Buscar

Fisiopatologia da Insuficiência Cardíaca

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes
Você viu 3, do total de 8 páginas

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes
Você viu 6, do total de 8 páginas

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Prévia do material em texto

(3,'(0,2/2*,$
$�LQFLGrQFLD�H�SUHYDOrQFLD�HVWmR�DXPHQWDQGR�
$�SRSXODomR�HVWi�ILFDQGR�PDLV�YHOKD
$�,&�QmR�DFRPHWH�VRPHQWH�D�SRSXODomR�LGRVD��QR�HQWDQWR��
TXDQWR�PDLV�YHOKR�R�LQGLYtGXR��PDLRU�D�SRVVLELOLGDGH�GR�
GHVHQYROYLPHQWR�GD�GRHQoD�
�
ż
$XPHQWR�QD�SUHYDOrQFLD�SUHFXUVRUHV
'0�
+$6�
'LVOLSLGHPLD�
ż
ͻ
2�SURJQyVWLFR�p�PDX�D�GHVSHLWR�GR�WUDWDPHQWR
2V�SDFLHQWHV�&ODVVH�,9�WHP�PRUWDOLGDGH�DQXDO�GH����D����ż
$�PRUWDOLGDGH�p�PDLRU�TXH�PXLWRV�WLSRV�GH�&kQFHUHVż
ͻ
1mR�Ki�XP�SURJUDPD�GH�GHWHFomR�SUHFRFH��FRPR�H[LVWH�SDUD�&D�GH�
PDPD��SRU�H[HPSOR�
ͻ
+263,7$/,=$d®(6�[�62%5(9,'$
4XDQGR�XP�SDFLHQWH�GHVHQYROYH�,&��H[LVWH�XPD�IDVH�VLQWRPiWLFD��2V�VLQWRPDV�
VmR�JUDGXDGRV�HP����QtYHLV��GH�DFRUGR�FRP�D�LQWHQVLGDGH��VHQGR�TXH�TXDQWR�
PDLRU�R�QtYHO��PDLV�OLPLWDQWH�p�D�GRHQoD��
4XDQGR�R�SDFLHQWH�DOFDQoD�D�FODVVH�IXQFLRQDO�,,,��HOH�Mi�HVWi�HP�XP�JUDX�PXLWR�
HYROXtGR�GD�GRHQoD��SRU�LVVR�TXH�H[LVWH�XPD�TXHGD�PXLWR�EUXVFD�GD�VREUHYLGD�
H�XP�DXPHQWR�GD�KRVSLWDOL]DomR��6H�KRXYHU�XPD�OLQKD�GH�PRUWDOLGDGH��HOD�
WDPEpP�HVWDULD�DXPHQWDQGR�
$�QRVVD�IXQomR�HQTXDQWR�SURILVVLRQDLV�GH�VD~GH��p�PDQWHU�R�SDFLHQWH�QDV�
FODVVHV�IXQFLRQDLV�DQWHULRUHV�j�,,,��PDQWr�OR�R�PDLV�HVWiYHO�H�FRQWURODGR�
SRVVtYHO�
'(),1,d­2
,QVXILFLrQFLD�&DUGtDFD�p�D�LQFDSDFLGDGH�GR�FRUDomR�HP�DGHTXDU�VXD�HMHomR�jV�
QHFHVVLGDGHV�PHWDEyOLFDV�GR�RUJDQLVPR��RX�ID]r�OD�VRPHQWH�DWUDYpV�GH�
HOHYDGDV�SUHVV}HV�GH�HQFKLPHQWR�
1D�FOtQLFD��SHUFHEHPRV�D�H[LVWrQFLD�GD�,&�DJXGD�DWUDYpV�GD�GLPLQXLomR�GD�
SHUIXVmR�SHULIpULFD��VXGRUHVH�IULD��SDOLGH]��UHGXomR�GR�WHPSR�GH�
HQFKLPHQWR�FDSLODU��UHEDL[DPHQWR�GR�QtYHO�GH�FRQVFLrQFLD�H�GLPLQXLomR�GD�
GLXUHVH��
ͻ
,QVXILFLrQFLD�&DUGtDFD
ƋƵĂƌƚĂͲĨĞŝƌĂ͕�ϮϬ�ĚĞ�ŵĂŝŽ�ĚĞ�ϮϬϮϬ ϭϲ͗ϰϬ
'(6(192/9,0(172�'$�,&
2�SDFLHQWH�WHP�XPD�OHVmR�LQLFLDO�SRU�DOJXPD�FDXVD �HWLRORJLD���FRQIRUPH�Ki�
OHVmR�GRV�PLyFLWRV�YDL�RFRUUHQGR�XPD�GLVIXQomR�GR�9(��IXQomR�GR�9(��VtVWROH�H�
GLiVWROH��QD�PDLRULD�GDV�,&�D�SHUGD�p�GD�FDSDFLGDGH�GLDVWyOLFD���&RP�R�WHPSR�D�
GLVIXQomR�YDL�FDXVDQGR�ILEURVH�H�SHUGD�GH�PLyFLWRV��LVVR�FXOPLQD�HP�XP�
UHPRGHODPHQWR�GR�9(��TXH�SRGH�VHU�D�GLODWDomR�RX�D�KLSHUWURILD�GR�YHQWUtFXOR��
R�TXH�DOWHUD�DLQGD�PDLV�D�GLQkPLFD�FDUGtDFD��$OpP�GLVVR��D�GLVIXQomR�JHUD�XPD�
IDOrQFLD�KHPRGLQkPLFD��D�FLUFXODomR�GH�VDQJXH�p�DOWHUDGD��R�FRUDomR�QmR�
UHFHEH�H�QHP�HMHWD�R�VDQJXH�GD�IRUPD�TXH�GHYHULD���TXH�SURYRFD�R�
DSDUHFLPHQWR�GD�,QVXILFLrQFLD�5HWUyJDGD�RX�$QWHUyJUDGD��3HOD�IDOrQFLD�
KHPRGLQkPLFD�WHPRV�XP�DXPHQWR�GR�UHPRGHODPHQWR�GR�9(��H�D�DWLYDomR�
QHXURKXPRUDO��$�DWLYDomR�QHXURKXPRUDO��RV�WHFLGRV�SHULIpULFRV�HQWHQGHP�TXH�
D�SHUIXVmR�Wi�EDL[D��D�DEUH�PmR�GH�PHFDQLVPRV�SDUD�UHYHUWHU�LVVR� p�XP�IDWRU�
GHWHUPLQDQWH�SDUD�D�QHFURVH�FDUGtDFD�H�SDUD�R�DXPHQWR�GR�UHPRGHODPHQWR�GR�
9(��H�FRPR�VH�QmR�EDVWDVVH��WDPEpP�JHUD�YDVRFRQVWULomR�SHULIpULFD��TXH�SLRUD�
PXLWR�R�GpELWR��Ki�XP�DXPHQWR�PXLWR�JUDQGH�GD�IRUoD�GH�FRQWUDomR��
DFHQWXDQGR�DLQGD�PDLV�R�UHPRGHODPHQWR�FDUGtDFR��,QVWDODGD�D�IDOrQFLD�
KHPRGLQkPLFD�H�RV�IDWRUHV�QHXURKXPRUDLV��WHPRV�D�,&&��FRP�RV�VLQDLV�H�
VLQWRPDV��D�PRUELGH]�H�D�PRUWH�
2�SULQFLSDO��YLOmR��GD�,&�p�D�YDVRFRQVWULomR� !�WUDWD�FRP�YDVRGLODWDomR��
PHVPR�TXH�LVVR�SURYRTXH�XP�TXDGUR�GH�KLSRWHQVmR���
ͻ
(7,2/2*,$6
0LRFDUGLRSDWLD�,VTXrPLFDͻ
0LRFDUGLRSDWLD�+LSHUWHQVLYDͻ
&DUGLRPLRSDWLD�&KDJiVLFDͻ
&DUGLRPLRSDWLD�3HULSDUWR
,QIODPDomR�GR�PLRFiUGLR�GHFRUUHQWH�GDV�DOWHUDo}HV�KRUPRQDLV�H�GD�
OLEHUDomR�GH�FLWRFLQDV�
ż
4XDGUR�&OtQLFR��HGHPD��FDQVDoR�H[DFHUEDGR�H�RUWRSQHLD�ż
ͻ
&DUGLRPLRSDWLD�'LODWDGD�,GLRSiWLFDͻ
&DUGLRPLRSDWLD�5HVWULWLYDͻ
&DUGLRPLRSDWLD�+LSHUWUyILFD
e�D�SULQFLSDO�FDXVD�GH�PRUWH�V~ELWD�HP�PHQRUHV�GH����DQRV�ż
ͻ
7UDQVSODQWH�ż
7DTXLFDUGLRPLRSDWLD
$UULWPLD� !�7DTXLFDUGLD� !�+LSHUWURILD� !�,&&
$�DUULWPLD�SRGH�VHU�VHFXQGiULD�DR�KLSHUWLUHRLGLVPR��SRU�
H[HPSOR��
�
ż
ͻ
9DOYXORSDWLDVͻ
0HGLFDPHQWRVD
$QWLDUUtWLPLFRV�ż
$JHQWHV�&LWRWy[LFRV��TXLPLRWHUiSLFRV�ż
%&&Vż
ͻ
7R[LQDV
ÈOFRROż
'URJDV��HVSHFLDOPHQWH�D�FRFDtQDż
ͻ
,QILOWUDWLYDV
'HSRVLomR�GH�VXEVWkQFLDV�QR�PLRFiUGLR��JHUDQGR�OHVmR
$PLORLGRVH��VDUFRLGRVH�H�KHPRFURPDWRVH�
ż
ͻ
,QIHFomR�YLUDOͻ
5(02'(/$0(172�9(175,&8/$5
8PD�OHVmR�FDUGtDFD�GH�TXDOTXHU�HWLRORJLD�YDL�DOWHUDU�D�FRQIRUPDomR�GR�
PLRFiUGLR��JHUDQGR�DOWHUDomR�GH�WDPDQKR��IRUPD�H�RX�IXQomR�YHQWULFXODU�
+LSHUWURILDͻ
'LODWDomRͻ
3HUGD�GH�PLyFLWRVͻ
$XPHQWR�GD�ILEURVH�LQWHUVWLFLDOͻ
)$/Ç1&,$�&$5'Ë$&$�
6H�R�FRUDomR��SRU�TXDOTXHU�PRWLYR��HQWUD�HP�IDOrQFLD��SDUDQGR�GH�HQFKHU�RX�
HVYD]LDU��WHUHPRV�GRLV�PHFDQLVPRV��XP�UHODFLRQDGR�DR�VDQJXH�TXH�FKHJD�DR�
FRUDomR�H�RXWUR�DR�VDQJXH�TXH�VDL�GR�FRUDomR��VHQGR�TXH�HVWHV�PHFDQLVPRV�
FRQWULEXHP�SDUD�R�VXUJLPHQWR�GRV�VLQDLV�H�VLQWRPDV�
,QVXILFLrQFLD�&DUGtDFD�5HWUyJUDGD� VH�R�FRUDomR�HVWi�VREUHFDUUHJDGR�GH�
YROXPH��RX�FRP�XP�DXPHQWR�GH�SUHVVmR�YHQWULFXODU�SHOD�DXVrQFLD�GH�
UHOD[DPHQWR��R�VDQJXH�QmR�HVFRD�GRV�iWULRV�SDUD�RV�YHQWUtFXORV��ORJR�RFRUUH�
XP�DXPHQWR�GD�SUHVVmR�QRV�iWULRV��TXH�OHYD�D�XP�DXPHQWR�GD�SUHVVmR�
YHQRVD��FRP�FRQVHTXHQWH�WUDQVXGDomR��FXOPLQDQGR�HP�FRQJHVWmR�YHQRVD��GDt�
DSDUHFHP�RV�VLQDLV��TXH�YmR�QRV�LQGLFDU�RQGH�HVWi�RFRUUHQGR�HVVD�LQVXILFLrQFLD�
,QVXILFLrQFLD�&DUGtDFD�'LUHLWD��D�FRQJHVWmR�p�QDV�YHLDV�H�WHFLGRV�
SHULIpULFRV��R�SDFLHQWH�DSUHVHQWD�HGHPD�GH�00,,��HGHPD�VDFUDO��DVFLWH�H�
WXUJrQFLD�MXJXODU�
ͻ
,QVXILFLrQFLD�&DUGtDFD�(VTXHUGD��D�FRQJHVWmR�p�QDV�YHLDV�SXOPRQDUHV��R�
H[WUDYDVDPHQWR�GH�OtTXLGRV�DFRPHWH�R�WHFLGR�SXOPRQDU�H�RV�DOYpRORV��
HQWmR�R�SDFLHQWH�YDL�DSUHVHQWDU�GLVSQpLD�DRV�HVIRUoRV��RUWRSQHLD�H�HGHPD�
SXOPRQDU�
ͻ
1HVWHV�FDVRV��R�WUDWDPHQWR�p�IHLWR�DWUDYpV�GRV�GLXUpWLFRV��TXH�YmR�SURPRYHU�
XPD�UHGXomR�GD�FRQJHVWmR��DVVRFLDGRV�DRV�YDVRGLODWDGRUHV��TXH�ID]HP�XP�
�VHTXHVWUR��GH�VDQJXH��GLPLQXLQGR�R�YROXPH�TXH�FKHJD�DR�FRUDomR�
,QVXILFLrQFLD�&DUGtDFD�$QWHUyJUDGD��FRP�D�IDOrQFLD�FDUGtDFD��WDQWR�SHOD�
SHUGD�GD�FRQWUDomR�TXDQWR�GR�UHOD[DPHQWR��Ki�XPD�UHGXomR�GR�GpELWR�FiUGLFR��
SHUGH�VH�YROXPH�VLVWyOLFR��ORJR��GLPLQXL�VH�R�IOX[R�VLVWrPLFR�H�D�SHUIXVmR�
WHFLGXDO��9DL�VH�PDQLIHVWDU�QD�IRUPD�GH�FDQVDoR�JHQHUDOL]DGR��SHUGD�GH�IRUoD�
PXVFXODU��UHEDL[DPHQWR�GR�QtYHO�GH�FRQVFLrQFLD�H�ROLJ~ULD��(QWmR�R�RUJDQLVPR�
LQLFLD�XP�PHFDQLVPR�GH�FRPSHQVDomR��FRP�GHVFDUJD�GH�DGUHQDOLQD��TXH�OHYD�j�
WDTXLFDUGLD��SDOLGH]�H�VXGRUHVH�IULD��


REV��SRGH�VHU�TXH�QD�SURYD�HOD�UHODFLRQH�FRP�R�FKRTXH��4XDQGR�R�SDFLHQWH�
WHP�PXLWDV�PDQLIHVWDo}HV�VLVWrPLFDV��FRP�UHEDL[DPHQWR�GR�QtYHO�GH�
FRQVFLrQFLD��HOH�Wi�HYROXLQGR�SUD�XP�FKRTXH�FDUGLRJrQLFR
0(&$1,6026�1(852+8025$,6�1$�,&
(P�FRQVHTXrQFLD�GD�GLVIXQomR�YHQWULFXODU�SRGH�RFRUUHU�UHGXomR�GR�GpELWR�
FDUGtDFR��OHYDQGR�D�XPD�KLSRSHUIXVmR�WHFLGXDO�H�FRURQDULDQD��TXH�SRGH�HVWDU�
DVVRFLDGD�RX�QmR�j�KLSRWHQVmR��,VVR�HVWLPXOD�RV�EDURUUHFHSWRUHV��OHYDQGR�j�
DWLYDomR�GH�PHFDQLVPRV�SDUD�WHQWDU�UHHVWDEHOHFHU�D�KHPRGLQkPLFD�H�UHYHUWHU�
R�TXDGUR�
0HFDQLVPR�1HXUROyJLFR��DWLYDomR�GR�6LVWHPD�1HUYRVR�6LPSiWLFR��FRP�
OLEHUDomR�GH�DGUHQDOLQD��TXH�SURPRYH
9DVRFRQVWULomRż
9HQRFRQVWULomRż
(VWLPXOR�UHQDO�SDUD�OLEHUDomR�GH�5HQLQDż
7DTXLFDUGLDż
ͻ
0HFDQLVPR�+RUPRQDO��DWLYDomR�GR�65$$��FRP�OLEHUDomR�GH�$QJLRWHQVLQD�
,,��TXH�YDL�SURPRYHU
9DVRFRQVWULomRż
5HDEVRUomR�GH�6yGLR�H�ÈJXDż
ͻ
(VVHV�GRLV�VLVWHPDV��FRP�VHXV�HIHLWRV��YmR�JHUDU�XPD�PHOKRUD�PRPHQWkQHD�GR�
GpELWR��QR�HQWDQWR��LVVR�YDL�RFRUUHU�jV�FXVWDV�GR�FUHVFLPHQWR�H�GR�
UHPRGHODPHQWR�FDUGtDFR��(VVH�UHPRGHODPHQWR�p�FRQVHTXrQFLD�GH�DSRSWRVHV��
IRUPDomR�GH�ILEURVH�H�GH�QHFURVH�FDUGtDFD��H�YDL�DFHOHUDU�R�SURFHVVR�GH�
IDOrQFLD�


(QWmR��DV�FDWHFRODPLQDV��D�DQJLRWHQVLQD�,,�H�D�DOGRVWHURQD��DR�PHVPR�
WHPSR�TXH�PDQWrP�R�GpELWR�FDUGtDFR��VmR�DV��YLOmV��GD�,&��YLVWR�TXH�
SURPRYHP�R�UHPRGHODPHQWR�
&RQGXWD� LQLELomR�GR�UHPRGHODPHQWR�SRU�LQLELomR�GR�6LPSiWLFR��GD�
$OGRVWHURQD�H�GD�$QJLRWHQVLQD�,,�
5HVSRVWDV�1HXURHQGyFULQDV�
4XDQGR�R�SDFLHQWH�FRPHoD�D�GHVHQYROYHU�D�,&��LQLFLD�VH�D�DWLYDomR�GR�
6LPSiWLFR�H�65$$��TXH�SURPRYHP�YDVRFRQVWULomR�H�UHWHQomR�GH�6yGLR�H�ÈJXD��
EXVFDQGR�D�PHOKRUD�GD�SHUIXVmR��
$R�PHVPR�WHPSR��WDPEpP�OLEHUDPRV��PDV�HP�PHQRU�TXDQWLGDGH��VXEVWkQFLDV�
TXH�VmR�FRQWUiULDV�jV�FDWHFRODPLQDV��j�DQJLRWHQVLQD�H�j�DOGRVWHURQD�
)DWRU�1DWULXUpWLFR�$WULDOͻ
3URVWDJODQGLQDV�ͻ
%UDGLFLQLQDͻ
'RSDPLQDͻ
+RMH��QR�WUDWDPHQWR��R�QRVVR�REMHWLYR�p�GLPLQXLU�D�YDVRFRQVWULomR�H�D�
UHWHQomR�GH�VyGLR�H�iJXD��H�DXPHQWDU�D�YDVRGLODWDomR�H�D�H[FUHomR�GH�VyGLR�H�iJXD�
'e%,72�&$5'Ë$&2
8PD�ERD�SHUIXVmR�p�GHSHQGHQWH�GR�GpELWR�FDUGtDFR��TXH�SRU�VXD�YH]�GHSHQGH�
GD�SUp�FDUJD��GD�SyV�FDUJD�H�GR�LQRWURSLVPR��
3Up�FDUJD� p�D�SUHVVmR�QD�SDUHGH�GR�YHQWUtFXOR�QR�PRPHQWR�LPHGLDWDPHQWH�
DQWHULRU�j�FRQWUDomR��'HSHQGH�GD�YROHPLD�H�GD�FRPSODFrQFLD�YHQWULFXODU�
9ROHPLD��YROXPH�VDQJXtQHR�
4XDQGR�R�FRUDomR�HVWi�HP�IDOrQFLD��D�JHQWH�SUHFLVD�UHGX]LU�D�SUp�
FDUJD��SUD�LVVR�D�JHQWH�GLPLQXL�D�YROHPLD��GLXUpWLFR��)XURVHPLGD�
ż
ͻ
&RPSODFrQFLD�YHQWULFXODU��FDSDFLGDGH�GR�YHQWUtFXOR�GH�UHOD[DU�SDUD�
DFRPRGDU�UHFHEHU�R�VDQJXH��
8P�SDFLHQWH�FRP�,&�GLDVWyOLFD�WHP�SUp�FDUJD�DXPHQWDGD�SRUTXH�R�
FRUDomR�QmR�UHOD[D�SRU�HVWDU�KLSHUWUyILFR��1mR�WHP�FRPR�D�JHQWH�
LQWHUIHULU�QD�FDSDFLGDGH�GH�UHOD[DPHQWR��HQWmR�EUDGLFDUGL]D�R�
SDFLHQWH��SDUD�TXH�R�WHPSR�GH�GLiVWROH�VHMD�PDLRU�
ż
ͻ


4XDQWR�PDLRU�D�YROHPLD�H�RX�D�FRPSODFrQFLD��PDLRU�D�SUp�FDUJD��1D�
LQVXILFLrQFLD�FDUGtDFD��D�JHQWH�SUHFLVD�5('8=,5�D�SUp�FDUJD�
3yV�FDUJD��p�D�SUHVVmR�TXH�R�9(�SUHFLVD�YHQFHU�SDUD�HMHWDU�R�VDQJXH�QR�
VLVWHPD�DUWHULDO��'HSHQGH�GD�3$�H�GD�5S��


4XDQWR�PDLRU�D�3$�H�D�5S��PDLRU�D�SyV�FDUJD��1D�LQVXILFLrQFLD�FDUGtDFD�D�
JHQWH�SUHFLVD�5('8=,5�D�SyV�FDUJD��SUD�LVVR�YDPRV�XVDU�UHGXWRUHV�GH�SUHVVmR�
�HVFROKD��1LWUDWRV��H�YDVRGLODWDGRUHV
,QRWURSLVPR� p�D�FDSDFLGDGH�GH�FRQWUDomR��D�FRQWUDWLOLGDGH�GR�YHQWUtFXOR��
'HYHPRV�DXPHQWD�OD�QD�,QVXILFLrQFLD�&DUGtDFD��SDUD�LVVR�XVDPRV�RV�IiUPDFRV�
FRP�HIHLWR�LQRWUySLFR�SRVLWLYR��HVFROKD��'REXWDPLQD�
0$1(-2�'2�3$&,(17(�&20�,&
9DVRGLODWDomR�H�([FUHomR�
GH�6yGLR�H�ÈJXD
,QGHSHQGHQWH�GD�HWLRORJLD��VH�Ki�GLVIXQomR�YHQWULFXODU��Ki�DWLYDomR�
QHXURKXPRUDO�
%HWD�%ORTXHDGRUHV��%%4�
%ORTXHLD�616
3RUTXH�FDXVD�GDQR�GLUHWR�DRV�PLyFLWRV��VREUHFDUJD�QR�LQIOX[R�
GH�FiOFLR�H�DSRSWRVH�
�
ż
ͻ
,(&$�%5$�
%ORTXHLD�$QJLRWHQVLQD�,,
3RUTXH�FDXVD�YDVRFRQVWULomR��DSRSWRVH�PLRFLWiULD�H�ILEURVH�
PLRFiUGLFD�
�
ż
ͻ
(VSLURQRODFWRQD�
%ORTXHLD�$OGRVWHURQD
&RQWUDLQGLFDGR�VH�WLYHU�KLSHUSRWDVVHPLD��
ż
ͻ
(92/8d­2�(�352*5(66­2�'$�,&
2�SDFLHQWH�p�FODVVLILFDGR�HP�HVWiJLRV�GH�$�j�'��GH�DFRUGR�FRP�D�SUHVHQoD�RX�
DXVrQFLD�GH�)DWRUHV�GH�5LVFR��$OWHUDo}HV�&DUGtDFDV�H�6LQWRPDV��
)DWRUHV�GH�5LVFR�
7DEDJLVPR�H�(OLWLVPRͻ
'LVOLSLGHPLDͻ
+$6ͻ
'0ͻ
$OWHUDo}HV�(VWUXWXUDLV�
'LVIXQomR�6LVWyOLFD��9(�ͻ
9DOYRSDWLDVͻ
+9(ͻ
,$0ͻ
(67È*,2�$ (67È*,2�% (67È*,2�& (67È*,2�'
)$725�'(�5,6&2 3UHVHQWH� 3UHVHQWH 3UHVHQWH 3UHVHQWH�
$/7(5$d­2 $XVHQWH 3UHVHQWH 3UHVHQWH 3UHVHQWH
6,1720$6 $XVHQWH $XVHQWH 3UHVHQWH 3UHVHQWH
2�SDFLHQWH�QR�HVWiJLR�$�p�R�TXH�HVWi�HP�FDVD��SURYDYHOPHQWH�VHP�WHU�D�PHQRU�
LGHLDV�GD�SRVVLELOLGDGH�GH�WHU�XPD�,&��2�%�D�JHQWH�Mi�DFRPSDQKD�QDV�XQLGDGHV��
SRUTXH�SRU�PDLV�TXH�QmR�WHQKD�VLQWRPDV�GD�,&��HOH�DSUHVHQWD�DOWHUDo}HV�TXH�R�
OHYDP�DWp�D�XQLGDGH��2�SDFLHQWH�&�Mi�HVWi�QR�KRVSLWDO�H�Mi�HVWi�VHQGR�WUDWDGR��
2�SDFLHQWH�'�WDPEpP�HVWi�QR�KRVSLWDO��SURYDYHOPHQWH�HP�XP�TXDGUR�EDVWDQWH�
VLQWRPiWLFR��JUDYH��Mi�IRL�WUDWDGR�H�QmR�WHYH�UHVSRVWD��D�FKDQFH�GH�yELWR�p�DOWD�
',$*1Ï67,&2
e�IHLWR�DWUDYpV�GRV�&ULWpULRV�GH�)UDPLQJKDP��TXH�HVWDEHOHFH�RV�VLQWRPDV�HP�
PDLRUHV�H�PHQRUHV�
&ULWpULRV�0DLRUHV
'LVSQHLD�3DUR[tVWLFD�1RWXUQDͻ
2UWRSQHLDͻ
7XUJrQFLD�-XJXODUͻ
$�SULQFtSLR�D�GLPLQXLomR�GR�'&�RFRUUH�VRPHQWH�QR�H[HUFtFLR�ͻ
,QVXILFLrQFLD�&DUGtDFD�GH�$OWR�'pELWR�
3DFLHQWHV�TXH�WHP�FRQGLo}HV�TXH�DXPHQWDP�PXLWR�D�QHFHVVLGDGH�GH�2���
UHFUXWDP�PXLWR�R�FRUDomR��RX�VHMD��R�GpELWR�SRGH�HVWDU�QRUPDO�RX�DWp�
QRUPDO���PDV�p�LQVXILFLHQWH�SDUD�VXSULU�DV�QHFHVVLGDGH�PHWDEyOLFDV�
ͻ
([��EHULEHUL��KLSHUWLUHRLGLVPR�H�DQHPLD�JUDYH�
,QWHUQRX�SDFLHQWH�FRP�,&��GRVD�76+�H�SHGH�KHPRJUDPD�
6H�+E�WLYHU�EDL[D��DXWRUL]D�WUDQVIXVmR�GH�VDQJXH���
ż
ͻ
(;$0(6�&203/(0(17$5(6�
5[�GH�7yUD[��
$XPHQWR�GD�iUHD�FDUGtDFDͻ
&RQJHVWmR�SXOPRQDU�QD�,&&�DJXGDͻ
(OHWURFDUGLRJUDPD�
$X[LOLD�QD�HWLRORJLD�H�Gi�XP�SURJQyVWLFRͻ
$ODUJDPHQWR�GR�456�LQGLFD�SLRU�SURJQyVWLFRͻ
(FRFDUGLRJUDPD�
'i�LQIRUPDo}HV�LPSRUWDQWHV�FRPR�)(��'&�H�HVSHVVXUD�GD�SDUHGH�GR�
FRUDomR
ͻ
3HUPLWH�OHYDQWDU�D�KLSyWHVH�GD�HWLRORJLDͻ
%13��p�R�)$1
6H��������QmR�p�LQVXILFLrQFLD�FDUGtDFDͻ
6H�!������SURYiYHO�LQVXILFLrQFLD�FDUGtDFDͻ
75$7$0(172
2EMHWLYR�
3DUDU�R�SURFHVVR�GH�UHPRGHODPHQWRͻ
'HL[DU�R�SDFLHQWH�DVVLQWRPiWLFR
9DVRGLODWD�SDUD�UHGX]LU�SyV�FDUJDż
9HQRGLODWD�SDUD�UHGX]LU�SUp�FDUJDż
$XPHQWD�R�LQRWURSLVPRż
ͻ
9DULD�GH�DFRUGR�FRP�R�HVWiJLR�GR�SDFLHQWH�
(VWiJLR�$��WUDWD�R�IDWRU�GH�ULVFRͻ
(VWiJLR�%��,(&$��%5$�H�%%4�SDUD�UHGX]LU�R�UHPRGHODPHQWRͻ
(VWiJLR�&��,(&$��%5$��%%4��$QWDJRQLVWD�GH�$OGRVWHURQD��6DFXELWULO���
6DFXELWULO��DXPHQWD�R�)$1�SRUTXH�EORTXHLD�VXD�GHJUDGDomR�
)$1�GLPLQXL�D�YROHPLD��
ż
ͻ

Continue navegando