derivatives. We mainly focused on benzoquinone (BQ), which is the product of the oxidation of HQ as it reduces the gold salt. We could demonstrate that HQ is regenerated from BQ exclusively under milling and acidic conditions. The regenerated HQ and other HQ-chlorinated molecules could then reduce gold-oxidized species, leading to higher conversions and economy of reactants. Our study highlights the intriguing and complex mechanisms of mechanochemical systems, in addition to fostering the atom and energy economy side of mechanochemical means to produce metal nanoparticles.

2.
Environ Sci Technol ; 58(10): 4510-4521, 2024 Mar 12.
Article in English | MEDLINE | ID: mdl-38426442

ABSTRACT

Polystyrene (PS) is one of the main synthetic polymers produced around the world, and it is present in the composition of a wide variety of single-use objects. When released into the environment, these materials are degraded by environmental factors, resulting in microplastics. We investigated the ability of Chironomus sancticaroli (Diptera, Chironomidae) to promote the fragmentation of PS microspheres (24.5 ± 2.9 µm) and the toxic effects associated with exposure to this polymer. C. sancticaroli larvae were exposed to 3 different concentrations of PS (67.5, 135, and 270 particles g-1 of dry sediment) for 144 h. Significant lethality was observed only at the highest concentration. A significant reduction in PS particle size as well as evidence of deterioration on the surface of the spheres, such as grooves and cracks, was observed. In addition, changes in oxidative stress biomarkers (SOD, CAT, MDA, and GST) were also observed. This is the first study to report the ability of Chironomus sp. to promote the biofragmentation of microplastics. The information obtained demonstrates that the macroinvertebrate community can play a key role in the degradation of plastic particles present in the sediment of freshwater environments and can also be threatened by such particle pollution.


Subject(s)
Chironomidae , Water Pollutants, Chemical , Animals , Microplastics/toxicity , Larva , Polystyrenes/toxicity , Chironomidae/metabolism , Plastics/toxicity , Water Pollutants, Chemical/analysis
3.
ACS Appl Mater Interfaces ; 16(9): 11467-11478, 2024 Mar 06.
Article in English | MEDLINE | ID: mdl-38382920

ABSTRACT

Plasmonic photocatalysis has been limited by the high cost and scalability of plasmonic materials, such as Ag and Au. By focusing on earth-abundant photocatalyst/plasmonic materials (HxMoO3) and Pd as a catalyst, we addressed these challenges by developing a solventless mechanochemical synthesis of Pd/HxMoO3 and optimizing photocatalytic activities in the visible range. We investigated the effect of HxMoO3 band gap excitation (at 427 nm), Pd interband transitions (at 427 nm), and HxMoO3 localized surface plasmon resonance (LSPR) excitation (at 640 nm) over photocatalytic activities toward the hydrogen evolution and phenylacetylene hydrogenation as model reactions. Although both excitation wavelengths led to comparable photoenhancements, a 110% increase was achieved under dual excitation conditions (427 + 640 nm). This was assigned to a synergistic effect of optical excitations that optimized the generation of energetic electrons at the catalytic sites. These results are important for the development of visible-light photocatalysts based on earth-abundant components.

4.
Chempluschem ; 88(10): e202300268, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37498229

ABSTRACT

The performance of mechanochemically synthesized supported bimetallic AgAu nanoalloy catalysts was evaluated in the oxidative cleavage of methyl oleate, a commonly available unsaturated bio-derived raw material. An extensive screening of supports (SiO2 , C, ZrO2 , Al2 O3 ), metallic ratios (Ag : Au), reaction times, temperatures, and use of solvents was carried out. The performance was optimized towards productivity and selectivity for the primary cleavage products (aldehydes and oxoesters). The optimal conditions were achieved in the absence of solvent, using Ag8 Au92 /SiO2 as catalyst, at 80 °C, reaction time of 1 h, substrate to catalyst=555 and 10 bar of molecular oxygen. A strong support effect was observed: the selectivity to aldehydes was best with silica as support, and to esters was best using zirconia. This shows not only that mechanochemical preparation of bimetallic catalysts is a powerful tool to generate useful catalyst compositions, but also that a safe, green, solventless synthesis of bio-derived products can be achieved by aerobic oxidative cleavage.

5.
Front Chem ; 10: 836597, 2022.
Article in English | MEDLINE | ID: mdl-35186886

ABSTRACT

Silver-gold nanoalloys were prepared from their metal salts precursors through bottom-up mechanochemical synthesis, using one-pot or galvanic replacement reaction strategies. The nanostructures were prepared over amorphous SiO2 as an inert supporting material, facilitating their stabilization without the use of any stabilizing agent. The nanomaterials were extensively characterized, confirming the formation of the bimetallic nanostructures. The nanoalloys were tested as catalysts in the hydrogenation of 2-nitroaniline and exhibited up to 4-fold the rate constant and up to 37% increased conversion compared to the respective single metal nanoparticles. Our approach is advantageous to produce nanoparticles with clean surfaces with available catalytic sites, directly in the solid-state and in an environmentally friendly manner.

6.
Int J Gynaecol Obstet ; 159(1): 254-262, 2022 Oct.
Article in English | MEDLINE | ID: mdl-35080264

ABSTRACT

OBJECTIVE: To determine fetal death rates (FDRs) according to maternal characteristics in Brazil. METHODS: A serial cross-sectional analysis was conducted based on vital statistics of the Brazilian population from 2007 to 2019. FDRs were estimated according to maternal and pregnancy characteristics. Annual percent change (APC) of FDR was assessed by joinpoint regression model. Causes of death were compared between the ante-/intrapartum periods. RESULTS: A significant reduction in FDR occurred in Brazil during 2007-2019 (11.1 and 10.43 in 2007 and 2019, respectively; APC -0.44). Only the northern region showed an increase in FDR. In 2019, the northeast and southeast had the highest and lowest FDRs, respectively (11.4 and 7.8/1000 live births). In adolescents, FDR increased from 2007 to 2016 (APC 1.75). In 2019, missing information was significantly high for maternal skin color (99.7%), schooling (17.0%), and age (7.0%) in fetal death registries. The most common causes of fetal death in the ante-/intrapartum periods were fetus and newborn affected by maternal conditions. CONCLUSION: A reduction in FDR has been achieved in Brazil over the last decade. However, there is an unmet need for decreasing social and regional disparities. A better system to attribute causes of death is needed to identifying priorities in maternal-fetal health care.


Subject(s)
Fetal Death , Prenatal Care , Adolescent , Brazil/epidemiology , Cross-Sectional Studies , Female , Humans , Infant, Newborn , Live Birth/epidemiology , Pregnancy
7.
Chem Commun (Camb) ; 56(71): 10329-10332, 2020 Sep 14.
Article in English | MEDLINE | ID: mdl-32760966

ABSTRACT

Current time-resolved in situ approaches limit the scope of mechanochemical investigations possible. Here we develop a new, general approach to simultaneously follow the evolution of bulk atomic and electronic structure during a mechanochemical synthesis. This is achieved by coupling two complementary synchrotron-based X-ray methods: X-ray absorption spectroscopy (XAS) and X-ray diffraction. We apply this method to investigate the bottom-up mechanosynthesis of technologically important Au micro and nanoparticles in the presence of three different reducing agents, hydroquinone, sodium citrate, and NaBH4. Moreover, we show how XAS offers new insight into the early stage generation of growth species (e.g. monomers and clusters), which lead to the subsequent formation of nanoparticles. These processes are beyond the detection capabilities of diffraction methods. This combined X-ray approach paves the way to new directions in mechanochemical research of advanced electronic materials.

8.
An Acad Bras Cienc ; 92(2): e20200800, 2020.
Article in English | MEDLINE | ID: mdl-32638868

ABSTRACT

In the second part of the review on electrochemical energy storage, the devolvement of batteries is explored. First, fundamental aspects of battery operation will be given, then, different materials and chemistry of rechargeable batteries will be explored, including each component of the cell. In negative electrodes, metallic, intercalation and transformation materials will be addressed. Examples are Li or Na metal batteries, graphite and other carbonaceous materials (such as graphene) for intercalation of metal-ions and transition metal oxides and silicon for transformation. In the positive electrode section, materials for intercalation and transformation will be reviewed. The state-of-the-art on intercalation as lithium cobalt oxide and nickel containing oxides will be approached for intercalation materials, whereas sulfur and metal-air will also be explored for transformation. Alongside, the role of electrolyte will be discussed concerning performance and safety, with examples for the next generation devices. Finally, a general future perspective will address both electrochemical capacitors and batteries.

9.
An Acad Bras Cienc ; 92(2): e20200796, 2020.
Article in English | MEDLINE | ID: mdl-32638869

ABSTRACT

The Nobel Prize in Chemistry 2019 recognized the importance of Li-ion batteries and the revolution they allowed to happen during the past three decades. They are part of a broader class of electrochemical energy storage devices, which are employed where electrical energy is needed on demand and so, the electrochemical energy is converted into electrical energy as required by the application. This opens a variety of possibilities on the utilization of energy storage devices, beyond the well-known mobile applications, assisting on the decarbonization of energy production and distribution. In this series of reviews in two parts, two main types of energy storage devices will be explored: electrochemical capacitors (part I) and rechargeable batteries (part II). More specifically, we will discuss about the materials used in each type of device, their main role in the energy storage process, their advantages and drawbacks and, especially, strategies to improve their performance. In the present part, electrochemical capacitors will be addressed. Their fundamental difference to batteries is explained considering the process at the electrode/electrolyte surface and the impact in performance. Materials used in electrochemical capacitors, including double layer capacitors and pseudocapacitive materials will be reviewed, highlighting the importance of electrolytes. As an important part of these strategies, synthetic routes for the production of nanoparticles will also be approached (part I).

10.
Chem Commun (Camb) ; 55(95): 14267-14270, 2019 Nov 26.
Article in English | MEDLINE | ID: mdl-31647479

ABSTRACT

A mechano-colloidal approach was developed to produce Au nanotadpoles. It comprises the generation of seeds by ball-milling from a solid mixture containing a precursor, reductant, and capping agent, followed by the dispersion of this mixture in water leading to seeded-growth to generate the target nanoparticle morphology.

11.
Sci Rep ; 9(1): 13093, 2019 09 11.
Article in English | MEDLINE | ID: mdl-31511664

ABSTRACT

The association of body mass index (BMI) and gestational weight gain (GWG) with preterm birth (PTB) remains controversial in the literature. To evaluate different maternal BMI and GWG categories, according to the initial BMI, in relation to different PTB subtypes and perinatal outcomes, we conducted a secondary analysis of a multicentre cross-sectional study, along with a nested case-control study including PTB from 20 centers in Brazil. Pre-pregnancy underweight was associated with a lower risk of provider-initiated PTB, while overweight and obesity were associated with a higher risk of provider-initiated PTB and a lower risk of spontaneous preterm birth. Insufficient gestational weight gain was associated with a higher prevalence of spontaneous PTB and preterm premature rupture of membranes. Excessive GWG correlated with a higher prevalence of provider-initiated PTB or preterm premature rupture of membranes. Irrespective of the initial BMI, the greater the rate of GWG, the higher the predicted probability of all PTB subtypes, except for spontaneous PTB in underweight women and those with normal BMI. On multivariate analysis, the initial BMI was shown to be the only factor associated with pi-PTB. Briefly, further studies evaluating the risk for PTB should consider that GWG may have a different role depending on the initial BMI and PTB subtype.


Subject(s)
Body Mass Index , Gestational Weight Gain , Premature Birth/diagnosis , Adult , Cross-Sectional Studies , Female , Humans , Male , Pregnancy , Prognosis
12.
Int J Gynaecol Obstet ; 146(1): 110-117, 2019 Jul.
Article in English | MEDLINE | ID: mdl-31055833

ABSTRACT

OBJECTIVE: To explore a conceptual framework of clinical conditions associated with preterm birth (PTB) by cluster analysis, assessing determinants for different PTB subtypes and related maternal and neonatal outcomes. METHODS: Secondary analysis of the Brazilian Multicentre Study on Preterm Birth of 33 740 births in 20 maternity hospitals between April 2011 and July 2012. In accordance with a prototype concept based on maternal, fetal, and placental conditions, an adapted k-means model and fuzzy algorithm were used to identify clusters using predefined conditions. The mains outcomes were phenotype clusters and maternal and neonatal outcomes. RESULTS: Among 4150 PTBs, three clusters of PTB phenotypes were identified: women who had PTB without any predefined conditions; women with mixed conditions; and women who had pre-eclampsia, eclampsia, HELLP syndrome and fetal growth restriction. The prevalence of different preterm subtypes differed significantly in the three clusters, varying from 80.95% of provider-initiated PTBs in cluster 3-6.62% in cluster 1 (P<0.001). Although some maternal characteristics differed among the clusters, maternal and neonatal outcomes did not. CONCLUSIONS: The analysis identified three clusters with distinct phenotypes. Women from the different clusters had different subtypes of PTB and maternal and pregnancy characteristics.


Subject(s)
Pregnancy Outcome/epidemiology , Premature Birth/etiology , Adult , Brazil/epidemiology , Cluster Analysis , Female , Fetal Growth Retardation/epidemiology , Fuzzy Logic , Humans , Infant, Newborn , Phenotype , Pre-Eclampsia/epidemiology , Pregnancy , Premature Birth/epidemiology , Prevalence , Risk Factors
13.
Arch Gynecol Obstet ; 299(2): 585-591, 2019 02.
Article in English | MEDLINE | ID: mdl-30607595

ABSTRACT

PURPOSE: Alterations in renal dimensions may be an early manifestation of deviation from normality, with possible repercussions beyond intrauterine life. The objective of this study was to establish reference curves for fetal kidney dimensions and volume from 14 to 40 weeks of gestation. METHODS: This is a prospective longitudinal study of 115 Brazilian participants in the "WHO multicentre study for the development of growth standards from fetal life to childhood: the fetal component". Pregnant women with clinical and sociodemographic characteristics allowing the full potential fetal growth were followed up from the first trimester until delivery. These women underwent serial sonographic evaluation of fetal kidneys. The longitudinal, anteroposterior and transverse diameters of both fetal kidneys were measured, in addition to calculation of kidney volume. By quantile regression analysis, reference curves of renal measurements related to gestational age were built. RESULTS: Standard normal sonographic values of renal biometry were defined during pregnancy. Reference values for the 10th, 50th and 90th centiles of different fetal kidney measurements (longitudinal, anteroposterior, transverse and volume) from the 14th to the 40th week of gestation were fitted. CONCLUSION: The reference curves presented should be of the utmost importance for screening and diagnosis of alterations in renal development during the intrauterine period.


Subject(s)
Fetal Development/physiology , Ultrasonography, Prenatal/methods , Adult , Child , Cohort Studies , Female , Humans , Longitudinal Studies , Pregnancy , Prospective Studies , Reference Values , Ultrasonography
14.
Molecules ; 22(9)2017 Sep 01.
Article in English | MEDLINE | ID: mdl-28862683

ABSTRACT

A series of isoniazid derivatives bearing a phenolic or heteroaromatic coupled frame were obtained by mechanochemical means. Their pH stability and their structural (conformer/isomer) analysis were checked. The activity of prepared derivatives against Mycobacterium tuberculosis cell growth was evaluated. Some compounds such as phenolic hydrazine 1a and almost all heteroaromatic ones, especially 2, 5 and 7, are more active than isoniazid, and their activity against some M. tuberculosis MDR clinical isolates was determined. Compounds 1a and 7 present a selectivity index >1400 evaluated on MRC5 human fibroblast cells. The mechanism of action of selected hydrazones was demonstrated to block mycolic acid synthesis due to InhA inhibition inside the mycobacterial cell.


Subject(s)
Antitubercular Agents/pharmacology , Isoniazid/chemical synthesis , Isoniazid/pharmacology , Antitubercular Agents/chemistry , Cell Death/drug effects , Cell Line , Chromatography, Thin Layer , Humans , Hydrazones/chemical synthesis , Hydrazones/chemistry , Hydrazones/pharmacology , Hydrogen-Ion Concentration , Hydrolysis , Isomerism , Isoniazid/chemistry , Magnetic Resonance Spectroscopy , Microbial Sensitivity Tests , Models, Molecular , Molecular Conformation , Mycobacterium tuberculosis/drug effects , Mycobacterium tuberculosis/growth & development , Quantum Theory , Spectrophotometry, Ultraviolet , Thermodynamics
15.
Int J Gynaecol Obstet ; 139(2): 222-229, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28803456

ABSTRACT

OBJECTIVE: To evaluate prenatal corticosteroid use in women experiencing spontaneous preterm labor and preterm delivery. METHODS: The present cross-sectional multicenter study analyzed interview data from patients attending 20 hospitals in Brazil owing to preterm delivery between April 1, 2011 and July 30, 2012. Patients were stratified based on preterm delivery occurring before 34 weeks or at 34-36+6  weeks of pregnancy, and the frequency of prenatal corticosteroid use at admission was compared. Prenatal corticosteroid use, sociodemographic data, obstetric characteristics, and neonatal outcomes were examined. RESULTS: There were 1455 preterm deliveries included in the present study; 527 (36.2%) occurred before 34 weeks of pregnancy and prenatal corticosteroids were used in 285 (54.1%) of these pregnancies. Among neonates delivered at 32-33+6  weeks, prenatal corticosteroid use was associated with lower pneumonia (P=0.026) and mortality (P=0.029) rates. Among neonates delivered at 34-36+6  weeks, prenatal corticosteroid use was associated with longer neonatal hospital admission (P<0.001), and an increased incidence of 5-minute Apgar scores below 7 (P=0.010), endotracheal intubation (P=0.042), surfactant use (P=0.006), neonatal morbidities (P=0.048), respiratory distress (P=0.048), and intraventricular hemorrhage (P=0.023). CONCLUSION: Preterm labor and late preterm delivery were associated with worse neonatal outcomes following prenatal corticosteroids. This could reflect a sub-optimal interval between administration and delivery.


Subject(s)
Betamethasone/therapeutic use , Obstetric Labor, Premature , Respiratory Distress Syndrome, Newborn/prevention & control , Adolescent , Adult , Betamethasone/adverse effects , Brazil , Drug Administration Schedule , Female , Gestational Age , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Outcome , Respiratory Distress Syndrome, Newborn/mortality , Young Adult
16.
Braz. j. infect. dis ; 21(4): 441-447, July-Aug. 2017. tab, graf
Article in English | LILACS | ID: biblio-888892

ABSTRACT

Abstract Background: Chronic hepatitis B is a major cause of cirrhosis, and the natural history of the disease has several clinical stages that should be thoroughly understood for the implementation of proper treatment. Nonetheless, curing the disease with antiviral treatment remains a challenge. Aims: To describe the clinical course, response to treatment, and poor prognostic factors in 247 hepatitis B virus chronic infection patients treated in a tertiary hospital in Brazil. Methods: This was a retrospective and observational study, by analyzing the medical records of HBV infected patients between January 2000 and January 2015. Results: Most patients were male (67.2%) and 74.1% were HBeAg negative. Approximately 41% had cirrhosis and 8.5% were hepatitis C virus coinfected. The viral load was negative after two years on lamivudine, entecavir and tenofovir in 86%, 90.6%, and 92.9% of the patients, respectively. The five-year resistance rates for lamivudine, adefovir, entecavir, and tenofovir were 57.5%, 51.8%, 1.9%, and 0%, respectively. The overall seroconversion rates were 31.2% for HBeAg and 9.4% for HBsAg. Hepatocellular carcinoma was diagnosed in 9.7% of patients, liver transplantation was performed in 9.7%, and overall mortality was 10.5%. Elevations of serum alanine aminotransferase (p = 0.0059) and viral load (p < 0.0001) were associated with progression to liver cirrhosis. High viral load was associated with progression to hepatocellular carcinoma (p < 0.0001). Significant risk factors associated with death were elevated alanine aminotransferase (p = 0.0039), liver cirrhosis (p < 0.0001), high viral load (p = 0.007), and hepatocellular carcinoma (p = 0.0008). HBeAg positive status was not associated with worse outcomes, and treatment may have been largely responsible. Conclusions: Elevations of viral load and serum alanine aminotransferase may select patients with worse prognosis, especially progression to cirrhosis and hepatocellular carcinoma, which were strongly association with death.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Antiviral Agents/therapeutic use , Hepatitis B virus/immunology , Carcinoma, Hepatocellular/virology , Hepatitis B, Chronic/drug therapy , Liver Cirrhosis/virology , Liver Neoplasms/virology , Prognosis , Retrospective Studies , Risk Factors , Carcinoma, Hepatocellular/mortality , Disease Progression , Viral Load , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/mortality , Liver Cirrhosis/mortality , Liver Neoplasms/mortality
17.
Braz J Infect Dis ; 21(4): 441-447, 2017.
Article in English | MEDLINE | ID: mdl-28554002

ABSTRACT

BACKGROUND: Chronic hepatitis B is a major cause of cirrhosis, and the natural history of the disease has several clinical stages that should be thoroughly understood for the implementation of proper treatment. Nonetheless, curing the disease with antiviral treatment remains a challenge. AIMS: To describe the clinical course, response to treatment, and poor prognostic factors in 247 hepatitis B virus chronic infection patients treated in a tertiary hospital in Brazil. METHODS: This was a retrospective and observational study, by analyzing the medical records of HBV infected patients between January 2000 and January 2015. RESULTS: Most patients were male (67.2%) and 74.1% were HBeAg negative. Approximately 41% had cirrhosis and 8.5% were hepatitis C virus coinfected. The viral load was negative after two years on lamivudine, entecavir and tenofovir in 86%, 90.6%, and 92.9% of the patients, respectively. The five-year resistance rates for lamivudine, adefovir, entecavir, and tenofovir were 57.5%, 51.8%, 1.9%, and 0%, respectively. The overall seroconversion rates were 31.2% for HBeAg and 9.4% for HBsAg. Hepatocellular carcinoma was diagnosed in 9.7% of patients, liver transplantation was performed in 9.7%, and overall mortality was 10.5%. Elevations of serum alanine aminotransferase (p=0.0059) and viral load (p<0.0001) were associated with progression to liver cirrhosis. High viral load was associated with progression to hepatocellular carcinoma (p<0.0001). Significant risk factors associated with death were elevated alanine aminotransferase (p=0.0039), liver cirrhosis (p<0.0001), high viral load (p=0.007), and hepatocellular carcinoma (p=0.0008). HBeAg positive status was not associated with worse outcomes, and treatment may have been largely responsible. CONCLUSIONS: Elevations of viral load and serum alanine aminotransferase may select patients with worse prognosis, especially progression to cirrhosis and hepatocellular carcinoma, which were strongly association with death.


Subject(s)
Antiviral Agents/therapeutic use , Carcinoma, Hepatocellular/virology , Hepatitis B virus/immunology , Hepatitis B, Chronic/drug therapy , Liver Cirrhosis/virology , Liver Neoplasms/virology , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma, Hepatocellular/mortality , Disease Progression , Female , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/mortality , Humans , Liver Cirrhosis/mortality , Liver Neoplasms/mortality , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Factors , Viral Load , Young Adult
18.
J Am Coll Cardiol ; 46(8): 1553-8, 2005 Oct 18.
Article in English | MEDLINE | ID: mdl-16226184

ABSTRACT

OBJECTIVES: We sought to investigate whether myocardial delayed enhancement (MDE) by magnetic resonance imaging (MRI) could quantify myocardial fibrosis (MF) in patients with Chagas' heart disease (CHD), thus defining the severity of the disease. BACKGROUND: Myocardial fibrosis secondary to ischemic disease can be imaged using MDE. Advanced CHD is characterized by progressive MF. METHODS: Fifty-one patients with CHD were enrolled: 15 seropositive asymptomatic participants in the indeterminate phase (IND); 26 patients with known clinical CHD; and 10 patients with known CHD and ventricular tachycardia (VT). Using a 1.5-T MRI system, we acquired left ventricular (LV) short-axis slices using cine-MRI (LV function) and inversion-recovery gradient-echo (MDE). RESULTS: Myocardial fibrosis by MRI was present in 68.6% of all patients, in 20% of IND, 84.6% of CHD, and 100% of VT (p < 0.001). Quantified MF increased progressively across disease severity subgroups (0.9 +/- 2.3% in IND; 16.0 +/- 12.3% in CHD; and 25.4 +/- 9.8% in VT, p < 0.001) and New York Heart Association functional classes (I: 7.5 +/- 9.5%; II: 21.9 +/- 13.8%; and III: 25.3 +/- 9.9% of LV mass, p < 0.001). Left ventricular ejection fraction and MF had significant negative correlation (r = -0.78, p < 0.001), similar to the segmental MF and function: 4.9 +/- 15.1% of MF in normal function, 32.5 +/- 32.5% in mildly hypokinetic, 57.8 +/- 31.4% in severely hypokinetic, and 72.3 +/- 36.2% in akinetic and dyskinetic segments, respectively (p < 0.001). CONCLUSIONS: In CHD, MDE by MRI quantifies MF that not only can be detected in the early asymptomatic stages but parallels well-established prognostic factors and provides unique information for clinical disease staging.


Subject(s)
Chagas Cardiomyopathy/pathology , Magnetic Resonance Imaging , Chagas Cardiomyopathy/complications , Female , Fibrosis , Humans , Male , Myocardium/pathology , Severity of Illness Index
19.
Arq. bras. cardiol ; 68(1): 39-42, Jan. 1997. ilus
Article in Portuguese | LILACS | ID: lil-320373

ABSTRACT

A case of a 62-year-old patient with Ebstein's anomaly is presented. Despite the severe anatomical abnormalities, he was asymptomatic until 61 years of age. Anatomic aspects, clinical features and the diagnostic techniques used are analyzed.


Subject(s)
Humans , Male , Middle Aged , Ebstein Anomaly , Echocardiography , Electrocardiography
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