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A multisystem pathophysiological approach to heart failure with preserved ejection fraction in the elderly: searching for new therapeutic strategies

Grant number: 15/17642-0
Support Opportunities:Scholarships abroad - Research Internship - Post-doctor
Effective date (Start): January 13, 2016
Effective date (End): January 12, 2017
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Maria Urbana Pinto Brandão Rondon
Grantee:Edgar Toschi Dias
Supervisor: Nicola Montano
Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
Research place: Università degli Studi di Milano, Italy  
Associated to the scholarship:13/07651-7 - Prognostic value of the oscillatory pattern of muscle sympathetic nerve activity in patients with heart failure, BP.PD


Heart failure (HF) is the first cause of mortality in aged people and it is estimated that prevalence of HF is 8.4% for people aged 75 years or older. The most recent epidemiological studies suggest that the prevalence and hospitalizations related to HF with preserved ejection fraction (HFpEF) is rising, and the growing elderly population guarantees further worsening of these trends. To date, there are no approved therapies to reduce hospitalization or mortality for HFpEF. The best described pathophysiological mechanisms of HF rely on the neuro-hormonal activation, which includes renin-angiotensin-aldosterone system activity and an autonomic nervous system (ANS) derangement, particularly a sympathetic overactivity. In addition, over the last years, a growing interest has been focused on the possible role of inflammation and immunity. Last, but not least, there is increasing evidence that epigenetic mechanisms, such as histone modifications, DNA methylation and RNA-based alterations, play a relevant role in HF progression. However, so far it is still unknown whether the ANS derangement, inflammatory response and gene mutations share common pathways also in HFpEF. Thus, to evaluate whether autonomic deregulation and inflammation are cross-linked in HFpEF, and which molecular pathways play a key role in the pathogenesis and the progression of HFpEF, we will study a population of hospitalized elderly subjects with a diagnosis of HFpEF. A one-year follow-up will be performed to evaluate the most predictive variables for re-hospitalization, cardiovascular acute events and mortality in HFpEF patients.

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Scientific publications (6)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
SUFFRITTI, C.; TOBALDINI, E.; SCHIAVON, R.; STRADA, S.; MAGGIONI, L.; MEHTA, S.; SANDRONE, G.; TOSCHI-DIAS, E.; CICARDI, M.; MONTANO, N.. Complement and contact system activation in acute congestive heart failure patients. CLINICAL AND EXPERIMENTAL IMMUNOLOGY, v. 190, n. 2, p. 251-257, . (15/17642-0, 13/07651-7)
TOSCHI-DIAS, EDGAR; TOBALDINI, ELEONORA; SOLBIATI, MONICA; COSTANTINO, GIORGIO; SANLORENZO, ROBERTO; DORIA, STEFANIA; IRTELLI, FLORIANA; MENCACCI, CLAUDIO; MONTANO, NICOLA. Sudarshan Kriya Yoga improves cardiac autonomic control in patients with anxiety-depression disorders. Journal of Affective Disorders, v. 214, p. 74-80, . (15/17642-0, 13/07651-7)
TOBALDINI, ELEONORA; TOSCHI-DIAS, EDGAR; TRIMARCHI, PIETRO DAVIDE; BRENA, NICOLA; COMANDUCCI, ANGELA; CASAROTTO, SILVIA; MONTANO, NICOLA; DEVALLE, GUYA. Cardiac autonomic responses to nociceptive stimuli in patients with chronic disorders of consciousness. CLINICAL NEUROPHYSIOLOGY, v. 129, n. 5, p. 1083-1089, . (15/17642-0, 13/07651-7)
TOSCHI-DIAS, EDGAR; MONTANO, NICOLA; TOBALDINI, ELEONORA; TREVIZAN, PATRICIA F.; GROEHS, V, RAPHAELA; ANTUNES-CORREA, LIGIA M.; NOBRE, THAIS S.; LOBO, DENISE M.; SALES, ALLAN R. K.; UENO-PARDI, LINDA M.; et al. Oscillatory Pattern of Sympathetic Nerve Bursts Is Associated With Baroreflex Function in Heart Failure Patients With Reduced Ejection Fraction. FRONTIERS IN NEUROSCIENCE, v. 15, . (10/50048-1, 15/17642-0, 13/07651-7, 15/22814-5)
TOSCHI-DIAS, EDGAR; RONDON, MARIA URBANA P. B.; COGLIATI, CHIARA; PAOLOCCI, NAZARENO; TOBALDINI, ELEONORA; MONTANO, NICOLA. Contribution of Autonomic Reflexes to the Hyperadrenergic State in Heart Failure. FRONTIERS IN NEUROSCIENCE, v. 11, . (15/17642-0, 13/07651-7)
GROEHS, RAPHAELA V.; NEGRAO, MARCELO V.; HAJJAR, LUDHMILA A.; JORDAO, CAMILA P.; CARVALHO, BRUNA P.; TOSCHI-DIAS, EDGAR; ANDRADE, ANA C.; HODAS, FABIANA P.; ALVES, MARIA J. N. N.; SARMENTO, ADRIANA O.; et al. Adjuvant Treatment with5-Fluorouraciland Oxaliplatin Does Not Influence Cardiac Function, Neurovascular Control, and Physical Capacity in Patients with Colon Cancer. ONCOLOGIST, v. 25, n. 12, . (13/07651-7, 15/22814-5, 15/05427-8, 15/17642-0)

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