MARIA CLEMENTINA PINTO GIORGI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
4 resultados
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- 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.
- Case Report: Multivessel Coronary Disease Assessment with SPECT Tc-99m-Sestamibi and Rubidium-82 PET/CT(2017) PADILHA, Bruno Gomes; SABINO, Daniela; GIORGI, Maria Clementina; SOARES JR., Jose; IZAKI, Marisa; MENEGHETTI, Jose Claudio
- Influence of the arm position in myocardial perfusion imaging acquisition(2014) IZAKI, Marisa; SOARES JUNIOR, Jose; GIORGI, Maria Clementina Pinto; MENEGHETTI, Jose ClaudioObjective: despite the technologic advances in myocardial perfusion imaging, we keep using an uncomfortable and sometimes impracticable patient position - supine with arms raised above the head (U). The purpose of this study was to investigate whether perfusion and functional cardiac gated SPECT scan results of acquisition U are equivalent to another position modality: supine with arms down at the sides of the trunk (D). Methods and Results: we performed U acquisition and in sequence D acquisition in 120 patients (pts) using a one-day MPI (rest-gated/stress), with 99mTc-sestamibi (370 MBq and 1110 MBq). Images were processed by the iterative reconstruction method (OSEM). Rest (R) and stress (S) studies were scored using 17-segments model. Functional parameters (left ventricular ejection fraction, and volumes) were automatically obtained by the quantitative gated SPECT (QGS) program. According to the degree of stress defects observed in U study, the patients were categorized in two subgroups: normal (SSS <= 3 or < 5%) and abnormal (SSS > 3 or >= 5%). Shoulder/back pain occurred in 23.3% of U patients and in 5% of D. No significant differences between U and D were found for SSS (p = 0.82) and SRS (p = 0.74) in normal group. In abnormal group, good correlation was found between U and D modes for SSS (Rho = 0.95, p = 0.0001) and SRS (Rho = 0.96 p = 0.0001), but the mean SSS (12.53 +/- 7.54) and SRS (10.60 +/- 7.08) values of D were significantly lower (p < 0.05) than SSS (13.43 +/- 6.81) and SRS (11.33 +/- 6.97) of U mode. Function measurements presented good correlations, except for end-diastolic volume (p = 0.0001). Conclusion: although D mode appears to be more comfortable and presented a good correlation with U values of SSS and SRS, in abnormal pts, the extent and severity of defects can be underestimated. Considering clinical implications of an accurate perfusion measurement, the acquisition with the arms down should be avoided.
- Cardiac amyloidosis: non-invasive diagnosis(2020) HOTTA, Viviane Tiemi; GIORGI, Maria Clementina Pinto; FERNANDES, Fabio; ABDUCHL, Maria Cristina Donadio; FALCAO, IlAndrea Maria Gomes Marinho; MADY, CharlesCardiac amyloidosis is an infiltrative disease which requires a high degree of clinical suspicion for appropriate diagnosis. Early diagnosis and the definition of the type of amyloidosis play a key role in the early treatment and prognosis of this disease. In this context, the use of cardiac biomarkers such as troponins and NT-proBNT associated with analysis by multimodality imaging methods like echocardiographic techniques such as strain, nuclear medicine, and cardiovascular resonance imaging have an increasing role in patients with cardiac amyloidosis. This article details the role of non-invasive diagnostic methods in patients with cardiac amyloidosis.