JOSE CLAUDIO MENEGHETTI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
18 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 18
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.- 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.
- 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
- Low-carbohydrate diet versus euglycemic hyperinsulinemic clamp for the assessment of myocardial viability with F-18-fluorodeoxyglucose-PET: a pilot study(2014) SOARES JR., Jose; RODRIGUES FILHO, Filadelfo; IZAKI, Marisa; GIORGI, Maria Clementina P.; CATAPIRRA, Rosa M. A.; ABE, Rubens; VINAGRE, Carmen G. C. M.; CERRI, Giovanni G.; MENEGHETTI, Jose ClaudioPositron emission tomography with F-18-fluorodeoxyglucose (FDG-PET) is considered the gold standard for myocardial viability. A pilot study was undertaken to compare FDG-PET using euglycemic hyperinsulinemic clamp before F-18-fluorodeoxyglucose (F-18-FDG) administration (PET-CLAMP) with a new proposed technique consisting of a 24-h low-carbohydrate diet before F-18-FDG injection (PET-DIET), for the assessment of hypoperfused but viable myocardium (hibernating myocardium). Thirty patients with previous myocardial infarction were subjected to rest Tc-99m-sestamibi-SPECT and two F-18-FDG studies (PET-CLAMP and PET-DIET). Myocardial tracer uptake was visually scored using a 5-point scale in a 17-segment model. Hibernating myocardium was defined as normal or mildly reduced metabolism (F-18-FDG uptake) in areas with reduced perfusion (Tc-99m-sestamibi uptake) since F-18-FDG uptake was higher than the degree of hypoperfusion-perfusion/metabolism mismatch indicating a larger flow defect. PET-DIET identified 79 segments and PET-CLAMP 71 as hibernating myocardium. Both methods agreed in 61 segments (agreement = 94.5 %, kappa = 0.78). PET-DIET identified 230 segments and PET-CLAMP 238 as nonviable. None of the patients had hypoglycemia after DIET, while 20 % had it during CLAMP. PET-DIET compared with PET-CLAMP had a good correlation for the assessment of hibernating myocardium. To our knowledge, these data provide the first evidence of the possibility of myocardial viability assessment with this technique.
- 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.
bookPart Cintilografia cardíaca com pirofosfato(2017) MENEGHETTI, José Cláudio; JúNIOR, José Soares; IZAKI, Marisa; GIORGI, Maria Clementina P.- Decreased glycolytic metabolism in non-compaction cardiomyopathy by F-18-fluoro-2-deoxyglucose positron emission tomography: new insights into pathophysiological mechanisms and clinical implications(2017) MELO, Marcelo Dantas Tavares de; GIORGI, Maria Clementina Pinto; ASSUNCAO JR., Antonildes Nascimento; DANTAS JR., Roberto Nery; ARAUJO FILHO, Jose de Arimateia; PARGA FILHO, Jose Rodrigues; BIERRENBACH, Ana Luiza de Souza; LIMA, Camila Rocon de; SOARES JR., Jose; MENEGUETTI, Jose Claudio; MADY, Charles; HAJJAR, Ludhmila Abrahao; KALIL FILHO, Roberto; BOCCHI, Edimar Alcides; SALEMI, Vera Maria CuryAims The pathophysiological mechanisms of left ventricular non-compaction cardiomyopathy (LVNC) remain controversial. This study performed combined F-18-fluoro-2-deoxyglucose dynamic positron emission tomography (FDG-PET) and 99mTc-sestamibi single-photon emission computed tomography (SPECT) studies to evaluate myocardial glucose metabolism and perfusion in patients with LVNC and their clinical implications. Methods and results Thirty patients (41 +/- 12 years, 53% male) with LVNC, diagnosed by cardiovascular magnetic resonance (CMR) criteria, and eight age-matched healthy controls (42 +/- 12 years, 50% male) were prospectively recruited to undergo FDG-PET with measurement of the myocardial glucose uptake rate (MGU) and SPECT to investigate perfusion-metabolism patterns. Patients with LVNC had lower global MGU compared with that in controls (36.9 +/- 8.8 vs. 44.6 +/- 5.4 mu mol/min/100 g, respectively, P = 0.02). Of 17 LV segments, MGU levels were significantly reduced in 8, and also a reduction was observed when compacted segments from LVNC were compared with the segments from control subjects (P < 0.001). Perfusion defects were also found in 15 (50%) patients (45 LV segments: 64.4% match, and 35.6% mismatch perfusion-metabolism pattern). Univariate and multivariate analyses showed that beta-blocker therapy was associated with increased MGU (beta coefficient = 10.1, P = 0.008). Moreover, a gradual increase occurred in MGU across the beta-blocker dose groups (P for trend = 0.01). Conclusion The reduction of MGU documented by FDG-PET in LVNC supports the hypothesis that a cellular metabolic pathway may play a role in the pathophysiology of LVNC. The beneficial effect of beta-blocker mediating myocardial.