JOSE CLAUDIO MENEGHETTI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- 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.
bookPart O Papel Atual do Teste Ergométrico Associado a Métodos de Imagem na Avaliação do Risco(2018) CHALELA, William Azem; FALCãO, Andréa Marinho; MENEGHETTI, José Cláudio; TSUTSUI, Jeane- Update of the Brazilian Guideline on Nuclear Cardiology-2020(2020) MASTROCOLA, Luiz Eduardo; AMORIM, Barbara Juarez; VITOLA, Joao Vicente; BRANDAO, Simone Cristina Soares; GROSSMAN, Gabriel Blacher; LIMA, Ronaldo de Souza Leao; LOPES, Rafael Willain; CHALELA, William Azem; CARREIRA, Lara Cristiane Terra Ferreira; ARAUJO, Jose Roberto Nolasco de; MESQUITA, Claudio Tinoco; MENEGHETTI, Jose Claudio
conferenceObject INFLUENCE OF LEFT BUNDLE BRANCH BLOCK IN ASSESSMENT OF MYOCARDIAL BLOOD FLOW FROM RUBIDIUM 82 POSITRON EMISSION TOMOGRAPHY IMAGING(2015) FALCAO, Andrea; CHALELA, William; GIORGI, Maria; IMADA, Rodrigo; SOARES JR., Jose; IZAKI, Marisa; KALIL-FILHO, Roberto; MENEGHETTI, Jose C.conferenceObject Myocardial perfusion scintigraphy (Gated-SPECT) in patients with ischemic ST-segment only during recovery phase of the exercise testing(2013) FALCAO, A.; CHALELA, W. A.; IMADA, R.; IRABI, R.; AZOURI, L. O.; COSTA, M.; KALIL FILHO, R.; RAMIRES, J. A. F.; MENEGHETTI, J. C.; BORGES-NETO, S.- Left ventricular function in response to dipyridamole stress: head-to-head comparison between (82)Rubidium PET and Tc-99m-sestamibi SPECT ECG-gated myocardial perfusion imaging(2017) GIORGI, Maria Clementina; MENEGHETTI, Jose Claudio; SOARES JR., Jose; IZAKI, Marisa; FALCAO, Andrea; IMADA, Rodrigo; CHALELA, William; OLIVEIRA, Marco Antonio de; NOMURA, Cesar; VERBERNE, Hein J.Myocardial perfusion imaging (MPI) with Tc-99m-sestamibi (sestamibi) SPECT and rubidium-82 (Rb-82) PET both allow for combined assessment of perfusion and left ventricular (LV) function. We sought to compare parameters of LV function obtained with both methods using a single dipyridamole stress dose. A group of 221 consecutive patients (65.2 +/- 10.4 years, 52.9% male) underwent consecutive sestamibi and Rb-82 MPI after a single dipyridamole stress dose. Sestamibi and Rb-82 summed rest (SRS), stress (SSS) and difference (SDS) scores, and LV end-diastolic (EDV) and end-systolic (ESV) volumes and left ventricular ejection fraction (LVEF) were compared. Bland-Altman analysis showed that with increasing ESV and EDV the difference between the two perfusion tracers increased both at rest and post-stress. The mean difference in EDV and ESV between the two perfusion tracers at rest could both be independently explained by the Rb-82 SDS and the sestamibi SRS. The combined models explained approximately 30% of the variation in these volumes between the two perfusion tracers (R-2 = 0.261, p = 0.005; R-2 = 0.296, p < 0.001, for EDV and ESV respectively). However, the mean difference in LVEF between sestamibi and Rb-82 showed no significant trend post-stress (R-2 = 0.001, p = 0.70) and only a modest linear increase with increasing LVEF values at rest (R-2 = 0.032, p = 0.009). Differences in left ventricular volumes between sestamibi and Rb-82 MPI increase with increasing volumes. However, these differences did only marginally affect LVEF between sestamibi and Rb-82. In clinical practice these results should be taken into account when comparing functional derived parameters between sestamibi and Rb-82 MPI.
conferenceObject Ischemic response to exercise testing in the recovery phase: real ischemia? Correlation with gated-SPECT data(2012) FALCAO, A.; AZOURI, L. O.; COSTA, M.; IMADA, R.; LANZ, J. R.; RAMIRES, J. A. F.; MENEGHETTI, J. C.; KALIL FILHO, R.; CHALELA, W. A.Purpose: The diagnostic and prognostic value of ST-segment depression (↓ST) occurring during the recovery period is less well defined as compared with that appearing during exercise testing (ET). Only few studies have investigated the clinical significance of this finding. Objective:The aim of this study was to compare↓ST in recovery with the gated-SPECT imaging incidence of myocardial ischemia. Methods: Seventy patients (pts) with ↓ST only during recovery, who underwent gated-SPECT associated with ET and Bruce protocol, were analyzed. Mean age was 60.1±9.8 years, 56 (78%) male, with previous myocardial infarction in 27.5%,coronary artery bypass graft in 21%, and percutaneous coronary interventionin 34%. Qualitative analysis of imaging used 5-point score (0-normal; 4-no up-take) for perfusion (17 myocardial segments), and 6-point score (0-normal; 5-diskinesia) for motility. Left ventricular ejection fraction (LVEF) was assessed after ET.↓ST, blood pressure (BP), heart rate (HR), time of tolerance to exercise (TTE), functional capacity (MET), appearance time to↓ST (AT↓ST), and presence of arrhythmias were evaluated during ET. Results: Abnormal perfusion was found in 57 pts (81,5%), 47% with transient defect and 11.4% associate with persistent defect; motility alteration in 23 pts (33%); mean LVEF 58%±11%, and 10.6±3 MET of functional capacity. No significant differences were found by comparing AT↓ST vs TTE (p=0.09); Abnormal perfusion vs TTE (p=0.38), and Abnormal perfusion vs MET (p=0.09). Conclusion: This study suggests that ↓ST occurring solely during recovery after ET is a relevant finding due to the high prevalence of myocardial ischemia in the gated-SPECT.