MARIA CLEMENTINA PINTO GIORGI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
33 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 33
bookPart Viabilidade miocárdica e PET-FDG(2012) MENEGHETTI, José Cláudio; JúNIOR, José Soares; IZAKI, Marisa; GIORGI, Maria Clementina P.bookPart Perfusão Miocárdica(2012) MENEGHETTI, José Cláudio; JúNIOR, José Soares; IZAKI, Marisa; GIORGI, Maria Clementina P.conferenceObject A decrease in glycolytic metabolism in noncompaction cardiomyopathy - Insights into pathophysiological mechanisms(2016) MELO, M. Dantas Tavares De; GIORGI, M. Clementina; DANTAS JUNIOR, R. Nery; LIMA, C. Rocon De; PARGA FILHO, J. Roberto; SOARES JUNIOR, J.; MENEGHETTI, J. Claudio; BIERRENBACH, A. Luiza; BOCCHI, E. Alcides; SALEMI, V. M. C.- Chagas' Disease: Update on Current Diagnosis(2016) FALCAO, Andrea Marinho; GIORGI, Maria Clementina; VIEIRA, Marcelo L. Campos; CHALELA, William A.; BORGES-NETO, SalvadorPurpose of Review Chagas' disease has become an emerging health problem due to increased migration. In the present review, we have summarized the usefulness of non-invasive imaging tools for the diagnosis of cardiac involvement in Chagas' disease, with emphasis on modern technologies. M-mode, bidimensional (2-D), and three-dimensional (3-D) echocardiographies may allow the evaluation of left ventricular (LV) regional and global contractile function, right ventricle (RV) impairment, evidence of aneurysms and thrombi, and assessment of diastolic function in any stage of the disease. Recent Findings New modalities such as strain and speckle-tracking imaging have brought non-invasive indices to the understanding of the mechanisms of cardiac dyssynchrony. The assessment of cardiac autonomic denervation using I-123-metaiodobenzylguanidine (I-123-MIBG), LV, and RV systolic function and the study of LV mechanical dyssynchrony by gated cardiac blood pool are available in current nuclear imaging for patients with Chagas' disease. The findings of myocardial fibrosis by cardiac magnetic resonance (CMR), mainly in inferolateral regions, are a marker of subclinical involvement and worse prognosis in Chagas' disease, even in patients with preserved ventricular function. Summary The detection and quantification of early signs of heart involvement by new technologies should be useful for risk stratification and in the clinical decision process for new therapeutic methods and could improve the natural history of the disease.
- Myocardial perfusion in patients with suspected coronary artery disease: comparison between 320-MDCT and rubidium-82 PET(2018) DANTAS JR., Roberto Nery; ASSUNCAO JR., Antonildes Nascimento; MARQUES FILHO, Ismar Aguiar; FAHEL, Mateus Guimaraes; NOMURA, Cesar Higa; AVILA, Luiz Francisco Rodrigues; GIORGI, Maria Clementina Pinto; SOARES JR., Jose; MENEGHETTI, Jose Claudio; PARGA, Jose RodriguesDespite advances in non-invasive myocardial perfusion imaging (MPI) evaluation, computed tomography (CT) multiphase MPI protocols have not yet been compared with the highly accurate rubidium-82 positron emission tomography ((RbPET)-Rb-82) MPI. Thus, this study aimed to evaluate agreement between (RbPET)-Rb-82 and 320-detector row CT (320-CT) MPI using a multiphase protocol in suspected CAD patients. Forty-four patients referred for MPI evaluation were prospectively enrolled and underwent dipyridamole stress (RbPET)-Rb-82 and multiphase 320-CT MPI (five consecutive volumetric acquisitions during stress). Statistical analyses were performed using the R software. There was high agreement for recognizing summed stress scores 4 (kappa 0.77, 95% CI 0.55-0.98, p < 0.001) and moderate for detecting SDS 2 (kappa 0.51, 95% CI 0.23-0.80, p < 0.001). In a per segment analysis, agreement was high for the presence of perfusion defects during stress and rest (kappa 0.75 and 0.82, respectively) and was moderate for impairment severity (kappa 0.58 and 0.65, respectively). The 320-CT protocol was safe, with low radiation burden (9.3 +/- 2.4 mSv). There was a significant agreement between dipyridamole stress 320-CT MPI and (RbPET)-Rb-82 MPI in the evaluation of suspected CAD patients of intermediate risk. The multiphase 320-CT MPI protocol was feasible, diagnostic and with relatively low radiation exposure. aEuro cent Rubidium-82 PET and 320-MDCT can perform MPI studies for CAD investigation. aEuro cent There is high agreement between rubidium-82 PET and 320-MDCT for MPI assessment. aEuro cent Multiphase CT perfusion protocols are feasible and with low radiation. aEuro cent Multiphase CT perfusion protocols can identify image artefacts.
bookPart Avaliação da invervação cardíaca com 123MIBGAvaliação da invervação cardíaca com 123MIBGAvaliação da invervação cardíaca com 123MIBGAvaliação da invervação cardíaca com 123MIBGAvaliação da invervação cardíaca com 123MIBG(2017) MENEGHETTI, José Cláudio; JúNIOR, José Soares; IZAKI, Marisa; GIORGI, Maria Clementina P.bookPart Inflamação e infecção cardiovasculares(2017) MENEGHETTI, José Cláudio; JúNIOR, José Soares; IZAKI, Marisa; GIORGI, Maria Clementina P.- Myocardial blood flow assessment with (82)rubidium-PET imaging in patients with left bundle branch block(2015) FALCAO, Andrea; CHALELA, William; GIORGI, Maria Clementina; IMADA, Rodrigo; SOARES JR., Jose; VAL, Renata Do; OLIVEIRA, Marco Antonio; IZAKI, Marisa; KALIL FILHO, Roberto; MENEGHETTI, Jose C.OBJECTIVES: Perfusion abnormalities are frequently seen in Single Photon Emission Computed Tomography (SPECT) when a left bundle branch block is present. A few studies have shown decreased coronary flow reserve in the left anterior descending territory, regardless of the presence of coronary artery disease. OBJECTIVE: We sought to investigate rubidium-82 (Rb-82) positron emission tomography imaging in the assessment of myocardial blood flow and coronary flow reserve in patients with left bundle branch block. METHODS: Thirty-eight patients with left bundle branch block (GI), median age 63.5 years, 22 (58%) female, 12 with coronary artery disease (>= 70%; GI-A) and 26 with no evidence of significant coronary artery disease (GI-B), underwent rest-dipyridamole stress Rb-82-positron emission tomography with absolute quantitative flow measurements using Cedars-Sinai software (mL/min/g). The relative myocardial perfusion and left ventricular ejection fraction were assessed in 17 segments. These parameters were compared with those obtained from 30 patients with normal (82) Rb-positron emission tomography studies and without left bundle branch block (GII). RESULTS: Stress myocardial blood flow and coronary flow reserve were significantly lower in GI than in GII (p<0.05). The comparison of coronary flow reserve between GI-A and GI-B showed that it was different from the global coronary flow reserve (p<0.05) and the stress flow was significantly lower in the anterior than in the septal wall for both groups. Perfusion abnormalities were more prevalent in GI-A (p=0.06) and the left ventricular ejection fraction was not different between GI-A and GI-B, whereas it was lower in GI than in GII (p<0.001). CONCLUSION: The data confirm that patients with left bundle branch block had decreased myocardial blood flow and coronary flow reserve and coronary flow reserve assessed by Rb-82-positron emission tomography imaging may be useful in identifying coronary artery disease in patients with left bundle branch block.
- Left cardiac sympathetic denervation for treatment of symptomatic systolic heart failure patients: a pilot study(2012) CONCEICAO-SOUZA, Germano Emilio; PEGO-FERNANDES, Paulo Manuel; CRUZ, Fatima das Dores; GUIMARAES, Guilherme Veiga; BACAL, Fernando; VIEIRA, Marcelo Luiz Campos; GRUPI, Cesar Jose; GIORGI, Maria Clementina Pinto; CONSOLIM-COLOMBO, Fernanda Marciano; NEGRAO, Carlos Eduardo; RONDON, Maria Urbana P.; MOREIRA, Luiz Felipe Pinho; BOCCHI, Edimar AlcidesTo evaluate the feasibility, safety, and potential beneficial effects of left cardiac sympathetic denervation (LCSD) in systolic heart failure (HF) patients. In this prospective, randomized pilot study, inclusion criteria were New York Heart Association (NYHA) functional class II or III, left ventricular ejection fraction (LVEF) 40, sinus rhythm, and resting heart rate 65 b.p.m., despite optimal medical therapy (MT). Fifteen patients were randomly assigned either to MT alone or MT plus LCSD. The primary endpoint was safety, measured by mortality in the first month of follow-up and morbidity according to pre-specified criteria. Secondary endpoints were exercise capacity, quality of life, LVEF, muscle sympathetic nerve activity (MSNA), brain natriuretic peptide (BNP) levels and 24 h Holter mean heart rate before and after 6 months. We studied clinical effects in long-term follow-up. Ten patients underwent LCSD. There were no adverse events attributable to surgery. In the LCSD group, LVEF improved from 25 6.6 to 33 5.2 (P 0.03); 6 min walking distance improved from 167 35 to 198 47 m (P 0.02). Minnesota Living with Heart Failure Questionnaire (MLWHFQ) score physical dimension changed from 21 5 to 15 7 (P 0.06). The remaining analysed variables were unchanged. During 848 549 days of follow-up, in the MT group, three patients either died or underwent cardiac transplantation (CT), while in the LCSD group six were alive without CT. LCSD was feasible and seemed to be safe in systolic HF patients. Its beneficial effects warrant the development of a larger randomized trial. Trail registration: NCT01224899.
bookPart Cintilografia miocárdica(2018) LINHARES, Pedro Vieira; LINHARES FILHO, Jaime Paula Pessoa; FONSECA, Wallyson Pereira; GIORGI, Maria Clementina Pinto; CHALELA, William Azem