Browsing by Author "Barbosa, M"
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- Analysis of Genes Involved in Oxidative Stress and Iron Metabolism in Heart Failure: A Step Forward in Risk StratificationPublication . Silva, PX; Aguiar, L; Gaspar, M; Faustino, P; Falcão, LM; Barbosa, M; Bicho, M; Inácio, ÂIntroduction: Heart failure (HF) is a clinical syndrome characterized by cardinal symptoms that may be accompanied by signs. It results from structural and/or functional abnormalities of the heart leading to elevated intracardiac pressures and/or inadequate cardiac output at rest and/or during exercise. The prevalence of iron deficiency and anemia justifies the current guidelines recommendation of screening. Genes HP, ACE, MTHFR, HFE, and CYBA are involved in oxidative mechanisms, iron metabolism, and hematologic homeostasis. This study investigates the contribution of variants Hp1/2 (HP), I/D (ACE), C677T (MTHFR), C282Y and H63D (HFE), and C242T (CYBA) to the development of HF, either independently or in epistasis. Methods: We used a database of 389 individuals, 143 HF patients, and 246 healthy controls. Genotypes were characterized through PAGE electrophoresis, PCR, PCR-RFLP, and multiplex-ARMS. Data analysis was performed with the SPSS® 26.0 software (IBM Corp., Armonk, NY). Results: We observed a significant association between the MTHFR gene and HF predisposition. The presence of allele T and genotype CT constituted risk, while genotype CC granted protection. Epistatic interactions revealed risk between genotype II of the ACE gene and genotypes CC (C282Y) or HH (H63D) of the HFE gene. Risk was also observed for interactions between genotype CC (CYBA)and genotypes 2-2 (HP), CT (MTHFR), or HH (HFE-H63D). Conclusion: We concluded that genes HP, ACE, MTHFR, HFE, and CYBA contribute to the susceptibility for HF, individually or in epistasis. This study contributes to the clarification of the role that genes involved in oxidative mechanisms and iron metabolism play in the physiopathology of HF. It is, therefore, a step forward in risk stratification and personalized medicine.
- Can Classic Biomarkers be Prognosticators in Heart Failure? - Data from the REFERENCE studyPublication . Barbosa, M; Matos, A; Bicho, M; Falcão, LM
- Capsaicin 8% patch: the challengePublication . Oliveira, C; Gomes, C; Rebelo, V; Barbosa, M
- Capsaícina 8% - O novo desafio na dor crónicaPublication . Oliveira, C; Gomes, C; Rebelo, V; Barbosa, M
- Capsaícina 8%: o novo desafio na dor crónica: comunicação oralPublication . Gomes, C; Rebelo, V; Barbosa, M; Oliveira, C
- Disruption of balance of oxidative stress-associated angiogenesis in heart failurePublication . Matos, A; Barbosa, M; Bicho, M; Falcão, LM
- Fatores angiogénicos modulados pelo perfil de plaquetas na insuficiência cardíacaPublication . Matos, A; Barbosa, M; Sequeira, T; Santos, AC; Bicho, M; Falcão, LM
- Gal-3 y ST2 como biomarcadores: un paso al frente en el pronóstico de la Insuficiencia CardíacaPublication . Barbosa, M; Matos, A; Bicho, M; Falcão, LMAims: The American College of Cardiology (ACA)/ American Heart Association (AHA) granted Galectin-3 (Gal-3) and Suppression of Tumorigenicity 2 (ST2) evaluation a class II recommendation for HF prognosis, as an adjunctive to conventional clinical risk factors and natriuretic peptides dosing in 2013. However, in Europe this endorsement is not valid. The purpose of this study was to study the association of Gal-3 and ST2 collected at-admission with early (defined as the period of 90 days post-discharge) rehospitalization and overall mortality, and end of follow-up overall mortality in HF patients. Additionally, aminoterminal B-type natriuretic peptide (NT-proBNP) at admission was considered to test if a multi-marker strategy could yield supplementary information. Material and Methods: Gal-3, ST2 and NT-proBNP were assessed in patients hospitalized with acute decompensated HF in class III or IV of New York Heart Association (NYHA). Univariate Cox proportional hazard model was used to assess the relationship between variables and outcomes. Since there are no standardized cut-offs for Gal-3 and ST2, the multiclass Area Under the Curve Receiver-Operator Characteristic (AUCROC) as defined by Hand and Till was used to evaluate the overall performance of each biomarker as a predictor of the outcomes. Results: We followed 65 patients for a median of 13.7 (Q1-Q3 6.7-18.9) months. Gal-3 correlated with short-term rehospitalization (HR: 9.886, 95% CI: 2.027-48.214, P-value=0.005), short-term mortality (HR: 13.731, 95% CI: 1.650-114.276, P value=0.015) and end of follow-up mortality (HR: 4.492, 95% CI: 1.594-12.656, P-value=0.004). The association of elevated NT-proBNP determinations increased the risk of short-term rehospitalization (HR: 11.985, 95% CI: 1.962-73.218, P value=0.007) and end of follow-up mortality (HR: 78.025, 95% CI: 7.592-801.926, P-value<0.001). ST2 correlated with end of follow-up mortality (HR: 4.846, 95% CI: 1.396-16.825, P-value=0.013). The risk further increased if NT-proBNP (HR: 5.953, 95% CI: 1.683- 21.055, P-value=0.006) or Gal-3 determinations (HR: 6.209, 95% CI: 2.393-16.114, P-value<0.001) were added. Conclusions: Elevated Gal-3 concentrations correlated with short-term rehospitalization, short-term mortality and end of follow-up mortality; whereas ST2 prognosticated end of follow-up mortality. Collective analysis with elevated NT-proBNP values further increased the outcomes’ risk. These results corroborate the assumption that promising novel biomarkers Gal-3 and ST2 could be valuable for HF risk stratification. We highlight that a multi-marker strategy added information, as a synergism between myocardial fibrosis biomarkers and the myocardial stretch peptide was observed.
- Insights from the pREdictors oF Early REadmission iN Chronic hEart failure (REFERENCE) StudyPublication . Barbosa, M; Matos, A; Bicho, M; Falcão, LM
- Insuficiencia Cardíaca: una Enfermedad Maligna Conclusiones del Estudio REFERENCEPublication . Barbosa, M; Matos, A; Bicho, M; Menezes Falcão, L